51
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Tsatsakis A, Vakonaki E, Tzatzarakis M, Flamourakis M, Nikolouzakis TK, Poulas K, Papazoglou G, Hatzidaki E, Papanikolaou NC, Drakoulis N, Iliaki E, Goulielmos GN, Kallionakis M, Lazopoulos G, Kteniadakis S, Alegkakis A, Farsalinos K, Spandidos DA. Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals. Int J Mol Med 2021; 48:200. [PMID: 34515322 PMCID: PMC8448546 DOI: 10.3892/ijmm.2021.5033] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
Soon after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in December, 2019, numerous research teams, assisted by vast capital investments, achieved vaccine development in a fraction of time. However, almost 8 months following the initiation of the European vaccination programme, the need for prospective monitoring of the vaccine-induced immune response, its determinants and related side-effects remains a priority. The present study aimed to quantify the immune response following full vaccination with the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine by measuring the levels of immunoglobulin G (IgG) titers in healthcare professionals. Moreover, common side-effects and factors associated with IgG titers were identified. For this purpose, blood samples from 517 individuals were obtained and analysed. Blood sampling was performed at a mean period of 69.0±23.5 days following the second dose of the vaccine. SARS-CoV-2 IgG titers had an overall mean value of 4.23±2.76. Females had higher titers than males (4.44±2.70 and 3.89 ±2.84, respectively; P=0.007), while non-smokers had higher titers than smokers (4.48±2.79 and 3.80±2.64, respectively; P=0.003). An older age was also associated with lower antibody titers (P<0.001). Moreover, the six most prevalent adverse effects were pain at the injection site (72.1%), generalized fatigue (40.5%), malaise (36.3%), myalgia (31,0%), headache (25.8%) and dizziness/weakness (21.6%). The present study demonstrated that the immune response after receiving the BNT162b2 COVID-19 mRNA vaccine is dependent on various modifiable and non-modifiable factors. Overall, the findings of the present study highlight two key aspects of the vaccination programs: First, the need for prospective immunosurveillance studies in order to estimate the duration of immunity, and second, the need to identify those individuals who are at a greater risk of developing low IgG titers in order to evaluate the need for a third dose of the vaccine.
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Affiliation(s)
- Aristidis Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Elena Vakonaki
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Manolis Tzatzarakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Matthaios Flamourakis
- Department of General Surgery, Venizeleion General Hospital, 71409 Heraklion, Greece
| | | | - Konstantinos Poulas
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500 Rio‑Patras, Greece
| | - Georgios Papazoglou
- Department of Emergency Medicine, Venizeleion General Hospital, 71409 Heraklion, Greece
| | - Eleftheria Hatzidaki
- Department of Neonatology and Neonatal Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
| | | | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Evangelia Iliaki
- Department of Internal Medicine, Venizeleion General Hospital, 71409 Heraklion, Greece
| | - Georgios N Goulielmos
- Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Manolis Kallionakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Georgios Lazopoulos
- Department of Cardiothoracic Surgery, University Hospital of Heraklion, 71500 Heraklion, Greece
| | | | - Athanasios Alegkakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Konstantinos Farsalinos
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500 Rio‑Patras, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
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52
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Puangsri P, Jinanarong V, Wattanapisit A. Impacts on and Care of Psychiatric Patients during the Outbreak of COVID-19. Clin Pract Epidemiol Ment Health 2021; 17:52-60. [PMID: 34497660 PMCID: PMC8386085 DOI: 10.2174/1745017902117010052] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/22/2021] [Accepted: 04/13/2021] [Indexed: 12/13/2022]
Abstract
The outbreak of coronavirus disease (COVID-19) in December 2019 has led to massive lifestyle, economic, and health changes. The COVID-19 pandemic has had broad impacts on psychiatric patients, exacerbating symptoms such as psychosis, depression, and suicidal ideation. Therefore, we aimed to review the psychological impacts of COVID-19 on psychiatric patients and mental healthcare staff and provide practical guidance for medical staff and authorities. The main findings of this review included the impacts of COVID-19 on psychiatric patients and mental health professionals as well as the transformation of mental health care. Greater consideration should be given to the care of patients with psychosis and depression because of their lack of self-care ability, neurocognitive impairment, and impaired immune function. Depressive symptoms can be exacerbated due to several factors, such as economic crises, social isolation, and limited physical activity. Unemployment and financial problems can lead to an increased suicide rate. Consequently, mental healthcare workers’ workload can increase, which could lead to burnout and psychological symptoms such as insomnia, depression, and anxiety. A transformation of psychiatric care is needed during the time of the pandemic. While emergency care should be maintained, outpatient care should be limited to decrease viral spread. Shifting care to telemedicine and community-based psychiatry can be helpful. Inpatient services should be adapted by tightening admission criteria, shortening the length of hospital stays, suspending some group activities, limiting visitors, and preparing for quarantine if necessary. Mental healthcare workers can be supported with telecommunication, appropriate work shifts, alternative accommodations, and good communication between the team leader and staff.
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Affiliation(s)
- Pavarud Puangsri
- School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Vinn Jinanarong
- Walailak University Hospital, Thasala, Nakhon Si Thammarat, Thailand
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53
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Pham QT, Le XTT, Phan TC, Nguyen QN, Ta NKT, Nguyen AN, Nguyen TT, Nguyen QT, Le HT, Luong AM, Koh D, Hoang MT, Pham HQ, Vu LG, Nguyen TH, Tran BX, Latkin CA, Ho CSH, Ho RCM. Impacts of COVID-19 on the Life and Work of Healthcare Workers During the Nationwide Partial Lockdown in Vietnam. Front Psychol 2021; 12:563193. [PMID: 34489769 PMCID: PMC8417359 DOI: 10.3389/fpsyg.2021.563193] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/05/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Healthcare workers are frontline responders facing a disproportionate increase in occupational responsibilities during the COVID-19 pandemic. Added work-related stress among healthcare personnel may lead to personal and work-related repercussions, such as burnout or decreased quality of care for patients; however, little is known about how the COVID-19 pandemic affects the daily work and life of these workers. This study aimed to evaluate the personal and occupational impacts of the COVID-19 induced partial lockdown in Vietnam among hospital staff. Methods: A cross-sectional web-based study was carried out to collect demographic data and the personal and job impacts of respondents during the second week of national lockdown in April 2020. Snowball sampling technique was applied to recruit 742 hospital staff. The exploratory factor analysis (EFA) was used to examine the validity of the instrument. Results: Of the 742 respondents, 21.2% agreed that “working attitude well-maintained,” followed by 16.1% of respondents who reported that there were “enough employees at work.” Only 3.2% of respondents agreed that “their work was appreciated by society.” Furthermore, healthcare workers in the central region were less likely to have experienced “Avoidance of disclosure and discrimination related to COVID-19” than other areas (Coef. = – 0.25, CI: −0.42 to −0.07). Being women also had a negative association with scores in “Avoidance of disclosure and discrimination related to COVID 19” domain (Coef. = −0.27, CI: −0.43 to −0.12) while having a positive association with “negative attitude towards working conditions” domain (Coef. = 0.19, CI: 0.09 to 0.3). In addition, working in administrative offices (Coef. = 0.20; 95% CI = 0.05 to 0.36) and infectious departments (Coef. = 0.36; 95% CI = 0.09 to 0.63) had a positive association with “Increased work pressure due to COVID 19” domain. Conclusion: These findings revealed marginal impacts of the COVID-19 pandemic on the work and life of hospital staff in Vietnam. Furthermore, this study highlighted the importance of implementing preventive strategies during the nationwide partial lockdown to manage hospital admissions and the burden on healthcare workers. Finally, this study characterizes targeted demographics that may benefit from appreciation by employers and society during a national pandemic.
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Affiliation(s)
- Quan Thi Pham
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Xuan Thi Thanh Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Tam Chi Phan
- School of Pharmacy, University of Southern California, Los Angeles, CA, United States
| | - Quang Nhat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,UFR Biosciences Department, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Nhung Kim Thi Ta
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Ngoc Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thao Thanh Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quynh Thi Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Mai Luong
- Viet Nam Health Environment Management Agency, Ministry of Health, Hanoi, Vietnam
| | - David Koh
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah (PAPRSB), Institute of Health Science, Universiti Brunei Darussalam, Gadong, Brunei.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Men Thi Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Trang Ha Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C M Ho
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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54
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Mehta P, Alle S, Chaturvedi A, Swaminathan A, Saifi S, Maurya R, Chattopadhyay P, Devi P, Chauhan R, Kanakan A, Vasudevan JS, Sethuraman R, Chidambaram S, Srivastava M, Chakravarthi A, Jacob J, Namagiri M, Konala V, Jha S, Priyakumar UD, Vinod PK, Pandey R. Clinico-Genomic Analysis Reveals Mutations Associated with COVID-19 Disease Severity: Possible Modulation by RNA Structure. Pathogens 2021; 10:1109. [PMID: 34578142 PMCID: PMC8464923 DOI: 10.3390/pathogens10091109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) manifests a broad spectrum of clinical presentations, varying in severity from asymptomatic to mortality. As the viral infection spread, it evolved and developed into many variants of concern. Understanding the impact of mutations in the SARS-CoV-2 genome on the clinical phenotype and associated co-morbidities is important for treatment and preventionas the pandemic progresses. Based on the mild, moderate, and severe clinical phenotypes, we analyzed the possible association between both, the clinical sub-phenotypes and genomic mutations with respect to the severity and outcome of the patients. We found a significant association between the requirement of respiratory support and co-morbidities. We also identified six SARS-CoV-2 genome mutations that were significantly correlated with severity and mortality in our cohort. We examined structural alterations at the RNA and protein levels as a result of three of these mutations: A26194T, T28854T, and C25611A, present in the Orf3a and N protein. The RNA secondary structure change due to the above mutations can be one of the modulators of the disease outcome. Our findings highlight the importance of integrative analysis in which clinical and genetic components of the disease are co-analyzed. In combination with genomic surveillance, the clinical outcome-associated mutations could help identify individuals for priority medical support.
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Affiliation(s)
- Priyanka Mehta
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
| | - Shanmukh Alle
- Center for Computational Natural Sciences and Bioinformatics, International Institute of Information Technology, Hyderabad 500032, India; (S.A.); (A.C.); (R.C.)
| | - Anusha Chaturvedi
- Center for Computational Natural Sciences and Bioinformatics, International Institute of Information Technology, Hyderabad 500032, India; (S.A.); (A.C.); (R.C.)
| | - Aparna Swaminathan
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
| | - Sheeba Saifi
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
| | - Ranjeet Maurya
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Partha Chattopadhyay
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Priti Devi
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Ruchi Chauhan
- Center for Computational Natural Sciences and Bioinformatics, International Institute of Information Technology, Hyderabad 500032, India; (S.A.); (A.C.); (R.C.)
| | - Akshay Kanakan
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
| | - Janani Srinivasa Vasudevan
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
| | - Ramanathan Sethuraman
- Intel Technology India Private Limited, Bangalore 530103, India; (R.S.); (S.C.); (M.S.); (A.C.); (J.J.); (M.N.); (V.K.)
| | - Subramanian Chidambaram
- Intel Technology India Private Limited, Bangalore 530103, India; (R.S.); (S.C.); (M.S.); (A.C.); (J.J.); (M.N.); (V.K.)
| | - Mashrin Srivastava
- Intel Technology India Private Limited, Bangalore 530103, India; (R.S.); (S.C.); (M.S.); (A.C.); (J.J.); (M.N.); (V.K.)
| | - Avinash Chakravarthi
- Intel Technology India Private Limited, Bangalore 530103, India; (R.S.); (S.C.); (M.S.); (A.C.); (J.J.); (M.N.); (V.K.)
| | - Johnny Jacob
- Intel Technology India Private Limited, Bangalore 530103, India; (R.S.); (S.C.); (M.S.); (A.C.); (J.J.); (M.N.); (V.K.)
| | - Madhuri Namagiri
- Intel Technology India Private Limited, Bangalore 530103, India; (R.S.); (S.C.); (M.S.); (A.C.); (J.J.); (M.N.); (V.K.)
| | - Varma Konala
- Intel Technology India Private Limited, Bangalore 530103, India; (R.S.); (S.C.); (M.S.); (A.C.); (J.J.); (M.N.); (V.K.)
| | - Sujeet Jha
- Max Super Speciality Hospital (A Unit of Devki Devi Foundation), Max Healthcare, Delhi 110017, India;
| | - U. Deva Priyakumar
- Center for Computational Natural Sciences and Bioinformatics, International Institute of Information Technology, Hyderabad 500032, India; (S.A.); (A.C.); (R.C.)
| | - P. K. Vinod
- Center for Computational Natural Sciences and Bioinformatics, International Institute of Information Technology, Hyderabad 500032, India; (S.A.); (A.C.); (R.C.)
| | - Rajesh Pandey
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Mall Road, Delhi 110017, India; (P.M.); (A.S.); (S.S.); (R.M.); (P.C.); (P.D.); (A.K.); (J.S.V.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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ÖZKAN OKTAY E, TUNCAY S, KAMAN T, KARASAKAL ÖF, ÖZCAN ÖÖ, SOYLAMIŞ T, KARAHAN M, KONUK M. An update comprehensive review on the status of COVID-19: vaccines, drugs, variants and neurological symptoms. Turk J Biol 2021; 45:342-357. [PMID: 34803439 PMCID: PMC8573837 DOI: 10.3906/biy-2106-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/28/2021] [Indexed: 12/13/2022] Open
Abstract
Various recently reported mutant variants, candidate and urgently approved current vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many current situations with severe neurological damage and symptoms as well as respiratory tract disorders have begun to be reported. In particular, drug, vaccine, and neutralizing monoclonal antibodies (mAbs) have been developed and are currently being evaluated in clinical trials. Here, we review lessons learned from the use of novel mutant variants of the COVID-19 virus, immunization, new drug solutions, and antibody therapies for infections. Next, we focus on the B 1.1.7, B 1.351, P.1, and B.1.617 lineages or variants of concern that have been reported worldwide, the new manifestations of neurological manifestations, the current therapeutic drug targets for its treatment, vaccine candidates and their efficacy, implantation of convalescent plasma, and neutralization of mAbs. We review specific clinical questions, including many emerging neurological effects and respiratory tract injuries, as well as new potential biomarkers, new studies in addition to known therapeutics, and chronic diseases of vaccines that have received immediate approval. To answer these questions, further understanding of the burden kinetics of COVID-19 and its correlation with neurological clinical outcomes, endogenous antibody responses to vaccines, pharmacokinetics of neutralizing mAbs, and action against emerging viral mutant variants is needed.
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Affiliation(s)
- Ebru ÖZKAN OKTAY
- Laboratory Technology Program, Vocational School of Health Services, Üsküdar University, İstanbulTurkey
| | - Salih TUNCAY
- Food Technology Program, Vocational School of Health Services, Üsküdar University, İstanbulTurkey
| | - Tuğba KAMAN
- Medical and Aromatic Plants Program, Vocational School of Health Services, Üsküdar University, İstanbulTurkey
| | - Ömer Faruk KARASAKAL
- Medical Laboratory Techniques Program, Vocational School of Health Services, Üsküdar University, İstanbulTurkey
| | - Öznur Özge ÖZCAN
- Physiotherapy Program, Vocational School of Health Services, Üsküdar University, İstanbul Turkey
| | - Tuğçe SOYLAMIŞ
- Laboratory Technology Program, Vocational School of Health Services, Üsküdar University, İstanbulTurkey
| | - Mesut KARAHAN
- Vocational School of Health Services, Üsküdar University, İstanbulTurkey
| | - Muhsin KONUK
- Department of Molecular Biology and Genetics, Faculty of Engineering and Natural Sciences, Üsküdar University, İstanbulTurkey
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56
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Rodrigues R, Costa de Oliveira S. The Impact of Angiotensin-Converting Enzyme 2 ( ACE2) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review. Microorganisms 2021; 9:1692. [PMID: 34442770 PMCID: PMC8398209 DOI: 10.3390/microorganisms9081692] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/19/2021] [Accepted: 08/06/2021] [Indexed: 01/08/2023] Open
Abstract
Angiotensin-Converting Enzyme 2 (ACE2) has been proved to be the main host cell receptor for the binding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the COVID-19 pandemic. The SARS-CoV-2 spike (S) protein binds to ACE2 to initiate the process of replication. This enzyme is widely present in human organ tissues, such as the heart and lung. The pathophysiology of ACE2 in SARS-CoV-2 infection is complex and may be associated with several factors and conditions that are more severe in COVID-19 patients, such as age, male gender, and comorbidities, namely, cardiovascular diseases, chronic respiratory diseases, obesity, and diabetes. Here we present a comprehensive review that aims to correlate the levels of expression of the ACE2 in patients with comorbidities and with a poor outcome in COVID-19 disease. Significantly higher levels of expression of ACE2 were observed in myocardial and lung tissues in heart failure and COPD patients, respectively. An age-dependent increase in SARS2-CoV-2 receptors in the respiratory epithelium may be also responsible for the increased severity of COVID-19 lung disease in elderly people. Although the role of ACE2 is highlighted regarding the damage that can arise upon the SARS-CoV-2 invasion, there was no association observed between renin-angiotensin-aldosterone system (RAAS) inhibitors and the severity of COVID-19.
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Affiliation(s)
- Rui Rodrigues
- Department of Pathology, Division of Microbiology, Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200-319 Porto, Portugal;
| | - Sofia Costa de Oliveira
- Department of Pathology, Division of Microbiology, Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200-319 Porto, Portugal;
- Center for Research in Health Technologies and Information Systems (CINTESIS), R. Dr. Plácido da Costa, 4200-450 Porto, Portugal
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57
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Kim KB, Choi H, Lee GD, Lee J, Lee S, Kim Y, Cho SY, Lee DG, Kim M. Analytical and Clinical Performance of Droplet Digital PCR in the Detection and Quantification of SARS-CoV-2. Mol Diagn Ther 2021; 25:617-628. [PMID: 34319580 PMCID: PMC8316104 DOI: 10.1007/s40291-021-00547-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Since the initial coronavirus disease outbreak in late 2019 (COVID-19), reverse-transcription real-time polymerase chain reaction (RT-qPCR) has become the gold standard test to detect severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2). However, a more sensitive and accurate diagnostic tool was required. Therefore, droplet digital polymerase chain reaction (ddPCR) was suggested as an alternative method. Here, we evaluated the performance of ddPCR to detect SARS-CoV-2 and compared it to the performance of RT-qPCR. METHODS The analytical performances, including limit of blank and limit of detection, were established using positive and negative SARS-CoV-2 reference materials. A total of 366 RNA extracts (173 positive and 193 negative by RT-qPCR) were collected from four institutions and tested with a Bio-Rad SARS-CoV-2 ddPCR kit that detects the SARS-CoV-2 genome using primers for N1 and N2. RESULTS Limit of blank was set at 0, and the limits of detection of N1 and N2 were 1.99 copies/μL and 5.18 copies/μL, respectively. Linearity was evaluated using serial dilution samples, which demonstrated good results (R2: 0.999, linear range: 5.88-6825.25 copies/μL for N1 and R2: 0.999, 5.53-5855.47 copies/μL for N2). The results of ddPCR and RT-qPCR revealed substantial agreement (Cohen's kappa: 0.639, p < 0.01). The 63 samples with positive ddPCR but negative RT-qPCR showed low copy numbers, and 55% of them had COVID-19-related symptoms. CONCLUSIONS Droplet digital polymerase chain reaction demonstrated excellent sensitivity for SARS-Cov-2 detection and consistently agreed with the results from conventional RT-qPCR. Furthermore, ddPCR provided quantitative data that can be used to monitor changes in the viral load of patients with COVID-19.
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Affiliation(s)
- Kyoung Bo Kim
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hayoung Choi
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Gun Dong Lee
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jaewoong Lee
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seungok Lee
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yonggoo Kim
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Yeon Cho
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Gun Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Myungshin Kim
- Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Gugliandolo A, Chiricosta L, Calcaterra V, Biasin M, Cappelletti G, Carelli S, Zuccotti G, Avanzini MA, Bramanti P, Pelizzo G, Mazzon E. SARS-CoV-2 Infected Pediatric Cerebral Cortical Neurons: Transcriptomic Analysis and Potential Role of Toll-like Receptors in Pathogenesis. Int J Mol Sci 2021; 22:8059. [PMID: 34360824 PMCID: PMC8347089 DOI: 10.3390/ijms22158059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 02/07/2023] Open
Abstract
Different mechanisms were proposed as responsible for COVID-19 neurological symptoms but a clear one has not been established yet. In this work we aimed to study SARS-CoV-2 capacity to infect pediatric human cortical neuronal HCN-2 cells, studying the changes in the transcriptomic profile by next generation sequencing. SARS-CoV-2 was able to replicate in HCN-2 cells, that did not express ACE2, confirmed also with Western blot, and TMPRSS2. Looking for pattern recognition receptor expression, we found the deregulation of scavenger receptors, such as SR-B1, and the downregulation of genes encoding for Nod-like receptors. On the other hand, TLR1, TLR4 and TLR6 encoding for Toll-like receptors (TLRs) were upregulated. We also found the upregulation of genes encoding for ERK, JNK, NF-κB and Caspase 8 in our transcriptomic analysis. Regarding the expression of known receptors for viral RNA, only RIG-1 showed an increased expression; downstream RIG-1, the genes encoding for TRAF3, IKKε and IRF3 were downregulated. We also found the upregulation of genes encoding for chemokines and accordingly we found an increase in cytokine/chemokine levels in the medium. According to our results, it is possible to speculate that additionally to ACE2 and TMPRSS2, also other receptors may interact with SARS-CoV-2 proteins and mediate its entry or pathogenesis in pediatric cortical neurons infected with SARS-CoV-2. In particular, TLRs signaling could be crucial for the neurological involvement related to SARS-CoV-2 infection.
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Affiliation(s)
- Agnese Gugliandolo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (A.G.); (L.C.); (P.B.)
| | - Luigi Chiricosta
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (A.G.); (L.C.); (P.B.)
| | - Valeria Calcaterra
- Department of Pediatrics, Ospedale dei Bambini “Vittore Buzzi”, 20154 Milano, Italy; (V.C.); (G.Z.)
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences–L. Sacco, University of Milan, 20157 Milan, Italy; (M.B.); (G.C.); (G.P.)
| | - Gioia Cappelletti
- Department of Biomedical and Clinical Sciences–L. Sacco, University of Milan, 20157 Milan, Italy; (M.B.); (G.C.); (G.P.)
| | - Stephana Carelli
- Pediatric Clinical Research Center Fondazione Romeo ed Enrica Invernizzi, University of Milan, 20157 Milan, Italy;
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Ospedale dei Bambini “Vittore Buzzi”, 20154 Milano, Italy; (V.C.); (G.Z.)
- Department of Biomedical and Clinical Sciences–L. Sacco, University of Milan, 20157 Milan, Italy; (M.B.); (G.C.); (G.P.)
| | - Maria Antonietta Avanzini
- Cell Factory, Pediatric Hematology Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Placido Bramanti
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (A.G.); (L.C.); (P.B.)
| | - Gloria Pelizzo
- Department of Biomedical and Clinical Sciences–L. Sacco, University of Milan, 20157 Milan, Italy; (M.B.); (G.C.); (G.P.)
- Pediatric Surgery Unit, Ospedale dei Bambini “Vittore Buzzi”, 20154 Milano, Italy
| | - Emanuela Mazzon
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (A.G.); (L.C.); (P.B.)
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Ramezanpour M, Bolt H, Hon K, Bouras GS, Psaltis AJ, Wormald PJ, Vreugde S. Cytokine-Induced Modulation of SARS-CoV2 Receptor Expression in Primary Human Nasal Epithelial Cells. Pathogens 2021; 10:pathogens10070848. [PMID: 34357998 PMCID: PMC8308731 DOI: 10.3390/pathogens10070848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Viral entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) via the spike protein enables endocytosis into host cells using the ACE2 receptor and TMPRSS2. The frequent upper respiratory tract symptoms of COVID-19 and the localization of the virus to the nasopharynx, the most common site of swabbing, indicate that the sinonasal mucosa may play an important role in SARS-CoV2 infection and viral replication. Methods: This paper investigates the presence of ACE2 receptor and TMPRESS2 expression in the primary human nasal epithelial cells (HNECs) from the following: chronic rhinosinusitis without nasal polyps (CRSsNP), CRS with nasal polyps (CRSwNP) and control (non-CRS) patients, and maps the expression changes when exposed to Th1, Th2, Th17-associated cytokines. Results: We found that ACE2 and TMPRSS2 expression was higher in control HNECs than CRSwNP HNECs, and that both ACE2 and TMPRSS2 were downregulated further by Th2 cytokines in CRSwNP HNECs. Conclusions: This indicates an immune dysregulated state of CRSwNP mucosa, which normally contributes to a chronic inflammatory state, and might support an altered susceptibility to SARS-CoV2 infection and transmission.
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Affiliation(s)
- Mahnaz Ramezanpour
- Department of Surgery-Otolaryngology, Head and Neck Surgery, Central Adelaide Local Health Network (Basil Hetzel Institute), The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, AS 5011, Australia; (M.R.); (H.B.); (K.H.); (G.S.B.); (A.J.P.); (P.-J.W.)
| | - Harrison Bolt
- Department of Surgery-Otolaryngology, Head and Neck Surgery, Central Adelaide Local Health Network (Basil Hetzel Institute), The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, AS 5011, Australia; (M.R.); (H.B.); (K.H.); (G.S.B.); (A.J.P.); (P.-J.W.)
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Karen Hon
- Department of Surgery-Otolaryngology, Head and Neck Surgery, Central Adelaide Local Health Network (Basil Hetzel Institute), The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, AS 5011, Australia; (M.R.); (H.B.); (K.H.); (G.S.B.); (A.J.P.); (P.-J.W.)
| | - George Spyro Bouras
- Department of Surgery-Otolaryngology, Head and Neck Surgery, Central Adelaide Local Health Network (Basil Hetzel Institute), The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, AS 5011, Australia; (M.R.); (H.B.); (K.H.); (G.S.B.); (A.J.P.); (P.-J.W.)
| | - Alkis James Psaltis
- Department of Surgery-Otolaryngology, Head and Neck Surgery, Central Adelaide Local Health Network (Basil Hetzel Institute), The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, AS 5011, Australia; (M.R.); (H.B.); (K.H.); (G.S.B.); (A.J.P.); (P.-J.W.)
| | - Peter-John Wormald
- Department of Surgery-Otolaryngology, Head and Neck Surgery, Central Adelaide Local Health Network (Basil Hetzel Institute), The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, AS 5011, Australia; (M.R.); (H.B.); (K.H.); (G.S.B.); (A.J.P.); (P.-J.W.)
| | - Sarah Vreugde
- Department of Surgery-Otolaryngology, Head and Neck Surgery, Central Adelaide Local Health Network (Basil Hetzel Institute), The Queen Elizabeth Hospital and The University of Adelaide, Adelaide, AS 5011, Australia; (M.R.); (H.B.); (K.H.); (G.S.B.); (A.J.P.); (P.-J.W.)
- Correspondence: ; Tel.: +618-8222-7158; Fax: +618-8222-7419
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Kumar D, Jahan S, Khan A, Siddiqui AJ, Redhu NS, Wahajuddin, Khan J, Banwas S, Alshehri B, Alaidarous M. Neurological Manifestation of SARS-CoV-2 Induced Inflammation and Possible Therapeutic Strategies Against COVID-19. Mol Neurobiol 2021; 58:3417-3434. [PMID: 33715108 PMCID: PMC7955900 DOI: 10.1007/s12035-021-02318-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/01/2021] [Indexed: 01/08/2023]
Abstract
There are regular reports of extrapulmonary infections and manifestations related to the ongoing COVID-19 pandemic. Coronaviruses are potentially neurotropic, which renders neuronal tissue vulnerable to infection, especially in elderly individuals or in those with neuro-comorbid conditions. Complaints of ageusia, anosmia, myalgia, and headache; reports of diseases such as stroke, encephalopathy, seizure, and encephalitis; and loss of consciousness in patients with COVID-19 confirm the neuropathophysiological aspect of this disease. The brain is linked to pulmonary organs, physiologically through blood circulation, and functionally through the nervous system. The interdependence of these vital organs may further aggravate the pathophysiological aspects of COVID-19. The induction of a cytokine storm in systemic circulation can trigger a neuroinflammatory cascade, which can subsequently compromise the blood-brain barrier and activate microglia- and astrocyte-borne Toll-like receptors, thereby leading to neuronal tissue damage. Hence, a holistic approach should be adopted by healthcare professionals while treating COVID-19 patients with a history of neurodegenerative disorders, neuropsychological complications, or any other neuro-compromised conditions. Imperatively, vaccines are being developed at top priority to contain the spread of the severe acute respiratory syndrome coronavirus 2, and different vaccines are at different stages of development globally. This review discusses the concerns regarding the neuronal complications of COVID-19 and the possible mechanisms of amelioration.
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Affiliation(s)
- Dipak Kumar
- Zoology Department, KKM College, Jamui, Munger University, Munger, India
| | - Sadaf Jahan
- Department of Medical Laboratories, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia, Kingdom of Saudi Arabia.
| | - Andleeb Khan
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
| | - Arif Jamal Siddiqui
- Department of Biology, College of Science, University of Hail, Hail, PO Box 2440, Saudi Arabia
| | - Neeru Singh Redhu
- Department of Molecular Biology, Biotechnology and Bioinformatics, Chaudhary Charan Singh Haryana Agricultural University, Hisar, Haryana 125004, India
| | - Wahajuddin
- Division of Pharmaceutics & Pharmacokinetics, CSIR-Central Drug Research Institute, Lucknow, UP, India
| | - Johra Khan
- Department of Medical Laboratories, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia, Kingdom of Saudi Arabia
| | - Saeed Banwas
- Department of Medical Laboratories, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia, Kingdom of Saudi Arabia
- Health and Basic Sciences Research Center, Majmaah University, Majmaah, 11952, Saudi Arabia
- Departments of Biomedical Sciences, Oregon State University, Corvallis, OR, 97331, USA
| | - Bader Alshehri
- Department of Medical Laboratories, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia, Kingdom of Saudi Arabia
- Health and Basic Sciences Research Center, Majmaah University, Majmaah, 11952, Saudi Arabia
| | - Mohammed Alaidarous
- Department of Medical Laboratories, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia, Kingdom of Saudi Arabia
- Health and Basic Sciences Research Center, Majmaah University, Majmaah, 11952, Saudi Arabia
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Semyachkina-Glushkovskaya O, Mamedova A, Vinnik V, Klimova M, Saranceva E, Ageev V, Yu T, Zhu D, Penzel T, Kurths J. Brain Mechanisms of COVID-19-Sleep Disorders. Int J Mol Sci 2021; 22:6917. [PMID: 34203143 PMCID: PMC8268116 DOI: 10.3390/ijms22136917] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 02/06/2023] Open
Abstract
2020 and 2021 have been unprecedented years due to the rapid spread of the modified severe acute respiratory syndrome coronavirus around the world. The coronavirus disease 2019 (COVID-19) causes atypical infiltrated pneumonia with many neurological symptoms, and major sleep changes. The exposure of people to stress, such as social confinement and changes in daily routines, is accompanied by various sleep disturbances, known as 'coronasomnia' phenomenon. Sleep disorders induce neuroinflammation, which promotes the blood-brain barrier (BBB) disruption and entry of antigens and inflammatory factors into the brain. Here, we review findings and trends in sleep research in 2020-2021, demonstrating how COVID-19 and sleep disorders can induce BBB leakage via neuroinflammation, which might contribute to the 'coronasomnia' phenomenon. The new studies suggest that the control of sleep hygiene and quality should be incorporated into the rehabilitation of COVID-19 patients. We also discuss perspective strategies for the prevention of COVID-19-related BBB disorders. We demonstrate that sleep might be a novel biomarker of BBB leakage, and the analysis of sleep EEG patterns can be a breakthrough non-invasive technology for diagnosis of the COVID-19-caused BBB disruption.
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Affiliation(s)
- Oxana Semyachkina-Glushkovskaya
- Institute of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Aysel Mamedova
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Valeria Vinnik
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Maria Klimova
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Elena Saranceva
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Vasily Ageev
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
| | - Tingting Yu
- Wuhan National Laboratory for Optoelectronics, Britton Chance Center for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan 430074, China; (T.Y.); (D.Z.)
- MoE Key Laboratory for Biomedical Photonics, Collaborative Innovation Center for Biomedical Engineering, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Dan Zhu
- Wuhan National Laboratory for Optoelectronics, Britton Chance Center for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan 430074, China; (T.Y.); (D.Z.)
- MoE Key Laboratory for Biomedical Photonics, Collaborative Innovation Center for Biomedical Engineering, School of Engineering Sciences, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Thomas Penzel
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
- Sleep Medicine Center, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jürgen Kurths
- Institute of Physics, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Atrakhanskaya Str. 83, 410012 Saratov, Russia; (A.M.); (V.V.); (M.K.); (E.S.); (V.A.)
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
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Swain O, Romano SK, Miryala R, Tsai J, Parikh V, Umanah GKE. SARS-CoV-2 Neuronal Invasion and Complications: Potential Mechanisms and Therapeutic Approaches. J Neurosci 2021; 41:5338-5349. [PMID: 34162747 PMCID: PMC8221594 DOI: 10.1523/jneurosci.3188-20.2021] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/12/2021] [Accepted: 05/02/2021] [Indexed: 12/15/2022] Open
Abstract
Clinical reports suggest that the coronavirus disease-19 (COVID-19) pandemic caused by severe acute respiratory syndrome (SARS)-coronavirus-2 (CoV-2) has not only taken millions of lives, but has also created a major crisis of neurologic complications that persist even after recovery from the disease. Autopsies of patients confirm the presence of the coronaviruses in the CNS, especially in the brain. The invasion and transmission of SARS-CoV-2 in the CNS is not clearly defined, but, because the endocytic pathway has become an important target for the development of therapeutic strategies for COVID-19, it is necessary to understand endocytic processes in the CNS. In addition, mitochondria and mechanistic target of rapamycin (mTOR) signaling pathways play a critical role in the antiviral immune response, and may also be critical for endocytic activity. Furthermore, dysfunctions of mitochondria and mTOR signaling pathways have been associated with some high-risk conditions such as diabetes and immunodeficiency for developing severe complications observed in COVID-19 patients. However, the role of these pathways in SARS-CoV-2 infection and spread are largely unknown. In this review, we discuss the potential mechanisms of SARS-CoV-2 entry into the CNS and how mitochondria and mTOR pathways might regulate endocytic vesicle-mitochondria interactions and dynamics during SARS-CoV-2 infection. The mechanisms that plausibly account for severe neurologic complications with COVID-19 and potential treatments with Food and Drug Administration-approved drugs targeting mitochondria and the mTOR pathways are also addressed.
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Affiliation(s)
- Olivia Swain
- Neuroscience Department, Krieger School of Arts and Sciences, The Johns Hopkins University, Baltimore, Maryland 21205
| | - Sofia K Romano
- Neuroscience Department, Krieger School of Arts and Sciences, The Johns Hopkins University, Baltimore, Maryland 21205
| | - Ritika Miryala
- Neuroscience Department, Krieger School of Arts and Sciences, The Johns Hopkins University, Baltimore, Maryland 21205
| | - Jocelyn Tsai
- Neuroscience Department, Krieger School of Arts and Sciences, The Johns Hopkins University, Baltimore, Maryland 21205
| | - Vinnie Parikh
- Neuroscience Department, Krieger School of Arts and Sciences, The Johns Hopkins University, Baltimore, Maryland 21205
| | - George K E Umanah
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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Replication Kinetics, Cell Tropism, and Associated Immune Responses in SARS-CoV-2- and H5N1 Virus-Infected Human Induced Pluripotent Stem Cell-Derived Neural Models. mSphere 2021; 6:e0027021. [PMID: 34160239 PMCID: PMC8265642 DOI: 10.1128/msphere.00270-21] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a wide variety of neurological complications. Even though SARS-CoV-2 is rarely detected in the central nervous system (CNS) or cerebrospinal fluid, evidence is accumulating that SARS-CoV-2 might enter the CNS via the olfactory nerve. However, what happens after SARS-CoV-2 enters the CNS is poorly understood. Therefore, we investigated the replication kinetics, cell tropism, and associated immune responses of SARS-CoV-2 infection in different types of neural cultures derived from human induced pluripotent stem cells (hiPSCs). SARS-CoV-2 was compared to the neurotropic and highly pathogenic H5N1 influenza A virus. SARS-CoV-2 infected a minority of individual mature neurons, without subsequent virus replication and spread, despite angiotensin-converting enzyme 2 (ACE2), transmembrane protease serine 2 (TMPRSS2), and neuropilin-1 (NPR1) expression in all cultures. However, this sparse infection did result in the production of type III interferons and interleukin-8 (IL-8). In contrast, H5N1 virus replicated and spread very efficiently in all cell types in all cultures. Taken together, our findings support the hypothesis that neurological complications might result from local immune responses triggered by virus invasion, rather than abundant SARS-CoV-2 replication in the CNS. IMPORTANCE Infections with the recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are often associated with neurological complications. Evidence suggests that SARS-CoV-2 enters the brain via the olfactory nerve; however, SARS-CoV-2 is only rarely detected in the central nervous system of COVID-19 patients. Here, we show that SARS-CoV-2 is able to infect neurons of human iPSC neural cultures but that this infection is abortive and does not result in virus spread to other cells. However, infection of neural cultures did result in the production of type III interferon and IL-8. This study suggests that SARS-CoV-2 might enter the CNS and infect individual neurons, triggering local immune responses that could contribute to the pathogenesis of SARS-CoV-2-associated CNS disease.
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Cárdenas-Rodríguez N, Bandala C, Vanoye-Carlo A, Ignacio-Mejía I, Gómez-Manzo S, Hernández-Cruz EY, Pedraza-Chaverri J, Carmona-Aparicio L, Hernández-Ochoa B. Use of Antioxidants for the Neuro-Therapeutic Management of COVID-19. Antioxidants (Basel) 2021; 10:971. [PMID: 34204362 PMCID: PMC8235474 DOI: 10.3390/antiox10060971] [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: 05/08/2021] [Revised: 06/07/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an emergent infectious disease that has caused millions of deaths throughout the world. COVID-19 infection's main symptoms are fever, cough, fatigue, and neurological manifestations such as headache, myalgias, anosmia, ageusia, impaired consciousness, seizures, and even neuromuscular junctions' disorders. In addition, it is known that this disease causes a series of systemic complications such as adverse respiratory distress syndrome, cardiac injury, acute kidney injury, and liver dysfunction. Due to the neurological symptoms associated with COVID-19, damage in the central nervous system has been suggested as well as the neuroinvasive potential of SARS-CoV-2. It is known that CoV infections are associated with an inflammation process related to the imbalance of the antioxidant system; cellular changes caused by oxidative stress contribute to brain tissue damage. Although anti-COVID-19 vaccines are under development, there is no specific treatment for COVID-19 and its clinical manifestations and complications; only supportive treatments with immunomodulators, anti-vascular endothelial growth factors, modulating drugs, statins, or nutritional supplements have been used. In the present work, we analyzed the potential of antioxidants as adjuvants for the treatment of COVID-19 and specifically their possible role in preventing or decreasing the neurological manifestations and neurological complications present in the disease.
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Affiliation(s)
- Noemí Cárdenas-Rodríguez
- Laboratorio de Neurociencias, Instituto Nacional de Pediatría, Secreatría de Salud, Ciudad de México 04530, Mexico; (A.V.-C.); (L.C.-A.)
| | - Cindy Bandala
- Division de Neurociencias, Instituto Nacional de Rehabilitación, Secretaría de Salud, Ciudad de México 14389, Mexico;
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | - América Vanoye-Carlo
- Laboratorio de Neurociencias, Instituto Nacional de Pediatría, Secreatría de Salud, Ciudad de México 04530, Mexico; (A.V.-C.); (L.C.-A.)
| | - Iván Ignacio-Mejía
- Laboratorio de Medicina Traslacional, Escuela Militar de Graduados de Sanidad, SEDENA, Ciudad de México 11200, Mexico;
| | - Saúl Gómez-Manzo
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México 04530, Mexico;
| | | | - José Pedraza-Chaverri
- Departamento de Biología, Facultad de Química, UNAM, Ciudad de México 04150, Mexico; (E.Y.H.-C.); (J.P.-C.)
| | - Liliana Carmona-Aparicio
- Laboratorio de Neurociencias, Instituto Nacional de Pediatría, Secreatría de Salud, Ciudad de México 04530, Mexico; (A.V.-C.); (L.C.-A.)
| | - Beatriz Hernández-Ochoa
- Laboratorio de Inmunoquímica, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México 06720, Mexico;
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Krupp K, Madhivanan P, Killgore WD“S, Ruiz JM, Carvajal S, Coull BM, Grandner MA. Neurological Manifestations in COVID-19: An Unrecognized Crisis in Our Elderly? ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2021; 3:e210013. [PMID: 34268500 PMCID: PMC8279204 DOI: 10.20900/agmr20210013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As of December 2020, there were more than 900,000 COVID-19 hospitalizations in the US with about 414,000 among individuals aged 65 years and older. Recent evidence suggests a growing number of older patients continue to suffer serious neurological comorbidities including polyneuropathy, cerebrovascular disease, central nervous system infection, cognitive deficits, and fatigue following discharge. Studies suggest that complaints manifest late in disease and persist beyond resolution of acute COVID-19 symptoms. Recent research reports that neurocognitive symptoms are correlated with severe disease, older age, male gender, and comorbidities including hypertension, renal failure, and neoplastic disease. The underlying causes are unclear, but current hypotheses include hypoxic-ischemic brain injury, immunopathological mechanisms, and neurotropism of SARS-CoV-2 infection. There is a pressing need for more research into the underlying mechanisms of post-COVID-19 neurological sequela, particularly in the elderly, a population already burdened with neurocognitive disorders.
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Affiliation(s)
- Karl Krupp
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
- Public Health Research Institute of India, Mysore, Karnataka 560020, India
| | - Purnima Madhivanan
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
- Public Health Research Institute of India, Mysore, Karnataka 560020, India
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA
| | | | - John M. Ruiz
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA
| | - Scott Carvajal
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Bruce M. Coull
- College of Medicine, University of Arizona, Tucson, AZ 85724, USA
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66
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Verrotti A, Mazzocchetti C, Iannetti P. Definitive pathognomonic signs and symptoms of paediatric neurological COVID-19 are still emerging. Acta Paediatr 2021; 110:1774-1777. [PMID: 33641209 PMCID: PMC8013208 DOI: 10.1111/apa.15827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/05/2021] [Accepted: 02/26/2021] [Indexed: 12/24/2022]
Abstract
Children with COVID-19 tend to show milder symptoms than adults during the pandemic, but growing evidence of neurological involvement has emerged. Some studies have reported neurological symptoms in children with COVID-19, which include multisystem inflammatory syndrome, a disease that shares some, but not all, of the characteristics of Kawasaki disease. This review presents, and discusses, the evidence to date. Our initial findings suggest that neurological manifestations can be considered to be the direct result of central nervous system viral invasion or post-infection immuno-mediated disease.
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67
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Falzone L, Gattuso G, Tsatsakis A, Spandidos DA, Libra M. Current and innovative methods for the diagnosis of COVID‑19 infection (Review). Int J Mol Med 2021; 47:100. [PMID: 33846767 PMCID: PMC8043662 DOI: 10.3892/ijmm.2021.4933] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID‑19) pandemic has forced the scientific community to rapidly develop highly reliable diagnostic methods in order to effectively and accurately diagnose this pathology, thus limiting the spread of infection. Although the structural and molecular characteristics of the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) were initially unknown, various diagnostic strategies useful for making a correct diagnosis of COVID‑19 have been rapidly developed by private research laboratories and biomedical companies. At present, rapid antigen or antibody tests, immunoenzymatic serological tests and molecular tests based on RT‑PCR are the most widely used and validated techniques worldwide. Apart from these conventional methods, other techniques, including isothermal nucleic acid amplification techniques, clusters of regularly interspaced short palindromic repeats/Cas (CRISPR/Cas)‑based approaches or digital PCR methods are currently used in research contexts or are awaiting approval for diagnostic use by competent authorities. In order to provide guidance for the correct use of COVID‑19 diagnostic tests, the present review describes the diagnostic strategies available which may be used for the diagnosis of COVID‑19 infection in both clinical and research settings. In particular, the technical and instrumental characteristics of the diagnostic methods used are described herein. In addition, updated and detailed information about the type of sample, the modality and the timing of use of specific tests are also discussed.
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Affiliation(s)
- Luca Falzone
- Epidemiology and Biostatistics Unit, National Cancer Institute-IRCCS 'Fondazione G. Pascale', I-80131 Naples, Italy
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, 71003 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania, Italy
- Research Center for the Prevention, Diagnosis and Treatment of Tumors, University of Catania, I-95123 Catania, Italy
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68
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Falzone L, Gattuso G, Tsatsakis A, Spandidos DA, Libra M. Current and innovative methods for the diagnosis of COVID‑19 infection (Review). Int J Mol Med 2021. [PMID: 33846767 DOI: 10.3892/ijmm.2021.4933/html] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
The Coronavirus Disease 2019 (COVID‑19) pandemic has forced the scientific community to rapidly develop highly reliable diagnostic methods in order to effectively and accurately diagnose this pathology, thus limiting the spread of infection. Although the structural and molecular characteristics of the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) were initially unknown, various diagnostic strategies useful for making a correct diagnosis of COVID‑19 have been rapidly developed by private research laboratories and biomedical companies. At present, rapid antigen or antibody tests, immunoenzymatic serological tests and molecular tests based on RT‑PCR are the most widely used and validated techniques worldwide. Apart from these conventional methods, other techniques, including isothermal nucleic acid amplification techniques, clusters of regularly interspaced short palindromic repeats/Cas (CRISPR/Cas)‑based approaches or digital PCR methods are currently used in research contexts or are awaiting approval for diagnostic use by competent authorities. In order to provide guidance for the correct use of COVID‑19 diagnostic tests, the present review describes the diagnostic strategies available which may be used for the diagnosis of COVID‑19 infection in both clinical and research settings. In particular, the technical and instrumental characteristics of the diagnostic methods used are described herein. In addition, updated and detailed information about the type of sample, the modality and the timing of use of specific tests are also discussed.
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Affiliation(s)
- Luca Falzone
- Epidemiology and Biostatistics Unit, National Cancer Institute‑IRCCS 'Fondazione G. Pascale', I‑80131 Naples, Italy
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95123 Catania, Italy
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, I‑95123 Catania, Italy
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Zolotovskaia IA, Shatskaia PR, Davydkin IL, Shavlovskaya OA. [Post-COVID-19 asthenic syndrome]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:25-30. [PMID: 34037351 DOI: 10.17116/jnevro202112104125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study the features of asthenic syndrome and the possibilities of its therapy in patients in the post-covid period. MATERIAL AND METHODS The study included 129 patients with an average age of 49.8±8.9 years who had undergone COVID-19 using a continuous sample method. Patients for the study were selected at the clinical bases of outpatient clinics in Samara (Russia) in July-August 2020. All patients signed an informed consent form prior to enrollment. Patients were randomized into two groups: in the main group (n=64), ethylmethylhydroxypyridine succinate (Neurox) was prescribed 1 tablet (125 mg) 3 times a day for 4 weeks; in the comparison group (n=65), medical drugs (MD) did not contain substances from the pharmacological group related to antihypoxants/antioxidants/nootropics. Three visits (V) were conducted: the first (V1) - the period of inclusion, the second (V2) - after 14 days, the third (V3) - on the 28th day from the start of therapy. The dynamics of the general state (weakness, fatigue, concentration, dizziness, headache, sleep disorders) were evaluated on a visual-analog scale (VAS), the assessment of the subjective feeling of severity of asthenia (fatigue, physical and mental fatigue, decreased motivation and activity) - on Multidimensional Fatigue Inventory (MFI-20), cognitive functions - on Mini-Mental State Examination (MMSE), vegetative tone - according to the Kerdo index. RESULTS At the end of the study (V3), statistically significant changes in indicators (VAS, MFI-20) were obtained only in the main group patients; no statistically significant differences were obtained for the Kerdo index. Analysis of the MMSE data revealed a decrease in cognitive functions in both groups, which may be associated with pseudocognitive deficits due to asthenia. CONCLUSIONS We have obtained evidence of a high incidence of asthenic syndrome after COVID-19. Against the background of taking Neurox, there was a decrease in the severity and expression of asthenia symptoms.
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Affiliation(s)
- I A Zolotovskaia
- Samara State Medical University of the Ministry of Healthcare of the Russian Federation, Samara, Russia
| | - P R Shatskaia
- Samara State Medical University of the Ministry of Healthcare of the Russian Federation, Samara, Russia
| | - I L Davydkin
- Samara State Medical University of the Ministry of Healthcare of the Russian Federation, Samara, Russia
| | - O A Shavlovskaya
- International University of Restorative Medicine, Moscow, Russia
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70
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Romero-Duarte Á, Rivera-Izquierdo M, Guerrero-Fernández de Alba I, Pérez-Contreras M, Fernández-Martínez NF, Ruiz-Montero R, Serrano-Ortiz Á, González-Serna RO, Salcedo-Leal I, Jiménez-Mejías E, Cárdenas-Cruz A. Sequelae, persistent symptomatology and outcomes after COVID-19 hospitalization: the ANCOHVID multicentre 6-month follow-up study. BMC Med 2021; 19:129. [PMID: 34011359 PMCID: PMC8134820 DOI: 10.1186/s12916-021-02003-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Long-term effects of COVID-19, also called Long COVID, affect more than 10% of patients. The most severe cases (i.e. those requiring hospitalization) present a higher frequency of sequelae, but detailed information on these effects is still lacking. The objective of this study is to identify and quantify the frequency and outcomes associated with the presence of sequelae or persistent symptomatology (SPS) during the 6 months after discharge for COVID-19. METHODS Retrospective observational 6-month follow-up study conducted in four hospitals of Spain. A cohort of all 969 patients who were hospitalized with PCR-confirmed SARS-CoV-2 from March 1 to April 15, 2020, was included. We collected all the SPS during the 6 months after discharge reported by patients during follow-up from primary care records. Cluster analyses were performed to validate the measures. The main outcome measures were return to the Emergency Services, hospital readmission and post-discharge death. Surviving patients' outcomes were collected through clinical histories and primary care reports. Multiple logistic regression models were applied. RESULTS The 797 (82.2%) patients who survived constituted the sample followed, while the rest died from COVID-19. The mean age was 63.0 years, 53.7% of them were men and 509 (63.9%) reported some sequelae during the first 6 months after discharge. These sequelae were very diverse, but the most frequent were respiratory (42.0%), systemic (36.1%), neurological (20.8%), mental health (12.2%) and infectious (7.9%) SPS, with some differences by sex. Women presented higher frequencies of headache and mental health SPS, among others. A total of 160 (20.1%) patients returned to the Emergency Services, 35 (4.4%) required hospital readmission and 8 (1.0%) died during follow-up. The main factors independently associated with the return to Emergency Services were persistent fever, dermatological SPS, arrythmia or palpitations, thoracic pain and pneumonia. CONCLUSIONS COVID-19 cases requiring hospitalization during the first wave of the pandemic developed a significant range of mid- to long-term SPS. A detailed list of symptoms and outcomes is provided in this multicentre study. Identification of possible factors associated with these SPS could be useful to optimize preventive follow-up strategies in primary care for the coming months of the pandemic.
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Affiliation(s)
| | - Mario Rivera-Izquierdo
- Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, Granada, Spain.
- Department of Preventive Medicine and Public Health, University of Granada, Avda. de la Investigación n°11, 18016, Granada, Spain.
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain.
| | - Inmaculada Guerrero-Fernández de Alba
- Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, Granada, Spain
- Service of Preventive Medicine and Public Health, Complejo Hospitalario de Jaén, Jaén, Spain
| | - Marina Pérez-Contreras
- Service of Preventive Medicine and Public Health, Hospital Universitario de Puerto Real, Puerto Real, Cádiz, Spain
| | - Nicolás Francisco Fernández-Martínez
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Rafael Ruiz-Montero
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Álvaro Serrano-Ortiz
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Rocío Ortiz González-Serna
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Inmaculada Salcedo-Leal
- Unidad de Gestión Clínica Interniveles de Prevención, Promoción y Vigilancia de la Salud, Hospital Universitario Reina Sofía, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (Imibic), Córdoba, Spain
| | - Eladio Jiménez-Mejías
- Department of Preventive Medicine and Public Health, University of Granada, Avda. de la Investigación n°11, 18016, Granada, Spain
- Chair of Teaching and Research in Family Medicine, SEMERGEN-UGR, University of Granada, Granada, Spain
| | - Antonio Cárdenas-Cruz
- School of Medicine, University of Granada, Granada, Spain
- Intensive Care Unit, Hospital de Poniente, El Ejido, Almería, Spain
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Asghar K, Abu Bakar M, Akram MJ, Farooq A, Siddique K, Rana IA, Ali J, Rashid MU, Khan AA, Loya A. Clinical Characteristics of COVID-19-Infected Cancer Patients in Pakistan: Differences Between Survivors and Non-Survivors. Front Oncol 2021; 11:655634. [PMID: 34094950 PMCID: PMC8173078 DOI: 10.3389/fonc.2021.655634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/15/2021] [Indexed: 12/19/2022] Open
Abstract
Background Cancer patients are considered as highly vulnerable individuals in the current COVID-19 pandemic. We studied the clinical characteristics of survivor and non-survivor COVID-19-infected cancer patients in Pakistan. Patients and Methods We did a retrospective study of 70 cancer patients with PCR-confirmed COVID-19 infection from Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore and Peshawar, Pakistan between April 13 and July 09, 2020. These patients were discharged from the hospital or had died by July 09, 2020. Clinical, pathological and radiological characteristics were compared between survivors and non-survivors by fisher's exact test and chi-square test. Univariable and multivariable logistic regression models were performed to explore the risk factors of mortality. Results Seventy cancer patients with SARS-CoV-2 infection were enrolled and the majority were males 38 (54.3%). 57 (81.4%) had solid tumors and 13 (18.6%) had hematological malignancies. Dyspnea (44 cases) was the most common symptom (62.9%). Complications were reported in 51 (72.9%) patients during the course of disease. 19 (27.1%) patients were admitted to an intensive care unit (ICU). A significant increase in the C-reactive protein level and neutrophil count was observed in the deceased patients as compared to the surviving patients. D-dimer values of ≥0.2 mg/L were significantly associated with mortality (P=0.01). We identified two independent risk factors associated with death, ICU admission (P=0.007) and D-dimer (P=0.003). Conclusion Pakistani cancer patients with COVID-19 infection reported poor prognosis. Intensive surveillance of clinicopathological characteristics of cancer patients infected with COVID-19 especially D-dimer values may play a pivotal role in the outcome of the disease.
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Affiliation(s)
- Kashif Asghar
- Department of Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Muhammad Abu Bakar
- Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Muhammad Junaid Akram
- Department of Internal Medicine (Pulmonology), Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Asim Farooq
- Department of Clinical Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Kashif Siddique
- Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Iftikhar Ali Rana
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Jamshed Ali
- Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, Pakistan
| | - Muhammad Usman Rashid
- Department of Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Ashraf Ali Khan
- Department of Internal Medicine (Infectious Diseases), Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Asif Loya
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
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Shahbazi M, Jafari M, Moulana Z, Sepidarkish M, Bagherzadeh M, Rezanejad M, Mirzakhani M, Javanian M, bayani M, Sadeghi‐Haddad‐Zavareh M, Mehdinezhad H, Ghadimi R, Ghasemzadeh M, Shokuhi Rad A, Mohammadnia‐Afrouzi M. Reduced frequency of T helper 17 and T helper 1 cells and their association with critical coronavirus disease 2019. APMIS 2021; 129:271-279. [PMID: 33792109 PMCID: PMC8250891 DOI: 10.1111/apm.13129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/12/2021] [Indexed: 02/06/2023]
Abstract
There is very little knowledge about the immune responses, particularly cellular immunity to coronavirus disease 2019 (COVID-19). The main objective of this study was to evaluate the frequency of T helper (Th) cell subtypes, including Th1, Th17, and Treg cells, in moderate-to-severe and critical COVID-19 patients compared to healthy controls. Twenty-nine moderate-to-severe and 13 critical patients confirmed for COVID-19, and 15 healthy subjects were included in this study. Interferon-γ (IFN-γ)-producing Th1 and interleukin-17A-producing Th17 and Treg cells in peripheral blood were measured with flow cytometry. The frequency of Th1 and Th17 was significantly decreased in critical patients compared to healthy subjects (aMD: -2.76 and - 2.34) and moderate-to-severe patients (aMD: -1.89 and - 1.89), respectively (p < 0.05). Differences were not significant between moderate-to-severe patients and healthy subjects for both Th1 (p = 0.358) and Th17 (p = 0.535), respectively. In contrast, significant difference was not observed between study subjects regarding the frequency of Treg cells. Patients with critical COVID-19 had a markedly lower Th1/Treg and Th17/Treg ratios compared with the controls and moderate-to-severe cases. Our study showed a dysregulated balance of Th1 and Th17 cells and its relation to the severity of COVID-19.
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Affiliation(s)
- Mehdi Shahbazi
- Immunoregulation Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
- Department of ImmunologySchool of MedicineBabol University of Medical SciencesBabolIran
| | - Mohammad Jafari
- Cellular and Molecular Research CenterGerash University of Medical SciencesGerashIran
| | - Zahra Moulana
- Infectious Diseases and Tropical Medicine Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
| | - Mahdi Sepidarkish
- Department of Biostatistics and EpidemiologySchool of Public HealthBabol University of Medical SciencesBabolIran
| | - Mojgan Bagherzadeh
- Immunoregulation Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
- Department of ImmunologySchool of MedicineBabol University of Medical SciencesBabolIran
| | - Maryam Rezanejad
- Student Research CommitteeSchool of MedicineBabol University of Medical SciencesBabolIran
| | - Mohammad Mirzakhani
- Student Research CommitteeSchool of MedicineBabol University of Medical SciencesBabolIran
| | - Mostafa Javanian
- Department of Biostatistics and EpidemiologySchool of Public HealthBabol University of Medical SciencesBabolIran
| | - Masomeh bayani
- Department of Biostatistics and EpidemiologySchool of Public HealthBabol University of Medical SciencesBabolIran
| | | | - Hamed Mehdinezhad
- Department of Internal MedicineRouhani HospitalBabol University of Medical SciencesBabolIran
| | - Reza Ghadimi
- Social Determinants of Health Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Ali Shokuhi Rad
- Department of Chemical and Biomolecular EngineeringUniversity of HoustonTexasUSA
| | - Mousa Mohammadnia‐Afrouzi
- Immunoregulation Research CenterHealth Research InstituteBabol University of Medical SciencesBabolIran
- Department of ImmunologySchool of MedicineBabol University of Medical SciencesBabolIran
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Palazzuoli A, Giustozzi M, Ruocco G, Tramonte F, Gronda E, Agnelli G. Thromboembolic Complications in Covid-19: From Clinical Scenario to Laboratory Evidence. Life (Basel) 2021; 11:life11050395. [PMID: 33925334 PMCID: PMC8145351 DOI: 10.3390/life11050395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/20/2022] Open
Abstract
SARS-Cov-2 infection, a pandemic disease since March 2020, is associated with a high percentage of cardiovascular complications mainly of a thromboembolic (TE) nature. Although clinical patterns have been described for the assessment of patients with increased risk, many TE complications occur in patients with apparently moderate risk. Notably, a recent statement from the European Society of Cardiology (ESC) atherosclerosis and vascular biology working group pointed out the key role of vascular endothelium for the recruitment of inflammatory and thrombotic pathways responsible for both disseminated intravascular coagulation and cardiovascular complications. Therefore, a better understanding of the pathophysiological process linking infection to increased TE risk is needed in order to understand the pathways of this dangerous liaison and possibly interrupt it with appropriate treatment. In this review, we describe the histological lesions and the related blood coagulation mechanisms involved in COVID-19, we define the laboratory parameters and clinical risk factors associated with TE events, and propose a prophylactic anticoagulation treatment in relation to the risk category. Finally, we highlight the concept that a solid risk assessment based on prospective multi-center data would be the challenge for a more precise risk stratification and more appropriate treatment.
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Affiliation(s)
- Alberto Palazzuoli
- Cardiovascular Diseases Unit, Department of Medical Sciences, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy; (G.R.); (F.T.)
- Correspondence: ; Tel.: +39-577-585-363 or +39-577-585-461; Fax: +39-577-233-480
| | - Michela Giustozzi
- Internal Vascular and Emergency Medicine and Stroke Unit, University of Perugia, 06121 Perugia, Italy; (M.G.); (G.A.)
| | - Gaetano Ruocco
- Cardiovascular Diseases Unit, Department of Medical Sciences, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy; (G.R.); (F.T.)
| | - Francesco Tramonte
- Cardiovascular Diseases Unit, Department of Medical Sciences, Le Scotte Hospital, University of Siena, Viale Bracci, 53100 Siena, Italy; (G.R.); (F.T.)
| | - Edoardo Gronda
- Department of Medicine and Medical Specialties, IRCCS Foundation Ca’ Granda Hospital, 20126 Milan, Italy;
| | - Giancarlo Agnelli
- Internal Vascular and Emergency Medicine and Stroke Unit, University of Perugia, 06121 Perugia, Italy; (M.G.); (G.A.)
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Llorens S, Nava E, Muñoz-López M, Sánchez-Larsen Á, Segura T. Neurological Symptoms of COVID-19: The Zonulin Hypothesis. Front Immunol 2021; 12:665300. [PMID: 33981312 PMCID: PMC8107207 DOI: 10.3389/fimmu.2021.665300] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
The irruption of SARS-CoV-2 during 2020 has been of pandemic proportions due to its rapid spread and virulence. COVID-19 patients experience respiratory, digestive and neurological symptoms. Distinctive symptom as anosmia, suggests a potential neurotropism of this virus. Amongst the several pathways of entry to the nervous system, we propose an alternative pathway from the infection of the gut, involving Toll-like receptor 4 (TLR4), zonulin, protease-activated receptor 2 (PAR2) and zonulin brain receptor. Possible use of zonulin antagonists could be investigated to attenuate neurological manifestations caused by SARS-CoV-19 infection.
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Affiliation(s)
- Sílvia Llorens
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain.,Centro Regional de Investigaciones Biomédicas (CRIB), University of Castilla-La Mancha, Albacete, Spain
| | - Eduardo Nava
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain.,Centro Regional de Investigaciones Biomédicas (CRIB), University of Castilla-La Mancha, Albacete, Spain
| | - Mónica Muñoz-López
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain.,Centro Regional de Investigaciones Biomédicas (CRIB), University of Castilla-La Mancha, Albacete, Spain
| | | | - Tomás Segura
- Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain.,Servicio de Neurología, Hospital General Universitario de Albacete, Albacete, Spain.,Instituto de Investigación en Discapacidades Neurológicas (IDINE), University of Castilla-La Mancha, Albacete, Spain
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75
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Shehata GA, Lord KC, Grudzinski MC, Elsayed M, Abdelnaby R, Elshabrawy HA. Neurological Complications of COVID-19: Underlying Mechanisms and Management. Int J Mol Sci 2021; 22:4081. [PMID: 33920904 PMCID: PMC8071289 DOI: 10.3390/ijms22084081] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/10/2021] [Accepted: 04/13/2021] [Indexed: 02/06/2023] Open
Abstract
COVID-19 is a severe respiratory disease caused by the newly identified human coronavirus (HCoV) Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The virus was discovered in December 2019, and in March 2020, the disease was declared a global pandemic by the World Health Organization (WHO) due to a high number of cases. Although SARS-CoV-2 primarily affects the respiratory system, several studies have reported neurological complications in COVID-19 patients. Headache, dizziness, loss of taste and smell, encephalitis, encephalopathy, and cerebrovascular diseases are the most common neurological complications that are associated with COVID-19. In addition, seizures, neuromuscular junctions' disorders, and Guillain-Barré syndrome were reported as complications of COVID-19, as well as neurodegenerative and demyelinating disorders. However, the management of these conditions remains a challenge. In this review, we discuss the prevalence, pathogenesis, and mechanisms of these neurological sequelae that are secondary to SARS-CoV-2 infection. We aim to update neurologists and healthcare workers on the possible neurological complications associated with COVID-19 and the management of these disease conditions.
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Affiliation(s)
- Ghaydaa A. Shehata
- Department of Neurology and Psychiatry, Assiut University Hospitals, Assiut 71511, Egypt;
| | - Kevin C. Lord
- Department of Physiology and Pharmacology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX 77304, USA;
| | | | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany;
| | - Ramy Abdelnaby
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany;
| | - Hatem A. Elshabrawy
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX 77304, USA
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76
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Alonso-Bellido IM, Bachiller S, Vázquez G, Cruz-Hernández L, Martínez E, Ruiz-Mateos E, Deierborg T, Venero JL, Real LM, Ruiz R. The Other Side of SARS-CoV-2 Infection: Neurological Sequelae in Patients. Front Aging Neurosci 2021; 13:632673. [PMID: 33889082 PMCID: PMC8055831 DOI: 10.3389/fnagi.2021.632673] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/12/2021] [Indexed: 12/19/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread around the globe causing coronavirus disease 2019 (COVID-19). Because it affects the respiratory system, common symptoms are cough and breathing difficulties with fever and fatigue. Also, some cases progress to acute respiratory distress syndrome (ARDS). The acute phase of COVID-19 has been also related to nervous system symptoms, including loss of taste and smell as well as encephalitis and cerebrovascular disorders. However, it remains unclear if neurological complications are due to the direct viral infection of the nervous system, or they appear as a consequence of the immune reaction against the virus in patients who presented pre-existing deficits or had a certain detrimental immune response. Importantly, the medium and long-term consequences of the infection by SARS-CoV-2 in the nervous system remain at present unknown. This review article aims to give an overview of the current neurological symptoms associated with COVID-19, as well as attempting to provide an insight beyond the acute affectation.
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Affiliation(s)
- Isabel M Alonso-Bellido
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla-Hospital, Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Sara Bachiller
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Biomedical Center, Lund University, Lund, Sweden.,Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla-Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Guillermo Vázquez
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla-Hospital, Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Luis Cruz-Hernández
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla-Hospital, Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Emilio Martínez
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla-Hospital, Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Ezequiel Ruiz-Mateos
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla-Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Tomas Deierborg
- Experimental Neuroinflammation Laboratory, Department of Experimental Medical Science, Biomedical Center, Lund University, Lund, Sweden
| | - José L Venero
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla-Hospital, Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Luis M Real
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Sevilla, Spain.,Departamento de Especialidades Quirúrgicas, Bioquímicas e Inmunología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Rocío Ruiz
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain.,Instituto de Biomedicina de Sevilla-Hospital, Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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77
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Melegari G, Rivi V, Zelent G, Nasillo V, De Santis E, Melegari A, Bevilacqua C, Zoli M, Meletti S, Barbieri A. Mild to Severe Neurological Manifestations of COVID-19: Cases Reports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073673. [PMID: 33915937 PMCID: PMC8036948 DOI: 10.3390/ijerph18073673] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
The main focus of Coronavirus disease 2019 (COVID-19) infection is pulmonary complications through virus-related neurological manifestations, ranging from mild to severe, such as encephalitis, cerebral thrombosis, neurocognitive (dementia-like) syndrome, and delirium. The hospital screening procedures for quickly recognizing neurological manifestations of COVID-19 are often complicated by other coexisting symptoms and can be obscured by the deep sedation procedures required for critically ill patients. Here, we present two different case-reports of COVID-19 patients, describing neurological complications, diagnostic imaging such as olfactory bulb damage (a mild and unclear underestimated complication) and a severe and sudden thrombotic stroke complicated with hemorrhage with a low-level cytokine storm and respiratory symptom resolution. We discuss the possible mechanisms of virus entrance, together with the causes of COVID-19-related encephalitis, olfactory bulb damage, ischemic stroke, and intracranial hemorrhage.
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Affiliation(s)
- Gabriele Melegari
- Anaesthesia and Intensive Care, Azienda Ospedaliero-Universitaria di Modena, 41125 Modena, Italy
- Correspondence: ; Tel.: +39-0593961536
| | - Veronica Rivi
- Department of Biomedical, Metabolic and Neural Sciences, Neuroscience Post Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy; (V.R.); (M.Z.)
| | - Gabriele Zelent
- Neuroradiology, Azienda Ospedaliero-Universitaria di Modena, 41125 Modena, Italy;
| | - Vincenzo Nasillo
- Department of Laboratory Medicine, Azienda Unità Sanitaria Locale, 41125 Modena, Italy; (V.N.); (E.D.S.); (A.M.)
| | - Elena De Santis
- Department of Laboratory Medicine, Azienda Unità Sanitaria Locale, 41125 Modena, Italy; (V.N.); (E.D.S.); (A.M.)
| | - Alessandra Melegari
- Department of Laboratory Medicine, Azienda Unità Sanitaria Locale, 41125 Modena, Italy; (V.N.); (E.D.S.); (A.M.)
| | - Claudia Bevilacqua
- School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, 41125 Modena, Italy; (C.B.); (A.B.)
| | - Michele Zoli
- Department of Biomedical, Metabolic and Neural Sciences, Neuroscience Post Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy; (V.R.); (M.Z.)
| | - Stefano Meletti
- Neurology, Azienda Ospedaliera Universitaria di Modena, 41125 Modena, Italy;
| | - Alberto Barbieri
- School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, 41125 Modena, Italy; (C.B.); (A.B.)
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78
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Taher T, Sheikh AB, Anwar F, Khosa F. SARS-CoV-2: its potential neurological manifestations and plausible mechanism: a review article. Acta Neurol Belg 2021; 121:331-339. [PMID: 33464546 PMCID: PMC7814371 DOI: 10.1007/s13760-020-01577-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/17/2020] [Indexed: 12/15/2022]
Abstract
Coronavirus disease (COVID-19) was first identified in late December 2019. The disease began in Wuhan, Hubei province in China and since then it has spread quickly to many countries all over the world. COVID-19 is caused by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was majorly seen to overwhelm the respiratory system with mild to severe acute respiratory syndrome considered pathognomic for the disease. However, with time a plethora of symptoms was observed in the patients infected with COVID-19 including strong evidence for neurological symptoms. Evidence suggests that the virus has both central and peripheral nervous system manifestations. Patients, particularly those who suffer from a severe illness, have a central nervous system (CNS) involvement and neurological manifestations. There is precise and targeted documentation of neurological symptoms with details of clinical, neurological, and electrophysiological findings. This review article thus gives an insight into the neuro-invasive potential of COVID-19 and discusses the possible pathogenesis.
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79
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Engin AB, Engin ED, Engin A. Current opinion in neurological manifestations of SARS-CoV-2 infection. CURRENT OPINION IN TOXICOLOGY 2021; 25:49-56. [PMID: 33817451 PMCID: PMC8006515 DOI: 10.1016/j.cotox.2021.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Neurological symptoms occur in approximately one-third of hospitalized patients with coronavirus disease 2019 (COVID-19). Among these symptoms, hypoxic encephalopathy develops in one-fifth of severe cases, while ischemic strokes due to thrombotic complications are common in one-third of COVID-19 intensive care patients. Brain involvement of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is eventuated by several routes, including hematogenous spread, transsynaptic entry through infected neurons, olfactory nerve, ocular epithelium, vascular endothelium, and impaired blood–brain barrier. Besides the high angiotensin-converting enzyme-2 (ACE2) binding affinity, and FURIN preactivation, SARS-CoV-2 maintains efficient neuronal entry while evading immune surveillance by using basigin and neuropilin-1 receptors. However, the neurological manifestations and their pathogenic mechanisms are still debated in COVID-19 patients.
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Affiliation(s)
- Ayse Basak Engin
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara, Turkey
| | - Evren Doruk Engin
- Ankara University, Biotechnology Institute, Gumusdere Campus, Kecioren, Ankara, Turkey
| | - Atilla Engin
- Gazi University, Faculty of Medicine, Department of General Surgery, Ankara, Turkey
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80
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Calina D, Hartung T, Mardare I, Mitroi M, Poulas K, Tsatsakis A, Rogoveanu I, Docea AO. COVID-19 pandemic and alcohol consumption: Impacts and interconnections. Toxicol Rep 2021; 8:529-535. [PMID: 33723508 PMCID: PMC7944101 DOI: 10.1016/j.toxrep.2021.03.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
Alcohol consumption is associated with multiple diseases and might contribute to vulnerability to SARS-CoV-2 infection. It can also catalyze exacerbations of mental and organic illnesses and predispose to behaviors with an increased risk of infection, severity of disease but also independently of sociopathic behavior and violence. Globally, millions of premature deaths from excessive alcohol consumption occur each year. This paper discusses the effects of increased alcohol consumption and the most important consequences on the health of the population during the social isolation and lockdown during current COVID-19 pandemic.
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Affiliation(s)
- Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
| | - Thomas Hartung
- CAAT-Europe at the University of Konstanz, 78464, Konstanz, Germany
- CAAT, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Ileana Mardare
- Department of Public Health and Management, “Carol Davila” University of Medicine and Pharmacy Bucharest, 050463, Bucharest, Romania
| | - Mihaela Mitroi
- ENT Department, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
| | - Konstantinos Poulas
- Laboratory of Molecular Biology and Immunology, School of Pharmacy, University of Patras, Patras, Greece
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece
- Department of Analytical and Forensic Medical Toxicology, Sechenov University, 119991, Moscow, Russia
| | - Ion Rogoveanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
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81
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Matsuishi Y, Mathis BJ, Shimojo N, Subrina J, Okubo N, Inoue Y. Severe COVID-19 Infection Associated with Endothelial Dysfunction Induces Multiple Organ Dysfunction: A Review of Therapeutic Interventions. Biomedicines 2021; 9:279. [PMID: 33801921 PMCID: PMC7999560 DOI: 10.3390/biomedicines9030279] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 02/06/2023] Open
Abstract
Since December 2019, the SARS-CoV-2 (COVID-19) pandemic has transfixed the medical world. COVID-19 symptoms vary from mild to severe and underlying chronic conditions such as pulmonary/cardiovascular disease and diabetes induce excessive inflammatory responses to COVID-19 and these underlying chronic diseases are mediated by endothelial dysfunction. Acute respiratory distress syndrome (ARDS) is the most common cause of death in COVID-19 patients, but coagulation induced by excessive inflammation, thrombosis, and disseminated intravascular coagulation (DIC) also induce death by multiple-organ dysfunction syndrome. These associations imply that maintaining endothelial integrity is crucial for favorable prognoses with COVID-19 and therapeutic intervention to support this may be beneficial. Here, we summarize the extent of heart injuries, ischemic stroke and hemorrhage, acute kidney injury, and liver injury caused by immune-mediated endothelial dysfunction that result in the phenomenon of multi-organ dysfunction seen in COVID-19 patients. Moreover, the potential therapeutic effect of angiotensin receptor blockers and angiotensin-converting enzyme inhibitors that improve endothelial dysfunction as well as the bradykinin storm are discussed.
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Affiliation(s)
- Yujiro Matsuishi
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (N.S.); (Y.I.)
- Pediatric Intensive Care Unit, University of Tsukuba Hospital, Tsukuba 305-8571, Japan
- Health & Diseases Research Center for Rural Peoples (HDRCRP), Dhaka 1205, Bangladesh;
| | - Bryan J. Mathis
- Medical English Communication Center, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8571, Japan;
| | - Nobutake Shimojo
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (N.S.); (Y.I.)
| | - Jesmin Subrina
- Health & Diseases Research Center for Rural Peoples (HDRCRP), Dhaka 1205, Bangladesh;
| | - Nobuko Okubo
- Neuroscience Nursing, St. Luke’s International University, Tokyo 104-0044, Japan;
| | - Yoshiaki Inoue
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan; (N.S.); (Y.I.)
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82
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COVID-19 engages clinical markers for the management of cancer and cancer-relevant regulators of cell proliferation, death, migration, and immune response. Sci Rep 2021; 11:5228. [PMID: 33664395 PMCID: PMC7933131 DOI: 10.1038/s41598-021-84780-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 02/18/2021] [Indexed: 12/13/2022] Open
Abstract
Clinical reports show that the management of cancer patients infected with SARS-CoV-2 requires modifications. Understanding of cancer-relevant mechanisms engaged by the virus is essential for the evidence-based management of cancer. The network of SARS-CoV-2 regulatory mechanisms was used to study potential engagement of oncogenes, tumor suppressors, other regulators of tumorigenesis and clinical markers used in the management of cancer patients. Our network analysis confirms links between COVID-19 and tumorigenesis that were predicted in epidemiological reports. The COVID-19 network shows the involvement of tumorigenesis regulators and clinical markers. Regulators of cell proliferation, death, migration, and the immune system were retrieved. Examples are pathways initiated by EGF, VEGF, TGFβ and FGF. The SARS-CoV-2 network engages markers for diagnosis, prognosis and selection of treatment. Intersection with cancer diagnostic signatures supports a potential impact of the virus on tumorigenesis. Clinical observations show the diversity of symptoms correlating with biological processes and types of cells engaged by the virus, e.g. epithelial, endothelial, smooth muscle, glial and immune system cells. Our results describe an extensive engagement of cancer-relevant mechanisms and clinical markers by COVID-19. Engagement by the virus of clinical markers provides a rationale for clinical decisions based on these markers.
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83
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Abdelghany TM, Ganash M, Bakri MM, Qanash H, Al-Rajhi AMH, Elhussieny NI. SARS-CoV-2, the other face to SARS-CoV and MERS-CoV: Future predictions. Biomed J 2021; 44:86-93. [PMID: 33602634 PMCID: PMC7603957 DOI: 10.1016/j.bj.2020.10.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 12/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) outbreak is proving to be an unprecedented disaster that lays its dark shadow on global health, economics and personal freedom. Severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) epidemics provide scientific data that is useful in better understanding and resolution of COVID-19. Similarities among SARS-CoV, MERS-CoV and SARS-CoV-2 have been investigated in the light of available data. SARS-CoV, MERS-CoV and SARS-CoV-2 evolved in bats and have positive-sense RNA genomes of 27.9 kb, 30.1 kb and 29.9 kb, respectively. Molecular and serological tools used for diagnosis of SARS and MERS patients resemble COVID-19 diagnostic tools. Stability and longevity data of SARS and MERS epidemics contribute in the current pandemic precaution policies. Trials to produce vaccines for SARS-CoV and MERS-CoV failed, therefore different strategies were employed for SARS-CoV2 vaccines production and during the past period antiviral agents, Convalescent plasma and monoclonal antibodies provide potential treatments for sever patients. The mortality rate caused by the SARS-CoV and MERS-CoV reached 15% and 37%, respectively. The first declarations about mortality rate of SARS-CoV-2 was around 2-4% but now this rate differed globally and reached more than 13% in some countries. A realistic COVID-19 outbreak scenario suggest that the pandemic might last for three years with fluctuation in the number of infected cases, unless vaccination process goes faster and/or antiviral drug is discovered.
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Affiliation(s)
- T M Abdelghany
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo, Egypt.
| | - Magdah Ganash
- Biology Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marwah M Bakri
- University College, Al-Ardah, Jazan University, Jazan, Saudi Arabia
| | - Husam Qanash
- Clinical Laboratory Science Department, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Aisha M H Al-Rajhi
- Biology Department, Faculty of Science, Princess Nora Bent Abdularahman University, Riyadh, Saudi Arabia
| | - Nadeem I Elhussieny
- Chemistry of Natural and Microbial Products Department, National Research Centre, Cairo, Egypt; Institute of Environmental Biology and Biotechnology, University of Applied Sciences, Bremen, Germany; Life Sciences and Chemistry Department, Jacobs University Bremen GmbH, Bremen, Germany
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84
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Malinowska B, Baranowska-Kuczko M, Kicman A, Schlicker E. Opportunities, Challenges and Pitfalls of Using Cannabidiol as an Adjuvant Drug in COVID-19. Int J Mol Sci 2021; 22:1986. [PMID: 33671463 PMCID: PMC7922403 DOI: 10.3390/ijms22041986] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to coronavirus disease 2019 (COVID-19) which, in turn, may be associated with multiple organ dysfunction. In this review, we present advantages and disadvantages of cannabidiol (CBD), a non-intoxicating phytocannabinoid from the cannabis plant, as a potential agent for the treatment of COVID-19. CBD has been shown to downregulate proteins responsible for viral entry and to inhibit SARS-CoV-2 replication. Preclinical studies have demonstrated its effectiveness against diseases of the respiratory system as well as its cardioprotective, nephroprotective, hepatoprotective, neuroprotective and anti-convulsant properties, that is, effects that may be beneficial for COVID-19. Only the latter two properties have been demonstrated in clinical studies, which also revealed anxiolytic and antinociceptive effects of CBD (given alone or together with Δ9-tetrahydrocannabinol), which may be important for an adjuvant treatment to improve the quality of life in patients with COVID-19 and to limit post-traumatic stress symptoms. However, one should be aware of side effects of CBD (which are rarely serious), drug interactions (also extending to drugs acting against COVID-19) and the proper route of its administration (vaping may be dangerous). Clearly, further clinical studies are necessary to prove the suitability of CBD for the treatment of COVID-19.
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Affiliation(s)
- Barbara Malinowska
- Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, 15-222 Białystok, Poland; (M.B.-K.); (A.K.)
| | - Marta Baranowska-Kuczko
- Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, 15-222 Białystok, Poland; (M.B.-K.); (A.K.)
- Department of Clinical Pharmacy, Medical University of Białystok, 15-222 Białystok, Poland
| | - Aleksandra Kicman
- Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, 15-222 Białystok, Poland; (M.B.-K.); (A.K.)
| | - Eberhard Schlicker
- Department of Pharmacology and Toxicology, University of Bonn, 53127 Bonn, Germany
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85
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Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021. [PMID: 33546463 DOI: 10.3390/ijerph18041415.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neuroinvasive properties of SARS-CoV-2 have allowed the hypothesis of several pathogenic mechanisms related to acute and chronic neurological sequelae. However, neuropathological correlates have been poorly systematically investigated, being retrieved from reports of single case or limited case series still. METHODS A PubMed search was carried out to review all publications on autopsy in subjects with "COronaVIrus Disease-19" (COVID-19). Among them, we focused on histological findings of the brain, which were compared with those from the authors' autoptic studies performed in some COVID-19 patients. RESULTS Only seven studies reported histological evidence of brain pathology in patients deceased for COVID-19, including three with reverse transcription-quantitative polymerase chain reaction evidence of viral infection. All these studies, in line with our experience, showed vascular-related and infection-related secondary inflammatory tissue damage due to an abnormal immune response. It is still unclear, however, whether these findings are the effect of a direct viral pathology or rather reflect a non-specific consequence of cardiovascular and pulmonary disease on the brain. CONCLUSIONS Notwithstanding the limited evidence available and the heterogeneity of the studies, we provide a preliminary description of the relationship between SARS-CoV-2 and brain sequelae. Systematic autoptic investigations are needed for accurate detection and adequate management of these patients.
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86
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Fisicaro F, Di Napoli M, Liberto A, Fanella M, Di Stasio F, Pennisi M, Bella R, Lanza G, Mansueto G. Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041415. [PMID: 33546463 PMCID: PMC7913756 DOI: 10.3390/ijerph18041415] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/18/2021] [Accepted: 01/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neuroinvasive properties of SARS-CoV-2 have allowed the hypothesis of several pathogenic mechanisms related to acute and chronic neurological sequelae. However, neuropathological correlates have been poorly systematically investigated, being retrieved from reports of single case or limited case series still. METHODS A PubMed search was carried out to review all publications on autopsy in subjects with "COronaVIrus Disease-19" (COVID-19). Among them, we focused on histological findings of the brain, which were compared with those from the authors' autoptic studies performed in some COVID-19 patients. RESULTS Only seven studies reported histological evidence of brain pathology in patients deceased for COVID-19, including three with reverse transcription-quantitative polymerase chain reaction evidence of viral infection. All these studies, in line with our experience, showed vascular-related and infection-related secondary inflammatory tissue damage due to an abnormal immune response. It is still unclear, however, whether these findings are the effect of a direct viral pathology or rather reflect a non-specific consequence of cardiovascular and pulmonary disease on the brain. CONCLUSIONS Notwithstanding the limited evidence available and the heterogeneity of the studies, we provide a preliminary description of the relationship between SARS-CoV-2 and brain sequelae. Systematic autoptic investigations are needed for accurate detection and adequate management of these patients.
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Affiliation(s)
- Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (F.F.); (A.L.); (M.P.)
| | - Mario Di Napoli
- Department of Neurology and Stroke Unit, San Camillo de’ Lellis General Hospital, Viale Kennedy 1, 02100 Rieti, Italy; (M.D.N.); (M.F.)
| | - Aldo Liberto
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (F.F.); (A.L.); (M.P.)
| | - Martina Fanella
- Department of Neurology and Stroke Unit, San Camillo de’ Lellis General Hospital, Viale Kennedy 1, 02100 Rieti, Italy; (M.D.N.); (M.F.)
| | - Flavio Di Stasio
- Department of Neurology and Stroke Unit Cesena-Forlì, Bufalini Hospital, AUSL Romagna, Viale Ghirotti 286, 47521 Cesena, Italy;
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (F.F.); (A.L.); (M.P.)
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy;
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgery Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
- Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero 78, 94018 Troina, Italy
- Correspondence: ; Tel.: +39-095-3782448
| | - Gelsomina Mansueto
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania “Luigi Vanvitelli”, Piazza L. Miraglia 2, 80138 Naples, Italy;
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Elgohary S, Elkhodiry AA, Amin NS, Stein U, El Tayebi HM. Thymoquinone: A Tie-Breaker in SARS-CoV2-Infected Cancer Patients? Cells 2021; 10:302. [PMID: 33540625 PMCID: PMC7912962 DOI: 10.3390/cells10020302] [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] [Received: 12/20/2020] [Revised: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 12/13/2022] Open
Abstract
Since the beginning of the SARS-CoV-2(severe acute respiratory syndrome-coronavirus-2) pandemic, arace to develop a vaccine has been initiated, considering the massive and rather significant economic and healthcare hits that this virus has caused. The pathophysiology occurring following COVID-19(coronavirus disease-2019) infection has givenhints regarding the supportive and symptomatic treatments to establish for patients, as no specific anti-SARS-CoV-2 is available yet. Patient symptoms vary greatly and range from mild symptoms to severe fatal complications. Supportive treatments include antipyretics, antiviral therapies, different combinations of broad-spectrum antibiotics, hydroxychloroquine and plasma transfusion. Unfortunately, cancer patients are at higher risk of viral infection and more likely to develop serious complications due to their immunocompromised state, the fact that they are already administering multiple medications, as well as combined comorbidity compared to the general population. It may seem impossible to find a drug that possesses both potent antiviral and anticancer effects specifically against COVID-19 infection and its complications and the existing malignancy, respectively. Thymoquinone (TQ) is the most pharmacologically active ingredient in Nigella sativa seeds (black seeds); it is reported to have anticancer, anti-inflammatory and antioxidant effects in various settings. In this review, we will discuss the multiple effects of TQ specifically against COVID-19, its beneficial effects against COVID-19 pathophysiology and multiple-organ complications, its use as an adjuvant for supportive COVID-19 therapy and cancer therapy, and finally, its anticancer effects.
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Affiliation(s)
- Sawsan Elgohary
- Molecular Pharmacology Research Group, Department of Pharmacology and Toxicology, Faculty of Pharmacy and Biotechnology, German University in Cairo, 11835 Cairo, Egypt; (S.E.); (A.A.E.); (N.S.A.)
| | - Aya A. Elkhodiry
- Molecular Pharmacology Research Group, Department of Pharmacology and Toxicology, Faculty of Pharmacy and Biotechnology, German University in Cairo, 11835 Cairo, Egypt; (S.E.); (A.A.E.); (N.S.A.)
| | - Nada S. Amin
- Molecular Pharmacology Research Group, Department of Pharmacology and Toxicology, Faculty of Pharmacy and Biotechnology, German University in Cairo, 11835 Cairo, Egypt; (S.E.); (A.A.E.); (N.S.A.)
| | - Ulrike Stein
- Experimental and Clinical Research Center, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany;
- Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany
- German Cancer Consortium (DKTK), 69120 Heidelberg, Germany
| | - Hend M. El Tayebi
- Molecular Pharmacology Research Group, Department of Pharmacology and Toxicology, Faculty of Pharmacy and Biotechnology, German University in Cairo, 11835 Cairo, Egypt; (S.E.); (A.A.E.); (N.S.A.)
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88
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Tong DM, Zhou YT, Wang YW. COVID-19-Associated Acute Brain Dysfunction Related to Sepsis. J Clin Med Res 2021; 13:82-91. [PMID: 33747322 PMCID: PMC7935626 DOI: 10.14740/jocmr4437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/13/2021] [Indexed: 12/17/2022] Open
Abstract
In global term, as of November 30, 2020, over 30 million people has been infected by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and more than 10,000,000 of them died of acute organ failure. Our reviews have shown that coronavirus disease 2019 (COVID-19) patients with pneumonia and acute respiratory distress syndrome (ARDS) have life-threatening acute brain dysfunction (ABD), ranging from altered mental status/delirium to stupor/coma. Altered mental status/delirium was the most common manifestation of ABD caused by severe COVID-19. The prevalence of altered mental status and/or delirium was up to 66-79.5%, and prevalence of coma was 10%. The most common clinical type of COVID-19-associated ABD was COVID-19-associated acute stroke including ischemic and hemorrhagic stroke (n > 350 cases), followed by COVID-19-associated encephalopathy (n > 200 cases), and COVID-19-associated central nervous system (CNS) infection (n > 70 cases). According to the Sepsis-3 criteria, we confess that severe COVID-19-associated ABD with ARDS and altered mental status is related to sepsis. Moreover, we also review the diagnosis and treatment of COVID-19-associated ABD with sepsis. In view of the fact that COVID-19 is at the peak of epidemic worldwide, we hope that this review will provide evidence of COVID-19 sepsis threating to the brain dysunction. Thus, recognizing the COVID-19-associated ABD related to sepsis is very important for early empirical combination therapy to survive severe COVID-19.
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Affiliation(s)
- Dao Ming Tong
- Department of Neurology, Affiliated Shuyang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Ye Ting Zhou
- Department of Surgery, Affiliated Shuyang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Yuan Wei Wang
- Department of Neurology, Affiliated Shuyang Hospital of Xuzhou Medical University, Jiangsu, China
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89
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Reza-Zaldívar EE, Hernández-Sapiéns MA, Minjarez B, Gómez-Pinedo U, Márquez-Aguirre AL, Mateos-Díaz JC, Matias-Guiu J, Canales-Aguirre AA. Infection Mechanism of SARS-COV-2 and Its Implication on the Nervous System. Front Immunol 2021; 11:621735. [PMID: 33584720 PMCID: PMC7878381 DOI: 10.3389/fimmu.2020.621735] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
In late December 2019, multiple atypical pneumonia cases resulted in severe acute respiratory syndrome caused by a pathogen identified as a novel coronavirus SARS-CoV-2. The most common coronavirus disease 2019 (COVID-19) symptoms are pneumonia, fever, dry cough, and fatigue. However, some neurological complications following SARS-CoV-2 infection include confusion, cerebrovascular diseases, ataxia, hypogeusia, hyposmia, neuralgia, and seizures. Indeed, a growing literature demonstrates that neurotropism is a common feature of coronaviruses; therefore, the infection mechanisms already described in other coronaviruses may also be applicable for SARS-CoV-2. Understanding the underlying pathogenetic mechanisms in the nervous system infection and the neurological involvement is essential to assess possible long-term neurological alteration of COVID-19. Here, we provide an overview of associated literature regarding possible routes of COVID-19 neuroinvasion, such as the trans-synapse-connected route in the olfactory pathway and peripheral nerve terminals and its neurological implications in the central nervous system.
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Affiliation(s)
- Edwin Estefan Reza-Zaldívar
- Unidad de Evaluación Preclínica, Unidad de Biotecnología Médica y Farmaceútica, CONACYT Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Guadalajara, Mexico
| | - Mercedes Azucena Hernández-Sapiéns
- Unidad de Evaluación Preclínica, Unidad de Biotecnología Médica y Farmaceútica, CONACYT Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Guadalajara, Mexico
| | - Benito Minjarez
- Centro Universitario de Ciencias Biológicas y Agropecuarias (CUCBA), Universidad de Guadalajara, Zapopan, Mexico
| | - Ulises Gómez-Pinedo
- Laboratory of Neurobiology, Department of Neurology, Institute of Neurosciences, San Carlos Institute for Health Research, Universidad Complutense, Madrid, Spain
| | - Ana Laura Márquez-Aguirre
- Unidad de Evaluación Preclínica, Unidad de Biotecnología Médica y Farmaceútica, CONACYT Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Guadalajara, Mexico
| | - Juan Carlos Mateos-Díaz
- Biotecnología Industrial, CONACYT Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Zapopan, Mexico
| | - Jorge Matias-Guiu
- Laboratory of Neurobiology, Department of Neurology, Institute of Neurosciences, San Carlos Institute for Health Research, Universidad Complutense, Madrid, Spain
| | - Alejandro Arturo Canales-Aguirre
- Unidad de Evaluación Preclínica, Unidad de Biotecnología Médica y Farmaceútica, CONACYT Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Guadalajara, Mexico
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90
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Chen CC, Chiang PC, Chen TH. The Biosafety and Risk Management in Preparation and Processing of Cerebrospinal Fluid and Other Neurological Specimens With Potential Coronavirus Infection. Front Neurol 2021; 11:613552. [PMID: 33551970 PMCID: PMC7855587 DOI: 10.3389/fneur.2020.613552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/24/2020] [Indexed: 11/17/2022] Open
Abstract
The recent outbreak of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2, has become a global threat. Due to neurological manifestations presented throughout the coronavirus disease process, the potential involvement of COVID-19 in central nervous system has attracted considerable attention. Notably, the neurologic system could be widely affected, with various complications such as acute cerebrovascular events, encephalitis, Guillain-Barré syndrome, and acute necrotizing hemorrhagic encephalopathy. However, the risk assessment of exposure to potential biohazards in the context of the COVID-19 pandemic has not been clearly clarified regarding the sampling, preparation, and processing neurological specimens. Further risk managements and implantations are seldom discussed either. This article aims to provide current recommendations and evidence-based reviews on biosafety issues of preparation and processing of cerebrospinal fluid and neurological specimens with potential coronavirus infection from the bedside to the laboratory.
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Affiliation(s)
- Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Pei-Chun Chiang
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
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91
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Seroprevalence of SARS-CoV-2-specific antibodies in the town of Ariano Irpino (Avellino, Campania, Italy): a population-based study. Future Sci OA 2021; 7:FSO673. [PMID: 33815819 PMCID: PMC7802431 DOI: 10.2144/fsoa-2020-0203] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The Italian municipality of Ariano Irpino (Avellino, Campania, Italy) was locked down by the regional authorities from March until April 2020 after several citizens tested positive for SARS coronavirus 2 (SARS-CoV-2). A serological mass screening campaign targeting the Ariano Irpino population using the Roche Cobas Elecsys anti-SARS-CoV-2 assay was organized by the Zoo-Prophylactic Institute of Southern Italy (Portici, Italy) and conducted in cooperation with the Local Health Unit (Azienda Sanitaria Locale – ASL – Avellino, Avellino, Italy), the Department of Public Health of University Federico II (Naples, Italy) and Department of Health Services of Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital (Naples, Italy) in May 2020. A total of 13,218 asymptomatic individuals were reviewed in this analysis. A total of 738 citizens tested positive for anti-SARS-CoV-2 antibodies (398 females, 340 males). The overall prevalence in the sample was 5.6% (95% CI: 5.2–6.0). Among seropositive citizens, 101 cases tested positive on RT-PCR (0.76% of the overall population). Among citizens aged 14–18, 18–65 and >65 years, the seroprevalence was equal to 6.1 (95% CI: 4.1–8.7), 5.6 (95% CI: 5.1–6.1) and 4% (95% CI: 3.3–4.8), respectively. In the pediatric cohort (<14 years old), seroprevalence was 13% (95% CI: 10.2–16.2). A serological-based screening strategy could be a cost-effective public health intervention to tackle the COVID-19 pandemic. A mass screening campaign targeting the Ariano Irpino population in Italy, including a total of 13,218 asymptomatic individuals, showed that 5.6% of the tested individuals had antibodies against the virus responsible for COVID-19 in the blood. Among citizens aged <14, 14–18, 18–65 and >65 years, the proportion of positive individuals was equal to 13, 6.1, 5.6 and 4%, respectively. These asymptomatic individuals, who were identified by a simple blood draw using an inexpensive test (costing only a few euros), could inadvertently spread the infection. A serological-based screening strategy could therefore be a cost-effective public health intervention.
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92
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Qi J, Zhou Y, Hua J, Zhang L, Bian J, Liu B, Zhao Z, Jin S. The scRNA-seq Expression Profiling of the Receptor ACE2 and the Cellular Protease TMPRSS2 Reveals Human Organs Susceptible to SARS-CoV-2 Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E284. [PMID: 33401657 PMCID: PMC7794913 DOI: 10.3390/ijerph18010284] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 01/08/2023]
Abstract
COVID-19 patients always develop multiple organ dysfunction syndromes other than lungs, suggesting the novel virus SARS-CoV-2 also invades other organs. Therefore, studying the viral susceptibility of other organs is important for a deeper understanding of viral pathogenesis. Angiotensin-converting enzyme II (ACE2) is the receptor protein of SARS-CoV-2, and TMPRSS2 promotes virus proliferation and transmission. We investigated the ACE2 and TMPRSS2 expression levels of cell types from 31 organs to evaluate the risk of viral infection using single-cell RNA sequencing (scRNA-seq) data. For the first time, we found that the gall bladder and fallopian tube are vulnerable to SARS-CoV-2 infection. Besides, the nose, heart, small intestine, large intestine, esophagus, brain, testis, and kidney are also identified to be high-risk organs with high expression levels of ACE2 and TMPRSS2. Moreover, the susceptible organs are grouped into three risk levels based on the ACE2 and TMPRSS2 expression. As a result, the respiratory system, digestive system, and urinary system are at the top-risk level for SARS-CoV-2 infection. This study provides evidence for SARS-CoV-2 infection in the human nervous system, digestive system, reproductive system, respiratory system, circulatory system, and urinary system using scRNA-seq data, which helps in the clinical diagnosis and treatment of patients.
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Affiliation(s)
| | | | | | | | | | | | | | - Shuilin Jin
- School of Mathematics, Harbin Institute of Technology, Harbin 150001, China; (J.Q.); (Y.Z.); (J.H.); (L.Z.); (J.B.); (B.L.); (Z.Z.)
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93
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Alexandris N, Lagoumintzis G, Chasapis CT, Leonidas DD, Papadopoulos GE, Tzartos SJ, Tsatsakis A, Eliopoulos E, Poulas K, Farsalinos K. Nicotinic cholinergic system and COVID-19: In silico evaluation of nicotinic acetylcholine receptor agonists as potential therapeutic interventions. Toxicol Rep 2020; 8:73-83. [PMID: 33425684 PMCID: PMC7776751 DOI: 10.1016/j.toxrep.2020.12.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 infection was announced as a pandemic in March 2020. Since then, several scientists have focused on the low prevalence of smokers among hospitalized COVID-19 patients. These findings led to our hypothesis that the Nicotinic Cholinergic System (NCS) plays a crucial role in the manifestation of COVID-19 and its severe symptoms. Molecular modeling revealed that the SARS-CoV-2 Spike glycoprotein might bind to nicotinic acetylcholine receptors (nAChRs) through a cryptic epitope homologous to snake toxins, substrates well documented and known for their affinity to the nAChRs. This binding model could provide logical explanations for the acute inflammatory disorder in patients with COVID-19, which may be linked to severe dysregulation of NCS. In this study, we present a series of complexes with cholinergic agonists that can potentially prevent SARS-CoV-2 Spike glycoprotein from binding to nAChRs, avoiding dysregulation of the NCS and moderating the symptoms and clinical manifestations of COVID-19. If our hypothesis is verified by in vitro and in vivo studies, repurposing agents currently approved for smoking cessation and neurological conditions could provide the scientific community with a therapeutic option in severe COVID-19.
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Key Words
- ACh, Acetylcholine
- AChBP, Acetylcholine-binding protein
- ARDS, acute respiratory distress syndrome
- BLAST, Basic Local Alignment Search Tool
- CHARMM, Chemistry at Harvard Macromolecular Mechanics
- CNS, Central Nervous System
- COVID-19
- Cholinergic agonists
- CoV, coronavirus
- DCD, single precision binary FORTRAN
- ECD, extracellular domain
- HADDOCK, High Ambiguity Driven protein-protein DOCKing
- HMGB1, High-mobility group protein 1
- IL, Interleukin
- Jak2, Janus kinases 2
- LBD, Ligand Binding Domain
- MD, Molecular Dynamics
- MDS, Molecular Dynamics Simulations
- MERS, Middle East Respiratory Syndrome
- NAMD, Nanoscale Molecular Dynamics
- NCBI, National Center for Biotechnology Information
- NCS, Nicotinic Cholinergic System
- NF-kB, nuclear factor kappa-light-chain-enhancer of activated B cells
- NPT, constant number, pressure, energy
- NVT, constant number, volume, energy
- Nicotinic acetylcholine receptors
- PDB, Protein Data Bank
- PME, Particle Mesh Ewald
- PRODIGY, PROtein binDIng enerGY prediction
- PyMOL, Python Molecule
- RBD, Receptor Binding Domain
- RMSD, Root-mean-square deviation
- SARS, Severe Acute Respiratory Syndrome
- SARS-CoV-2
- SARS-CoV-2 S1, SARS - 2 Spike Subunit 1 protein
- STAT3, signal transducer and activator of transcription 3
- STD NMR, Saturation Transfer Difference Nuclear Magnetic Resonance
- Spike glycoprotein
- TNF, Tumor Necrosis Factor
- VMD, Visual Molecular Dynamics
- lig, ligand
- nAChRs, nicotinic acetylcholine receptors
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Affiliation(s)
- Nikolaos Alexandris
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
| | - George Lagoumintzis
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
- Institute of Research and Innovation - IRIS, Patras Science Park SA, 26500 Patras, Greece
| | - Christos T. Chasapis
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
| | - Demetres D. Leonidas
- Department of Biochemistry and Biotechnology, University of Thessaly, Biopolis, 41500 Larissa, Greece
| | - Georgios E. Papadopoulos
- Department of Biochemistry and Biotechnology, University of Thessaly, Biopolis, 41500 Larissa, Greece
| | | | | | - Elias Eliopoulos
- Department of Biotechnology, Laboratory of Genetics, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece
| | - Konstantinos Poulas
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
- Institute of Research and Innovation - IRIS, Patras Science Park SA, 26500 Patras, Greece
| | - Konstantinos Farsalinos
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
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Russo G, Pennisi M, Fichera E, Motta S, Raciti G, Viceconti M, Pappalardo F. In silico trial to test COVID-19 candidate vaccines: a case study with UISS platform. BMC Bioinformatics 2020; 21:527. [PMID: 33308153 PMCID: PMC7733700 DOI: 10.1186/s12859-020-03872-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023] Open
Abstract
Background SARS-CoV-2 is a severe respiratory infection that infects humans. Its outburst entitled it as a pandemic emergence. To get a grip on this outbreak, specific preventive and therapeutic interventions are urgently needed. It must be said that, until now, there are no existing vaccines for coronaviruses. To promptly and rapidly respond to pandemic events, the application of in silico trials can be used for designing and testing medicines against SARS-CoV-2 and speed-up the vaccine discovery pipeline, predicting any therapeutic failure and minimizing undesired effects. Results We present an in silico platform that showed to be in very good agreement with the latest literature in predicting SARS-CoV-2 dynamics and related immune system host response. Moreover, it has been used to predict the outcome of one of the latest suggested approach to design an effective vaccine, based on monoclonal antibody. Universal Immune System Simulator (UISS) in silico platform is potentially ready to be used as an in silico trial platform to predict the outcome of vaccination strategy against SARS-CoV-2. Conclusions In silico trials are showing to be powerful weapons in predicting immune responses of potential candidate vaccines. Here, UISS has been extended to be used as an in silico trial platform to speed-up and drive the discovery pipeline of vaccine against SARS-CoV-2.
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Affiliation(s)
- Giulia Russo
- Department of Drug Sciences, University of Catania, 95125, Catania, Italy
| | - Marzio Pennisi
- Computer Science Institute, DiSIT, University of Eastern Piedmont, 15125, Alessandria, Italy
| | | | - Santo Motta
- National Research Council of Italy, 00185, Rome, Italy
| | - Giuseppina Raciti
- Department of Drug Sciences, University of Catania, 95125, Catania, Italy.
| | - Marco Viceconti
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, 40136, Bologna, Italy
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95
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Zhang M, Zhou L, Wang J, Wang K, Wang Y, Pan X, Ma A. The nervous system-A new territory being explored of SARS-CoV-2. J Clin Neurosci 2020; 82:87-92. [PMID: 33317745 PMCID: PMC7598569 DOI: 10.1016/j.jocn.2020.10.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/17/2020] [Accepted: 10/21/2020] [Indexed: 12/15/2022]
Abstract
In December 2019, COVID-19 outbroke in Wuhan, then sweeping the mainland of China and the whole world rapidly. On March 4, Beijing Ditan Hospital confirmed the existence of SARS-CoV-2 in the cerebrospinal fluid by gene sequencing, indicating the neurotropic involvement of SARS-CoV-2. Meanwhile, neurological manifestations in the central nervous system, peripheral nervous system and skeletal muscular were also observed, indicating the potential neuroinvasion of SARS-CoV-2. In particular, we focused on its neurological manifestations and specific pathogenesis, as well as its comparison with other viral respiratory infections. Finally, we further summarized the significance of the neuroinvasion and the follow-up issues that need to be paid attention to by scientists, so as to help neurologists understand the influence of SARS-CoV-2 on nervous system better and promote the accurate diagnosis and efficient treatment of COVID-19.
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Affiliation(s)
- Meng Zhang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Lingyan Zhou
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Jing Wang
- Department of Rheumatology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Kun Wang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Yuan Wang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Xudong Pan
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Aijun Ma
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
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96
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Tsatsakis A, Calina D, Falzone L, Petrakis D, Mitrut R, Siokas V, Pennisi M, Lanza G, Libra M, Doukas SG, Doukas PG, Kavali L, Bukhari A, Gadiparthi C, Vageli DP, Kofteridis DP, Spandidos DA, Paoliello MMB, Aschner M, Docea AO. SARS-CoV-2 pathophysiology and its clinical implications: An integrative overview of the pharmacotherapeutic management of COVID-19. Food Chem Toxicol 2020; 146:111769. [PMID: 32979398 PMCID: PMC7833750 DOI: 10.1016/j.fct.2020.111769] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023]
Abstract
Common manifestations of COVID-19 are respiratory and can extend from mild symptoms to severe acute respiratory distress. The severity of the illness can also extend from mild disease to life-threatening acute respiratory distress syndrome (ARDS). SARS-CoV-2 infection can also affect the gastrointestinal tract, liver and pancreatic functions, leading to gastrointestinal symptoms. Moreover, SARS-CoV-2 can cause central and peripheral neurological manifestations, affect the cardiovascular system and promote renal dysfunction. Epidemiological data have indicated that cancer patients are at a higher risk of contracting the SARS-CoV-2 virus. Considering the multitude of clinical symptoms of COVID-19, the objective of the present review was to summarize their pathophysiology in previously healthy patients, as well as in those with comorbidities. The present review summarizes the current, though admittedly fluid knowledge on the pathophysiology and symptoms of COVID-19 infection. Although unclear issues still remain, the present study contributes to a more complete understanding of the disease, and may drive the direction of new research. The recognition of the severity of the clinical symptoms of COVID-19 is crucial for the specific therapeutic management of affected patients.
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Affiliation(s)
- Aristides Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece; I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori "Fondazione G. Pascale", 80131, Naples, Italy.
| | - Dimitrios Petrakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece.
| | - Radu Mitrut
- Department of Cardiology, University and Emergency Hospital, 050098, Bucharest, Romania.
| | - Vasileios Siokas
- Department of Neurology, University of Thessaly, University Hospital of Larissa, 41221, Larissa, Greece.
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123, Catania, Italy.
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123, Catania, Italy; Department of Neurology IC, Oasi Research Institute-IRCCS, 94018, Troina, Italy.
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123, Catania, Italy; Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123, Catania, Italy.
| | - Sotirios G Doukas
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece; Department of Internal Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ, 08901, USA.
| | - Panagiotis G Doukas
- University of Pavol Josef Safarik University, Faculty of Medicine, Kosice, Slovakia.
| | - Leena Kavali
- Department of Internal Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ, 08901, USA.
| | - Amar Bukhari
- Department of Medicine, Division of Pulmonary and Critical Care 240 Easton Ave, Adult Ambulatory at Cares Building 4th Floor, New Brunswick, NJ, 08901, USA.
| | - Chiranjeevi Gadiparthi
- Division of Gastroenterology, Hepatology and Clinical Nutrition, Saint Peter's University Hospital, New Brunswick, NJ, USA.
| | - Dimitra P Vageli
- Department of Surgery, The Yale Larynx Laboratory, New Haven, CT, 06510, USA.
| | - Diamantis P Kofteridis
- Department of Internal Medicine, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece.
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion, 71003, Greece.
| | - Monica M B Paoliello
- Department of Molecular Pharmacology, Albert Eisntein College of Medicine, 1300 Morris Park Avenue Bronx, NY, 10461, USA.
| | - Michael Aschner
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; Department of Molecular Pharmacology, Albert Eisntein College of Medicine, 1300 Morris Park Avenue Bronx, NY, 10461, USA.
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
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97
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Scutari R, Piermatteo L, Manuelli MC, Iannetta M, Salpini R, Bertoli A, Alteri C, Saccomandi P, Bellocchi MC, Malagnino V, Teti E, Sforza D, Siragusa L, Grande M, Sarmati L, Svicher V, Andreoni M, Ceccherini-Silberstein F. Long-Term SARS-CoV-2 Infection Associated with Viral Dissemination in Different Body Fluids Including Bile in Two Patients with Acute Cholecystitis. Life (Basel) 2020; 10:E302. [PMID: 33238410 PMCID: PMC7700357 DOI: 10.3390/life10110302] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 12/13/2022] Open
Abstract
Our study aimed to investigate the kinetics of SARS-CoV-2 RNA in bile and in different body fluids of two SARS-CoV-2 positive patients with acute cholecystitis by innovative droplet digital PCR (ddPCR) assays. For each patient, nasopharyngeal- and rectal swabs, bile, urine, and plasma samples were collected at different time points for SARS-CoV-2 RNA quantification by two ddPCR assays. For both patients, ddPCR revealed persistent and prolonged detection of viral RNA in the nasopharyngeal swab despite triple-negative or single-positive results by qRT-PCR. In Patient 1, SARS-CoV-2 RNA dropped more rapidly in bile and rectal-swab and declined slowly in nasopharyngeal swab and plasma, becoming undetectable in all compartments 97 days after symptoms started. Conversely, in patient 2, SARS-CoV-2 RNA was detected, even if at low copies, in all body samples (with the exception of urine) up to 75 days after the onset of symptoms. This study highlights that SARS-CoV-2 RNA can persist for a prolonged time in respiratory samples and in several biological samples despite negativity to qRT-PCR, supporting SARS-CoV-2's ability to provoke persistent and disseminated infection and therefore to contribute to extra-pulmonary clinical manifestations.
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Affiliation(s)
- Rossana Scutari
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
| | - Matteo Ciancio Manuelli
- Surgical Emergency Unit, Emergency Department, Polyclinic Tor Vergata Foundation, 00133 Rome, Italy; (M.C.M.); (D.S.)
| | - Marco Iannetta
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.I.); (V.M.); (E.T.); (L.S.); (M.A.)
| | - Romina Salpini
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
| | - Ada Bertoli
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
- Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, 00133 Rome, Italy
| | - Claudia Alteri
- Department of Oncology and Hemato-oncology, University of Milan, 20122 Milan, Italy;
| | - Patrizia Saccomandi
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
| | - Maria Concetta Bellocchi
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
| | - Vincenzo Malagnino
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.I.); (V.M.); (E.T.); (L.S.); (M.A.)
| | - Elisabetta Teti
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.I.); (V.M.); (E.T.); (L.S.); (M.A.)
| | - Daniele Sforza
- Surgical Emergency Unit, Emergency Department, Polyclinic Tor Vergata Foundation, 00133 Rome, Italy; (M.C.M.); (D.S.)
| | - Leandro Siragusa
- Department of Surgical Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy; (L.S.); (M.G.)
| | - Michele Grande
- Department of Surgical Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy; (L.S.); (M.G.)
| | - Loredana Sarmati
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.I.); (V.M.); (E.T.); (L.S.); (M.A.)
| | - Valentina Svicher
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
| | - Massimo Andreoni
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.I.); (V.M.); (E.T.); (L.S.); (M.A.)
| | - Francesca Ceccherini-Silberstein
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (R.S.); (L.P.); (R.S.); (A.B.); (P.S.); (M.C.B.); (F.C.-S.)
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98
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Tancheva L, Petralia MC, Miteva S, Dragomanova S, Solak A, Kalfin R, Lazarova M, Yarkov D, Ciurleo R, Cavalli E, Bramanti A, Nicoletti F. Emerging Neurological and Psychobiological Aspects of COVID-19 Infection. Brain Sci 2020; 10:E852. [PMID: 33198412 PMCID: PMC7696269 DOI: 10.3390/brainsci10110852] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 12/21/2022] Open
Abstract
The SARS-CoV-2 virus, first reported in December 2019 in China, is the causative agent of the current COVID-19 pandemic that, at the time of writing (1 November 2020) has infected almost 43 million people and caused the death of more than 1 million people. The spectrum of clinical manifestations observed during COVID-19 infection varies from asymptomatic to critical life-threatening clinical conditions. Emerging evidence shows that COVID-19 affects far more organs than just the respiratory system, including the heart, kidneys, blood vessels, liver, as well as the central nervous system (CNS) and the peripheral nervous system (PNS). It is also becoming clear that the neurological and psychological disturbances that occur during the acute phase of the infection may persist well beyond the recovery. The aim of this review is to propel further this emerging and relevant field of research related to the pathophysiology of neurological manifestation of COVID-19 infection (Neuro-COVID). We will summarize the PNS and CNS symptoms experienced by people with COVID-19 both during infection and in the recovery phase. Diagnostic and pharmacological findings in this field of study are strongly warranted to address the neurological and psychological symptoms of COVID-19.
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Affiliation(s)
- Lyubka Tancheva
- Department of Behavior Neurobiology, Institute of Neurobiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (L.T.); (S.M.); (S.D.); (R.K.); (M.L.)
| | - Maria Cristina Petralia
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (M.C.P.); (R.C.); (A.B.)
| | - Simona Miteva
- Department of Behavior Neurobiology, Institute of Neurobiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (L.T.); (S.M.); (S.D.); (R.K.); (M.L.)
| | - Stela Dragomanova
- Department of Behavior Neurobiology, Institute of Neurobiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (L.T.); (S.M.); (S.D.); (R.K.); (M.L.)
- Department of Pharmacology, Toxicology and Pharmacotherapy, Faculty of Pharmacy, Medical University, 9002 Varna, Bulgaria
| | - Ayten Solak
- Institute of Cryobiology and food technologies, Agricultural Academy, 1407 Sofia, Bulgaria;
| | - Reni Kalfin
- Department of Behavior Neurobiology, Institute of Neurobiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (L.T.); (S.M.); (S.D.); (R.K.); (M.L.)
| | - Maria Lazarova
- Department of Behavior Neurobiology, Institute of Neurobiology, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (L.T.); (S.M.); (S.D.); (R.K.); (M.L.)
| | - Dobri Yarkov
- Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria;
| | - Rosella Ciurleo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (M.C.P.); (R.C.); (A.B.)
| | - Eugenio Cavalli
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 89, 95123 Catania, Italy;
| | - Alessia Bramanti
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (M.C.P.); (R.C.); (A.B.)
| | - Ferdinando Nicoletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 89, 95123 Catania, Italy;
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99
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Silva TF, Tomiotto-Pellissier F, Sanfelice RA, Gonçalves MD, da Silva Bortoleti BT, Detoni MB, Rodrigues ACJ, Carloto ACM, Concato VM, Siqueira EDS, Costa IN, Pavanelli WR, Conchon-Costa I, Miranda-Sapla MM. A 21st Century Evil: Immunopathology and New Therapies of COVID-19. Front Immunol 2020; 11:562264. [PMID: 33193331 PMCID: PMC7652766 DOI: 10.3389/fimmu.2020.562264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/05/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19) has been classified as a global threat, affecting millions of people and killing thousands. It is caused by the SARS-CoV-2 virus, which emerged at the end of 2019 in Wuhan, China, quickly spreading worldwide. COVID-19 is a disease with symptoms that range from fever and breathing difficulty to acute respiratory distress and death, critically affecting older patients and people with previous comorbidities. SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) receptor and mainly spreads through the respiratory tract, which it then uses to reach several organs. The immune system of infected patients has been demonstrated to suffer important alterations, such as lymphopenia, exhausted lymphocytes, excessive amounts of inflammatory monocytes and macrophages, especially in the lungs, and cytokine storms, which may contribute to its severity and difficulty of establishing an effective treatment. Even though no specific treatment is currently available, several studies have been investigating potential therapeutic strategies, including the use of previously approved drugs and immunotherapy. In this context, this review addresses the interaction between SARS-CoV-2 and the patient's host immune system during infection, in addition to discussing the main immunopathological mechanisms involved in the development of the disease and potential new therapeutic approaches.
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Affiliation(s)
- Taylon Felipe Silva
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | | | - Raquel Arruda Sanfelice
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Manoela Daiele Gonçalves
- Laboratory of Biotransformation and Phytochemistry, Department of Chemistry, Center of Exact Sciences, State University of Londrina, Londrina, Brazil
| | | | - Mariana Barbosa Detoni
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Ana Carolina Jacob Rodrigues
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Amanda Cristina Machado Carloto
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Virgínia Márcia Concato
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Elaine da Silva Siqueira
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Idessania Nazareth Costa
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Wander Rogério Pavanelli
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Ivete Conchon-Costa
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
| | - Milena Menegazzo Miranda-Sapla
- Laboratory of Immunoparasitology of Neglected Diseases and Cancer—LIDNC, Department of Pathological Sciences, Center of Biological Sciences, State University of Londrina, Londrina, Brazil
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100
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Affiliation(s)
- Richard C Becker
- Department of Medicine, University of Cincinnati Heart and Circulation Research Institute, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
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