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Jadaan SA, Khan AW. Recent Update of COVID-19 Vaccines. Adv Pharm Bull 2022; 12:219-236. [PMID: 35620327 PMCID: PMC9106961 DOI: 10.34172/apb.2022.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/08/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has been recently identified as a novel member of beta coronaviruses (CoVs) and the cause of coronavirus disease 2019 (COVID-19). It has been first discovered in China and soon has spread across continents with an escalating number of mortalities. There is an urgent need for developing a COVID-19 vaccine to control the rapid transmission and the deleterious impact of the virus. The potent vaccine should have a good tolerable and efficacious profile to induce target-specific humoral and cellular immune responses. It should also exhibit no or minimal detrimental effects in children, young adults, and elderly people with or without co-morbidities from different racial backgrounds. Previously published findings of SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV) played vital role in the characterization of surface spike proteins as the tool of entry of the SARS-CoV-2 into host cells. It has become evident that SARS-CoVs have high genetic similarity and this implies antecedent vaccination strategies could be implicated in the production of COVID-19 vaccines. Although several vaccines have been approved and rolled out, only a handful of them have passed the three phases of clinical studies. This review highlights the completed, and ongoing clinical trials of COVID-19 vaccines and efforts are being made globally to avert the pandemic.
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Affiliation(s)
- Sameer A. Jadaan
- College of Health & Medical Technology, Middle Technical University, Baghdad-Iraq
| | - Abdul Waheed Khan
- Department of Diabetes, Central Clinical School, Monash University, Victoria-Australia
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52
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Dass SA, Balakrishnan V, Arifin N, Lim CSY, Nordin F, Tye GJ. The COVID-19/Tuberculosis Syndemic and Potential Antibody Therapy for TB Based on the Lessons Learnt From the Pandemic. Front Immunol 2022; 13:833715. [PMID: 35242137 PMCID: PMC8886238 DOI: 10.3389/fimmu.2022.833715] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/25/2022] [Indexed: 12/19/2022] Open
Abstract
2020 will be marked in history for the dreadful implications of the COVID-19 pandemic that shook the world globally. The pandemic has reshaped the normality of life and affected mankind in the aspects of mental and physical health, financial, economy, growth, and development. The focus shift to COVID-19 has indirectly impacted an existing air-borne disease, Tuberculosis. In addition to the decrease in TB diagnosis, the emergence of the TB/COVID-19 syndemic and its serious implications (possible reactivation of latent TB post-COVID-19, aggravation of an existing active TB condition, or escalation of the severity of a COVID-19 during TB-COVID-19 coinfection), serve as primary reasons to equally prioritize TB. On a different note, the valuable lessons learnt for the COVID-19 pandemic provide useful knowledge for enhancing TB diagnostics and therapeutics. In this review, the crucial need to focus on TB amid the COVID-19 pandemic has been discussed. Besides, a general comparison between COVID-19 and TB in the aspects of pathogenesis, diagnostics, symptoms, and treatment options with importance given to antibody therapy were presented. Lastly, the lessons learnt from the COVID-19 pandemic and how it is applicable to enhance the antibody-based immunotherapy for TB have been presented.
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Affiliation(s)
- Sylvia Annabel Dass
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden, Malaysia
| | - Venugopal Balakrishnan
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden, Malaysia
| | - Norsyahida Arifin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden, Malaysia
| | - Crystale Siew Ying Lim
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Fazlina Nordin
- Tissue Engineering Centre (TEC), Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - Gee Jun Tye
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Minden, Malaysia
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53
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Zimmermann P, Curtis N. Why Does the Severity of COVID-19 Differ With Age?: Understanding the Mechanisms Underlying the Age Gradient in Outcome Following SARS-CoV-2 Infection. Pediatr Infect Dis J 2022; 41:e36-e45. [PMID: 34966142 PMCID: PMC8740029 DOI: 10.1097/inf.0000000000003413] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 11/26/2022]
Abstract
Although there are many hypotheses for the age-related difference in the severity of COVID-19, differences in innate, adaptive and heterologous immunity, together with differences in endothelial and clotting function, are the most likely mechanisms underlying the marked age gradient. Children have a faster and stronger innate immune response to SARS-CoV-2, especially in the nasal mucosa, which rapidly controls the virus. In contrast, adults can have an overactive, dysregulated and less effective innate response that leads to uncontrolled pro-inflammatory cytokine production and tissue injury. More recent exposure to other viruses and routine vaccines in children might be associated with protective cross-reactive antibodies and T cells against SARS-CoV-2. There is less evidence to support other mechanisms that have been proposed to explain the age-related difference in outcome following SARS-CoV-2 infection, including pre-existing immunity from exposure to common circulating coronaviruses, differences in the distribution and expression of the entry receptors ACE2 and TMPRSS2, and difference in viral load.
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Affiliation(s)
- Petra Zimmermann
- From the Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Paediatrics, Fribourg Hospital HFR, Fribourg, Switzerland
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Infectious Diseases Research Group, Murdoch Children’s Research Institute, Parkville, Australia
| | - Nigel Curtis
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Infectious Diseases Research Group, Murdoch Children’s Research Institute, Parkville, Australia
- Infectious Diseases Unit, The Royal Children’s Hospital Melbourne, Parkville, Australia
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54
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Farnudian-Habibi A, Mirjani M, Montazer V, Aliebrahimi S, Katouzian I, Abdolhosseini S, Rahmani A, Keyvani H, Ostad SN, Rad-Malekshahi M. Review on Approved and Inprogress COVID-19 Vaccines. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH 2022; 21:e124228. [PMID: 36060923 PMCID: PMC9420219 DOI: 10.5812/ijpr.124228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/15/2021] [Accepted: 08/04/2021] [Indexed: 11/24/2022]
Abstract
The last generation of Coronavirus named COVID-19 is responsible for the recent worldwide outbreak. Concerning the widespread and quick predominance, there is a critical requirement for designing appropriate vaccines to surmount this grave problem. Correspondingly, in this revision, COVID-19 vaccines (which are being developed until March 29th, 2021) are classified into specific and non-specific categories. Specific vaccines comprise genetic-based vaccines (mRNA, DNA), vector-based, protein/recombinant protein vaccines, inactivated viruses, live-attenuated vaccines, and novel strategies including microneedle arrays (MNAs), and nanoparticles vaccines. Moreover, specific vaccines such as BCG, MRR, and a few other vaccines are considered Non-specific. What is more, according to the significance of Bioinformatic sciences in the cutting-edge vaccine design and rapid outbreak of COVID-19, herein, Bioinformatic principles including reverse vaccinology, epitopes prediction/selection and, their further applications in the design of vaccines are discussed. Last but not least, safety, challenges, advantages, and future prospects of COVID-19 vaccines are highlighted.
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Affiliation(s)
- Amir Farnudian-Habibi
- Department of Pharmaceutical Biomaterials, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mobina Mirjani
- Department of Pharmaceutical Biomaterials, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahideh Montazer
- Department of Clinical Pharmacy, Virtual University of Medical Sciences, Tehran, Iran
| | - Shima Aliebrahimi
- Department of Medical Education, Virtual University of Medical Sciences, Tehran, Iran
| | - Iman Katouzian
- Australasian Nanoscience and Nanotechnology Initiative (ANNI), 8054 Monash University LPO, Clayton, 3168, Victoria, Australia
| | - Saeed Abdolhosseini
- School of Electrical and Computer Engineering, College of Engineering, University of Tehran, 14395-515 Tehran, Iran
| | - Ali Rahmani
- Department of Pharmaceutical Biomaterials, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Keyvani
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Nasser Ostad
- Toxicology and Poisoning Research Centre, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Toxicology and Poisoning Research Centre, Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mazda Rad-Malekshahi
- Department of Pharmaceutical Biomaterials, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Pharmaceutical Biomaterials, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
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Lommatzsch M, Rabe KF, Taube C, Joest M, Kreuter M, Wirtz H, Blum TG, Kolditz M, Geerdes-Fenge H, Otto-Knapp R, Häcker B, Schaberg T, Ringshausen FC, Vogelmeier CF, Reinmuth N, Reck M, Gottlieb J, Konstantinides S, Meyer J, Worth H, Windisch W, Welte T, Bauer T. Risk Assessment for Patients with Chronic Respiratory Conditions in the Context of the SARS-CoV-2 Pandemic Statement of the German Respiratory Society with the Support of the German Association of Chest Physicians. Respiration 2022; 101:307-320. [PMID: 35231915 PMCID: PMC8985038 DOI: 10.1159/000518896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 12/23/2022] Open
Abstract
Assessing the risk for specific patient groups to suffer from severe courses of COVID-19 is of major importance in the current SARS-CoV-2 pandemic. This review focusses on the risk for specific patient groups with chronic respiratory conditions, such as patients with asthma, chronic obstructive pulmonary disease, cystic fibrosis (CF), sarcoidosis, interstitial lung diseases, lung cancer, sleep apnea, tuberculosis, neuromuscular diseases, a history of pulmonary embolism, and patients with lung transplants. Evidence and recommendations are detailed in exemplary cases. While some patient groups with chronic respiratory conditions have an increased risk for severe courses of COVID-19, an increasing number of studies confirm that asthma is not a risk factor for severe COVID-19. However, other risk factors such as higher age, obesity, male gender, diabetes, cardiovascular diseases, chronic kidney or liver disease, cerebrovascular and neurological disease, and various immunodeficiencies or treatments with immunosuppressants need to be taken into account when assessing the risk for severe COVID-19 in patients with chronic respiratory diseases.
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Affiliation(s)
- Marek Lommatzsch
- Department of Pneumology, University of Rostock, Rostock, Germany
| | | | - Christian Taube
- Klinik für Pneumologie, University of Essen, Duisburg, Germany
| | | | | | - Hubert Wirtz
- Department of Pneumology, University of Leipzig, Leipzig, Germany
| | | | - Martin Kolditz
- Department of Pneumology, University of Dresden, Dresden, Germany
| | | | - Ralf Otto-Knapp
- German Central Committee against Tuberculosis, DZK, Berlin, Germany
| | - Brit Häcker
- German Central Committee against Tuberculosis, DZK, Berlin, Germany
| | | | | | - Claus F. Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany
| | | | - Martin Reck
- LungenClinic Großhansdorf, Großhansdorf, Germany
| | - Jens Gottlieb
- Department of Respiratory Medicine, University of Hannover, Hanover, Germany
| | | | - Joachim Meyer
- Lung Center Bogenhausen and Harlaching, Hospital Munich, Munich, Germany
| | | | | | - Tobias Welte
- Department of Respiratory Medicine, University of Hannover, Hanover, Germany
| | - Torsten Bauer
- Lung Hospital Heckeshorn, Helios Klinikum Emil von Behring, Berlin, Germany
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56
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Soto JA, Gálvez NMS, Andrade CA, Ramírez MA, Riedel CA, Kalergis AM, Bueno SM. BCG vaccination induces cross-protective immunity against pathogenic microorganisms. Trends Immunol 2022; 43:322-335. [PMID: 35074254 DOI: 10.1016/j.it.2021.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 01/03/2023]
Abstract
Bacillus Calmette-Guérin (BCG) is an attenuated Mycobacterium bovis strain used as a vaccine to prevent Mycobacterium tuberculosis (M. tb) infection. Its ability to potentiate the immune response induced by other vaccines and to promote nonspecific immunomodulatory effects has been described. These effects can be triggered by epigenetic reprogramming and metabolic shifts on innate immune cells, a phenomenon known as trained immunity. The induction of trained immunity may contribute to explain why BCG vaccination effectively decreases disease symptoms caused by pathogens different from M. tb. This article explains the importance of BCG immunization and the possible mechanisms associated with the induction of trained immunity, which might be used as a strategy for rapid activation of the immune system against unrelated pathogens.
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Affiliation(s)
- Jorge A Soto
- Millennium Institute of Immunology and Immunotherapy, Santiago 8330025, Chile; Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331010, Chile
| | - Nicolás M S Gálvez
- Millennium Institute of Immunology and Immunotherapy, Santiago 8330025, Chile; Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331010, Chile
| | - Catalina A Andrade
- Millennium Institute of Immunology and Immunotherapy, Santiago 8330025, Chile; Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331010, Chile
| | - Mario A Ramírez
- Millennium Institute of Immunology and Immunotherapy, Santiago 8330025, Chile; Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331010, Chile
| | - Claudia A Riedel
- Millennium Institute of Immunology and Immunotherapy, Santiago 8330025, Chile; Departamento de Ciencias Biológicas, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
| | - Alexis M Kalergis
- Millennium Institute of Immunology and Immunotherapy, Santiago 8330025, Chile; Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331010, Chile; Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile.
| | - Susan M Bueno
- Millennium Institute of Immunology and Immunotherapy, Santiago 8330025, Chile; Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago 8331010, Chile.
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57
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Revaccination with Bacille Calmette-Guérin (BCG) is associated with an increased risk of abscess and lymphadenopathy. NPJ Vaccines 2022; 7:6. [PMID: 35031617 PMCID: PMC8760267 DOI: 10.1038/s41541-021-00421-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/02/2021] [Indexed: 01/03/2023] Open
Abstract
The reported frequency and types of adverse events following initial vaccination and revaccination with Bacille Calmette-Guérin (BCG) varies worldwide. Using active surveillance in a randomised controlled trial of BCG vaccination (the BRACE trial), we determined the incidence and risk factors for the development of BCG injection site abscess and regional lymphadenopathy. Injection site abscess occurred in 3% of 1387 BCG-vaccinated participants; the majority (34/41, 83%) resolved without treatment. The rate was higher in BCG-revaccinated participants (OR 3.6, 95% CI 1.7-7.5), in whom abscess onset was also earlier (median 16 vs. 27 days, p = 0.008). No participant with an abscess had a positive interferon-gamma release assay. Regional lymphadenopathy occurred in 48/1387 (3%) of BCG-vaccinated participants, with a higher rate in revaccinated participants (OR 2.1, 95% CI 1.1-3.9). BCG-associated lymphadenopathy, but not injection site abscess, was influenced by age and sex. A previous positive tuberculin skin test was not associated with local reactions. The increased risk of injection site abscess or lymphadenopathy following BCG revaccination is relevant to BCG vaccination policy in an era when BCG is increasingly being considered for novel applications.
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58
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Tarabini RF, Rigo MM, Faustino Fonseca A, Rubin F, Bellé R, Kavraki LE, Ferreto TC, Amaral Antunes D, de Souza APD. Large-Scale Structure-Based Screening of Potential T Cell Cross-Reactivities Involving Peptide-Targets From BCG Vaccine and SARS-CoV-2. Front Immunol 2022; 12:812176. [PMID: 35095907 PMCID: PMC8793865 DOI: 10.3389/fimmu.2021.812176] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/21/2021] [Indexed: 12/22/2022] Open
Abstract
Although not being the first viral pandemic to affect humankind, we are now for the first time faced with a pandemic caused by a coronavirus. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been responsible for the COVID-19 pandemic, which caused more than 4.5 million deaths worldwide. Despite unprecedented efforts, with vaccines being developed in a record time, SARS-CoV-2 continues to spread worldwide with new variants arising in different countries. Such persistent spread is in part enabled by public resistance to vaccination in some countries, and limited access to vaccines in other countries. The limited vaccination coverage, the continued risk for resistant variants, and the existence of natural reservoirs for coronaviruses, highlight the importance of developing additional therapeutic strategies against SARS-CoV-2 and other coronaviruses. At the beginning of the pandemic it was suggested that countries with Bacillus Calmette-Guérin (BCG) vaccination programs could be associated with a reduced number and/or severity of COVID-19 cases. Preliminary studies have provided evidence for this relationship and further investigation is being conducted in ongoing clinical trials. The protection against SARS-CoV-2 induced by BCG vaccination may be mediated by cross-reactive T cell lymphocytes, which recognize peptides displayed by class I Human Leukocyte Antigens (HLA-I) on the surface of infected cells. In order to identify potential targets of T cell cross-reactivity, we implemented an in silico strategy combining sequence-based and structure-based methods to screen over 13,5 million possible cross-reactive peptide pairs from BCG and SARS-CoV-2. Our study produced (i) a list of immunogenic BCG-derived peptides that may prime T cell cross-reactivity against SARS-CoV-2, (ii) a large dataset of modeled peptide-HLA structures for the screened targets, and (iii) new computational methods for structure-based screenings that can be used by others in future studies. Our study expands the list of BCG peptides potentially involved in T cell cross-reactivity with SARS-CoV-2-derived peptides, and identifies multiple high-density "neighborhoods" of cross-reactive peptides which could be driving heterologous immunity induced by BCG vaccination, therefore providing insights for future vaccine development efforts.
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Affiliation(s)
- Renata Fioravanti Tarabini
- Laboratory of Clinical and Experimental Immunology, Infant Center, School of Health Science, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - André Faustino Fonseca
- Antunes Lab, Department of Biology and Biochemistry, University of Houston, Houston, TX, United States
| | - Felipe Rubin
- School of Technology - Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rafael Bellé
- Laboratório de alto desempenho – Centro de Apoio ao desenvolvimento cientifico e tecnológico da (IDEIA), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Lydia E Kavraki
- Kavraki Lab, Department of Computer Science, Rice University, Houston, TX, United States
| | - Tiago Coelho Ferreto
- School of Technology - Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil,Laboratório de alto desempenho – Centro de Apoio ao desenvolvimento cientifico e tecnológico da (IDEIA), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Dinler Amaral Antunes
- Antunes Lab, Department of Biology and Biochemistry, University of Houston, Houston, TX, United States,*Correspondence: Ana Paula Duarte de Souza, ; Dinler Amaral Antunes,
| | - Ana Paula Duarte de Souza
- Laboratory of Clinical and Experimental Immunology, Infant Center, School of Health Science, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil,*Correspondence: Ana Paula Duarte de Souza, ; Dinler Amaral Antunes,
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59
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Pittet LF, Fritschi N, Tebruegge M, Dutta B, Donath S, Messina NL, Casalaz D, Hanekom WA, Britton WJ, Robins-Browne R, Curtis N, Ritz N. Bacille Calmette-Guérin Skin Reaction Predicts Enhanced Mycobacteria-Specific T Cell Responses in Infants. Am J Respir Crit Care Med 2022; 205:830-841. [DOI: 10.1164/rccm.202108-1892oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Laure F Pittet
- The Royal Children's Hospital Melbourne, 6453, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, 34361, Parkville, Victoria, Australia
- The University of Melbourne, 2281, Melbourne, Victoria, Australia
| | | | - Marc Tebruegge
- The University of Melbourne, 2281, Melbourne, Victoria, Australia
- University College London, 4919, London, United Kingdom of Great Britain and Northern Ireland
- Evelina London Children's Hospital, 443490, London, United Kingdom of Great Britain and Northern Ireland
| | - Binita Dutta
- Murdoch Childrens Research Institute, 34361, Parkville, Victoria, Australia
| | - Susan Donath
- Murdoch Childrens Research Institute, 34361, Parkville, Victoria, Australia
- The University of Melbourne, 2281, Melbourne, Victoria, Australia
| | - Nicole L Messina
- Murdoch Childrens Research Institute, 34361, Parkville, Victoria, Australia
- The University of Melbourne, 2281, Melbourne, Victoria, Australia
| | - Dan Casalaz
- Mercy Hospital for Women, 37244, Heidelberg, Victoria, Australia
| | | | - Warwick J. Britton
- Centenary Institute, 6022, TB Researtch Program, Sydney, New South Wales, Australia
| | - Roy Robins-Browne
- Murdoch Childrens Research Institute, 34361, Parkville, Victoria, Australia
- The Peter Doherty Institute for Infection and Immunity, 534133, Melbourne, Victoria, Australia
| | - Nigel Curtis
- The Royal Children's Hospital Melbourne, 6453, Parkville, Victoria, Australia
- Murdoch Childrens Research Institute, 34361, Parkville, Victoria, Australia
- The University of Melbourne, 2281, Melbourne, Victoria, Australia
| | - Nicole Ritz
- The University of Melbourne, 2281, Melbourne, Victoria, Australia
- University of Basel, 27209, Basel, Switzerland
- University Children’s Hospital Basel, 30280, Basel, Switzerland
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60
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Ahmed SM, Nasr MA, Elshenawy SE, Hussein AE, El-Betar AH, Mohamed RH, El-Badri N. BCG vaccination and the risk of COVID 19: A possible correlation. Virology 2022; 565:73-81. [PMID: 34742127 PMCID: PMC8552046 DOI: 10.1016/j.virol.2021.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/01/2021] [Accepted: 10/17/2021] [Indexed: 01/04/2023]
Abstract
Bacillus Calmette-Guérin (BCG) vaccine is currently used to prevent tuberculosis infection. The vaccine was found to enhance resistance to certain types of infection including positive sense RNA viruses. The current COVID-19 pandemic is caused by positive sense RNA, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A higher mortality rate of COVID-19 patients was reported in countries where BCG vaccination is not routinely administered, when compared to the vaccinated ones. We hypothesized that BCG vaccine may control SARS-CoV2 infection via modulating the monocyte immune response. We analyzed GSE104149 dataset to investigate whether human monocytes of BCG-vaccinated individuals acquire resistance to SARS-CoV-2 infection. Differentially expressed genes obtained from the dataset were used to determine enriched pathways, biological processes, and molecular functions for monocytes post BCG vaccination. Our data show that BCG vaccine promotes a more effective immune response of monocytes against SARS-CoV2, but probably not sufficient to prevent the infection.
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Affiliation(s)
- Sara M Ahmed
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, October Gardens, 12582, 6th of October City, Giza, Egypt
| | - Mohamed A Nasr
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, October Gardens, 12582, 6th of October City, Giza, Egypt
| | - Shimaa E Elshenawy
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, October Gardens, 12582, 6th of October City, Giza, Egypt
| | - Alaa E Hussein
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, October Gardens, 12582, 6th of October City, Giza, Egypt
| | - Ahmed H El-Betar
- Department of Urology, Ahmed Maher Teaching Hospital, Cairo, Egypt
| | | | - Nagwa El-Badri
- Center of Excellence for Stem Cells and Regenerative Medicine (CESC), Zewail City of Science and Technology, October Gardens, 12582, 6th of October City, Giza, Egypt.
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61
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A new measure of hygiene inequality applied to urban-rural comparison. Int J Hyg Environ Health 2022; 239:113876. [PMID: 34757280 PMCID: PMC9798102 DOI: 10.1016/j.ijheh.2021.113876] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/13/2021] [Accepted: 10/20/2021] [Indexed: 01/01/2023]
Abstract
Access to hygiene services remains one of the most urgent challenges facing countries, especially low-income ones. This has become much more critical in the current context of the COVID-19 pandemic. The WHO/UNICEF Joint Monitoring Program globally monitors access to hygiene service levels. As data are in three parts with a constant sum and a positive value, they are compositional data. Inequality is monitored in disaggregated data; in the urban-rural case, this is done through a simple difference between the urban and rural service levels. However, this simple form of calculation does not take into account the characteristics of the data, which can lead to erroneous interpretations of the results. Therefore, we propose an alternative measure of inequality that uses a ternary diagram and does not infringe on the data properties. The results of the new urban-rural inequality measure show spatial heterogeneity. The highest inequality occurs in Colombia, with a value of 37.1 percentage points, and the lowest in Turkmenistan, with a value of zero. Our results also show that 73 of the 76 countries evaluated have higher basic hygiene services in urban areas than in rural areas. This means that urban households have more availability of a handwashing facility on-premises with soap and water than rural households. Likewise, by subdividing the ternary diagram into ternary parcels, we could group and rank the countries based on hygiene service conditions in a hierarchical order using tripartite information. Finally, our study finds that a multivariate measure of inequality can be important for the public policies of the sector with a general vision, which underscores the value of making evidence-based decisions.
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Finotti P. Sequence similarity of HSP65 of Mycobacterium bovis BCG with SARS-CoV-2 spike and nuclear proteins: may it predict an antigen-dependent immune protection of BCG against COVID-19? Cell Stress Chaperones 2022; 27:37-43. [PMID: 34755305 PMCID: PMC8577642 DOI: 10.1007/s12192-021-01244-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 12/23/2022] Open
Abstract
The Bacillus Calmette-Guérin (BCG) vaccine is known to have protective effects not only against tuberculosis but also against other unrelated infectious diseases caused by different pathogens. Several epidemiological studies have also documented the beneficial influence of BCG vaccine in reducing both susceptibility to and severity of SARS-CoV-2 infection. The protective, non-specific effects of BCG vaccination would be related to an antigen-independent enhancement of the innate immunity, termed trained immunity. However, the knowledge that heat shock protein (HSP)65 is the main antigen of Mycobacterium bovis BCG prompted us to verify whether sequence similarity existed between HSP65 and SARS-CoV-2 spike (S) and nuclear (N) proteins that could support an antigen-driven immune protection of BCG vaccine. The results of the in silico investigation showed an extensive sequence similarity of HSP65 with both the viral proteins, especially SARS-CoV-2 S, that also involved the regions comprising immunodominant epitopes. The finding that the predicted B cell and CD4+ T cell epitopes of HSP65 shared strong similarity with the predicted B and T cell epitopes of both SARS-CoV-2 S and N would support the possibility of a cross-immune reaction of HSP65 of BCG with SARS-CoV-2.
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Affiliation(s)
- Paola Finotti
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Building "C," Largo E. Meneghetti 2, 35135, Padua, Italy.
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Bisi-Onyemaechi A, Tagbo B, Chukwubike C, Okafor E. COVID-19 experiences and vaccine confidence among health workers and non-health workers. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_66_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Bayode T, Popoola A, Akogun O, Siegmund A, Magidimisha-Chipungu H, Ipingbemi O. Spatial variability of COVID-19 and its risk factors in Nigeria: A spatial regression method. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2022; 138:102621. [PMID: 34880507 PMCID: PMC8639413 DOI: 10.1016/j.apgeog.2021.102621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/30/2021] [Accepted: 11/30/2021] [Indexed: 05/07/2023]
Abstract
The novel and unprecedented Coronavirus disease (COVID-19) pandemic has negatively impacted most nations of the world within a short period. While its disproportionate social and spatial variability has been established, the reality in Nigeria is yet to be studied. In this paper, advanced spatial statistical techniques were engaged to study the burden of COVID-19 and its risk factors within the first quarter (March-May) of its incidence in Nigeria. The spatial autocorrelation (Moran's I) test reveals a significant but marginal cluster of COVID-19 occurrence in Nigeria (I = 0.11, p < 0.05). A model comparison between ordinary least square (OLS) and spatial error model (SER) was explored having checked for multicollinearity in the dataset. The OLS model explained about 64% (adjusted R2 = 0.64) of variation in COVID-19 cases, however with significantly clustered residuals. The SER model performed better with randomly distributed residuals. The significant predictors were population density, international airport, and literacy ratio. Furthermore, this study addressed the spatial planning implications of the ongoing disease outbreak while it advocates transdisciplinary approach to urban planning practices in Nigeria.
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Affiliation(s)
- Taye Bayode
- Heidelberg Centre for Environment (HCE) & Institute of Geography, Heidelberg University, Germany
- Department of Geography - Research Group for Earth Observation(geo), UNESCO Chair on World Heritage and Biosphere Reserve Observation and Education, Heidelberg University of Education, Germany
| | - Ayobami Popoola
- SARChI Chair for Inclusive Cities, University of KwaZulu-Natal, South Africa
| | - Olawale Akogun
- Department of Urban and Regional Planning, University of Ibadan, Oyo State, Nigeria
| | - Alexander Siegmund
- Heidelberg Centre for Environment (HCE) & Institute of Geography, Heidelberg University, Germany
- Department of Geography - Research Group for Earth Observation(geo), UNESCO Chair on World Heritage and Biosphere Reserve Observation and Education, Heidelberg University of Education, Germany
| | | | - Olusiyi Ipingbemi
- Department of Urban and Regional Planning, University of Ibadan, Oyo State, Nigeria
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65
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Koupaei M, Naimi A, Moafi N, Mohammadi P, Tabatabaei FS, Ghazizadeh S, Heidary M, Khoshnood S. Clinical Characteristics, Diagnosis, Treatment, and Mortality Rate of TB/COVID-19 Coinfectetd Patients: A Systematic Review. Front Med (Lausanne) 2021; 8:740593. [PMID: 34926494 PMCID: PMC8671757 DOI: 10.3389/fmed.2021.740593] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: Novel coronavirus (COVID-19) and tuberculosis (TB) are the newest and one of the oldest global threats, respectively. In the COVID-19 era, due to the health system's focus on the COVID-19 epidemic, the national TB control program received less attention, leading to a worsening of the global TB epidemic. In this study, we will review the characteristics of TB patients coinfected with COVID-19. Material and Methods: Using Scopus, PubMed/Medline, Embase, and Web of Science databases, a systematic search was performed. Case reports and case series on TB/COVID-19 coinfection published from January 1, 2019 to February 24, 2021 were collected. There were no limitations regarding publication language. Results: Eleven case series and 20 case reports were identified from 18 countries, with the majority them being from India (N = 6) and China (N = 4). Overall, 146 patients (114 men and 32 women) coinfected with TB and COVID-19 enrolled. Smoking (15.1%), diabetes (14.4%), and hypertension (8.9%) were the most frequent comorbidities among these patients. The COVID-19 patients with TB mainly suffered fever (78.8%), cough (63.7%), and respiratory distress (22.6%). Hydroxychloroquine (64.0%) and lopinavir/ritonavir (39.5%) were the most common treatments for them. The mortality rate was 13.0% and the rate of discharged patients was 87.0%. Conclusion: Global prevalence of COVID-19-related deaths is 6.6%. Our results showed that 13.0% of patients with TB/COVID-19 died. Thus, this study indicated that coinfection of TB and COVID-19 can increase the mortality. The respiratory symptoms of TB and COVID-19 are very similar, and this causes them to be misdiagnosed. In addition, TB is sometimes diagnosed later than COVID-19 and the severity of the disease worsens, especially in patients with underlying conditions. Therefore, patients with TB should be screened regularly in the COVID-19 era to prevent the spread of the TB/COVID-19 coinfection.
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Affiliation(s)
- Maryam Koupaei
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Adel Naimi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Narges Moafi
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Paria Mohammadi
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Faezeh Sadat Tabatabaei
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Soroosh Ghazizadeh
- Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohsen Heidary
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.,Department of Laboratory Sciences, School of Paramedical Sciences, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Saeed Khoshnood
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Chauhan A, Singh M, Agarwal A, Jaiswal N, M Lakshmi PV, Singh M. Exploring the role of bacillus calmette-guerin vaccination in protection against COVID-19. Int J Mycobacteriol 2021; 10:433-436. [PMID: 34916464 DOI: 10.4103/ijmy.ijmy_179_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background In recent studies, it has been established that countries having Bacillus Calmette-Guerin (BCG) vaccination programs reported less COVID-19 cases and deaths per population Preliminary studies suggest that BCG vaccination could upregulate the vaccine-induced immunity against SARS-CoV-2. Hence, the recent study was aimed to determine the association of BCG vaccine with the development of COVID-19 in health care workers. Methods The participants included in the study were healthcare workers (doctors, paramedics, and other supporting staff) working in the high and low-risk zones of COVID-19 in the hospital. The Graph Pad statistical analysis tool was used to determine the association of preliminary BCG vaccination with their COVID-19 status. Results A total of 200 health care workers working in different departments of the hospital were enrolled in the study. The relative risk of COVID-19 positivity in BCG vaccinated versus unvaccinated was 0.79 (0.50-1.25). There was also a significant negative correlation between two groups. The relative risk of COVID-19 positivity in those with a BCG scar was 0.63 (0.44-0.92). The relative risk of COVID-19 infection in those with a history of tuberculosis was 1.08 (0.56-2.09). Conclusion The present study did not support the beneficial effect of BCG vaccine in protection against the development of COVID-19 disease.
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Affiliation(s)
- Anil Chauhan
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manvi Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Agarwal
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nishant Jaiswal
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P V M Lakshmi
- Department of Community Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Suliman S, Pelzer PT, Shaku M, Rozot V, Mendelsohn SC. Meeting report: Virtual Global Forum on Tuberculosis Vaccines, 20-22 April 2021. Vaccine 2021; 39:7223-7229. [PMID: 34538522 PMCID: PMC8441545 DOI: 10.1016/j.vaccine.2021.08.094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/26/2021] [Indexed: 12/28/2022]
Abstract
The Global Forum on Tuberculosis (TB) Vaccines was held virtually from 20 to 22 April 2021, marking its 20th anniversary. The Global Forum on TB Vaccines is the world's largest gathering of stakeholders striving to develop new vaccines to prevent TB. The program included more than 60 speakers in 11 scientific sessions, panel discussions, and workshops. It provided an overview of the state of the field, and an opportunity to share the latest research findings, as well as new and innovative approaches to TB vaccine research and development (R&D). This year, it was held against the backdrop of the COVID-19 pandemic and convened researchers, developers, funders, and other stakeholders remotely to discuss opportunities and challenges for TB vaccine R&D in these unprecedented times.
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Affiliation(s)
- Sara Suliman
- Stop TB Partnership Working Group on New TB Vaccines, New York, NY, USA; Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Puck T Pelzer
- Stop TB Partnership Working Group on New TB Vaccines, New York, NY, USA; KNCV Tuberculosis Foundation, The Hague, the Netherlands
| | - Moagi Shaku
- Stop TB Partnership Working Group on New TB Vaccines, New York, NY, USA
| | - Virginie Rozot
- Stop TB Partnership Working Group on New TB Vaccines, New York, NY, USA; South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Department of Pathology, Wernher and Beit South Building, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa
| | - Simon C Mendelsohn
- Stop TB Partnership Working Group on New TB Vaccines, New York, NY, USA; South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Department of Pathology, Wernher and Beit South Building, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa.
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68
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Qu M, Zhou X, Li H. BCG vaccination strategies against tuberculosis: updates and perspectives. Hum Vaccin Immunother 2021; 17:5284-5295. [PMID: 34856853 DOI: 10.1080/21645515.2021.2007711] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Bacillus Calmette-Guérin (BCG) is the only licensed vaccine against tuberculosis (TB). However, BCG has variable efficacy and cannot completely prevent TB infection and transmission. Therefore, the worldwide prevalence of TB calls for urgent development of a more effective TB vaccine. In the absence of other approved vaccines, it is also necessary to improve the efficacy of BCG itself. Intravenous (IV) BCG administration and BCG revaccination strategies have recently shown promising results for clinical usage. Therefore, it is necessary for us to revisit the BCG vaccination strategies and summarize the current research updates related to BCG vaccination. This literature review provides an updated overview and perspectives of the immunization strategies against TB using BCG, which may inspire the following research on TB vaccine development.
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Affiliation(s)
- Mengjin Qu
- College of Veterinary Medicine, China Agricultural University, Beijing, China.,Key Laboratory of Animal Epidemiology and Zoonosis, Ministry of Agriculture, National Animal Transmissible Spongiform Encephalopathy Laboratory, China Agricultural University, Beijing, China
| | - Xiangmei Zhou
- College of Veterinary Medicine, China Agricultural University, Beijing, China.,Key Laboratory of Animal Epidemiology and Zoonosis, Ministry of Agriculture, National Animal Transmissible Spongiform Encephalopathy Laboratory, China Agricultural University, Beijing, China
| | - Hao Li
- College of Veterinary Medicine, China Agricultural University, Beijing, China.,Center for Infectious Disease Research, School of Medicine, Tsinghua University, Beijing, China
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69
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Martini F, Champagne E. The Contribution of Human Herpes Viruses to γδ T Cell Mobilisation in Co-Infections. Viruses 2021; 13:v13122372. [PMID: 34960641 PMCID: PMC8704314 DOI: 10.3390/v13122372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/12/2022] Open
Abstract
γδ T cells are activated in viral, bacterial and parasitic infections. Among viruses that promote γδ T cell mobilisation in humans, herpes viruses (HHVs) occupy a particular place since they infect the majority of the human population and persist indefinitely in the organism in a latent state. Thus, other infections should, in most instances, be considered co-infections, and the reactivation of HHV is a serious confounding factor in attributing γδ T cell alterations to a particular pathogen in human diseases. We review here the literature data on γδ T cell mobilisation in HHV infections and co-infections, and discuss the possible contribution of HHVs to γδ alterations observed in various infectious settings. As multiple infections seemingly mobilise overlapping γδ subsets, we also address the concept of possible cross-protection.
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The (Still Unknown) Hypothetical Protective Role of COVID-19 Therapy in Bladder Cancer. J Clin Med 2021; 10:jcm10235473. [PMID: 34884178 PMCID: PMC8658423 DOI: 10.3390/jcm10235473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/21/2021] [Accepted: 11/12/2021] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic continues to put a strain on the entire world population. The common features of bladder cancer (BCa) and COVID infection have been widely reported and discussion may continue regarding treatment as well. We have highlighted how COVID-19 therapy has many implications with BCa therapy, in particular with potential protective role.
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Fleites YA, Aguiar J, Cinza Z, Bequet M, Marrero E, Vizcaíno M, Esquivel I, Diaz M, Sin-Mayor A, Garcia M, Martinez SM, Beato A, Galarraga AG, Mendoza-Mari Y, Valdés I, García G, Lemos G, González I, Canaán-Haden C, Figueroa N, Oquendo R, Akbar SM, Mahtab MA, Uddin MH, Guillén GE, Muzio VL, Pentón E, Aguilar JC. HeberNasvac, a Therapeutic Vaccine for Chronic Hepatitis B, Stimulates Local and Systemic Markers of Innate Immunity: Potential Use in SARS-CoV-2 Postexposure Prophylaxis. Euroasian J Hepatogastroenterol 2021; 11:59-70. [PMID: 34786358 PMCID: PMC8566153 DOI: 10.5005/jp-journals-10018-1344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction More than 180 million people have been infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and more than 4 million coronavirus disease-2019 (COVID-19) patients have died in 1.5 years of the pandemic. A novel therapeutic vaccine (NASVAC) has shown to be safe and to have immunomodulating and antiviral properties against chronic hepatitis B (CHB). Materials and methods A phase I/II, open-label controlled and randomized clinical trial of NASVAC as a postexposure prophylaxis treatment was designed with the primary aim of assessing the local and systemic immunomodulatory effect of NASVAC in a cohort of suspected and SARS-CoV-2 risk-contact patients. A total of 46 patients, of both sexes, 60 years or older, presenting with symptoms of COVID-19 were enrolled in the study. Patients received NASVAC (100 μg per Ag per dose) via intranasal at days 1, 7, and 14 and sublingual, daily for 14 days. Results and discussion The present study detected an increased expression of toll-like receptors (TLR)-related genes in nasopharyngeal tonsils, a relevant property considering these are surrogate markers of SARS protection in the mice model of lethal infection. The HLA-class II increased their expression in peripheral blood mononuclear cell's (PBMC's) monocytes and lymphocytes, which is an attractive property taking into account the functional impairment of innate immune cells from the periphery of COVID-19-infected subjects. NASVAC was safe and well tolerated by the patients with acute respiratory infections and evidenced a preliminary reduction in the number of days with symptoms that needs to be confirmed in larger studies. Conclusions Our data justify the use of NASVAC as preemptive therapy or pre-/postexposure prophylaxis of SARS-CoV-2 and acute respiratory infections in general. The use of NASVAC or their active principles has potential as immunomodulatory prophylactic therapies in other antiviral settings like dengue as well as in malignancies like hepatocellular carcinoma where these markers have shown relation to disease progression. How to cite this article Fleites YA, Aguiar J, Cinza Z, et al. HeberNasvac, a Therapeutic Vaccine for Chronic Hepatitis B, Stimulates Local and Systemic Markers of Innate Immunity: Potential Use in SARS-CoV-2 Postexposure Prophylaxis. Euroasian J Hepato-Gastroenterol 2021;11(2):59–70.
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Affiliation(s)
- Yoel A Fleites
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Jorge Aguiar
- Department of Vaccines, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Zurina Cinza
- Department of Vaccines, Clinical Trials Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Monica Bequet
- Department of Pharmaceuticals, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Elieser Marrero
- Department of Quality Control Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | | | - Idelsis Esquivel
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Marisol Diaz
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Adriana Sin-Mayor
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Maura Garcia
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Sara M Martinez
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Abrahan Beato
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Ana G Galarraga
- Department of Clinical Trials, Luis Diaz Soto Hospital, Havana, Cuba
| | - Yssel Mendoza-Mari
- Department of Pharmaceuticals, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Iris Valdés
- Department of Vaccines, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Gerardo García
- Department of Quality Control Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Gilda Lemos
- Department of Vaccines, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Isabel González
- Department of Pharmaceuticals, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Camila Canaán-Haden
- Department of Pharmaceuticals, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Nelvis Figueroa
- Department of Vaccines, Clinical Trials Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Rachel Oquendo
- Department of Vaccines, Clinical Trials Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Sheikh Mf Akbar
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Mamun A Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mohammad H Uddin
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Gerardo E Guillén
- Department of Vaccines, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Verena L Muzio
- Department of Vaccines, Clinical Trials Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Eduardo Pentón
- Department of Vaccines, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Julio C Aguilar
- Department of Vaccines, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Havana, Cuba
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Kumar NP, Padmapriyadarsini C, Rajamanickam A, Bhavani PK, Nancy A, Jayadeepa B, Selvaraj N, Asokan D, Renji RM, Venkataramani V, Tripathy S, Babu S. BCG vaccination induces enhanced frequencies of memory T cells and altered plasma levels of common γc cytokines in elderly individuals. PLoS One 2021; 16:e0258743. [PMID: 34758029 PMCID: PMC8580239 DOI: 10.1371/journal.pone.0258743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/26/2021] [Indexed: 12/03/2022] Open
Abstract
BCG vaccination is known to induce innate immune memory, which confers protection against heterologous infections. However, the effect of BCG vaccination on the conventional adaptive immune cells subsets is not well characterized. We investigated the impact of BCG vaccination on the frequencies of T cell subsets and common gamma c (γc) cytokines in a group of healthy elderly individuals (age 60–80 years) at one month post vaccination as part of our clinical study to examine the effect of BCG on COVID-19. Our results demonstrate that BCG vaccination induced enhanced frequencies of central (p<0.0001) and effector memory (p<0.0001) CD4+ T cells and diminished frequencies of naïve (p<0.0001), transitional memory (p<0.0001), stem cell memory (p = 0.0001) CD4+ T cells and regulatory T cells. In addition, BCG vaccination induced enhanced frequencies of central (p = 0.0008), effector (p<0.0001) and terminal effector memory (p<0.0001) CD8+ T cells and diminished frequencies of naïve (p<0.0001), transitional memory (p<0.0001) and stem cell memory (p = 0.0034) CD8+T cells. BCG vaccination also induced enhanced plasma levels of IL-7 (p<0.0001) and IL-15 (p = 0.0020) but diminished levels of IL-2 (p = 0.0033) and IL-21 (p = 0.0020). Thus, BCG vaccination was associated with enhanced memory T cell subsets as well as memory enhancing γc cytokines in elderly individuals, suggesting its ability to induce non-specific adaptive immune responses.
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Affiliation(s)
- Nathella Pavan Kumar
- ICMR-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai, India
- * E-mail: (NPK); (SB)
| | | | | | - Perumal Kannabiran Bhavani
- ICMR-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai, India
| | - Arul Nancy
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Bharathi Jayadeepa
- ICMR-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai, India
| | - Nandhini Selvaraj
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Dinesh Asokan
- ICMR-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai, India
| | | | | | - Srikanth Tripathy
- ICMR-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai, India
- Dr D Y Patil Medical College, Hospital and Research Centre, Pune, India
| | - Subash Babu
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
- * E-mail: (NPK); (SB)
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Mandala WL, Liu MKP. SARS-CoV-2 and HIV-1: Should HIV-1-Infected Individuals in Sub-Saharan Africa Be Considered a Priority Group for the COVID-19 Vaccines? Front Immunol 2021; 12:797117. [PMID: 34858440 PMCID: PMC8630634 DOI: 10.3389/fimmu.2021.797117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
Since its emergence in 2019 SARS-CoV-2 has proven to have a higher level of morbidity and mortality compared to the other prevailing coronaviruses. Although initially most African countries were spared from the devastating effect of SARS-CoV-2, at present almost every country has been affected. Although no association has been established between being HIV-1-infected and being more vulnerable to contracting COVID-19, HIV-1-infected individuals have a greater risk of developing severe COVID-19 and of COVID-19 related mortality. The rapid development of the various types of COVID-19 vaccines has gone a long way in mitigating the devastating effects of the virus and has controlled its spread. However, global vaccine deployment has been uneven particularly in Africa. The emergence of SARS-CoV-2 variants, such as Beta and Delta, which seem to show some subtle resistance to the existing vaccines, suggests COVID-19 will still be a high-risk infection for years. In this review we report on the current impact of COVID-19 on HIV-1-infected individuals from an immunological perspective and attempt to make a case for prioritising COVID-19 vaccination for those living with HIV-1 in Sub-Saharan Africa (SSA) countries like Malawi as one way of minimising the impact of COVID-19 in these countries.
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Affiliation(s)
- Wilson Lewis Mandala
- Academy of Medical Sciences, Malawi University of Science and Technology (MUST), Thyolo, Malawi
| | - Michael K. P. Liu
- Centre for Immunology and Vaccinology, Department of Infectious Disease, Imperial College London, London, United Kingdom
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74
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Zhang N, Jack Chan PT, Jia W, Dung CH, Zhao P, Lei H, Su B, Xue P, Zhang W, Xie J, Li Y. Analysis of efficacy of intervention strategies for COVID-19 transmission: A case study of Hong Kong. ENVIRONMENT INTERNATIONAL 2021; 156:106723. [PMID: 34161908 PMCID: PMC8214805 DOI: 10.1016/j.envint.2021.106723] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 05/25/2023]
Abstract
By the end of February 2021, COVID-19 had spread to over 230 countries, with more than 100 million confirmed cases and 2.5 million deaths. To control infection spread with the least disruption to economic and societal activities, it is crucial to implement the various interventions effectively. In this study, we developed an agent-based SEIR model, using real demographic and geographic data from Hong Kong, to analyse the efficiency of various intervention strategies in preventing infection by the SARS-CoV-2 virus. Close contact route including short-range airborne is considered as the main transmission routes for COVID-19 spread. Contact tracing is not that useful if all other interventions have been fully deployed. The number of infected individuals could be halved if people reduced their close contact rate by 25%. For reducing transmission, students should be prioritized for vaccination rather than retired older people and preschool aged children. Home isolation, and taking the nucleic acid test (NAT) as soon as possible after symptom onset, are much more effective interventions than wearing masks in public places. Temperature screening in public places only disrupted the infection spread by a small amount when other interventions have been fully implemented. Our results may be useful for other highly populated cities, when choosing their intervention strategies to prevent outbreaks of COVID-19 and similar diseases.
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Affiliation(s)
- Nan Zhang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China; Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Pak-To Jack Chan
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Wei Jia
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China; Zhejiang Institute of Research and Innovation, The University of Hong Kong, Lin An, Zhejiang, China
| | - Chung-Hin Dung
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Pengcheng Zhao
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Hao Lei
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Boni Su
- China Electric Power Planning & Engineering Institute, Beijing, China
| | - Peng Xue
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Weirong Zhang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Jingchao Xie
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, China.
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75
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Chowdhury UN, Faruqe MO, Mehedy M, Ahmad S, Islam MB, Shoombuatong W, Azad A, Moni MA. Effects of Bacille Calmette Guerin (BCG) vaccination during COVID-19 infection. Comput Biol Med 2021; 138:104891. [PMID: 34624759 PMCID: PMC8479467 DOI: 10.1016/j.compbiomed.2021.104891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) is caused by the infection of highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as the novel coronavirus. In most countries, the containment of this virus spread is not controlled, which is driving the pandemic towards a more difficult phase. In this study, we investigated the impact of the Bacille Calmette Guerin (BCG) vaccination on the severity and mortality of COVID-19 by performing transcriptomic analyses of SARS-CoV-2 infected and BCG vaccinated samples in peripheral blood mononuclear cells (PBMC). A set of common differentially expressed genes (DEGs) were identified and seeded into their functional enrichment analyses via Gene Ontology (GO)-based functional terms and pre-annotated molecular pathways databases, and their Protein-Protein Interaction (PPI) network analysis. We further analysed the regulatory elements, possible comorbidities and putative drug candidates for COVID-19 patients who have not been BCG-vaccinated. Differential expression analyses of both BCG-vaccinated and COVID-19 infected samples identified 62 shared DEGs indicating their discordant expression pattern in their respected conditions compared to control. Next, PPI analysis of those DEGs revealed 10 hub genes, namely ITGB2, CXCL8, CXCL1, CCR2, IFNG, CCL4, PTGS2, ADORA3, TLR5 and CD33. Functional enrichment analyses found significantly enriched pathways/GO terms including cytokine activities, lysosome, IL-17 signalling pathway, TNF-signalling pathways. Moreover, a set of identified TFs, miRNAs and potential drug molecules were further investigated to assess their biological involvements in COVID-19 and their therapeutic possibilities. Findings showed significant genetic interactions between BCG vaccination and SARS-CoV-2 infection, suggesting an interesting prospect of the BCG vaccine in relation to the COVID-19 pandemic. We hope it may potentially trigger further research on this critical phenomenon to combat COVID-19 spread.
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Affiliation(s)
- Utpala Nanda Chowdhury
- Department of Computer Science and Engineering, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Omar Faruqe
- Department of Computer Science and Engineering, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Mehedy
- Department of Computer Science and Engineering, University of Rajshahi, Rajshahi, Bangladesh
| | - Shamim Ahmad
- Department of Computer Science and Engineering, University of Rajshahi, Rajshahi, Bangladesh
| | - M. Babul Islam
- Department of Electrical and Electronic Engineering, University of Rajshahi, Rajshahi, Bangladesh
| | - Watshara Shoombuatong
- Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand
| | - A.K.M. Azad
- Faculty of Science, Engineering & Technology, Swinburne University of Technology Sydney, Australia
| | - Mohammad Ali Moni
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia,Corresponding author
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76
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Glynn JR, Dube A, Fielding K, Crampin AC, Kanjala C, Fine PEM. The effect of BCG revaccination on all-cause mortality beyond infancy: 30-year follow-up of a population-based, double-blind, randomised placebo-controlled trial in Malawi. THE LANCET. INFECTIOUS DISEASES 2021; 21:1590-1597. [PMID: 34237262 PMCID: PMC8550897 DOI: 10.1016/s1473-3099(20)30994-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Trials of BCG vaccination to prevent or reduce severity of COVID-19 are taking place in adults, some of whom have been previously vaccinated, but evidence of the beneficial, non-specific effects of BCG come largely from data on mortality in infants and young children, and from in-vitro and animal studies, after a first BCG vaccination. We assess all-cause mortality following a large BCG revaccination trial in Malawi. METHODS The Karonga Prevention trial was a population-based, double-blind, randomised controlled in Karonga District, northern Malawi, that enrolled participants between January, 1986, and November, 1989. The trial compared BCG (Glaxo-strain) revaccination versus placebo to prevent tuberculosis and leprosy. 46 889 individuals aged 3 months to 75 years were randomly assigned to receive BCG revaccination (n=23 528) or placebo (n=23 361). Here we report mortality since vaccination as recorded during active follow-up in northern areas of the district in 1991-94, and in a demographic surveillance follow-up in the southern area in 2002-18. 7389 individuals who received BCG (n=3746) or placebo (n=3643) lived in the northern follow-up areas, and 5616 individuals who received BCG (n=2798) or placebo (n=2818) lived in the southern area. Year of death or leaving the area were recorded for those not found. We used survival analysis to estimate all-cause mortality. FINDINGS Follow-up information was available for 3709 (99·0%) BCG recipients and 3612 (99·1%) placebo recipients in the northern areas, and 2449 (87·5%) BCG recipients and 2413 (85·6%) placebo recipients in the southern area. There was no difference in mortality between the BCG and placebo groups in either area, overall or by age group or sex. In the northern area, there were 129 deaths per 19 694 person-years at risk in the BCG group (6·6 deaths per 1000 person-years at risk [95% CI 5·5-7·8]) versus 133 deaths per 19 111 person-years at risk in the placebo group (7·0 deaths per 1000 person-years at risk [95% CI 5·9-8·2]; HR 0·94 [95% CI 0·74-1·20]; p=0·62). In the southern area, there were 241 deaths per 38 399 person-years at risk in the BCG group (6·3 deaths per 1000 person-years at risk [95% CI 5·5-7·1]) versus 230 deaths per 38 676 person-years at risk in the placebo group (5·9 deaths per 1000 person-years at risk [95% CI 5·2-6·8]; HR 1·06 [95% CI 0·88-1·27]; p=0·54). INTERPRETATION We found little evidence of any beneficial effect of BCG revaccination on all-cause mortality. The high proportion of deaths attributable to non-infectious causes beyond infancy, and the long time interval since BCG for most deaths, might obscure any benefits. FUNDING British Leprosy Relief Association (LEPRA); Wellcome Trust.
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Affiliation(s)
- Judith R Glynn
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Albert Dube
- Malawi Epidemiology and Intervention Research Unit, Chilumba and Lilongwe, Malawi
| | - Katherine Fielding
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Amelia C Crampin
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Malawi Epidemiology and Intervention Research Unit, Chilumba and Lilongwe, Malawi
| | - Chifundo Kanjala
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Malawi Epidemiology and Intervention Research Unit, Chilumba and Lilongwe, Malawi
| | - Paul E M Fine
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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77
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Villanueva P, Pittet LF, Curtis N. Management of Bacille Calmette-Guérin Lymphadenitis and Abscess in Immunocompetent Children: A Systematic Review. Pediatr Infect Dis J 2021; 40:1037-1045. [PMID: 34636800 DOI: 10.1097/inf.0000000000003237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no consensus on managing common adverse reactions to Bacille Calmette-Guérin (BCG) vaccination. We systematically reviewed the management of BCG-associated regional lymphadenitis and injection site abscess in immunocompetent individuals. METHODS Searches of Medline, Embase and PubMed were done until November 2020. Randomized controlled trials (RCTs) and cohort studies that compared management strategies for complications of intradermal BCG vaccination were included. RESULTS Of 1338 individual articles, 15 met inclusion criteria. Six RCTs, 4 prospective and 4 retrospective cohort studies compared management in 1022 children with BCG-associated lymphadenitis. For nonsuppurative lymphadenitis, no antimicrobial was found to significantly impact on time to resolution or prevention of suppuration. For suppurative lymphadenitis, there was some evidence that needle aspiration shortens time to resolution and prevents sinus tract formation. Surgical excision (mainly offered for persistent suppurative lymphadenitis) generally had favorable outcome. Two cohort studies (including 1 aforementioned) compared management strategies in up to 36 children with BCG injection site abscess; one showed no difference in outcome in children treated with antibiotics and the other reported complete resolution without treatment. CONCLUSIONS Evidence does not support a role for antimicrobial therapy in the management of localized reactions to BCG vaccination in immunocompetent children. Needle aspiration may shorten the recovery period for BCG-associated suppurative lymphadenitis. BCG injection site abscess usually heals without treatment. However, studies are limited and cases are not well defined. Growing research into novel BCG applications provides opportunities to investigate optimal management strategies for adverse reactions in a prospective manner using active safety surveillance.
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Affiliation(s)
- Paola Villanueva
- From the Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Laure F Pittet
- From the Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Infectious Diseases Unit, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Nigel Curtis
- From the Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Infectious Diseases Unit, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
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78
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Pittet LF, Messina NL, Gardiner K, Orsini F, Abruzzo V, Bannister S, Bonten M, Campbell JL, Croda J, Dalcolmo M, Elia S, Germano S, Goodall C, Gwee A, Jamieson T, Jardim B, Kollmann TR, Guimarães Lacerda MV, Lee KJ, Legge D, Lucas M, Lynn DJ, McDonald E, Manning L, Munns CF, Perrett KP, Prat Aymerich C, Richmond P, Shann F, Sudbury E, Villanueva P, Wood NJ, Lieschke K, Subbarao K, Davidson A, Curtis N. BCG vaccination to reduce the impact of COVID-19 in healthcare workers: Protocol for a randomised controlled trial (BRACE trial). BMJ Open 2021; 11:e052101. [PMID: 34711598 PMCID: PMC8557250 DOI: 10.1136/bmjopen-2021-052101] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/02/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION BCG vaccination modulates immune responses to unrelated pathogens. This off-target effect could reduce the impact of emerging pathogens. As a readily available, inexpensive intervention that has a well-established safety profile, BCG is a good candidate for protecting healthcare workers (HCWs) and other vulnerable groups against COVID-19. METHODS AND ANALYSIS This international multicentre phase III randomised controlled trial aims to determine if BCG vaccination reduces the incidence of symptomatic and severe COVID-19 at 6 months (co-primary outcomes) compared with no BCG vaccination. We plan to randomise 10 078 HCWs from Australia, The Netherlands, Spain, the UK and Brazil in a 1:1 ratio to BCG vaccination or no BCG (control group). The participants will be followed for 1 year with questionnaires and collection of blood samples. For any episode of illness, clinical details will be collected daily, and the participant will be tested for SARS-CoV-2 infection. The secondary objectives are to determine if BCG vaccination reduces the rate, incidence, and severity of any febrile or respiratory illness (including SARS-CoV-2), as well as work absenteeism. The safety of BCG vaccination in HCWs will also be evaluated. Immunological analyses will assess changes in the immune system following vaccination, and identify factors associated with susceptibility to or protection against SARS-CoV-2 and other infections. ETHICS AND DISSEMINATION Ethical and governance approval will be obtained from participating sites. Results will be published in peer-reviewed open-access journals. The final cleaned and locked database will be deposited in a data sharing repository archiving system. TRIAL REGISTRATION ClinicalTrials.gov NCT04327206.
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Affiliation(s)
- Laure F Pittet
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Nicole L Messina
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Kaya Gardiner
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Francesca Orsini
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Veronica Abruzzo
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Samantha Bannister
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Marc Bonten
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | | | - Julio Croda
- Oswaldo Cruz Foundation, Campo Grande, Mato Grosso do Sul, Brazil
- School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
- Yale School of Public Health, New Haven, Connecticut, USA
| | - Margareth Dalcolmo
- Helio Fraga Reference Center, Oswaldo Cruz Foundation Ministry of Health, Rio de Janeiro, Brazil
- Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sonja Elia
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Immunisation Service, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Susie Germano
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Casey Goodall
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Amanda Gwee
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Tenaya Jamieson
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Bruno Jardim
- Institute of Clinical Research Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Tobias R Kollmann
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Marcus Vinícius Guimarães Lacerda
- Institute of Clinical Research Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Instituto Leônidas & Maria Deane, Oswaldo Cruz Foundation, Manaus, Amazonas, Brazil
| | - Katherine J Lee
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Donna Legge
- Department of Pharmacy, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Michaela Lucas
- Department of Immunology, QE2 Medical Centre, PathWest Laboratory Medicine Western Australia, Nedlands, Western Australia, Australia
- Department of Immunology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Department of Immunology and General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - David J Lynn
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Ellie McDonald
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Laurens Manning
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
- Department of Infectious Diseases, Fiona Stanley Hospital, Bull Creek, Western Australia, Australia
| | - Craig F Munns
- Department of Endocrinology & Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten P Perrett
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Allergy and Immunology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Melbourne Children's Trial Centre, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Cristina Prat Aymerich
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
- Institut d'Investigació Germans Trias i Pujol, Departament de Genètica i Microbiologia, CIBER de enfermedades respiratorias (CIBERES), Instituto de Salud Carlos III, Universitat Autònoma de Barcelona, Badalona, Catalunya, Spain
| | - Peter Richmond
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Department of Immunology and General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Frank Shann
- Infectious Diseases, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Eva Sudbury
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Paola Villanueva
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas J Wood
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- The Sydney Children's Hospitals Network Randwick and Westmead, Sydney, New South Wales, Australia
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, New South Wales, Australia
| | - Katherine Lieschke
- Melbourne Children's Trial Centre, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kanta Subbarao
- WHO Collaborating Centre for Reference and Research on Influenza and Department of Microbiology and Immunology, University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Andrew Davidson
- Melbourne Children's Trial Centre, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Nigel Curtis
- Infectious Diseases Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
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Monereo-Sánchez J, Luykx JJ, Pinzón-Espinosa J, Richard G, Motazedi E, Westlye LT, Andreassen OA, van der Meer D. Diphtheria And Tetanus Vaccination History Is Associated With Lower Odds of COVID-19 Hospitalization. Front Immunol 2021; 12:749264. [PMID: 34691063 PMCID: PMC8529993 DOI: 10.3389/fimmu.2021.749264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/08/2021] [Indexed: 01/20/2023] Open
Abstract
Background COVID-19 is characterized by strikingly large, mostly unexplained, interindividual variation in symptom severity: while some individuals remain nearly asymptomatic, others suffer from severe respiratory failure. Previous vaccinations for other pathogens, in particular tetanus, may partly explain this variation, possibly by readying the immune system. Methods We made use of data on COVID-19 testing from 103,049 participants of the UK Biobank (mean age 71.5 years, 54.2% female), coupled to immunization records of the last ten years. Using logistic regression, covarying for age, sex, respiratory disease diagnosis, and socioeconomic status, we tested whether individuals vaccinated for tetanus, diphtheria or pertussis, differed from individuals that had only received other vaccinations on 1) undergoing a COVID-19 test, 2) being diagnosed with COVID-19, and 3) whether they developed severe COVID-19 symptoms. Results We found that individuals with registered diphtheria or tetanus vaccinations are less likely to develop severe COVID-19 than people who had only received other vaccinations (diphtheria odds ratio (OR)=0.47, p-value=5.3*10-5; tetanus OR=0.52, p-value=1.2*10-4). Discussion These results indicate that a history of diphtheria or tetanus vaccinations is associated with less severe manifestations of COVID-19. These vaccinations may protect against severe COVID-19 symptoms by stimulating the immune system. We note the correlational nature of these results, yet the possibility that these vaccinations may influence the severity of COVID-19 warrants follow-up investigations.
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Affiliation(s)
- Jennifer Monereo-Sánchez
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Jurjen J Luykx
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Outpatient Second Opinion Clinic, GGNet Mental Health, Warnsveld, Netherlands
| | - Justo Pinzón-Espinosa
- Department of Mental Health, Parc Tauli University Hospital, Sabadell, Barcelona, Spain.,Department of Clinical Psychiatry, School of Medicine, University of Panama, Panama, Panama.,Department of Medicine, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ehsan Motazedi
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dennis van der Meer
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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80
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TAMTA SHIKA, VINODHKUMAR OR, KARTHIKEYAN A, DUBAL ZB, KHAN SHARUN, A SAIED ABDULRAHMAN, DHAWAN MANISH, DHAMA KULDEEP, MALIK YS. Epidemiological profiling of SARS-CoV-2 with focus on one-health approaches in mitigating COVID-19 pandemic. THE INDIAN JOURNAL OF ANIMAL SCIENCES 2021. [DOI: 10.56093/ijans.v91i10.117206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Of the 1,415 human pathogens identified, 175 are responsible for causing emerging diseases, 132 are zoonotic and majority of the diseases are categorized as emerging or re-emerging. Emerging novel Coronavirus (COVID- 19) is one of them, and it is responsible for causing social and economically critical disease in both humans and animals. This review presents the understanding of epidemiological characteristics of the COVID-19 pandemic related to host, agent, and the environment with transmission and spread of the disease for better prevention of the COVID-19. The inclination of the viruses to spillover between different species and determining the number of the reservoir of coronaviruses in an entirely new host to create infection is of emerging importance. The understanding of disease patterns will potentiate our expertise to alert how, when, and where the potential epidemic will occur. One health approach involves co-operation from all the sectors, including healthcare (medical and veterinary), environmental, pharmaceutical, educational, research, police, and administration, to combat the COVID-19 pandemic and reduce the public health threat.
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81
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Shaikh N, Pelzer PT, Thysen SM, Roy P, Harris RC, White RG. Impact of COVID-19 Disruptions on Global BCG Coverage and Paediatric TB Mortality: A Modelling Study. Vaccines (Basel) 2021; 9:1228. [PMID: 34835161 PMCID: PMC8624525 DOI: 10.3390/vaccines9111228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
The impact of COVID-19 disruptions on global Bacillus Calmette-Guérin (BCG) coverage and paediatric tuberculosis (TB) mortality is still unknown. To fill this evidence-gap and guide mitigation measures, we estimated the impact of COVID-19 disruptions on global BCG coverage and paediatric TB mortality. First, we used data from multiple sources to estimate COVID-19-disrupted BCG vaccination coverage. Second, using a static mathematical model, we estimated the number of additional paediatric TB deaths in the first 15 years of life due to delayed/missed vaccinations in 14 scenarios-varying in duration of disruption, and magnitude and timing of catch-up. We estimated a 25% reduction in global BCG coverage within the disruption period. The best-case scenario (3-month disruption, 100% catch-up within 3 months) resulted in an additional 886 (0.5%) paediatric TB deaths, and the worst-case scenario (6-month disruption with no catch-up) resulted in an additional 33,074 (17%) deaths. The magnitude of catch-up was found to be the most influential variable in minimising excess paediatric TB mortality. Our results show that ensuring catch-up vaccination of missed children is a critical priority, and delivery of BCG alongside other routine vaccines may be a feasible way to achieve catch-up. Urgent action is required to support countries with recovering vaccination coverages to minimise paediatric deaths.
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Affiliation(s)
- Nabila Shaikh
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.C.H.); (R.G.W.)
| | - Puck T. Pelzer
- Technical Division, KNCV Tuberculosis, Maanweg 174, 2516 AB The Hague, The Netherlands;
| | - Sanne M. Thysen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, 2004 Frederiksberg, Denmark;
- Bandim Health Project, Apartado 861, Bissau 1004, Guinea-Bissau
| | - Partho Roy
- Immunisation and Countermeasures, National Infection Service, Public Health England, London NW9 5EQ, UK;
| | - Rebecca C. Harris
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.C.H.); (R.G.W.)
- Sanofi Pasteur, South Beach Tower 18-11, Singapore 189767, Singapore
| | - Richard G. White
- TB Modelling Group, TB Centre, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (R.C.H.); (R.G.W.)
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82
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Arslan Gulen T, Bayraktar M, Yaksi N, Kayabas U. Is the course of COVID-19 associated with tuberculin skin test diameter? A retrospective study. J Med Virol 2021; 94:1020-1026. [PMID: 34676582 PMCID: PMC8662280 DOI: 10.1002/jmv.27414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/20/2021] [Indexed: 01/08/2023]
Abstract
The pathogenesis of coronavirus disease 2019 (COVID‐19) is still not fully understood. As severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2) has a similar pathogenetic pathway to Mycobacterium tuberculosis, it has been reported that there may be a relationship between Bacille Calmette–Guérin (BCG) vaccination rate and COVID‐19 severity. This study investigated the relationship between tuberculin skin test (TST) induration diameter and the clinical course of COVID‐19. Of 1963 adult patients who underwent TST, 76 patients with SARS‐COV‐2 infection confirmed by RT‐PCR analysis of respiratory tract samples were included in the study. Relationships between COVID‐19 clinical severity and TST positivity, induration size, and other clinical parameters were analyzed. Of the 76 patients, TST results were negative for 53 patients (69.7%) and positive for 23 patients (30.3%). COVID‐19 severity was mild in 47 patients (61.8%), moderate in 22 patients (28.9%), and severe in seven patients (9.3%). All TST‐positive patients had mild disease. Patients with mild disease had a significantly higher TST positivity rate (p < 0.001) and larger induration diameter (p < 0.001). The area under the receiver operating characteristic (ROC) curve of TST induration size for the differentiation of mild with moderate and severe disease was 0.768 (p < 0.001). The maximum Youden J index value was 0.522 at an induration diameter of 6.5 mm, which had a sensitivity of 66.0% and specificity of 86.2%. COVID‐19 patients with positive TST showed a significantly higher rate of mild disease than those with negative TST. TST positivity is favorably associated with the course of COVID‐19. TST induration diameters larger than 6.5 mm were highly specific in predicting a milder clinical presentation of COVID‐19. Patients with positive tuberculin skin test (TST) had milder COVID‐19 symptoms. TST induration diameter is favorably associated with the course of COVID‐19.
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Affiliation(s)
- Tugba Arslan Gulen
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Muhammet Bayraktar
- Department of Public Health, Faculty of Medicine, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Nese Yaksi
- Division of Community Health Center, City Health Directorate, Nigde, Turkey
| | - Uner Kayabas
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Nigde Omer Halisdemir University, Nigde, Turkey
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83
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Trautmann A. [Mechanisms underlying chronic fatigue, a symptom too often overlooked]. Med Sci (Paris) 2021; 37:910-919. [PMID: 34647880 DOI: 10.1051/medsci/2021143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Acute fatigue after exertion, like acute inflammation after injury, is useful for our body. On the contrary, both chronic fatigue and chronic inflammation are deleterious, and they are associated in many diseases. In this first part, we will analyze different immune phenomena (bystander activation, memory of the innate immune system, link with the intestinal microbiota) involved in triggering chronic inflammation. This review aims at looking for links between different signs and symptoms associated with chronic fatigue, as well as between different diseases in which severe chronic fatigue can manifest. Possible underlying mechanisms for these phenomena are discussed. This is a proposal made by a researcher, with no clinical experience, to doctors confronted with an entity that is still largely mysterious. The link between chronic inflammation, neuroinflammation and fatigue will be examined in a second part.
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Affiliation(s)
- Alain Trautmann
- UMR CNRS 8104, Inserm 1016, université Paris Descartes, Institut Cochin, rue Méchain, 75014 Paris, France
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84
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Prentice S, Dockrell HM. BCG Specific and Nonspecific Effects: Different Questions, Similar Challenges. J Infect Dis 2021; 224:1105-1108. [PMID: 34244763 PMCID: PMC8514176 DOI: 10.1093/infdis/jiab307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/10/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Sarah Prentice
- Department of Paediatrics and Neonatology, East and North Hertfordshire NHS Trust, Stevenage, United Kingdom
| | - Hazel M Dockrell
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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85
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COVID-19 and Beyond: Exploring Public Health Benefits from Non-Specific Effects of BCG Vaccination. Microorganisms 2021; 9:microorganisms9102120. [PMID: 34683441 PMCID: PMC8539044 DOI: 10.3390/microorganisms9102120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/29/2021] [Accepted: 10/06/2021] [Indexed: 12/23/2022] Open
Abstract
Bacille Calmette–Guérin (BCG) vaccination, widely used throughout the world to protect against infant tuberculous meningitis and miliary tuberculosis (TB), can provide broad non-specific protection against infectious respiratory diseases in certain groups. Interest in BCG has seen a resurgence within the scientific community as the mechanisms for non-specific protection have begun to be elucidated. The impact of the COVID-19 pandemic on nearly every aspect of society has profoundly illustrated the pressure that respiratory infections can place on a national healthcare system, further renewing interest in BCG vaccination as a public health policy to reduce the burden of those illnesses. However, the United States does not recommend BCG vaccination due to its variable effectiveness against adult TB, the relatively low risk of Mycobacterium tuberculosis infection in most of the United States, and the vaccine’s interference with tuberculin skin test reactivity that complicates TB screening. In this review, we explore the broad immune training effects of BCG vaccination and literature on the effects of BCG vaccination on COVID-19 spread, disease severity, and mortality. We further discuss barriers to scheduled BCG vaccination in the United States and how those barriers could potentially be overcome.
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86
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Chaudhari VL, Godbole CJ, Gandhe PP, Gogtay NJ, Thatte UM. Association of Bacillus Calmette Guerin Vaccine Strains with COVID-19 Morbidity and Mortality - Evaluation of Global Data. Indian J Community Med 2021; 46:727-730. [PMID: 35068744 PMCID: PMC8729294 DOI: 10.4103/ijcm.ijcm_103_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Literature suggests that the presence of the current Bacillus Calmette Guerin (BCG) policy appears to mitigate COVID-19 disease burden but no information exists on the nature of the BCG strain and disease burden. OBJECTIVES To study the association between type of BCG strain, BCG coverage (%), and COVID-19 disease burden. METHODOLOGY An audit of global data on strains and disease burden was done. Country-specific data for COVID-19 cases and deaths, BCG-related data, and income level were obtained from the online databases, and the association was analyzed using linear regression. RESULTS Data of 139 countries were studied and 117 (84%) had a current BCG policy. Data on BCG strains were available for 51 countries and 18/51 (35%) used the Danish strain. While the choice of strain did not impact COVID-19-related disease burden, the presence of a current BCG policy was significantly associated with lower COVID-19 mortality. CONCLUSION The presence of current BCG policy is associated with decreased COVID-19-related disease burden, but the type of strain used by a country in its vaccination program does not impact disease burden.
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Affiliation(s)
- Vijaya Laxman Chaudhari
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Charuta Jaykumar Godbole
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Prajakta Parag Gandhe
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Nithya Jaideep Gogtay
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
| | - Urmila Mukund Thatte
- Department of Clinical Pharmacology, Seth GS Medical College and KEM Hospital, Mumbai, Maharshtra, India
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87
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Pallikkuth S, Williams E, Pahwa R, Hoffer M, Pahwa S. Association of Flu specific and SARS-CoV-2 specific CD4 T cell responses in SARS-CoV-2 infected asymptomatic heath care workers. Vaccine 2021; 39:6019-6024. [PMID: 34531078 PMCID: PMC8403669 DOI: 10.1016/j.vaccine.2021.08.092] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/30/2021] [Accepted: 08/26/2021] [Indexed: 12/27/2022]
Abstract
Influenza vaccination is widely advocated to avoid infection with influenza virus, a serious respiratory pathogen, and this was greatly emphasized during the raging COVID-19 epidemic. We conducted a study for baseline Flu specific immunity in a group of health care workers with documented past SARs-CoV-2 infection (designated COVID+) with mild or no symptoms and compared them with a control group that had not been infected with SARS CoV-2 (COVID-). Concurrently, we examined flu and SARS-CoV-2 specific T cell responses using the AIM (activation induced molecules) assay by flow cytometry. All COVID+ and 40% COVID- participants exhibited AIM responses to SARS-CoV-2 peptides, but only COVID+ were positive for SARs-CoV-2 antibody. Influenza HIN1 antigen specific CD4 T cells were found in 92% COVID+ and 76% COVID- participants and exhibited a strong direct correlation with SARS-CoV-2 specific CD4 T cells. This observation suggests that influenza specific T cell immunity may impact immune responses to SARS-CoV-2.
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Affiliation(s)
- Suresh Pallikkuth
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Erin Williams
- Department of Otolaryngology, University of Miami Miller School of Medicine, FL 33136, USA
| | - Rajendra Pahwa
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Michael Hoffer
- Department of Otolaryngology, University of Miami Miller School of Medicine, FL 33136, USA
| | - Savita Pahwa
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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88
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Lobo N, Brooks NA, Zlotta AR, Cirillo JD, Boorjian S, Black PC, Meeks JJ, Bivalacqua TJ, Gontero P, Steinberg GD, McConkey D, Babjuk M, Alfred Witjes J, Kamat AM. 100 years of Bacillus Calmette-Guérin immunotherapy: from cattle to COVID-19. Nat Rev Urol 2021; 18:611-622. [PMID: 34131332 PMCID: PMC8204595 DOI: 10.1038/s41585-021-00481-1] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 02/07/2023]
Abstract
Bacillus Calmette-Guérin (BCG) is the most widely used vaccine worldwide and has been used to prevent tuberculosis for a century. BCG also stimulates an anti-tumour immune response, which urologists have harnessed for the treatment of non-muscle-invasive bladder cancer. A growing body of evidence indicates that BCG offers protection against various non-mycobacterial and viral infections. The non-specific effects of BCG occur via the induction of trained immunity and form the basis for the hypothesis that BCG vaccination could be used to protect against the severity of coronavirus disease 2019 (COVID-19). This Perspective article highlights key milestones in the 100-year history of BCG and projects its potential role in the COVID-19 pandemic.
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Affiliation(s)
- Niyati Lobo
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Nathan A Brooks
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Alexandre R Zlotta
- Division of Urology, Department of Surgery, Sinai Health System, University of Toronto, Toronto, ON, Canada
- Department of Surgical Oncology, Division of Urology, Princess Margaret Cancer Centre, University of Toronto and University Health Network, Toronto, ON, Canada
| | - Jeffrey D Cirillo
- Department of Microbial Pathogenesis and Immunology, Texas A&M Health Science Center, Bryan, TX, USA
| | | | | | - Joshua J Meeks
- Northwestern University School of Medicine, Chicago, IL, USA
| | - Trinity J Bivalacqua
- The James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Paolo Gontero
- Division of Urology, Molinette Hospital, University of Torino School of Medicine, Torino, Italy
| | | | - David McConkey
- Johns Hopkins Greenberg Bladder Cancer Institute, Brady Urological Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Marko Babjuk
- Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - J Alfred Witjes
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Ashish M Kamat
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA.
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89
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Junapudi SS, Junapudi S, Ega K, Chidipi B. Major cardiac concerns in therapy and vaccinations for COVID-19. Metabol Open 2021; 11:100102. [PMID: 34222851 PMCID: PMC8238645 DOI: 10.1016/j.metop.2021.100102] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/26/2021] [Indexed: 02/07/2023] Open
Abstract
The necessity and impact of SARS-CoV-2 on the world's health have led to the development and production of practical and useful vaccines for this deadly respiratory virus. Since April 2020, a vaccine for the virus has been developed. Given that comorbidities such as diabetes, hypertension, and cardiovascular disease are more prone to viruses and the risk of infection, vaccines should be designed to protect against high-risk respiratory illnesses. In this review, we discussed the cardiovascular alteration in SARS-CoV-2 treatment, and we also reviewed the vaccination information and studies that have been done to primary considerations for cardiac patients.
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Affiliation(s)
- Syam Sundar Junapudi
- Department of Community Medicine, Govt Medical College Suryapet, Suryapet District, Telangana, 508213, India
| | - Sunil Junapudi
- Department of Pharmaceutical Chemistry, Geethanjali College of Pharmacy, Cherryal, Keesara, Medchalmalkajgiri District, Telangana, 501301, India
| | - Kishore Ega
- Department of Pediatrics, Narayana Medical College, Nellore, Andhra Pradesh-524002, India
| | - Bojjibabu Chidipi
- Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL,33612, USA
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90
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Eggenhuizen PJ, Ng BH, Chang J, Fell AL, Cheong RMY, Wong WY, Gan PY, Holdsworth SR, Ooi JD. BCG Vaccine Derived Peptides Induce SARS-CoV-2 T Cell Cross-Reactivity. Front Immunol 2021; 12:692729. [PMID: 34421902 PMCID: PMC8374943 DOI: 10.3389/fimmu.2021.692729] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/13/2021] [Indexed: 12/29/2022] Open
Abstract
Epidemiological studies and clinical trials suggest Bacillus Calmette-Guérin (BCG) vaccine has protective effects against coronavirus disease 2019 (COVID-19). There are now over 30 clinical trials evaluating if BCG vaccination can prevent or reduce the severity of COVID-19. However, the mechanism by which BCG vaccination can induce severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific T cell responses is unknown. Here, we identify 8 novel BCG-derived peptides with significant sequence homology to either SARS-CoV-2 NSP3 or NSP13-derived peptides. Using an in vitro co-culture system, we show that human CD4+ and CD8+ T cells primed with a BCG-derived peptide developed enhanced reactivity to its corresponding homologous SARS-CoV-2-derived peptide. As expected, HLA differences between individuals meant that not all persons developed immunogenic responses to all 8 BCG-derived peptides. Nevertheless, all of the 20 individuals that were primed with BCG-derived peptides developed enhanced T cell reactivity to at least 7 of 8 SARS-CoV-2-derived peptides. These findings provide an in vitro mechanism that may account, in part, for the epidemiologic observation that BCG vaccination confers some protection from COVID-19.
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Affiliation(s)
- Peter J Eggenhuizen
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Boaz H Ng
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Janet Chang
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Ashleigh L Fell
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Rachel M Y Cheong
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Wey Y Wong
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Poh-Yi Gan
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.,Department of Immunology, Monash Health, Monash Medical Centre, Clayton, VIC, Australia
| | - Stephen R Holdsworth
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.,Department of Immunology, Monash Health, Monash Medical Centre, Clayton, VIC, Australia
| | - Joshua D Ooi
- Centre for Inflammatory Diseases, Department of Medicine, Monash Medical Centre, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
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Sharma D. Repurposing of the childhood vaccines: could we train the immune system against the SARS-CoV-2. Expert Rev Vaccines 2021; 20:1051-1057. [PMID: 34313516 PMCID: PMC8425442 DOI: 10.1080/14760584.2021.1960161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The COVID-19 pandemic is a globalized health concern caused by a beta-coronavirus named Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Since December 2019, when this outbreak flared in Wuhan, China, COVID-19 cases have been continuously rising all over the world. Due to the emergence of SARS-CoV-2 mutants, subsequent waves are flowing in a faster manner as compared to the primary wave, which is more contagious and causing higher mortality. Recently, India has emerged as the new epicenter of the second wave by mutants of SARS-CoV-2. After almost eighteen months of this outbreak, some COVID-19 dedicated therapeutics and vaccines are available, and a few are under trial, but the situation is still uncontrolled. AREA COVERED This perspective article covers the repurposing of childhood vaccines like Bacille Calmette-Guerin (BCG), Measles, Mumps, Rubella (MMR), and Oral Polio Vaccine (OPV), which are live attenuated vaccines and have been shown the protective effect through 'trained immunity and 'crossreactivity.' EXPERT OPINION This perspective article has suggested that combinatorial use of these childhood vaccines might exert a better protective effect along with the available COVID-19 therapeutic and vaccines which could be considered as a preventive option against SARS-CoV-2 infection as well as its subsequent waves.
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Affiliation(s)
- Divakar Sharma
- Hericure Healthcare Pvt Ltd, Pune, India.,Present affiliation: Department of Microbiology, Maulana Azad Medical College, New Delhi, India
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92
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Magadán S, Mikelez-Alonso I, Borrego F, González-Fernández Á. Nanoparticles and trained immunity: Glimpse into the future. Adv Drug Deliv Rev 2021; 175:113821. [PMID: 34087325 DOI: 10.1016/j.addr.2021.05.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 12/17/2022]
Abstract
Emerging evidences show that innate immune cells can display changes in their functional programs after infection or vaccination, which lead to immunomodulation (increased or reduced responsiveness) upon secondary activation to the same stimuli or even to a different one. Innate cells acquire features of immunological memory, nowadays using the new term of "trained immunity" or "innate immune memory", which is different from the specific memory immune response elicited by B and T lymphocytes. The review focused on the concept of trained immunity, mostly on myeloid cells. Special attention is dedicated to the pathogen recognition along the evolution (bacteria, plants, invertebrate and vertebrate animals), and to techniques used to study epigenetic reprogramming and metabolic rewiring. Nanomaterials can be recognized by immune cells offering a very promising way to learn about trained immunity. Nanomaterials could be modified in order to immunomodulate the responses ad hoc. Many therapeutic possibilities are opened, and they should be explored.
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93
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McNair D, Hu H, Selwyn C. Looking in the medicine cabinet: methods for using real-world data to assess the impact of measles, mumps and rubella (MMR) and recombinant adjuvanted varicella-zoster vaccines on coronavirus disease 2019 (COVID-19) prevention and case fatality. Gates Open Res 2021. [DOI: 10.12688/gatesopenres.13329.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Analysis of real-world data can be used to identify promising leads and dead ends among products being repurposed for clinical practice for coronavirus disease 2019 (COVID-19). This paper uses real-world data from Cerner Labs collected from 90 source institutions in the United States to assess the potential impact of two viral vaccines on COVID-19 case fatality rates. Methods: We identified 373,032 polymerase chase reaction (PCR)-positive COVID-19 cases in the Cerner Labs database between 01-MAR-2020 and 31-DEC-2020 and identified patients that had received measles, mumps and rubella (MMR) or a recombinant adjuvanted varicella-zoster vaccine within the previous 5 years. We calculated heterogeneity scores to support interpretation of results across institutions, and used stepwise forward variable selection to construct covariable-based propensity scores. These scores were used to match cases and control for biasing and confounding issues inherent in observational data. Results: Neither the recombinant adjuvanted varicella-zoster vaccine nor MMR showed significant efficacy in prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We could not derive clinically significant results on the impact of MMR for case fatality rates due to persistently high rates of heterogeneity between institutions. However, we were able to achieve acceptable levels of heterogeneity for the analysis of the recombinant adjuvanted varicella-zoster vaccine, and found a clinically meaningful benefit of reduced case fatality rate, with an odds ratio of 0.43 (95% confidence interval [CI]: 0.38 – 0.48). Conclusions: Using propensity score matching and heterogeneity statistics can help guide our interpretation of real-world data, and rigorous statistical methods are needed to reduce bias or disparities in data interpretation. Applying these methods to the impact of viral vaccines on COVID-19 case fatalities yields actionable findings for further analysis.
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Yang YL, Kuo HC. Public Health Interventions for COVID-19 Reduce Kawasaki Disease in Taiwan. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8080623. [PMID: 34438515 PMCID: PMC8392252 DOI: 10.3390/children8080623] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/10/2021] [Accepted: 07/22/2021] [Indexed: 12/20/2022]
Abstract
Background: Kawasaki disease (KD) is a syndrome of unknown cause that results in high fever and coronary vasculitis in children. The incidence of KD increased in Taiwan over the past few decades. Taiwanese government executed domains of early screening, effective methods for isolation or quarantine, and digital technologies for identifying potential cases for the early elimination strategy for coronavirus disease 2019 (COVID-19) and public health interventions for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 pandemic, leading to an effective reduction of the risk of airway infections in children. The purpose of this study is to analyze whether those public health interventions reduce the incidence of KD in 2020. Methods: Patients with KD who visited Chang Gung Memorial Hospital (CGMH) between 1 January, 2018, and 31 December, 2020 were included for trend analysis. This is a retrospective case series study conducted at the CGMH, which consists of a network of seven hospital branches equipped with more than 10,000 beds in different areas of Taiwan. Results: Compared with the 2018 and 2019 databases, the incidence of KD decreased significantly by 30% and 31%, respectively (p < 0.05) in 2020, when public health interventions were comprehensively implemented in Taiwan. This result shows that the incidence of KD decreased during the COVID-19 pandemic in Taiwan without change of the presentation KD (typical or incomplete) and percentage of IVIG resistance in 2020. Conclusion: As public health interventions were carried out for the SARS-CoV-2 pandemic, the incidence of KD was significantly reduced in Taiwan. Is KD a preventable disease?
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Affiliation(s)
- Ya-Ling Yang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: ; Tel.: +886-7731-7123 (ext. 8320)
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95
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Sarangi MK, Padhi S, Dheeman S, Karn SK, Patel LD, Yi DK, Nanda SS. Diagnosis, prevention, and treatment of coronavirus disease: a review. Expert Rev Anti Infect Ther 2021; 20:243-266. [PMID: 34151679 DOI: 10.1080/14787210.2021.1944103] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Coronavirus disease (COVID-19) was first reported in Wuhan, China, in late December 2019 and subsequently, declared a pandemic. As of 3 June 2021, 172,493,290 individuals have acquired COVID-19 and 3,708,334 patients have died worldwide, according to the World Health Organization.Areas covered: This review explores epidemiology; virology; pathogenesis; genomic variations; mode of transmission; clinical occurrence; diagnosis; and treatment with antiviral agents, antibiotics, and supportive therapies. It covers a nanotechnology-based treatment approach and emphasizes the importance of herbal and marine antiviral drugs. The review attempts to explain current advances in research, prevention, and control of COVID-19 spread through artificial intelligence and vaccine development status under cosmopolitan consideration.Expert opinion: While COVID-19 research is advancing at full capacity, the discovery of drugs or vaccines that can fight the pandemic is necessary. Human survival in such a critical situation will be possible only with the development of strong immunity by opting for exercise, yoga, and consumption of hygienic food and beverages. Therefore, education about COVID-19 lethality and its impact on livelihood is important. The pandemic has also shown positive effects on the environment, such as a significant reduction in environmental pollution and global warming and improvement in river water quality.
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Affiliation(s)
- Manoj Kumar Sarangi
- Department of Pharmaceutics, School of Pharmaceutical Sciences & Technology, Sardar Bhagwan Singh University, Balawala, Dehradun, Uttarakhand, India
| | - Sasmita Padhi
- Department of Pharmaceutics, School of Pharmaceutical Sciences & Technology, Sardar Bhagwan Singh University, Balawala, Dehradun, Uttarakhand, India
| | - Shrivardhan Dheeman
- Department of Microbiology, School of Life Sciences, Sardar Bhagwan Singh University, Balawala, Dehradun, Uttarakhand, India
| | - Santosh Kumar Karn
- Department of Biotechnology and Biochemistry, School of Life Sciences, Sardar Bhagwan Singh University, Balawala, Dehradun, Uttarakhand, India
| | - L D Patel
- Department of Pharmacy, Sharda School of Pharmacy, Ahmedabad, Gujarat, India
| | - Dong Kee Yi
- Department of Chemistry, Myongji University, Yongin, South Korea
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96
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Bath PM, Coleman CM, Gordon AL, Lim WS, Webb AJ. Nitric oxide for the prevention and treatment of viral, bacterial, protozoal and fungal infections. F1000Res 2021; 10:536. [PMID: 35685687 PMCID: PMC9171293 DOI: 10.12688/f1000research.51270.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/15/2021] [Indexed: 12/15/2022] Open
Abstract
Although the antimicrobial potential of nitric oxide (NO) is widely published, it is little used clinically. NO is a key signalling molecule modulating vascular, neuronal, inflammatory and immune responses. Endogenous antimicrobial activity is largely mediated by high local NO concentrations produced by cellular inducible nitric oxide synthase, and by derivative reactive nitrogen oxide species including peroxynitrite and S-nitrosothiols. NO may be taken as dietary substrate (inorganic nitrate, L-arginine), and therapeutically as gaseous NO, and transdermal, sublingual, oral, intranasal and intravenous nitrite or nitrate. Numerous preclinical studies have demonstrated that NO has generic static and cidal activities against viruses (including β-coronaviruses such as SARS-CoV-2), bacteria, protozoa and fungi/yeasts in vitro. Therapeutic effects have been seen in animal models in vivo, and phase II trials have demonstrated that NO donors can reduce microbial infection. Nevertheless, excess NO, as occurs in septic shock, is associated with increased morbidity and mortality. In view of the dose-dependent positive and negative effects of NO, safety and efficacy trials of NO and its donors are needed for assessing their role in the prevention and treatment of infections. Trials should test dietary inorganic nitrate for pre- or post-exposure prophylaxis and gaseous NO or oral, topical or intravenous nitrite and nitrate for treatment of mild-to-severe infections, including due to SARS-CoV-2 (COVID-19). This review summarises the evidence base from in vitro, in vivo and early phase clinical studies of NO activity in viral, bacterial, protozoal and fungal infections.
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Affiliation(s)
- Philip M Bath
- Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, Notts, NG7 2UH, UK
- Stroke, Nottingham University Hospitals NHS Trust, Nottingham, Notts, NG7 2UH, UK
| | - Christopher M Coleman
- Division of Infection, Immunity and Microbes, School of Life Sciences, University of Nottingham, Nottingham, Notts, NG7 2UH, UK
| | - Adam L Gordon
- Unit of Injury, Inflammation and Recovery Sciences, University of Nottingham, Derby, Derbyshire, DE22 3NE, UK
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Nottingham, Notts, UK
| | - Wei Shen Lim
- Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
| | - Andrew J Webb
- Clinical Pharmacology, School of Cardiovascular Medicine & Sciences, Kings College London British Heart Foundation Centre of Research Excellence, St Thomas' Hospital, London, SE1 7EH, UK
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97
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Bath PM, Coleman CM, Gordon AL, Lim WS, Webb AJ. Nitric oxide for the prevention and treatment of viral, bacterial, protozoal and fungal infections. F1000Res 2021; 10:536. [PMID: 35685687 PMCID: PMC9171293 DOI: 10.12688/f1000research.51270.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/18/2023] Open
Abstract
Although the antimicrobial potential of nitric oxide (NO) is widely published, it is little used clinically. NO is a key signalling molecule modulating vascular, neuronal, inflammatory and immune responses. Endogenous antimicrobial activity is largely mediated by high local NO concentrations produced by cellular inducible nitric oxide synthase, and by derivative reactive nitrogen oxide species including peroxynitrite and S-nitrosothiols. NO may be taken as dietary substrate (inorganic nitrate, L-arginine), and therapeutically as gaseous NO, and transdermal, sublingual, oral, intranasal and intravenous nitrite or nitrate. Numerous preclinical studies have demonstrated that NO has generic static and cidal activities against viruses (including β-coronaviruses such as SARS-CoV-2), bacteria, protozoa and fungi/yeasts in vitro. Therapeutic effects have been seen in animal models in vivo, and phase II trials have demonstrated that NO donors can reduce microbial infection. Nevertheless, excess NO, as occurs in septic shock, is associated with increased morbidity and mortality. In view of the dose-dependent positive and negative effects of NO, safety and efficacy trials of NO and its donors are needed for assessing their role in the prevention and treatment of infections. Trials should test dietary inorganic nitrate for pre- or post-exposure prophylaxis and gaseous NO or oral, topical or intravenous nitrite and nitrate for treatment of mild-to-severe infections, including due to SARS-CoV-2 (COVID-19). This review summarises the evidence base from in vitro, in vivo and early phase clinical studies of NO activity in viral, bacterial, protozoal and fungal infections.
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Affiliation(s)
- Philip M. Bath
- Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, Notts, NG7 2UH, UK
- Stroke, Nottingham University Hospitals NHS Trust, Nottingham, Notts, NG7 2UH, UK
| | - Christopher M. Coleman
- Division of Infection, Immunity and Microbes, School of Life Sciences, University of Nottingham, Nottingham, Notts, NG7 2UH, UK
| | - Adam L. Gordon
- Unit of Injury, Inflammation and Recovery Sciences, University of Nottingham, Derby, Derbyshire, DE22 3NE, UK
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Nottingham, Notts, UK
| | - Wei Shen Lim
- Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
| | - Andrew J. Webb
- Clinical Pharmacology, School of Cardiovascular Medicine & Sciences, Kings College London British Heart Foundation Centre of Research Excellence, St Thomas' Hospital, London, SE1 7EH, UK
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98
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Chauhan NK, Shadrach BJ, Garg MK, Bhatia P, Bhardwaj P, Gupta MK, Dutt N, Jalandra RN, Garg P, Nag VL, Sharma P, Bohra GK, Kumar D, Elhence PA, Banerjee M, Mathur D, Purohit AH, Gadepalli R, Sureka B, Misra S. Predictors of Clinical Outcomes in Adult COVID-19 Patients Admitted to a Tertiary Care Hospital in India: an analytical cross-sectional study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021024. [PMID: 34212921 PMCID: PMC8343753 DOI: 10.23750/abm.v92i3.10630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/08/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND The outbreak ofsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted inexponential rise in the number of patients getting hospitalised with corona virus disease 2019 (COVID-19). There is a paucity of data from South East Asian Region related to the predictors of clinical outcomes in these patients. This formed the basis of conducting our study. METHODS This was an analytical cross-sectional study. Demographic, clinical, radiological and laboratory data of 125 patients was collected on admission. The study outcome was death or discharge after recovery. For univariate analysis, unpaired t-test, Chi-square and Fisher's Exact test were used. Receiver operating characteristic (ROC) curves were plotted for Sequential Organ Failure Assessment (SOFA) score and few laboratory parameters. Logistic regression was applied for multivariate analysis. RESULTS Elderly age, ischemic heart disease and smoking were significantly associated with mortality. Elevated levels of D-dimer and lactate dehydrogenase (LDH) and reduced lymphocyte counts were the predictors of mortality. The ROCs for SOFA score curve showed a cut-off value ≥ 3.5 (sensitivity- 91.7% and specificity- 87.5%), for IL-6 the cut-off value was ≥ 37.9 (sensitivity- 96% and specificity- 78%) and for lymphocyte counts, a cut off was calculated to be less than and equal to 1.46 x 109per litre (sensitivity-75.2%and specificity- 83.3%). CONCLUSION Old age, smoking history, ischemic heart disease and laboratory parameters including elevated D-dimer, raised LDH and low lymphocyte counts at baseline are associated with COVID-19 mortality. A higher SOFA score at admission is a poor prognosticator in COVID-19 patients.
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Affiliation(s)
| | - Benhur Joel Shadrach
- Department of Pulmonary Medicine,All India Institute of Medical Sciences, Jodhpur.
| | - Mahendra Kumar Garg
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur.
| | - Pradeep Bhatia
- Department of Anaesthesiology and Critical care, All India Institute of Medical Sciences, Jodhpur.
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur.
| | - Manoj Kumar Gupta
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur.
| | - Naveen Dutt
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur.
| | - Ram Niwas Jalandra
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur.
| | - Pawan Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur.
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur.
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur.
| | - Gopal Krishna Bohra
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur.
| | - Deepak Kumar
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur.
| | | | - Mithu Banerjee
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur.
| | - Deepti Mathur
- Research assistant, All India Institute of Medical Sciences, Jodhpur.
| | | | | | - Binit Sureka
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur.
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur.
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99
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van Eijk LE, Binkhorst M, Bourgonje AR, Offringa AK, Mulder DJ, Bos EM, Kolundzic N, Abdulle AE, van der Voort PHJ, Olde Rikkert MGM, van der Hoeven JG, den Dunnen WFA, Hillebrands J, van Goor H. COVID-19: immunopathology, pathophysiological mechanisms, and treatment options. J Pathol 2021; 254:307-331. [PMID: 33586189 PMCID: PMC8013908 DOI: 10.1002/path.5642] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread globally despite the worldwide implementation of preventive measures to combat the disease. Although most COVID-19 cases are characterised by a mild, self-limiting disease course, a considerable subset of patients develop a more severe condition, varying from pneumonia and acute respiratory distress syndrome (ARDS) to multi-organ failure (MOF). Progression of COVID-19 is thought to occur as a result of a complex interplay between multiple pathophysiological mechanisms, all of which may orchestrate SARS-CoV-2 infection and contribute to organ-specific tissue damage. In this respect, dissecting currently available knowledge of COVID-19 immunopathogenesis is crucially important, not only to improve our understanding of its pathophysiology but also to fuel the rationale of both novel and repurposed treatment modalities. Various immune-mediated pathways during SARS-CoV-2 infection are relevant in this context, which relate to innate immunity, adaptive immunity, and autoimmunity. Pathological findings in tissue specimens of patients with COVID-19 provide valuable information with regard to our understanding of pathophysiology as well as the development of evidence-based treatment regimens. This review provides an updated overview of the main pathological changes observed in COVID-19 within the most commonly affected organ systems, with special emphasis on immunopathology. Current management strategies for COVID-19 include supportive care and the use of repurposed or symptomatic drugs, such as dexamethasone, remdesivir, and anticoagulants. Ultimately, prevention is key to combat COVID-19, and this requires appropriate measures to attenuate its spread and, above all, the development and implementation of effective vaccines. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Larissa E van Eijk
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Mathijs Binkhorst
- Department of Paediatrics, Subdivision of NeonatologyRadboud University Medical Center Amalia Children's HospitalNijmegenThe Netherlands
| | - Arno R Bourgonje
- Department of Gastroenterology and Hepatology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Annette K Offringa
- Microbiology and System BiologyNetherlands Organisation for Applied Scientific ResearchZeistThe Netherlands
| | - Douwe J Mulder
- Department of Internal Medicine, Division of Vascular Medicine, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Eelke M Bos
- Department of NeurosurgeryErasmus University Medical CenterRotterdamThe Netherlands
| | - Nikola Kolundzic
- Stem Cell Laboratory, Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Assisted Conception Unit, Guy's HospitalLondonUK
| | - Amaal E Abdulle
- Department of Internal Medicine, Division of Vascular Medicine, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Peter HJ van der Voort
- Department of Critical Care, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Marcel GM Olde Rikkert
- Department of Geriatric MedicineRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Wilfred FA den Dunnen
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Jan‐Luuk Hillebrands
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, Division of Pathology, University of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
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100
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Chiu WT, Scholl J, Li YCJ, Wu J. So Few COVID-19 Cases in Taiwan: Has Population Immune Health Played a Role? Front Public Health 2021; 9:676750. [PMID: 34195171 PMCID: PMC8236524 DOI: 10.3389/fpubh.2021.676750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wen-Ta Chiu
- AHMC Health System, Alhambra, CA, United States
| | | | - Yu-Chuan Jack Li
- College of Medical Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
- International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jonathan Wu
- AHMC Health System, Alhambra, CA, United States
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