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Sierra I, Pyfrom S, Weiner A, Zhao G, Driscoll A, Yu X, Gregory BD, Vaughan AE, Anguera MC. Unusual X chromosome inactivation maintenance in female alveolar type 2 cells is correlated with increased numbers of X-linked escape genes and sex-biased gene expression. Stem Cell Reports 2023; 18:489-502. [PMID: 36638790 PMCID: PMC9968984 DOI: 10.1016/j.stemcr.2022.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 01/13/2023] Open
Abstract
Sex differences exist for many lung pathologies, including COVID-19 and pulmonary fibrosis, but the mechanistic basis for this remains unclear. Alveolar type 2 cells (AT2s), which play a key role in alveolar lung regeneration, express the X-linked Ace2 gene that has roles in lung repair and SARS-CoV-2 pathogenesis, suggesting that X chromosome inactivation (XCI) in AT2s might impact sex-biased lung pathology. Here we investigate XCI maintenance and sex-specific gene expression profiles using male and female AT2s. Remarkably, the inactive X chromosome (Xi) lacks robust canonical Xist RNA "clouds" and less enrichment of heterochromatic modifications in human and mouse AT2s. We demonstrate that about 68% of expressed X-linked genes in mouse AT2s, including Ace2, escape XCI. There are genome-wide expression differences between male and female AT2s, likely influencing both lung physiology and pathophysiologic responses. These studies support a renewed focus on AT2s as a potential contributor to sex-biased differences in lung disease.
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Affiliation(s)
- Isabel Sierra
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Pyfrom
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aaron Weiner
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gan Zhao
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amanda Driscoll
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xiang Yu
- Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Brian D Gregory
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew E Vaughan
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Penn Lung Biology Institute, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Montserrat C Anguera
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Zalpoor H, Liaghat M, Bakhtiyari M, Shapourian H, Akbari A, Shahveh S, Nabi-Afjadi M, Minaei Beirami S, Tarhriz V. Kaempferol's potential effects against SARS-CoV-2 and COVID-19-associated cancer progression and chemo-resistance. Phytother Res 2023; 37:1731-1739. [PMID: 36706035 DOI: 10.1002/ptr.7706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Hamidreza Zalpoor
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran
| | - Mahsa Liaghat
- Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran.,Department of Medical Laboratory sciences, Faculty of Medical Sciences, Kazerun Branch, Islamic Azad University, Kazerun, Iran
| | - Maryam Bakhtiyari
- Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran.,Department of Medical Laboratory Sciences, Faculty of Allied Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hooriyeh Shapourian
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdullatif Akbari
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran
| | - Shaghayegh Shahveh
- American Association of Naturopath Physician (AANP), Washington, DC, USA
| | - Mohsen Nabi-Afjadi
- Department of Biochemistry, Faculty of biological science, Tarbiat Modares University, Tehran, Iran
| | - Sohrab Minaei Beirami
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Research Center for Infectious Diseases and Tropical Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Tarhriz
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Research Center for Infectious Diseases and Tropical Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Cooksey KE, Sanz C, Massamba JM, Ebombi TF, Teberd P, Abea G, Mbebouti G, Kienast I, Brogan S, Stephens C, Morgan D. Predictors of respiratory illness in western lowland gorillas. Primates 2023:10.1007/s10329-022-01045-6. [PMID: 36653552 PMCID: PMC9849104 DOI: 10.1007/s10329-022-01045-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/08/2022] [Indexed: 01/20/2023]
Abstract
Infectious disease is hypothesized to be one of the most important causes of morbidity and mortality in wild great apes. Specific socioecological factors have been shown to influence incidences of respiratory illness and disease prevalence in some primate populations. In this study, we evaluated potential predictors (including age, sex, group size, fruit availability, and rainfall) of respiratory illness across three western lowland gorilla groups in the Republic of Congo. A total of 19,319 observational health assessments were conducted during daily follows of habituated gorillas in the Goualougo and Djéké Triangles over a 4-year study period. We detected 1146 incidences of clinical respiratory signs, which indicated the timing of probable disease outbreaks within and between groups. Overall, we found that males were more likely to exhibit signs than females, and increasing age resulted in a higher likelihood of respiratory signs. Silverback males showed the highest average monthly prevalence of coughs and sneezes (Goualougo: silverback Loya, 9.35 signs/month; Djéké: silverback Buka, 2.65 signs/month; silverback Kingo,1.88 signs/month) in each of their groups. Periods of low fruit availability were associated with an increased likelihood of respiratory signs. The global pandemic has increased awareness about the importance of continuous monitoring and preparedness for infectious disease outbreaks, which are also known to threaten wild ape populations. In addition to the strict implementation of disease prevention protocols at field sites focused on great apes, there is a need for heightened vigilance and systematic monitoring across sites to protect both wildlife and human populations.
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Affiliation(s)
- Kristena E. Cooksey
- Department of Anthropology, Washington University in St. Louis, 1 Brookings Drive, Campus Box 1114, Saint Louis, MO 63130 USA
| | - Crickette Sanz
- Department of Anthropology, Washington University in St. Louis, 1 Brookings Drive, Campus Box 1114, Saint Louis, MO 63130 USA ,Wildlife Conservation Society, Congo Program, B.P. 14537, Brazzaville, Republic of Congo
| | - Jean Marie Massamba
- Wildlife Conservation Society, Congo Program, B.P. 14537, Brazzaville, Republic of Congo
| | - Thierry Fabrice Ebombi
- Wildlife Conservation Society, Congo Program, B.P. 14537, Brazzaville, Republic of Congo
| | - Prospère Teberd
- Wildlife Conservation Society, Congo Program, B.P. 14537, Brazzaville, Republic of Congo
| | - Gaston Abea
- Wildlife Conservation Society, Congo Program, B.P. 14537, Brazzaville, Republic of Congo
| | - Gaeton Mbebouti
- Wildlife Conservation Society, Congo Program, B.P. 14537, Brazzaville, Republic of Congo
| | - Ivonne Kienast
- Department of Natural Resources and the Environment, Cornell University, Ithaca, NY 14850 USA ,K. Lisa Yang Center for Conservation Bioacoustics, Cornell Lab of Ornithology, Cornell University, Ithaca, NY 14850 USA
| | - Sean Brogan
- Wildlife Conservation Society, Congo Program, B.P. 14537, Brazzaville, Republic of Congo
| | - Colleen Stephens
- Department of Anthropology, Washington University in St. Louis, 1 Brookings Drive, Campus Box 1114, Saint Louis, MO 63130 USA
| | - David Morgan
- Fisher Center for the Study and Conservation of Apes, Lincoln Park Zoo, 2001 N. Clark Street, Chicago, IL 60614 USA
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Mina FB, Billah M, Karmakar S, Das S, Rahman MS, Hasan MF, Acharjee UK. An online observational study assessing clinical characteristics and impacts of the COVID-19 pandemic on mental health: a perspective study from Bangladesh. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023; 31:319-327. [PMID: 33432286 PMCID: PMC7787928 DOI: 10.1007/s10389-020-01445-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023]
Abstract
Purpose The pandemic of coronavirus disease 2019 (COVID-19) has cost numerous lives and induced tremendous mental stress among people. The purpose of this research was to determine anxiety and depression levels, clinical features, and the connections between demographic variables and depression prevalence as well as anxiety prevalence among reported COVID-19 cases in Bangladesh. Methods For the purpose of data collection, an online cross-sectional survey was carried out from May 26 to June 27, 2020, utilizing a Google adapted preformed questionnaire. The form was shared with a short overview and justification through Facebook, Twitter, Facebook messenger, Viber, and What's App. The Google form contains five parts: a brief introduction, an approval statement, demographics, clinical and radiological data, and mental health assessment by the Generalized Anxiety Disorder 7-item (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Formal ethical clearance was taken from the Institute of Biological Science (IBSc), Bangladesh. Informed consent was ensured before participation. Results One hundred and fifty-three (153) patients with COVID-19 who had an average age of 39.43 ± 17.59 years with male predominance (72%) were included. A total of 32.7% were doing health-care related jobs, and 17.7% lost their jobs due to COVID-19. Patients had a median income of 30,000 Bangladesh taka (BDT). Of all, 12.4% of the participants showed asymptomatic features, whereas 87.6% of patients were symptomatic and presented with fever (79%), cough (58.8%), myalgia (24.2%), breathlessness (23.5%), sore throat (21.6%), fatigue (19.6%), headache (13.7%), nausea and/or vomiting (11.8%), runny nose (9.8%), chest pain (9.2%), diarrhea (8.5%), stuffy nose (3.2%), ARDS (2.6%), oral ulcer (2.6%), and conjunctivitis (1.9%). Overall, the prevalence of anxiety and depression was 63.5% and 56.6%, respectively. Among the participants, 13.2% had only anxiety, 6.3% had only depression, and 50.3% had both. Conclusion In most cases, middle age, male, and healthy workers were patients. Fever and cough were the standard presentations. Approximately two-thirds or 66.67% of patients had anxiety and depression, one or both.
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Affiliation(s)
- Fahmida Begum Mina
- grid.412656.20000 0004 0451 7306Department of Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Mutasim Billah
- grid.412656.20000 0004 0451 7306Department of Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, 6205 Bangladesh ,grid.412656.20000 0004 0451 7306Joarder DNA & Chromosome Research Laboratory, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Sumon Karmakar
- grid.412656.20000 0004 0451 7306Molecular Biology and Protein Science Laboratory, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Sabuj Das
- grid.412656.20000 0004 0451 7306Department of Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Md. Siddikur Rahman
- grid.412656.20000 0004 0451 7306Department of Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Md. Faruk Hasan
- grid.412656.20000 0004 0451 7306Department of Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, 6205 Bangladesh ,grid.412656.20000 0004 0451 7306Joarder DNA & Chromosome Research Laboratory, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Uzzal Kumar Acharjee
- grid.412656.20000 0004 0451 7306Joarder DNA & Chromosome Research Laboratory, University of Rajshahi, Rajshahi, 6205 Bangladesh
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Sekaran K, Polachirakkal Varghese R, Gnanasambandan R, Karthik G, Ramya I, George Priya Doss C. Molecular modeling of C1-inhibitor as SARS-CoV-2 target identified from the immune signatures of multiple tissues: An integrated bioinformatics study. Cell Biochem Funct 2023; 41:112-127. [PMID: 36517964 DOI: 10.1002/cbf.3769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/02/2022] [Accepted: 11/27/2022] [Indexed: 12/16/2022]
Abstract
The expeditious transmission of the severe acute respiratory coronavirus 2 (SARS-CoV-2), a strain of COVID-19, crumbled the global economic strength and caused a veritable collapse in health infrastructure. The molecular modeling of the novel coronavirus research sounds promising and equips more evidence about the pragmatic therapeutic options. This article proposes a machine-learning framework for identifying potential COVID-19 transcriptomic signatures. The transcriptomics data contains immune-related genes collected from multiple tissues (blood, nasal, and buccal) with accession number: GSE183071. Extensive bioinformatics work was carried out to identify the potential candidate markers, including differential expression analysis, protein interactions, gene ontology, and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment studies. The overlapping investigation found SERPING1, the gene that encodes a glycosylated plasma protein C1-INH, in all three datasets. Furthermore, the immuno-informatics study was conducted on the C1-INH protein. 5DU3, the protein identifier of C1-INH, was fetched to identify the antigenicity, major histocompatibility (MHC) Class I and II binding epitopes, allergenicity, toxicity, and immunogenicity. The screening of peptides satisfying the vaccine-design criteria based on the metrics mentioned above is performed. The drug-gene interaction study reported that Rhucin is strongly associated with SERPING1. HSIC-Lasso (Hilbert-Schmidt independence criterion-least absolute shrinkage and selection operator), a model-free biomarker selection technique, was employed to identify the genes having a nonlinear relationship with the target class. The gene subset is trained with supervised machine learning models by a leave-one-out cross-validation method. Explainable artificial intelligence techniques perform the model interpretation analysis.
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Affiliation(s)
- Karthik Sekaran
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | | | - R Gnanasambandan
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - G Karthik
- Department of Medicine, Christian Medical College, Vellore, India
| | - I Ramya
- Department of Medicine, Christian Medical College, Vellore, India
| | - C George Priya Doss
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
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56
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Han E, Gyöngyösi M. [Long COVID-A New Challenge in Medicine: Focus on Pregnancy and Breastfeeding]. JOURNAL FUR GYNAKOLOGISCHE ENDOKRINOLOGIE (OSTERREICHISCHE AUSG.) 2023; 33:7-12. [PMID: 36747883 PMCID: PMC9893966 DOI: 10.1007/s41974-023-00250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 02/05/2023]
Abstract
Long COVID (coronavirus disease) has been described as a new multi-organ disease, which appears to be more prevalent in women than in men. Pregnant and breastfeeding women are a special subgroup of patients to consider with long COVID, as only scarce data have been collected to date. Menstrual changes are commonly observed during or after COVID-19; some studies also attribute slight changes of cycle length to previous inoculation against the virus. Pregnant women who have a symptomatic infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are at a higher risk for adverse outcomes and pregnancy-associated complications. Moreover, more and robust data are required to evaluate vertical transmission. COVID vaccines are the most effective tool against the pandemic, as they prevent infection, but also appear to be able to ease long COVID symptoms. Vaccines have been proven safe and effective in both pregnant and breastfeeding women. This article aims to present current data on long COVID in pregnant and breastfeeding women and elucidate risk factors and possible treatment options.
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Affiliation(s)
- Emilie Han
- Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090 Wien, Österreich
| | - Mariann Gyöngyösi
- Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090 Wien, Österreich
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Zielińska A, Eder P, Karczewski J, Szalata M, Hryhorowicz S, Wielgus K, Szalata M, Dobrowolska A, Atanasov AG, Słomski R, Souto EB. Tocilizumab-coated solid lipid nanoparticles loaded with cannabidiol as a novel drug delivery strategy for treating COVID-19: A review. Front Immunol 2023; 14:1147991. [PMID: 37033914 PMCID: PMC10073701 DOI: 10.3389/fimmu.2023.1147991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Commonly used clinical strategies against coronavirus disease 19 (COVID-19), including the potential role of monoclonal antibodies for site-specific targeted drug delivery, are discussed here. Solid lipid nanoparticles (SLN) tailored with tocilizumab (TCZ) and loading cannabidiol (CBD) are proposed for the treatment of COVID-19 by oral route. TCZ, as a humanized IgG1 monoclonal antibody and an interleukin-6 (IL-6) receptor agonist, can attenuate cytokine storm in patients infected with SARS-CoV-2. CBD (an anti-inflammatory cannabinoid and TCZ agonist) alleviates anxiety, schizophrenia, and depression. CBD, obtained from Cannabis sativa L., is known to modulate gene expression and inflammation and also shows anti-cancer and anti-inflammatory properties. It has also been recognized to modulate angiotensin-converting enzyme II (ACE2) expression in SARS-CoV-2 target tissues. It has already been proven that immunosuppressive drugs targeting the IL-6 receptor may ameliorate lethal inflammatory responses in COVID-19 patients. TCZ, as an immunosuppressive drug, is mainly used to treat rheumatoid arthritis, although several attempts have been made to use it in the active hyperinflammatory phase of COVID-19, with promising outcomes. TCZ is currently administered intravenously. It this review, we discuss the potential advances on the use of SLN for oral administration of TCZ-tailored CBD-loaded SLN, as an innovative platform for managing SARS-CoV-2 and related infections.
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Affiliation(s)
- Aleksandra Zielińska
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Poznan, Poland
- *Correspondence: Aleksandra Zielińska, ; Piotr Eder, ; Eliana B. Souto,
| | - Piotr Eder
- Department of Gastroenterology, Dietetics, and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
- *Correspondence: Aleksandra Zielińska, ; Piotr Eder, ; Eliana B. Souto,
| | - Jacek Karczewski
- Department of Environmental Medicine/Department of Gastroenterology, Human Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Marlena Szalata
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Poznań, Poland
| | - Szymon Hryhorowicz
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Poznan, Poland
| | - Karolina Wielgus
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Milena Szalata
- Department of Biotechnology, Institute of Natural Fibres and Medicinal Plants National Research Institute, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics, and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Atanas G. Atanasov
- Institute of Genetics and Animal Biotechnology, Magdalenka, Poland
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Department of Pharmacognosy, University of Vienna, Vienna, Austria
| | - Ryszard Słomski
- Institute of Human Genetics, Polish Academy of Sciences Poznan, Poznan, Poland
| | - Eliana B. Souto
- UCIBIO – Applied Molecular Biosciences Unit, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- *Correspondence: Aleksandra Zielińska, ; Piotr Eder, ; Eliana B. Souto,
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Wiese BM, Alvarez Reyes A, Vanderah TW, Largent-Milnes TM. The endocannabinoid system and breathing. Front Neurosci 2023; 17:1126004. [PMID: 37144090 PMCID: PMC10153446 DOI: 10.3389/fnins.2023.1126004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/16/2023] [Indexed: 05/06/2023] Open
Abstract
Recent changes in cannabis accessibility have provided adjunct therapies for patients across numerous disease states and highlights the urgency in understanding how cannabinoids and the endocannabinoid (EC) system interact with other physiological structures. The EC system plays a critical and modulatory role in respiratory homeostasis and pulmonary functionality. Respiratory control begins in the brainstem without peripheral input, and coordinates the preBötzinger complex, a component of the ventral respiratory group that interacts with the dorsal respiratory group to synchronize burstlet activity and drive inspiration. An additional rhythm generator: the retrotrapezoid nucleus/parafacial respiratory group drives active expiration during conditions of exercise or high CO2. Combined with the feedback information from the periphery: through chemo- and baroreceptors including the carotid bodies, the cranial nerves, stretch of the diaphragm and intercostal muscles, lung tissue, and immune cells, and the cranial nerves, our respiratory system can fine tune motor outputs that ensure we have the oxygen necessary to survive and can expel the CO2 waste we produce, and every aspect of this process can be influenced by the EC system. The expansion in cannabis access and potential therapeutic benefits, it is essential that investigations continue to uncover the underpinnings and mechanistic workings of the EC system. It is imperative to understand the impact cannabis, and exogenous cannabinoids have on these physiological systems, and how some of these compounds can mitigate respiratory depression when combined with opioids or other medicinal therapies. This review highlights the respiratory system from the perspective of central versus peripheral respiratory functionality and how these behaviors can be influenced by the EC system. This review will summarize the literature available on organic and synthetic cannabinoids in breathing and how that has shaped our understanding of the role of the EC system in respiratory homeostasis. Finally, we look at some potential future therapeutic applications the EC system has to offer for the treatment of respiratory diseases and a possible role in expanding the safety profile of opioid therapies while preventing future opioid overdose fatalities that result from respiratory arrest or persistent apnea.
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Affiliation(s)
- Beth M. Wiese
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
| | - Angelica Alvarez Reyes
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
- College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Todd W. Vanderah
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
| | - Tally M. Largent-Milnes
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
- *Correspondence: Tally M. Largent-Milnes,
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Li Y, Wei Z, Ma X, Xu J, Zhao X, Cao Q, Di G. Efficacy and Safety of Mesenchymal Stromal Cells Therapy for COVID-19 Infection: A Systematic Review and Meta-analysis. Curr Stem Cell Res Ther 2023; 18:143-152. [PMID: 34872483 DOI: 10.2174/1574888x16666211206145839] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/30/2021] [Accepted: 09/14/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease prevalent worldwide with a high mortality rate, and there is currently no specific medicine to treat patients. OBJECTIVE We aimed to assess the safety and efficacy of stem cell therapy for COVID-19 by providing references for subsequent clinical treatments and trials. METHOD We systematically searched PubMed, Embase, Cochrane, and Web of Science, using the following keywords: "stem cell" or "stromal cell" and "COVID-19." Controlled clinical trials published in English until 24th August 2021 were included. We followed the PRISMA guidelines and used Cochrane Collaboration's tool for assessing the risk of bias. We analysed the data using a fixed-effect model. RESULTS We identified 1779 studies, out of which eight were eligible and included in this study. Eight relevant studies consisted of 156 patients treated with stem cells and 144 controls (300 individuals in total). There were no SAEs associated with stem cell therapy in all six studies, and no significant differences in AEs (p = 0.09, I2 = 40%, OR = 0.53, 95% CI: 0.26 to 1.09) between the experimental group and control group were observed. Moreover, the meta-analysis found that stem cell therapy effectively reduced the high mortality rate of COVID-19 (14/156 vs. 43/144; p<0.0001, I2 = 0%, OR=0.18, 95% CI: 0.08 to 0.41). CONCLUSION This study suggests that MSCs therapy for COVID-19 has shown some promising results in safety and efficacy. It effectively reduces the high mortality rate of COVID-19 and does not increase the incidence of adverse events.
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Affiliation(s)
- Yaxin Li
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Ziyang Wei
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Xinyu Ma
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Jing Xu
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Xia Zhao
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qilong Cao
- Qingdao Haier Biotech Co. Ltd., Qingdao, China
| | - Guohu Di
- School of Basic Medicine, Qingdao University, Qingdao, China
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60
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Solis O, Beccari AR, Iaconis D, Talarico C, Ruiz-Bedoya CA, Nwachukwu JC, Cimini A, Castelli V, Bertini R, Montopoli M, Cocetta V, Borocci S, Prandi IG, Flavahan K, Bahr M, Napiorkowski A, Chillemi G, Ooka M, Yang X, Zhang S, Xia M, Zheng W, Bonaventura J, Pomper MG, Hooper JE, Morales M, Rosenberg AZ, Nettles KW, Jain SK, Allegretti M, Michaelides M. The SARS-CoV-2 spike protein binds and modulates estrogen receptors. SCIENCE ADVANCES 2022; 8:eadd4150. [PMID: 36449624 PMCID: PMC9710872 DOI: 10.1126/sciadv.add4150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein binds angiotensin-converting enzyme 2 as its primary infection mechanism. Interactions between S and endogenous proteins occur after infection but are not well understood. We profiled binding of S against >9000 human proteins and found an interaction between S and human estrogen receptor α (ERα). Using bioinformatics, supercomputing, and experimental assays, we identified a highly conserved and functional nuclear receptor coregulator (NRC) LXD-like motif on the S2 subunit. In cultured cells, S DNA transfection increased ERα cytoplasmic accumulation, and S treatment induced ER-dependent biological effects. Non-invasive imaging in SARS-CoV-2-infected hamsters localized lung pathology with increased ERα lung levels. Postmortem lung experiments from infected hamsters and humans confirmed an increase in cytoplasmic ERα and its colocalization with S in alveolar macrophages. These findings describe the discovery of a S-ERα interaction, imply a role for S as an NRC, and advance knowledge of SARS-CoV-2 biology and coronavirus disease 2019 pathology.
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Affiliation(s)
- Oscar Solis
- Biobehavioral Imaging and Molecular Neuropsychopharmacology Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD 21224, USA
| | | | | | | | - Camilo A. Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB-II Room 109, Baltimore, MD 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jerome C. Nwachukwu
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, 130 Scripps Way, Jupiter, FL 33458, USA
| | - Annamaria Cimini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- Sbarro Institute for Cancer Research and Molecular Medicine, Department of Biology, Temple University, Philadelphia, PA 19122, USA
| | - Vanessa Castelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | | | - Monica Montopoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
- VIMM- Veneto Institute of Molecular Medicine, Fondazione per la Ricerca Biomedica Avanzata, Padova, Italy
| | - Veronica Cocetta
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Stefano Borocci
- Department for Innovation in Biological, Agro-Food and Forest Systems, DIBAF, University of Tuscia, Viterbo, Italy
| | - Ingrid G. Prandi
- Department for Innovation in Biological, Agro-Food and Forest Systems, DIBAF, University of Tuscia, Viterbo, Italy
| | - Kelly Flavahan
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB-II Room 109, Baltimore, MD 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Melissa Bahr
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB-II Room 109, Baltimore, MD 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Anna Napiorkowski
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB-II Room 109, Baltimore, MD 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Giovanni Chillemi
- Department for Innovation in Biological, Agro-Food and Forest Systems, DIBAF, University of Tuscia, Viterbo, Italy
| | - Masato Ooka
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Rockville, MD 20850, USA
| | - Xiaoping Yang
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Shiliang Zhang
- Neuronal Networks Section, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD 21224, USA
| | - Menghang Xia
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Rockville, MD 20850, USA
| | - Wei Zheng
- Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Rockville, MD 20850, USA
| | - Jordi Bonaventura
- Departament de Patologia i Terapèutica Experimental, Institut de Neurociències, Universitat de Barcelona, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Martin G. Pomper
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jody E. Hooper
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Marisela Morales
- Neuronal Networks Section, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD 21224, USA
| | - Avi Z. Rosenberg
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kendall W. Nettles
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, 130 Scripps Way, Jupiter, FL 33458, USA
| | - Sanjay K. Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, 1550 Orleans Street, CRB-II Room 109, Baltimore, MD 21287, USA
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Marcello Allegretti
- Dompé farmaceutici S.p.A, L’Aquila, Italy
- Corresponding author. (M.M.); (M.A.)
| | - Michael Michaelides
- Biobehavioral Imaging and Molecular Neuropsychopharmacology Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD 21224, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Corresponding author. (M.M.); (M.A.)
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Guarnieri G, Bertagna De Marchi L, Marcon A, Panunzi S, Batani V, Caminati M, Furci F, Senna G, Alaibac M, Vianello A. Relationship between hair shedding and systemic inflammation in COVID-19 pneumonia. Ann Med 2022; 54:869-874. [PMID: 35341398 PMCID: PMC8959503 DOI: 10.1080/07853890.2022.2054026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: A higher risk for COVID-19 infection and severity for men compared to women has been described since the beginning of the pandemic. The role of androgens has been recently highlighted as they control two key steps of coronavirus infection mediated through the transmembrane protease serin 2 (TMPRRS2) and the angiotensin-converting enzyme 2 (ACE2) receptor in the lung tissue. Furthermore, a high incidence of androgenic alopecia among males with COVID-19 disease have been reported.Objective: This study aims to evaluate the telogen effluvium (TE) prevalence and its relationship with clinical and immunologic parameters in a sample of patients consecutively evaluated after recovery from COVID-19 pneumonia in Northern Italy.Methods: Overall 104 patients were recruited within three months from COVID-19 pneumonia recovery; 80 (77%) had been hospitalized in a Respiratory Intensive Care Unit and the remaining ones had been treated at home. The extent of TE was assessed with a visual analogic scale for thick bundle of hairs. Demographic and clinical data and systemic inflammation biomarkers were also evaluated.Results. Thirty-two patients reported a history of TE and their mean TE-VAS score was 5.78 ± 1.72 (range 3-9). Women had about a 5-fold higher risk (odds) of complaining of TE compared to males (OR = 4.69, 95%CI: 1.91, 11.49; p = .001), and the association became stronger when adjusted for COVID-19 severity (hospital admission vs home care: OR = 6.09, 95%CI: 2.34, 15.88; p < .001). Levels of C-reactive protein >1.90 mg/l (ORadj: 2.43, 95%CI 0.85, 7.05, p = 0.096) or IL 1β > 5 ng/l (ORadj 4.72, 95%CI: 1.31, 23.19, p = .03) were also significantly associated with TE.Conclusion: This exploratory study raises the hypothesis that hair shedding is more strictly related to the severity of COVID-19 disease and the underlying inflammation rather than to patients' hormonal status. KEY MESSAGESThe presence of Telogen effluvium (TE) was significantly more common in women.Higher severity of the Covid-19 disease seems to play a critical role, more important than the hormonal influence, in the development of TE.The severity of inflammation related to TE and Covid-19 could also play a role as suggested by the higher levels of CRP and platelets and IL1β.
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Affiliation(s)
- Gabriella Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, Respiratory Pathophysiology Unit, University of Padova, Padova, Italy
| | - Leonardo Bertagna De Marchi
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, Respiratory Pathophysiology Unit, University of Padova, Padova, Italy
| | - Alessandro Marcon
- Department of Diagnostics and Public Health, Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
| | - Silvia Panunzi
- Department of Diagnostics and Public Health, Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
| | - Veronica Batani
- Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy
| | - Marco Caminati
- Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy
| | - Fabiana Furci
- Allergy Unit and Asthma Center, Verona University Hospital, Verona, Italy
| | - Gianenrico Senna
- Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy.,Allergy Unit and Asthma Center, Verona University Hospital, Verona, Italy
| | - Mauro Alaibac
- Department of Medicine-DIMED, Unit of Dermatology, University of Padova, Padova, Italy
| | - Andrea Vianello
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, Respiratory Pathophysiology Unit, University of Padova, Padova, Italy
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Coelingh Bennink HJ, Egberts JF, Debruyne FM. Testosterone suppression combined with high dose estrogen as potential treatment of SARS-CoV-2. A mini review. Heliyon 2022; 8:e12376. [PMID: 36540359 PMCID: PMC9754753 DOI: 10.1016/j.heliyon.2022.e12376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/06/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Compared to females, males experience severe acute respiratory syndrome due to COVID-19 (SARS-CoV-2) more often, and also die more frequently from COVID-19. Testosterone has inhibitory and estrogens have favorable effects on the immune system. Both ACE2 and TMPRSS2 are specific host-cellular proteins stimulating viral entry in cells and SARS-CoV-2. Both proteins can be suppressed by inhibition of testosterone levels and by stimulation of estrogen levels. Therefore, both androgen-deprivation therapy (ADT) and estrogen therapy (ET) may decrease COVID-19 virus cell entry. Literature was searched for evidence of COVID-19 treatment benefits with estrogens, progesterone, androgen deprivation, and anti-androgens. Data supporting the effect of ADT on SARS-CoV-2 are sparse and inconsistent. The benefit of anti-androgen therapy is inconsistent. Data on the effect of ET were not found. Indirect estrogen data related to menopausal hormone therapy and hormonal contraception are favorable. In a small study, progesterone had some beneficial effects. The combination of ADT and ET (ADET) has never been studied as a treatment option for SARS-CoV-2. Based on the mode of action of the combination, it is hypothesized that ADET may be an effective and safe treatment of SARS-CoV-2, to be confirmed in a clinical trial.
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Costa AJ, Lemes RMR, Bartolomeo CS, Nunes TA, Pereira GC, Oliveira RB, Gomes AL, Smaili SS, Maciel RMDB, Newson L, Ramirez AL, Okuda LH, Prado CM, Stilhano RS, Ureshino RP. Overexpression of estrogen receptor GPER1 and G1 treatment reduces SARS-CoV-2 infection in BEAS-2B bronchial cells. Mol Cell Endocrinol 2022; 558:111775. [PMID: 36096380 PMCID: PMC9458763 DOI: 10.1016/j.mce.2022.111775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022]
Abstract
Gender-bias in COVID-19 severity has been suggested by clinical data. Experimental data in cell and animal models have demonstrated the role of sex hormones, particularly estrogens, in viral infections such as in COVID-19. SARS-CoV-2 uses ACE2 as a receptor to recognize host cells, and the protease TMPRSS2 for priming the Spike protein, facilitating virus entry into cells. However, the involvement of estrogenic receptors in SARS-CoV-2 infection are still being explored. Thus, in order to investigate the role of estrogen and its receptors in COVID-19, the estrogen receptors ERα, ERβ and GPER1 were overexpressed in bronchial BEAS-2B cell, and then infected with SARS-CoV-2. Interestingly, the levels of ACE2 and TMPRSS2 mRNA were higher in SARS-CoV-2-infected cells, but no difference was observed in cells with estrogen receptors overexpression. GPER1 can be involved in virus infection or replication, since its higher levels reduces SARS-CoV-2 load. On the other hand, pharmacological antagonism of GPER1 enhanced viral load. Those data suggest that GPER1 has an important role in SARS-CoV-2 infection.
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Affiliation(s)
- Angelica Jardim Costa
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Pharmacology, São Paulo, SP, Brazil
| | - Robertha Mariana Rodrigues Lemes
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Department of Biological Sciences, Diadema, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil
| | - Cynthia Silva Bartolomeo
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Departament of Biosciences, Santos, SP, Brazil
| | - Tamires Alves Nunes
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Departament of Biosciences, Santos, SP, Brazil
| | - Gabriela Cruz Pereira
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Biochemistry, São Paulo, SP, Brazil
| | - Rafaela Brito Oliveira
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Department of Biological Sciences, Diadema, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil
| | - Alexandre Lopes Gomes
- Instituto Biológico, Secretaria de Agricultura e Abastecimento, São Paulo, SP, Brazil
| | - Soraya Soubhi Smaili
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Pharmacology, São Paulo, SP, Brazil
| | - Rui Monteiro de Barros Maciel
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Medicine, São Paulo, SP, Brazil
| | - Louise Newson
- Newson Health Research and Education, Stratford-Upon-Avon, UK
| | | | - Liria Hiromi Okuda
- Instituto Biológico, Secretaria de Agricultura e Abastecimento, São Paulo, SP, Brazil
| | - Carla Máximo Prado
- Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Departament of Biosciences, Santos, SP, Brazil
| | - Roberta Sessa Stilhano
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Portes Ureshino
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Department of Biological Sciences, Diadema, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil.
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Brola W, Wilski M. Neurological consequences of COVID-19. Pharmacol Rep 2022; 74:1208-1222. [PMID: 36180640 PMCID: PMC9524739 DOI: 10.1007/s43440-022-00424-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 12/13/2022]
Abstract
In December 2019, cases of pneumonia caused by infection with the previously unknown severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to coronavirus disease 2019 (COVID-19), were identified. Typical manifestations of COVID-19 are fever, cough, fatigue and dyspnoea. Initially, it was thought that the mechanism of action of SARS-CoV-2 was only associated with respiratory tract invasion, but it was later revealed that the infection might involve many other organs and systems, including the central and peripheral nervous systems. Neurological complications associated with SARS-CoV-2 infection include encephalopathy, encephalitis, meningitis, acute disseminated encephalomyelitis (ADEM), ischaemic and haemorrhagic stroke and cerebral venous sinus thrombosis. In cases of peripheral nervous system involvement, smell and taste disorders, myopathy or the signs and symptoms of Guillain‒Barré syndrome are observed. The most common early neurological complications, particularly during the first year of the epidemic, were anosmia and taste disorders, which, according to some studies, occurred in over 80 percent of patients with COVID-19. The proportion of patients with serious neurological manifestations was small compared to the global number of patients, but the numbers of SARS-CoV-2 infections and critical patients increased substantially. The experience from 2 years of the pandemic has shown that approximately 13% of infected patients suffer from severe neurological complications. The relationship between SARS-CoV-2 and the nervous system is not only a cause of neurological complications in previously healthy individuals but also directly and indirectly affects the courses of many nervous system diseases.
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Affiliation(s)
- Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, Al. IX Wieków Kielc 19, 25-317, Kielce, Poland.
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznan, Poland
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Khosravifar M, Koolaji S, Rezaei N, Ghanbari A, Hashemi SM, Ghasemi E, Bitaraf A, Tabatabaei‐Malazy O, Rezaei N, Fateh SM, Dilmaghani‐Marand A, Haghshenas R, Kazemi A, Pakatchian E, Kompani F, Djalalinia S. A year of experience with COVID-19 in patients with cancer: A nationwide study. Cancer Rep (Hoboken) 2022; 6:e1678. [PMID: 36437484 PMCID: PMC9875662 DOI: 10.1002/cnr2.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/07/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cancer is a major public health problem and comorbidity associated with COVID-19 infection. According to previous studies, a higher mortality rate of COVID-19 in cancer patients has been reported. AIMS This study was undertaken to determine associated risk factors and epidemiological characteristics of hospitalized COVID-19 patients with cancer using a nationwide COVID-19 hospital data registry in Iran for the first time. METHODS In this retrospective study, we used a national data registry of hospitalized patients with Severe Acute Respiratory Syndrome (SARS) symptoms and patients with confirmed positive COVID-19 PCR between 18 February 2020 and 18 November 2020. The patients were classified into two groups patients with/without malignancy. Logistic regression model was utilized to analyze demographic factors, clinical features, comorbidities, and their associations with the disease outcomes. RESULTS In this study, 11 068 and 645 186 in-patients with SARS symptoms with and without malignancy were included, respectively. About 1.11% of our RT-PCR-positive patients had cancer. In patients with malignancy and COVID-19, older ages than 60 (OR: 1.88, 95% CI: 1.29-2.74, p-value: .001), male gender (OR: 1.43, 95% CI: 1.16-1.77, p-value: .001), concomitant chronic pulmonary diseases (CPD) (OR: 1.75, 95% CI: 1.14-2.68, p-value: .009), and presence of dyspnea (OR; 2.00, 95% CI: 1.60-2.48, p-value: <.001) were associated with increased mortality rate. CONCLUSION Given the immunocompromised state of patients with malignancy and their vulnerability to Covid-19 complications, collecting data on the comorbidities and their effects on the disease outcome can build on a better clinical view and help clinicians make decisions to manage these cases better; for example, determining special clinical care, especially in the shortage of health services.
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Affiliation(s)
- Mina Khosravifar
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sogol Koolaji
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Negar Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ali Ghanbari
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Seyedeh Melika Hashemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Ghasemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ali Bitaraf
- School of MedicineKermanshah University of Medical sciencesKermanshahIran
| | - Ozra Tabatabaei‐Malazy
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Nazila Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sahar Mohammadi Fateh
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Arezou Dilmaghani‐Marand
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Rosa Haghshenas
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Ameneh Kazemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Pakatchian
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Farzad Kompani
- Division of Hematology and OncologyChildren's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical SciencesTehranIran
| | - Shirin Djalalinia
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran,Deputy of Research and TechnologyMinistry of Health and Medical EducationTehranIran
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Dastoorpoor M, Khodadadi N, Borsi SH, Jamshidi F, Farsani AB, Noorzadeh M. Epidemiological, clinical and imaging characteristics of female prisoners with definite COVID-19 in a prison in the southwest, Iran, 2020. Int J Prison Health 2022; 18:407-416. [PMID: 38899620 DOI: 10.1108/ijph-03-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Prisoners are at greater risk of infectious diseases compared to the general population. While imprisoned, it is often difficult to observe Coronavirus 2019 (COVID-19) prevention strategies such as social distancing. To the authors' knowledge, no study has been conducted worldwide to examine the condition of female prisoners with COVID-19. Therefore, this study aims to investigate the epidemiological, clinical and imaging characteristics of prisoners with COVID-19 in Ahvaz Women's Prison (southwest, Iran). DESIGN/METHODOLOGY/APPROACH The data for this descriptive cross-sectional study was collected using a checklist including epidemiological information, clinical symptoms, X-ray and computed tomography scan findings of the chest, underlying diseases and the final status of all female prisoners whose COVID-19 test was positive. FINDINGS This study included 139 female prisoners with COVID-19 with a mean age of 37.19 ± 12.67 years. The most common underlying diseases were hypertension (14.4%), obesity (10.8%) and chronic obstructive pulmonary disease (9.4%). The most common symptoms at the onset of the disease were myalgia (59.0%), cough (41.0%) and dyspnea (37.4%). The most common radiological symptoms were ground-glass opacity (12.9%) and atelectasis (7.2%). In terms of extension of involvement, both lungs were involved in 8.6% of patients. In terms of zonal involvement, the lower lobes were more involved (8.6%). In terms of involvement position, the most common was sub-pleural (10.1%). None of the patients died. ORIGINALITY/VALUE Because the incidence, morbidity and mortality rate of COVID-19 in the prison population are likely to differ from those of the public. This study sought to investigate the situation of prisoners with COVID-19 in Ahvaz Prison, Khuzestan Province. To the best of the authors' knowledge, this is the first worldwide study in this regard in women's prisons.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Department of Biostatistics and Epidemiology, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Hamid Borsi
- Department of Biostatistics and Epidemiology, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farkhondeh Jamshidi
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Babaei Farsani
- Department of Forensic Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehrdad Noorzadeh
- Department of Biostatistics and Epidemiology, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Khandker S, Akther A, Syed BH, Shafiullah R, Ahmed K, Chowdhury AA, Khan S. Post-COVID-19 complications in home and hospital-based care: A study from Dhaka city, Bangladesh. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1037649. [PMID: 36504697 PMCID: PMC9731105 DOI: 10.3389/fresc.2022.1037649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/21/2022] [Indexed: 11/25/2022]
Abstract
A cross-sectional survey was undertaken to understand the management patterns and post-COVID-19 complications among hospital and home-treated participants. Retrospective information was collected from four COVID-19 dedicated hospitals and four selected community settings. Using probability proportional sampling, 925 participants were selected. Data were collected using a semi-structured questionnaire. Bivariate and multivariate logistic regression analysis and the exact chi-square tests were utilized to analyze the association between the studied variables. A total of 659 participants responded (response rate 70.93%); 375 from hospitals and 284 from communities. About 80% of participants were mild cases, 75% were treated at home, and 65% of hospital-treated participants were referred after home treatment. Participants treated at home-to hospital and directly in the hospital had 1.64 and 3.38 times longer recovery time respectively than what home-based participants had. A significant increasing trend (p < 0.001) of co-morbidities was found among referred and hospital treated participants. Age, level of education, physical exercise, practicing preventive measures, exposure to sunlight, and intake of carbohydrate, additional liquid, food supplements, and avoidance of junk foods were significantly associated with place of treatment. Post-COVID-19 difficulties of all factors were statistically significant for home treatment participants, whilst only depression (p = 0.026), chest pain (p = 0.017), and digestive disorders (p = 0.047) were significant (p < 0.05) for hospital treated participants. The outcomes from this study provide insight into a range of post-COVID-19 difficulties relating to at home and in hospital treatment participants. There are clear differences in the complications experienced, many of which are statistically significant. The health care professionals, the community people and COVID-19 survivors will be benefitted from the study findings, and the policy level people may use the information for designing health education program on post COVID-19 complications.
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Affiliation(s)
- Salamat Khandker
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh,Correspondence: Salamat Khandker
| | - Aivee Akther
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Billal H. Syed
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Rezoun Shafiullah
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Kawsar Ahmed
- School of Mathematics & Statistics, Central South University, Changsha, China
| | | | - Salim Khan
- Head, Department of Public Health, Birmingham City University, Birmingham, United Kingdom
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Allan M, Lièvre M, Laurenson-Schaefer H, de Barros S, Jinnai Y, Andrews S, Stricker T, Formigo JP, Schultz C, Perrocheau A, Fitzner J. The World Health Organization COVID-19 surveillance database. Int J Equity Health 2022; 21:167. [PMID: 36419127 PMCID: PMC9685131 DOI: 10.1186/s12939-022-01767-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
In January 2020, SARS-CoV-2 virus was identified as a cause of an outbreak in China. The disease quickly spread worldwide, and the World Health Organization (WHO) declared the pandemic in March 2020.From the first notifications of spread of the disease, the WHO's Emergency Programme implemented a global COVID-19 surveillance system in coordination with all WHO regional offices. The system aimed to monitor the spread of the epidemic over countries and across population groups, severity of the disease and risk factors, and the impact of control measures. COVID-19 surveillance data reported to WHO is a combination of case-based data and weekly aggregated data, focusing on a minimum global dataset for cases and deaths including disaggregation by age, sex, occupation as a Health Care Worker, as well as number of cases tested, and number of cases newly admitted for hospitalization. These disaggregations aim to monitor inequities in COVID-19 distribution and risk factors among population groups.SARS-CoV-2 epidemic waves continue to sweep the world; as of March 2022, over 445 million cases and 6 million deaths have been reported worldwide. Of these, over 327 million cases (74%) have been reported in the WHO surveillance database, of which 255 million cases (57%) are disaggregated by age and sex. A public dashboard has been made available to visualize trends, age distributions, sex ratios, along with testing and hospitalization rates. It includes a feature to download the underlying dataset.This paper will describe the data flows, database, and frontend public dashboard, as well as the challenges experienced in data acquisition, curation and compilation and the lessons learnt in overcoming these. Two years after the pandemic was declared, COVID-19 continues to spread and is still considered a Public Health Emergency of International Concern (PHEIC). While WHO regional and country offices have demonstrated tremendous adaptability and commitment to process COVID-19 surveillance data, lessons learnt from this major event will serve to enhance capacity and preparedness at every level, as well as institutional empowerment that may lead to greater sharing of public health evidence during a PHEIC, with a focus on equity.
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Affiliation(s)
- Maya Allan
- WHO-HQ WHE COVID-19 IMST, Geneva, Switzerland.
| | - Maja Lièvre
- WHO-HQ WHE COVID-19 IMST, Geneva, Switzerland
| | | | | | - Yuka Jinnai
- WHO-HQ WHE COVID-19 IMST, Geneva, Switzerland
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van Hensbergen M, den Heijer CDJ, Mujakovic S, Dukers-Muijrers NHTM, Wolffs PFG, van Loo IHM, Hoebe CJPA. Evaluation of symptomatology and viral load among residents and healthcare staff in long-term care facilities: A coronavirus disease 2019 retrospective case-cohort study. PLoS One 2022; 17:e0276796. [PMID: 36327239 PMCID: PMC9632776 DOI: 10.1371/journal.pone.0276796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives We evaluated COVID-19 symptoms, case fatality rate (CFR), and viral load among all Long-Term Care Facility (LTCF) residents and staff in South Limburg, the Netherlands (February 2020-June 2020, wildtype SARS-CoV-2 Wuhan strain). Methods Patient information was gathered via regular channels used to notify the public health services. Ct-values were obtained from the Maastricht University Medical Centre laboratory. Logistic regression analyses were performed to assess associations between COVID-19, symptoms, CFR, and viral load. Results Of 1,457 staff and 1,540 residents, 35.1% and 45.2% tested positive for COVID-19. Symptoms associated with COVID-19 for female staff were fever, cough, muscle ache and loss of taste and smell. Associated symptoms for men were cough, and loss of taste and smell. Associated symptoms for residents were subfebrility, fatigue, and fever for male residents only. LTCF residents had a higher mean viral load compared to staff. Male residents had a higher CFR (35.8%) compared to women (22.5%). Female residents with Ct-values 31 or less had increased odds of mortality. Conclusions Subfebrility and fatigue seem to be associated with COVID-19 in LTCF residents. Therefore, physicians should also consider testing residents who (only) show aspecific symptoms whenever available resources prohibit testing of all residents. Viral load was higher in residents compared to staff, and higher in male residents compared to female residents. All COVID-19 positive male residents, as well as female residents with a medium to high viral load (Ct-values 31 or lower) should be monitored closely, as these groups have an overall increased risk of mortality.
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Affiliation(s)
- Mitch van Hensbergen
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Limburg, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
- * E-mail:
| | - Casper D. J. den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Limburg, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, Limburg, the Netherlands
| | - Suhreta Mujakovic
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Limburg, The Netherlands
| | - Nicole H. T. M. Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Limburg, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg, the Netherlands
| | - Petra F. G. Wolffs
- Faculty of Health, Medicine and Life Sciences, Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, Limburg, the Netherlands
| | - Inge H. M. van Loo
- Faculty of Health, Medicine and Life Sciences, Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, Limburg, the Netherlands
| | - Christian J. P. A. Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Limburg, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, Limburg, the Netherlands
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A population-based cohort study of sex and risk of severe outcomes in covid-19. Eur J Epidemiol 2022; 37:1159-1169. [PMID: 36301399 PMCID: PMC9607822 DOI: 10.1007/s10654-022-00919-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022]
Abstract
There is a male sex disadvantage in morbidity and mortality due to COVID-19. Proposed explanations to this disparity include gender-related health behaviors, differential distribution of comorbidities and biological sex differences. In this study, we investigated the association between sex and risk of severe COVID-19 while adjusting for comorbidities, socioeconomic factors, as well as unmeasured factors shared by cohabitants which are often left unadjusted. We conducted a total-population-based cohort study (n = 1,854,661) based on individual-level register data. Cox models was used to estimate the associations between sex and risk for severe COVID-19. We additionally used a within-household design and conditional Cox models aiming to account for unmeasured factors shared by cohabitants. A secondary aim was to compare the risk of COVID-19 related secondary outcomes between men and women hospitalized due to COVID-19 using logistic regression. Men were at higher risk for hospitalization (HR = 1.63;95%CI = 1.57–1.68), ICU admission (HR = 2.63;95%CI = 2.38–2.91) and death (HR = 1.81;95%CI = 1.68–1.95) due to COVID-19, based on fully adjusted models. However, the effect of sex varied significantly across age groups: Among people in their 50s, men had > four times higher risk of COVID-19 death. The within-household design did not provide any further explanation to the sex disparity. Among patients hospitalized due to COVID-19, men had an increased risk for viral pneumonia, acute respiratory distress syndrome, acute respiratory insufficiency, acute kidney injury, and sepsis which persisted in fully adjusted models. Recognition of the combined effect of sex and age on COVID-19 outcomes has implications for policy strategies to reduce the adverse effects of the disease.
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Sun Y, Zou Y, Wang H, Cui G, Yu Z, Ren Z. Immune response induced by novel coronavirus infection. Front Cell Infect Microbiol 2022; 12:988604. [PMID: 36389144 PMCID: PMC9641212 DOI: 10.3389/fcimb.2022.988604] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2 has been prominent around the world since it was first discovered, affecting more than 100 million people. Although the symptoms of most infected patients are not serious, there is still a considerable proportion of patients who need hospitalization and even develop fatal symptoms such as cytokine storms, acute respiratory distress syndrome and so on. Cytokine storm is usually described as a collection of clinical manifestations caused by overactivation of the immune system, which plays an important role in tissue injury and multiorgan failure. The immune system of healthy individuals is composed of two interrelated parts, the innate immune system and the adaptive immune system. Innate immunity is the body's first line of defense against viruses; it can quickly perceive viruses through pattern recognition receptors and activate related inflammatory pathways to clear pathogens. The adaptive immune system is activated by specific antigens and is mainly composed of CD4+ T cells, CD8+ T cells and B cells, which play different roles in viral infection. Here, we discuss the immune response after SARS-CoV-2 infection. In-depth study of the recognition of and response of innate immunity and adaptive immunity to SARS-CoV-2 will help to prevent the development of critical cases and aid the exploration of more targeted treatments.
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Affiliation(s)
- Ying Sun
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yawen Zou
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haiyu Wang
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guangying Cui
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zujiang Yu
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhigang Ren
- Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, China
- Gene Hospital of Henan Province, Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Wang ZP, Hua M, Jiu T, Ge RL, Bai Z. Biofunctional roles of estrogen in coronavirus disease 2019: Beyond a steroid hormone. Front Pharmacol 2022; 13:1003469. [PMID: 36339571 PMCID: PMC9626865 DOI: 10.3389/fphar.2022.1003469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/06/2022] [Indexed: 09/26/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), epidemic poses a major global public health threat with more than one million daily new infections and hundreds of deaths. To combat this global pandemic, efficient prevention and management strategies are urgently needed. Together with the main characteristics of COVID-19, impaired coagulation with dysfunctions of the immune response in COVID-19 pathophysiology causes high mortality and morbidity. From recent clinical observations, increased expression of specific types of estrogen appears to protect patients from SARS-CoV-2 infection, thereby, reducing mortality. COVID-19 severity is less common in women than in men, particularly in menopausal women. Furthermore, estrogen levels are negatively correlated with COVID-19 severity and mortality. These findings suggest that estrogen plays a protective role in the pathophysiology of COVID-19. In this review, we discuss the potential roles of estrogen in blocking the SARS-CoV-2 from invading alveolar cells and replicating, and summarize the potential mechanisms of anti-inflammation, immune modulation, reactive oxygen species resistance, anti-thrombosis, vascular dilation, and vascular endothelium protection. Finally, the potential therapeutic effects of estrogen against COVID-19 are reviewed. This review provides insights into the role of estrogen and its use as a potential strategy to reduce the mortality associated with COVID-19, and possibly other viral infections and discusses the possible challenges and pertinent questions.
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Affiliation(s)
- Zhong-Ping Wang
- Clinical Medicine, School of Medicine, Qinghai University, Xining, China
- Department of Respiratory and Critical Diseases, Affiliated Hospital of Qinghai University, Xining, China
| | - Mao Hua
- Department of Respiratory and Critical Diseases, Affiliated Hospital of Qinghai University, Xining, China
| | - Tai Jiu
- Department of Respiratory and Critical Diseases, Affiliated Hospital of Qinghai University, Xining, China
| | - Ri-Li Ge
- Research Center of High-Altitude Medicine, School of Medicine, Qinghai University, Xining, China
- Joint Lab of Qinghai-Utah for High Altitude Medicine, School of Medicine, Qinghai University, Xining, China
| | - Zhenzhong Bai
- Clinical Medicine, School of Medicine, Qinghai University, Xining, China
- Research Center of High-Altitude Medicine, School of Medicine, Qinghai University, Xining, China
- Joint Lab of Qinghai-Utah for High Altitude Medicine, School of Medicine, Qinghai University, Xining, China
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A Prognostic Model for the Respiratory Function of Patients with Nonsevere Pulmonary Infection Based on Breathing Exercises and Acupuncture Therapy: Development and Validation. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9057575. [PMID: 36213584 PMCID: PMC9536990 DOI: 10.1155/2022/9057575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 01/08/2023]
Abstract
Objective. In this study, a prognostic model for the respiratory function was constructed based on the treatment methods of patients with nonsevere pulmonary infection, aiming to provide a reference for clinical decision-making. Method. A total of 500 patients with nonsevere pulmonary infection were included in this study. The patients were randomized into training set (
) and validation set (
), and the baseline characteristics were collected. All patients received breathing exercises or breathing exercises combined with acupuncture therapy for 3 months, and then the forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) was assessed. Next, an ordinal multinomial logistic regression model was used to analyze prognostic factors affecting respiratory function of patients with nonsevere pulmonary infection. The Test of Parallel Lines was used to determine the accuracy (ACC) of the model and screen the influencing factors. The confusion matrix was drawn, and the ACC and harmonic mean (F1 score) were calculated to evaluate the feasibility of the model results. Results. Results of the ordinal multinomial logistic regression model showed that age (
), treatment method (
), underlying diseases (
), and sex (
) were independent factors affecting the respiratory function of patients in the training set. The ACC value of the training set was 88.86%, and that of the validation set was 91.33%, indicating a high accuracy and favorable predictive ability of the model. Besides, the F1 score was 62.38%, indicating a high reliability of the model. Conclusion. The prognostic model for respiratory function of patients with nonsevere pulmonary infection constructed in this study had favorable predictive performance, which is of great significance in the clinical nursing and treatment of patients with pulmonary infection.
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Infection increases activity via Toll dependent and independent mechanisms in Drosophila melanogaster. PLoS Pathog 2022; 18:e1010826. [PMID: 36129961 PMCID: PMC9529128 DOI: 10.1371/journal.ppat.1010826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/03/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Host behavioural changes are among the most apparent effects of infection. ‘Sickness behaviour’ can involve a variety of symptoms, including anorexia, depression, and changed activity levels. Here, using a real-time tracking and behavioural profiling platform, we show that in Drosophila melanogaster, several systemic bacterial infections cause significant increases in physical activity, and that the extent of this activity increase is a predictor of survival time in some lethal infections. Using multiple bacteria and D. melanogaster immune and activity mutants, we show that increased activity is driven by at least two different mechanisms. Increased activity after infection with Micrococcus luteus, a Gram-positive bacterium rapidly cleared by the immune response, strictly requires the Toll ligand spätzle. In contrast, increased activity after infection with Francisella novicida, a Gram-negative bacterium that cannot be cleared by the immune response, is entirely independent of both Toll and the parallel IMD pathway. The existence of multiple signalling mechanisms by which bacterial infections drive increases in physical activity implies that this effect may be an important aspect of the host response. Sickness behaviours are often observed during infection. Animals have been shown to change their feeding, mating, social and resting (sleeping) behaviours in response to infection. We show here that fruit-flies infected with bacteria respond by increasing their physical activity and decreasing the amount of time spent sleeping. This increase in activity is seen in some, but not all, bacterial infections, and appears to be driven by at least two different mechanisms: with some bacteria, activating the immune response is the only requirement to induce increased activity, while other bacteria induce increased activity independently of known immune detection pathways. The biological role of increased activity is unclear; flies in the wild may be driven to flee sites where infection risk or pathogen burden is high. Alternatively, increased activity could serve a less direct anti-microbial function. For example, active animals may be more likely to encounter potential mates or food resource.
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Summers V. Sex differences in number of X chromosomes and X-chromosome inactivation in females promote greater variability in hearing among males. Biol Sex Differ 2022; 13:49. [PMID: 36114557 PMCID: PMC9482204 DOI: 10.1186/s13293-022-00457-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/27/2022] [Indexed: 01/19/2023] Open
Abstract
Background For more than 150 years, research studies have documented greater variability across males than across females (“greater male variability”—GMV) over a broad range of behavioral and morphological measures. In placental mammals, an ancient difference between males and females that may make an important contribution to GMV is the different pattern of activation of X chromosomes across cells in females (mosaic inactivation of one the two X chromosomes across cells) vs males (consistent activation of a single X chromosome in all cells). In the current study, variability in hearing thresholds was examined for human listeners with thresholds within the normal range. Initial analyses compared variability in thresholds across males vs. across females. If greater across-male than across-female variability was present, and if these differences in variability related to the different patterns X-chromosome activation in males vs. females, it was expected that correlations between related measures within a given subject (e.g., hearing thresholds at given frequency in the two ears) would be greater in males than females. Methods Hearing thresholds at audiometric test frequencies (500–6000 or 500–8000 Hz) were extracted from two datasets representing more than 8500 listeners with normal hearing (4590 males, 4376 females). Separate data analyses were carried out on each dataset to compare: (1) relative variability in hearing thresholds across males vs. across females at each test frequency; (2) correlations between both across-ear and within-ear hearing thresholds within males vs. within females, and (3) mean thresholds for females vs. males at each frequency. Results A consistent pattern of GMV in hearing thresholds was seen across frequencies in both datasets. In addition, both across-ear and within-ear correlations between thresholds were consistently greater in males than females. Previous studies have frequently reported lower mean thresholds for females than males for listeners with normal hearing. One of the datasets replicated this result, showing a clear and consistent pattern of lower mean thresholds for females. The second data set did not show clear evidence of this female advantage. Conclusions Hearing thresholds showed clear evidence of greater variability across males than across females and higher correlations across related threshold measures within males than within females. The results support a link between the observed GMV and the mosaic pattern of X-activation for females that is not present in males. Supplementary Information The online version contains supplementary material available at 10.1186/s13293-022-00457-9. Greater variability in hearing thresholds across males than females for human listeners with thresholds within the normal range. Higher within-ear and between-ear correlations between thresholds for males than females consistent with sex chromosome effects on variability NIH-mandated inclusion of sex as a biological variable should include sex differences in variability and underlying mechanisms
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The Entero-Mammary Pathway and Perinatal Transmission of Gut Microbiota and SARS-CoV-2. Int J Mol Sci 2022; 23:ijms231810306. [PMID: 36142219 PMCID: PMC9499685 DOI: 10.3390/ijms231810306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 02/08/2023] Open
Abstract
COVID-19 is a severe respiratory disease threatening pregnant women, which increases the possibility of adverse pregnancy outcomes. Several recent studies have demonstrated the ability of SARS-CoV-2 to infect the mother enterocytes, disturbing the gut microbiota diversity. The aim of this study was to characterize the entero-mammary microbiota of women in the presence of the virus during delivery. Fifty mother−neonate pairs were included in a transversal descriptive work. The presence of SARS-CoV-2 RNA was detected in nasopharyngeal, mother rectal swabs (MRS) and neonate rectal swabs (NRS) collected from the pairs, and human colostrum (HC) samples collected from mothers. The microbiota diversity was characterized by high-throughput DNA sequencing of V3-16S rRNA gene libraries prepared from HC, MRS, and NRS. Data were analyzed with QIIME2 and R. Our results indicate that several bacterial taxa are highly abundant in MRS positive for SARS-CoV-2 RNA. These bacteria mostly belong to the Firmicutes phylum; for instance, the families Bifidobacteriaceae, Oscillospiraceae, and Microbacteriaceae have been previously associated with anti-inflammatory effects, which could explain the capability of women to overcome the infection. All samples, both positive and negative for SARS-CoV-2, featured a high abundance of the Firmicutes phylum. Further data analysis showed that nearly 20% of the bacterial diversity found in HC was also identified in MRS. Spearman correlation analysis highlighted that some genera of the Proteobacteria and Actinobacteria phyla were negatively correlated with MRS and NRS (p < 0.005). This study provides new insights into the gut microbiota of pregnant women and their potential association with a better outcome during SARS-CoV-2 infection.
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A comparison between SARS-CoV-1 and SARS-CoV2: an update on current COVID-19 vaccines. Daru 2022; 30:379-406. [PMID: 36050585 PMCID: PMC9436716 DOI: 10.1007/s40199-022-00446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/05/2022] [Indexed: 10/31/2022] Open
Abstract
Since the outbreak of the novel coronavirus disease 2019 (COVID-19) in Wuhan, China, many health care systems have been heavily engaged in treating and preventing the disease, and the year 2020 may be called as “historic COVID-19 vaccine breakthrough”. Due to the COVID-19 pandemic, many companies have initiated investigations on developing an efficient and safe vaccine against the virus. From Moderna and Pfizer in the United States to PastocoVac in Pasteur Institute of Iran and the University of Oxford in the United Kingdom, different candidates have been introduced to the market. COVID-19 vaccine research has been facilitated based on genome and structural information, bioinformatics predictions, epitope mapping, and data obtained from the previous developments of severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1) and middle east respiratory syndrome coronavirus (MERS-CoV) vaccine candidates. SARS-CoV genome sequence is highly homologous to the one in COVID-19 and both viruses use the same receptor, angiotensin-converting enzyme 2 (ACE2). Moreover, the immune system responds to these viruses, partially in the same way. Considering the on-going COVID-19 pandemic and previous attempts to manufacture SARS-CoV vaccines, this paper is going to discuss clinical cases as well as vaccine challenges, including those related to infrastructures, transportation, possible adverse reactions, utilized delivery systems (e.g., nanotechnology and electroporation) and probable vaccine-induced mutations.
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Premenopausal and postmenopausal women during the COVID-19 pandemic. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2022; 21:200-206. [PMID: 36254124 PMCID: PMC9551364 DOI: 10.5114/pm.2022.118695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/19/2022] [Indexed: 01/09/2023]
Abstract
The current global COVID-19 mortality rate is estimated to be around 3.4%; however, it is dependent on age, sex, and comorbidities. Epidemiological evidence shows gender disparities in COVID-19 severity and fatality, with non-menopausal females having milder severity and better outcomes than age-matched males. However, the difference vanishes when comparing postmenopausal women with age-matched men. It has been suggested that, to some extent, this is due to the protective role of female hormones, such as anti-Müllerian hormone and oestradiol (E2), in non-menopausal women. Oestrogens have been hypothesized to be crucial in modulating viral infection and the progression of the disease via an action on immune/inflammatory responses and angiotensin-converting enzyme type 2 expression. Hence, the most likely explanation is that, because the levels of oestrogen in females after menopause decrease, oestrogen no longer offers a beneficial effect as seen in younger females. The COVID-19 pandemic has highlighted the serious negative effects arising from the state of E2 deficiency. Therefore, hormone replacement therapy gains further support as the damaging effect of the decline in ovarian function affects many biological systems, and recently with the COVID-19 pandemic, oestrogen's vital role within the immune system has become quite clear. However, additional clinical investigations regarding hormone replacement therapy are urgently needed to further verify the protective and therapeutic effects of E2 on menopausal women with COVID-19.
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Vasa A, Kini M, Neugarten J, Bellin E, Golestaneh L. Does comorbidity burden explain the higher COVID-19 mortality risk among men? A retrospective cross-sectional analysis of a well-defined cohort of patients in Bronx, New York. BMJ Open 2022; 12:e063862. [PMID: 36581961 PMCID: PMC9437736 DOI: 10.1136/bmjopen-2022-063862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Men have a higher mortality rate and more severe COVID-19 infection than women. The mechanism for this is unclear. We hypothesise that innate sex differences, rather than comorbidity burden, drive higher male mortality. DESIGN Retrospective cohort. SETTING Montefiore Health System (MHS) in Bronx, New York, USA. PARTICIPANTS A cohort population of 364 992 patients at MHS between 1 January 2018 and 1 January 2020 was defined, from which individuals hospitalised during the pre-COVID period (1 January 2020-15 February 2020) (n=5856) and individuals hospitalised during the COVID-19 surge (1 March 2020-15 April 2020) (n=4793) were examined for outcomes. A subcohort with confirmed COVID-19+ hospitalisation was also examined (n=1742). PRIMARY AND SECONDARY OUTCOME MEASURES Hospitalisation and in-hospital mortality. RESULTS Men were older, had more comorbidities, lower body mass index and were more likely to smoke. Unadjusted logistic regression showed a higher odds of death in hospitalised men than women during both the pre-COVID-19 and COVID-19 periods (pre-COVID-19, OR: 1.66 vs COVID-19 OR: 1.98). After adjustment for relevant clinical and demographic factors, the higher risk of male death attenuated towards the null in the pre-COVID-19 period (OR 1.36, 95% CI 1.05 to 1.76) but remained significantly higher in the COVID-19 period (OR 2.02; 95% CI 1.73 to 2.34).In the subcohort of COVID-19+ hospitalised patients, men had 1.37 higher odds of in-hospital death (95% CI 1.09 to 1.72), which was not altered by adjustment for comorbidity (OR remained at 1.38 (95% CI 1.08 to 1.76)) but was attenuated with addition of initial pulse oximetry on presentation (OR 1.26, 95% CI 0.99 to 1.62). CONCLUSIONS Higher male mortality risk during the COVID-19 period despite adjustment for comorbidity supports the role of innate physiological susceptibility to COVID-19 death. Attenuation of higher male risk towards the null after adjustment for severity of lung disease in hospitalised COVID-19+ patients further supports the role of higher severity of COVID-19 pneumonia in men.
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Affiliation(s)
- Aastha Vasa
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Maya Kini
- Rye Country Day School, Rye, New York, USA
| | - Joel Neugarten
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Eran Bellin
- Epidemiology and Population Health, Montefiore Medical Center, Yonkers, New York, USA
| | - Ladan Golestaneh
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
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Clinical Characteristics among Patients with COVID-19: A Single-Center Experience from Medina, Saudi Arabia. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). To assess the effect of COVID-19 disease on hematology, coagulation profiles, renal and liver function over the course of the disease, the following laboratory tests were performed: WBCs per mm3, lymphocytes count, Platelet, D-dimmer, AST, Albumin, LDH, Ferritin, CRP, blood culture and viral loads. Patients were grouped according to their initial viral load (Group1: low viral load (L), Group 2: moderate viral load (I), and Group 3, high viral load (H)). The study population median age of the patients was 58 years, and 69% were male. Generally, all patients were admitted to the intensive care unit. Most of the patients (79.5%) had an intermediate viral load, 14.5% had a high viral load, and 5.7% had a low viral load. The Kusakal-Walli’s test revealed a significant difference in the levels of white blood cells, lymphocytes, platelet, D-dimer, AST, CRP, and ferritin (p <0.0001). One hundred twenty-two isolates were recovered from 5362 blood cultures; where as 75% were multiple resistant to three classes of antibiotics and more. True bacteremia was most commonly caused by Klebsiella pneumoniae (45%), Acinetobacter baumannii (30%), and C. albicans (7%). The potential risk factors of advanced age, lymphopenia, D-dimer concentrations greater than 2µg/mL, and ferritin concentrations greater than 400ng/mL may assist clinicians to improve the management of the case and reduce mortality.
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RACHDI R, HANNACHI S, ZRIBI S, AYED O, ABID R, MOATEMRI Z, MHAMDI S, DABBOUSSI S, GHARSALLAH H, SELLAMI W, SAMMOUD W, MASSOUDI H, LAMINE K, DJEBBI O, HAMMAMI R, BEN MOUSSA M, BELLAAJ R, BATTIKH R, RACHDI MR, FERJANI M. [Comparative study of patients hospitalized for SARS-CoV-2 infection in two consecutive waves in Tunisia]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2022; 2:mtsi.v2i3.2022.207. [PMID: 36284562 PMCID: PMC9557822 DOI: 10.48327/mtsi.v2i3.2022.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022]
Abstract
Introduction Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemographic, clinical and evolutionary features of COVID-19 patients hospitalized at the Military Hospital of Tunis (HMPIT) during the 2nd and 3rd waves that affected the country. Patients and methods Observational prospective study involving 1,527 COVID-19 patients hospitalized at HMPIT over 11 months, divided into two periods: from July 2020 to December 2020 called the second wave (V2) and from January 2021 to May 2021 called the third wave (V3). We compared the epidemiological data, the clinical form and the evolution of the patients for each period. Results The number of hospitalized patients was 636 during V2 compared to 891 during V3. Average age was 63.5 ± 15.3 years during V2 versus 65.8 ± 17.8 years during V3 (P = not significant [NS]). The percentage of young adults [18-40 years] was 6.5% during V2 compared to 6.7% during V3 (P = NS). The gender ratio (M/F) was 1.59 for V2 and 1.42 for V3 (P = NS). Comorbidities were present in 65% of V2 patients and 66.3% of V3 patients (P = NS), with hypertension being the most prevalent one in both groups (47.2% for V2 versus 44.9% for V3; P = NS), followed by overweight, dyslipidemia and diabetes (33% for V2 versus 39.3% for V3; P = 0.012). The median duration between symptoms onset and hospitalization was 7 days [5-10] during V2 versus 8.5 days during V3 [5-12] (P = 0.0004). The severe clinical form was present in 49% of patients admitted during V2 compared to 34.8% during V3 (P < 10-3). The critical form represented 18.6% of cases during V2 against 16.8% during V3 (P = NS). The average hospital length of stay in COVID units (outside of intensive care unit) was 8.4 ± 5.4 days during V2 and 9.8 ± 5.7 days during V3. The average length of stay was significantly longer for the intensive care unit (11.3 ± 3.4 days for V2 versus 13.8 ± 3.9 days for V3; P = 0.01). The case fatality rate was 24.5% during V2 and 20.7% during V3 (P = NS). Median age of death was 70.2 years [42-88] during V2 and 70.4 years [22-96] during V3 with 2 patients less than 40 years of age (1%) for the latter period. The gender ratio (M/F) of deceased patients was 3.21 for V2 and 1.5 for V3 (P = 0.001). The case fatality rate was higher in the intensive care unit (65.4% for V2 versus 69.7% for V3; P = NS). Causes of death were dominated by ARDS (acute respiratory distress syndrome) for both periods (55.1% for V2 versus 70.8% for V3; P = 0.002), followed by septic shock (12.8% for V2 versus 10.8% for V3; P = NS) and multi-organ failure (9.6% for V2 versus 7.0% for V3; P = NS). Conclusion This study revealed a decrease in severe and critical clinical forms during the 3rd wave, as well as a decrease in the case fatality rate compared to the previous wave, due to improved management and vaccination. On the other hand, the percentage of ARDS was significantly higher during this wave probably related to the beginning of circulation in our country of the Delta variant causing more severe clinical cases.
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Affiliation(s)
- Rim RACHDI
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,*
| | - Souha HANNACHI
- Service des maladies infectieuses, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Sabrine ZRIBI
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Oumaima AYED
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Rim ABID
- Service des maladies infectieuses, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Zied MOATEMRI
- Service de pneumo-phtisiologie, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Samira MHAMDI
- Service de pneumo-phtisiologie, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Salsabil DABBOUSSI
- Service de pneumo-phtisiologie, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Hédi GHARSALLAH
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Walid SELLAMI
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | | | - Hakim MASSOUDI
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Khaled LAMINE
- Service d'accueil des urgences, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Olfa DJEBBI
- Service d'accueil des urgences, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Rim HAMMAMI
- Service d'accueil des urgences, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | | | - Ridha BELLAAJ
- Service d'hygiène hospitalière et de protection de l'environnement, Hôpital militaire principal d'instruction de Tunis (HMPIT), 1008 Montfleury, Tunis, Tunisie,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Riadh BATTIKH
- Service des maladies infectieuses, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Mohamed Radhouane RACHDI
- Service de gynécologie obstétrique, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
| | - Mustapha FERJANI
- Service d'anesthésie-réanimation, HMPIT,Faculté de médecine de Tunis, Université Tunis El Manar, Tunisie
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Kim DK, Park JJ, Yang WJ, Doo SW, Kim JH. Relationship Between Androgen Deprivation Therapy for Prostate Cancer and Risk of SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis. J Korean Med Sci 2022; 37:e237. [PMID: 35942555 PMCID: PMC9359920 DOI: 10.3346/jkms.2022.37.e237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Several cohort studies have explored the relationship between androgen deprivation therapy (ADT) and the severity of coronavirus disease 2019 (COVID-19). This study aimed to characterize the relationship between ADT and the severity of COVID-19 in patients with prostate cancer. METHODS A systematic search was conducted using PubMed, Embase, and Cochrane Library databases from the inception of each database until February 31, 2020. Patients with prostate cancer who were treated with ADT were assigned to treatment group while those patients who were not treated with ADT were assigned to the control group. Outcomes were severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positivity, hospitalization, intensive care unit (ICU) admission, and death. The risk of bias was evaluated using ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool. RESULTS Three studies with qualitative synthesis were included. Finally, two studies with quantitative synthesis having a total of 44,213 patients were included for the present systematic review. There was no significant difference in SARS-CoV-2 positive rate (odds ratio [OR], 0.52; 95% confidence intervals [Cis], 0.13-2.09; P = 0.362), hospitalization (OR, 0.52; 95% CIs, 0.07-3.69; P = 0.514), ICU admission (OR, 0.93; 95% CIs, 0.39-2.23, P = 0.881), or death (OR, 0.88; 95% CIs, 0.06-12.06; P = 0.934) between ADT and non-ADT groups. CONCLUSION Qualitative and quantitative analyses of previous studies revealed no significant effect of ADT on COVID-19. However, more studies with higher quality that explore biochemical and immunological factors involved are needed to confirm this finding in the future.
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Affiliation(s)
- Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Joon Park
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- Urological Biomedicine Research Institute, Soonchunhyang University Seoul Hospital, Seoul, Korea.
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Elevated Salivary Inflammatory Biomarkers are Associated with SARS-CoV-2 Infection Severity. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:1543918. [PMID: 35967091 PMCID: PMC9363936 DOI: 10.1155/2022/1543918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/13/2022] [Accepted: 06/06/2022] [Indexed: 12/15/2022]
Abstract
High levels of inflammatory cytokines in serum have been reported in patients with severe SARS-CoV-2 infection. There is growing interest in recognizing the role of inflammatory biomarkers in saliva in diagnosing systemic diseases. This study assumed that estimating biomarkers in saliva samples from patients infected with SARS-CoV-2 would distinguish between mild and severe cases. Saliva was collected from 142 controls and 158 SARS-CoV-2 patients (mild 72 and severe 86) to measure interleukin-6 (IL-6), C-reactive protein (CRP), and C-X-C motif chemokine ligand-10 (CXCL-10). IL-6 and CXCL-10 were significantly increased in patients with mild and severe SARS-CoV-2 infections. CRP was significantly increased only in severe SARS-CoV-2 cases. All biomarkers were significantly higher in severe cases than in mild cases (p < 0.001). Among patients with SARS-CoV-2 infection, men showed significantly higher CRP and CXCL-10 levels than females (p < 0.01 and 0.05, respectively). In addition, elderly patients (40–80 years) had significantly higher IL-6, CRP, and CXCL-10 (p < 0.001). Patients with diabetes and hypertension showed elevated IL-6, CRP, and CXCL-10 (p < 0.001). There was a significant positive correlation between IL-6, CRP, CXCL-10, and between age, IL-6, CRP, and CXCL-10. Saliva may have a future value in measuring the inflammatory biomarkers associated with the severity of SARS-CoV2 infection and therapeutic monitoring.
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Metwally AA, Zhang T, Wu S, Kellogg R, Zhou W, Contrepois K, Tang H, Snyder M. Robust identification of temporal biomarkers in longitudinal omics studies. Bioinformatics 2022; 38:3802-3811. [PMID: 35762936 PMCID: PMC9344853 DOI: 10.1093/bioinformatics/btac403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/28/2022] [Accepted: 06/26/2022] [Indexed: 11/16/2022] Open
Abstract
MOTIVATION Longitudinal studies increasingly collect rich 'omics' data sampled frequently over time and across large cohorts to capture dynamic health fluctuations and disease transitions. However, the generation of longitudinal omics data has preceded the development of analysis tools that can efficiently extract insights from such data. In particular, there is a need for statistical frameworks that can identify not only which omics features are differentially regulated between groups but also over what time intervals. Additionally, longitudinal omics data may have inconsistencies, including non-uniform sampling intervals, missing data points, subject dropout and differing numbers of samples per subject. RESULTS In this work, we developed OmicsLonDA, a statistical method that provides robust identification of time intervals of temporal omics biomarkers. OmicsLonDA is based on a semi-parametric approach, in which we use smoothing splines to model longitudinal data and infer significant time intervals of omics features based on an empirical distribution constructed through a permutation procedure. We benchmarked OmicsLonDA on five simulated datasets with diverse temporal patterns, and the method showed specificity greater than 0.99 and sensitivity greater than 0.87. Applying OmicsLonDA to the iPOP cohort revealed temporal patterns of genes, proteins, metabolites and microbes that are differentially regulated in male versus female subjects following a respiratory infection. In addition, we applied OmicsLonDA to a longitudinal multi-omics dataset of pregnant women with and without preeclampsia, and OmicsLonDA identified potential lipid markers that are temporally significantly different between the two groups. AVAILABILITY AND IMPLEMENTATION We provide an open-source R package (https://bioconductor.org/packages/OmicsLonDA), to enable widespread use. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Ahmed A Metwally
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
- Illumina Artificial Intelligence Laboratory, Illumina Inc., San Diego, CA 92122, USA
- Systems and Biomedical Engineering Department, Faculty of Engineering, Cairo University, Giza 12613, Egypt
| | - Tom Zhang
- Department of Computer Science, Columbia University, New York, NY 10027, USA
| | - Si Wu
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Ryan Kellogg
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Wenyu Zhou
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Kevin Contrepois
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Hua Tang
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Michael Snyder
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
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Averyanova M, Vishnyakova P, Yureneva S, Yakushevskaya O, Fatkhudinov T, Elchaninov A, Sukhikh G. Sex hormones and immune system: Menopausal hormone therapy in the context of COVID-19 pandemic. Front Immunol 2022; 13:928171. [PMID: 35983046 PMCID: PMC9379861 DOI: 10.3389/fimmu.2022.928171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
The fatal outcomes of COVID-19 are related to the high reactivity of the innate wing of immunity. Estrogens could exert anti-inflammatory effects during SARS-CoV-2 infection at different stages: from increasing the antiviral resistance of individual cells to counteracting the pro-inflammatory cytokine production. A complex relationship between sex hormones and immune system implies that menopausal hormone therapy (MHT) has pleiotropic effects on immunity in peri- and postmenopausal patients. The definite immunological benefits of perimenopausal MHT confirm the important role of estrogens in regulation of immune functionalities. In this review, we attempt to explore how sex hormones and MHT affect immunological parameters of the organism at different level (in vitro, in vivo) and what mechanisms are involved in their protective response to the new coronavirus infection. The correlation of sex steroid levels with severity and lethality of the disease indicates the potential of using hormone therapy to modulate the immune response and increase the resilience to adverse outcomes. The overall success of MHT is based on decades of experience in clinical trials. According to the current standards, MHT should not be discontinued in COVID-19 with the exception of critical cases.
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Affiliation(s)
- Marina Averyanova
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov of Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Polina Vishnyakova
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov of Ministry of Healthcare of Russian Federation, Moscow, Russia
- Peoples’ Friendship University of Russia, Medical Institute, Moscow, Russia
- *Correspondence: Polina Vishnyakova,
| | - Svetlana Yureneva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov of Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Oksana Yakushevskaya
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov of Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Timur Fatkhudinov
- Peoples’ Friendship University of Russia, Medical Institute, Moscow, Russia
- A. P. Avtsyn Research Institute of Human Morphology, Laboratory of Growth and Development, Moscow, Russia
| | - Andrey Elchaninov
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov of Ministry of Healthcare of Russian Federation, Moscow, Russia
| | - Gennady Sukhikh
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov of Ministry of Healthcare of Russian Federation, Moscow, Russia
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Arefin S, Hernandez L, Ward LJ, Schwarz A, Barany P, Stenvinkel P, Kublickiene K. Angiotensin-converting enzyme 2 and transmembrane protease serine 2 in female and male patients with end-stage kidney disease. Eur J Clin Invest 2022; 52:e13786. [PMID: 35366343 PMCID: PMC9541326 DOI: 10.1111/eci.13786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/24/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individuals with chronic kidney disease are affected by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to multiple comorbidities and altered immune system. The first step of the infection process is the binding of SARS-CoV-2 with angiotensin-converting enzyme 2 (ACE2) receptor, followed by its priming by transmembrane protease serine 2 (TMPRSS2). We hypothesized that circulating soluble ACE2 levels, as well as the expressions of ACE2 and TMPRSS2 in the microvasculature, are increased in patients with end-stage kidney disease (ESKD). METHODS A total of 210 participants were enrolled, representing 80 ESKD patients and 73 non-CKD controls for soluble ACE2, and 31 ESKD and 26 non-CKD controls for vasculature and fat tissue bioassays. We have assessed ACE2 expression in blood using ELISA and in tissue using immunofluorescence. RESULTS Soluble ACE2 levels were higher in ESKD patients compared to controls; however, there is no sex difference observed. In ESKD and controls, soluble ACE2 positively correlated with Interleukin 6 (IL-6) and C-reactive protein (CRP), respectively. Similarly, ACE2 tissue expression in the vasculature was higher in ESKD patients; moreover, this higher ACE2 expression was observed only in male ESKD patients. In addition, TMPRSS2 expression was observed in vessels from males and females but showed no sex difference. The expression of ACE2 receptor was higher in ESKD patients on ACE-inhibitor/angiotensin blocker treatment. CONCLUSION ESKD is associated with increased ACE2 levels in the circulation and pronounced in male vasculature; however, further studies are warranted to assess possible sex differences on specific treatment regime(s) for different comorbidities present in ESKD.
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Affiliation(s)
- Samsul Arefin
- Division of Renal Medicine, Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | - Leah Hernandez
- Division of Renal Medicine, Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liam J Ward
- Division of Renal Medicine, Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Angelina Schwarz
- Division of Renal Medicine, Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Peter Barany
- Division of Renal Medicine, Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
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Vallejo MS, Blümel JE, Bencosme A, Calle A, Dextre M, Díaz K, López M, Miranda C, Ñañez M, Ojeda E, Rey C, Rodrigues MA, Salinas C, Tserotas K, Pérez-López FR. Factors affecting climacteric women with SARS-CoV-2 infection: A multinational Latin America study (REDLINC XI). Maturitas 2022; 165:33-37. [PMID: 35905570 PMCID: PMC9303064 DOI: 10.1016/j.maturitas.2022.07.006] [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: 03/01/2022] [Revised: 07/02/2022] [Accepted: 07/09/2022] [Indexed: 01/08/2023]
Abstract
Objective To evaluate the association between factors, especially those linked to the climacteric, and a history of COVID-19 infection. Methods This was an observational, cross-sectional, and analytical study in which women from ten Latin American countries, aged 40–64, who attended a routine health check-up were invited to participate. A positive history for COVID-19 was based on reverse transcription-polymerase chain reaction reports. We evaluated sociodemographic, clinical, lifestyle, anthropometric variables, and menopausal symptoms using the Menopause Rating Scale (MRS). Results A total of 1238 women were included for analysis, of whom 304 (24.6 %) had a positive history for COVID-19. The median [interquartile range: IQR] age of participants was 53 [IQR 12] years, duration of formal education was 16 [6] years, body mass index 25.6 [5.1] kg/m2, and total MRS score 10 [13]. In a logistic regression model, factors positively associated with COVID-19 included postmenopausal status and having a family history of dementia (OR: 1.53; 95 % CI: 1.13–2.07, and 2.40; 1.65–3.48, respectively), whereas negatively associated were use of menopausal hormone therapy (current or past), being a housewife, and being nulliparous (OR: 0.47; 95 % CI: 0.30–0.73; 0.72; 0.53–0.97 and 0.56; 0.34–0.92, respectively). Smoking, being sexually active, and use of hypnotics were also factors positively associated with COVID-19. Conclusion Postmenopausal status and a family history of dementia were more frequent among women who had had COVID-19, and the infection was less frequent among current or past menopause hormone therapy users and in those with less physical contact.
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Affiliation(s)
- María S Vallejo
- Clínica Quilín, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | - Juan E Blümel
- Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile.
| | - Ascanio Bencosme
- Ginecología Obstetricia, Hospital Metropolitano de Santiago, Santiago de los Caballeros, Dominican Republic
| | - Andrés Calle
- Centro Integral de Salud Obstétrica y Femenina-CISOF, Quito, Ecuador
| | - Maribel Dextre
- Ginecología Obstetricia, Clínica Internacional-Clínica Javier Prado, Lima, Peru
| | - Karen Díaz
- Centro Ciudad Mujer, Ministerio de Salud, Asunción, Paraguay
| | - Marcela López
- Clínica Alemana y Hospital Militar, Santiago de Chile, Chile
| | - Carlos Miranda
- Hospital Central FAP-Instituto Médico Miraflores, Lima, Peru
| | - Mónica Ñañez
- II Cátedra de Ginecología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eliana Ojeda
- Departamento Académico de Medicina Humana, Universidad Andina del Cusco, Cusco, Peru
| | - Claudia Rey
- Medicina Ginecológica Consultorios Médicos, Buenos Aires, Argentina
| | - Marcio A Rodrigues
- Department Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Faustino R Pérez-López
- Instituto Aragonés de Ciencias de la Salud, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
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88
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Mavragani CP, Skarlis C, Kostopoulos IV, Maratou E, Moutsatsou P, Terpos E, Tsitsilonis OE, Dimopoulos MA, Sfikakis PP. Distinct type I interferon responses between younger women and older men contribute to the variability of COVID-19 outcomes: Hypothesis generating insights from COVID-19 convalescent individuals. Cytokine 2022; 157:155964. [PMID: 35868117 PMCID: PMC9289092 DOI: 10.1016/j.cyto.2022.155964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
Background/Objective Older age and male sex have been consistently found to be associated with dismal outcomes among COVID-19 infected patients. In contrast, premenopausal females present the lowest mortality among adults infected by SARS-CoV-2. The goal of the present study was to investigate whether peripheral blood type I interferon (IFN) signature and interleukin (IL)-6 serum levels -previously shown to contribute to COVID-19-related outcomes in hospitalized patients- is shaped by demographic contributors among COVID-19 convalescent individuals. Patients and Methods Type I IFN-inducible genes in peripheral blood, as well as serum IL-6 levels were quantified in 61 COVID-19 convalescent healthy individuals (34 females, 27 males; age range 18–70 years, mean 35.7 ± 15.9 years) who recovered from COVID-19 without requiring hospitalization within a median of 3 months prior to inclusion in the present study. Among those, 17 were older than 50 years (11 males, 6 females) and 44 equal to or less than 50 years (16 males, 28 females). Expression analysis of type I IFN-inducible genes (MX-1, IFIT-1, IFI44) was performed by real time PCR and a type I IFN score, reflecting type I IFN peripheral activity, was calculated. IL-6 and C-reactive protein levels were determined by a commercially available ELISA. Results COVID-19 convalescent individuals older than 50 years exhibited significantly decreased peripheral blood type I IFN scores along with significantly increased IL-6 serum levels compared to their younger counterparts less than 50 years old (5.4 ± 4.3 vs 16.8 ± 24.7, p = 0.02 and 10.6 ± 16.9 vs 2.9 ± 8.0 ng/L, p = 0.03, respectively). Following sex stratification, peripheral blood type I IFN score was found to be significantly higher in younger females compared to both younger and older males (22.9 ± 29.2 vs 6.3 ± 4.6 vs 4.5 ± 3.7, p = 0.01 and p = 0.002, respectively). Regarding IL-6, an opposite pattern was observed, with the highest levels being detected among older males and the lowest levels among younger females (11.6 ± 18.9 vs 2.5 ± 7.8 ng/L, p = 0.03). Conclusion Constitutive higher type I IFN responses and dampened IL-6 production observed in younger women of premenopausal age, along with lower type I IFN responses and increased IL-6 levels in older males, could account for the discrete clinical outcomes seen in the two population groups, as consistently revealed in COVID-19 epidemiological studies.
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Affiliation(s)
- Clio P Mavragani
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens (NKUA), M. Asias 75, 11527 Athens, Greece; Fourth Department of Internal Medicine, School of Medicine, University Hospital Attikon, NKUA, 12462 Haidari, Greece; Joint Academic Rheumatology Program, NKUA, Greece.
| | - Charalampos Skarlis
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens (NKUA), M. Asias 75, 11527 Athens, Greece
| | | | - Eirini Maratou
- Department of Clinical Biochemistry, School of Medicine, University General Hospital Attikon, NKUA, 12462 Haidari, Greece
| | - Paraskevi Moutsatsou
- Department of Clinical Biochemistry, School of Medicine, University General Hospital Attikon, NKUA, 12462 Haidari, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, NKUA, 11528 Athens, Greece
| | | | | | - Petros P Sfikakis
- Joint Academic Rheumatology Program, NKUA, Greece; First Department of Propaedeutic Internal Medicine, School of Medicine, Laiko General Hospital, NKUA, 15772 Athens, Greece
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89
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Twitchell DK, Christensen MB, Hackett G, Morgentaler A, Saad F, Pastuszak AW. Examining Male Predominance of Severe COVID-19 Outcomes: A Systematic Review. ANDROGENS: CLINICAL RESEARCH AND THERAPEUTICS 2022; 3:41-53. [PMID: 36199281 PMCID: PMC9527649 DOI: 10.1089/andro.2022.0006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 05/26/2023]
Abstract
Although not universal, many epidemiological data sources signal that a higher proportion of males than females with confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections have adverse outcomes, such as intensive care unit (ICU) admission and death. Though likely multifactorial, the various hypotheses that have been proposed as underlying factors behind this trend are related to greater smoking prevalence among males, testosterone (T) deficiency causing an inflammatory storm, androgen-driven pathogenesis of SARS-CoV-2, a protective effect of estrogen in females, and inborn errors of cytokine immunity. This review aims at examining the evidence and at assessing the likelihood that the factors being investigated are contributory to the reported trend of male predominance of severe COVID-19 cases. Sources were obtained using the PubMed database and were selected based on their relevance to one of the primary hypotheses attempting to explain the strong male sex bias of severe SARS-CoV-2 infections. Emphasis was placed on meta-analyses and population-based studies. Sources are current through February 22, 2022. A severe COVID-19 case or outcome is defined in this review as a progression of the SARS-CoV-2 virus that results in either admission to an ICU for management of symptoms and clinical stabilization or which leads to death. Although the trend of male predominance of severe COVID-19 cases is likely multifactorial, the hypothesis of T deficiency causing an inflammatory storm has support from many studies with limited conflicting evidence. An inborn error in cytokine immunity is also well supported, but it needs more studies to add support to the hypothesis. The immunologic protective effect of estrogen is supported by multiple studies, but it also has conflicting evidence. It appears less likely that the trend is caused solely by an increased prevalence of smoking among males or an androgen-driven pathogenesis, based on the extent of conflicting evidence.
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Affiliation(s)
| | - Michael B. Christensen
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Geoffrey Hackett
- Department of Men's Health, Little Aston Hospital, Sutton Coldfield, United Kingdom
| | - Abraham Morgentaler
- Division of Urology, Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Farid Saad
- Department of Men's Health Research, Gulf Medical University, Ajman, UAE
| | - Alexander W. Pastuszak
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Carbonnel M, Daclin C, Tarantino N, Groiseau O, Morin V, Rousseau A, Vasse M, Hertig A, Kennel T, Ayoubi JM, Vieillard V. Plasticity of natural killer cells in pregnant patients infected with SARS-CoV-2 and their neonates during childbirth. Front Immunol 2022; 13:893450. [PMID: 35911747 PMCID: PMC9335005 DOI: 10.3389/fimmu.2022.893450] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/28/2022] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 pandemic has occurred due to infection caused by the SARS-CoV-2 coronavirus, which impacts gestation and pregnancy. In SARS-CoV-2 infection, only very rare cases of vertical transmission have been reported, suggesting that fetal immune imprinting due to a maternal infection is probably a result of changes in maternal immunity. Natural killer (NK) cells are the leading maternal immune cells that act as a natural defense system to fight infections. They also play a pivotal role in the establishment and maintenance of pregnancy. While peripheral NK cells display specific features in patients infected with SARS-CoV-2 in the general population, information remains elusive in pregnant mothers and neonates. In the present study, we analyzed the characteristics of NK cells isolated from both neonatal umbilical cord blood and maternal peripheral blood close to the time of delivery. Phenotype and functions were compared in 18 healthy pregnant women and 34 COVID-19 patients during pregnancy within an ongoing infection (PCR+; N = 15) or after recovery (IgG+PCR−; N = 19). The frequency of NK cells from infected women and their neonates was correlated with the production of inflammatory cytokines in the serum. The expression of NKG2A and NKp30, as well as degranulation of NK cells in pregnant women with ongoing infection, were both negatively correlated to estradiol level. Furthermore, NK cells from the neonates born to infected women were significantly decreased and also correlated to estradiol level. This study highlights the relationship between NK cells, inflammation, and estradiol in patients with ongoing infection, providing new insights into the impact of maternal SARS-CoV-2 infection on the neonate.
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Affiliation(s)
- Marie Carbonnel
- Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France
- University of Versailles, Versailles, France
| | - Camille Daclin
- Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France
- University of Versailles, Versailles, France
| | - Nadine Tarantino
- Sorbonne Université, Inserm U1135, CNRS ERL 8255, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Olivia Groiseau
- Sorbonne Université, Inserm U1135, CNRS ERL 8255, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Véronique Morin
- Sorbonne Université, Inserm U1135, CNRS ERL 8255, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Alice Rousseau
- Sorbonne Université, Inserm U1135, CNRS ERL 8255, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Marc Vasse
- Department of Clinical Biology, Hôpital Foch, Suresnes, France
- INSERM UMRS-1176, University Paris-Sud, Orsay, France
| | - Alexandre Hertig
- Nephrology and Renal Transplantation Department, Hôpital Foch, Suresnes, France
| | - Titouan Kennel
- Department of Clinic Research, Hôpital Foch, Suresnes, France
| | - Jean Marc Ayoubi
- Department of Obstetrics and Gynecology, Hôpital Foch, Suresnes, France
- University of Versailles, Versailles, France
| | - Vincent Vieillard
- Sorbonne Université, Inserm U1135, CNRS ERL 8255, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
- *Correspondence: Vincent Vieillard,
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91
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Al-Jarallah M, Rajan R, Dashti R, Al Saber A, Brady PA, Abdelnaby H, Alroomi M, Aboelhassan W, Abdullah M, AlNasrallah N, Al-Bader B, Malhas H, Ramadhan M, Alotaibi N, Al Saleh M, Almutairi F, Zhanna KD. In-hospital mortality in SARS-CoV-2 stratified by sex diffrences: A retrospective cross-sectional cohort study. Ann Med Surg (Lond) 2022; 79:104026. [PMID: 35757308 PMCID: PMC9212930 DOI: 10.1016/j.amsu.2022.104026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 12/29/2022] Open
Abstract
Background The aim of this study was to determine in-hospital mortality in patients presenting with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) and to evaluate for any differences in outcome according to sex differences. Methods Patients with SRS-CoV-2 infection were recruited into this retrospective cohort study between February 26 and September 8, 2020 and strаtified ассоrding tо the sex differences. Results In tоtаl оf 3360 раtients (meаn аge 44 ± 17 years) were included, of whom 2221 (66%) were mаle. The average length of hospitalization was 13 days (range: 2–31 days). During hospitalization and follow-up 176 patients (5.24%) died. In-hospital mortality rates were significantly different according to gender (p=<0.001). Specifically, male gender was associated with significantly greater mortality when compared to female gender with results significant at an alpha of 0.05, LL = 28.67, df = 1, p = 0.001, suggesting that gender could reliably determine mortality rates. The coefficient for the males was significant, B = 1.02, SE = 0.21, HR = 2.78, p < 0.001, indicating that an observation in the male category will have a hazard 2.78 times greater than that in the female category. Multivariate logistic regression confirmed male patients admitted with SARS-CoV-2had higher сumulаtive аll-саuse in-hоsрitаl mоrtаlity (6.8% vs. 2.3%; аdjusted оdds rаtiо (аОR), 2.80; 95% (СI): [1.61–5.03]; р < 0.001). Conclusions Male gender was an independent predictor of in-hospital mortality in this study. The mortality rate among male SARS-CoV-2 patients was 2.8 times higher when compared with females. Male gender is an independent predictor of in-hospital mortality in COVID-19 patients. The mortality rate among male SARS-CoV-2 patients was 2.8 times higher when compared with females. Averаge length оf ICU stаy wаs longer in males.
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Affiliation(s)
- Mohammed Al-Jarallah
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait
| | - Rajesh Rajan
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait
- Corresponding author.
| | - Raja Dashti
- Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait
| | - Ahmad Al Saber
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, G1 1XH, UK
| | - Peter A. Brady
- Department of Cardiology, Illinois Masonic Medical Center, Chicago IL, USA
| | - Hassan Abdelnaby
- Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Department of Medicine, Division of Gastroenterology, Al Sabah Hospital, Shuwaikh Medical Area, Kuwait
| | - Moudhi Alroomi
- Department of Infectious Diseases, Infectious Diseases Hospital, Shuwaikh Medical Area, Kuwait
| | - Wael Aboelhassan
- Department of Medicine, Division of Gastroenterology, Jaber Al Ahmed Hospital, South Surra, Kuwait
| | - Mohammed Abdullah
- Department of Infectious Diseases, Infectious Diseases Hospital, Shuwaikh Medical Area, Kuwait
| | | | - Bader Al-Bader
- Department of Medicine, Farwaniya Hospital, Farwaniya, Kuwait
| | - Haya Malhas
- Department of Emergency Medicine, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
| | - Maryam Ramadhan
- Department of Obstetrics and Gynaecology, Maternity Hospital, Shuwaikh Medical Area, Kuwait
| | - Naser Alotaibi
- Department of Medicine, Al Adan Hospital, Hadiya, Kuwait
| | | | - Farah Almutairi
- Department of Medicine, Farwaniya Hospital, Farwaniya, Kuwait
| | - Kobalava D. Zhanna
- Department of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics Named After V.S. Moiseev, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
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92
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Damiri S, Shojaee A, Dehghani M, Shahali Z, Abbasi S, Daroudi R. National geographical pattern of COVID-19 hospitalization, case fatalities, and associated factors in patients covered by Iran Health Insurance Organization. BMC Public Health 2022; 22:1274. [PMID: 35773657 PMCID: PMC9243909 DOI: 10.1186/s12889-022-13649-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Understanding the Spatio-temporal distribution and interpersonal comparisons are important tools in etiological studies. This study was conducted to investigate the temporal and geographical distribution of COVID-19 hospitalized patients in the Iran Health Insurance Organization (IHIO) insured population (the second largest social health insurance organization) and the factors affecting their case fatality rate (CFR). Methods In this descriptive-analytical cross-sectional study, the demographic and clinical data of all insured of the IHIO who were hospitalized with COVID-19 in hospitals across the country until March 2021 was extracted from the comprehensive system of handling the inpatient documents of this organization. The Excel 2019 and GeoDA software were used for descriptive reporting and geographical distribution of variables. A multiple logistic regression model was used to estimate the Odds Ratio (OR) of death in patients with COVID-19 using STATA 14 software. Results During the first 14 months of the COVID-19 outbreak in Iran, 0.72% of the IHIO insured (303,887 individuals) were hospitalized with COVID-19. Hospitalization per 100,000 people varied from 192.51 in East Azerbaijan to 1,277.49 in Yazd province. The overall CFR in hospitalized patients was 14%. Tehran and Kohgiluyeh & BoyerAhmad provinces had the highest and lowest CFR with 19.39% and 5.19%, respectively. The highest odds of death were in those over 80 years old people (OR = 9.65), ICU-admitted (OR = 7.49), Hospitalized in governmental hospitals (OR = 2.08), Being a foreign national (OR = 1.45), hospitalized in November (OR = 1.47) and Residence in provinces such as Sistan & Baluchestan (OR = 1.47) and Razavi Khorasan (OR = 1.66) respectively. Furthermore, the odds of death were lower in females (OR = 0.81) than in males. Conclusions A sound understanding of the primary causes of COVID-19 death and severity in different groups can be the basis for developing programs focused on more vulnerable groups in order to manage the crisis more effectively and benefit from resources more efficiently. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13649-0.
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Affiliation(s)
- Soheila Damiri
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave., Tehran, 1417613191, Iran
| | - Ali Shojaee
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave., Tehran, 1417613191, Iran.,National Center for Health Insurance Research, Tehran, Iran
| | - Mohsen Dehghani
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Shahali
- National Center for Health Insurance Research, Tehran, Iran
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Khwaja M, Chopra D, Verma PK, Jauhari N, Shehnaz S. Clinical Profile of Indoor Covid-19 Patients at a Medical Institute In India: A Retrospective analysis. INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: COVID-19 has caused a very high burden of morbidity and mortality across the world, India being also badly affected. The disease has a wide spectrum ranging from asymptomatic to severe illness and death. Research work on the epidemiological and clinical profile of patients is scarce in India. Objectives: This study was conducted to know the clinico-epidemiological profile of indoor hospitalized Covid 19 patients. Methods: a retrospective analysis (record based) conducted at a designated COVID tertiary care center. Study period-1st August 2020 to 31st October 2020. Study Unit- Laboratory confirmed COVID 19 patients admitted in the hospital. Sample size- All the 894 patients with complete record were included in the study. Results: The mean age was 47.68± 17.62 years. Around 14.1% of the population was asymptomatic. 75.7% were classified as having a mild disease. The cure rate was 82.9% and deaths were reported in 9.4%. Conclusions: Our findings were similar to findings observed in other studies. A positive significant correlation was noticed between age, duration, clinical severity and outcome of patient. The clinical severity was also found to be associated with age, duration of symptoms and outcome of patient
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94
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Rovito R, Augello M, Ben-Haim A, Bono V, d'Arminio Monforte A, Marchetti G. Hallmarks of Severe COVID-19 Pathogenesis: A Pas de Deux Between Viral and Host Factors. Front Immunol 2022; 13:912336. [PMID: 35757770 PMCID: PMC9231592 DOI: 10.3389/fimmu.2022.912336] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/02/2022] [Indexed: 12/15/2022] Open
Abstract
Two years into Coronavirus Disease 2019 (COVID-19) pandemic, a comprehensive characterization of the pathogenesis of severe and critical forms of COVID-19 is still missing. While a deep dysregulation of both the magnitude and functionality of innate and adaptive immune responses have been described in severe COVID-19, the mechanisms underlying such dysregulations are still a matter of scientific debate, in turn hampering the identification of new therapies and of subgroups of patients that would most benefit from individual clinical interventions. Here we review the current understanding of viral and host factors that contribute to immune dysregulation associated with COVID-19 severity in the attempt to unfold and broaden the comprehension of COVID-19 pathogenesis and to define correlates of protection to further inform strategies of targeted therapeutic interventions.
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Affiliation(s)
- Roberta Rovito
- Clinic of Infectious Diseases and Tropical Medicine, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Matteo Augello
- Clinic of Infectious Diseases and Tropical Medicine, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Assaf Ben-Haim
- Clinic of Infectious Diseases and Tropical Medicine, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases and Tropical Medicine, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Antonella d'Arminio Monforte
- Clinic of Infectious Diseases and Tropical Medicine, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases and Tropical Medicine, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
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95
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Chlamydas S, Markouli M, Strepkos D, Piperi C. Epigenetic mechanisms regulate sex-specific bias in disease manifestations. J Mol Med (Berl) 2022; 100:1111-1123. [PMID: 35764820 PMCID: PMC9244100 DOI: 10.1007/s00109-022-02227-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/02/2022] [Accepted: 06/20/2022] [Indexed: 12/15/2022]
Abstract
Abstract Sex presents a vital determinant of a person’s physiology, anatomy, and development. Recent clinical studies indicate that sex is also involved in the differential manifestation of various diseases, affecting both clinical outcome as well as response to therapy. Genetic and epigenetic changes are implicated in sex bias and regulate disease onset, including the inactivation of the X chromosome as well as sex chromosome aneuploidy. The differential expression of X-linked genes, along with the presence of sex-specific hormones, exhibits a significant impact on immune system function. Several studies have revealed differences between the two sexes in response to infections, including respiratory diseases and COVID-19 infection, autoimmune disorders, liver fibrosis, neuropsychiatric diseases, and cancer susceptibility, which can be explained by sex-biased immune responses. In the present review, we explore the input of genetic and epigenetic interplay in the sex bias underlying disease manifestation and discuss their effects along with sex hormones on disease development and progression, aiming to reveal potential new therapeutic targets. Key messages Sex is involved in the differential manifestation of various diseases. Epigenetic modifications influence X-linked gene expression, affecting immune response to infections, including COVID-19. Epigenetic mechanisms are responsible for the sex bias observed in several respiratory and autoimmune disorders, liver fibrosis, neuropsychiatric diseases, and cancer.
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Affiliation(s)
- Sarantis Chlamydas
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 M. Asias Street Bldg 16, 11527, Athens, Greece.,Olink Proteomics, Uppsala, Sweden
| | - Mariam Markouli
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 M. Asias Street Bldg 16, 11527, Athens, Greece
| | - Dimitrios Strepkos
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 M. Asias Street Bldg 16, 11527, Athens, Greece
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 75 M. Asias Street Bldg 16, 11527, Athens, Greece.
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Hallak J, Teixeira TA, Barrozo LV, Singer J, Kallas EG, Saldiva PH. Male sex rather than socioeconomic vulnerability as a determinant for COVID-19 death in Sao Paulo: A population-based study. SAGE Open Med 2022; 10:20503121221105583. [PMID: 35756353 PMCID: PMC9218439 DOI: 10.1177/20503121221105583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: To determine the role of the male sex as a risk factor for coronavirus disease deaths in Sao Paulo and to what extent socioeconomic vulnerability and individual health issues can interfere in such risk. Methods: The primary cause of death, age, sex, comorbidities, and code of the Human Development Units of the residence of 37,583 individuals in Sao Paulo, Brazil, were obtained from the records on confirmed coronavirus disease resident hospitalizations of the city of Sao Paulo from the National Influenza Surveillance Information System. A social vulnerability index was assigned to each Human Development Unit. Using “death” as the outcome variable and sex, admission to the intensive care unit, obesity, renal and heart diseases, diabetes, and social vulnerability as confounders, the odds of death for males and females were compared via logistic regression. Results: The odds of death for males were 1.242 (confidence interval 95% = 1.237, 1.247) times the corresponding odds for females with the same values for all confounders. We estimated the odds of death for patients living in regions with high social vulnerability as 2.243 (CI 95% = 2.151, 2.339) times the corresponding odds of patients living in regions with very low social vulnerability with the same values of the remaining variables. Conclusion: The male:female death ratio by severe acute respiratory syndrome coronavirus 2 infection in Sao Paulo cannot be attributed only to comorbidities or social vulnerabilities. Our results suggest that the male sex is an independent biological risk factor for coronavirus disease death. Besides sex-specific factors, further research should focus on crucial biological factors in male sex coronavirus disease mortality.
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Affiliation(s)
- Jorge Hallak
- Division of Urology, Department of Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Thiago A Teixeira
- Division of Urology, Department of Surgery, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Ligia V Barrozo
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.,Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo, Brazil
| | - Júlio Singer
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.,Department of Statistics, Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Esper G Kallas
- Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo Hn Saldiva
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.,Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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97
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Functional associations between polymorphic regions of the human 3'IgH locus and COVID-19 disease. Gene X 2022; 838:146698. [PMID: 35772651 PMCID: PMC9241982 DOI: 10.1016/j.gene.2022.146698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose The pandemic diffusion of Coronavirus Disease 2019 (COVID-19) has highlighted significant gender-related differences in disease severity. Despite several hypotheses being proposed, how the genetic background of COVID-19 patients might impact clinical outcomes remains largely unknown. Methods We collected blood samples from 192 COVID-19 patients (115 men, 77 women, mean age 67 ± 19 years) admitted between March and June 2020 at two different hospital centers in Italy, and determined the allelic distribution of nine Single Nucleotide Polymorphisms (SNPs), located at the 3’Regulatory Region (3’RR)-1 in the immunoglobulin (Ig) heavy chain locus, including *1 and *2 alleles of polymorphic hs1.2 enhancer region. Results In COVID-19 patients, the genotyped SNPs exhibited strong Linkage Disequilibrium and produced 7 specific haplotypes, associated to different degrees of disease severity, including the occurrence of pneumonia. Additionally, the allele *2, which comprises a DNA binding site for the Estrogen receptor alpha (ERα) in the polymorphic enhancer hs1.2 of 3’RR-1, was significantly enriched in women with a less severe disease. Conclusions These findings document genetic variants associated to individual clinical severity of COVID-19 disease. Most specifically, a novel genetic protective factor was identified that might explain the sex-related differences in immune response to Sars-COV-2 infection in humans.
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98
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Female Patients with Pneumonia on Intensive Care Unit Are under Risk of Fatal Outcome. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060827. [PMID: 35744090 PMCID: PMC9229246 DOI: 10.3390/medicina58060827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The impact of sex on mortality in patients with pneumonia requiring intensive care unit (ICU) treatment is still a controversial discussion, with studies providing heterogeneous results. The reasons for sex differences are widespread, including hormonal, immunologic and therapeutic approaches. This study's aim was to evaluate sex-related differences in the mortality of ICU patients with pneumonia. Material and Methods: A prospective observational clinical trial was performed at Charité University Hospital in Berlin. Inclusion criteria were a diagnosis of pneumonia and a treatment period of over 24 h on ICU. A total of 436 mainly postoperative patients were included. Results: Out of 436 patients, 166 (38.1%) were female and 270 (61.9%) were male. Significant differences in their SOFA scores on admission, presence of immunosuppression and diagnosed cardiovascular disease were observed. Male patients were administered more types of antibiotics per day (p = 0.028) at significantly higher daily costs (in Euros) per applied anti-infective drug (p = 0.003). Mortalities on ICU were 34 (20.5%) in females and 39 (14.4%) in males (p = 0.113), before correcting for differences in patient characteristics using logistic regression analysis, and afterwards, the female sex showed an increased risk of ICU mortality with an OR of 1.775 (1.029-3.062, p = 0.039). Conclusions: ICU mortality was significantly higher in female patients with pneumonia. The identification of sex-specific differences is important to increase awareness among clinicians and allow resource allocation. The impact of sex on illness severity, sex differences in infectious diseases and the consequences on treatment need to be elucidated in the future.
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99
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Alesci A, Pergolizzi S, Fumia A, Miller A, Cernigliaro C, Zaccone M, Salamone V, Mastrantonio E, Gangemi S, Pioggia G, Cicero N. Immune System and Psychological State of Pregnant Women during COVID-19 Pandemic: Are Micronutrients Able to Support Pregnancy? Nutrients 2022; 14:nu14122534. [PMID: 35745263 PMCID: PMC9227584 DOI: 10.3390/nu14122534] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/04/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
The immune system is highly dynamic and susceptible to many alterations throughout pregnancy. Since December 2019, a pandemic caused by coronavirus disease 19 (COVID-19) has swept the globe. To contain the spread of COVID-19, immediate measures such as quarantine and isolation were implemented. These containment measures have contributed to exacerbate situations of anxiety and stress, especially in pregnant women, who are already particularly anxious about their condition. Alterations in the psychological state of pregnant women are related to alterations in the immune system, which is more vulnerable under stress. COVID-19 could therefore find fertile soil in these individuals and risk more severe forms. Normally a controlled dietary regimen is followed during pregnancy, but the use of particular vitamins and micronutrients can help counteract depressive-anxiety states and stress, can improve the immune system, and provide an additional weapon in the defense against COVID-19 to bring the pregnancy to fruition. This review aims to gather data on the impact of COVID-19 on the immune system and psychological condition of pregnant women and to assess whether some micronutrients can improve their psychophysical symptoms.
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Affiliation(s)
- Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Anthea Miller
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy;
| | - Caterina Cernigliaro
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Maria Zaccone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Vanessa Salamone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Enza Mastrantonio
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98125 Messina, Italy;
| | - Nicola Cicero
- Department of Biomedical and Dental Science and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
- Correspondence: (A.A.); (A.F.); (N.C.)
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100
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Masyeni S, Nelwan EJ, Fatawy RM, Wibawa S, Nugraha PA, Antara J, Suparta A, Asmara DGW, Yenny LGS, Budhitresna AAG, Arimas D, Indriani D, Parwata K, Sutarjana K, Sugiartha E, Kahari S, Wardhana CA, Indraningrat AAG, Mulyantari K, Pasek AW, Putrawan O, Yustiani NT, Wardana G, Wijaya MI, Aryana S, Gayatri Y, Sukmawati DD, Suastika K, Merati TP, Bakta M, Widiana R. Clinical characteristics and outcomes of COVID-19 patients in Bali, Indonesia. PLoS One 2022; 17:e0269026. [PMID: 35687545 PMCID: PMC9187108 DOI: 10.1371/journal.pone.0269026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 05/12/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali, Indonesia, and evaluates the diagnostic value of their clinical symptoms. Method This observational study was conducted in eight hospitals. The patients were classified as non-severe COVID-19, severe COVID-19, and non-COVID-19. Demographics, clinical, laboratory, and radiologic characteristics, and outcomes of COVID-19 patients were collected. Factors associated with the severity and outcomes were assessed using the chi-squared test or ANOVA when appropriate. We also compared the clinical features of non-severe COVID-19 and non-COVID-19 patients to evaluate the diagnostic accuracy. Results This study included 92 patients: 41 non-COVID-19 and 51 COVID-19 patients, comprising 45 non-severe and six severe cases. The most common symptoms of COVID-19 were cough (47.1%), fever (31.0%), and dyspnea (25.3%). Cough, fatigue, and anosmia have high accuracy, and combining these complaints in clinical diagnostics offered a higher accuracy in predicting COVID-19 patients (60.1%). We found lower lymphocyte counts and interleukin-1R levels and higher levels of C-reactive protein, interleukin-6, and interleukin-8 in severe compared than in non-severe COVID-19 patients. Lactate dehydrogenase was associated with intensive care unit admission and ventilator use, while other markers such as neutrophil-lymphocyte ratio, C-reactive protein, and interleukin-6 were not. Conclusion A battery of symptoms, including cough, fatigue, and anosmia, is likely associated with COVID-19 in Bali. Clinicians should be aware of these symptoms to ensure a prompt diagnostic test for COVID-19, beyond other causes of acute febrile illnesses.
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Affiliation(s)
- Sri Masyeni
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa/Sanjiwani Hospital, Bali, Indonesia
| | - Erni Juwita Nelwan
- Infectious Disease and Immunology Research Center, Indonesia Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- * E-mail: (EJN); (SA)
| | - Rois Muqsith Fatawy
- Infectious Disease and Immunology Research Center, Indonesia Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Putu Arya Nugraha
- Department of Internal Medicine, Pratama Giri Emas Hospital, Bali, Indonesia
| | - Jarwa Antara
- Department of Internal Medicine, Nyitdah Tabanan Hospital, Bali, Indonesia
| | | | - D. G. Wedha Asmara
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa/Sanjiwani Hospital, Bali, Indonesia
| | - L. G. Sri Yenny
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa/Sanjiwani Hospital, Bali, Indonesia
| | - A. A. G. Budhitresna
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa/Sanjiwani Hospital, Bali, Indonesia
| | - Dewi Arimas
- Department of Clinical Pathology, Singaraja Hospital, Bali, Indonesia
| | | | - Kmg Parwata
- Klungkung Semarapura Hospital, Bali, Indonesia
| | | | | | - Siska Kahari
- Department of Internal Medicine, Nyitdah Tabanan Hospital, Bali, Indonesia
| | - Clareza Arief Wardhana
- Department of Clinical Pathology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - A. A. G. Indraningrat
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa/Sanjiwani Hospital, Bali, Indonesia
| | - Kadek Mulyantari
- Department of Clinical Pathology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | | | | | | | | | - Made Indra Wijaya
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa/Sanjiwani Hospital, Bali, Indonesia
| | - Suka Aryana
- Department of Internal Medicine, Sanglah Hospital, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
- * E-mail: (EJN); (SA)
| | - Yuli Gayatri
- Department of Internal Medicine, Sanglah Hospital, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Dewi Dian Sukmawati
- Department of Internal Medicine, Sanglah Hospital, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Ketut Suastika
- Department of Internal Medicine, Sanglah Hospital, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Tuti Parwati Merati
- Department of Internal Medicine, Sanglah Hospital, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Made Bakta
- Department of Internal Medicine, Sanglah Hospital, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
| | - Raka Widiana
- Department of Internal Medicine, Sanglah Hospital, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
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