151
|
van Kessel SAM, Olde Hartman TC, Lucassen PLBJ, van Jaarsveld CHM. Post-acute and long-COVID-19 symptoms in patients with mild diseases: a systematic review. Fam Pract 2022; 39:159-167. [PMID: 34268556 PMCID: PMC8414057 DOI: 10.1093/fampra/cmab076] [Citation(s) in RCA: 151] [Impact Index Per Article: 75.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND It is expected that GPs are increasingly confronted with a large group of patients with symptoms persisting three weeks after initial symptoms of a mild (managed in the outpatient setting) COVID-19 infection. Currently, research on these persistent symptoms mainly focuses on patients with severe infections (managed in an inpatient setting) whereas patients with mild disease are rarely studied. OBJECTIVE The main objective of this systematic review was to create an overview of the nature and frequency of persistent symptoms experienced by patients after mild COVID-19 infection. METHODS Systematic literature searches were performed in Pubmed, Embase and PsychINFO on 2 February 2021. Quantitative studies, qualitative studies, clinical lessons and case reports were considered eligible designs. RESULTS In total, nine articles were included in this literature review. The frequency of persistent symptoms in patients after mild COVID-19 infection ranged between 10% and 35%. Symptoms persisting after a mild COVID-19 infection can be distinguished into physical, mental and social symptoms. Fatigue was the most frequently described persistent symptom. Other frequently occurring persistent symptoms were dyspnoea, cough, chest pain, headache, decreased mental and cognitive status and olfactory dysfunction. In addition, it was found that persisting symptoms after a mild COVID-19 infection can have major consequences for work and daily functioning. CONCLUSION There is already some evidence that symptoms of mild COVID-19 persist after 3 weeks in a third of patients. However, there is a lack of data about symptoms persisting after 3 months (long-COVID). More research is needed to help GPs in managing long-COVID.
Collapse
Affiliation(s)
- Sophie A M van Kessel
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Tim C Olde Hartman
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Peter L B J Lucassen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
| | - Cornelia H M van Jaarsveld
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands
| |
Collapse
|
152
|
Papadopoulos D, Ntanasis-Stathopoulos I, Gavriatopoulou M, Evangelakou Z, Malandrakis P, Manola MS, Gianniou DD, Kastritis E, Trougakos IP, Dimopoulos MA, Karalis V, Terpos E. Predictive Factors for Neutralizing Antibody Levels Nine Months after Full Vaccination with BNT162b2: Results of a Machine Learning Analysis. Biomedicines 2022; 10:biomedicines10020204. [PMID: 35203412 PMCID: PMC8869256 DOI: 10.3390/biomedicines10020204] [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: 12/14/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/07/2023] Open
Abstract
Vaccination against SARS-CoV-2 with BNT162b2 mRNA vaccine plays a critical role in COVID-19 prevention. Although BNT162b2 is highly effective against COVID-19, a time-dependent decrease in neutralizing antibodies (NAbs) is observed. The aim of this study was to identify the individual features that may predict NAbs levels after vaccination. Machine learning techniques were applied to data from 302 subjects. Principal component analysis (PCA), factor analysis of mixed data (FAMD), k-means clustering, and random forest were used. PCA and FAMD showed that younger subjects had higher levels of neutralizing antibodies than older subjects. The effect of age is strongest near the vaccination date and appears to decrease with time. Obesity was associated with lower antibody response. Gender had no effect on NAbs at nine months, but there was a modest association at earlier time points. Participants with autoimmune disease had lower inhibitory levels than participants without autoimmune disease. K-Means clustering showed the natural grouping of subjects into five categories in which the characteristics of some individuals predominated. Random forest allowed the characteristics to be ordered by importance. Older age, higher body mass index, and the presence of autoimmune diseases had negative effects on the development of NAbs against SARS-CoV-2, nine months after full vaccination.
Collapse
Affiliation(s)
- Dimitris Papadopoulos
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece;
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Zoi Evangelakou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Panagiotis Malandrakis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Maria S. Manola
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Despoina D. Gianniou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Ioannis P. Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (Z.E.); (M.S.M.); (D.D.G.); (I.P.T.)
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
| | - Vangelis Karalis
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece;
- Correspondence: (V.K.); (E.T.)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (M.G.); (P.M.); (E.K.); (M.A.D.)
- Correspondence: (V.K.); (E.T.)
| |
Collapse
|
153
|
AYYILDIZ A, ÇOBANER N, YELKEN B. Sepsis induced coagulopathy score and D-dimer levels in COVID-19 patients followed in intensive care; what has changed in COVID era? JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.992132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
154
|
Does Oxidative Stress Management Help Alleviation of COVID-19 Symptoms in Patients Experiencing Diabetes? Nutrients 2022; 14:nu14020321. [PMID: 35057501 PMCID: PMC8780958 DOI: 10.3390/nu14020321] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome (SARS)-CoV-2 virus causes novel coronavirus disease 2019 (COVID-19) with other comorbidities such as diabetes. Diabetes is the most common cause of diabetic nephropathy, which is attributed to hyperglycemia. COVID-19 produces severe complications in people with diabetes mellitus. This article explains how SARS-CoV-2 causes more significant kidney damage in diabetic patients. Importantly, COVID-19 and diabetes share inflammatory pathways of disease progression. SARS-CoV-2 binding with ACE-2 causes depletion of ACE-2 (angiotensin-converting enzyme 2) from blood vessels, and subsequently, angiotensin-II interacts with angiotensin receptor-1 from vascular membranes that produce NADPH (nicotinamide adenine dinucleotide hydrogen phosphate) oxidase, oxidative stress, and constriction of blood vessels. Since diabetes and COVID-19 can create oxidative stress, we hypothesize that COVID-19 with comorbidities such as diabetes can synergistically increase oxidative stress leading to end-stage renal failure and death. Antioxidants may therefore prevent renal damage-induced death by inhibiting oxidative damage and thus can help protect people from COVID-19 related comorbidities. A few clinical trials indicated how effective the antioxidant therapy is against improving COVID-19 symptoms, based on a limited number of patients who experienced COVID-19. In this review, we tried to understand how effective antioxidants (such as vitamin D and flavonoids) can act as food supplements or therapeutics against COVID-19 with diabetes as comorbidity based on recently available clinical, preclinical, or in silico studies.
Collapse
|
155
|
Inoue A, Takahashi H, Ibe T, Ishii H, Kurata Y, Ishizuka Y, Hamamoto Y. Comparison of semiquantitative chest CT scoring systems to estimate severity in coronavirus disease 2019 (COVID-19) pneumonia. Eur Radiol 2022; 32:3513-3524. [PMID: 35020014 PMCID: PMC8753957 DOI: 10.1007/s00330-021-08435-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To compare the clinical usefulness among three different semiquantitative computed tomography (CT) severity scoring systems for coronavirus disease 2019 (COVID-19) pneumonia. METHODS Two radiologists independently reviewed chest CT images in 108 patients to rate three CT scoring systems (total CT score [TSS], chest CT score [CCTS], and CT severity score [CTSS]). We made a minor modification to CTSS. Quantitative dense area ratio (QDAR: the ratio of lung involvement to lung parenchyma) was calculated using the U-net model. Clinical severity at admission was classified as severe (n = 14) or mild (n = 94). Interobserver agreement, interpretation time, and degree of correlation with clinical severity as well as QDAR were evaluated. RESULTS Interobserver agreement was excellent (intraclass correlation coefficient: 0.952-0.970, p < 0.001). Mean interpretation time was significantly longer in CTSS (48.9-80.0 s) than in TSS (25.7-41.7 s, p < 0.001) and CCTS (27.7-39.5 s, p < 0.001). Area under the curve for differentiating clinical severity at admission was 0.855-0.842 in TSS, 0.853-0.850 in CCTS, and 0.853-0.836 in CTSS. All scoring systems correlated with QDAR in the order of CCTS (ρ = 0.443-0.448), TSS (ρ = 0.435-0.437), and CTSS (ρ = 0.415-0.426). CONCLUSIONS All semiquantitative scoring systems demonstrated substantial diagnostic performance for clinical severity at admission with excellent interobserver agreement. Interpretation time was significantly shorter in TSS and CCTS than in CTSS. The correlation between the scoring system and QDAR was highest in CCTS, followed by TSS and CTSS. CCTS appeared to be the most appropriate CT scoring system for clinical practice. KEY POINTS • Three semiquantitative scoring systems demonstrate substantial accuracy (area under the curve: 0.836-0.855) for diagnosing clinical severity at admission and (area under the curve: 0.786-0.802) for risk of developing critical illness. • Total CT score (TSS) and chest CT score (CCTS) were considered to be more appropriate in terms of clinical usefulness as compared with CT severity score (CTSS), given the shorter interpretation time in TSS and CCTS, and the lowest correlation with quantitative dense area ratio in CTSS. • CCTS is assumed to distinguish subtle from mild lung involvement better than TSS by adopting a 5% threshold in scoring the degree of severity.
Collapse
Affiliation(s)
- Akitoshi Inoue
- Department of Radiology, Shiga University of Medical Science, Ōtsu, Japan.,Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Hiroaki Takahashi
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Tatsuya Ibe
- Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Saitama, Japan
| | - Hisashi Ishii
- Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Saitama, Japan
| | - Yuhei Kurata
- Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Saitama, Japan
| | - Yoshikazu Ishizuka
- Department of Radiology, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Saitama, Japan
| | - Yoichiro Hamamoto
- Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Saitama, Japan
| |
Collapse
|
156
|
Rifai A, Wahono CS, Pratama MZ, Handono K, Susianti H, Iskandar A, Diyah N, Santoningsih D, Samsu N, Gunawan A. Association Between the Effectiveness and Immunogenicity of Inactivated SARS-CoV2 Vaccine (CoronaVac) with the Presence of Hypertension among Health Care Workers. Clin Exp Hypertens 2022; 44:233-239. [PMID: 34994256 DOI: 10.1080/10641963.2021.2022687] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to observe the association between the presence of hypertension with Covid-19 vaccine effectiveness among healthcare workers who received CoronaVac vaccination. METHODS We conducted a prospective cohort study in Saiful Anwar General Hospital, Malang, Indonesia on 155 healthcare workers aged 18-59 years old who already received twice of the CoronaVac (Sinovac Life Science, Beijing, China) injection with 14-day intervals. Hypertension was diagnosed according to the 2020 International Society of Hypertension. Subjects were monitored for six months. The primary outcome was the rate of Covid-19 diagnosed by the pharyngeal swab for the real-time reverse transcription-polymerase chain reaction (RT-PCR) examination. The secondary endpoints were: (1) severity of Covid-19 among infected participants; (2) rate of hospitalizations; and (3) anti-SRBD antibody levels measured by ECLIA. RESULTS Among 155 participants, 18.7% of them were diagnosed with hypertension, and 31.0% had the desirable BP target according to the current guidelines. Subjects with hypertension, especially those with uncontrolled blood pressure, had a higher incidence of Covid-19 infection than subjects without hypertension. Subjects with symptomatic Covid-19 and hospitalized because of Covid-19 were higher in participants with hypertension. The anti-SRBD antibody levels were lower in the second month after CoronaVac vaccination in hypertensive subjects. In contrast, comparable anti-SRBD levels were seen from both groups at sixth months after vaccination. CONCLUSION Hypertension was associated with lower vaccine effectiveness in healthcare workers. Subjects with hypertension had a higher risk of being infected with Covid-19 despite getting a complete dose of vaccination and lower antibody production.
Collapse
Affiliation(s)
- Achmad Rifai
- Nephrology and Hypertension Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Cesarius Singgih Wahono
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Mirza Zaka Pratama
- Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Kusworini Handono
- Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Hani Susianti
- Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Agustin Iskandar
- Department of Clinical Pathology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Nurima Diyah
- Department of Microbiology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Dewi Santoningsih
- Department of Microbiology, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Nur Samsu
- Nephrology and Hypertension Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| | - Atma Gunawan
- Nephrology and Hypertension Division, Department of Internal Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar General Hospital, Malang, Indonesia
| |
Collapse
|
157
|
Loey M, El-Sappagh S, Mirjalili S. Bayesian-based optimized deep learning model to detect COVID-19 patients using chest X-ray image data. Comput Biol Med 2022; 142:105213. [PMID: 35026573 PMCID: PMC8730711 DOI: 10.1016/j.compbiomed.2022.105213] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/21/2021] [Accepted: 01/02/2022] [Indexed: 12/12/2022]
Abstract
Coronavirus Disease 2019 (COVID-19) is extremely infectious and rapidly spreading around the globe. As a result, rapid and precise identification of COVID-19 patients is critical. Deep Learning has shown promising performance in a variety of domains and emerged as a key technology in Artificial Intelligence. Recent advances in visual recognition are based on image classification and artefacts detection within these images. The purpose of this study is to classify chest X-ray images of COVID-19 artefacts in changed real-world situations. A novel Bayesian optimization-based convolutional neural network (CNN) model is proposed for the recognition of chest X-ray images. The proposed model has two main components. The first one utilizes CNN to extract and learn deep features. The second component is a Bayesian-based optimizer that is used to tune the CNN hyperparameters according to an objective function. The used large-scale and balanced dataset comprises 10,848 images (i.e., 3616 COVID-19, 3616 normal cases, and 3616 Pneumonia). In the first ablation investigation, we compared Bayesian optimization to three distinct ablation scenarios. We used convergence charts and accuracy to compare the three scenarios. We noticed that the Bayesian search-derived optimal architecture achieved 96% accuracy. To assist qualitative researchers, address their research questions in a methodologically sound manner, a comparison of research method and theme analysis methods was provided. The suggested model is shown to be more trustworthy and accurate in real world.
Collapse
Affiliation(s)
- Mohamed Loey
- Department of Computer Science, Faculty of Computers and Artificial Intelligence, Benha University, Benha, 13518, Egypt; Information Technology Program, New Cairo Technological University, New Cairo, Egypt; Computer Engineering Department, Cybersecurity Department, Engineering and Information Technology College, Buraydah Colleges, Buraydah, Al-Qassim, Saudi Arabia.
| | - Shaker El-Sappagh
- Department of Information Systems, Faculty of Computers and Artificial Intelligence, Benha University, Benha, 13518, Egypt; Faculty of Computer Science and Engineering, Galala University, Suez 435611, Egypt.
| | - Seyedali Mirjalili
- Center for Artificial Intelligence Research and Optimization, Torrens University Australia, Fortitude Valley, Brisbane, QLD, 4006, Australia; Yonsei Frontier Lab, Yonsei University, Seoul, South Korea.
| |
Collapse
|
158
|
Discovery of C-12 dithiocarbamate andrographolide analogues as inhibitors of SARS-CoV-2 main protease: In vitro and in silico studies. Comput Struct Biotechnol J 2022; 20:2784-2797. [PMID: 35677603 PMCID: PMC9167041 DOI: 10.1016/j.csbj.2022.05.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 11/27/2022] Open
Abstract
Andrographolide analogues were found to inhibit SARS-CoV-2 main protease. The compounds 3k, 3l, 3m and 3t showed promising in vitro inhibitory activity. Most of the candidates could bind well to the SARS-CoV-2 main protease active site.
A global crisis of coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has impacted millions of people’s lives throughout the world. In parallel to vaccine development, identifying potential antiviral agents against SARS-CoV-2 has become an urgent need to combat COVID-19. One of the most attractive drug targets for discovering anti-SARS-CoV-2 agents is the main protease (Mpro), which plays a pivotal role in the viral life cycle. This study aimed to elucidate a series of twenty-one 12-dithiocarbamate-14-deoxyandrographolide analogues as SARS-CoV-2 Mpro inhibitors using in vitro and in silico studies. These compounds were initially screened for the inhibitory activity toward SARS-CoV-2 Mpro by in vitro enzyme-based assay. We found that compounds 3k, 3l, 3m and 3t showed promising inhibitory activity against SARS-CoV-2 Mpro with >50% inhibition at 10 μM. Afterward, the binding mode of each compound in the active site of SARS-CoV-2 Mpro was explored by molecular docking. The optimum docked complexes were then chosen and subjected to molecular dynamic (MD) simulations. The MD results suggested that all studied complexes were stable along the simulation time, and most of the compounds could fit well with the SARS-CoV-2 Mpro active site, particularly at S1, S2 and S4 subsites. The per-residue decomposition free energy calculations indicated that the hot-spot residues essential for ligand binding were T25, H41, C44, S46, M49, C145, H163, M165, E166, L167, D187, R188, Q189 and T190. Therefore, the obtained information from the combined experimental and computational techniques could lead to further optimization of more specific and potent andrographolide analogues toward SARS-CoV-2 Mpro.
Collapse
|
159
|
Terpos E, Karalis V, Ntanasis-Stathopoulos I, Apostolakou F, Gumeni S, Gavriatopoulou M, Papadopoulos D, Malandrakis P, Papanagnou ED, Korompoki E, Kastritis E, Papassotiriou I, Trougakos IP, Dimopoulos MA. Sustained but Declining Humoral Immunity Against SARS-CoV-2 at 9 Months Postvaccination With BNT162b2: A Prospective Evaluation in 309 Healthy Individuals. Hemasphere 2022; 6:e677. [PMID: 34938959 PMCID: PMC8687721 DOI: 10.1097/hs9.0000000000000677] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/02/2021] [Indexed: 12/13/2022] Open
Abstract
The sustainability of coronavirus 19 (COVID-19) vaccine-induced immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to be determined to inform public health decisions on vaccination programs and prevention measures against COVID-19. The aim of the present study was to prospectively evaluate the kinetics of neutralizing antibodies (NAbs) and anti-S-receptor binding domain (RBD IgGs) against SARS-CoV-2 after full vaccination with the BNT162b2 mRNA vaccine for up to 9 months in healthy individuals (NCT04743388). The assessments were performed at the following time points after the second vaccination: 2 weeks, 1 month, 3 months, 6 months, and 9 months. The measurements were performed with the GenScript's cPassTM SARS-CoV-2 NAbs Detection Kit (GenScript, Inc.; Piscataway, NJ) and the Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics GmbH; Mannheim, Germany). Three hundred nine participants with a median age of 48 years were included. A gradual decline in both NAbs and anti-S-RBD IgGs became evident from 2 weeks to 9 months postvaccination. Both NAbs and anti-S-RBD IgGs levels were significantly lower at 9 months compared with the previous timepoints. Interestingly, age was found to exert a statistically significant effect on NAbs elimination only during the first-trimester postvaccination, as older age was associated with a more rapid clearance of NAbs. Furthermore, simulation studies predicted that the median NAb value would fall from 66% at 9 months to 59% and 45% at 12 and 18 months postvaccination, respectively. This finding may reflect a declining degree of immune protection against COVID-19 and advocates for the administration of booster vaccine shots especially in areas with emerging outbreaks.
Collapse
Affiliation(s)
- Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Vangelis Karalis
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | | | - Filia Apostolakou
- Department of Clinical Biochemistry, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Sentiljana Gumeni
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Dimitris Papadopoulos
- Section of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Panagiotis Malandrakis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Eleni-Dimitra Papanagnou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Eleni Korompoki
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Ioannis P. Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Greece
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Greece
| |
Collapse
|
160
|
Pulido Morales LL, Buitrago Romero JS, Ardila Sanchez IA, Yepes-Calderon F. Turning any bed into an intensive care unit with the Internet of things and artificial intelligence technology. Presenting the enhanced mechanical ventilator. F1000Res 2022; 11:1570. [PMID: 36798112 PMCID: PMC9925877 DOI: 10.12688/f1000research.127647.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
The recent Coronavirus disease 2019 (COVID-19) pandemic displayed weaknesses in the healthcare infrastructures worldwide and exposed a lack of specialized personnel to cover the demands of a massive calamity. We have developed a portable ventilator that uses real-time vitals read from the patient to estimate -- through artificial intelligence -- the optimal operation point. The ventilator has redundant telecommunication capabilities; therefore, the remote assistance model can protect specialists and relatives from highly contagious agents. Additionally, we have designed a system that automatically publishes information in a proprietary cloud centralizer to keep physicians and relatives informed. The system was tested in a residential last-mile connection, and transaction times below the second were registered. The timing scheme allows us to operate up to 200 devices concurrently on these lowest-specification transmission control protocol/internet protocol (TCP/IP) services, promptly transmitting data for online processing and reporting. The ventilator is a proof of concept of automation that has behavioral and cognitive inputs to cheaply, yet reliably, extend the installed capacity of the healthcare systems and multiply the response of the skilled medical personnel to cover high-demanding scenarios and improve service quality.
Collapse
Affiliation(s)
| | | | - Ismael A Ardila Sanchez
- Facultad Tecnológica, Universidad Distrital Francisco José de Caldas, Bogota, Bogota, Colombia
| | - Fernando Yepes-Calderon
- I+D+I, GYM Group SA, Cali, Valle del Cauca, Colombia.,Research and Development, Science Based Platforms LLC, Fort Pierce, Florida, 34950, USA.,Facultad de Medicina, Universidad del Valle, Cali, Valle del Cauca, Colombia
| |
Collapse
|
161
|
Fabrazzo M, Russo A, Luciano M, Camerlengo A, Catapano P, Amoroso B, Catapano F, Coppola N. Delirium and Psychiatric Sequelae Associated to SARS-CoV-2 in Asymptomatic Patients With Psychiatric History and Mild Cognitive Impairment as Risk Factors: Three Case Reports. Front Psychiatry 2022; 13:868286. [PMID: 35463530 PMCID: PMC9021604 DOI: 10.3389/fpsyt.2022.868286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/10/2022] [Indexed: 12/15/2022] Open
Abstract
Human coronaviruses have neuroinvasive and neurotropic abilities that might explain psychiatric outcomes in affected patients. We hypothesized that delirium might be the sole clinical manifestation or even the prodrome of a psychiatric episode consistent with the mental history of a few infected patients with a preexisting diagnosed cognitive impairment. We examined three patients with preexisting mild cognitive impairment and delirium at admission for suspected SARS-CoV-2 infection. We diagnosed delirium using DSM-5 and Confusion Assessment Method (CAM) and measured consciousness level by the Glasgow Coma Scale. All the patients had no history of fever, respiratory complications, anosmia or ageusia, meningitis, and negative cerebrospinal fluid analysis for SARS-CoV-2. Our first patient had no psychiatric history, the second reported only a depressive episode, and the third had a history of bipolar disorder dated back to 40 years before. In the first patient, delirium resolved 2 days following the admission. The other two patients recovered in 4 and 14 days, and delirium appeared as the prodrome of a new psychiatric episode resembling past events. Clinicians should monitor the possibility that SARS-CoV-2 presence in the brain might clinically manifest in the form of delirium and acute psychiatric sequelae, even without other systemic symptoms. Psychiatric history and preexisting mild cognitive impairment are to be considered as predisposing factors for COVID-19 sequelae in delirium patients.
Collapse
Affiliation(s)
- Michele Fabrazzo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Russo
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessio Camerlengo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pierluigi Catapano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bianca Amoroso
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Catapano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Coppola
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
162
|
Alrashidi F, Alaroush N. Post SARS-CoV-2 infection and hair loss. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2022. [DOI: 10.4103/jdds.jdds_16_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
163
|
Futagami H, Sato H, Yoshida R, Yasui K, Yagi T, Fujiwara T. Acute acalculous cholecystitis caused by SARS-CoV-2 infection: A case report and literature review. Int J Surg Case Rep 2022; 90:106731. [PMID: 34976597 PMCID: PMC8714611 DOI: 10.1016/j.ijscr.2021.106731] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 12/07/2022] Open
Abstract
Background Emerging data indicate that gastrointestinal disorders, in addition to pulmonary dysfunction, are also hallmarks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Case presentation A 42-year-old man with maintenance hemodialysis developed high fever and dyspnea. He was positive for SARS-CoV-2 and was diagnosed with pneumonia. After treatment for SARS-CoV-2, his respiratory condition improved. However, he developed right upper quadrant pain with elevated inflammatory markers (white blood cells, 21,160/μL; c-reactive protein, 163.9 mg/L) on the 13th day. Abdominal computed tomography revealed acute acalculous cholecystitis. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed together with antibiotic therapy, which resulted in improvement of symptoms. Laparoscopic cholecystectomy was performed 36 days after PTGBD. Conclusion We report a rare case of acute acalculous cholecystitis (AAC) following pneumonia caused by SARS-CoV-2 infection. We also conducted a literature search to characterize SARS-CoV-2-related cholecystitis. Infection with SARS-CoV-2 is an important trigger for AAC, and appropriate therapeutic alternatives should be cautiously selected according to individual cases. We experienced a case of acute acalculous cholecystitis (AAC) following COVID-19. We conducted a literature review to explore clinical features of COVID19 related AAC. SARS-CoV-2 infection should be considered as an important trigger for AAC.
Collapse
|
164
|
Pervichko E, Mitina O, Koniukhovskaia J, Stepanova O. Verification of the Psychometric Characteristics of the Nijmegen Questionnaire for the Diagnosis of Dysfunctional Breathing During the COVID-19 Pandemic on a Russian Sample. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The purpose of the study was to check the psychometric properties of the Nijmegen questionnaire (NQ) (Van Dixhoorn, Duivenvoorden, 1985), aimed at diagnosing the presence of signs of dysfunctional breathing (DВ) according to self–reports of respondents in the conditions of the COVID-19 pandemic in a Russian-speaking sample. The study sample consisted of 1 362 respondents (1 153 women and 209 men) aged 18 to 88 years (mean age 38.3±11.4) who filled out an online questionnaire from April to December 2020 during the COVID-19 pandemic. The following methods were used to test the construct validity of the Russian version of the NQ: 1) Perceived Stress Scale-10 (PSS-10; Ababkov et al., 2016); 2) State-Trait Anxiety Inventory (STAI, Khanin, 1976), the scales of which were modified to measure the level of anxiety during a pandemic (State anxiety) and before the pandemic (Trait anxiety) (Pervichko et al., 2020); 3) The Symptom Check List-32 (SCL-32) (Mitina, Gorbunova, 2011); (4) An abridged version of the Six-Factor Personality Inventory HEXACO-24 (Egorova et al, 2019). The study participants also completed a socio-demographic questionnaire (Pervichko et al., 2020). The results of checking the Russian-language version of the NQ for reliability are presented: the value of the internal consistency coefficient α-Cronbach for the integral indicator = 0.877. Four subscales were identified, the indicators of which improved when the questionnaire was reduced to 10 points. Internal convergent and discriminant validity has been verified for the abridged version. The external constructive validity of the questionnaire is proved. High rates of correlation with stress, situational and personal anxiety, as well as other symptoms of psychological distress were revealed. In addition, a high correlation with emotionality has been established. The problem of the "threshold" value of NQ required to identify the formed symptom complex of DB is discussed. The prevalence of DB symptoms before and during the pandemic was compared. A significant difference in the indicators on the scale for men and women was established. Using the obtained Russian-language version of NQ, it was shown that in the conditions of the COVID-19 pandemic, 27.7% of the study participants who were not sick with COVID-19 showed signs of a formed DB symptom complex, which is more than twice higher than the population indicators in the pre-pandemic period. The frequency of occurrence of the holistic symptom complex of DB in women is three times higher than in men: 31.0% vs 9.1% (p<0.001). The results of the study allow us to conclude that NQ is a reliable and valid tool for diagnosing the severity of DB symptoms, which can be recommended for use as an express diagnostic tool for the presence of psychogenically caused respiratory disorders in persons complaining of "difficulty breathing" in the absence of objective grounds.
Collapse
|
165
|
Jafari-Oori M, Dehi M, Ebadi A, Moradian ST, jafari M. Incidence of cardiac complications following COVID-19 infection: An umbrella meta-analysis study. Heart Lung 2022; 52:136-145. [PMID: 35074740 PMCID: PMC8743575 DOI: 10.1016/j.hrtlng.2022.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 01/08/2023]
Abstract
Background COVID-19 causes fatal cardiac damages. Despite many overwhelming meta-analysis related to cardiac complications following COVID-19 disease, no umbrella meta-analysis study has been conducted. Objectives We aimed to report the summarized pooled incidences of cardiac complications in the overall, critically ill, and deceased patients, compare the cardiac complications between the severe/non-severe or deceased/non-deceased patients, and also compare poor outcomes between patients with/without acute myocardial injury (AMI). Methods PubMed, Scopus, web of science, Cochrane, ProQuest, Springer, Sage journals were searched before April 2021. After assessing the quality and duplicate data, data were run by the random/fixed-effect models, I2 heterogeneity index, Egger's test, and sensitivity analysis. Results After removing duplicate data, in the overall COVID-19 patients, the pooled incidence of AMI, heart failure, arrhythmia, cardiac arrest, and acute coronary syndrome (ACS) were 21%, 14%, 16%, 3.46%, and 1.3%, respectively. In the patients with severe disease, the pooled incidence of AMI and shock were 33 and 35%, respectively. Similarly, in the deceased COVID-19 patients, the pooled incidence rate of AMI and arrhythmia were 56% and 47.5%, respectively. The patients with severe disease were at higher risk of AMI (RR = 5.27) and shock (OR = 20.18) compared with the non-severe cases. Incidence of AMI was associated with transfer to the intensive care units (ICU) (RR = 2.92) and mortality (RR = 2.57, OR = 8.36), significantly. Conclusion Cardiac complications were found to be increased alarmingly in COVID-19 patients. Baseline and during hospitalization checking with electrocardiography, echocardiography, and measuring of cardiac biomarkers should be applied.
Collapse
|
166
|
Ji Z, Hu H, Qiang X, Lin S, Pang B, Cao L, Zhang L, Liu S, Chen Z, Zheng W, Liu C, Wang H, Zhang J. Traditional Chinese Medicine for COVID-19: A Network Meta-Analysis and Systematic Review. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 50:883-925. [PMID: 35729086 DOI: 10.1142/s0192415x22500379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To compare the efficacy of different traditional Chinese medicine (TCM) therapies for the treatment of coronavirus disease 2019 (COVID-19) and provide a higher level of evidence in the form of network meta-analysis (NMA) and systematic review. We searched the studies from the following databases: CNKI, VIP, WanFang, SinoMed, PubMed, Embase, and Web of Science from the establishment of the respective database until December 2021. Relevant studies were screened according to the pre-established inclusion criteria. The quality of the included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were assessed using the risk of bias (ROB) tool and the Methodological Index for Non-Randomized Studies (MINORS), respectively. R software 4.1.1 and Stata 13.1 were used for data analysis and mapping. A total of 34 studies were included in this network meta-analysis that tested 24 TCM interventions and included 3443 patients. Using cluster analysis of time to negative SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR), the length of hospital stay and composite events, we found that Jinyinhua oral liquid (JYH, 120 mL) + conventional Western medicine (CWM) has the highest SUCRA value at 88.64%, 85.61% and 84.24%. The traditional meta-analysis results revealed that Qingfei Paidu decoction + CWM were significantly different compared with CWM alone for the score of clinical symptoms (MD =-0.75, 95% CI [-1.04, -0.47]). Nine studies reported 57 adverse reactions (ADRs) and 3 adverse events (ADEs) in TCM + CWM groups, and eight studies reported 33 ADRs and 8 ADEs in CWM groups. In conclusion, the combination of TCM and CWM approaches may enhance the efficacy of CWM in COVID-19 patients. Based on the NMA result, JYH (120 mL) + CWM may be a more effective treatment and deserves further investigation. However, the differences in many comparisons between TCM interventions did not reach statistical significance; therefore, further high-quality studies are required to validate these findings.
Collapse
Affiliation(s)
- Zhaochen Ji
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Haiyin Hu
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Xiaoyu Qiang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Shanshan Lin
- The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300073, P. R. China
| | - Bo Pang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Lujia Cao
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Li Zhang
- The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300150, P. R. China
| | - Shigang Liu
- Department of Respiratory Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Zhe Chen
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Wenke Zheng
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Chunxiang Liu
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Hui Wang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China
| |
Collapse
|
167
|
Vizcardo D, Salvador LF, Nole-Vara A, Dávila KP, Alvarez-Risco A, Yáñez JA, Mejia CR. Sociodemographic Predictors Associated with the Willingness to Get Vaccinated against COVID-19 in Peru: A Cross-Sectional Survey. Vaccines (Basel) 2021; 10:48. [PMID: 35062709 PMCID: PMC8780036 DOI: 10.3390/vaccines10010048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/17/2022] Open
Abstract
During the race for the development of a vaccine against COVID-19, even before its commercialization, part of the population has already shown a growing fear of its application. We designed an analytical cross-sectional study using an anonymous survey in the 25 departments of Peru. We surveyed whether the participants were planning on getting vaccinated, as well as other characteristics that were cross-checked in a uni-, bi- and multivariate manner. Of the 1776 respondents, 70% (1251) stated that they were planning to be vaccinated, 20% (346) did not know yet or doubted it, and 10% (179) did not want to be vaccinated. We observed that those who did not get infected with COVID-19 exhibited a higher frequency to not wanting or were uncertain about getting vaccinated (aPR: 1.40; 95% CI: 1.09-1.81; p-value = 0.008). In contrast, there was a lower frequency of vaccine refusal among university students (aPR: 0.75; 95% CI: 0.61-0.92; p-value = 0.005) and healthcare workers (aPR: 0.59; 95% CI: 0.44-0.80; p-value = 0.001); adjusted by place of residence. There is still an important percentage of respondents who do not want to be vaccinated or are hesitant to do it, which was associated with educational level, being a healthcare worker and if they were previously infected with COVID-19. Our results could offer useful information about COVID-19 vaccination campaigns.
Collapse
Affiliation(s)
- David Vizcardo
- Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru; (D.V.); (L.F.S.); (A.N.-V.); (K.P.D.)
| | - Linder Figueroa Salvador
- Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru; (D.V.); (L.F.S.); (A.N.-V.); (K.P.D.)
| | - Arian Nole-Vara
- Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru; (D.V.); (L.F.S.); (A.N.-V.); (K.P.D.)
| | - Karen Pizarro Dávila
- Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru; (D.V.); (L.F.S.); (A.N.-V.); (K.P.D.)
| | - Aldo Alvarez-Risco
- Facultad de Ciencias Empresariales y Económicas, Carrera de Negocios Internacionales, Universidad de Lima, Lima 15023, Peru;
| | - Jaime A. Yáñez
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima 15072, Peru
- Gerencia Corporativa de Asuntos Científicos y Regulatorios, Teoma Global, Lima 15073, Peru
| | - Christian R. Mejia
- Translational Medicine Research Centre, Universidad Norbert Wiener, Lima 15073, Peru;
| |
Collapse
|
168
|
Zodpey SP, Negandhi H, Kamal VK, Bhatnagar T, Ganeshkumar P, Athavale A, Kadri A, Patel A, Bhagyalaxmi A, Khismatrao D, Theranirajan E, Banumathi G, Singh K, Parameshwari P, Kshirsagar P, Saxena R, Deshpande SG, Satyanand K, Hadke S, Dube S, Subramaniam S, Madan S, Kadam S, Anand T, Jeyashree K, Ponnaiah M, Rana M, Murhekar MV, Reddy DCS. Determinants of severity among hospitalised COVID-19 patients: Hospital-based case-control study, India, 2020. PLoS One 2021; 16:e0261529. [PMID: 34965276 PMCID: PMC8716035 DOI: 10.1371/journal.pone.0261529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 12/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background Risk factors for the development of severe COVID-19 disease and death have been widely reported across several studies. Knowledge about the determinants of severe disease and mortality in the Indian context can guide early clinical management. Methods We conducted a hospital-based case control study across nine sites in India to identify the determinants of severe and critical COVID-19 disease. Findings We identified age above 60 years, duration before admission >5 days, chronic kidney disease, leucocytosis, prothrombin time > 14 sec, serum ferritin >250 ng/mL, d-dimer >0.5 ng/mL, pro-calcitonin >0.15 μg/L, fibrin degradation products >5 μg/mL, C-reactive protein >5 mg/L, lactate dehydrogenase >150 U/L, interleukin-6 >25 pg/mL, NLR ≥3, and deranged liver function, renal function and serum electrolytes as significant factors associated with severe COVID-19 disease. Interpretation We have identified a set of parameters that can help in characterising severe COVID-19 cases in India. These parameters are part of routinely available investigations within Indian hospital settings, both public and private. Study findings have the potential to inform clinical management protocols and identify patients at high risk of severe outcomes at an early stage.
Collapse
Affiliation(s)
| | | | | | - Tarun Bhatnagar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Arvind Athavale
- Chirayu Medical College & Hospital, Bhopal, Madhya Pradesh, India
| | - Amiruddin Kadri
- B.J. Medical College, New Civil Hospital, Ahmedabad, Gujarat, India
| | - Amit Patel
- Care Institute of Medical Sciences, Ahmedabad, Gujarat, India
| | - A. Bhagyalaxmi
- B.J. Medical College, New Civil Hospital, Ahmedabad, Gujarat, India
| | | | - E. Theranirajan
- Institute of Community Medicine, Madras Medical College, Chennai, Tamil Nadu, India
| | | | - Krishna Singh
- Chirayu Medical College & Hospital, Bhopal, Madhya Pradesh, India
| | - P. Parameshwari
- Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India
| | - Prasita Kshirsagar
- Rajiv Gandhi Medical College, Chhatrapati Shivaji Maharaj Hospital, Maharashtra, Thane, India
| | - Rita Saxena
- Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Sanjay G. Deshpande
- Datta Meghe Medical College, Meghe Hospital and Research Centre, Nagpur, Maharashtra, India
| | | | - Saurabh Hadke
- Datta Meghe Medical College, Meghe Hospital and Research Centre, Nagpur, Maharashtra, India
| | - Simmi Dube
- Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | | | - Surabhi Madan
- Care Institute of Medical Sciences, Ahmedabad, Gujarat, India
| | - Swapnali Kadam
- Rajiv Gandhi Medical College, Chhatrapati Shivaji Maharaj Hospital, Maharashtra, Thane, India
| | - Tanu Anand
- Indian Council of Medical Research (ICMR), New Delhi, India
| | | | | | - Manish Rana
- GMERS Medical college, Ahmedabad, Gujarat, India
| | - Manoj V. Murhekar
- ICMR National Institute of Epidemiology, Chennai, Tamil Nadu, India
- * E-mail:
| | - DCS Reddy
- Independent consultant, Lucknow, Uttar Pradesh, India
| |
Collapse
|
169
|
García-Bernalt Diego J, Fernández-Soto P, Muñoz-Bellido JL, Febrer-Sendra B, Crego-Vicente B, Carbonell C, López-Bernús A, Marcos M, Belhassen-García M, Muro A. Detection of SARS-CoV-2 RNA in Urine by RT-LAMP: A Very Rare Finding. J Clin Med 2021; 11:158. [PMID: 35011899 PMCID: PMC8745354 DOI: 10.3390/jcm11010158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/27/2021] [Indexed: 01/08/2023] Open
Abstract
Detection of SARS-CoV-2 is routinely performed in naso/oropharyngeal swabs samples from patients via RT-qPCR. The RT-LAMP technology has also been used for viral RNA detection in respiratory specimens with both high sensitivity and specificity. Recently, we developed a novel RT-LAMP test for SARS-CoV-2 RNA detection in nasopharyngeal swab specimens (named, N15-RT-LAMP) that can be performed as a single-tube colorimetric method, in a real-time platform, and as dry-LAMP. To date, there has been very little success in detecting SARS-CoV-2 RNA in urine by RT-qPCR, and the information regarding urine viral excretion is still scarce and not comprehensive. Here, we tested our N15-RT-LAMP on the urine of 300 patients admitted to the Hospital of Salamanca, Spain with clinical suspicion of COVID-19, who had a nasopharyngeal swab RT-qPCR-positive (n = 100), negative (n = 100), and positive with disease recovery (n = 100) result. The positive group was also tested by RT-qPCR for comparison to N15-RT-LAMP. Only a 4% positivity rate was found in the positive group via colorimetric N15-RT-LAMP and 2% via RT-qPCR. Our results are consistent with those obtained in other studies that the presence of SARS-CoV-2 RNA in urine is a very rare finding. The absence of SARS-CoV-2 RNA in urine in the recovered patients might suggest that the urinary route is very rarely used for viral particle clearance.
Collapse
Affiliation(s)
- Juan García-Bernalt Diego
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
| | - Juan Luis Muñoz-Bellido
- Microbiology and Parasitology Service, Complejo Asistencial Universitario de Salamanca (CAUSA), University of Salamanca, 37007 Salamanca, Spain;
| | - Begoña Febrer-Sendra
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
| | - Beatriz Crego-Vicente
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
| | - Cristina Carbonell
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
- Internal Medicine Service, Unidad de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), University of Salamanca, 37007 Salamanca, Spain;
| | - Amparo López-Bernús
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
- Internal Medicine Service, Unidad de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), University of Salamanca, 37007 Salamanca, Spain;
| | - Miguel Marcos
- Internal Medicine Service, Unidad de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), University of Salamanca, 37007 Salamanca, Spain;
| | - Moncef Belhassen-García
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
- Internal Medicine Service, Unidad de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), University of Salamanca, 37007 Salamanca, Spain;
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Biomedical Research Institute of Salamanca, Faculty of Pharmacy, University of Salamanca, 37007 Salamanca, Spain; (J.G.-B.D.); (B.F.-S.); (B.C.-V.); (C.C.); (A.L.-B.); (M.B.-G.)
| |
Collapse
|
170
|
Przekop D, Gruszewska E, Chrostek L. Liver function in COVID-19 infection. World J Hepatol 2021; 13:1909-1918. [PMID: 35069997 PMCID: PMC8727219 DOI: 10.4254/wjh.v13.i12.1909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/07/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) disease affects multiple organs, including anomalies in liver function. In this review we summarize the knowledge about liver injury found during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with special attention paid to possible mechanisms of liver damage and abnormalities in liver function tests allowing for the evaluation of the severity of liver disease. Abnormalities in liver function observed in COVID-19 disease are associated with the age and sex of patients, severity of liver injury, presence of comorbidity and pre-treatment. The method of antiviral treatment can also impact on liver function, which manifests as increasing values in liver function tests. Therefore, analysis of variations in liver function tests is necessary in evaluating the progression of liver injury to severe disease.
Collapse
Affiliation(s)
- Dagmara Przekop
- Diagnostics-Experimental Center of Sexually Transmissible Diseases, Bialystok 15-879, Poland
| | - Ewa Gruszewska
- Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok 15-269, Poland
| | - Lech Chrostek
- Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok 15-269, Poland
| |
Collapse
|
171
|
Odilov A, Volkov A, Abdullaev A, Gasanova T, Lipina T, Babichenko I. COVID-19: Multiorgan Dissemination of SARS-CoV-2 Is Driven by Pulmonary Factors. Viruses 2021; 14:v14010039. [PMID: 35062243 PMCID: PMC8777766 DOI: 10.3390/v14010039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/12/2021] [Accepted: 12/22/2021] [Indexed: 02/07/2023] Open
Abstract
Multi-organ failure is one of the common causes of fatal outcome in COVID-19 patients. However, the pathogenetic association of the SARS-CoV-2 viral load (VL) level with fatal dysfunctions of the lungs, liver, kidneys, heart, spleen and brain, as well as with the risk of death in COVID-19 patients remains poorly understood. SARS-CoV-2 VL in the lungs, heart, liver, kidneys, brain, spleen and lymph nodes have been measured by RT qPCR using the following formula: NSARS-CoV-2/NABL1 × 100. Dissemination of SARS-CoV-2 in 30.5% of cases was mono-organ, and in 63.9% of cases, it was multi-organ. The average SARS-CoV-2 VL in the exudative phase of diffuse alveolar damage (DAD) was 60 times higher than in the proliferative phase. The SARS-CoV-2 VL in the lungs ranged from 0 to 250,281 copies. The "pulmonary factors" of SARS-CoV-2 multi-organ dissemination are the high level of SARS-CoV-2 VL (≥4909) and the exudative phase of DAD. The frequency of SARS-CoV-2 dissemination to lymph nodes was 86.9%, heart-56.5%, spleen-52.2%, liver-47.8%, kidney-26%, and brain-13%. We found no link between the SARS-CoV-2 VL level in the liver, kidneys, and heart and the serum level of CPK, LDH, ALP, ALT, AST and Cr of COVID-19 patients. Isolated detection of SARS-CoV-2 RNA in the myocardium of COVID-19 patients who died from heart failure is possible. The pathogenesis of COVID-19-associated multi-organ failure requires further research in a larger cohort of patients.
Collapse
Affiliation(s)
- Akmaljon Odilov
- Department of Pathological Anatomy, Peoples′ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia; (A.V.); (I.B.)
- Correspondence:
| | - Alexey Volkov
- Department of Pathological Anatomy, Peoples′ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia; (A.V.); (I.B.)
- Department of Pathological Anatomy, Municipal Clinical Hospital Named after E.O. Mukhin, Moscow 111399, Russia
| | - Adhamjon Abdullaev
- Laboratory of Molecular Hematology, National Research Center for Hematology, Novy Zykovski lane 4a, Moscow 125167, Russia;
| | - Tatiana Gasanova
- Department of Virology, Lomonosov Moscow State University, Leninskie gori, 1, 40, Moscow 119234, Russia;
| | - Tatiana Lipina
- Department of Cell Biology and Histology, Faculty of Biology, Lomonosov Moscow State University, Leninskie gori, 1, 12, Moscow 119234, Russia;
| | - Igor Babichenko
- Department of Pathological Anatomy, Peoples′ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia; (A.V.); (I.B.)
| |
Collapse
|
172
|
Khaloo P, Shaqdan A, Ledesma PA, Uzomah UA, Jennifer Galvin, Ptaszek LM, Ruskin JN. Distinct etiologies of high-sensitivity troponin T elevation predict different mortality risks for patients hospitalized with COVID-19. Int J Cardiol 2021; 351:118-125. [PMID: 34952038 PMCID: PMC8690225 DOI: 10.1016/j.ijcard.2021.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/24/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022]
Abstract
Background Cardiovascular events in the context of COVID-19 infection increase the risk of negative patient outcomes, but large cohort studies describing this association are limited. The purpose of the current study was to investigate the potential associations between cardiovascular events and mortality in patients hospitalized due to COVID-19. Methods A retrospective chart review was performed in 2450 patients hospitalized for confirmed COVID-19 infection within a single hospital network between March 15 and June 15, 2020. Logistic regression analysis was used to identify predictors of mortality. Results In the study population, 57% of patients had elevated high sensitivity troponin (hs-TnT) levels. Acute heart failure occurred in 23% of patients and arrhythmias were observed in 8% of patients. Of the 1401 patients with elevated hs-TnT levels, a primary cardiac etiology (e.g., myocardial infarction) was identified in 653 (47%) patients. In the remaining 748 (53%) patients, there was evidence of a primary non-cardiac etiology for hs-TnT elevation such as renal failure (n = 304) and critical illness (n = 286). Elevated hs-TnT was associated with increased risk of mortality. A significantly higher mortality rate was observed for hs-TnT elevation associated with a primary cardiac etiology (OR 4.6, 95% CI: 2.7–7.6; P < 0.001) than a primary non-cardiac etiology (OR 2.7, 95% CI: 1.6–4.5; P < 0.001). Conclusions Elevated hs-TnT in the context of COVID-19 infection is associated with a significantly increased mortality risk. Hs-TnT elevation in the context of a primary cardiac etiology confers a nearly 2-fold higher mortality risk than hs-TnT elevation due to a primary non-cardiac etiology.
Collapse
Affiliation(s)
- Pegah Khaloo
- Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Ayman Shaqdan
- Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Pablo A Ledesma
- Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Uwajachukwumma A Uzomah
- Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Jennifer Galvin
- Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Leon M Ptaszek
- Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Jeremy N Ruskin
- Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States of America.
| |
Collapse
|
173
|
Williams TL, Strachan G, Macrae RGC, Kuc RE, Nyimanu D, Paterson AL, Sinha S, Maguire JJ, Davenport AP. Differential expression in humans of the viral entry receptor ACE2 compared with the short deltaACE2 isoform lacking SARS-CoV-2 binding sites. Sci Rep 2021; 11:24336. [PMID: 34934117 PMCID: PMC8692523 DOI: 10.1038/s41598-021-03731-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/02/2021] [Indexed: 12/13/2022] Open
Abstract
ACE2 is a membrane protein that regulates the cardiovascular system. Additionally, ACE2 acts as a receptor for host cell infection by human coronaviruses, including SARS-CoV-2 that emerged as the cause of the on-going COVID-19 pandemic and has brought unprecedented burden to economy and health. ACE2 binds the spike protein of SARS-CoV-2 with high affinity and shows little variation in amino acid sequence meaning natural resistance is rare. The discovery of a novel short ACE2 isoform (deltaACE2) provides evidence for inter-individual differences in SARS-CoV-2 susceptibility and severity, and likelihood of developing subsequent 'Long COVID'. Critically, deltaACE2 loses SARS-CoV-2 spike protein binding sites in the extracellular domain, and is predicted to confer reduced susceptibility to viral infection. We aimed to assess the differential expression of full-length ACE2 versus deltaACE2 in a panel of human tissues (kidney, heart, lung, and liver) that are implicated in COVID-19, and confirm ACE2 protein in these tissues. Using dual antibody staining, we show that deltaACE2 localises, and is enriched, in lung airway epithelia and bile duct epithelia in the liver. Finally, we also confirm that a fluorescently tagged SARS-CoV-2 spike protein monomer shows low binding at lung and bile duct epithelia where dACE2 is enriched.
Collapse
Affiliation(s)
- Thomas L Williams
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Level 6, Addenbrooke's Centre for Clinical Investigation, Addenbrooke's Hospital, Box 110, Cambridge, CB2 0QQ, UK
| | - Gregory Strachan
- Wellcome Trust-MRC Institute of Metabolic Science, Metabolic Research Laboratories, Addenbrooke's Biomedical Campus, Cambridge, UK
| | - Robyn G C Macrae
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Level 6, Addenbrooke's Centre for Clinical Investigation, Addenbrooke's Hospital, Box 110, Cambridge, CB2 0QQ, UK
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Rhoda E Kuc
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Level 6, Addenbrooke's Centre for Clinical Investigation, Addenbrooke's Hospital, Box 110, Cambridge, CB2 0QQ, UK
| | - Duuamene Nyimanu
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Level 6, Addenbrooke's Centre for Clinical Investigation, Addenbrooke's Hospital, Box 110, Cambridge, CB2 0QQ, UK
| | - Anna L Paterson
- Department of Pathology, Royal Papworth Hospital NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sanjay Sinha
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Janet J Maguire
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Level 6, Addenbrooke's Centre for Clinical Investigation, Addenbrooke's Hospital, Box 110, Cambridge, CB2 0QQ, UK
| | - Anthony P Davenport
- Experimental Medicine and Immunotherapeutics, University of Cambridge, Level 6, Addenbrooke's Centre for Clinical Investigation, Addenbrooke's Hospital, Box 110, Cambridge, CB2 0QQ, UK.
| |
Collapse
|
174
|
Cekic S, Karali Z, Cicek F, Canitez Y, Sapan N. The Impact of the COVID-19 Pandemic in Adolescents with Asthma. J Korean Med Sci 2021; 36:e339. [PMID: 34931499 PMCID: PMC8688346 DOI: 10.3346/jkms.2021.36.e339] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 11/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is affecting people at any age and there is limited information about the effect of the COVID-19 pandemic on quality of life (QoL) in adolescents with asthma. In the present study, it was aimed to assess the attitudes of adolescents with asthma toward the COVID-19 pandemic and determine the effects of the pandemic on their QoL. METHODS In total, 125 adolescents with asthma and 98 healthy adolescents participated in the present study. The questionnaire form consisted of three parts. In the first part, all the participants were asked whether they complied with the protective measures against COVID-19. The second part included questions for measuring the participants' level of concern about COVID-19, while the third part consisted of EUROHIS-QOL 8. RESULTS The patient and control groups were similar in terms of the female/male ratio (55/70 and 48/50, respectively) and mean participant age (14.6 ± 2 and 15.1 ± 1.65 years, respectively) (P = 0.459 and P = 0.062, respectively). The prevalence of COVID-19 in the patients (n = 2, 1.6%) was lower than that in the controls (n = 6, 6.1%); however, the difference was not statistically significant (P = 0.142). The total EUROHIS-QOL score was significantly lower in the patients (31.2 ± 6.7) than in the controls (33.7 ± 4.4) (P < 0.001). The total QoL scores of asthmatic adolescents without other allergic disease (31.4 ± 6.7) was also lower than those of the controls (33.7 ± 4.4) (P = 0.009). Treatment disruption was significantly more common in patients who received subcutaneous immunotherapy (n = 20, 48.8%) than in those who did not (n = 8, 9.5%) (P < 0.001). Moreover, the patients had lower EUROHIS-QOL scores in the overall QoL, general health, finance, and home domains. CONCLUSION Our results indicate that the mean QoL score of asthmatic adolescents during COVID-19 pandemic is lower than in the healthy population. Disruption in their treatment was most common in patients with asthma who were receiving subcutaneous immunotherapy.
Collapse
Affiliation(s)
- Sukru Cekic
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Zuhal Karali
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Fatih Cicek
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Yakup Canitez
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Nihat Sapan
- Division of Pediatric Allergy, Uludag University Faculty of Medicine, Bursa, Turkey.
| |
Collapse
|
175
|
Pan T, Chen R, He X, Yuan Y, Deng X, Li R, Yan H, Yan S, Liu J, Zhang Y, Zhang X, Yu F, Zhou M, Ke C, Ma X, Zhang H. Infection of wild-type mice by SARS-CoV-2 B.1.351 variant indicates a possible novel cross-species transmission route. Signal Transduct Target Ther 2021; 6:420. [PMID: 34907154 PMCID: PMC8669038 DOI: 10.1038/s41392-021-00848-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/15/2021] [Accepted: 12/01/2021] [Indexed: 12/18/2022] Open
Abstract
COVID-19 is identified as a zoonotic disease caused by SARS-CoV-2, which also can cross-transmit to many animals but not mice. Genetic modifications of SARS-CoV-2 or mice enable the mice susceptible to viral infection. Although neither is the natural situation, they are currently utilized to establish mouse infection models. Here we report a direct contact transmission of SARS-CoV-2 variant B.1.351 in wild-type mice. The SARS-CoV-2 (B.1.351) replicated efficiently and induced significant pathological changes in lungs and tracheas, accompanied by elevated proinflammatory cytokines in the lungs and sera. Mechanistically, the receptor-binding domain (RBD) of SARS-CoV-2 (B.1.351) spike protein turned to a high binding affinity to mouse angiotensin-converting enzyme 2 (mACE2), allowing the mice highly susceptible to SARS-CoV-2 (B.1.351) infection. Our work suggests that SARS-CoV-2 (B.1.351) expands the host range and therefore increases its transmission route without adapted mutation. As the wild house mice live with human populations quite closely, this possible transmission route could be potentially risky. In addition, because SARS-CoV-2 (B.1.351) is one of the major epidemic strains and the mACE2 in laboratory-used mice is naturally expressed and regulated, the SARS-CoV-2 (B.1.351)/mice could be a much convenient animal model system to study COVID-19 pathogenesis and evaluate antiviral inhibitors and vaccines.
Collapse
Affiliation(s)
- Ting Pan
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China.,Center for Infection and Immunity Study, School of Medicine, Shenzhen Campus of Sun Yat-sen University, 518107, Shenzhen, Guangdong, China
| | - Ran Chen
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Xin He
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Yaochang Yuan
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Xiaohui Deng
- Center for Infection and Immunity Study, School of Medicine, Shenzhen Campus of Sun Yat-sen University, 518107, Shenzhen, Guangdong, China
| | - Rong Li
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Haiping Yan
- Department of Gastroenterology, The Eighth Affiliated Hospital, Sun Yat-sen University, 518033, Shenzhen, Guangdong, China
| | - Shumei Yan
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 510060, Guangzhou, Guangdong, China
| | - Jun Liu
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Yiwen Zhang
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Xiantao Zhang
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Fei Yu
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, China
| | - Mo Zhou
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China
| | - Changwen Ke
- Guangdong Provincial Center for Disease Control and Prevention, 511430, Guangzhou, Guangdong, China
| | - Xiancai Ma
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China. .,Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, China. .,National Guangzhou Laboratory, Bio-Island, 510320, Guangzhou, Guangdong, China.
| | - Hui Zhang
- Institute of Human Virology, Key Laboratory of Tropical Disease Control of Ministry Education, Guangdong Engineering Research Center for Antimicrobial Agent and Immunotechnology, Zhongshan School of Medicine, Sun Yat-sen University, 510080, Guangzhou, Guangdong, China. .,National Guangzhou Laboratory, Bio-Island, 510320, Guangzhou, Guangdong, China.
| |
Collapse
|
176
|
Potential long-term effects of SARS-CoV-2 infection on the pulmonary vasculature: a global perspective. Nat Rev Cardiol 2021; 19:314-331. [PMID: 34873286 PMCID: PMC8647069 DOI: 10.1038/s41569-021-00640-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 12/13/2022]
Abstract
The lungs are the primary target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with severe hypoxia being the cause of death in the most critical cases. Coronavirus disease 2019 (COVID-19) is extremely heterogeneous in terms of severity, clinical phenotype and, importantly, global distribution. Although the majority of affected patients recover from the acute infection, many continue to suffer from late sequelae affecting various organs, including the lungs. The role of the pulmonary vascular system during the acute and chronic stages of COVID-19 has not been adequately studied. A thorough understanding of the origins and dynamic behaviour of the SARS-CoV-2 virus and the potential causes of heterogeneity in COVID-19 is essential for anticipating and treating the disease, in both the acute and the chronic stages, including the development of chronic pulmonary hypertension. Both COVID-19 and chronic pulmonary hypertension have assumed global dimensions, with potential complex interactions. In this Review, we present an update on the origins and behaviour of the SARS-CoV-2 virus and discuss the potential causes of the heterogeneity of COVID-19. In addition, we summarize the pathobiology of COVID-19, with an emphasis on the role of the pulmonary vasculature, both in the acute stage and in terms of the potential for developing chronic pulmonary hypertension. We hope that the information presented in this Review will help in the development of strategies for the prevention and treatment of the continuing COVID-19 pandemic. In this Review, the authors discuss the potential causes of the heterogeneity of COVID-19 and summarize the pathobiology of the disease, with an emphasis on the role of the pulmonary vasculature in the acute stage and the potential for developing chronic pulmonary hypertension. A thorough understanding of the dynamic behaviour of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential to understanding its heterogeneous effects on the pulmonary vasculature in patients with coronavirus disease 2019 (COVID-19). The severity and clinical phenotype of COVID-19 are influenced by host factors, including socioeconomic factors and genetics. Silent hypoxia is a major and independent cause of lung damage in COVID-19; the use of modern imaging techniques is proving to be very valuable in identifying silent hypoxia. The pulmonary vascular system has a major role in the pathobiology of COVID-19. Both COVID-19 and chronic pulmonary hypertension are global diseases with a complex interaction.
Collapse
|
177
|
The Effects of Vitamin C on the Multiple Pathophysiological Stages of COVID-19. Life (Basel) 2021; 11:life11121341. [PMID: 34947872 PMCID: PMC8708699 DOI: 10.3390/life11121341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 12/22/2022] Open
Abstract
Currently available anti-viral drugs may be useful in reducing the viral load but are not providing the necessary physiological effects to reduce the SARS-CoV-2 complications efficiently. Treatments that provide better clinical outcomes are urgently needed. Vitamin C (ascorbic acid, AA) is an essential nutrient with many biological roles that have been proven to play an important part in immune function; it serves as an antioxidant, an anti-viral, and exerts anti-thrombotic effects among many other physiological benefits. Research has proven that AA at pharmacological doses can be beneficial to patients with acute respiratory distress syndrome (ARDS) and other respiratory illnesses, including sepsis. In addition, High-Dose Intravenous Vitamin C (HDIVC) has proven to be effective in patients with different viral diseases, such as influenza, chikungunya, Zika, and dengue. Moreover, HDIVC has been demonstrated to be very safe. Regarding COVID-19, vitamin C can suppress the cytokine storm, reduce thrombotic complications, and diminish alveolar and vascular damage, among other benefits. Due to these reasons, the use of HDIVC should be seriously considered in complicated COVID-19 patients. In this article, we will emphasize vitamin C’s multiple roles in the most prominent pathophysiological processes presented by the COVID-19 disease.
Collapse
|
178
|
Nebulization of glutathione and N-Acetylcysteine as an adjuvant therapy for COVID-19 onset. ADVANCES IN REDOX RESEARCH : AN OFFICIAL JOURNAL OF THE SOCIETY FOR REDOX BIOLOGY AND MEDICINE AND THE SOCIETY FOR FREE RADICAL RESEARCH-EUROPE 2021; 3:100015. [PMID: 35425932 PMCID: PMC8349474 DOI: 10.1016/j.arres.2021.100015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022]
Abstract
Ever since its emergence, the highly transmissible and debilitating coronavirus disease spread at an incredibly fast rate, causing global devastation in a matter of months. SARS-CoV-2, the novel coronavirus responsible for COVID-19, infects hosts after binding to ACE2 receptors present on cells from many structures pertaining to the respiratory, cardiac, hematological, neurological, renal and gastrointestinal systems. COVID-19, however, appears to trigger a severe cytokine storm syndrome in pulmonary structures, resulting in oxidative stress, exacerbated inflammation and alveolar injury. Due to the recent nature of this disease no treatments have shown complete efficacy and safety. More recently, however, researchers have begun to direct some attention towards GSH and NAC. These natural antioxidants play an essential role in several biological processes in the body, especially the maintenance of the redox equilibrium. In fact, many diseases appear to be strongly related to severe oxidative stress and deficiency of endogenous GSH. The high ratios of ROS over GSH, in particular, appear to reflect severity of symptoms and prolonged hospitalization of COVID-19 patients. This imbalance interferes with the body's ability to detoxify the cellular microenvironment, fold proteins, replenish antioxidant levels, maintain healthy immune responses and even modulate apoptotic events. Oral administration of GSH and NAC is convenient and safe, but they are susceptible to degradation in the digestive tract. Considering this drawback, nebulization of GSH and NAC as an adjuvant therapy may therefore be a viable alternative for the management of the early stages of COVID-19.
Collapse
|
179
|
Srinivasan K, Pandey AK, Livingston A, Venkatesh S. Roles of host mitochondria in the development of COVID-19 pathology: Could mitochondria be a potential therapeutic target? MOLECULAR BIOMEDICINE 2021; 2:38. [PMID: 34841263 PMCID: PMC8608434 DOI: 10.1186/s43556-021-00060-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/04/2021] [Indexed: 02/07/2023] Open
Abstract
The recent emergence of severe acute respiratory syndrome-Corona Virus 2 (SARS-CoV-2) in late 2019 and its spread worldwide caused an acute pandemic of Coronavirus disease 19 (COVID-19). Since then, COVID-19 has been under intense scrutiny as its outbreak led to significant changes in healthcare, social activities, and economic settings worldwide. Although angiotensin-converting enzyme-2 (ACE-2) receptor is shown to be the primary port of SARS-CoV-2 entry in cells, the mechanisms behind the establishment and pathologies of COVID-19 are poorly understood. As recent studies have shown that host mitochondria play an essential role in virus-mediated innate immune response, pathologies, and infection, in this review, we will discuss in detail the entry and progression of SARS-CoV-2 and how mitochondria could play roles in COVID-19 disease. We will also review the potential interactions between SARS-CoV-2 and mitochondria and discuss possible treatments, including whether mitochondria as a potential therapeutic target in COVID-19. Understanding SARS-CoV-2 and mitochondrial interactions mediated virus establishment, inflammation, and other consequences may provide a unique mechanism and conceptual advancement in finding a novel treatment for COVID-19.
Collapse
Affiliation(s)
- Kavya Srinivasan
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers -New Jersey Medical School, The State University of New Jersey, Newark, NJ USA
- New York Institute of Technology, Old Westbury, NY USA
| | - Ashutosh Kumar Pandey
- Department of Pharmacology, Physiology and Neuroscience, Rutgers -New Jersey Medical School, The State University of New Jersey, Newark, NJ USA
| | | | - Sundararajan Venkatesh
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers -New Jersey Medical School, The State University of New Jersey, Newark, NJ USA
| |
Collapse
|
180
|
Emmenegger M, Kumar SS, Emmenegger V, Malinauskas T, Buettner T, Rose L, Schierack P, Sprinzl MF, Sommer CJ, Lackner KJ, Aguzzi A, Roggenbuck D, Frauenknecht KBM. Anti-prothrombin autoantibodies enriched after infection with SARS-CoV-2 and influenced by strength of antibody response against SARS-CoV-2 proteins. PLoS Pathog 2021; 17:e1010118. [PMID: 34860860 PMCID: PMC8673606 DOI: 10.1371/journal.ppat.1010118] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/15/2021] [Accepted: 11/15/2021] [Indexed: 12/15/2022] Open
Abstract
Antiphospholipid antibodies (aPL), assumed to cause antiphospholipid syndrome (APS), are notorious for their heterogeneity in targeting phospholipids and phospholipid-binding proteins. The persistent presence of Lupus anticoagulant and/or aPL against cardiolipin and/or β2-glycoprotein I have been shown to be independent risk factors for vascular thrombosis and pregnancy morbidity in APS. aPL production is thought to be triggered by-among other factors-viral infections, though infection-associated aPL have mostly been considered non-pathogenic. Recently, the potential pathogenicity of infection-associated aPL has gained momentum since an increasing number of patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been described with coagulation abnormalities and hyperinflammation, together with the presence of aPL. Here, we present data from a multicentric, mixed-severity study including three cohorts of individuals who contracted SARS-CoV-2 as well as non-infected blood donors. We simultaneously measured 10 different criteria and non-criteria aPL (IgM and IgG) by using a line immunoassay. Further, IgG antibody response against three SARS-CoV-2 proteins was investigated using tripartite automated blood immunoassay technology. Our analyses revealed that selected non-criteria aPL were enriched concomitant to or after an infection with SARS-CoV-2. Linear mixed-effects models suggest an association of aPL with prothrombin (PT). The strength of the antibody response against SARS-CoV-2 was further influenced by SARS-CoV-2 disease severity and sex of the individuals. In conclusion, our study is the first to report an association between disease severity, anti-SARS-CoV-2 immunoreactivity, and aPL against PT in patients with SARS-CoV-2.
Collapse
Affiliation(s)
- Marc Emmenegger
- Institute of Neuropathology, University of Zurich, Zurich, Switzerland
| | | | - Vishalini Emmenegger
- Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland
| | - Tomas Malinauskas
- Division of Structural Biology, Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | | | - Laura Rose
- GA Generic Assays GmbH, Dahlewitz, Germany
| | - Peter Schierack
- Institute of Biotechnology, Faculty Environment and Natural Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Faculty of Health Sciences Brandenburg, University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Martin F. Sprinzl
- Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Clemens J. Sommer
- Institute of Neuropathology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Adriano Aguzzi
- Institute of Neuropathology, University of Zurich, Zurich, Switzerland
| | - Dirk Roggenbuck
- GA Generic Assays GmbH, Dahlewitz, Germany
- Institute of Biotechnology, Faculty Environment and Natural Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Faculty of Health Sciences Brandenburg, University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Katrin B. M. Frauenknecht
- Institute of Neuropathology, University of Zurich, Zurich, Switzerland
- Institute of Neuropathology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| |
Collapse
|
181
|
Deer RR, Rock MA, Vasilevsky N, Carmody L, Rando H, Anzalone AJ, Basson MD, Bennett TD, Bergquist T, Boudreau EA, Bramante CT, Byrd JB, Callahan TJ, Chan LE, Chu H, Chute CG, Coleman BD, Davis HE, Gagnier J, Greene CS, Hillegass WB, Kavuluru R, Kimble WD, Koraishy FM, Köhler S, Liang C, Liu F, Liu H, Madhira V, Madlock-Brown CR, Matentzoglu N, Mazzotti DR, McMurry JA, McNair DS, Moffitt RA, Monteith TS, Parker AM, Perry MA, Pfaff E, Reese JT, Saltz J, Schuff RA, Solomonides AE, Solway J, Spratt H, Stein GS, Sule AA, Topaloglu U, Vavougios GD, Wang L, Haendel MA, Robinson PN. Characterizing Long COVID: Deep Phenotype of a Complex Condition. EBioMedicine 2021; 74:103722. [PMID: 34839263 PMCID: PMC8613500 DOI: 10.1016/j.ebiom.2021.103722] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/22/2021] [Accepted: 11/15/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Numerous publications describe the clinical manifestations of post-acute sequelae of SARS-CoV-2 (PASC or "long COVID"), but they are difficult to integrate because of heterogeneous methods and the lack of a standard for denoting the many phenotypic manifestations. Patient-led studies are of particular importance for understanding the natural history of COVID-19, but integration is hampered because they often use different terms to describe the same symptom or condition. This significant disparity in patient versus clinical characterization motivated the proposed ontological approach to specifying manifestations, which will improve capture and integration of future long COVID studies. METHODS The Human Phenotype Ontology (HPO) is a widely used standard for exchange and analysis of phenotypic abnormalities in human disease but has not yet been applied to the analysis of COVID-19. FUNDING We identified 303 articles published before April 29, 2021, curated 59 relevant manuscripts that described clinical manifestations in 81 cohorts three weeks or more following acute COVID-19, and mapped 287 unique clinical findings to HPO terms. We present layperson synonyms and definitions that can be used to link patient self-report questionnaires to standard medical terminology. Long COVID clinical manifestations are not assessed consistently across studies, and most manifestations have been reported with a wide range of synonyms by different authors. Across at least 10 cohorts, authors reported 31 unique clinical features corresponding to HPO terms; the most commonly reported feature was Fatigue (median 45.1%) and the least commonly reported was Nausea (median 3.9%), but the reported percentages varied widely between studies. INTERPRETATION Translating long COVID manifestations into computable HPO terms will improve analysis, data capture, and classification of long COVID patients. If researchers, clinicians, and patients share a common language, then studies can be compared/pooled more effectively. Furthermore, mapping lay terminology to HPO will help patients assist clinicians and researchers in creating phenotypic characterizations that are computationally accessible, thereby improving the stratification, diagnosis, and treatment of long COVID. FUNDING U24TR002306; UL1TR001439; P30AG024832; GBMF4552; R01HG010067; UL1TR002535; K23HL128909; UL1TR002389; K99GM145411.
Collapse
Affiliation(s)
- Rachel R Deer
- University of Texas Medical Branch, Galveston, TX, USA.
| | | | - Nicole Vasilevsky
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Monarch Initiative
| | - Leigh Carmody
- Monarch Initiative; The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Halie Rando
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alfred J Anzalone
- Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Marc D Basson
- Department of Surgery, University of North Dakota School of Medicine and Health Sciences
| | - Tellen D Bennett
- Section of Informatics and Data Science, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Eilis A Boudreau
- Department of Neurology; Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239
| | - Carolyn T Bramante
- Departments of Internal Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455
| | - James Brian Byrd
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, 48109
| | - Tiffany J Callahan
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lauren E Chan
- Monarch Initiative; College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Haitao Chu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN USA
| | - Christopher G Chute
- Johns Hopkins University, Schools of Medicine, Public Health, and Nursing, Baltimore, MD, USA
| | - Ben D Coleman
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA; Institute for Systems Genomics, University of Connecticut, Farmington, CT 06032, USA
| | | | - Joel Gagnier
- Departments of Orthopaedic Surgery & Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Casey S Greene
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - William B Hillegass
- University of Mississippi Medical Center, University of Mississippi Medical Center, Jackson, MS, USA; Departments of Data Science and Medicine
| | | | - Wesley D Kimble
- West Virginia Clinical and Translational Science Institute, West Virginia University, Morgantown, WV, USA
| | | | | | - Chen Liang
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Feifan Liu
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Hongfang Liu
- Department of Artificial Intelligence and Informatics, Mayo Clinic, MN, USA
| | | | - Charisse R Madlock-Brown
- Department of Diagnostic and Health Sciences, University of Tennessee Health Science Center, 920 Madison Ave. Suite 518N, Memphis TN 38613
| | - Nicolas Matentzoglu
- Monarch Initiative; Semanticly Ltd; European Bioinformatics Institute (EMBL-EBI)
| | - Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center
| | - Julie A McMurry
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Monarch Initiative
| | - Douglas S McNair
- Quantitative Sciences, Global Health Div., Gates Foundation, Seattle, WA 98109, USA
| | | | | | - Ann M Parker
- Pulmonary and Critical Care Medicine, Johns Hopkins University, Schools of Medicine, Baltimore, MD, USA
| | - Mallory A Perry
- Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, USA
| | | | - Justin T Reese
- Monarch Initiative; Lawrence Berkeley National Laboratory
| | - Joel Saltz
- Stony Brook University; Biomedical Informatics
| | | | - Anthony E Solomonides
- Outcomes Research Network, Research Institute, NorthShore University HealthSystem, Evanston, IL 60201, USA; Institute for Translational Medicine, University of Chicago, Chicago, IL, USA
| | - Julian Solway
- Institute for Translational Medicine, University of Chicago, Chicago, IL, USA
| | - Heidi Spratt
- University of Texas Medical Branch, Galveston, TX, USA
| | - Gary S Stein
- University of Vermont Larner College of Medicine, Departments of Biochemistry and Surgery, Burlington, Vermont 05405
| | | | | | - George D Vavougios
- Department of Computer Science and Telecommunications, University of Thessaly, Papasiopoulou 2 - 4, P.C.; 131 - Galaneika, Lamia, Greece; Department of Neurology, Athens Naval Hospital 70 Deinokratous Street, P.C. 115 21 Athens, Greece; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, P.C. 41500 Larissa, Greece
| | - Liwei Wang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, MN, USA
| | - Melissa A Haendel
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Monarch Initiative.
| | - Peter N Robinson
- Monarch Initiative; The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA; Institute for Systems Genomics, University of Connecticut, Farmington, CT 06032, USA.
| |
Collapse
|
182
|
The microvascular hypothesis underlying neurologic manifestations of long COVID-19 and possible therapeutic strategies. Cardiovasc Endocrinol Metab 2021; 10:193-203. [PMID: 34765889 PMCID: PMC8575441 DOI: 10.1097/xce.0000000000000253] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023]
Abstract
With the ongoing distribution of the coronavirus disease (COVID) vaccines, the pandemic of our age is ending, leaving the world to deal with its well-documented aftereffects. Long COVID comprises a variety of symptoms, of which the neurological component prevails. The most permeating theory on the genesis of these symptoms builds upon the development of microvascular dysfunction similar to that seen in numerous vascular diseases such as diabetes. This can occur through the peripheral activation of angiotensin-converting enzyme 2 receptors, or through exacerbations of pro-inflammatory cytokines that can remain in circulation even after the infection diminishes. Several drugs have been identified to act on the neurovascular unit to promote repair, such as gliptins, and others. They also succeeded in improving neurologic outcome in diabetic patients. The repurposing of such drugs for treatment of long COVID-19 can possibly shorten the time to recovery of long COVID-19 syndrome.
Collapse
|
183
|
Yan D, Ra OH, Yan B. The nucleoside antiviral prodrug remdesivir in treating COVID-19 and beyond with interspecies significance. ANIMAL DISEASES 2021; 1:15. [PMID: 34778881 PMCID: PMC8422062 DOI: 10.1186/s44149-021-00017-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/25/2021] [Indexed: 01/18/2023] Open
Abstract
Infectious pandemics result in hundreds and millions of deaths, notable examples of the Spanish Flu, the Black Death and smallpox. The current pandemic, caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), is unprecedented even in the historical term of pandemics. The unprecedentedness is featured by multiple surges, rapid identification of therapeutic options and accelerated development of vaccines. Remdesivir, originally developed for Ebola viral disease, is the first treatment of COVID-19 (Coronavirus disease 2019) approved by the United States Food and Drug Administration. As demonstrated by in vitro and preclinical studies, this therapeutic agent is highly potent with a broad spectrum activity against viruses from as many as seven families even cross species. However, randomized controlled trials have failed to confirm the efficacy and safety. Remdesivir improves some clinical signs but not critical parameters such as mortality. This antiviral agent is an ester/phosphorylation prodrug and excessive hydrolysis which increases cellular toxicity. Remdesivir is given intravenously, leading to concentration spikes and likely increasing the potential of hydrolysis-based toxicity. This review has proposed a conceptual framework for improving its efficacy and minimizing toxicity not only for the COVID-19 pandemic but also for future ones caused by remdesivir-sensitive viruses.
Collapse
Affiliation(s)
- Daisy Yan
- Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Philadelphia, PA 19107 USA
| | - One Hyuk Ra
- Department of Anesthesiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 USA
| | - Bingfang Yan
- Division of Pharmaceutical Sciences, James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH 45229 USA
| |
Collapse
|
184
|
Fabrazzo M, Russo A, Camerlengo A, Tucci C, Luciano M, De Santis V, Perris F, Catapano F, Coppola N. Delirium and Cognitive Impairment as Predisposing Factors of COVID-19 Infection in Neuropsychiatric Patients: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1244. [PMID: 34833462 PMCID: PMC8622938 DOI: 10.3390/medicina57111244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023]
Abstract
SARS-CoV-2 neuroinvasive and neurotropic abilities may underlie delirium onset and neuropsychiatric outcomes. Only a limited number of studies have addressed the potential effect of SARS-CoV-2 infection on mental health so far. Most studies mainly reported the acute onset of mixed neuropsychiatric conditions in patients infected with SARS-CoV-2, characterized by agitated behavior, altered level of consciousness, and disorganized thinking, regardless of psychological or socioeconomic triggering factors. The present narrative review aims to analyze and discuss the mechanisms underlying the neuroinvasive/neurotropic properties of SARS-CoV-2 and the subsequent mental complications. Delirium appeared as a clinical manifestation of SARS-CoV-2 brain infection in some patients, without systemic or multiple organ failure symptoms. A small number of studies demonstrated that neuropsychiatric symptoms associated with COVID-19, initially presenting as a confused state, may subsequently evolve in a way that is consistent with the patients' neuropsychiatric history. A literature analysis on this topic prevalently showed case reports and case series of patients presenting delirium or delirium-like symptoms as the main outburst of COVID-19, plus a cognitive impairment, from mild to severe, which pre-existed or was demonstrated during the acute phase or after infection. Dementia appeared as one of the most frequent predisposing factors to SARS-CoV-2 infection complicated with delirium. Instead, contrasting data emerged on the potential link between COVID-19 and delirium in patients with cognitive impairment and without a neuropsychiatric history. Therefore, clinicians should contemplate the possibility that COVID-19 appears as delirium followed by a psychiatric exacerbation, even without other systemic symptoms. In addition, cognitive impairment might act as a predisposing factor for COVID-19 in patients with delirium.
Collapse
Affiliation(s)
- Michele Fabrazzo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy; (A.C.); (C.T.); (M.L.); (V.D.S.); (F.P.); (F.C.)
| | - Antonio Russo
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, Via S. Pansini 5, 80131 Naples, Italy; (A.R.); (N.C.)
| | - Alessio Camerlengo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy; (A.C.); (C.T.); (M.L.); (V.D.S.); (F.P.); (F.C.)
| | - Claudia Tucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy; (A.C.); (C.T.); (M.L.); (V.D.S.); (F.P.); (F.C.)
| | - Mario Luciano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy; (A.C.); (C.T.); (M.L.); (V.D.S.); (F.P.); (F.C.)
| | - Valeria De Santis
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy; (A.C.); (C.T.); (M.L.); (V.D.S.); (F.P.); (F.C.)
| | - Francesco Perris
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy; (A.C.); (C.T.); (M.L.); (V.D.S.); (F.P.); (F.C.)
| | - Francesco Catapano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, Italy; (A.C.); (C.T.); (M.L.); (V.D.S.); (F.P.); (F.C.)
| | - Nicola Coppola
- Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, Via S. Pansini 5, 80131 Naples, Italy; (A.R.); (N.C.)
| |
Collapse
|
185
|
Rodman J, Ferraz M, Baran A, Zhang B. Optical coherence tomography angiography of retinal vasculature in recovered COVID-19 patients compared to age and ethnic matched controls. Clin Exp Optom 2021; 105:842-847. [PMID: 34751081 DOI: 10.1080/08164622.2021.1978817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
CLINICAL RELEVANCE Understanding the impact of the COVID-19 virus on the retinochoroidal vasculature can provide valuable information regarding potential multi-organ ischaemic sequelae in COVID-19 patients, and can thus be a useful tool for optometrists, ophthalmologists, pulmonologists, infectious disease specialists and others. BACKGROUND Assessment of retinochoroidal vasculature alterations in recovered mild COVID-19 patients using optical coherence tomography angiography (OCTA) when compared to age and ethnic matched controls. METHODS Multimodal imaging was performed using OCTA, spectral domain (SD)-OCT (Optovue RTVue XR Avanti; Optovue, Inc, Fremont, CA), and colour fundus photography (Compass; iCare Inc, Raleigh, NC). Vessel flow density, foveal avascular zone, foveal perimeter circumference and retinal thickness were calculated automatically by the OCTA software on 6 × 6mm angiograms. Morphologic changes in the retinochoroidal vasculature on OCTA were assessed and compared with the findings on fundoscopy, SD-OCT and fundus photography and were evaluated by two trained graders. RESULTS Mean vessel parafoveal density, superior and inferior hemispheric vessel density and perifoveal temporal vessel density on 6 × 6 angiograms of the superficial capillary plexus were lower among the COVID-19 patients when compared to their age and ethnic matched controls. Vessel flow density of the deep capillary plexus, foveal avascular zone size and circumference and retinal thickness did not illustrate statistical significance between the groups. CONCLUSION OCTA provides non-invasive high-resolution imaging of the retinochoroidal vascular network. Compared with conventional imaging, OCTA can demonstrate precise microvascular structural alterations in the retinal vessels before visible on SD-OCT or fundus examination. When matched for age and ethnicity, patients with a history of mild COVID illness manifested alterations in vessel density.
Collapse
Affiliation(s)
- Julie Rodman
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Mariana Ferraz
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Ariela Baran
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, USA
| |
Collapse
|
186
|
Poor neutralizing antibody responses in 106 patients with WM after vaccination against SARS-CoV-2: a prospective study. Blood Adv 2021; 5:4398-4405. [PMID: 34529762 PMCID: PMC8450138 DOI: 10.1182/bloodadvances.2021005444] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/28/2021] [Indexed: 12/15/2022] Open
Abstract
Anti–SARS-CoV-2 vaccination leads to lower production of antibodies in WM patients. Treatment with rituximab or BTK inhibitors was an independent prognostic factor for suboptimal antibody response after vaccination.
Immunocompromised patients with hematologic malignancies are more susceptible to COVID-19 and at higher risk of severe complications and worse outcomes compared with the general population. In this context, we evaluated the humoral response by determining the titers of neutralizing antibodies (NAbs) against SARS-CoV-2 in patients with Waldenström macroglobulinemia (WM) after vaccination with the BNT162b2 or AZD1222 vaccine. A US Food and Drug Administration–approved enzyme-linked immunosorbent assay–based methodology was implemented to evaluate NAbs on the day of the first vaccine shot, as well as on days 22 and 50 afterward. A total of 106 patients with WM (43% men; median age, 73 years) and 212 healthy controls (46% men; median age, 66 years) who were vaccinated during the same period at the same center were enrolled in the study (which is registered at www.clinicaltrials.gov as #NCT04743388). Our data indicate that vaccination with either 2 doses of the BNT162b2 or 1 dose of the AZD1222 vaccine leads to lower production of NAbs against SARS-CoV-2 in patients with WM compared with controls on days 22 and 50 (P < .001 for all comparisons). Disease-related immune dysregulation and therapy-related immunosuppression are involved in the low humoral response. Importantly, active treatment with either rituximab or Bruton’s tyrosine kinase inhibitors was proven as an independent prognostic factor for suboptimal antibody response after vaccination. In conclusion, patients with WM have low humoral response after COVID-19 vaccination, which underlines the need for timely vaccination ideally during a treatment-free period and for continuous vigilance on infection control measures.
Collapse
|
187
|
Martínez PT, García PD, Salas MR, Sánchez RR, Avendaño-Ortíz J, Guerrero-Monjo S, García F, Llamas MÁ, López-Collazo E, Saz-Leal P, Del Fresno C. SARS-CoV-2 IgG seropositivity in a cohort of 449 non-hospitalized individuals during Spanish COVID-19 lockdown. Sci Rep 2021; 11:21612. [PMID: 34732800 PMCID: PMC8566591 DOI: 10.1038/s41598-021-00990-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/21/2021] [Indexed: 12/13/2022] Open
Abstract
The Coronavirus Disease of 2019 (COVID-19) pandemic caused by SARS-CoV-2 led the Spanish government to impose a national lockdown in an attempt to control the spread of the infection. Mobility restrictions and the requirement of a medical prescription for serological testing for COVID-19 were included among the control measures. Under this scenario, between April 15th and June 15th, 2020, we performed an observational study including 449 individuals allowed to be tested according to the governmental restrictions, i.e. fulfilling the following prescription requirements: manifestation of COVID-19-compatible symptoms, contact with a confirmed COVID-19 patient, or employment as an essential worker, including health care workers, firefighters and public safety personnel such as police. Importantly, a relevant feature of the studied cohort was that none of the participants had been hospitalized. We analyzed SARS-CoV-2 IgG seropositivity in this specific cohort, uncovering intrinsic features of great demographic interest. The overall rate of IgG seropositivity was 33.69% (95% CI: 29.27-38.21). This frequency was comparable among the different participant occupations. A RT-PCR positive test, contact with a household member previously tested positive and the presence of COVID-19-compatible symptoms were positively associated with IgG + results. Among these symptoms, ageusia/anosmia was positively and independently associated with SARS-CoV-2 IgG seropositivity, while odynophagia was inversely associated. However, fever, ageusia/anosmia and asthenia were the most frequent symptoms described by IgG + subjects. Therefore, our data illustrate how specific cohorts display particular characteristics that should be taken into account when studying population-wide SARS-CoV-2 seroprevalence and key defining symptoms of COVID-19.
Collapse
Affiliation(s)
| | | | | | | | - José Avendaño-Ortíz
- The Innate Immune Response Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | | | | | - Miguel Ángel Llamas
- EMPIREO Diagnóstico Molecular, Madrid, Spain
- LABIANA Pharmaceuticals SLU, Barcelona, Spain
| | - Eduardo López-Collazo
- The Innate Immune Response Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | | | - Carlos Del Fresno
- The Innate Immune Response Group, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain.
| |
Collapse
|
188
|
Zandi M, Soltani S, Fani M, Abbasi S, Ebrahimi S, Ramezani A. Severe acute respiratory syndrome coronavirus 2 and respiratory syncytial virus coinfection in children. Osong Public Health Res Perspect 2021; 12:286-292. [PMID: 34719220 PMCID: PMC8561020 DOI: 10.24171/j.phrp.2021.0140] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/08/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has infected many people around the world. Children are considered an important target group for SARS-CoV-2, as well as other viral infections such as respiratory syncytial virus infection. Both SARS-CoV-2 and respiratory syncytial virus can affect the respiratory tract. Coinfection of SARS-CoV-2 and respiratory syncytial virus can pose significant challenges in terms of diagnosis and treatment in children. This review compares the symptoms, diagnostic methods, and treatment of COVID-19 and respiratory syncytial virus infection in children.
Collapse
Affiliation(s)
- Milad Zandi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Soltani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Fani
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Samaneh Abbasi
- Department of Microbiology, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | - Saeedeh Ebrahimi
- Department of Medical Microbiology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Ramezani
- Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| |
Collapse
|
189
|
Khave LJ, Zafari P, Pirsalehi A, Salari S, Baghestani A, Akbari ME, Bashash D. Association between thrombocytopenia and platelet profile with morbidity/mortality of severe and non-severe COVID-19 patients. Rev Assoc Med Bras (1992) 2021; 67:1670-1675. [DOI: 10.1590/1806-9282.20210720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/02/2021] [Indexed: 08/29/2023] Open
Affiliation(s)
| | | | | | - Sina Salari
- Shahid Beheshti University of Medical Sciences, Iran
| | | | | | | |
Collapse
|
190
|
Sarohan AR, Kızıl M, İnkaya AÇ, Mahmud S, Akram M, Cen O. A novel hypothesis for COVID-19 pathogenesis: Retinol depletion and retinoid signaling disorder. Cell Signal 2021; 87:110121. [PMID: 34438017 PMCID: PMC8380544 DOI: 10.1016/j.cellsig.2021.110121] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 02/08/2023]
Abstract
The SARS-CoV-2 virus has caused a worldwide COVID-19 pandemic. In less than a year and a half, more than 200 million people have been infected and more than four million have died. Despite some improvement in the treatment strategies, no definitive treatment protocol has been developed. The pathogenesis of the disease has not been clearly elucidated yet. A clear understanding of its pathogenesis will help develop effective vaccines and drugs. The immunopathogenesis of COVID-19 is characteristic with acute respiratory distress syndrome and multiorgan involvement with impaired Type I interferon response and hyperinflammation. The destructive systemic effects of COVID-19 cannot be explained simply by the viral tropism through the ACE2 and TMPRSS2 receptors. In addition, the recently identified mutations cannot fully explain the defect in all cases of Type I interferon synthesis. We hypothesize that retinol depletion and resulting impaired retinoid signaling play a central role in the COVID-19 pathogenesis that is characteristic for dysregulated immune system, defect in Type I interferon synthesis, severe inflammatory process, and destructive systemic multiorgan involvement. Viral RNA recognition mechanism through RIG-I receptors can quickly consume a large amount of the body's retinoid reserve, which causes the retinol levels to fall below the normal serum levels. This causes retinoid insufficiency and impaired retinoid signaling, which leads to interruption in Type I interferon synthesis and an excessive inflammation. Therefore, reconstitution of the retinoid signaling may prove to be a valid strategy for management of COVID-19 as well for some other chronic, degenerative, inflammatory, and autoimmune diseases.
Collapse
Affiliation(s)
- Aziz Rodan Sarohan
- Department of Obstetrics and Gynecology, Medicina Plus Medical Center, 75. Yıl Mah., İstiklal Cad. 1305 Sk., No: 16 Sultangazi, İstanbul, Turkey.
| | - Murat Kızıl
- Department of Chemistry, Faculty of Science, Dicle University. Diyarbakır, Turkey
| | - Ahmet Çağkan İnkaya
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey
| | - Shokhan Mahmud
- Department of Pharmacognosy, College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region, Iraq
| | - Muhammad Akram
- Department of Eastern Medicine Government College, University Faisalabad, Pakistan
| | - Osman Cen
- Department of Microbiology and Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America; Department of Natural Sciences and Engineering, John Wood College, Quincy, IL, United States of America
| |
Collapse
|
191
|
Sartorius R, Trovato M, Manco R, D'Apice L, De Berardinis P. Exploiting viral sensing mediated by Toll-like receptors to design innovative vaccines. NPJ Vaccines 2021; 6:127. [PMID: 34711839 PMCID: PMC8553822 DOI: 10.1038/s41541-021-00391-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/01/2021] [Indexed: 12/12/2022] Open
Abstract
Toll-like receptors (TLRs) are transmembrane proteins belonging to the family of pattern-recognition receptors. They function as sensors of invading pathogens through recognition of pathogen-associated molecular patterns. After their engagement by microbial ligands, TLRs trigger downstream signaling pathways that culminate into transcriptional upregulation of genes involved in immune defense. Here we provide an updated overview on members of the TLR family and we focus on their role in antiviral response. Understanding of innate sensing and signaling of viruses triggered by these receptors would provide useful knowledge to prompt the development of vaccines able to elicit effective and long-lasting immune responses. We describe the mechanisms developed by viral pathogens to escape from immune surveillance mediated by TLRs and finally discuss how TLR/virus interplay might be exploited to guide the design of innovative vaccine platforms.
Collapse
Affiliation(s)
- Rossella Sartorius
- Institute of Biochemistry and Cell Biology, C.N.R., Via Pietro Castellino 111, 80131, Naples, Italy.
| | - Maria Trovato
- Institute of Biochemistry and Cell Biology, C.N.R., Via Pietro Castellino 111, 80131, Naples, Italy
| | - Roberta Manco
- Institute of Biochemistry and Cell Biology, C.N.R., Via Pietro Castellino 111, 80131, Naples, Italy
| | - Luciana D'Apice
- Institute of Biochemistry and Cell Biology, C.N.R., Via Pietro Castellino 111, 80131, Naples, Italy.
| | | |
Collapse
|
192
|
Fratta Pasini AM, Stranieri C, Girelli D, Busti F, Cominacini L. Is Ferroptosis a Key Component of the Process Leading to Multiorgan Damage in COVID-19? Antioxidants (Basel) 2021; 10:antiox10111677. [PMID: 34829548 PMCID: PMC8615234 DOI: 10.3390/antiox10111677] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 01/08/2023] Open
Abstract
Even though COVID-19 is mostly well-known for affecting respiratory pathology, it can also result in several extrapulmonary manifestations, leading to multiorgan damage. A recent reported case of SARS-CoV-2 myocarditis with cardiogenic shock showed a signature of myocardial and kidney ferroptosis, a novel, iron-dependent programmed cell death. The term ferroptosis was coined in the last decade to describe the form of cell death induced by the small molecule erastin. As a specific inducer of ferroptosis, erastin inhibits cystine-glutamate antiporter system Xc-, blocking transportation into the cytoplasm of cystine, a precursor of glutathione (GSH) in exchange with glutamate and the consequent malfunction of GPX4. Ferroptosis is also promoted by intracellular iron overload and by the iron-dependent accumulation of polyunsaturated fatty acids (PUFA)-derived lipid peroxides. Since depletion of GSH, inactivation of GPX4, altered iron metabolism, and upregulation of PUFA peroxidation by reactive oxygen species are peculiar signs of COVID-19, there is the possibility that SARS-CoV-2 may trigger ferroptosis in the cells of multiple organs, thus contributing to multiorgan damage. Here, we review the molecular mechanisms of ferroptosis and its possible relationship with SARS-CoV-2 infection and multiorgan damage. Finally, we analyze the potential interventions that may combat ferroptosis and, therefore, reduce multiorgan damage.
Collapse
|
193
|
Zhuang X, Tsukuda S, Wrensch F, Wing PA, Schilling M, Harris JM, Borrmann H, Morgan SB, Cane JL, Mailly L, Thakur N, Conceicao C, Sanghani H, Heydmann L, Bach C, Ashton A, Walsh S, Tan TK, Schimanski L, Huang KYA, Schuster C, Watashi K, Hinks TS, Jagannath A, Vausdevan SR, Bailey D, Baumert TF, McKeating JA. The circadian clock component BMAL1 regulates SARS-CoV-2 entry and replication in lung epithelial cells. iScience 2021; 24:103144. [PMID: 34545347 PMCID: PMC8443536 DOI: 10.1016/j.isci.2021.103144] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus, is a global health issue with unprecedented challenges for public health. SARS-CoV-2 primarily infects cells of the respiratory tract via spike glycoprotein binding to angiotensin-converting enzyme (ACE2). Circadian rhythms coordinate an organism's response to its environment and can regulate host susceptibility to virus infection. We demonstrate that silencing the circadian regulator Bmal1 or treating lung epithelial cells with the REV-ERB agonist SR9009 reduces ACE2 expression and inhibits SARS-CoV-2 entry and replication. Importantly, treating infected cells with SR9009 limits SARS-CoV-2 replication and secretion of infectious particles, showing that post-entry steps in the viral life cycle are influenced by the circadian system. Transcriptome analysis revealed that Bmal1 silencing induced interferon-stimulated gene transcripts in Calu-3 lung epithelial cells, providing a mechanism for the circadian pathway to limit SARS-CoV-2 infection. Our study highlights alternative approaches to understand and improve therapeutic targeting of SARS-CoV-2.
Collapse
Affiliation(s)
- Xiaodong Zhuang
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Senko Tsukuda
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Florian Wrensch
- Université de Strasbourg, Strasbourg, France and INSERM, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France
| | - Peter A.C. Wing
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Chinese Academy of Medical Sciences (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
| | - Mirjam Schilling
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - James M. Harris
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Helene Borrmann
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sophie B. Morgan
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Nuffield Department of Medicine, Experimental Medicine, University of Oxford, UK
| | - Jennifer L. Cane
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Nuffield Department of Medicine, Experimental Medicine, University of Oxford, UK
| | - Laurent Mailly
- Université de Strasbourg, Strasbourg, France and INSERM, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France
| | - Nazia Thakur
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, UK
| | - Carina Conceicao
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, UK
| | - Harshmeena Sanghani
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Laura Heydmann
- Université de Strasbourg, Strasbourg, France and INSERM, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France
| | - Charlotte Bach
- Université de Strasbourg, Strasbourg, France and INSERM, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France
| | - Anna Ashton
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Steven Walsh
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Tiong Kit Tan
- MRC Human Immunology Unit, MRC Weatherall Institute, John Radcliffe Hospital, Oxford 17 OX3 9DS, UK
| | - Lisa Schimanski
- Chinese Academy of Medical Sciences (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
- MRC Human Immunology Unit, MRC Weatherall Institute, John Radcliffe Hospital, Oxford 17 OX3 9DS, UK
| | - Kuan-Ying A. Huang
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University and Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Catherine Schuster
- Université de Strasbourg, Strasbourg, France and INSERM, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France
| | - Koichi Watashi
- Department of Virology II, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
- Department of Applied Biological Science, Tokyo University of Science, Noda 278-8510, Japan
| | - Timothy S.C. Hinks
- Respiratory Medicine Unit and National Institute for Health Research Oxford Biomedical Research Centre, Nuffield Department of Medicine, Experimental Medicine, University of Oxford, UK
| | - Aarti Jagannath
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Dalan Bailey
- The Pirbright Institute, Ash Road, Pirbright, Woking, Surrey, UK
| | - Thomas F. Baumert
- Université de Strasbourg, Strasbourg, France and INSERM, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France
- Pole Hépato-digestif, IHU, Hopitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jane A. McKeating
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Chinese Academy of Medical Sciences (CAMS) Oxford Institute (COI), University of Oxford, Oxford, UK
| |
Collapse
|
194
|
Abstract
Coronavirus disease (COVID-19) skin manifestations have been increasingly reported in medical literature. Recent discussions have identified a lack of images of skin of color (SOC) patients with COVID-19 related skin findings despite people with skin of color being disproportionately affected with the disease. There have been calls to prioritize the identification of COVID-19 skin manifestations in patients with SOC and disseminate these findings. The objective of this article is to review the existing literature on COVID-19 skin manifestations and, where possible, discuss how they may present differently in patients with SOC. Further research is needed to allow primary care physicians and dermatologists to be aware of and easily identify patients with cutaneous findings that may be secondary to COVID-19. Patients presenting with idiopathic dermatologic manifestations should be considered for COVID-19 testing and follow public health guidelines for self-isolation.
Collapse
Affiliation(s)
- Edgar Akuffo-Addo
- 12366 Undergraduate Medical Education, Faculty of Medicine, University of Toronto, ON, Canada
| | - Mathew N Nicholas
- 7938 Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | - Marissa Joseph
- Department of Pediatrics, Faculty of Medicine, University of Toronto, ON, Canada.,Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Division of Dermatology, Women's College Hospital, Toronto, ON, Canada
| |
Collapse
|
195
|
Rad HS, Röhl J, Stylianou N, Allenby MC, Bazaz SR, Warkiani ME, Guimaraes FSF, Clifton VL, Kulasinghe A. The Effects of COVID-19 on the Placenta During Pregnancy. Front Immunol 2021; 12:743022. [PMID: 34603330 PMCID: PMC8479199 DOI: 10.3389/fimmu.2021.743022] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 08/26/2021] [Indexed: 12/21/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. The virus primarily affects the lungs where it induces respiratory distress syndrome ranging from mild to acute, however, there is a growing body of evidence supporting its negative effects on other system organs that also carry the ACE2 receptor, such as the placenta. The majority of newborns delivered from SARS-CoV-2 positive mothers test negative following delivery, suggesting that there are protective mechanisms within the placenta. There appears to be a higher incidence of pregnancy-related complications in SARS-CoV-2 positive mothers, such as miscarriage, restricted fetal growth, or still-birth. In this review, we discuss the pathobiology of COVID-19 maternal infection and the potential adverse effects associated with viral infection, and the possibility of transplacental transmission.
Collapse
Affiliation(s)
- Habib Sadeghi Rad
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Joan Röhl
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Nataly Stylianou
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mark C Allenby
- School of Chemical Engineering, University of Queensland, St Lucia, QLD, Australia.,Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sajad Razavi Bazaz
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, Australia
| | - Majid E Warkiani
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Vicki L Clifton
- Mater Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Arutha Kulasinghe
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,The University of Queensland Diamantina Institute (UQDI), Brisbane, QLD, Australia
| |
Collapse
|
196
|
Abdelmoaty MM, Yeapuri P, Machhi J, Olson KE, Shahjin F, Kumar V, Zhou Y, Liang J, Pandey K, Acharya A, Byrareddy SN, Mosley RL, Gendelman HE. Defining the Innate Immune Responses for SARS-CoV-2-Human Macrophage Interactions. Front Immunol 2021; 12:741502. [PMID: 34671355 PMCID: PMC8521106 DOI: 10.3389/fimmu.2021.741502] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/15/2021] [Indexed: 12/19/2022] Open
Abstract
Host innate immune response follows severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and it is the driver of the acute respiratory distress syndrome (ARDS) amongst other inflammatory end-organ morbidities. Such life-threatening coronavirus disease 2019 (COVID-19) is heralded by virus-induced activation of mononuclear phagocytes (MPs; monocytes, macrophages, and dendritic cells). MPs play substantial roles in aberrant immune secretory activities affecting profound systemic inflammation and end-organ malfunctions. All follow the presence of persistent viral components and virions without evidence of viral replication. To elucidate SARS-CoV-2-MP interactions we investigated transcriptomic and proteomic profiles of human monocyte-derived macrophages. While expression of the SARS-CoV-2 receptor, the angiotensin-converting enzyme 2, paralleled monocyte-macrophage differentiation, it failed to affect productive viral infection. In contrast, simple macrophage viral exposure led to robust pro-inflammatory cytokine and chemokine expression but attenuated type I interferon (IFN) activity. Both paralleled dysregulation of innate immune signaling pathways, specifically those linked to IFN. We conclude that the SARS-CoV-2-infected host mounts a robust innate immune response characterized by a pro-inflammatory storm heralding end-organ tissue damage.
Collapse
Affiliation(s)
- Mai M. Abdelmoaty
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, United States
- Therapeutic Chemistry Department, Pharmaceutical and Drug Industries Research Division, National Research Centre, Giza, Egypt
| | - Pravin Yeapuri
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, United States
| | - Jatin Machhi
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Katherine E. Olson
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Farah Shahjin
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Vikas Kumar
- Mass Spectrometry and Proteomics Core, University of Nebraska Medical Center, Omaha, NE, United States
| | - You Zhou
- Center for Biotechnology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Jingjing Liang
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Kabita Pandey
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Arpan Acharya
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Siddappa N. Byrareddy
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - R. Lee Mosley
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Howard E. Gendelman
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| |
Collapse
|
197
|
Schou TM, Joca S, Wegener G, Bay-Richter C. Psychiatric and neuropsychiatric sequelae of COVID-19 - A systematic review. Brain Behav Immun 2021; 97:328-348. [PMID: 34339806 PMCID: PMC8363196 DOI: 10.1016/j.bbi.2021.07.018] [Citation(s) in RCA: 219] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 12/12/2022] Open
Abstract
It has become evident that coronavirus disease 2019 (COVID-19) has a multi-organ pathology that includes the brain and nervous system. Several studies have also reported acute psychiatric symptoms in COVID-19 patients. An increasing number of studies are suggesting that psychiatric deficits may persist after recovery from the primary infection. In the current systematic review, we provide an overview of the available evidence and supply information on potential risk factors and underlying biological mechanisms behind such psychiatric sequelae. We performed a systematic search for psychiatric sequelae in COVID-19 patients using the databases PubMed and Embase. Included primary studies all contained information on the follow-up period and provided quantitative measures of mental health. The search was performed on June 4th 2021. 1725 unique studies were identified. Of these, 66 met the inclusion criteria and were included. Time to follow-up ranged from immediately after hospital discharge up to 7 months after discharge, and the number of participants spanned 3 to 266,586 participants. Forty studies reported anxiety and/or depression, 20 studies reported symptoms- or diagnoses of post-traumatic stress disorder (PTSD), 27 studies reported cognitive deficits, 32 articles found fatigue at follow-up, and sleep disturbances were found in 23 studies. Highlighted risk factors were disease severity, duration of symptoms, and female sex. One study showed brain abnormalities correlating with cognitive deficits, and several studies reported inflammatory markers to correlate with symptoms. Overall, the results from this review suggest that survivors of COVID-19 are at risk of psychiatric sequelae but that symptoms generally improve over time.
Collapse
Affiliation(s)
- Thor Mertz Schou
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Samia Joca
- Department of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Cecilie Bay-Richter
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark.
| |
Collapse
|
198
|
Kumar S, Çalışkan DM, Janowski J, Faist A, Conrad BCG, Lange J, Ludwig S, Brunotte L. Beyond Vaccines: Clinical Status of Prospective COVID-19 Therapeutics. Front Immunol 2021; 12:752227. [PMID: 34659259 PMCID: PMC8519339 DOI: 10.3389/fimmu.2021.752227] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
Since November 2019 the SARS-CoV-2 pandemic has caused nearly 200 million infection and more than 4 million deaths globally (Updated information from the World Health Organization, as on 2nd Aug 2021). Within only one year into the pandemic, several vaccines were designed and reached approval for the immunization of the world population. The remarkable protective effects of the manufactured vaccines are demonstrated in countries with high vaccination rates, such as Israel and UK. However, limited production capacities, poor distribution infrastructures and political hesitations still hamper the availability of vaccines in many countries. In addition, due to the emergency of SARS-CoV-2 variants with immune escape properties towards the vaccines the global numbers of new infections as well as patients developing severe COVID-19, remains high. New studies reported that about 8% of infected individuals develop long term symptoms with strong personal restrictions on private as well as professional level, which contributes to the long socioeconomic problems caused by this pandemic. Until today, emergency use-approved treatment options for COVID-19 are limited to the antiviral Remdesivir, a nucleoside analogue targeting the viral polymerase, the glucocorticosteroide Dexamethasone as well as neutralizing antibodies. The therapeutic benefits of these treatments are under ongoing debate and clinical studies assessing the efficiency of these treatments are still underway. To identify new therapeutic treatments for COVID-19, now and by the post-pandemic era, diverse experimental approaches are under scientific evaluation in companies and scientific research teams all over the world. To accelerate clinical translation of promising candidates, repurposing approaches of known approved drugs are specifically fostered but also novel technologies are being developed and are under investigation. This review summarizes the recent developments from the lab bench as well as the clinical status of emerging therapeutic candidates and discusses possible therapeutic entry points for the treatment strategies with regard to the biology of SARS-CoV-2 and the clinical course of COVID-19.
Collapse
Affiliation(s)
- Sriram Kumar
- Institute of Virology, University of Münster, Münster, Germany
- EvoPAD Research Training Group 2220, University of Münster, Münster, Germany
| | - Duygu Merve Çalışkan
- Institute of Virology, University of Münster, Münster, Germany
- EvoPAD Research Training Group 2220, University of Münster, Münster, Germany
| | - Josua Janowski
- Institute of Virology, University of Münster, Münster, Germany
- SP BioSciences Graduate Program, University of Münster, Münster, Germany
| | - Aileen Faist
- Institute of Virology, University of Münster, Münster, Germany
- CiM-IMPRS Graduate Program, University of Münster, Münster, Germany
| | | | - Julius Lange
- Institute of Virology, University of Münster, Münster, Germany
| | - Stephan Ludwig
- Institute of Virology, University of Münster, Münster, Germany
- EvoPAD Research Training Group 2220, University of Münster, Münster, Germany
- CiM-IMPRS Graduate Program, University of Münster, Münster, Germany
- Interdisciplinary Centre for Medical Research, University of Münster, Münster, Germany
| | - Linda Brunotte
- Institute of Virology, University of Münster, Münster, Germany
- Interdisciplinary Centre for Medical Research, University of Münster, Münster, Germany
| |
Collapse
|
199
|
Boutou AK, Georgopoulou A, Pitsiou G, Stanopoulos I, Kontakiotis T, Kioumis I. Changes in the respiratory function of COVID-19 survivors during follow-up: A novel respiratory disorder on the rise? Int J Clin Pract 2021; 75:e14301. [PMID: 33932073 PMCID: PMC8236973 DOI: 10.1111/ijcp.14301] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The Human Coronavirus Disease 2019 (COVID-19) is a highly contagious respiratory disorder that may result in acute respiratory distress syndrome. The aim of this review was to investigate the incidence and type of respiratory function abnormalities during the follow-up of patients who recovered from COVID-19. METHODS A systematic search of MEDLINE was conducted, utilising various term combinations. Studies that assessed any respiratory function parameter during the re-evaluation of patients who recovered from COVID-19 and were published as full-text articles in English are included in this review. RESULTS Amongst 183 articles initially retrieved, 8 fulfilled the criteria and were included in this review; they involved a total of 341 adult patients. Four were retrospective studies, one was a prospective cohort study, one was a randomised control trial and two were case reports/case series. The follow-up time ranged from 1 month since symptom onset to 3 months after discharge. The most frequent abnormality was reduced lung diffusion for carbon monoxide (DLCO), followed by a restrictive pattern. Other findings are the lack of resting hypoxemia, the reduced respiratory muscle strength and the decreased exercise capacity, although relative data are extremely limited. CONCLUSION Patients who recovered from COVID-19 present with abnormal respiratory function at short-term follow-up, mainly with reduced lung diffusion and a restrictive pattern. However, results are currently very limited in order safe conclusions to be made, regarding the exact incidence of these abnormalities and whether they may be temporary or permanent.
Collapse
Affiliation(s)
- Afroditi K. Boutou
- 1Department of Respiratory MedicineG. Papanikolaou HospitalThessalonikiGreece
| | - Athina Georgopoulou
- 1Department of Respiratory MedicineG. Papanikolaou HospitalThessalonikiGreece
| | - Georgia Pitsiou
- Department of Respiratory FailureAristotle University of ThessalonikiThessalonikiGreece
| | - Ioannis Stanopoulos
- Department of Respiratory FailureAristotle University of ThessalonikiThessalonikiGreece
| | - Theodoros Kontakiotis
- Department of Respiratory MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Ioannis Kioumis
- 1Department of Respiratory MedicineG. Papanikolaou HospitalThessalonikiGreece
| |
Collapse
|
200
|
Greenway A, Leahy N, Torrieri L, An A, Fink SA, Witenko C, Shikar M, Winchell RJ, Barie PS, Liu SI. Skin Failure Among Critically Ill Patients Afflicted with Coronavirus Disease 2019 (COVID-19). J Intensive Care Med 2021; 36:1331-1339. [PMID: 34591701 DOI: 10.1177/08850666211046532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: To characterize skin integrity among coronavirus disease 2019 (COVID-19) patients treated in the intensive care unit (ICU), and identify risk factors for skin failure (SF) in these patients. Design: The characteristic, profound pro-inflammatory, hypercoagulable state of COVID-19 is manifested by the high severity of illness and extensive organ dysfunction observed in these patients. SF in critically ill patients, although described previously, exhibits a uniquely complex pathogenesis in this population. Patients: Retrospective review of all COVID-19 patients (confirmed positive for severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) admitted to a single surgical ICU for at least 48 hours between March-June 2020. Interventions: Data were extracted from a COVID-19 institutional data repository that harvested data from electronic health records and other clinical data sources. Demographics; coagulation/inflammation biomarkers; number, location, and stage of SF lesions; resource utilization; and outcomes were captured. Measurements and Main Results: 64 patients met inclusion criteria; 51 (80%) developed SF (SF+ ). Forty-three (85%) developed stage 3 or higher SF (χ2 = 22.66, P < .0001). Thirty-nine of 51 (76%) SF+ patients developed more than one SF lesion (χ2 = 13.26, P = .0003). SF+ patients manifested a profound pro-inflammatory, hypercoagulable phenotype (lower serum albumin and higher ferritin, interleukin [IL]-6 and D-dimer concentrations [all, P < .001]). Durations of mechanical ventilation, vasopressor therapy, and ICU length of stay were significantly longer (all, P < .05) in the SF + patients. Conclusions: The unique characteristics of COVID-19 dermatopathology and the strong correlation between markers of inflammation and development of SF reflect COVID-19-related organ dysfunction and its deleterious effects on the microcirculation. Considering that skin is invaded directly by SARS-CoV-2 and affected by COVID-19-related immune complex deposition and microthrombosis, SF may reflect disease as opposed to pressure injuries related to processes of care. In the context of COVID-19 critical illness, SF should not be considered a "never event."
Collapse
Affiliation(s)
- Andrew Greenway
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Nicole Leahy
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Lisa Torrieri
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Anjile An
- Weill Cornell Medicine, New York, NY
| | - Sarah A Fink
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Corey Witenko
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | - Morgan Shikar
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| | | | | | - Susan I Liu
- 159947NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY
| |
Collapse
|