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Logette E, Lorin C, Favreau C, Oshurko E, Coggan JS, Casalegno F, Sy MF, Monney C, Bertschy M, Delattre E, Fonta PA, Krepl J, Schmidt S, Keller D, Kerrien S, Scantamburlo E, Kaufmann AK, Markram H. A Machine-Generated View of the Role of Blood Glucose Levels in the Severity of COVID-19. Front Public Health 2021; 9:695139. [PMID: 34395368 PMCID: PMC8356061 DOI: 10.3389/fpubh.2021.695139] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 started spreading toward the end of 2019 causing COVID-19, a disease that reached pandemic proportions among the human population within months. The reasons for the spectrum of differences in the severity of the disease across the population, and in particular why the disease affects more severely the aging population and those with specific preconditions are unclear. We developed machine learning models to mine 240,000 scientific articles openly accessible in the CORD-19 database, and constructed knowledge graphs to synthesize the extracted information and navigate the collective knowledge in an attempt to search for a potential common underlying reason for disease severity. The machine-driven framework we developed repeatedly pointed to elevated blood glucose as a key facilitator in the progression of COVID-19. Indeed, when we systematically retraced the steps of the SARS-CoV-2 infection, we found evidence linking elevated glucose to each major step of the life-cycle of the virus, progression of the disease, and presentation of symptoms. Specifically, elevations of glucose provide ideal conditions for the virus to evade and weaken the first level of the immune defense system in the lungs, gain access to deep alveolar cells, bind to the ACE2 receptor and enter the pulmonary cells, accelerate replication of the virus within cells increasing cell death and inducing an pulmonary inflammatory response, which overwhelms an already weakened innate immune system to trigger an avalanche of systemic infections, inflammation and cell damage, a cytokine storm and thrombotic events. We tested the feasibility of the hypothesis by manually reviewing the literature referenced by the machine-generated synthesis, reconstructing atomistically the virus at the surface of the pulmonary airways, and performing quantitative computational modeling of the effects of glucose levels on the infection process. We conclude that elevation in glucose levels can facilitate the progression of the disease through multiple mechanisms and can explain much of the differences in disease severity seen across the population. The study provides diagnostic considerations, new areas of research and potential treatments, and cautions on treatment strategies and critical care conditions that induce elevations in blood glucose levels.
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Affiliation(s)
- Emmanuelle Logette
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Henry Markram
- Blue Brain Project, École polytechnique fédérale de Lausanne (EPFL), Geneva, Switzerland
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52
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Qin W, Chen S, Zhang Y, Dong F, Zhang Z, Hu B, Zhu Z, Li F, Wang X, Wang Y, Zhen K, Wang J, Wan Y, Li H, Elalamy I, Li C, Zhai Z, Wang C. Diffusion capacity abnormalities for carbon monoxide in patients with COVID-19 at 3-month follow-up. Eur Respir J 2021; 58:13993003.03677-2020. [PMID: 33574077 PMCID: PMC7877322 DOI: 10.1183/13993003.03677-2020] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/15/2020] [Indexed: 12/22/2022]
Abstract
Objective To evaluate pulmonary function and clinical symptoms in coronavirus disease 2019 (COVID-19) survivors within 3 months after hospital discharge, and to identify risk factors associated with impaired lung function. Methods and material COVID-19 patients were prospectively followed-up with pulmonary function tests and clinical characteristics for 3 months following discharge from a hospital in Wuhan, China between January and February 2020. Results 647 patients were included. 87 (13%) patients presented with weakness, 63 (10%) with palpitations and 56 (9%) with dyspnoea. The prevalence of each of the three symptoms were markedly higher in severe patients than nonsevere patients (19% versus 10% for weakness, p=0.003; 14% versus 7% for palpitations, p=0.007; 12% versus 7% for dyspnoea, p=0.014). Results of multivariable regression showed increased odds of ongoing symptoms among severe patients (OR 1.7, 95% CI 1.1–2.6; p=0.026) or patients with longer hospital stays (OR 1.03, 95% CI 1.00–1.05; p=0.041). Pulmonary function test results were available for 81 patients, including 41 nonsevere and 40 severe patients. In this subgroup, 44 (54%) patients manifested abnormal diffusing capacity of the lung for carbon monoxide (DLCO) (68% severe versus 42% nonsevere patients, p=0.019). Chest computed tomography (CT) total severity score >10.5 (OR 10.4, 95% CI 2.5–44.1; p=0.001) on admission and acute respiratory distress syndrome (ARDS) (OR 4.6, 95% CI 1.4–15.5; p=0.014) were significantly associated with impaired DLCO. Pulmonary interstitial damage may be associated with abnormal DLCO. Conclusion Pulmonary function, particularly DLCO, declined in COVID-19 survivors. This decrease was associated with total severity score of chest CT >10.5 and ARDS occurrence. Pulmonary interstitial damage might contribute to the imparied DLCO. COVID-19 patients present with impaired DLCO at 90 days after discharge, particularly severe patients. Chest CT TSS >10.5 and ARDS occurrence are associated with impaired DLCO. Pulmonary interstitial damage may contribute to the impaired DLCO.https://bit.ly/2JevUtm
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Affiliation(s)
- Wei Qin
- Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China.,These authors contributed equally as co-first authors
| | - Shi Chen
- Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China.,These authors contributed equally as co-first authors
| | - Yunxia Zhang
- Dept of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,These authors contributed equally as co-first authors
| | - Fen Dong
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China.,These authors contributed equally as co-first authors
| | - Zhu Zhang
- Dept of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,These authors contributed equally as co-first authors
| | - Bingzhu Hu
- Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China
| | - Ziyang Zhu
- Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China
| | - Fajiu Li
- Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China
| | - Xiaojiang Wang
- Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China
| | - Yimin Wang
- Dept of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Kaiyuan Zhen
- Dept of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China
| | - Jing Wang
- Institute of Basic Research, Chinese Academy of Medical Sciences, Beijing, China
| | - YuLei Wan
- Dept of Radiology, Affiliated Hospital of Jianghan University, Wuhan, China
| | - Hongbo Li
- Dept of Radiology, Affiliated Hospital of Jianghan University, Wuhan, China
| | - Ismaïl Elalamy
- Hematology and Thrombosis Center, Tenon University Hospital, INSERM UMRS 938, Sorbonne University, Paris, France.,The First I.M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Chenghong Li
- Dept of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China.,These authors contributed equally to this article as lead authors and supervised the work
| | - Zhenguo Zhai
- Dept of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China .,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,These authors contributed equally to this article as lead authors and supervised the work
| | - Chen Wang
- Dept of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,National Clinical Research Center for Respiratory Diseases, Beijing, China.,Peking Union Medical College, Chinese, Academy of Medical Sciences, Beijing, China
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53
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John AE, Joseph C, Jenkins G, Tatler AL. COVID-19 and pulmonary fibrosis: A potential role for lung epithelial cells and fibroblasts. Immunol Rev 2021; 302:228-240. [PMID: 34028807 PMCID: PMC8237078 DOI: 10.1111/imr.12977] [Citation(s) in RCA: 111] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic rapidly spread around the world following the first reports in Wuhan City, China in late 2019. The disease, caused by the novel SARS-CoV-2 virus, is primarily a respiratory condition that can affect numerous other bodily systems including the cardiovascular and gastrointestinal systems. The disease ranges in severity from asymptomatic through to severe acute respiratory distress requiring intensive care treatment and mechanical ventilation, which can lead to respiratory failure and death. It has rapidly become evident that COVID-19 patients can develop features of interstitial pulmonary fibrosis, which in many cases persist for as long as we have thus far been able to follow the patients. Many questions remain about how such fibrotic changes occur within the lung of COVID-19 patients, whether the changes will persist long term or are capable of resolving, and whether post-COVID-19 pulmonary fibrosis has the potential to become progressive, as in other fibrotic lung diseases. This review brings together our existing knowledge on both COVID-19 and pulmonary fibrosis, with a particular focus on lung epithelial cells and fibroblasts, in order to discuss common pathways and processes that may be implicated as we try to answer these important questions in the months and years to come.
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Affiliation(s)
- Alison E. John
- Nottingham NIHR Respiratory Biomedical Research CentreUniversity of NottinghamNottinghamUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Chitra Joseph
- Nottingham NIHR Respiratory Biomedical Research CentreUniversity of NottinghamNottinghamUK
| | - Gisli Jenkins
- Nottingham NIHR Respiratory Biomedical Research CentreUniversity of NottinghamNottinghamUK
- National Heart and Lung InstituteImperial CollegeLondonUK
| | - Amanda L. Tatler
- Nottingham NIHR Respiratory Biomedical Research CentreUniversity of NottinghamNottinghamUK
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54
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Postinfectious Interstitial Pneumonia After COVID-19 Infection. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021; 29:e193-e194. [PMID: 34191908 PMCID: PMC8115427 DOI: 10.1097/ipc.0000000000000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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55
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Hsieh JYC, Chin TT. An emerging entity after pandemic: Post-coronavirus disease 2019 syndrome and associated medical complications. SAGE Open Med 2021; 9:20503121211023631. [PMID: 34178339 PMCID: PMC8202311 DOI: 10.1177/20503121211023631] [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: 12/06/2020] [Accepted: 03/08/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 is a devastating illness that has infected millions of people since the beginning of year 2020, through its multi-systemic manifestations that range widely in severity. Because current knowledge on the types and severities of medical illnesses encountered by patients who recovered from coronavirus disease 2019 is limited, it remains unknown whether these illnesses are direct sequelae of coronavirus disease 2019 infection or unrelated coincidences. In this article, we summarize the evidence currently available on post-coronavirus disease 2019 medical complications and propose directions for studying the long-term complications of coronavirus disease 2019 in the future.
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Affiliation(s)
| | - Tan Tze Chin
- Department of Internal Medicine, Singapore General Hospital, Singapore
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56
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Taylor RR, Trivedi B, Patel N, Singh R, Ricketts WM, Elliott K, Yarwood M, White V, Hylton H, Allen R, Thomas G, Kapil V, McGuckin R, Pfeffer PE. Post-COVID symptoms reported at asynchronous virtual review and stratified follow-up after COVID-19 pneumonia. Clin Med (Lond) 2021; 21:e384-e391. [PMID: 34103378 DOI: 10.7861/clinmed.2021-0037] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The COVID-19 pandemic has strained healthcare systems and how best to address post-COVID health needs is uncertain. Here we describe the post-COVID symptoms of 675 patients followed up using a virtual review pathway, stratified by severity of acute COVID infection. METHODS COVID-19 survivors completed an online/telephone questionnaire of symptoms after 12+ weeks and a chest radiograph. Dependent on findings at virtual review, patients were provided information leaflets, attended for investigations and/or were reviewed face-to-face. Outcomes were compared between patients following high-risk and low-risk admissions for COVID pneumonia, and community referrals. RESULTS Patients reviewed after hospitalisation for COVID pneumonia had a median of two ongoing physical health symptoms post-COVID. The most common was fatigue (50.3% of high-risk patients). Symptom burden did not vary significantly by severity of hospitalised COVID pneumonia but was highest in community referrals. Symptoms suggestive of depression, anxiety and post-traumatic stress disorder were common (depression occurred in 24.9% of high-risk patients). Asynchronous virtual review facilitated triage of patients at highest need of face-to-face review. CONCLUSION Many patients continue to have a significant burden of post-COVID symptoms irrespective of severity of initial pneumonia. How best to assess and manage long COVID will be of major importance over the next few years.
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Affiliation(s)
| | | | | | | | - William M Ricketts
- Barts Health NHS Trust, London, UK, and hon clinical senior lecturer, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | | | | | | | | | | | | | - Vikas Kapil
- Barts Health NHS Trust, London, UK, and clinical senior lecturer, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | | | - Paul E Pfeffer
- Barts Health NHS Trust, London, UK, and hon senior lecturer, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
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57
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Strumiliene E, Zeleckiene I, Bliudzius R, Samuilis A, Zvirblis T, Zablockiene B, Strumila A, Gruslys V, Malinauskiene L, Kasiulevicius V, Jancoriene L. Follow-Up Analysis of Pulmonary Function, Exercise Capacity, Radiological Changes, and Quality of Life Two Months after Recovery from SARS-CoV-2 Pneumonia. ACTA ACUST UNITED AC 2021; 57:medicina57060568. [PMID: 34204878 PMCID: PMC8229364 DOI: 10.3390/medicina57060568] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/25/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
Background and objective: According to the World Health Organization (WHO), more than 100 million people have already recovered from SARS-CoV-2 infection. Therefore, it is imperative to understand the possible outcomes of COVID-19. The aim of our study was to evaluate pulmonary function, exercise capacity, residual radiological changes, and health-related quality of life (HRQoL) at follow-up in a cohort of SARS-CoV-2 pneumonia survivors. Materials and Methods: Patients with SARS-CoV-2 infection and radiologically confirmed lung injury, with no chronic lung disease prior to this infection, were included in the study. Patients’ evaluation 2 months after their discharge from hospital included spirometry (FVC, FEV1, FEV1/FVC), determination of lung volume (TLC, VC, RV) and diffusing capacity of lung for carbon monoxide (DLCO, adjusted for hemoglobin), 6-Minute Walk Test (6MWT), chest CT scan, and 36-Item Short Form General Health Survey (SF-36). Results: Fifty-one patients (25 men, 26 women) were included. The mean age was 56 years (SD-11,72). Eighteen patients (35.3%) had experienced moderate COVID-19, 21 (41.2%) severe COVID-19, and 12 (23.5%) were critically ill. The mean follow-up visit time after the discharge from hospital was 60 days (SD-17). Pulmonary function at follow-up was impaired in 24 (47.2%) patients. Reduced lung volume was observed in 15 (29.4%) patients, DLCO reduction in 15 (29.4%) patients, and only one patient displayed obstruction. Twelve patients out of 51 (12/51, 27.3%) showed reduced physical capacity in the 6 MWT, and 3/51 (9.1%) showed desaturation, with SO2 < 90%. Different levels of abnormality were found in 49/51 (96,1%) patients on follow-up chest CT; the median radiological score was 10.9 (SD ± 8.87, possible maximal score, 25). Ground-glass opacity was the most common radiological feature, found in 45 (88.2%) patients. The SF-36 scores demonstrated a reduction in health status across all domains, with the lowest scores for limitations in social activities because of physical problems, vitality, and general health. Conclusion: In the group of COVID-19 pneumonia survivors 2 months after hospital discharge, residual changes in the lungs on chest CT and in lung function and reduced physical and HRQoL status were found in a significant number of patients. To evaluate COVID-19 long-term consequences, a longer follow-up period is needed.
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Affiliation(s)
- Edita Strumiliene
- Department of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania; (V.G.); (L.M.)
- Correspondence:
| | - Ingrida Zeleckiene
- Centre of Radiology and Nuclear Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania; (I.Z.); (R.B.); (A.S.)
| | - Rytis Bliudzius
- Centre of Radiology and Nuclear Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania; (I.Z.); (R.B.); (A.S.)
| | - Arturas Samuilis
- Centre of Radiology and Nuclear Medicine, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania; (I.Z.); (R.B.); (A.S.)
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio 21/27, LT-03101 Vilnius, Lithuania; (B.Z.); (A.S.); (V.K.); (L.J.)
| | - Tadas Zvirblis
- Institute of Mechanical Science, Vilnius Gediminas Technical University, Sauletekio al. 11, LT-10223 Vilnius, Lithuania;
| | - Birute Zablockiene
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio 21/27, LT-03101 Vilnius, Lithuania; (B.Z.); (A.S.); (V.K.); (L.J.)
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
| | - Arunas Strumila
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio 21/27, LT-03101 Vilnius, Lithuania; (B.Z.); (A.S.); (V.K.); (L.J.)
- Department of Pediatric Surgery, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
| | - Vygantas Gruslys
- Department of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania; (V.G.); (L.M.)
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio 21/27, LT-03101 Vilnius, Lithuania; (B.Z.); (A.S.); (V.K.); (L.J.)
| | - Laura Malinauskiene
- Department of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania; (V.G.); (L.M.)
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio 21/27, LT-03101 Vilnius, Lithuania; (B.Z.); (A.S.); (V.K.); (L.J.)
| | - Vytautas Kasiulevicius
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio 21/27, LT-03101 Vilnius, Lithuania; (B.Z.); (A.S.); (V.K.); (L.J.)
| | - Ligita Jancoriene
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio 21/27, LT-03101 Vilnius, Lithuania; (B.Z.); (A.S.); (V.K.); (L.J.)
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania
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Kalra RS, Dhanjal JK, Meena AS, Kalel VC, Dahiya S, Singh B, Dewanjee S, Kandimalla R. COVID-19, Neuropathology, and Aging: SARS-CoV-2 Neurological Infection, Mechanism, and Associated Complications. Front Aging Neurosci 2021; 13:662786. [PMID: 34149397 PMCID: PMC8209245 DOI: 10.3389/fnagi.2021.662786] [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: 02/01/2021] [Accepted: 05/05/2021] [Indexed: 01/08/2023] Open
Abstract
The spectrum of health complications instigated by coronavirus disease 2019 (COVID-19, caused by the novel severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2) pandemic has been diverse and complex. Besides the evident pulmonary and cardiovascular threats, accumulating clinical data points to several neurological complications, which are more common in elderly COVID-19 patients. Recent pieces of evidence have marked events of neuro infection and neuroinvasion, producing several neurological complications in COVID-19 patients; however, a systematic understanding of neuro-pathophysiology and manifested neurological complications, more specifically in elderly COVID-19 patients is largely elusive. Since the elderly population gradually develops neurological disorders with aging, COVID-19 inevitably poses a higher risk of neurological manifestations to the aged patients. In this report, we reviewed SARS-CoV-2 infection and its role in neurological manifestations with an emphasis on the elderly population. We reviewed neuropathological events including neuroinfection, neuroinvasion, and their underlying mechanisms affecting neuromuscular, central- and peripheral- nervous systems. We further assessed the imminent neurological challenges in the COVID-19 exposed population, post-SARS-CoV-2-infection. Given the present state of clinical preparedness, the emerging role of AI and machine learning was also discussed concerning COVID-19 diagnostics and its management. Taken together, the present review summarizes neurological outcomes of SARS-CoV-2 infection and associated complications, specifically in elderly patients, and underlines the need for their clinical management in advance.
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Affiliation(s)
- Rajkumar Singh Kalra
- AIST-INDIA DAILAB, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Jaspreet Kaur Dhanjal
- Department of Computational Biology, Indraprastha Institute of Information Technology Delhi, Okhla Industrial Estate, New Delhi, India
| | - Avtar Singh Meena
- CSIR-Centre for Cellular and Molecular Biology (CCMB), Hyderabad, India
| | - Vishal C. Kalel
- Department of Systems Biochemistry, Institute of Biochemistry and Pathobiochemistry, Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Surya Dahiya
- Conservative Dentistry and Endodontics, Maharishi Markandeshwar College of Dental Sciences and Research, Ambala, India
| | - Birbal Singh
- ICAR-Indian Veterinary Research Institute (IVRI), Regional Station, Palampur, India
| | - Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata, India
| | - Ramesh Kandimalla
- Applied Biology, CSIR-Indian Institute of Chemical Technology (IICT), Hyderabad, India
- Department of Biochemistry, Kakatiya Medical College, Warangal, India
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59
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Iqbal FM, Lam K, Sounderajah V, Clarke JM, Ashrafian H, Darzi A. Characteristics and predictors of acute and chronic post-COVID syndrome: A systematic review and meta-analysis. EClinicalMedicine 2021; 36:100899. [PMID: 34036253 PMCID: PMC8141371 DOI: 10.1016/j.eclinm.2021.100899] [Citation(s) in RCA: 189] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A significant proportion of individuals experience lingering and debilitating symptoms following acute COVID-19 infection. The National Institute for Health and Care Excellence (NICE) have coined the persistent cluster of symptoms as post-COVID syndrome. This has been further sub-categorised into acute post-COVID syndrome for symptoms persisting three weeks beyond initial infection and chronic post-COVID syndrome for symptoms persisting beyond twelve weeks. The aim of this review was to detail the prevalence of clinical features and identify potential predictors for acute and chronic post-COVID syndrome. METHODS A systematic literature search, with no language restrictions, was performed to identify studies detailing characteristics and outcomes related to survivorship of post-COVID syndrome. The last search was performed on 6 March 2021 and all pre-dating published articles included. A means of proportion meta-analysis was performed to quantify characteristics of acute and chronic post-COVID syndrome. Study quality was assessed with a specific risk of bias tool. PROSPERO Registration: CRD42020222855. FINDINGS A total of 43 studies met the eligibility criteria; of which, 38 allowed for meta-analysis. Fatigue and dyspnoea were the most prevalent symptoms in acute post-COVID (0·37 and 0·35) and fatigue and sleep disturbance in chronic post-COVID syndrome (0·48 and 0·44), respectively. The available evidence is generally of poor quality, with considerable risk of bias, and are of observational design. INTERPRETATION In conclusion, this review highlights that flaws in data capture and interpretation, noted in the uncertainty within our meta-analysis, affect the applicability of current knowledge. Policy makers and researchers must focus on understanding the impact of this condition on individuals and society with appropriate funding initiatives and global collaborative research.
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Affiliation(s)
- Fahad M Iqbal
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Kyle Lam
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Viknesh Sounderajah
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Jonathan M Clarke
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
- EPSRC Centre for Mathematics of Precision Healthcare, Imperial College London, London SW7 2AZ, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London W2 1NY, UK
- Institute of Global Health Innovation, Faculty Building, South Kensington Campus, Kensington SW7 2AZ, London, UK
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60
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Kiener M, Roldan N, Machahua C, Sengupta A, Geiser T, Guenat OT, Funke-Chambour M, Hobi N, Kruithof-de Julio M. Human-Based Advanced in vitro Approaches to Investigate Lung Fibrosis and Pulmonary Effects of COVID-19. Front Med (Lausanne) 2021; 8:644678. [PMID: 34026781 PMCID: PMC8139419 DOI: 10.3389/fmed.2021.644678] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/01/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused considerable socio-economic burden, which fueled the development of treatment strategies and vaccines at an unprecedented speed. However, our knowledge on disease recovery is sparse and concerns about long-term pulmonary impairments are increasing. Causing a broad spectrum of symptoms, COVID-19 can manifest as acute respiratory distress syndrome (ARDS) in the most severely affected patients. Notably, pulmonary infection with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the causing agent of COVID-19, induces diffuse alveolar damage (DAD) followed by fibrotic remodeling and persistent reduced oxygenation in some patients. It is currently not known whether tissue scaring fully resolves or progresses to interstitial pulmonary fibrosis. The most aggressive form of pulmonary fibrosis is idiopathic pulmonary fibrosis (IPF). IPF is a fatal disease that progressively destroys alveolar architecture by uncontrolled fibroblast proliferation and the deposition of collagen and extracellular matrix (ECM) proteins. It is assumed that micro-injuries to the alveolar epithelium may be induced by inhalation of micro-particles, pathophysiological mechanical stress or viral infections, which can result in abnormal wound healing response. However, the exact underlying causes and molecular mechanisms of lung fibrosis are poorly understood due to the limited availability of clinically relevant models. Recently, the emergence of SARS-CoV-2 with the urgent need to investigate its pathogenesis and address drug options, has led to the broad application of in vivo and in vitro models to study lung diseases. In particular, advanced in vitro models including precision-cut lung slices (PCLS), lung organoids, 3D in vitro tissues and lung-on-chip (LOC) models have been successfully employed for drug screens. In order to gain a deeper understanding of SARS-CoV-2 infection and ultimately alveolar tissue regeneration, it will be crucial to optimize the available models for SARS-CoV-2 infection in multicellular systems that recapitulate tissue regeneration and fibrotic remodeling. Current evidence for SARS-CoV-2 mediated pulmonary fibrosis and a selection of classical and novel lung models will be discussed in this review.
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Affiliation(s)
- Mirjam Kiener
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Urology Research Laboratory, University of Bern, Bern, Switzerland
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Nuria Roldan
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Carlos Machahua
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Arunima Sengupta
- Organs-on-Chip Technologies, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
| | - Thomas Geiser
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olivier Thierry Guenat
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Organs-on-Chip Technologies, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
- Department of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Manuela Funke-Chambour
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nina Hobi
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Marianna Kruithof-de Julio
- Department for BioMedical Research DBMR, Urology Research Laboratory, University of Bern, Bern, Switzerland
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
- Organoid Core, Department for BioMedical Research, University of Bern, Bern, Switzerland
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SAHA AYAN, AHSAN MOHAMMEDMOINUL, QUADER TAREKUL, SHOHAN MOHAMMADUMERSHARIF, NAHER SABEKUN, DUTTA PREYA, AKASH ALSHAHRIAR, MEHEDI HMHAMIDULLAH, CHOWDHURY ASMARMANULLAH, KARIM HASANUL, RAHMAN TAZRINA, PARVIN AYESHA. Characteristics, management and outcomes of critically ill COVID-19 patients admitted to ICU in hospitals in Bangladesh: a retrospective study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E33-E45. [PMID: 34322614 PMCID: PMC8283638 DOI: 10.15167/2421-4248/jpmh2021.62.1.1838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/27/2021] [Indexed: 01/08/2023]
Abstract
Objectives This study aimed to analyze the epidemiological and clinical characteristics of COVID-19 cases and investigate risk factors including comorbidities and age in relation with the clinical aftermath of COVID-19 in ICU admitted cases in Bangladesh. Methods In this retrospective study, epidemiological and clinical characteristics, complications, laboratory results, and clinical management of the patients were studied from data obtained from 168 individuals diagnosed with an advanced prognosis of COVID-19 admitted in two hospitals in Bangladesh. Results Individuals in the study sample contracted COVID-19 through community transmission. 56.5% (n = 95) cases died in intensive care units (ICU) during the study period. The median age was 56 years and 79.2% (n = 134) were male. Typical clinical manifestation included Acute respiratory distress syndrome (ARDS) related complications (79.2%), fever (54.2%) and cough (25.6%) while diabetes mellitus (52.4%), hypertension (41.1%) and heart diseases (16.7%) were the conventional comorbidities. Clinical outcomes were detrimental due to comorbidities rather than age and comorbid individuals over 50 were at more risk. In the sample, oxygen saturation was low (< 95% SpO2) in 135 patients (80.4%) and 158 (93.4%) patients received supplemental oxygen. Identical biochemical parameters were found in both deceased and surviving cases. Administration of antiviral drug Remdesivir and the glucocorticoid, Dexamethasone increased the proportion of surviving patients slightly. Conclusions Susceptibility to developing critical illness due to COVID-19 was found more in comorbid males. These atypical patients require more clinical attention from the prospect of controlling mortality rate in Bangladesh.
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Affiliation(s)
- AYAN SAHA
- Disease Biology and Molecular Epidemiology Research Group, Chattogram, Bangladesh
- Children’s Cancer Institute, Faculty of Medicine, University of New South Wales, Australia
- Correspondence: Ayan Saha, Disease Biology and Molecular Epidemiology Research Group, Chattogram, Bangladesh - E-mail: -
| | | | - TAREK-UL QUADER
- Intensive Care Unit, Chittagong Medical College, Chattogram, Bangladesh
| | | | - SABEKUN NAHER
- Department of Microbiology, University of Chittagong, Chattogram, Bangladesh
| | - PREYA DUTTA
- Disease Biology and Molecular Epidemiology Research Group, Chattogram, Bangladesh
- Department of Pharmacy, BGC Trust University Bangladesh, Chattogram, Bangladesh
| | - AL-SHAHRIAR AKASH
- Department of Genetic Engineering and Biotechnology, University of Chittagong, Chattogram, Bangladesh
| | | | | | - HASANUL KARIM
- Intensive Care Unit, 250 Beded General Hospital, Chattogram, Bangladesh
| | - TAZRINA RAHMAN
- Department of Microbiology and Virology, Chittagong Medical College, Chattogram, Bangladesh
| | - AYESHA PARVIN
- Department of Biochemistry, Chittagong Medical College, Chattogram, Bangladesh
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Goulart CDL, Silva RN, Oliveira MR, Guizilini S, Rocco IS, Mendez VMF, Bonjorno JC, Caruso FR, Arena R, Borghi-Silva A. Lifestyle and rehabilitation during the COVID-19 pandemic: guidance for health professionals and support for exercise and rehabilitation programs. Expert Rev Anti Infect Ther 2021; 19:1385-1396. [PMID: 33852807 DOI: 10.1080/14787210.2021.1917994] [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: 12/16/2022]
Abstract
Introduction: The coronavirus disease-2019 (COVID-19) is a highly contagious respiratory viral disease for both the general population and healthcare professionals caring for infected patients. Of particular concern is the potential for significant respiratory, cardiovascular, physical, and psychological dysfunctions.Areas covered: In this context, the current review will focus on the following areas: 1) staying physically active during the COVID-19 pandemic; 2) highlighting the importance of understanding COVID-19 mechanisms; 3) preventing infections for healthcare workers by using personal protective equipment; 4) highlighting importance of respiratory care and physical therapy during hospitalization in patients with COVID-19; and 5) facilitating referral to a rehabilitation program in patients recovering from COVID-19.Expert opinion: We recommend daily physical exercise, outdoors or at home, as physical exercise increases the synthesis of anti-inflammatory cytokines; Patients with COVID-19 may develop severe acute respiratory syndrome, hypoxemia, diffuse alveolar damage, ACE2 reduction in the cardiovascular system and muscle weakness acquired through a prolonged hospital stay; The role of the physiotherapist in the hospital environment is of fundamental importance-early mobilization is highly recommended in severe cases of COVID-19.
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Affiliation(s)
- Cássia Da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Rebeca Nunes Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Solange Guizilini
- Department of the Human Movement Sciences, Universidade Federal De São Paulo - UNIFESP, Santos, SP, Brazil
| | - Isadora Salvador Rocco
- Department of the Human Movement Sciences, Universidade Federal De São Paulo - UNIFESP, Santos, SP, Brazil
| | | | - José Carlos Bonjorno
- Department of Medicine, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Flavia Rossi Caruso
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL., USA.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Universidade Federal De Sao Carlos, Sao Carlos, SP, Brazil.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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63
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Gianella P, Rigamonti E, Marando M, Tamburello A, Grazioli Gauthier L, Argentieri G, Puligheddu C, Pagnamenta A, Pons M, Fusi-Schmidhauser T. Clinical, radiological and functional outcomes in patients with SARS-CoV-2 pneumonia: a prospective observational study. BMC Pulm Med 2021; 21:136. [PMID: 33902513 PMCID: PMC8072729 DOI: 10.1186/s12890-021-01509-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND All over the world, SARS-CoV-2 pneumonia is causing a significant short-term morbidity and mortality, but the medium-term impact on lung function and quality of life of affected patients are still unknown. METHODS In this prospective observational study, 39 patients with SARS-CoV-2 pneumonia were recruited from a single COVID-19 hospital in Southern Switzerland. At three months patients underwent radiological and functional follow-up through CT scan, lung function tests, and 6 min walking test. Furthermore, quality of life was assessed through self-reported questionnaires. RESULTS Among 39 patients with SARS-CoV-2 pneumonia, 32 (82% of all participants) presented abnormalities in CT scan and 25 (64.1%) had lung function tests impairment at three months. Moreover, 31 patients (79.5%) reported a perception of poor health due to respiratory symptoms and all 39 patients showed an overall decreased quality of life. CONCLUSIONS Medium-term follow up at three months of patients diagnosed with SARS-CoV-2 pneumonia shows the persistence of abnormalities in CT scans, a significant functional impairment assessed by lung function tests and a decreased quality of life in affected patients. Further studies evaluating the long-term impact are warranted to guarantee an appropriate follow-up to patients recovering from SARS-CoV-2 pneumonia.
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Affiliation(s)
- Pietro Gianella
- Department of Internal Medicine, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland
- Division of Pneumology, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Elia Rigamonti
- Department of Internal Medicine, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland
| | - Marco Marando
- Department of Internal Medicine, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland
| | - Adriana Tamburello
- Department of Internal Medicine, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland
| | - Lorenzo Grazioli Gauthier
- Department of Internal Medicine, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland
| | - Gianluca Argentieri
- IIMSI - Radiology Department, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Carla Puligheddu
- IIMSI - Radiology Department, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Alberto Pagnamenta
- Department of Intensive Care, Intensive Care Unit Ospedale Regionale Di Mendrisio, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Unit of Biostatistics, Bellinzona, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Marco Pons
- Department of Internal Medicine, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland
- Division of Pneumology, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Division of Pneumology, University of Geneva, Geneva, Switzerland
| | - Tanja Fusi-Schmidhauser
- Department of Internal Medicine, Ospedale Regionale Di Lugano, Ente Ospedaliero Cantonale, Via Tesserete 46, 6900 Lugano, Switzerland
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Yan Q, Li P, Ye X, Huang X, Feng B, Ji T, Chen Z, Li F, Zhang Y, Luo K, Chen F, Mo X, Wang J, Feng L, Hu F, Lei C, Qu L, Chen L. Longitudinal Peripheral Blood Transcriptional Analysis Reveals Molecular Signatures of Disease Progression in COVID-19 Patients. THE JOURNAL OF IMMUNOLOGY 2021; 206:2146-2159. [PMID: 33846224 DOI: 10.4049/jimmunol.2001325] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/21/2021] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with some patients developing severe illness or even death. Disease severity has been associated with increased levels of proinflammatory cytokines and lymphopenia. To elucidate the atlas of peripheral immune response and pathways that might lead to immunopathology during COVID-19 disease course, we performed a peripheral blood RNA sequencing analysis of the same patient's samples collected from symptom onset to full recovery. We found that PBMCs at different disease stages exhibited unique transcriptome characteristics. We observed that SARS-CoV-2 infection caused excessive release of inflammatory cytokines and lipid mediators as well as an aberrant increase of low-density neutrophils. Further analysis revealed an increased expression of RNA sensors and robust IFN-stimulated genes expression but a repressed type I IFN production. SARS-CoV-2 infection activated T and B cell responses during the early onset but resulted in transient adaptive immunosuppression during severe disease state. Activation of apoptotic pathways and functional exhaustion may contribute to the reduction of lymphocytes and dysfunction of adaptive immunity, whereas increase in IL2, IL7, and IL15 may facilitate the recovery of the number and function of lymphocytes. Our study provides comprehensive transcriptional signatures of peripheral blood response in patients with moderate COVID-19.
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Affiliation(s)
- Qihong Yan
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Pingchao Li
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Xianmiao Ye
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Xiaohan Huang
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Bo Feng
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Tianxing Ji
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Zhilong Chen
- Xiamen Institutes of Respiratory Health, Xiamen, China
| | - Feng Li
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Yudi Zhang
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Kun Luo
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Fengjuan Chen
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Xiaoneng Mo
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Jianhua Wang
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Liqiang Feng
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Fengyu Hu
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Chunliang Lei
- Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
| | - Linbing Qu
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China;
| | - Ling Chen
- State Key Laboratory of Respiratory Disease, Guangdong Laboratory of Computational Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; .,Guangzhou Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China; and
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65
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Burden and prevalence of risk factors for severe COVID-19 in the ageing European population - a SHARE-based analysis. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:2081-2090. [PMID: 33868899 PMCID: PMC8036158 DOI: 10.1007/s10389-021-01537-7] [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: 08/21/2020] [Accepted: 03/30/2021] [Indexed: 01/08/2023]
Abstract
Aim International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aimed to describe the distribution of these risk factors across Europe. Subject and methods Prevalence of risk factors for severe COVID-19 was identified based on interviews from 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results A total of 75.3% of the study population (corresponding to approx. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (approx. 36 million men and 43 million women) had at least two factors, and 21.2% (approx. 17 million men and 20 million women) had at least three risk factors. The prevalence of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions Information about the prevalence of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 and thus to decide appropriate strategies to mitigate the pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-021-01537-7.
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Sansone A, Mollaioli D, Ciocca G, Colonnello E, Limoncin E, Balercia G, Jannini EA. "Mask up to keep it up": Preliminary evidence of the association between erectile dysfunction and COVID-19. Andrology 2021; 9:1053-1059. [PMID: 33742540 PMCID: PMC8250520 DOI: 10.1111/andr.13003] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/08/2021] [Accepted: 03/16/2021] [Indexed: 12/12/2022]
Abstract
Background Erectile dysfunction (ED), as the hallmark of endothelial dysfunction, could be a short‐ or long‐term complication of COVID‐19. Additionally, being ED a clinical marker and predictor of non‐communicable chronic diseases, particularly cardiovascular, subjects with ED could potentially have a higher risk of contracting COVID‐19. Objectives To investigate the prevalence of ED among subjects with a reported diagnosis of COVID‐19 and to measure the association of COVID‐19 and ED. Materials and methods We reviewed data from the Sex@COVID online survey (performed between April 7 and May 4, 2020, in Italy) to retrieve a sample of Italian male sexually active subjects with reported SARS‐CoV‐2 infection. A matching sample of COVID‐19‐negative male sexually active subjects was also retrieved using propensity score matching in a 3:1 ratio. The survey used different standardized psychometric tools to measure effects of lockdown and social distancing on the intrapsychic, relational, and sexual health of Italian subjects. Results One hundred subjects were included in the analysis (25 COVID‐positive; 75 COVID‐negative). The prevalence of ED, measured with the Sexual Health Inventory for Men, was significantly higher in the COVID+ group (28% vs. 9.33%; p = 0.027). Logistic regression models confirmed a significant effect of COVID‐19 on the development of ED, independently of other variables affecting erectile function, such as psychological status, age, and BMI [OR 5.66, 95% CI: 1.50–24.01]. Likewise, subjects with ED were more likely to have COVID‐19, once corrected for age and BMI [OR 5.27, 95% CI: 1.49–20.09]. Discussion and conclusion On top of well‐described pathophysiological mechanisms, there is preliminary evidence in a real‐life population of ED as a risk factor of developing COVID‐19 and possibly occurring as a consequence of COVID‐19. Universal vaccination against the COVID‐19 and the personal protective equipment could possibly have the added benefit of preventing sexual dysfunctions.
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Affiliation(s)
- Andrea Sansone
- Endocrinology and Medical Sexology (ENDOSEX, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Daniele Mollaioli
- Endocrinology and Medical Sexology (ENDOSEX, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, Health Studies "Sapienza" University of Rome, Rome, Italy
| | - Elena Colonnello
- Endocrinology and Medical Sexology (ENDOSEX, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Erika Limoncin
- Endocrinology and Medical Sexology (ENDOSEX, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Emmanuele A Jannini
- Endocrinology and Medical Sexology (ENDOSEX, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
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Gao WJ, Liu JX, Liu MN, Yao YD, Liu ZQ, Liu L, He HH, Zhou H. Macrophage 3D migration: A potential therapeutic target for inflammation and deleterious progression in diseases. Pharmacol Res 2021; 167:105563. [PMID: 33746053 DOI: 10.1016/j.phrs.2021.105563] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/13/2021] [Accepted: 03/15/2021] [Indexed: 12/14/2022]
Abstract
Macrophages are heterogeneous cells that have different physiological functions, such as chemotaxis, phagocytosis, endocytosis, and secretion of various factors. All physiological functions of macrophages are integral to homeostasis, immune defense and tissue repair. However, in several diseases, macrophages are recruited from the blood towards inflammatory sites. This process is called macrophage migration, which promotes deleterious disease progression. Macrophage migration is a key player in many inflammatory diseases, autoimmune diseases and cancers because it contributes to the accumulation of proinflammatory factors, the destruction of tissues and the development of tumors. Therefore, macrophage migration is proposed to be a potential therapeutic target. Macrophages migrate between two-dimensional (2D) and three-dimensional (3D) environments, implying that distinct migratory features and mechanisms are involved. Compared with the 2D migration of macrophages, 3D migration involves more complex variations in cellular morphology and dynamics. The structure of the extracellular matrix, a key factor, is modified in diseases that influence macrophage 3D migration. Macrophage 3D migration relates to disease pathology. Research that focuses on macrophage 3D migration is an emerging field and was reviewed in this article to indicate the molecular and cellular mechanisms of macrophage migration in 3D environments and to provide potential targets for controlling disease progression associated with this migration.
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Affiliation(s)
- Wan-Jiao Gao
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Jian-Xin Liu
- School of Pharmaceutical Sciences, Hunan University of Medicine, Huaihua City, Hunan Province, PR China
| | - Meng-Nan Liu
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; National Traditional Chinese Medicine Clinical Research Base and Department of Cardiovascular Medicine, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, PR China
| | - Yun-Da Yao
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Zhong-Qiu Liu
- Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Liang Liu
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Huan-Huan He
- The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai City, Guangdong Province 519000, PR China
| | - Hua Zhou
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, Guangzhou University of Chinese Medicine, Guangzhou, PR China; Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai City, Guangdong Province 519000, PR China.
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Tiwari D, Naidoo K, Chatiwala N, Bartlo PL, Triola A, Ong B, Gore S. Exploratory Analysis of Physical Therapy Process of Care and Psychosocial Impact of the COVID-19 Pandemic on Physical Therapists. Phys Ther 2021; 101:6159688. [PMID: 33693829 PMCID: PMC7989178 DOI: 10.1093/ptj/pzab088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/20/2021] [Accepted: 02/26/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the physical therapy process of care, clinical practices, and the self-reported psychosocial impact of working during the 2020 pandemic on physical therapists and physical therapist assistants. METHODS An electronic survey including closed and open-ended questions was distributed to physical therapists employed in a range of health care settings across the United States. RESULTS Physical therapy use and process of care varied across settings. Feasibility of performing an assessment was the main driver for selection of outcome measures. Interventions were mainly geared toward improving respiratory function and deconditioning. Prone patient positioning, now commonplace, was used infrequently by therapists in acute care prior to coronavirus disease 2019 (COVID-19). Similarly, outpatient and home care settings noted an increase in the use of respiratory-driven interventions such as incentive spirometry and breathing exercises. Qualitative data analysis revealed both physical barriers (personal protective equipment [PPE]) and social barriers to care. Therapists noted challenges in discharge planning and patient/family education due to the impact of social isolation. They also noted difficulty maintaining productivity standards because of additional time spent in changing PPE and following safety measures. Participants dealt with rapid changes in their role, changing productivity standards, and needing to increase their knowledge in a short amount of time. CONCLUSION Physical therapy use varied widely across settings. Despite some concern for personal health, respondents felt that the COVID-19 pandemic increased a sense of togetherness among team members and promoted greater appreciation for life and work. IMPACT This exploration of the process of care and current clinical practices across settings provides important knowledge about the role of physical therapists and physical therapist assistants in the care of patients with COVID-19. Gaining an understanding of the psychosocial impact of the pandemic among therapists could assist in creating solutions to better support clinicians' well-being.
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Affiliation(s)
| | | | | | | | | | - Brandon Ong
- MGH Institute of Health Professions Boston, MA
| | - Shweta Gore
- Address all correspondence to Shweta Gore PT, DPT, PhD, Board Certified Geriatric Clinical Specialist, American Board of Physical Therapy Specialties, Physical Therapy Department, MGH Institute of Health Professions, 36, 1 Ave, Boston, MA-02129, @shwetagore81,
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Rahmani-Kukia N, Abbasi A. Physiological and Immunological Causes of the Susceptibility of Chronic Inflammatory Patients to COVID-19 Infection: Focus on Diabetes. Front Endocrinol (Lausanne) 2021; 12:576412. [PMID: 33746897 PMCID: PMC7971178 DOI: 10.3389/fendo.2021.576412] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/19/2021] [Indexed: 12/14/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has recently emerged, which was then spread rapidly in more than 190 countries worldwide so far. According to the World Health Organization, 3,232,062 global cases of COVID-19 were confirmed on April 30th with a mortality rate of 3.4%. Notably, the symptoms are almost similar to those of flu such as fever, cough, and fatigue. Unfortunately, the global rates of morbidity and mortality caused by this disease are more and still increasing on a daily basis. The rates for patients suffering from inflammatory diseases like diabetes, is even further, due to their susceptibility to the pathogenesis of COVID-19. In this review, we attempted to focus on diabetes to clarify the physiological and immunological characteristics of diabetics before and after the infection with COVID-19. We hope these conceptions could provide a better understanding of the mechanisms involved in COVID-19 susceptibility and increase the awareness of risk to motivate behavior changes in vulnerable people for enhancing the prevention. Up to now, the important role of immune responses, especially the innate ones, in the development of the worst signs in COVID-19 infection have been confirmed. Therefore, to better control patients with COVID-19, it is recommended to consider a history of chronic inflammatory diseases as well as the way of controlling immune response in these patients.
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Affiliation(s)
- Nasim Rahmani-Kukia
- Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ardeshir Abbasi
- Department of Immunology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Silva RN, Goulart CDL, Oliveira MR, Tacao GY, Back GD, Severin R, Faghy MA, Arena R, Borghi-Silva A. Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation. Expert Rev Respir Med 2021; 15:1107-1120. [PMID: 33606567 DOI: 10.1080/17476348.2021.1893169] [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] [Indexed: 02/06/2023]
Abstract
INTRODUCTION It has become increasingly evident that COVID-19 contributes to multiorgan pathophysiology. The systemic inflammatory response increases both pro-inflammatory cytokine and chemokine levels, leading to immune dysregulation and increasing the likelihood of incurring cardiac and pulmonary injuries. AREAS COVERED Longer periods of hospitalization (~20 days) increase susceptibility to ICU-acquired muscle weakness and deconditioning, which decreases muscle function and functional capacity. These conditions affect the quality of life in the post-COVID-19 period and require multi-disciplinary approaches to rehabilitate the cardiopulmonary and musculoskeletal systems of these patients. In this context, this narrative review, which included articles published in the Embase, PEDro and PubMed databases up to December 2020, is focused on discussing the essential role of exercise and rehabilitation health professionals in the COVID-19 recovery process, from hospitalization to hospital discharge, addressing strategies for professionals to mitigate the cardiac and pulmonary impairments associated with hospitalization to home or ambulatory rehabilitation, purposing ways to conduct rehabilitation programs to restore their functional status and quality of life after the infection. EXPERT OPINION In the current environment, these findings further point to the vital role of rehabilitation health professionals in the coming years and the urgent need to develop strategies to assist COVID-19 survivors.
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Affiliation(s)
- Rebeca Nunes Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Cássia Da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Murilo Rezende Oliveira
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Guilherme Yassuyuki Tacao
- Department of Physiotherapy, Postgraduate Program in Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Zip-code: Presidente Prudente, SP, Brazil
| | - Guilherme Dionir Back
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil
| | - Richard Severin
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department of Physical Therapy Department, College of Applied Health Science, the University of Illinois at Chicago, Chicago, IL, USA.,Department of Physical Therapy, Robbins College of Applied Health Sciences, Baylor University, Waco, TX, USA
| | - Mark A Faghy
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department School of Human Sciences, Human Science Research Centre, University of Derby, Derby, UK
| | - Ross Arena
- Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.,Department of Physical Therapy Department, College of Applied Health Science, the University of Illinois at Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Department of Physiotherapy, Federal University of São Carlos (Ufscar), Monjolinho, Zip-code: São Carlos, SP, Brazil.,Department of Physical Therapy, Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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71
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González J, Benítez ID, Carmona P, Santisteve S, Monge A, Moncusí-Moix A, Gort-Paniello C, Pinilla L, Carratalá A, Zuil M, Ferrer R, Ceccato A, Fernández L, Motos A, Riera J, Menéndez R, Garcia-Gasulla D, Peñuelas O, Bermejo-Martin JF, Labarca G, Caballero J, Torres G, de Gonzalo-Calvo D, Torres A, Barbé F. Pulmonary Function and Radiologic Features in Survivors of Critical COVID-19: A 3-Month Prospective Cohort. Chest 2021; 160:187-198. [PMID: 33676998 PMCID: PMC7930807 DOI: 10.1016/j.chest.2021.02.062] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/12/2021] [Accepted: 02/25/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND More than 20% of hospitalized patients with COVID-19 demonstrate ARDS requiring ICU admission. The long-term respiratory sequelae in such patients remain unclear. RESEARCH QUESTION What are the major long-term pulmonary sequelae in critical patients who survive COVID-19? STUDY DESIGN AND METHODS Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-min walking test [6MWT]), and chest CT imaging. RESULTS One hundred twenty-five patients admitted to the ICU with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%) and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median distance in the 6MWT was 400 m (interquartile range, 362-440 m). CT scans showed abnormal results in 70.2% of patients, demonstrating reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT scan showed worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT scan were age and length of invasive mechanical ventilation during the ICU stay. INTERPRETATION Three months after hospital discharge, pulmonary structural abnormalities and functional impairment are highly prevalent in patients with ARDS secondary to COVID-19 who required an ICU stay. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months after discharge.
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Affiliation(s)
- Jessica González
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Paola Carmona
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Sally Santisteve
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Aida Monge
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Lucía Pinilla
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Amara Carratalá
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María Zuil
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Pulmonary Department, Hospital Clinic, Universitat de Barcelona, IDIBAPS, ICREA, Barcelona, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Pulmonary Department, Hospital Clinic, Universitat de Barcelona, IDIBAPS, ICREA, Barcelona, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Pulmonary Department, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario de Getafe, Madrid, Spain
| | - Jesús F Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Gonzalo Labarca
- Faculty of Medicine, Faculty of Pharmacy, University of Concepcion, Concepción, Chile; Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepcion, Concepción, Chile
| | - Jesus Caballero
- Intensive Care Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain
| | - Gerard Torres
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Pulmonary Department, Hospital Clinic, Universitat de Barcelona, IDIBAPS, ICREA, Barcelona, Spain
| | - Ferran Barbé
- Pulmonary Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain; Translational Research in Respiratory Medicine Group (TRRM), Lleida, Spain; Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
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Gentil P, de Lira CAB, Coswig V, Barroso WKS, Vitorino PVDO, Ramirez-Campillo R, Martins W, Souza D. Practical Recommendations Relevant to the Use of Resistance Training for COVID-19 Survivors. Front Physiol 2021; 12:637590. [PMID: 33746777 PMCID: PMC7966515 DOI: 10.3389/fphys.2021.637590] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/26/2021] [Indexed: 12/21/2022] Open
Abstract
The novel coronavirus disease (COVID-19) has emerged at the end of 2019 and caused a global pandemic. The disease predominantly affects the respiratory system; however, there is evidence that it is a multisystem disease that also impacts the cardiovascular system. Although the long-term consequences of COVID-19 are not well-known, evidence from similar diseases alerts for the possibility of long-term impaired physical function and reduced quality of life, especially in those requiring critical care. Therefore, rehabilitation strategies are needed to improve outcomes in COVID-19 survivors. Among the possible strategies, resistance training (RT) might be particularly interesting, since it has been shown to increase functional capacity both in acute and chronic respiratory conditions and in cardiac patients. The present article aims to propose evidence-based and practical suggestions for RT prescription for people who have been diagnosed with COVID-19 with a special focus on immune, respiratory, and cardiovascular systems. Based on the current literature, we present RT as a possible safe and feasible activity that can be time-efficient and easy to be implemented in different settings.
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Affiliation(s)
- Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil.,Hypertension League, Federal University of Goiás, Goiânia, Brazil
| | | | - Victor Coswig
- College of Physical Education, Federal University of Pará, Castanhal, Brazil
| | | | - Priscila Valverde de Oliveira Vitorino
- Hypertension League, Federal University of Goiás, Goiânia, Brazil.,Social Sciences and Health School, Pontifical Catholic University of Goiás, Goiânia, Brazil
| | - Rodrigo Ramirez-Campillo
- Laboratory of Human Performance, Quality of Life and Wellness Research Group, Department of Physical Activity Sciences, Universidad de Los Lagos, Osorno, Chile.,Centro de Investigación en Fisiología del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Wagner Martins
- Physiotherapy College, University of Brasília, Brasília, Brazil
| | - Daniel Souza
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
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73
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Benavides-Córdoba V, Guerrero-Jaramillo D, Betancourt-Peña J. Pulmonary Rehabilitation in COVID-19: The Contribution of other Chronic Lung Syndromes for the Intervention of a Novel Disease. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210129124433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract::
COVID-19 has spread throughout the world causing a significant number of cases of
pneumonia and SARS. Patients with COVID-19 may also have other cardiovascular, respiratory,
and neuromuscular disorders. These multisystemic complications present the need for comprehensive
interventions focused on improving symptoms, functional capacity, and quality of life. Pulmonary
rehabilitation has the potential to offer some of these benefits. However, the evidence related
to specific aspects of pulmonary rehabilitation evaluation and intervention in COVID19 is limited.
We have learned from experiences with other types of chronic lung diseases that have used pulmonary
rehabilitation successfully. While the evidence of rehabilitation emerges in COVID-19, it is
necessary to establish some initial recommendations, prepared according to the sequelae found until
now.
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Affiliation(s)
- Vicente Benavides-Córdoba
- Facultad de Salud Universidad del Valle, Facultad de Salud y Rehabilitación Institucion Universitaria Escuela Nacional del Deporte, Cali, Colombia
| | - Diana Guerrero-Jaramillo
- Secretaría de Salud Publica Municipal, Facultad de Salud, Universidad Santiago de Cali, Colombia
| | - Jhonatan Betancourt-Peña
- Facultad de Salud y Rehabilitacion Institucion Universitaria Escuela Nacional del Deporte, Facultad de Salud Universidad del Valle, Cali, Colombia
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74
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Saini G, Swahn MH, Aneja R. Disentangling the Coronavirus Disease 2019 Health Disparities in African Americans: Biological, Environmental, and Social Factors. Open Forum Infect Dis 2021; 8:ofab064. [PMID: 33732752 PMCID: PMC7928626 DOI: 10.1093/ofid/ofab064] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
The stark racial disparities related to the coronavirus disease 2019 (COVID-19) pandemic in the United States, wherein minority populations are disproportionately getting infected and succumbing to the disease, is of grave concern. It is critical to understand and address the underlying causes of these disparities that are complex and driven by interacting environmental, social and biological factors. In this article we focus on the African American community and examine how social and environmental determinants of health intersect with biological factors (comorbidities, underlying genetics, host immunity, vitamin D levels, epigenetics) to exacerbate risk for morbidity and mortality.
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Affiliation(s)
- Geetanjali Saini
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta, Georgia, USA
| | - Monica H Swahn
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Ritu Aneja
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta, Georgia, USA
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75
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Zhang S, Chen H, Yue D, Blackwell TS, Lv C, Song X. Long non-coding RNAs: Promising new targets in pulmonary fibrosis. J Gene Med 2021; 23:e3318. [PMID: 33533071 PMCID: PMC7988597 DOI: 10.1002/jgm.3318] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/09/2021] [Accepted: 01/15/2021] [Indexed: 12/11/2022] Open
Abstract
Pulmonary fibrosis is characterized by progressive and irreversible scarring in the lungs with poor prognosis and treatment. It is caused by various factors, including environmental and occupational exposures, and some rheumatic immune diseases. Even the rapid global spread of the COVID‐19 pandemic can also cause pulmonary fibrosis with a high probability. Functions attributed to long non‐coding RNAs (lncRNAs) make them highly attractive diagnostic and therapeutic targets in fibroproliferative diseases. Therefore, an understanding of the specific mechanisms by which lncRNAs regulate pulmonary fibrotic pathogenesis is urgently needed to identify new possibilities for therapy. In this review, we focus on the molecular mechanisms and implications of lncRNAs targeted protein‐coding and non‐coding genes during pulmonary fibrogenesis, and systematically analyze the communication of lncRNAs with various types of RNAs, including microRNA, circular RNA and mRNA. Finally, we propose the potential approach of lncRNA‐based diagnosis and therapy for pulmonary fibrosis. We hope that understanding these interactions between protein‐coding and non‐coding genes will contribute to the development of lncRNA‐based clinical applications for pulmonary fibrosis.
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Affiliation(s)
- Songzi Zhang
- Department of Cellular and Genetic Medicine, School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China.,Department of Respiratory Medicine, Affiliated Hospital to Binzhou Medical University, Binzhou Medical University, Binzhou, China
| | - Hongbin Chen
- Department of Cellular and Genetic Medicine, School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China
| | - Dayong Yue
- Department of Cellular and Genetic Medicine, School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China
| | | | - Changjun Lv
- Department of Cellular and Genetic Medicine, School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China.,Department of Respiratory Medicine, Affiliated Hospital to Binzhou Medical University, Binzhou Medical University, Binzhou, China
| | - Xiaodong Song
- Department of Cellular and Genetic Medicine, School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China.,Department of Respiratory Medicine, Affiliated Hospital to Binzhou Medical University, Binzhou Medical University, Binzhou, China
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76
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Zuo Z, Wu T, Pan L, Zuo C, Hu Y, Luo X, Jiang L, Xia Z, Xiao X, Liu J, Ye M, Deng M. Modalities and Mechanisms of Treatment for Coronavirus Disease 2019. Front Pharmacol 2021; 11:583914. [PMID: 33643033 PMCID: PMC7908061 DOI: 10.3389/fphar.2020.583914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly throughout the world. Although COVID-19 has a relatively low case severity rate compared to SARS and Middle East Respiratory syndrome it is a major public concern because of its rapid spread and devastating impact on the global economy. Scientists and clinicians are urgently trying to identify drugs to combat the virus with hundreds of clinical trials underway. Current treatments could be divided into two major part: anti-viral agents and host system modulatory agents. On one hand, anti-viral agents focus on virus infection process. Umifenovir blocks virus recognizing host and entry. Remdesivir inhibits virus replication. Chloroquine and hydroxychloroquine involve preventing the whole infection process, including virus transcription and release. On the other hand, host system modulatory agents are associated with regulating the imbalanced inflammatory reaction and biased immune system. Corticosteroid is believed to be commonly used for repressing hyper-inflammation, which is one of the major pathologic mechanisms of COVID-19. Convalescent plasma and neutralizing antibodies provide essential elements for host immune system and create passive immunization. Thrombotic events are at high incidence in COVID-19 patients, thus anti-platelet and anti-coagulation are crucial, as well. Here, we summarized these current or reproposed agents to better understand the mechanisms of agents and give an update of present research situation.
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Affiliation(s)
- Zhihong Zuo
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Ting Wu
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Liangyu Pan
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
| | - Chenzhe Zuo
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Yingchuo Hu
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
| | - Xuan Luo
- Hunan Yuanpin Cell Biotechnology Co., Ltd., Changsha, China
| | - Liping Jiang
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Zanxian Xia
- Department of Cell Biology, School of Life Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Animal Models for Human Diseases, Hunan Key Laboratory of Medical Genetics and Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Xiaojuan Xiao
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
| | - Jing Liu
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
| | - Mao Ye
- Molecular Science and Biomedicine Laboratory, State Key Laboratory for Chemo/Biosensing and Chemometrics, College of Biology, College of Chemistry and Chemical Engineering, Collaborative Innovation Center for Molecular Engineering for Theranostics, Hunan University, Changsha, China
| | - Meichun Deng
- Department of Biochemistry and Molecular Biology and Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
- Hunan Key Laboratory of Animal Models for Human Diseases, Hunan Key Laboratory of Medical Genetics and Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
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77
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O'Sullivan O, Barker-Davies R, Chamley R, Sellon E, Jenkins D, Burley R, Holden L, Nicol AM, Phillip R, Bennett AN, Nicol E, Holdsworth DA. Defence Medical Rehabilitation Centre (DMRC) COVID-19 Recovery Service. BMJ Mil Health 2021; 169:271-276. [PMID: 33547188 DOI: 10.1136/bmjmilitary-2020-001681] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 11/04/2022]
Abstract
Coronavirus disease 2019 (COVID-19) causes significant mortality and morbidity, with an unknown impact in the medium to long term. Evidence from previous coronavirus epidemics indicates that there is likely to be a substantial burden of disease, potentially even in those with a mild acute illness. The clinical and occupational effects of COVID-19 are likely to impact on the operational effectiveness of the Armed Forces. Collaboration between Defence Primary Healthcare, Defence Secondary Healthcare, Defence Rehabilitation and Defence Occupational Medicine resulted in the Defence Medical Rehabilitation Centre COVID-19 Recovery Service (DCRS). This integrated clinical and occupational pathway uses cardiopulmonary assessment as a cornerstone to identify, diagnose and manage post-COVID-19 pathology.
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Affiliation(s)
- Oliver O'Sullivan
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, Nottinghamshire, UK.,Headquarters Army Medical Services (HQ AMS), Camberley, Surrey, UK
| | - R Barker-Davies
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, Nottinghamshire, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - R Chamley
- Academic Department of Military Medicine, Birmingham, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - E Sellon
- Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK.,Royal Centre for Defence Medicine, Birmingham, UK
| | - D Jenkins
- Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK.,Royal Centre for Defence Medicine, Birmingham, UK
| | - R Burley
- Headquarters Defence Primary Healthcare, Lichfield, Staffordshire, UK
| | - L Holden
- Royal Centre for Defence Medicine, Birmingham, UK
| | - A M Nicol
- Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, Nottinghamshire, UK
| | - R Phillip
- Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, Nottinghamshire, UK
| | - A N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, Nottinghamshire, UK.,National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - E Nicol
- Royal Centre for Defence Medicine, Birmingham, UK.,Royal Brompton Hospital, London, UK
| | - D A Holdsworth
- Academic Department of Military Medicine, Birmingham, UK .,Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
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78
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Faghy MA, Arena R, Stoner L, Haraf RH, Josephson R, Hills AP, Dixit S, Popovic D, Smith A, Myers J, Bacon SL, Niebauer J, Dourado VZ, Babu AS, Maden-Wilkinson TM, Copeland RJ, Gough LA, Bond S, Stuart K, Bewick T, Ashton REM. The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network. Prog Cardiovasc Dis 2021; 67:2-10. [PMID: 33549590 PMCID: PMC7859729 DOI: 10.1016/j.pcad.2021.01.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 12/14/2022]
Abstract
COVID-19 is one of the biggest health crises that the world has seen. Whilst measures to abate transmission and infection are ongoing, there continues to be growing numbers of patients requiring chronic support, which is already putting a strain on health care systems around the world and which may do so for years to come. A legacy of COVID-19 will be a long-term requirement to support patients with dedicated rehabilitation and support services. With many clinical settings characterized by a lack of funding and resources, the need to provide these additional services could overwhelm clinical capacity. This position statement from the Healthy Living for Pandemic Event Protection (HL-PIVOT) Network provides a collaborative blueprint focused on leading research and developing clinical guidelines, bringing together professionals with expertise in clinical services and the exercise sciences to develop the evidence base needed to improve outcomes for patients infected by COVID-19.
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Affiliation(s)
- Mark A Faghy
- Human Sciences Research Centre, College of Science and Engineering, University of Derby, UK; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA.
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, USA
| | - Lee Stoner
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Exercise and Sport Science, University of North Carolina, USA
| | - Rebecca H Haraf
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Richard Josephson
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals, Cleveland Medical Centre, Hospitals Cleveland, OH, USA
| | - Andrew P Hills
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; School of Health Sciences, University of Tasmania, Australia
| | - Snehil Dixit
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Medical Rehabilitation Sciences, King Khalid University, Saudi Arabia
| | - Dejana Popovic
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Clinic for Cardiology, University Clinical Centre Serbia, University of Belgrade, Serbia
| | - Andy Smith
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Unaffiliated Independent Exercise Scientist, York, UK
| | - Jonathan Myers
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; VA Palo Alto Health Care System, Stanford University School of Medicine, California, USA
| | - Simon L Bacon
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Health, Kinesiology, and Applied Physiology (HKAP), Concordia University, Montreal, Canada; Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
| | - Josef Niebauer
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria; Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Victor Z Dourado
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Human Movement Sciences, Federal University of São Paulo, Santos, SP, Brazil; Department of Global Health and Population, Lown Scholars in Cardiovascular Health Program at Harvard T.H. Chan School of Public Health, USA
| | - Abraham S Babu
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Thomas M Maden-Wilkinson
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Robert J Copeland
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Lewis A Gough
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Centre for Life and Sport Sciences (CLaSS) Research Centre, School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Sam Bond
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, USA
| | - Kaz Stuart
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Centre of Research in Health and Society, University of Cumbria, Carlisle, UK
| | - Thomas Bewick
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Respiratory Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Ruth E M Ashton
- Human Sciences Research Centre, College of Science and Engineering, University of Derby, UK; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
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- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
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79
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Wiertz CMH, Vints WAJ, Maas GJCM, Rasquin SMC, van Horn YY, Dremmen MPM, Hemmen B, Verbunt JA. COVID-19: Patient Characteristics in the First Phase of Postintensive Care Rehabilitation. Arch Rehabil Res Clin Transl 2021; 3:100108. [PMID: 33558860 PMCID: PMC7859717 DOI: 10.1016/j.arrct.2021.100108] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective To describe clinical characteristics of patients after intensive care unit (ICU) treatment for coronavirus disease 2019 (COVID-19) who were admitted for inpatient rehabilitation. Design A cross-sectional design. Setting Inpatient rehabilitation care in the Netherlands. Participants All post-ICU patients with COVID-19 admitted to the rehabilitation center between April 2 and May 13, 2020, were invited to participate in the study. Included were patients older than 18 years needing inpatient rehabilitation after ICU treatment for COVID-19 (N=60; mean age, 59.9y; 75% male). Interventions Not applicable. Main Outcome Measures The following information was collected in the first week of inpatient rehabilitation care: (1) demographics; (2) ICU stay parameters; (3) medical, physical, and functional characteristics; and (4) self-reported symptoms. Results The most important findings for rehabilitation were the following: in the first week after discharge to the rehabilitation center, 38.3% of all patients experienced exercise-induced oxygen desaturation, in 72.7% muscle weakness was present in all major muscle groups, and 21.7% had a reduced mobility in 1 or both shoulders. Furthermore 40% had dysphagia, and 39.2% reported symptoms of anxiety. Conclusion Post-ICU patients with COVID-19 display physical and anxiety symptoms as reported in other post-ICU patient groups. However, this study showed some remarkable clinical characteristics of post-ICU patients with COVID-19. Rehabilitation programs need to anticipate on this. Long-term follow-up studies are necessary.
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Affiliation(s)
| | - Wouter A J Vints
- Adelante Zorggroep, Hoensbroek, The Netherlands.,Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
| | - Geert J C M Maas
- Adelante Zorggroep, Hoensbroek, The Netherlands.,Department for Health and Technique, Physiotherapy, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | | | | | - Martijn P M Dremmen
- Adelante Zorggroep, Hoensbroek, The Netherlands.,Department of Rehabilitation Medicine, Zuyderland Medical Centre, Heerlen-Sittard, The Netherlands
| | - Bena Hemmen
- Adelante Zorggroep, Hoensbroek, The Netherlands.,Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jeanine A Verbunt
- Adelante Zorggroep, Hoensbroek, The Netherlands.,Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
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80
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McDonald LT. Healing after COVID-19: are survivors at risk for pulmonary fibrosis? Am J Physiol Lung Cell Mol Physiol 2021; 320:L257-L265. [PMID: 33355522 PMCID: PMC7900916 DOI: 10.1152/ajplung.00238.2020] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 12/18/2020] [Accepted: 12/20/2020] [Indexed: 12/16/2022] Open
Abstract
The novel SARS-CoV-2 coronavirus, which is responsible for COVID-19 disease, was first reported in Wuhan, China, in December of 2019. The virus rapidly spread, and the World Health Organization declared a pandemic by March 2020. With millions of confirmed cases worldwide, there is growing concern and considerable debate regarding the potential for coronavirus infection to contribute to an appreciable burden of chronic respiratory symptoms or fibrotic disease among recovered individuals. Because the first case of COVID-19 was documented less than one year ago, data regarding long-term clinical outcomes are not yet available, and predictions for long-term outcome are speculative at best. However, due to the staggering number of cases and the severity of disease in many individuals, there is a critical need to consider the potential long-term implications of COVID-19. This review examines current basic and clinical data regarding fibrogenic mechanisms of viral injury in the context of SARS-CoV-2. Several intersecting mechanisms between coronavirus infection and fibrotic pathways are discussed to highlight factors and processes that may be targetable to improve patient outcome. Reports of post-infection sequelae from previous coronavirus outbreaks are presented toward the goal of improved recognition of potential contributing risk factors for fibrotic disease.
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Affiliation(s)
- Lindsay T McDonald
- Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
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81
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Peng Y, Tao H, Satyanarayanan SK, Jin K, Su H. A Comprehensive Summary of the Knowledge on COVID-19 Treatment. Aging Dis 2021; 12:155-191. [PMID: 33532135 PMCID: PMC7801274 DOI: 10.14336/ad.2020.1124] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/24/2020] [Indexed: 01/08/2023] Open
Abstract
Currently, the world is challenged by the coronavirus disease 2019 (COVID-19) pandemic. Epidemiologists and researchers worldwide are invariably trying to understand and combat this precarious new disease. Scrutinizing available drug options and developing potential new drugs are urgent needs to subdue this pandemic. Several intervention strategies are being considered and handled worldwide with limited success, and many drug candidates are yet in the trial phase. Despite these limitations, the development of COVID-19 treatment strategies has been accelerated to improve the clinical outcome of patients with COVID-19, and some countries have efficiently kept it under control. Recently, the use of natural and traditional medicine has also set the trend in coronavirus treatment. This review aimed to discuss the prevailing COVID-19 treatment strategies available globally by examining their efficacy, potential mechanisms, limitations, and challenges in predicting a future potential treatment candidate and bridging them with the effective traditional Chinese medicine (TCM). The findings might enrich the knowledge on traditional alternative medication and its complementary role with Western medicine in managing the COVID-19 epidemic.
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Affiliation(s)
- Yu Peng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
| | - Hongxun Tao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
| | - Senthil Kumaran Satyanarayanan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
| | - Kunlin Jin
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA.
| | - Huanxing Su
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
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82
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Sansone A, Mollaioli D, Ciocca G, Limoncin E, Colonnello E, Vena W, Jannini EA. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak. J Endocrinol Invest 2021; 44:223-231. [PMID: 32661947 PMCID: PMC7355084 DOI: 10.1007/s40618-020-01350-1] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The COVID-19 pandemic, caused by the SARS-CoV-2, represents an unprecedented challenge for healthcare. COVID-19 features a state of hyperinflammation resulting in a "cytokine storm", which leads to severe complications, such as the development of micro-thrombosis and disseminated intravascular coagulation (DIC). Despite isolation measures, the number of affected patients is growing daily: as of June 12th, over 7.5 million cases have been confirmed worldwide, with more than 420,000 global deaths. Over 3.5 million patients have recovered from COVID-19; although this number is increasing by the day, great attention should be directed towards the possible long-term outcomes of the disease. Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients. METHODS A literature research on the possible mechanisms involved in the development of ED in COVID-19 survivors was performed. RESULTS Endothelial dysfunction, subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics all contribute to the potential onset of ED. Additionally, COVID-19 might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED. Testicular function in COVID-19 patients requires careful investigation for the unclear association with testosterone deficiency and the possible consequences for reproductive health. Treatment with phosphodiesterase-5 (PDE5) inhibitors might be beneficial for both COVID-19 and ED. CONCLUSION COVID-19 survivors might develop sexual and reproductive health issues. Andrological assessment and tailored treatments should be considered in the follow-up.
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Affiliation(s)
- A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - D Mollaioli
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - G Ciocca
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - E Limoncin
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - E Colonnello
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - W Vena
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, MI, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
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83
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Adivitiya, Kaushik MS, Chakraborty S, Veleri S, Kateriya S. Mucociliary Respiratory Epithelium Integrity in Molecular Defense and Susceptibility to Pulmonary Viral Infections. BIOLOGY 2021; 10:95. [PMID: 33572760 PMCID: PMC7911113 DOI: 10.3390/biology10020095] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 01/08/2023]
Abstract
Mucociliary defense, mediated by the ciliated and goblet cells, is fundamental to respiratory fitness. The concerted action of ciliary movement on the respiratory epithelial surface and the pathogen entrapment function of mucus help to maintain healthy airways. Consequently, genetic or acquired defects in lung defense elicit respiratory diseases and secondary microbial infections that inflict damage on pulmonary function and may even be fatal. Individuals living with chronic and acute respiratory diseases are more susceptible to develop severe coronavirus disease-19 (COVID-19) illness and hence should be proficiently managed. In light of the prevailing pandemic, we review the current understanding of the respiratory system and its molecular components with a major focus on the pathophysiology arising due to collapsed respiratory epithelium integrity such as abnormal ciliary movement, cilia loss and dysfunction, ciliated cell destruction, and changes in mucus rheology. The review includes protein interaction networks of coronavirus infection-manifested implications on the molecular machinery that regulates mucociliary clearance. We also provide an insight into the alteration of the transcriptional networks of genes in the nasopharynx associated with the mucociliary clearance apparatus in humans upon infection by severe acute respiratory syndrome coronavirus-2.
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Affiliation(s)
- Adivitiya
- Laboratory of Optobiology, School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India; (A.); (M.S.K.); (S.C.)
| | - Manish Singh Kaushik
- Laboratory of Optobiology, School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India; (A.); (M.S.K.); (S.C.)
| | - Soura Chakraborty
- Laboratory of Optobiology, School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India; (A.); (M.S.K.); (S.C.)
| | - Shobi Veleri
- Drug Safety Division, ICMR-National Institute of Nutrition, Hyderabad 500007, India;
| | - Suneel Kateriya
- Laboratory of Optobiology, School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India; (A.); (M.S.K.); (S.C.)
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84
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Afsahi AM, Lombardi AF, Valizadeh S, Gholamrezanezhad A. Life after recovery from SARS, influenza, and Middle East respiratory syndrome: An insight into possible long-term consequences of COVID-19. World J Clin Infect Dis 2021; 11:1-10. [DOI: 10.5495/wjcid.v11.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/02/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
Viral infectious diseases have become an increased public health issue in the past 20 years. The outbreaks of severe acute respiratory syndrome coronavirus (SARS-CoV-1) in 2002, influenza H1N1 in 2009, Middle East respiratory syndrome-CoV in 2012, and the current new coronavirus SARS-CoV-2 have shown that viral infectious diseases are a major concern in the 21st century. As the world lives under the pandemic of a new coronavirus (COVID-19), knowing the clinical characteristics from those past diseases and their long-term outcomes is important to understand the current coronavirus pandemic and its complications and consequences better and plan for possible future outbreaks. Several long-term complications have been described with these respiratory viral diseases, such as decreased pulmonary function, pulmonary fibrosis, chronic fatigue syndrome, avascular necrosis of bone, polyneuropathy, encephalitis, posttraumatic stress disorder, depression, and anxiety. This article summarizes several studies describing chronic complications and long-term outcomes of patients recovered from these viral syndromes.
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Affiliation(s)
| | | | - Sara Valizadeh
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine of USC, Los Angeles, CA 90033, United States
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85
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Vancini RL, de Lira CAB, Gentil P, Andrade MS. Neurological features of COVID-19 and epilepsy: Could neuromuscular assessment be a physical and functional marker? Epilepsy Behav 2021; 114:107648. [PMID: 33309238 PMCID: PMC7831858 DOI: 10.1016/j.yebeh.2020.107648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil.
| | - Claudio Andre Barbosa de Lira
- Setor de Fisiologia Humana e do Exercício, Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
| | - Paulo Gentil
- Setor de Fisiologia Humana e do Exercício, Laboratório de Avaliação do Movimento Humano, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil
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86
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Lima GHV, Guimarães PL, Baboghluian M. COVID-19 AND SURFING: PROBLEMS, STRATEGIES AND SOLUTIONS FOR SURFERS. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127012020_0056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The pandemic caused by coronavirus disease (COVID-19) has changed the routine of surfers, professionals and all those involved in surfing. This unusual global crisis has caused major organizational, financial and social disruption for surfers, coaches, federations and fans. The world of sports, including surfing, entered extreme and uncharted territory, in which all competitions were postponed and many beaches were closed, preventing any kind of surfing activity. The primary objective of this article is to identify potential harmful effects caused by the COVID-19 pandemic on the health of surfers, while the secondary objective is to provide practical recommendations for coaches, professional and amateur surfers to reduce the undesirable consequences of forced quarantine and direct the resumption of surfing activities while protecting the health of those involved. The main problems indicated were: the effects on body composition due to calorie imbalance, possible cardiac and pulmonary alterations caused by COVID-19, musculoskeletal symptoms and the consequences of detraining. The article also suggests recommendations for new attitudes towards surfing. Surfing is a growing sport that has been included in the upcoming Olympic Games in Tokyo. As the sport grows and becomes more professional, measures to protect the health of surfers need to be put in place. The current pandemic situation is extremely delicate and the measures proposed in this study are intended to serve as a guide for surfers and professionals in order to minimize the harmful effects of this situation. Level of Evidence IV; Type of Study: Literature review.
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Affiliation(s)
| | | | - Marcelo Baboghluian
- Faculdade de Medicina de Taubaté, Brazil; Instituto Mar Azul de Medicina Esportiva, Brazil
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87
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Kouhsari E, Azizian K, Sholeh M, Shayestehpour M, Hashemian M, Karamollahi S, Yaghoubi S, Sadeghiifard N. Clinical, epidemiological, laboratory, and radiological characteristics of novel Coronavirus (2019-nCoV) in retrospective studies: A systemic review and meta-analysis. Indian J Med Microbiol 2021; 39:104-115. [PMID: 33610239 PMCID: PMC7667392 DOI: 10.1016/j.ijmmb.2020.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND In December 2019, a novel pneumonia related to the 2019 coronavirus unexpectedly developed in Wuhan, China. We aimed to review data of the novel Coronavirus (2019-nCoV) by analyzing all the published retrospective studies on the clinical, epidemiological, laboratory, and radiological characteristics of patients with 2019-nCoV. METHODS We searched in four bibliographic databases PubMed, Scopus, Embase, and Web of Science) for studies March 10, 2020 focused on the clinical, epidemiological, laboratory, and radiological characteristics of patients with 2019-nCoV for meta-analysis. The Newcastle-Ottawa Scale was used to quality assessment, and publication bias was analyzed by Egger's test. In the meta-analysis, a random-effects model with Stata/SE software, v.14.1 (StataCorp, College Station, TX) was used to obtain a pooled incidence rate. RESULTS Fifty studies were included in this systematic review and meta-analysis with 8815 patients and the mean age was 46 years and 4647 (52.7%) were male. The pooled incidences rate of clinical symptoms were: fever (83%, 95% CI: 0.77, 0.89), cough (59%, 95% CI: 0.48, 0.69), myalgia or fatigue (31%, 95% CI: 0.23, 0.39), sputum production (29%, 95% CI: 0.21, 0.39), and dyspnea (19%, 95% CI: 0.12, 0.26). The pooled incidence rate of acute respiratory distress syndrome (ARDS) was (22%, 95% CI: 0.00, 0.60). CONCLUSION The results of this systemic review and meta-analysis present a quantitative pooled incidence rate of different characters of 2019-nCoV and has great potential to develop diagnosis and patient's stratification in 2019-nCoV. However, this conclusions of this study still requisite to be warranted by more careful design, larger sample size multivariate studies to corroborate the results of this meta-analysis.
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Affiliation(s)
- Ebrahim Kouhsari
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran; Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Khalil Azizian
- Department of Lab Science, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Mohammad Sholeh
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shayestehpour
- Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Marzieh Hashemian
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Somayeh Karamollahi
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Sajad Yaghoubi
- Department of Clinical Microbiology, Iranshahr University of Medical Sciences, Iranshahr, Iran.
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Abstract
In this review, we explore the challenges of chronic pain and fatigue in clinical practice. Both pain and fatigue are common, troubling and frequently overlapping symptoms, and we describe both the clinical burden and the 'clinical problem'. We explore commonly associated symptoms and possible pathological associations, including variant connective tissue (joint hypermobility), small fibre neuropathy, mast cell activation, dysregulated inflammatory and interoceptive processes, which may inform treatment targets. We suggest a multidisciplinary management approach.
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Affiliation(s)
- Jessica A Eccles
- Brighton and Sussex Medical School, Falmer, UK, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK and Sussex Partnership Foundation NHS Trust, Brighton, UK
| | - Kevin A Davies
- Brighton and Sussex Medical School, Falmer, UK and medical director, The Advisory Committee on Clinical Excellence Awards (ACCEA), Leeds, UK
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Affiliation(s)
- Eun-Joong Kim
- Department of Clinical Laboratory Science, Chungbuk Health & Science University, Cheongju, Korea
| | - Dongsup Lee
- Department of Clinical Laboratory Science, Hyejeon College, Hongseong, Korea
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Experience in Multiple Sclerosis Patients with COVID-19 and Disease-Modifying Therapies: A Review of 873 Published Cases. J Clin Med 2020; 9:jcm9124067. [PMID: 33339436 PMCID: PMC7766122 DOI: 10.3390/jcm9124067] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic is a challenge for all participants in the healthcare system. At the beginning of the pandemic, many physicians asked themselves what risk their patients, especially those with chronic diseases, were exposed to. We present an overview of all patients with multiple sclerosis (MS) and SARS-CoV-2 infection published in the literature so far. In total, there are publications on 873 SARS-CoV-2 positive MS patients and information on the outcome can be given for 700 patients. With regard to the different disease modifying therapies (DMTs), by far the most cases were described under anti-CD20 treatment (n = 317). The mortality rate of all MS patients was 4% and a further 3% required invasive or non-invasive ventilation. When looking at the severe and fatal cases, it is particularly noticeable that patients without DMTs, with previous cardiovascular diseases, or with a severe degree of disability are at risk. Immunosuppressive therapy itself does not appear to be a substantial risk factor. Rather, it is reasonable to assume that the therapies could be protective, either directly, by mitigating the cytokine storm, or indirectly, by reducing the disease activity of MS.
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91
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Wijeratne T, Crewther S. Post-COVID 19 Neurological Syndrome (PCNS); a novel syndrome with challenges for the global neurology community. J Neurol Sci 2020; 419:117179. [PMID: 33070003 PMCID: PMC7550857 DOI: 10.1016/j.jns.2020.117179] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/11/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Tissa Wijeratne
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Department of Neurology, Western Health & University Melbourne, AIMSS, Level Three, WHCRE, Sunshine Hospital, St Albans 3021, Australia; Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapura, Sri Lanka.
| | - Sheila Crewther
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Department of Neurology, Western Health & University Melbourne, AIMSS, Level Three, WHCRE, Sunshine Hospital, St Albans 3021, Australia
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92
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Lee DY, Cho J, You SC, Park RW, Kim CS, Lee EY, Aizenstein H, Andreescu C, Karim H, Hong CH, Rho HW, Park B, Son SJ. Risk of Mortality in Elderly Coronavirus Disease 2019 Patients With Mental Health Disorders: A Nationwide Retrospective Study in South Korea. Am J Geriatr Psychiatry 2020; 28:1308-1316. [PMID: 33023798 PMCID: PMC7521355 DOI: 10.1016/j.jagp.2020.09.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study aimed to investigate the different clinical characteristics among elderly coronavirus disease 2019 (COVID-19) patients with and without mental disorders in South Korea and determine if these characteristics have an association with underlying mental disorders causing mortality. METHOD A population-based comparative cohort study was conducted using the national claims database. Individuals aged ≥65 years with confirmed COVID-19 between January 1, 2020 and April 10, 2020 were assessed. The endpoints for evaluating mortality for all participants were death, 21 days after diagnosis, or April 10, 2020. The risk of mortality associated with mental disorders was estimated using Cox hazards regression. RESULTS We identified 814 elderly COVID-19 patients (255 [31.3%] with mental disorder and 559 [68.7%] with nonmental disorder). Individuals with mental disorders were found more likely to be older, taking antithrombotic agents, and had diabetes, hypertension, chronic obstructive lung disease, and urinary tract infections than those without mental disorders. After propensity score stratification, our study included 781 patients in each group (236 [30.2%] with mental disorder and 545 [69.8%] with nonmental disorder). The mental disorder group showed higher mortality rates than the nonmental disorder group (12.7% [30/236] versus 6.8% [37/545]). However, compared to patients without mental disorders, the hazard ratio (HR) for mortality in elderly COVID-19 patients with mental disorders was not statistically significant (HR: 1.57, 95%CI: 0.95-2.56). CONCLUSION Although the association between mental disorders in elderly individuals and mortality in COVID-19 is unclear, this study suggests that elderly patients with comorbid conditions and those taking psychiatric medications might be at a higher risk of COVID-19.
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Affiliation(s)
- Dong Yun Lee
- Department of Psychiatry, Ajou University School of Medicine (DYL, CHH, HWR, SJS), Suwon, South Korea
| | - Jaehyeong Cho
- Department of Biomedical Sciences, Graduate School of Ajou University (JC, RWP, CSK), Suwon, South Korea
| | - Seng Chan You
- Department of Biomedical Informatics, Ajou University School of Medicine (SCY, RWP, EYL, BP), Suwon, South Korea
| | - Rae Woong Park
- Department of Biomedical Sciences, Graduate School of Ajou University (JC, RWP, CSK), Suwon, South Korea,Department of Biomedical Informatics, Ajou University School of Medicine (SCY, RWP, EYL, BP), Suwon, South Korea
| | - Chung Soo Kim
- Department of Biomedical Sciences, Graduate School of Ajou University (JC, RWP, CSK), Suwon, South Korea
| | - Eun Young Lee
- Department of Biomedical Informatics, Ajou University School of Medicine (SCY, RWP, EYL, BP), Suwon, South Korea,Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center (EYL, BP), Suwon, South Korea
| | - Howard Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine (HA, CA, HK), PA
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine (HA, CA, HK), PA
| | - Helmet Karim
- Department of Psychiatry, University of Pittsburgh School of Medicine (HA, CA, HK), PA
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine (DYL, CHH, HWR, SJS), Suwon, South Korea
| | - Hyun Woong Rho
- Department of Psychiatry, Ajou University School of Medicine (DYL, CHH, HWR, SJS), Suwon, South Korea
| | - Bumhee Park
- Department of Biomedical Informatics, Ajou University School of Medicine (SCY, RWP, EYL, BP), Suwon, South Korea; Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center (EYL, BP), Suwon, South Korea.
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine (DYL, CHH, HWR, SJS), Suwon, South Korea.
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Díez JM, Romero C, Vergara-Alert J, Belló-Perez M, Rodon J, Honrubia JM, Segalés J, Sola I, Enjuanes L, Gajardo R. Cross-neutralization activity against SARS-CoV-2 is present in currently available intravenous immunoglobulins. Immunotherapy 2020; 12:1247-1255. [PMID: 32900263 PMCID: PMC7480323 DOI: 10.2217/imt-2020-0220] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/25/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Cross-reactivity against human coronaviruses with Flebogamma® DIF and Gamunex®-C, two available intravenous immunoglobulins (IVIG), has been reported. In this study, these IVIG were tested for neutralization activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV and Middle East respiratory syndrome CoV (MERS-CoV). Materials & methods: Neutralization capacity of lots of IVIG manufactured prior to COVID-19 pandemic was assessed against these viruses in cell culture. Infectivity neutralization was quantified by percent reduction in plaque-forming units and/or cytopathic/cytotoxic methods. Results: All IVIG preparations showed neutralization of SARS-CoV-2 isolates. All IVIG lots produced neutralization of SARS-CoV. No IVIG preparation showed significant neutralizing activity against MERS-CoV. Conclusion: The tested IVIG contain antibodies with significant in vitro cross-neutralization capacity against SARS-CoV-2 and SARS-CoV, but not MERS-CoV. These preparations are currently under evaluation as potential therapies for COVID-19.
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Affiliation(s)
- José María Díez
- Bioscience Research & Development, Grifols, Barcelona, Spain
| | - Carolina Romero
- Bioscience Research & Development, Grifols, Barcelona, Spain
| | - Júlia Vergara-Alert
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Melissa Belló-Perez
- Laboratorio Coronavirus. Departamento de Biología Molecular y Celular, CNB-CSIC, Madrid, Spain
| | - Jordi Rodon
- IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - José Manuel Honrubia
- Laboratorio Coronavirus. Departamento de Biología Molecular y Celular, CNB-CSIC, Madrid, Spain
| | - Joaquim Segalés
- UAB, CReSA (IRTA-UAB), Campus de la Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
- Departament de Sanitat i Anatomia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
| | - Isabel Sola
- Laboratorio Coronavirus. Departamento de Biología Molecular y Celular, CNB-CSIC, Madrid, Spain
| | - Luis Enjuanes
- Laboratorio Coronavirus. Departamento de Biología Molecular y Celular, CNB-CSIC, Madrid, Spain
| | - Rodrigo Gajardo
- Bioscience Research & Development, Grifols, Barcelona, Spain
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94
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Wang Y, Jin C, Wu CC, Zhao H, Liang T, Liu Z, Jian Z, Li R, Wang Z, Li F, Zhou J, Cai S, Liu Y, Li H, Liang Y, Tian C, Yang J. Organizing pneumonia of COVID-19: Time-dependent evolution and outcome in CT findings. PLoS One 2020; 15:e0240347. [PMID: 33175876 PMCID: PMC7657520 DOI: 10.1371/journal.pone.0240347] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023] Open
Abstract
Background As a pandemic, a most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease (COVID-19). We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19. Materials and methods 106 COVID-19 patients with OP based on CT findings were retrospectively included and categorized into non-severe (mild/common) and severe (severe/critical) groups. CT features including lobar distribution, presence of ground glass opacities (GGO), consolidation, linear opacities and total severity CT score were evaluated at three time intervals from symptom-onset to CT scan (day 0–7, day 8–14, day > 14). Discharge or adverse outcome (admission to ICU or death), and pulmonary sequelae (complete absorption or lesion residuals) on CT after discharge were analyzed based on the CT features at different time interval. Results 79 (74.5%) patients were non-severe and 103 (97.2%) were discharged at median day 25 (range, day 8–50) after symptom-onset. Of 67 patients with revisit CT at 2–4 weeks after discharge, 20 (29.9%) had complete absorption of lesions at median day 38 (range, day 30–53) after symptom-onset. Significant differences between complete absorption and residuals groups were found in percentages of consolidation (1.5% vs. 13.8%, P = 0.010), number of involved lobe > 3 (40.0% vs. 72.5%, P = 0.030), CT score > 4 (20.0% vs. 65.0%, P = 0.010) at day 8–14. Conclusion Most OP cases had good prognosis. Approximately one-third of cases had complete absorption of lesions during 1–2 months after symptom-onset while those with increased frequency of consolidation, number of involved lobe > 3, and CT score > 4 at week 2 after symptom-onset may indicate lesion residuals on CT.
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Affiliation(s)
- Yan Wang
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Chao Jin
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Carol C. Wu
- Department of Thoracic Imaging, University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Huifang Zhao
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Ting Liang
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Zhe Liu
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Zhijie Jian
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Runqing Li
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Zekun Wang
- Department of Radiology, The Eighth Hospital of Xi’an, Xi’an, P.R. China
| | - Fen Li
- Department of Radiology, The Eighth Hospital of Xi’an, Xi’an, P.R. China
| | - Jie Zhou
- Department of Radiology, Xi’an Chest Hospital, Xi’an, P.R. China
| | - Shubo Cai
- Department of Radiology, Xi’an Chest Hospital, Xi’an, P.R. China
| | - Yang Liu
- Department of Cardiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Hao Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Yukun Liang
- Department of Radiology, Ankang Center Hospital, Ankang, P.R. China
| | - Cong Tian
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, P.R. China
- * E-mail:
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95
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Li J, Zhang Y, Wang F, Liu B, Li H, Tang G, Chang Z, Liu A, Fu C, Lv Y, Gao J, Li J. Cardiac damage in patients with the severe type of coronavirus disease 2019 (COVID-19). BMC Cardiovasc Disord 2020; 20:479. [PMID: 33167876 PMCID: PMC7652577 DOI: 10.1186/s12872-020-01758-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/26/2020] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has become a global pandemic. Studies showed COVID-19 affected not only the lung but also other organs. In this study, we aimed to explore the cardiac damage in patients with COVID-19. Methods We collected data of 100 patients diagnosed as severe type of COVID-19 from February 8 to April 10, 2020, including demographics, illness history, physical examination, laboratory test, and treatment. In-hospital mortality were observed. Cardiac damage was defined as plasma hypersensitive troponin I (hsTnI) over 34.2 pg/ml and/or N-terminal-pro brain natriuretic peptide (NTproBNP) above 450 pg/ml at the age < 50, above 900 pg/ml at the age < 75, or above 1800 pg/ml at the age ≥ 75. Results The median age of the patients was 62.0 years old. 69 (69.0%) had comorbidities, mainly presenting hypertension, diabetes, and cardiovascular disease. Fever (69 [69.0%]), cough (63 [63.0%]), chest distress (13 [13.0%]), and fatigue (12 [12.0%]) were the common initial symptoms. Cardiac damage occurred in 25 patients. In the subgroups, hsTnI was significantly higher in elder patients (≥ 60 years) than in the young (median [IQR], 5.2 [2.2–12.8] vs. 1.9 [1.9–6.2], p = 0.018) and was higher in men than in women (4.2 [1.9–12.8] vs. 2.9 [1.9–7.4], p = 0.018). The prevalence of increased NTproBNP was significantly higher in men than in women (32.1% vs. 9.1%, p = 0.006), but was similar between the elder and young patients (20.0% vs. 25.0%, p = 0.554). After multivariable analysis, male and hypertension were the risk factors of cardiac damage. The mortality was 4.0%. Conclusions Cardiac damage exists in patients with the severe type of COVID-19, especially in male patients with hypertension. Clinicians should pay more attention to cardiac damage.
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Affiliation(s)
- Jing Li
- Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China.
| | - Yinghua Zhang
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Fang Wang
- Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Bing Liu
- Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Hui Li
- Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Guodong Tang
- Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Zhigang Chang
- Division of Intensive Care Unit, Beijing Hospital, Beijing, 100730, China
| | - Aihua Liu
- Division of Rheumatology and Immunology, Beijing Hospital, Beijing, 100730, China
| | - Chunyi Fu
- Division of Emergency, Beijing Hospital, Beijing, 100730, China
| | - You Lv
- Division of Cardiology, Beijing Hospital, #1 Dahua Road, Dongcheng District, Beijing, 100730, China
| | - Jing Gao
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China.
| | - Jing Li
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China. .,National Center Research Center of Geriatric Diseases [Xuanwu Hospital], Beijing, 100053, China.
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96
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Sami R, Soltaninejad F, Amra B, Naderi Z, Haghjooy Javanmard S, Iraj B, Haji Ahmadi S, Shayganfar A, Dehghan M, Khademi N, Sadat Hosseini N, Mortazavi M, Mansourian M, Mañanas MA, Marateb HR, Adibi P. A one-year hospital-based prospective COVID-19 open-cohort in the Eastern Mediterranean region: The Khorshid COVID Cohort (KCC) study. PLoS One 2020; 15:e0241537. [PMID: 33151983 PMCID: PMC7644058 DOI: 10.1371/journal.pone.0241537] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 10/17/2020] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 is rapidly scattering worldwide, and the number of cases in the Eastern Mediterranean Region is rising. Thus, there is a need for immediate targeted actions. We designed a longitudinal study in a hot outbreak zone to analyze the serial findings between infected patients for detecting temporal changes from February 2020. In a hospital-based open-cohort study, patients are followed from admission until one year from their discharge (the 1st, 4th, 12th weeks, and the first year). The patient recruitment phase finished at the end of August 2020, and the follow-up continues by the end of August 2021. The measurements included demographic, socio-economics, symptoms, health service diagnosis and treatment, contact history, and psychological variables. The signs improvement, death, length of stay in hospital were considered primary, and impaired pulmonary function and psychotic disorders were considered main secondary outcomes. Moreover, clinical symptoms and respiratory functions are being determined in such follow-ups. Among the first 600 COVID-19 cases, 490 patients with complete information (39% female; the average age of 57±15 years) were analyzed. Seven percent of these patients died. The three main leading causes of admission were: fever (77%), dry cough (73%), and fatigue (69%). The most prevalent comorbidities between COVID-19 patients were hypertension (35%), diabetes (28%), and ischemic heart disease (14%). The percentage of primary composite endpoints (PCEP), defined as death, the use of mechanical ventilation, or admission to an intensive care unit was 18%. The Cox Proportional-Hazards Model for PCEP indicated the following significant risk factors: Oxygen saturation < 80% (HR = 6.3; [CI 95%: 2.5,15.5]), lymphopenia (HR = 3.5; [CI 95%: 2.2,5.5]), Oxygen saturation 80%-90% (HR = 2.5; [CI 95%: 1.1,5.8]), and thrombocytopenia (HR = 1.6; [CI 95%: 1.1,2.5]). This long-term prospective Cohort may support healthcare professionals in the management of resources following this pandemic.
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Affiliation(s)
- Ramin Sami
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Forogh Soltaninejad
- The Respiratory Research Center, Pulmonary Division, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Babak Amra
- Bamdad Respiratory Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohre Naderi
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh Haghjooy Javanmard
- Department of Physiology, School of Medicine, Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somayeh Haji Ahmadi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azin Shayganfar
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnegar Dehghan
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nilufar Khademi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mojgan Mortazavi
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Barcelona, Spain
| | - Miquel Angel Mañanas
- Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Barcelona, Spain
- Biomedical Research Networking Center in Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Zaragoza, Spain
| | - Hamid Reza Marateb
- Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona Tech (UPC), Barcelona, Spain
- Biomedical Engineering Department, Engineering Faculty, University of Isfahan, Isfahan, Iran
- Machine Learning Department, Isfahan Cardiovascular Research Center (a WHO-collaborating center), Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Before the current pandemic, there had been two global epidemics from major coronavirus outbreaks since the turn of the century: severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Both epidemics left survivors with fatigue, persistent shortness of breath, reduced quality of life and a significant burden of mental health problems.It is likely that some of the chronic problems encountered by survivors of SARS and MERS may be relevant for medical planning of the services required for survivors of coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2. Given the similarities between the diseases, the recovery and rehabilitation of the survivors of COVID-19 is likely to be focused around cardiopulmonary sequelae, fatigue and the psychological burden of COVID-19, but in a much larger population.
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Affiliation(s)
- Oliver O'Sullivan
- Defence Medical Rehabilitation Centre Stanford Hall, Stanford-on-Sour, UK oliver.o'
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98
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Juan Y, Yuanyuan C, Qiuxiang Y, Cong L, Xiaofeng L, Yundong Z, Jing C, Peifeng Q, Yan L, Xiaojiao X, Yujie L. Psychological distress surveillance and related impact analysis of hospital staff during the COVID-19 epidemic in Chongqing, China. Compr Psychiatry 2020; 103:152198. [PMID: 32980595 PMCID: PMC7419281 DOI: 10.1016/j.comppsych.2020.152198] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/12/2020] [Accepted: 07/17/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hospital staff are vulnerable and at high risk of novel coronavirus disease (COVID-19) infection. The aim of this study was to monitor the psychological distress in hospital staff and examine the relationship between the psychological distress and possible causes during the COVID-19 epidemic. METHODS An online survey was conducted from February 1 to February 14, 2020. Hospital staff from five national COVID-19 designated hospitals in Chongqing participated. Data collected included demographics and stress responses to COVID-19: 1) the impact of event scale to measure psychological stress reactions; 2) generalizedanxietydisorder 7 to measure anxiety symptoms; 3) Patient Health Questionnaire 9 to measure depression symptoms; 4) Yale-Brown Obsessive-Compulsive Scale to measure obsessive-compulsive symptoms (OCS); and 5) Patient Health Questionnaire 15 to measure somatization symptoms. Multiple logistic regression analysis was used to identify factors that were correlated with psychological distress. RESULTS Hospital staff that participated in this study were identified as either doctors or nurses. A total of 456 respondents completed the questionnaires with a response rate of 91.2%. The mean age was 30.67 ± 7.48 years (range, 17 to 64 years). Of all respondents, 29.4% were men. Of the staff surveyed, 43.2% had stress reaction syndrome. The highest prevalence of psychological distress was OCS (37.5%), followed by somatization symptoms (33.3%), anxiety symptoms (31.6%), and depression symptoms (29.6%). Univariate analyses indicated that female subjects, middle aged subjects, subjects in the low income group, and subjects working in isolation wards were prone to experience psychological distress. Multiple logistic regression analysis showed "Reluctant to work or considered resignation" (odds ratio [OR], 5.192; 95%CI, 2.396-11.250; P < .001), "Afraid to go home because of fear of infecting family" (OR, 2.099; 95%CI, 1.299-3.391; P = .002) "Uncertainty about frequent modification of infection and control procedures" (OR, 1.583; 95%CI, 1.061-2.363; P = .025), and"Social support" (OR, 1.754; 95%CI, 1.041-2.956; P = .035) were correlated with psychological reactions. "Reluctant to work or considered resignation" and "Afraid to go home because of fear of infecting family" were associated with a higher risk of symptoms of Anxiety (OR, 3.622; 95% CI, 1.882-6.973; P < .001; OR, 1.803; 95% CI, 1.069-3.039; P = .027), OCS (OR, 5.241; 95% CI, 2.545-10.793; P < .001; OR, 1.999; 95% CI, 1.217-3.282; P = .006) and somatization (OR, 5.177; 95% CI, 2.595-10.329; P < .001; OR, 1.749; 95% CI, 1.051-2.91; P = .031). "Stigmatization and rejection in neighborhood because of hospital work", "Reluctant to work or considered resignation" and "Uncertainty about frequent modification of infection and control procedures" were associated with a higher risk of symptoms of Depression(OR, 2.297; 95% CI, 1.138-4.637; P = .020; OR, 3.134; 95% CI, 1.635-6.006; P = .001; OR, 1.645; 95% CI, 1.075-2.517; P = .022). CONCLUSIONS Hospital staff showed different prevalence of psychological distress during the COVID-19 epidemic. Our study confirmed the severity of negative psychological distress on hospital staff and identified factors associated with negative psychological distress that can be used to provide valuable information for psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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Affiliation(s)
- Yang Juan
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China
| | - Cheng Yuanyuan
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China
| | - You Qiuxiang
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China
| | - Liu Cong
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China
| | - Lai Xiaofeng
- Department of Cardiology, General Hospital of Chongqing Group, Chongqing 400000, China
| | - Zhang Yundong
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China
| | - Cheng Jing
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China
| | - Qiao Peifeng
- Department of Neurology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 401120, China
| | - Long Yan
- Department of Neurology, Daping Hospital, Army Special Medical Center of PLA, 10 Changjiang Branch Road, Chongqing 400042, China
| | - Xiang Xiaojiao
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Yuzhong Road, Chongqing 400010, China
| | - Lai Yujie
- Department of Neurology, The Third Affiliated Hospital of Chongqing Medical University, 1 Shuanghu Road, Chongqing 401120, China.
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Tan SC, Haines K, Zhang N. Beyond the ventilator: Rehabilitation for critically ill patients with coronavirus disease 2019. Aust Crit Care 2020; 33:485-487. [PMID: 33250130 PMCID: PMC7690265 DOI: 10.1016/j.aucc.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Sing Chee Tan
- Intensive Care Specialist, Northern Health, Victoria, Australia.
| | | | - Nina Zhang
- Rehabilitation Specialist, Melbourne Health, Victoria, Australia
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Minakshi R, Jan AT, Rahman S, Kim J. A Testimony of the Surgent SARS-CoV-2 in the Immunological Panorama of the Human Host. Front Cell Infect Microbiol 2020; 10:575404. [PMID: 33262955 PMCID: PMC7687052 DOI: 10.3389/fcimb.2020.575404] [Citation(s) in RCA: 4] [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: 06/23/2020] [Accepted: 08/26/2020] [Indexed: 12/19/2022] Open
Abstract
The resurgence of SARS in the late December of 2019 due to a novel coronavirus, SARS-CoV-2, has shadowed the world with a pandemic. The physiopathology of this virus is very much in semblance with the previously known SARS-CoV and MERS-CoV. However, the unprecedented transmissibility of SARS-CoV-2 has been puzzling the scientific efforts. Though the virus harbors much of the genetic and architectural features of SARS-CoV, a few differences acquired during its evolutionary selective pressure is helping the SARS-CoV-2 to establish prodigious infection. Making entry into host the cell through already established ACE-2 receptor concerted with the action of TMPRSS2, is considered important for the virus. During the infection cycle of SARS-CoV-2, the innate immunity witnesses maximum dysregulations in its molecular network causing fatalities in aged, comorbid cases. The overt immunopathology manifested due to robust cytokine storm shows ARDS in severe cases of SARS-CoV-2. A delayed IFN activation gives appropriate time to the replicating virus to evade the host antiviral response and cause disruption of the adaptive response as well. We have compiled various aspects of SARS-CoV-2 in relation to its unique structural features and ability to modulate innate as well adaptive response in host, aiming at understanding the dynamism of infection.
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Affiliation(s)
- Rinki Minakshi
- Department of Microbiology, Swami Shraddhanand College, University of Delhi, New Delhi, India
| | - Arif Tasleem Jan
- School of Biosciences and Biotechnology, Baba Ghulam Shah Badshah University, Rajouri, India
| | - Safikur Rahman
- Munshi Singh College, BR Ambedkar Bihar University, Muzaffarpur, India
| | - Jihoe Kim
- Department of Medical Biotechnology, Research Institute of Cell Culture, Yeungnam University, Gyeongsan-si, South Korea
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