151
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Shahcheraghi SH, Ayatollahi J, Aljabali AAA, Shastri MD, Shukla SD, Chellappan DK, Jha NK, Anand K, Katari NK, Mehta M, Satija S, Dureja H, Mishra V, Almutary AG, Alnuqaydan AM, Charbe N, Prasher P, Gupta G, Dua K, Lotfi M, Bakshi HA, Tambuwala MM. An overview of vaccine development for COVID-19. Ther Deliv 2021; 12:235-244. [PMID: 33624533 PMCID: PMC7923686 DOI: 10.4155/tde-2020-0129] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/15/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic continues to endanger world health and the economy. The causative SARS-CoV-2 coronavirus has a unique replication system. The end point of the COVID-19 pandemic is either herd immunity or widespread availability of an effective vaccine. Multiple candidate vaccines - peptide, virus-like particle, viral vectors (replicating and nonreplicating), nucleic acids (DNA or RNA), live attenuated virus, recombinant designed proteins and inactivated virus - are presently under various stages of expansion, and a small number of vaccine candidates have progressed into clinical phases. At the time of writing, three major pharmaceutical companies, namely Pfizer and Moderna, have their vaccines under mass production and administered to the public. This review aims to investigate the most critical vaccines developed for COVID-19 to date.
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Affiliation(s)
- Seyed H Shahcheraghi
- Infectious Diseases Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Jamshid Ayatollahi
- Infectious Diseases Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alaa AA Aljabali
- Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Irbid, Jordan
| | - Madhur D Shastri
- School of Pharmacy & Pharmacology, University of Tasmania, Hobart, Australia
| | - Shakti D Shukla
- Priority Research Centre for Healthy Lungs, School of Medicine & Public Health, The University of Newcastle, Callaghan, Australia
| | - Dinesh K Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Niraj K Jha
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Krishnan Anand
- Department of Chemical Pathology, School of Pathology, Faculty of Health Sciences & National Health Laboratory Service, University of the Free State, Bloemfontein, South Africa
| | - Naresh K Katari
- Department of Chemistry, School of Science, GITAM Deemed to be University, Hyderabad 502329, India
| | - Meenu Mehta
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Saurabh Satija
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Harish Dureja
- Faculty of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, India
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Abdulmajeed G Almutary
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Saudi Arabia
| | - Abdullah M Alnuqaydan
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Saudi Arabia
| | - Nitin Charbe
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O’Higgins, Santiago 340, Región Metropolitana, Chile
| | - Parteek Prasher
- Department of Chemistry, University of Petroleum & Energy Studies, Dehradun 248007, India
| | - Gaurav Gupta
- School of Pharmaceutical Sciences, Suresh Gyan Vihar University, Jaipur, India
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Marzieh Lotfi
- Department of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Abortion Research Center, Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamid A Bakshi
- School of Pharmacy & Pharmaceutical Sciences, Ulster University, Coleraine, County Londonderry, Northern Ireland, BT52 1SA, UK
| | - Murtaza M Tambuwala
- School of Pharmacy & Pharmaceutical Sciences, Ulster University, Coleraine, County Londonderry, Northern Ireland, BT52 1SA, UK
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152
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Abstract
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.
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153
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Sallam M. COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic Review of Vaccine Acceptance Rates. Vaccines (Basel) 2021; 9:160. [PMID: 33669441 PMCID: PMC7920465 DOI: 10.3390/vaccines9020160] [Citation(s) in RCA: 1064] [Impact Index Per Article: 354.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 12/29/2022] Open
Abstract
Utility of vaccine campaigns to control coronavirus 2019 disease (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and healthcare workers appears to have a decisive role in the successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on 25 December 2020. Results from 31 peer-reviewed published studies met the inclusion criteria and formed the basis for the final COVID-19 vaccine acceptance estimates. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors and nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In the majority of survey studies among the general public stratified per country (29/47, 62%), the acceptance of COVID-19 vaccination showed a level of ≥70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East and North Africa, Sub-Saharan Africa, Eastern Europe, Central Asia, Middle and South America. Addressing the scope of COVID-19 vaccine hesitancy in various countries is recommended as an initial step for building trust in COVID-19 vaccination efforts.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan; ; Tel.: +962-79-184-5186
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
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154
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Silveira MM, Moreira GMSG, Mendonça M. DNA vaccines against COVID-19: Perspectives and challenges. Life Sci 2021; 267:118919. [PMID: 33352173 PMCID: PMC7749647 DOI: 10.1016/j.lfs.2020.118919] [Citation(s) in RCA: 151] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/01/2020] [Accepted: 12/13/2020] [Indexed: 12/23/2022]
Abstract
The coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is associated with several fatal cases worldwide. The rapid spread of this pathogen and the increasing number of cases highlight the urgent development of vaccines. Among the technologies available for vaccine development, DNA vaccination is a promising alternative to conventional vaccines. Since its discovery in the 1990s, it has been of great interest because of its ability to elicit both humoral and cellular immune responses while showing relevant advantages regarding producibility, stability, and storage. This review aimed to summarize the current knowledge and advancements on DNA vaccines against COVID-19, particularly those in clinical trials.
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Affiliation(s)
| | | | - Marcelo Mendonça
- Federal University of Agreste of Pernambuco, Veterinary Medicine Course, Garanhuns, Pernambuco, Brazil
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155
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Biała M, Lelonek E, Knysz B. COVID-19 vaccine candidates: A review. POSTEP HIG MED DOSW 2021. [DOI: 10.5604/01.3001.0014.7051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In December 2019 the first cases of atypical pneumonia caused by a novel coronavirus
SARS-CoV-2 were reported in Wuhan, China. This new infection was called coronavirus disease
2019 (COVID-19). SARS-CoV-2 is primarily transmitted human-to-human via direct contact and
via the air-respiratory droplets and/or aerosols. The clinical manifestations of COVID-19 could
range from asymptomatic or mild non-specific symptoms to severe pneumonia with multiple
organ failure and death. The virus spread rapidly to almost all the countries in the world
within a few months, and on the 11th of March 2020, the World Health Organization (WHO)
announced the COVID-19 pandemic. Since then, a dynamic increase in the number of COVID-19
infections and deaths has been recorded worldwide. The COVID-19 pandemic is accelerating
and causing annex tensive impact on the functioning of health care and is also leading to an
economic crisis in the world. Today, it is difficult to ultimately assess the long-term effects
of the pandemic, although it is known that they will be experienced for decades. Therefore,
the most important goal is to stop the pandemic and develop an effective vaccine against
SARS-CoV-2. Using the ClinicalTrials.gov and World Health Organization databases, we shed
light on the current worldwide clinical and pre-clinical trials in search for a COVID-19 vaccine.
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Affiliation(s)
- Martyna Biała
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiences, Wroclaw Medical University, Poland
| | - Edyta Lelonek
- Department and Clinic of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Brygida Knysz
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiences, Wroclaw Medical University, Poland
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156
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Vivarelli S, Falzone L, Torino F, Scandurra G, Russo G, Bordonaro R, Pappalardo F, Spandidos DA, Raciti G, Libra M. Immune-checkpoint inhibitors from cancer to COVID‑19: A promising avenue for the treatment of patients with COVID‑19 (Review). Int J Oncol 2021; 58:145-157. [PMID: 33491759 PMCID: PMC7864014 DOI: 10.3892/ijo.2020.5159] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
The severe acute respiratory syndrome associated coronavirus‑2 (SARS‑CoV‑2) poses a threat to human life worldwide. Since early March, 2020, coronavirus disease 2019 (COVID‑19), characterized by an acute and often severe form of pneumonia, has been declared a pandemic. This has led to a boom in biomedical research studies at all stages of the pipeline, from the in vitro to the clinical phase. In line with this global effort, known drugs, currently used for the treatment of other pathologies, including antivirals, immunomodulating compounds and antibodies, are currently used off‑label for the treatment of COVID‑19, in association with the supportive standard care. Yet, no effective treatments have been identified. A new hope stems from medical oncology and relies on the use of immune‑checkpoint inhibitors (ICIs). In particular, amongst the ICIs, antibodies able to block the programmed death‑1 (PD‑1)/PD ligand-1 (PD‑L1) pathway have revealed a hidden potential. In fact, patients with severe and critical COVID‑19, even prior to the appearance of acute respiratory distress syndrome, exhibit lymphocytopenia and suffer from T‑cell exhaustion, which may lead to viral sepsis and an increased mortality rate. It has been observed that cancer patients, who usually are immunocompromised, may restore their anti‑tumoral immune response when treated with ICIs. Moreover, viral-infected mice and humans, exhibit a T‑cell exhaustion, which is also observed following SARS‑CoV‑2 infection. Importantly, when treated with anti‑PD‑1 and anti‑PD‑L1 antibodies, they restore their T‑cell competence and efficiently counteract the viral infection. Based on these observations, four clinical trials are currently open, to examine the efficacy of anti‑PD‑1 antibody administration to both cancer and non‑cancer individuals affected by COVID‑19. The results may prove the hypothesis that restoring exhausted T‑cells may be a winning strategy to beat SARS‑CoV‑2 infection.
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Affiliation(s)
- Silvia Vivarelli
- Section of General Pathology, Clinics and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori 'Fondazione G. Pascale', I-80131 Naples
| | - Francesco Torino
- Department of Systems Medicine, Medical Oncology, University of Rome Tor Vergata, I-00133 Rome
| | | | - Giulia Russo
- Department of Drug Sciences, University of Catania, I-95123 Catania
| | | | - Francesco Pappalardo
- Department of Drug Sciences, University of Catania, I-95123 Catania
- Research Center for Prevention, Diagnosis and Treatment of Tumors, University of Catania, I-95123 Catania, Italy
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | | | - Massimo Libra
- Section of General Pathology, Clinics and Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, I-95123 Catania
- Research Center for Prevention, Diagnosis and Treatment of Tumors, University of Catania, I-95123 Catania, Italy
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157
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Mishra SK, Tripathi T. One year update on the COVID-19 pandemic: Where are we now? Acta Trop 2021; 214:105778. [PMID: 33253656 PMCID: PMC7695590 DOI: 10.1016/j.actatropica.2020.105778] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023]
Abstract
We are living through an unprecedented crisis with the rapid spread of the new coronavirus disease (COVID-19) worldwide within a short time. The timely availability of thousands of SARS-CoV-2 genomes has enabled the scientific community to study the origin, structures, and pathogenesis of the virus. The pandemic has spurred research publication and resulted in an unprecedented number of therapeutic proposals. Because the development of new drugs is time consuming, several strategies, including drug repurposing and repositioning, are being tested to treat patients with COVID-19. Researchers have developed several potential vaccine candidates that have shown promise in phase II and III trials. As of 12 November 2020, 164 candidate vaccines are in preclinical evaluation, and 48 vaccines are in clinical evaluation, of which four have cleared phase III trials (Pfizer/BioNTech's BNT162b2, Moderna's mRNA-1273, University of Oxford & AstraZeneca's AZD1222, and Gamaleya's Sputnik V vaccine). Despite the acquisition of a vast body of scientific information, treatment depends only on the clinical management of the disease through supportive care. At the pandemic's 1-year mark, we summarize current information on SARS-CoV-2 origin and biology, and advances in the development of therapeutics. The updated information presented here provides a comprehensive report on the scientific progress made in the past year in understanding of SARS-CoV-2 biology and therapeutics.
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Affiliation(s)
- Sanjay Kumar Mishra
- Department of Botany, Ewing Christian College, Prayagraj- 211003, Uttar Pradesh, India
| | - Timir Tripathi
- Molecular and Structural Biophysics Laboratory, Department of Biochemistry, North-Eastern Hill University, Shillong 793022, Meghalaya, India.
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158
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Mohammad MHS. Immune response scenario and vaccine development for SARS-CoV-2 infection. Int Immunopharmacol 2021; 94:107439. [PMID: 33571745 PMCID: PMC7846221 DOI: 10.1016/j.intimp.2021.107439] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/10/2021] [Accepted: 01/23/2021] [Indexed: 12/28/2022]
Abstract
COVID-19 pandemic has started in December 2019 in China and quickly extended to become a worldwide health and economic emergency issue. It is caused by the novel coronavirus; SARS-CoV-2. COVID-19 patients’ clinical presentations vary from asymptomatic infection or flu like symptoms to serious pneumonia which could be associated with multiple organ failure possibly leading to death. It is understood that the immune response to SARS-CoV-2 includes all elements of the immune system which could altogether succeed in viral elimination and complete cure. Meanwhile, this immune response may also lead to disease progression and could be responsible for the patient’s death. Many trials have been done recently to create therapies and vaccines against human coronavirus infections such as MERS or SARS, however, till now, there is some controversy about the effectiveness and safety of antiviral drugs and vaccines which have been developed to treat and prevent this disease and its management depends mainly on supportive care. The spike glycoprotein or protein S of SARS-CoV-2 is the main promoter that induces development of neutralizing antibodies; hence, many attempts of vaccines and antiviral drugs development have been designed to be directed specifically against this protein. While some of these attempts have been proved to be efficient in in vitro settings, only few of them have been proceeded to randomized animal trials and human studies which makes COVID-19 prevention an ongoing challenge. This review describes the natural immune response scenario during COVID-19 and the vaccines development trials to create efficient vaccines thus helping to build more effective approaches for prophylaxis and management.
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Affiliation(s)
- Mai H S Mohammad
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, P.O. 41522, Egypt.
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159
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Niculet E, Chioncel V, Elisei AM, Miulescu M, Buzia OD, Nwabudike LC, Craescu M, Draganescu M, Bujoreanu F, Marinescu E, Arbune M, Radaschin DS, Bobeica C, Nechita A, Tatu AL. Multifactorial expression of IL-6 with update on COVID-19 and the therapeutic strategies of its blockade (Review). Exp Ther Med 2021; 21:263. [PMID: 33603870 PMCID: PMC7851683 DOI: 10.3892/etm.2021.9693] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
Interleukin 6 (IL-6), a cytokine produced by various cells of the human body (macrophages, lymphocytes, astrocytes, ischemic myocytes, endothelial cells) has both pro-inflammatory and anti-inflammatory properties, being a key component in regulating various physiologic and pathological processes. The structure of this molecule and the receptor system it possesses are important due to the different activities that IL-6 can exert; through trans-signaling pro-inflammatory activities are mediated, while through classic signaling, IL-6 is responsible for anti-inflammatory and regenerative activities. IL-6 signaling is involved in coronary artery disease and the global COVID-19 pandemic. This proatherogenic cytokine reaches elevated serum levels in the cytokine storm generated by SARS-CoV-2, and is also associated with smoking or obesity-classic cardiovascular risk factors which promote inflammatory states. IL-6 levels are proportionally correlated with dyslipidemia, hypertension and glucose dysregulation, and they are associated with poor outcomes in patients with unstable angina or acute myocardial infarction. IL-6 targeting for treatment development (not only) in cardiovascular disease and COVID-19 is still a matter of ongoing research, although tocilizumab has proven to be effective in reducing the proatherogenic effects of IL-6 and is suggested to improve COVID-19 patient survival.
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Affiliation(s)
- Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Valentin Chioncel
- Cardio-Thoracic Department, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,Clinical Cardiology Department, 'Bagdasar Arseni' Emergency Hospital, 041915 Bucharest, Romania
| | - Alina M Elisei
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Magdalena Miulescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Olimpia D Buzia
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Lawrence C Nwabudike
- Department of Diabetic Foot Care, 'Prof. N. Paulescu' National Institute of Diabetes, 011233 Bucharest, Romania
| | - Mihaela Craescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Miruna Draganescu
- Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Florin Bujoreanu
- Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Elisabeta Marinescu
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Manuela Arbune
- Centre of Medical-Pharmaceutical Research, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Diana Sabina Radaschin
- Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania
| | - Carmen Bobeica
- Department of Dermato-Venereology, Doctoral School, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania
| | - Aurel Nechita
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Department of Pediatrics, 'Sf. Ioan' Clinical Hospital for Children, 800487 Galati, Romania
| | - Alin L Tatu
- Research Center in The Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, 'Dunărea de Jos' University, 800010 Galati, Romania.,Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800010 Galati, Romania.,Department of Dermatology, 'Sf. Cuvioasa Parascheva' Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
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160
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Cergan R, Dumitru M, Vrinceanu D, Neagos A, Jeican II, Ciuluvica RC. Ultrasonography of the larynx: Novel use during the SARS-CoV-2 pandemic (Review). Exp Ther Med 2021; 21:273. [PMID: 33603880 PMCID: PMC7851652 DOI: 10.3892/etm.2021.9704] [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: 10/12/2020] [Accepted: 11/10/2020] [Indexed: 01/26/2023] Open
Abstract
Few articles have been published on the subject of laryngeal ultrasonography. However, considering the increased power and accuracy of ultrasound technology, this imaging modality should be reevaluated. The present review aimed to increase the awareness of fellow specialists regarding the use of this imaging tool in healthcare units that do not benefit from onsite ear, nose and throat (ENT) service. We illustrate the ultrasonographic examination protocol for the larynx along with the relevant anatomic landmarks. We review cases with laryngeal tumoral pathology that underwent ultrasonographic examination for improved management. All findings were confirmed through computerized tomography (CT) and endoscopy performed by the ENT specialist. The ultrasound of the larynx has potential utility in diagnosis (e.g., laryngeal abnormalities, speech and swallowing abnormalities, identification of endotracheal tube placement), treatment (e.g., guidance of percutaneous tracheostomy and cricothyrotomy) and prognosis (e.g., prediction of postextubation stridor and difficult intubation). This imaging modality could be useful in the current SARS-CoV-2 pandemics in reducing the exposure to invasive maneuvers producing aerosol, such as endoscopy.
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Affiliation(s)
- Romica Cergan
- Department of Anatomy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihai Dumitru
- Department of Anatomy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Daniela Vrinceanu
- ENT Department, Bucharest Emergency University Hospital, 010271 Bucharest, Romania
| | - Adriana Neagos
- ENT Department, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Târgu Mureş, Romania
| | - Ionut Isaia Jeican
- Department of Anatomy, 'Iuliu Hatieganu' University of Medicine and Pharmacy, 400012 Cluj, Romania
| | - Radu Constantin Ciuluvica
- Department of Anatomy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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161
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Islam MT, Quispe C, Martorell M, Docea AO, Salehi B, Calina D, Reiner Ž, Sharifi-Rad J. Dietary supplements, vitamins and minerals as potential interventions against viruses: Perspectives for COVID-19. INT J VITAM NUTR RES 2021; 92:49-66. [DOI: 10.1024/0300-9831/a000694] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract. The novel coronavirus (SARS-CoV-2) causing COVID-19 disease pandemic has infected millions of people and caused more than thousands of deaths in many countries across the world. The number of infected cases is increasing day by day. Unfortunately, we do not have a vaccine and specific treatment for it. Along with the protective measures, respiratory and/or circulatory supports and some antiviral and retroviral drugs have been used against SARS-CoV-2, but there are no more extensive studies proving their efficacy. In this study, the latest publications in the field have been reviewed, focusing on the modulatory effects on the immunity of some natural antiviral dietary supplements, vitamins and minerals. Findings suggest that several dietary supplements, including black seeds, garlic, ginger, cranberry, orange, omega-3 and -6 polyunsaturated fatty acids, vitamins (e.g., A, B vitamins, C, D, E), and minerals (e.g., Cu, Fe, Mg, Mn, Na, Se, Zn) have anti-viral effects. Many of them act against various species of respiratory viruses, including severe acute respiratory syndrome-related coronaviruses. Therefore, dietary supplements, including vitamins and minerals, probiotics as well as individual nutritional behaviour can be used as adjuvant therapy together with antiviral medicines in the management of COVID-19 disease.
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Affiliation(s)
- Muhammad Torequl Islam
- Department of Pharmacy, Life Science Faculty, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Bangladesh
| | - Cristina Quispe
- Facultad de Ciencias de la Salud, Universidad Arturo Prat, Chile
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, and Centre for Healthy Living, University of Concepción, Concepción, Chile
- Universidad de Concepción, Unidad de Desarrollo Tecnológico (UDT), Concepción, Chile
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, Romania
| | - Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, Romania
| | - Željko Reiner
- Department of Internal Medicine, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Croatia
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
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Li D, Gaynor SM, Quick C, Chen JT, Stephenson BJK, Coull BA, Lin X. Identifying US Counties with High Cumulative COVID-19 Burden and Their Characteristics. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2020.12.02.20234989. [PMID: 33300014 PMCID: PMC7724685 DOI: 10.1101/2020.12.02.20234989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
UNLABELLED Identifying areas with high COVID-19 burden and their characteristics can help improve vaccine distribution and uptake, reduce burdens on health care systems, and allow for better allocation of public health intervention resources. Synthesizing data from various government and nonprofit institutions of 3,142 United States (US) counties as of 12/21/2020, we studied county-level characteristics that are associated with cumulative case and death rates using regression analyses. Our results showed counties that are more rural, counties with more White/non-White segregation, and counties with higher percentages of people of color, in poverty, with no high school diploma, and with medical comorbidities such as diabetes and hypertension are associated with higher cumulative COVID-19 case and death rates. We identify the hardest hit counties in US using model-estimated case and death rates, which provide more reliable estimates of cumulative COVID-19 burdens than those using raw observed county-specific rates. Identification of counties with high disease burdens and understanding the characteristics of these counties can help inform policies to improve vaccine distribution, deployment and uptake, prevent overwhelming health care systems, and enhance testing access, personal protection equipment access, and other resource allocation efforts, all of which can help save more lives for vulnerable communities. SIGNIFICANCE STATEMENT We found counties that are more rural, counties with more White/non-White segregation, and counties with higher percentages of people of color, in poverty, with no high school diploma, and with medical comorbidities such as diabetes and hypertension are associated with higher cumulative COVID-19 case and death rates. We also identified individual counties with high cumulative COVID-19 burden. Identification of counties with high disease burdens and understanding the characteristics of these counties can help inform policies to improve vaccine distribution, deployment and uptake, prevent overwhelming health care systems, and enhance testing access, personal protection equipment access, and other resource allocation efforts, all of which can help save more lives for vulnerable communities.
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Mazilu L, Katsiki N, Nikolouzakis TK, Aslanidis MI, Lazopoulos G, Kouretas D, Tsatsakis A, Suceveanu AI, Stoian AP, Parepa IR, Voinea F, Suceveanu AP, Arsene AL, Velescu BȘ, Vesa C, Nitipir C. Thrombosis and Haemostasis challenges in COVID-19 - Therapeutic perspectives of heparin and tissue-type plasminogen activator and potential toxicological reactions-a mini review. Food Chem Toxicol 2021; 148:111974. [PMID: 33421462 PMCID: PMC7837001 DOI: 10.1016/j.fct.2021.111974] [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: 10/14/2020] [Revised: 12/19/2020] [Accepted: 01/02/2021] [Indexed: 12/20/2022]
Abstract
The coronavirus disease (COVID)-19 pandemic is a major challenge for the health systems worldwide. Acute respiratory distress syndrome (ARDS), is one of the most common complications of the COVID-19 infection. The activation of the coagulation system plays an important role in the pathogenesis of ARDS. The development of lung coagulopathy involves thrombin generation and fibrinolysis inhibition. Unfractionated heparin and its recently introduced counterpart low molecular weight heparin (LMWH), are widely used anticoagulants with a variety of clinical indications allowing for limited and manageable physio-toxicologic side effects while the use of protamine sulfate, heparin's effective antidote, has made their use even safer. Tissue-type plasminogen activator (tPA) is approved as intravenous thrombolytic treatment. The present narrative review discusses the use of heparin and tPA in the treatment of COVID-19-induced ARDS and their related potential physio-toxicologic side effects. The article is a quick review of articles on anticoagulation in COVID infection and the potential toxicologic reactions associated with these drugs.
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Affiliation(s)
- Laura Mazilu
- Oncology Department, Clinical Emergency Hospital, Faculty of Medicine, "Ovidius" University, Constanța, Romania
| | - Niki Katsiki
- First Department of Internal Medicine, Diabetes Center, Division of Endocrinology and Metabolism, AHEPA University Hospital, Thessaloniki, Greece
| | | | | | - George Lazopoulos
- Department of Cardiothoracic Surgery, University General Hospital of Heraklion, Medical School, University of Crete, Greece
| | - Dimitrios Kouretas
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Greece
| | - Aristidis Tsatsakis
- Department of Biochemistry and Biotechnology, University of Thessaly, Larisa, 41500, Greece
| | - Andra-Iulia Suceveanu
- Gastroenterology Department, Clinical Emergency Hospital, Faculty of Medicine, "Ovidius" University, Constanța, Romania
| | - Anca-Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
| | - Irinel-Raluca Parepa
- Cardiology Department, Clinical Emergency Hospital, Faculty of Medicine, "Ovidius" University, Constanța, Romania
| | - Felix Voinea
- Urology Department, Clinical Emergency Hospital, Faculty of Medicine, "Ovidius" University, Constanța, Romania
| | - Adrian Paul Suceveanu
- Internal Medicine Department, Clinical Emergency Hospital, Faculty of Medicine, "Ovidius" University, Constanța, Romania
| | - Andreea Letiția Arsene
- Faculty of Pharmacy, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Bruno Ștefan Velescu
- Faculty of Pharmacy, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Cosmin Vesa
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Cornelia Nitipir
- Oncology Department, Elias Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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164
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Shrivastava S, Shrivastava P. The role of nursing professionals and challenges encountered in the effective containment of the ongoing COVID-19 pandemic. ACTA MEDICA INTERNATIONAL 2021. [DOI: 10.4103/amit.amit_10_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
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165
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Sidiropoulou P, Docea AO, Nikolaou V, Katsarou MS, Spandidos DA, Tsatsakis A, Calina D, Drakoulis N. Unraveling the roles of vitamin D status and melanin during Covid‑19 (Review). Int J Mol Med 2021; 47:92-100. [PMID: 33416113 PMCID: PMC7723676 DOI: 10.3892/ijmm.2020.4802] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/25/2020] [Indexed: 11/06/2022] Open
Abstract
As the coronavirus disease 2019 (COVID‑19) continues to spread worldwide, it has become evident that the morbidity and mortality rates clearly vary across nations. Although several factors may account for this disparity, striking differences within and between populations indicate that ethnicity might impact COVID‑19 clinical outcomes, reflecting the 'color of disease'. Therefore, the role of key biological variables that could interplay with viral spreading and severity indices has attracted increasing attention, particularly among non‑Caucasian populations. Although the links between vitamin D status and the incidence and severity of COVID-19 remain elusive, several lines of emerging evidence suggest that vitamin D signaling, targeting several immune‑mediated pathways, may offer potential benefits at different stages of SARS-CoV-2 infection. Given that the vitamin D status is modulated by several intrinsic and extrinsic factors, including skin type (pigmentation), melanin polymers may also play a role in variable COVID‑19 outcomes among diverse population settings. Moreover, apart from the well‑known limiting effects of melanin on the endogenous production of vitamin D, the potential crosstalk between the pigmentary and immune system may also require special attention concerning the current pandemic. The present review article aimed to shed light on a range of mostly overlooked host factors, such as vitamin D status and melanin pigments, that may influence the course and outcome of COVID‑19.
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Affiliation(s)
- Polytimi Sidiropoulou
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, 'A. Sygros' Hospital for Skin and Venereal Diseases, 16121 Athens, Greece
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Vasiliki Nikolaou
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, 'A. Sygros' Hospital for Skin and Venereal Diseases, 16121 Athens, Greece
| | - Martha-Spyridoula Katsarou
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771 Athens
| | | | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Department of Analytical Toxicology, Pharmaceutical Chemistry and Pharmacognosy, Sechenov University, 119991 Moscow, Russia
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771 Athens
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166
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Li X, Li T, Wang H. Treatment and prognosis of COVID-19: Current scenario and prospects (Review). Exp Ther Med 2021; 21:3. [PMID: 33235612 PMCID: PMC7678645 DOI: 10.3892/etm.2020.9435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/22/2020] [Indexed: 12/24/2022] Open
Abstract
SARS-CoV-2 is the seventh member of the family of coronaviruses that can cause infections in humans, termed as COVID-19, which is now a global pandemic. Because it is a novel virus, considerable efforts and extensive studies are needed to fully understand its characteristics. Its symptoms and severity range from mild to critical, depending on several factors, such as host susceptibility to the virus and their immune system, with the most common symptoms being fever, fatigue, sore throat and runny nose. There is no clear treatment available yet, though several options are being explored, with research for vaccines being at the forefront. Traditional Chinese Medicine may also be used as a treatment option. Since this virus is similar to the SARS-CoV and MERS viruses, considerable insight can be gained from previous studies. Although many patients recover completely, there are several factors that lead to poor prognosis. This review summarizes the research carried out so far in terms of treatment options and prognosis factors associated with COVID-19.
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Affiliation(s)
- Xuemei Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, P.R. China
| | - Tao Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, P.R. China
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-Inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-Inflammatory and Immune Medicine, Anhui Anti-Inflammatory and Immune Medicine Innovation Team, Hefei, Anhui 230032, P.R. China
| | - Huihui Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, P.R. China
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167
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Kostoff RN, Briggs MB, Porter AL. Toxicology issues related to the COVID–19 outbreak. TOXICOLOGICAL RISK ASSESSMENT AND MULTI-SYSTEM HEALTH IMPACTS FROM EXPOSURE 2021. [PMCID: PMC8342276 DOI: 10.1016/b978-0-323-85215-9.00017-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In viral pandemics, such as coronavirus disease 2019 (COVID–19), the impact of real-life exposures to multiple toxic stressors that increase immune system dysfunction is followed by the main pandemic-associated virus (SARS–CoV–2, for COVID–19) exploiting the dysfunctional immune system to trigger a chain of events ultimately leading to the pandemic (COVID–19). Thus pandemics have two main components: virology (focused on the virus) and toxicology (focused on the toxic stressors). The present chapter will focus mainly on the immune system toxicology component. It identifies the factors shown most frequently to increase immune system dysfunction, and then addresses vaccine toxicology in detail. The chapter concludes by reviewing two types of treatments: immune-augmenting and immune-strengthening. The immune-augmenting approaches are virology-centric (e.g., quarantine, face masks, repurposed antiviral treatments, vaccines, etc.), and the immune-strengthening approaches are toxicology-centric (e.g., eliminating the factors that contribute to immune system dysfunction, and adding factors that increase immune system health).
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168
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Nikolouzakis TK, Tsatsakis AM. Dethroning the crown. From the kinetics and dynamics of COVID–19 diagnosis to promising treatments. TOXICOLOGICAL RISK ASSESSMENT AND MULTI-SYSTEM HEALTH IMPACTS FROM EXPOSURE 2021. [PMCID: PMC8342275 DOI: 10.1016/b978-0-323-85215-9.00033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The SARS–CoV–2 pandemic has become a great stressor for health systems worldwide, and the global scientific community is trying to effectively understand key aspects of this infection in order to halt its progression. National and local authorities have endorsed COVID–19 testing both for symptomatic and asymptomatic individuals who fulfill certain criteria and for public health or infection control purposes. Therefore understanding kinetics and dynamics of COVID–19 is crucial for diagnosis and potential treatments. Current diagnostic modalities include: (1) reverse-transcription polymerase chain reaction (RT–PCR) assay (currently the preferred initial diagnostic test for COVID–19); (2) antigen testing—tests that detect SARS–CoV–2 antigen can be performed rapidly and at the point of care; and (3) serologic detection of antibodies against SARS–CoV–2. As for the treatment, there are a few FDA-approved drugs for the treatment of COVID–19. However, definitive clinical trial data are needed to identify safety of COVID–19 treatments. In the meantime, current practice of SARS–CoV–2 treatment is based greatly on symptomatic care with critical care support applied when hemodynamic, respiratory, or renal insufficiency is needed. Antiviral therapies aim for the inhibition of viral entry (via the ACE2 receptor and TMPRSS2), viral membrane fusion, and endocytosis or the activity of the SARS–CoV–2 3CLprotease and the RNA-dependent RNA polymerase. Moreover, agents that modulate immune response, such as human blood-derived products and immunomodulatory therapies, are being explored as adjunctive treatments for the management of moderate to critical infection. In addition to the antiviral medications and the immune-based therapies administration of antithrombotic therapy, use of vitamins C and D and zinc is suggested.
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169
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Bobik TV, Kostin NN, Skryabin GA, Tsabai PN, Simonova MA, Knorre VD, Stratienko ON, Aleshenko NL, Vorobiev II, Khurs EN, Mokrushina YA, Smirnov IV, Alekhin AI, Nikitin AE, Gabibov AG. COVID-19 in Russia: Clinical and Immunological Features of the First-Wave Patients. Acta Naturae 2021; 13:102-115. [PMID: 33959390 PMCID: PMC8084292 DOI: 10.32607/actanaturae.11374] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/16/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease outbreak in 2019 (COVID-19) has now achieved the level of a global pandemic and affected more than 100 million people on all five continents and caused over 2 million deaths. Russia is, needless to say, among the countries affected by SARS-CoV-2, and its health authorities have mobilized significant efforts and resources to fight the disease. The paper presents the result of a functional analysis of 155 patients in the Moscow Region who were examined at the Central Clinical Hospital of the Russian Academy of Sciences during the first wave of the pandemic (February-July, 2020). The inclusion criteria were a positive PCR test and typical, computed tomographic findings of viral pneumonia in the form of ground-glass opacities. A clinical correlation analysis was performed in four groups of patients: (1) those who were not on mechanical ventilation, (2) those who were on mechanical ventilation, and (3) those who subsequently recovered or (4) died. The correlation analysis also considered confounding comorbidities (diabetes, metabolic syndrome, hypertension, etc.). The immunological status of the patients was examined (levels of immunoglobulins of the M, A, G classes and their subclasses, as well as the total immunoglobulin level) using an original SARS-CoV-2 antibody ELISA kit. The ELISA kit was developed using linear S-protein RBD-SD1 and NTD fragments, as well as the N-protein, as antigens. These antigens were produced in the prokaryotic E. coli system. Recombinant RBD produced in the eukaryotic CHO system (RBD CHO) was used as an antigen representing conformational RBD epitopes. The immunoglobulin A level was found to be the earliest serological criterion for the development of a SARS-CoV-2 infection and it yielded the best sensitivity and diagnostic significance of ELISA compared to that of class M immunoglobulin. We demonstrated that the seroconversion rate of "early" N-protein-specific IgM and IgA antibodies is comparable to that of antibodies specific to RBD conformational epitopes. At the same time, seroconversion of SARS-CoV-2 N-protein-specific class G immunoglobulins was significantly faster compared to that of other specific antibodies. Our findings suggest that the strong immunogenicity of the RBD fragment is for the most part associated with its conformational epitopes, while the linear RBD and NTD epitopes have the least immunogenicity. An analysis of the occurrence rate of SARS-CoV-2-specific immunoglobulins of different classes revealed that RBD- and N-specific antibodies should be evaluated in parallel to improve the sensitivity of ELISA. An analysis of the immunoglobulin subclass distribution in sera of seropositive patients revealed uniform induction of N-protein-specific IgG subclasses G1-G4 and IgA subclasses A1-A2 in groups of patients with varying severity of COVID-19. In the case of the S-protein, G1, G3, and A1 were the main subclasses of antibodies involved in the immune response.
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Affiliation(s)
- T. V. Bobik
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - N. N. Kostin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - G. A. Skryabin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - P. N. Tsabai
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - M. A. Simonova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - V. D. Knorre
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - O. N. Stratienko
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - N. L. Aleshenko
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - I. I. Vorobiev
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - E. N. Khurs
- Engelhardt Institute of Molecular Biology, RAS, Moscow, 119991 Russia
| | - Yu. A. Mokrushina
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - I. V. Smirnov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
| | - A. I. Alekhin
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - A. E. Nikitin
- Central Clinical Hospital of the Russian Academy of Sciences, Moscow, 117593 Russia
| | - A. G. Gabibov
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 117997 Russia
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170
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Alexandris N, Lagoumintzis G, Chasapis CT, Leonidas DD, Papadopoulos GE, Tzartos SJ, Tsatsakis A, Eliopoulos E, Poulas K, Farsalinos K. Nicotinic cholinergic system and COVID-19: In silico evaluation of nicotinic acetylcholine receptor agonists as potential therapeutic interventions. Toxicol Rep 2020; 8:73-83. [PMID: 33425684 PMCID: PMC7776751 DOI: 10.1016/j.toxrep.2020.12.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 infection was announced as a pandemic in March 2020. Since then, several scientists have focused on the low prevalence of smokers among hospitalized COVID-19 patients. These findings led to our hypothesis that the Nicotinic Cholinergic System (NCS) plays a crucial role in the manifestation of COVID-19 and its severe symptoms. Molecular modeling revealed that the SARS-CoV-2 Spike glycoprotein might bind to nicotinic acetylcholine receptors (nAChRs) through a cryptic epitope homologous to snake toxins, substrates well documented and known for their affinity to the nAChRs. This binding model could provide logical explanations for the acute inflammatory disorder in patients with COVID-19, which may be linked to severe dysregulation of NCS. In this study, we present a series of complexes with cholinergic agonists that can potentially prevent SARS-CoV-2 Spike glycoprotein from binding to nAChRs, avoiding dysregulation of the NCS and moderating the symptoms and clinical manifestations of COVID-19. If our hypothesis is verified by in vitro and in vivo studies, repurposing agents currently approved for smoking cessation and neurological conditions could provide the scientific community with a therapeutic option in severe COVID-19.
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Key Words
- ACh, Acetylcholine
- AChBP, Acetylcholine-binding protein
- ARDS, acute respiratory distress syndrome
- BLAST, Basic Local Alignment Search Tool
- CHARMM, Chemistry at Harvard Macromolecular Mechanics
- CNS, Central Nervous System
- COVID-19
- Cholinergic agonists
- CoV, coronavirus
- DCD, single precision binary FORTRAN
- ECD, extracellular domain
- HADDOCK, High Ambiguity Driven protein-protein DOCKing
- HMGB1, High-mobility group protein 1
- IL, Interleukin
- Jak2, Janus kinases 2
- LBD, Ligand Binding Domain
- MD, Molecular Dynamics
- MDS, Molecular Dynamics Simulations
- MERS, Middle East Respiratory Syndrome
- NAMD, Nanoscale Molecular Dynamics
- NCBI, National Center for Biotechnology Information
- NCS, Nicotinic Cholinergic System
- NF-kB, nuclear factor kappa-light-chain-enhancer of activated B cells
- NPT, constant number, pressure, energy
- NVT, constant number, volume, energy
- Nicotinic acetylcholine receptors
- PDB, Protein Data Bank
- PME, Particle Mesh Ewald
- PRODIGY, PROtein binDIng enerGY prediction
- PyMOL, Python Molecule
- RBD, Receptor Binding Domain
- RMSD, Root-mean-square deviation
- SARS, Severe Acute Respiratory Syndrome
- SARS-CoV-2
- SARS-CoV-2 S1, SARS - 2 Spike Subunit 1 protein
- STAT3, signal transducer and activator of transcription 3
- STD NMR, Saturation Transfer Difference Nuclear Magnetic Resonance
- Spike glycoprotein
- TNF, Tumor Necrosis Factor
- VMD, Visual Molecular Dynamics
- lig, ligand
- nAChRs, nicotinic acetylcholine receptors
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Affiliation(s)
- Nikolaos Alexandris
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
| | - George Lagoumintzis
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
- Institute of Research and Innovation - IRIS, Patras Science Park SA, 26500 Patras, Greece
| | - Christos T. Chasapis
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
| | - Demetres D. Leonidas
- Department of Biochemistry and Biotechnology, University of Thessaly, Biopolis, 41500 Larissa, Greece
| | - Georgios E. Papadopoulos
- Department of Biochemistry and Biotechnology, University of Thessaly, Biopolis, 41500 Larissa, Greece
| | | | | | - Elias Eliopoulos
- Department of Biotechnology, Laboratory of Genetics, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece
| | - Konstantinos Poulas
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
- Institute of Research and Innovation - IRIS, Patras Science Park SA, 26500 Patras, Greece
| | - Konstantinos Farsalinos
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500, Rio-Patras, Greece
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Hossain MK, Hassanzadeganroudsari M, Apostolopoulos V. Why METH users are at high risk of fatality due to COVID-19 infection? Expert Rev Vaccines 2020; 19:1101-1103. [DOI: 10.1080/14760584.2020.1858059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Md Kamal Hossain
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Tsatsakis A, Calina D, Falzone L, Petrakis D, Mitrut R, Siokas V, Pennisi M, Lanza G, Libra M, Doukas SG, Doukas PG, Kavali L, Bukhari A, Gadiparthi C, Vageli DP, Kofteridis DP, Spandidos DA, Paoliello MMB, Aschner M, Docea AO. SARS-CoV-2 pathophysiology and its clinical implications: An integrative overview of the pharmacotherapeutic management of COVID-19. Food Chem Toxicol 2020; 146:111769. [PMID: 32979398 PMCID: PMC7833750 DOI: 10.1016/j.fct.2020.111769] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023]
Abstract
Common manifestations of COVID-19 are respiratory and can extend from mild symptoms to severe acute respiratory distress. The severity of the illness can also extend from mild disease to life-threatening acute respiratory distress syndrome (ARDS). SARS-CoV-2 infection can also affect the gastrointestinal tract, liver and pancreatic functions, leading to gastrointestinal symptoms. Moreover, SARS-CoV-2 can cause central and peripheral neurological manifestations, affect the cardiovascular system and promote renal dysfunction. Epidemiological data have indicated that cancer patients are at a higher risk of contracting the SARS-CoV-2 virus. Considering the multitude of clinical symptoms of COVID-19, the objective of the present review was to summarize their pathophysiology in previously healthy patients, as well as in those with comorbidities. The present review summarizes the current, though admittedly fluid knowledge on the pathophysiology and symptoms of COVID-19 infection. Although unclear issues still remain, the present study contributes to a more complete understanding of the disease, and may drive the direction of new research. The recognition of the severity of the clinical symptoms of COVID-19 is crucial for the specific therapeutic management of affected patients.
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Affiliation(s)
- Aristides Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece; I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori "Fondazione G. Pascale", 80131, Naples, Italy.
| | - Dimitrios Petrakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece.
| | - Radu Mitrut
- Department of Cardiology, University and Emergency Hospital, 050098, Bucharest, Romania.
| | - Vasileios Siokas
- Department of Neurology, University of Thessaly, University Hospital of Larissa, 41221, Larissa, Greece.
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123, Catania, Italy.
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123, Catania, Italy; Department of Neurology IC, Oasi Research Institute-IRCCS, 94018, Troina, Italy.
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123, Catania, Italy; Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123, Catania, Italy.
| | - Sotirios G Doukas
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece; Department of Internal Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ, 08901, USA.
| | - Panagiotis G Doukas
- University of Pavol Josef Safarik University, Faculty of Medicine, Kosice, Slovakia.
| | - Leena Kavali
- Department of Internal Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ, 08901, USA.
| | - Amar Bukhari
- Department of Medicine, Division of Pulmonary and Critical Care 240 Easton Ave, Adult Ambulatory at Cares Building 4th Floor, New Brunswick, NJ, 08901, USA.
| | - Chiranjeevi Gadiparthi
- Division of Gastroenterology, Hepatology and Clinical Nutrition, Saint Peter's University Hospital, New Brunswick, NJ, USA.
| | - Dimitra P Vageli
- Department of Surgery, The Yale Larynx Laboratory, New Haven, CT, 06510, USA.
| | - Diamantis P Kofteridis
- Department of Internal Medicine, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece.
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion, 71003, Greece.
| | - Monica M B Paoliello
- Department of Molecular Pharmacology, Albert Eisntein College of Medicine, 1300 Morris Park Avenue Bronx, NY, 10461, USA.
| | - Michael Aschner
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; Department of Molecular Pharmacology, Albert Eisntein College of Medicine, 1300 Morris Park Avenue Bronx, NY, 10461, USA.
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
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173
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Albulescu R, Dima SO, Florea IR, Lixandru D, Serban AM, Aspritoiu VM, Tanase C, Popescu I, Ferber S. COVID-19 and diabetes mellitus: Unraveling the hypotheses that worsen the prognosis (Review). Exp Ther Med 2020; 20:194. [PMID: 33101484 PMCID: PMC7579812 DOI: 10.3892/etm.2020.9324] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/11/2020] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the caused disease - coronavirus disease 2019 (COVID-19), has affected so far >6,000,000 people worldwide, with variable grades of severity, and has already inflicted >350,000 deaths. SARS-CoV-2 infection seems severely affected by background diseases such as diabetes mellitus and its related complications, that seem to be favoring the most severe manifestations of SARS-CoV-2 and, therefore, require special attention in clinical care units. The present literature review focus on addressing several hypotheses explaining why diabetic patients could develop multi-organ failure in severe acute respiratory syndrome coronavirus (SARS-CoV) infections. Undoubtedly, as diabetes related complications are present it is expected to emphasize the severity of the COVID-19. Dermatological complications can occur and worsen in diabetic patients, and diseases such as acanthosis nigricans and psoriasis are prone to more severe manifestations of COVID-19. Approaches to treat SARS-CoV-2 infected patients, based on different solutions i.e. plasma therapy, use of antiviral compounds, development of vaccines or new therapeutic agents are ongoing.
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Affiliation(s)
- Radu Albulescu
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- National Institute for Chemical-Pharmaceutical R&D, 031299 Bucharest, Romania
| | - Simona Olimpia Dima
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Ioana Raluca Florea
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Daniela Lixandru
- Fundeni Clinical Institute, 022328 Bucharest, Romania
- Department of Biochemistry, ‘Carol Davila’ University of Medicine and Pharmacy, 050047 Bucharest, Romania
| | - Andreea Madalina Serban
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Veronica Madalina Aspritoiu
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
| | - Cristiana Tanase
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- Department of Biochemistry-Proteomics,‘Victor Babes’ National Institute of Pathology, 050096 Bucharest, Romania
- Correspondence to: Professor Cristiana Tanase, ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 185 Vacaresti Road, 004051 Bucharest, Romania
| | - Irinel Popescu
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Sarah Ferber
- ‘Nicolae Cajal’ Institute, ‘Titu Maiorescu’ University, 004051 Bucharest, Romania
- Center for Stem Cells and Regenerative Medicine, Sheba Medical Center, 5262000 Hashomer, Israel
- Orgenesis Ltd., 6997801 Aviv, Israel
- Department of Human Genetics, Aviv University, Sackler School of Medicine, 6997801 Aviv, Israel
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174
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Dhama K, Patel SK, Natesan S, Vora KS, Iqbal Yatoo M, Tiwari R, Saxena SK, Singh KP, Singh R, Malik YS. COVID-19 in the elderly people and advances in vaccination approaches. Hum Vaccin Immunother 2020; 16:2938-2943. [PMID: 33270497 PMCID: PMC8641606 DOI: 10.1080/21645515.2020.1842683] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023] Open
Abstract
The rapid worldwide spread of the COVID-19 pandemic, caused by the newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in tens of millions of infections and over one million deaths. SARS-CoV-2 infection affects all age groups; however, those over 60 years old are affected more severely. Moreover, pre-existing co-morbidities result in higher COVID-19-associated mortality in the geriatric population. This article highlights the associated risk factors of SARS-CoV-2 infection in older people and progress in developing COVID-19 vaccines, especially for efficient vaccination of the older population. There is also a summary of immunomodulatory and immunotherapeutic approaches to ameliorate the outcome of COVID-19 in older individuals.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Shailesh Kumar Patel
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Senthilkumar Natesan
- Department of Infectious Diseases, Indian Institute of Public Health Gandhinagar, Ganghinagar, Gujarat, India
| | - Kranti Suresh Vora
- Department of Infectious Diseases, Indian Institute of Public Health Gandhinagar, Ganghinagar, Gujarat, India
- Health Research Institut, University of Canberra, ACT, Australia
| | - Mohd Iqbal Yatoo
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - Shailendra K Saxena
- Centre for Advanced Research (CFAR), Faculty of Medicine, King George’s Medical University (KGMU), Lucknow, India
| | - Karam Pal Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Rajendra Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Yashpal Singh Malik
- Division of Biological Standardization, ICAR–Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
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175
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Pan Y, Li Q, Yu X, Luo Q, Qin T, Xin N, Zhang Q, Li X, Du X, Zhao Q, Sun L. Retrospective analysis of the effect of current clinical medications and clinicopathological factors on viral shedding in COVID-19 patients. Biomed Rep 2020; 13:68. [PMID: 33194192 PMCID: PMC7657086 DOI: 10.3892/br.2020.1375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/23/2020] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to identify the risk factors associated with prolonged shedding in patients with coronavirus disease 2019 (COVID-19), and to evaluate the effects of current clinical and clinicopathological factors on viral shedding in patients. A total of 186 COVID-19 inpatients were enrolled in this multicentre retrospective analysis. Detailed clinical data of each patient were collected, and the factors that affected the duration of viral shedding were retrospectively analysed. The median duration of viral shedding in the 186 COVID-19 patients was 13 days. The median duration of viral shedding was 12 days in non-severe patients, and 17 days in severe patients, and there was a significant difference between the two groups (P<0.001). Multi-factor regression analysis suggested that the onset-hospitalization interval [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.15-1.41; P<0.001] and comorbidity with a chronic disease (OR, 2.43; 95% CI, 1.14-5.17; P=0.021) were independent risk factors for prolonged viral shedding, whereas lopinavir/ritonavir (LPV/r) was an independent protective factor (OR, 0.28; 95% CI, 0.11-0.75; P=0.011). Spearman's rank correlation analysis showed that the onset-drug interval was positively correlated with the duration of viral shedding (r=0.446; P<0.0001). Umifenovir, and low and short courses of glucocorticoids were not associated with prolonged viral shedding. The prolonged viral shedding was the initial causative factor of persistent aggravation of the patient's conditions. The interval between presentation of symptoms and hospitalization as well as complications with a comorbid chronic disease were independent risk factors for prolonged viral shedding. LPV/r shortened the duration of viral shedding, and the smaller the interval between presentation and LPV/r onset was, the faster viral shedding occurred.
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Affiliation(s)
- Yanfeng Pan
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Qingqing Li
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Xue Yu
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
| | - Qiankun Luo
- Department of Hepatobiliary and Pancreatic Surgery, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, P.R. China
| | - Tao Qin
- Department of Hepatobiliary and Pancreatic Surgery, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, P.R. China
| | - Ningbo Xin
- Department of Infectious Diseases, Zhengzhou Sixth People's Hospital, Zhengzhou, Henan 450000, P.R. China
| | - Qian Zhang
- Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, P.R. China
| | - Xianyang Li
- Department of Infectious Diseases, Shenqiu County People's Hospital, Zhoukou, Henan 466300, P.R. China
| | - Xinwei Du
- Department of Infectious Diseases, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 205011, P.R. China
| | - Qingxia Zhao
- Department of Infectious Diseases, Zhengzhou Sixth People's Hospital, Zhengzhou, Henan 450000, P.R. China
| | - Li Sun
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
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176
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Wang Y, Wang P, Wang H, Luo Y, Wan L, Jiang M, Chu Y. Lactoferrin for the treatment of COVID-19 (Review). Exp Ther Med 2020; 20:272. [PMID: 33199997 PMCID: PMC7664603 DOI: 10.3892/etm.2020.9402] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) outbreak was caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical outcomes of elderly individuals and those with underlying diseases affected by COVID-19 are serious, and may result in acute respiratory distress syndrome (ARDS) and even mortality. Currently, the clinical treatments for COVID-19 mostly involve symptom alleviation measures and non-specific broad spectrum antiviral drugs, as highly effective antiviral drugs and vaccines are not yet available. Lactoferrin (LF) is a safe iron-binding glycoprotein that is present in the milk of the majority of mammals and exhibits broad-spectrum antiviral activity, including against coronaviruses. In addition, LF also exhibits anti-inflammatory, anti-infective and immune-regulating properties, which are in line with the treatment requirements for SARS-CoV-2 infection. Therefore, the use of LF may be of value in the prevention and/or management of COVID-19. The aim of the present review was to summarize the previous reports on the antiviral properties of LF and compare these with the characteristics of SARS-CoV-2 infection, in order to determine whether LF could be used to assist in the prevention of COVID-19 and to investigate the possible underlying mechanisms governing its mode of action.
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Affiliation(s)
- Yidan Wang
- Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Puxiu Wang
- Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Haoran Wang
- Neoland Bioscience, Weihai, Shandong 264200, P.R. China
| | - Yifan Luo
- Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Long Wan
- Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Mingyan Jiang
- Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Yang Chu
- Department of Pharmacy, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
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177
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Florea AA, Sirbu CA, Ghinescu MC, Plesa CF, Sirbu AM, Mitrica M, Ionita-Radu F. SARS-CoV-2, multiple sclerosis, and focal deficit in a postpartum woman: A case report. Exp Ther Med 2020; 21:92. [PMID: 33363603 DOI: 10.3892/etm.2020.9524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023] Open
Abstract
SARS-CoV-2 infections raise many practical concerns in a woman with multiple sclerosis (MS) during the perinatal period. On the other hand, the impact of COVID-19 on patients with MS and disease-modifying therapies (DMTs) is unknown. We report on a female patient who was treated with interferon beta 1a (IFNB-1a) for many years for relapsing-remitting multiple sclerosis (RRMS) until December 2018. She developed COVID 19 infection in April 2020, after giving birth to a healthy baby girl, five weeks before. She developed a mild right hemiparesis 2 weeks later, without cold symptoms. On admission, PCR for SARS-CoV-2 was positive, and she received antivirals and corticotherapy. One month later, specific IgG and IgM antibodies were negative. The patient did not develop immunity to COVID-19 infection. This report raises several problems. The focal deficit could be a real relapse or a pseudo-relapse due to SARS-CoV-2 and postpartum patient vulnerability. The treatment options in this particular case raise many challenges. The absence of antibodies after a SARS-CoV-2 infection raises a big question over the acquired immunity, the increased risk of reinfection, and the subsequent evolution of MS. The standard of care for a woman with MS and COVID-19 infection during the postpartum period must be explored and more precise recommendations must be established in the future.
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Affiliation(s)
- Anca Alexandra Florea
- Department of Neurology, 'Dr Carol Davila' Central Military Emergency University Hospital, Bucharest 010242, Romania
| | - Carmen Adella Sirbu
- Department of Neurology, 'Dr Carol Davila' Central Military Emergency University Hospital, Bucharest 010242, Romania.,Department of Medical-Surgical and Prophylactic Disciplines, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Minerva Claudia Ghinescu
- Department of Medical-Surgical and Prophylactic Disciplines, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Cristina Florentina Plesa
- Department of Neurology, 'Dr Carol Davila' Central Military Emergency University Hospital, Bucharest 010242, Romania.,Department of Medical-Surgical and Prophylactic Disciplines, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Anca Maria Sirbu
- Department of Endocrinology, National Institute of Endocrinology, CI Parhon, 011863 Bucharest, Romania
| | - Marian Mitrica
- Department of Neurosurgery, 'Dr Carol Davila' Central Military Emergency University Hospital, 010242 Bucharest, Romania
| | - Florentina Ionita-Radu
- Department of Medical-Surgical and Prophylactic Disciplines, Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania.,Department of Gastroenterology, 'Dr Carol Davila' Central Military Emergency University Hospital, 010242 Bucharest, Romania
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178
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Lopes N, Vernuccio F, Costantino C, Imburgia C, Gregoretti C, Salomone S, Drago F, Lo Bianco G. An Italian Guidance Model for the Management of Suspected or Confirmed COVID-19 Patients in the Primary Care Setting. Front Public Health 2020; 8:572042. [PMID: 33330317 PMCID: PMC7732472 DOI: 10.3389/fpubh.2020.572042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023] Open
Abstract
An outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 started in China's Hubei province at the end of 2019 has rapidly become a pandemic. In Italy, a great number of patients was managed in primary care setting and the role of general practitioners and physicians working in the first-aid emergency medical service has become of utmost importance to coordinate the network between the territory and hospitals during the pandemic. Aim of this manuscript is to provide a guidance model for the management of suspected, probable, or confirmed cases of SARS-CoV-2 infection in the primary care setting, from diagnosis to treatment, applying also the recommendations of the Italian Society of General Medicine. Moreover, this multidisciplinary contribution would analyze and synthetize the preventive measures to limit the spread of SARS-CoV-2 infection in the general population as well as the perspective for vaccines.
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Affiliation(s)
- Noemi Lopes
- Provincial Health Authority of Palermo, Palermo, Italy
| | - Federica Vernuccio
- Centro Neurolesi Bonino Pulejo Istituto di Ricovero e Cura a Carattere Scientifico - Scientific Institutes of Hospitalization and Care (IRCCS), Messina, Italy
- Department of Science for Health Promotion and Mother to Child Care, University of Palermo, Palermo, Italy
- Section of Radiology - Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D'Alessandro”, University of Palermo, Palermo, Italy
| | - Claudia Imburgia
- Infectious Disease Unit, National Relevance Hospital Trust, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Cesare Gregoretti
- Department of Surgical, Oncological, and Stomatological Sciences, University of Palermo, Palermo, Italy
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy
| | - Salvatore Salomone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Giuliano Lo Bianco
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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179
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Vankadari N, Jeyasankar NN, Lopes WJ. Structure of the SARS-CoV-2 Nsp1/5'-Untranslated Region Complex and Implications for Potential Therapeutic Targets, a Vaccine, and Virulence. J Phys Chem Lett 2020; 11:9659-9668. [PMID: 33135884 PMCID: PMC7641045 DOI: 10.1021/acs.jpclett.0c02818] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/20/2020] [Indexed: 05/02/2023]
Abstract
SARS-CoV-2 is the cause of the ongoing Coronavirus disease 19 (COVID-19) pandemic around the world causing pneumonia and lower respiratory tract infections. In understanding the SARS-CoV-2 pathogenicity and mechanism of action, it is essential to depict the full repertoire of expressed viral proteins. The recent biological studies have highlighted the leader protein Nsp1 of SARS-CoV-2 importance in shutting down the host protein production. Besides, it still enigmatic how Nsp1 regulates for translation. Here we report the novel structure of Nsp1 from SARS-CoV-2 in complex with the SL1 region of 5'UTR of SARS-CoV-2, and its factual interaction is corroborated with enzyme kinetics and experimental binding affinity studies. The studies also address how leader protein Nsp1 of SARS-CoV-2 recognizes its self RNA toward translational regulation by further recruitment of the 40S ribosome. With the aid of molecular dynamics and simulations, we also demonstrated the real-time stability and functional dynamics of the Nsp1/SL1 complex. The studies also report the potential inhibitors and their mode of action to block viral protein/RNA complex formation. This enhance our understanding of the mechanism of the first viral protein Nsp1 synthesized in the human cell to regulate the translation of self and host. Understanding the structure and mechanism of SARS-CoV-2 Nsp1 and its interplay with the viral RNA and ribosome will open the arena for exploring the development of live attenuated vaccines and effective therapeutic targets for this disease.
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Affiliation(s)
- Naveen Vankadari
- Monash Biomedicine Discovery Institute and
Department of Biochemistry and Molecular Biology and
Faculty of Medicine, Nursing and Health
Science, Monash University, Clayton
Victoria 3800, Australia
| | - Nandhini Nisha Jeyasankar
- Monash Biomedicine Discovery Institute and
Department of Biochemistry and Molecular Biology and
Faculty of Medicine, Nursing and Health
Science, Monash University, Clayton
Victoria 3800, Australia
| | - Wilma Jerom Lopes
- Monash Biomedicine Discovery Institute and
Department of Biochemistry and Molecular Biology and
Faculty of Medicine, Nursing and Health
Science, Monash University, Clayton
Victoria 3800, Australia
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180
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Labetoulle R, Detoc M, Gagnaire J, Berthelot P, Pelissier C, Fontana L, Botelho-Nevers E, Gagneux-Brunon A. COVID-19 in health-care workers: lessons from SARS and MERS epidemics and perspectives for chemoprophylaxis and vaccines. Expert Rev Vaccines 2020; 19:937-947. [PMID: 33107353 DOI: 10.1080/14760584.2020.1843432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: The world is now facing the COVID-19 pandemic. Experience with SARS-CoV and MERS-CoV, and early reports about SARS-CoV-2 infection suggest that health-care settings and health-care workers (HCWs) are vulnerable in the context of the emergence of a new coronavirus. Areas covered: To highlight the need for prophylactic strategies particularly for HCWs, we identified SARS-CoV, MERS-CoV, and SARS-CoV-2 outbreaks in health-care settings and the incidence of infections in HCWs by a search on MEDLINE and MEDxRIV (for SARS-Cov-2). To identify prophylactic strategies against, we conducted a search on MEDLINE and clinicaltrials.gov about studies involving SARS-CoV, MERS-CoV, and SARS-CoV-2. Expert opinion: HCWs account for a great part of SARS, MERS, and SARS-CoV-2 infections, they may also contribute to the spread of the disease, particularly in health-care settings, and contribute to nosocomial outbreaks. Some preventive strategies were evaluated in previous emerging coronavirus epidemics, particularly in MERS-CoV. For COVID-19 prevention, different chemoprophylaxis with drug repositioning and new agents are under evaluation, and different vaccine candidates entered clinical development, with clinical trials. HCWs are a crucial target population for pre-exposure and post-exposure prophylaxis.
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Affiliation(s)
- Rémi Labetoulle
- Department of Microbiology, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Maëlle Detoc
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Julie Gagnaire
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France
| | - Philippe Berthelot
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
| | - Carole Pelissier
- Department of Occupational Medicine, University Hospital of Saint-Etienne , France
| | - Luc Fontana
- Department of Occupational Medicine, University Hospital of Saint-Etienne , France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases and Infection Control, University Hospital of Saint-Etienne , Saint-Etienne, France.,CIC-1408 Vaccinologie INSERM, University Hospital of Saint-Etienne , Saint-Etienne, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, GIMAP EA 3064 Université Jean Monnet, Université De Lyon , Saint-Etienne, France.,Chaire Prévention, Vaccination et Contrôle de l'Infection, PRESAGE Institute, PREVACCI department, Université De Lyon , Saint-Etienne, France
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181
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Szkaradkiewicz-Karpińska AK, Szkaradkiewicz A. Towards a more effective strategy for COVID-19 prevention (Review). Exp Ther Med 2020; 21:33. [PMID: 33262819 PMCID: PMC7690340 DOI: 10.3892/etm.2020.9465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
At the end of 2019, a new disease, similar to severe acute respiratory syndrome (SARS) associated with SARS-CoV was reported in Wuhan, China. It was quickly discovered that the etiological factor of the new disease (COVID-19) was a previously unknown SARS coronavirus 2 (SARS-CoV-2). The global spread of of COVID-19 has lead to the declaration of a pandemic status in 2019-2020 as declared by the World Health Organization and Public Health Emergency of International Concern. SARS-CoV-2 characterizes with high epidemic potential and is effectively disseminated between humans. SARS-CoV and SARS-CoV-2 are closely related pathogens. Their prime route of distribution is air-droplet transmission. Combating infectious diseases disseminated by inhalation is very difficult, and mainly relies on the use of vaccines. However, despite the lack of an effective anti-SARS-CoV vaccine and specific antiviral drugs, the strict sanitary procedures proved to be sufficient to stop the SARS epidemic in June 2003. However, epidemic research has indicated that SARS-CoV-2 is transmitted in humans significantly more effectively than SARS-CoV; therefore, the COVID-19 pandemic continues to expand. This indicates that the so far anti-epidemic activities to control COVID-19 are insufficient. In the current review, the possibility of using interferon α (IFN-α) as a preventive agent of COVID-19 is discussed. The current data concerning anti-COVID-19 vaccines and specific drugs against SARS-CoV-2 are also discussed. The aim of the current review is to contribute to the introduction of a more efficient strategy in the protection of the human population against COVID-19.
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Affiliation(s)
- Anna K Szkaradkiewicz-Karpińska
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, University of Medical Sciences, 60-812 Poznań, Poland
| | - Andrzej Szkaradkiewicz
- Institute of Health and Physical Culture, State Higher Vocational School, 64-100 Leszno, Poland
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182
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Morales-Torres J, Aceves-Ávila FJ. Rheumatologists in the COVID-19 era: will there be a new role for the rheumatologist in the care of rheumatic patients? Clin Rheumatol 2020; 39:3177-3183. [PMID: 32889590 PMCID: PMC7474326 DOI: 10.1007/s10067-020-05380-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Jorge Morales-Torres
- Hospital Aranda de la Parra, Hidalgo 329, 37000, Leon, GTO, Mexico.
- Morales Vargas, Centro de Investigación, Blvd. Adolfo López Mateos 218-D Poniente, 37000, Leon, GTO, Mexico.
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183
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Kostoff RN, Kanduc D, Porter AL, Shoenfeld Y, Calina D, Briggs MB, Spandidos DA, Tsatsakis A. Vaccine- and natural infection-induced mechanisms that could modulate vaccine safety. Toxicol Rep 2020; 7:1448-1458. [PMID: 33110761 PMCID: PMC7581376 DOI: 10.1016/j.toxrep.2020.10.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/17/2020] [Indexed: 12/20/2022] Open
Abstract
A degraded/dysfunctional immune system appears to be the main determinant of serious/fatal reaction to viral infection (for COVID-19, SARS, and influenza alike). There are four major approaches being employed or considered presently to augment or strengthen the immune system, in order to reduce adverse effects of viral exposure. The three approaches that are focused mainly on augmenting the immune system are based on the concept that pandemics/outbreaks can be controlled/prevented while maintaining the immune-degrading lifestyles followed by much of the global population. The fourth approach is based on identifying and introducing measures aimed at strengthening the immune system intrinsically in order to minimize future pandemics/outbreaks. Specifically, the four measures are: 1) restricting exposure to virus; 2) providing reactive/tactical treatments to reduce viral load; 3) developing vaccines to prevent, or at least attenuate, the infection; 4) strengthening the immune system intrinsically, by a) identifying those factors that contribute to degrading the immune system, then eliminating/reducing them as comprehensively, thoroughly, and rapidly as possible, and b) replacing the eliminated factors with immune-strengthening factors. This paper focuses on vaccine safety. A future COVID-19 vaccine appears to be the treatment of choice at the national/international level. Vaccine development has been accelerated to achieve this goal in the relatively near-term, and questions have arisen whether vaccine safety has been/is being/will be compromised in pursuit of a shortened vaccine development time. There are myriad mechanisms related to vaccine-induced, and natural infection-induced, infections that could adversely impact vaccine effectiveness and safety. This paper summarizes many of those mechanisms.
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Affiliation(s)
- Ronald N. Kostoff
- Research Affiliate, School of Public Policy, Georgia Institute of Technology, Gainesville, VA, 20155, USA
| | - Darja Kanduc
- Department of Biosciences, Biotechnologies, and Biopharmaceutics, University of Bari, 70125 Bari, Italy
| | - Alan L. Porter
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, 30332, USA
- Search Technology, Inc., Peachtree Corners, GA, 30092, USA
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5265601, Israel
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Sechenov University, Moscow, Russia
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71409, Heraklion, Greece
| | - Aristidis Tsatsakis
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Sechenov University, Moscow, Russia
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
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184
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Sharifi-Rad J, Kamiloglu S, Yeskaliyeva B, Beyatli A, Alfred MA, Salehi B, Calina D, Docea AO, Imran M, Anil Kumar NV, Romero-Román ME, Maroyi A, Martorell M. Pharmacological Activities of Psoralidin: A Comprehensive Review of the Molecular Mechanisms of Action. Front Pharmacol 2020; 11:571459. [PMID: 33192514 PMCID: PMC7643726 DOI: 10.3389/fphar.2020.571459] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/28/2020] [Indexed: 12/29/2022] Open
Abstract
Analysis of the most relevant studies on the pharmacological properties and molecular mechanisms of psoralidin, a bioactive compound from the seeds of Cullen corylifolium (L.) Medik. confirmed its complex therapeutic potential. In the last years, the interest of the scientific community regarding psoralidin increased, especially after the discovery of its benefits in estrogen-related diseases and as a chemopreventive agent. Growing preclinical pieces of evidence indicate that psoralidin has anticancer, antiosteoporotic, anti-inflammatory, anti-vitiligo, antibacterial, antiviral, and antidepressant-like effects. Here, we provide a comprehensive and critical review of psoralidin on its bioavailability, pharmacological activities with focus on molecular mechanisms and cell signaling pathways. In this review, we conducted literature research on the PubMed database using the following keywords: “Psoralidin” or “therapeutic effects” or “biological activity” or “Cullen corylifolium” in order to identify relevant studies regarding PSO bioavailability and mechanisms of therapeutic effects in different diseases based on preclinical, experimental studies. In the light of psoralidin beneficial actions for human health, this paper gathers complete information on its pharmacotherapeutic effects and opens new natural therapeutic perspectives in chronic diseases.
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Affiliation(s)
- Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Senem Kamiloglu
- Science and Technology Application and Research Center (BITAUM), Bursa Uludag University, Bursa, Turkey
| | - Balakyz Yeskaliyeva
- Faculty of Chemistry and Chemical Technology, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Ahmet Beyatli
- Department of Medicinal and Aromatic Plants, University of Health Sciences, Istanbul, Turkey
| | - Mary Angelia Alfred
- Department of Chemistry, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Muhammad Imran
- Faculty of Allied Health Sciences, University Institute of Diet and Nutritional Sciences, The University of Lahore, Lahore, Pakistan
| | | | - Maria Eugenia Romero-Román
- Laboratorio de Análisis Químico, Departamento de Producción Vegetal, Facultad de Agronomía, Universidad de Concepción, Concepción, Chile
| | - Alfred Maroyi
- Department of Botany, University of Fort Hare, Alice, South Africa
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, Centre for Healthy Living, University of Concepción, Concepción, Chile.,Unidad de Desarrollo Tecnológico, UDT, Universidad de Concepción, Concepción, Chile
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185
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Liu Y, Wang K, Massoud TF, Paulmurugan R. SARS-CoV-2 Vaccine Development: An Overview and Perspectives. ACS Pharmacol Transl Sci 2020; 3:844-858. [PMID: 33062951 PMCID: PMC7526333 DOI: 10.1021/acsptsci.0c00109] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019, abbreviated as COVID-19, is caused by a new strain of coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It started in late December 2019 in Wuhan, China, and by mid-March 2020, the disease had spread globally. As of July 17, 2020, this pandemic virus has infected 13.9 million people and claimed the life of approximately 593 000 people globally, and the numbers continue to climb. An unprecedented effort is underway to develop therapeutic and prophylactic strategies against this disease. Various drugs and vaccines are undergoing rapid development, and some of these are already in phase III clinical trials. Although Russia was the first to release a vaccine by skipping phase III clinical trials, there is no evidence of large-scale clinical trials, and the safety and efficacy of the vaccine are still a concern. Nevertheless, critical lessons can be learned and data garnered for developing promising vaccines against this rapidly emerging virus or other similar pathogens in the future. In this overview, we cover the available information on the various vaccine development initiatives by different companies, the potential strategies adopted for vaccine design, and the challenges and clinical impact expected from these vaccines. We also briefly discuss the possible role of these vaccines and the specific concerns for their use in patients with pre-existing disease conditions such as cardiovascular, lung, kidney, and liver diseases, cancer patients who are receiving immunosuppressive medications, including anticancer chemotherapies, and many other sensitive populations, such as children and the elderly.
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Affiliation(s)
- Yi Liu
- Molecular
Imaging Program at Stanford (MIPS), Stanford
University, 3155 Porter Drive, Palo Alto, California 94304, United States
- Department
of Critical Care Medicine, The Second Affiliated
Hospital of Chongqing Medical University, Chongqing, China
| | - Kai Wang
- Molecular
Imaging Program at Stanford (MIPS), Stanford
University, 3155 Porter Drive, Palo Alto, California 94304, United States
| | - Tarik F. Massoud
- Molecular
Imaging Program at Stanford (MIPS), Stanford
University, 3155 Porter Drive, Palo Alto, California 94304, United States
| | - Ramasamy Paulmurugan
- Molecular
Imaging Program at Stanford (MIPS), Stanford
University, 3155 Porter Drive, Palo Alto, California 94304, United States
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186
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Calina D, Sarkar C, Arsene AL, Salehi B, Docea AO, Mondal M, Islam MT, Zali A, Sharifi-Rad J. Recent advances, approaches and challenges in targeting pathways for potential COVID-19 vaccines development. Immunol Res 2020; 68:315-324. [PMID: 33006053 PMCID: PMC7529090 DOI: 10.1007/s12026-020-09154-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/11/2020] [Indexed: 12/24/2022]
Abstract
During the COVID-19 pandemic in a modern era, there is a global consensus on the need for the rapid development of a vaccine against SARS-CoV-2 for effective and sustainable control. Developing these vaccines is fundamental to public health. This urgent need is supported by the scientific explosion in structural and genomic biology that facilitates the urgent development of an ideal COVID-19 vaccine, using new pathways to facilitate its large-scale development, testing, and manufacture. Here, we summarize the types of COVID-19 candidate vaccines, their current stage in early testing in human clinical trials, and the challenges for their implementation.
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Affiliation(s)
- Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Chandan Sarkar
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
| | - Andreea Letitia Arsene
- Department of Department of Microbiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bahare Salehi
- Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran.,Student Research Committee, School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Milon Mondal
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
| | - Muhammad Torequl Islam
- Department of Pharmacy, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, 02125719, Iran
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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187
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Lima M, Siokas V, Aloizou AM, Liampas I, Mentis AFA, Tsouris Z, Papadimitriou A, Mitsias PD, Tsatsakis A, Bogdanos DP, Baloyannis SJ, Dardiotis E. Unraveling the Possible Routes of SARS-COV-2 Invasion into the Central Nervous System. Curr Treat Options Neurol 2020; 22:37. [PMID: 32994698 PMCID: PMC7515807 DOI: 10.1007/s11940-020-00647-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW To describe the possible neuroinvasion pathways of Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV-2), the virus responsible for the Coronavirus disease-19 (Covid-19) pandemic. RECENT FINDINGS We present data regarding the family of Coronaviruses (CoVs) and the central nervous system (CNS), and describe parallels between SARS-CoV-2 and other members of the family, which have been investigated in more depth and combine these findings with the recent advancements regarding SARS-CoV-2. SUMMARY SARS-CoV-2 like other CoVs is neuroinvasive, neurotropic and neurovirulent. Two main pathways of CNS penetration seem to be the strongest candidates, the hematogenous and the neuronal. Τhe olfactory route in particular appears to play a significant role in neuroinvasion of coronaviruses and SARS-CoV-2, as well. However, existing data suggest that other routes, involving the nasal epithelium in general, lymphatic tissue and the CSF may also play roles in SARS-CoV-2 invasion into the CNS.
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Affiliation(s)
- Maria Lima
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Ioannis Liampas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Alexios-Fotios A. Mentis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
- Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece
| | - Zisis Tsouris
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Anastasios Papadimitriou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Panayiotis D. Mitsias
- Department of Neurology, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202 USA
- School of Medicine, Wayne State University, Detroit, MI 48202 USA
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Stavros J. Baloyannis
- Research Institute for Alzheimer’s Disease, Aristotelian University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
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188
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Kostoff RN, Briggs MB, Porter AL, Spandidos DA, Tsatsakis A. [Comment] COVID‑19 vaccine safety. Int J Mol Med 2020; 46:1599-1602. [PMID: 33000193 PMCID: PMC7521561 DOI: 10.3892/ijmm.2020.4733] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/18/2020] [Indexed: 12/19/2022] Open
Abstract
In response to the SARS-CoV-2 outbreak, and the resulting COVID-19 pandemic, a global competition to develop an anti-COVID-19 vaccine has ensued. The targeted time frame for initial vaccine deployment is late 2020. The present article examines whether short-term, mid-term, and long-term vaccine safety can be achieved under such an accelerated schedule, given the myriad vaccine-induced mechanisms that have demonstrated adverse effects based on previous clinical trials and laboratory research. It presents scientific evidence of potential pitfalls associated with eliminating critical phase II and III clinical trials, and concludes that there is no substitute currently available for long-term human clinical trials to ensure long-term human safety.
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Affiliation(s)
- Ronald N Kostoff
- School of Public Policy, Georgia Institute of Technology, Gainesville, VA 20155, USA
| | | | - Alan L Porter
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 70013 Heraklion, Greece
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 70013 Heraklion, Greece
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189
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Sarkar C, Mondal M, Torequl Islam M, Martorell M, Docea AO, Maroyi A, Sharifi-Rad J, Calina D. Potential Therapeutic Options for COVID-19: Current Status, Challenges, and Future Perspectives. Front Pharmacol 2020; 11:572870. [PMID: 33041814 PMCID: PMC7522523 DOI: 10.3389/fphar.2020.572870] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/24/2020] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic represents an unprecedented challenge for the researchers to offer safe, tolerable, and effective treatment strategies for its causative agent known as SARS-CoV-2. With the rapid evolution of the pandemic, even the off-label use of existing drugs has been restricted by limited availability. Several old antivirals, antimalarial, and biological drugs are being reconsidered as possible therapies. The effectiveness of the controversial treatment options for COVID-19 such as nonsteroidal antiinflammatory drugs, angiotensin 2 conversion enzyme inhibitors and selective angiotensin receptor blockers was also discussed. A systemic search in the PubMed, Science Direct, LitCovid, Chinese Clinical Trial Registry, and ClinicalTrials.gov data bases was conducted using the keywords "coronavirus drug therapy," passive immunotherapy for COVID-19', "convalescent plasma therapy," (CPT) "drugs for COVID-19 treatment," "SARS-CoV-2," "COVID-19," "2019-nCoV," "coronavirus immunology," "microbiology," "virology," and individual drug names. Systematic reviews, case presentations and very recent clinical guidelines were included. This narrative review summarizes the available information on possible therapies for COVID-19, providing recent data to health professionals.
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Affiliation(s)
- Chandan Sarkar
- Department of Pharmacy, Life Science School, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj (Dhaka), Bangladesh
| | - Milon Mondal
- Department of Pharmacy, Life Science School, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj (Dhaka), Bangladesh
| | - Muhammad Torequl Islam
- Laboratory of Theoretical and Computational Biophysics, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, and Centre for Healthy Living, University of Concepción, Concepción, Chile
- Universidad de Concepción, Unidad de Desarrollo Tecnológico, UDT, Concepción, Chile
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Alfred Maroyi
- Department of Botany, University of Fort Hare, Alice, South Africa
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
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190
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Smitha T, Thomas A. A brief outlook on the current emerging trends of COVID 19 vaccines. J Oral Maxillofac Pathol 2020; 24:206-211. [PMID: 33456225 PMCID: PMC7802844 DOI: 10.4103/jomfp.jomfp_334_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- T Smitha
- Department of Oral and Maxillofacial Pathology, VSDCH, Bengaluru, Karnataka, India
| | - Anela Thomas
- Department of Oral and Maxillofacial Pathology, VSDCH, Bengaluru, Karnataka, India
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191
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Tanasa IA, Manciuc C, Carauleanu A, Navolan DB, Bohiltea RE, Nemescu D. Anosmia and ageusia associated with coronavirus infection (COVID-19) - what is known? Exp Ther Med 2020; 20:2344-2347. [PMID: 32765712 PMCID: PMC7401831 DOI: 10.3892/etm.2020.8808] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/28/2020] [Indexed: 01/08/2023] Open
Abstract
In 2020 a new pandemic caused by the SARS-CoV-2 coronavirus is affecting the lives of millions of patients and healthcare workers worldwide. The clinical picture of this infection is in a dynamic process of discovery, and more symptoms emerge as the clinicians observe and diagnose manifestations that affect multiple organs. Anosmia (loss of smell), and ageusia (loss of taste) become more frequently cited as independent symptoms or in association with the most common manifestations of the disease, such as fever, cough and dyspnea. A thorough screening program will prevent most nosocomial and community-acquired infections by promoting efficient triage and specific measures such as isolation of the patients. Therefore, it is important to include frequent symptoms in the anamnesis and questionnaires to select those patients who might benefit from testing, isolation, and treatment. This study summarizes the existing data regarding the association of anosmia and ageusia with the SARS-CoV-2 infection. It also aims to describe manifestations of these, particularly in the clinical picture of all symptomatic patients.
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Affiliation(s)
- Ingrid Andrada Tanasa
- Department of Obstetrics and Gynecology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Carmen Manciuc
- Department of Infectious Diseases, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alexandru Carauleanu
- Department of Obstetrics and Gynecology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dan Bogdan Navolan
- Department of Obstetrics and Gynecology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Roxana Elena Bohiltea
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Dragos Nemescu
- Department of Obstetrics and Gynecology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
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192
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Akiyama T, Hirata T, Fujimoto T, Hatakeyama S, Yamazaki R, Nomura T. The Natural-Mineral-Based Novel Nanomaterial IFMC Increases Intravascular Nitric Oxide without Its Intake: Implications for COVID-19 and beyond. NANOMATERIALS 2020; 10:nano10091699. [PMID: 32872395 PMCID: PMC7559745 DOI: 10.3390/nano10091699] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/16/2020] [Accepted: 08/27/2020] [Indexed: 01/22/2023]
Abstract
There are currently no promising therapy strategies for either the treatment or prevention of novel coronavirus disease 2019 (COVID-19), despite the urgent need. In addition to respiratory diseases, vascular complications are rapidly emerging as a key threat of COVID-19. Existing nitric oxide (NO) therapies have been shown to improve the vascular system; however, they have different limitations in terms of safety, usability and availability. In light of this, we hypothesise that a natural-mineral-based novel nanomaterial, which was developed based on NO therapy, might be a viable strategy for the treatment and prevention of COVID-19. The present study examined if it could induce an increase of intravascular NO, vasodilation and the consequent increase of blood flow rate and temperature in a living body. The intravascular NO concentration in the hepatic portal of rats was increased by 0.17 nM over 35.2 s on average after its application. An ultrasonic Doppler flow meter showed significant increases in the blood flow rate and vessel diameter, but no difference in the blood flow velocity. These were corroborated by measurements of human hand surface temperature. To our knowledge, this result is the first evidence where an increase of intravascular NO and vasodilation were induced by bringing a natural-mineral-based nanomaterial into contact with or close to a living body. The precise mechanisms remain a matter for further investigation; however, we may assume that endothelial NO synthase, haemoglobin and endothelium-derived hyperpolarising factor are deeply involved in the increase of intravascular NO.
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Affiliation(s)
- Tomohiro Akiyama
- Advanced Research Laboratories, Tokyo City University, Tokyo 158-8557, Japan;
- Graduate School of Information Technology, Kobe Institute of Computing, Kobe 650-0001, Japan
- Graduate School of Education, Kyoto University, Kyoto 606-8501, Japan
- Graduate School of Global Environmental Studies, Sophia University, Tokyo 102-8554, Japan
- Correspondence: (T.A.); (T.H.)
| | - Takamichi Hirata
- Advanced Research Laboratories, Tokyo City University, Tokyo 158-8557, Japan;
- Graduate School of Integrative Science and Engineering, Electrical Engineering and Chemistry, Tokyo City University, Tokyo 158-8557, Japan; (S.H.); (R.Y.)
- Correspondence: (T.A.); (T.H.)
| | - Takahiro Fujimoto
- Advanced Research Laboratories, Tokyo City University, Tokyo 158-8557, Japan;
- Clinic F Laser Medicine & Surgery, Tokyo 102-0083, Japan
| | - Shinnosuke Hatakeyama
- Graduate School of Integrative Science and Engineering, Electrical Engineering and Chemistry, Tokyo City University, Tokyo 158-8557, Japan; (S.H.); (R.Y.)
| | - Ryuhei Yamazaki
- Graduate School of Integrative Science and Engineering, Electrical Engineering and Chemistry, Tokyo City University, Tokyo 158-8557, Japan; (S.H.); (R.Y.)
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COVID-19 vaccines: ethical framework concerning human challenge studies. ACTA ACUST UNITED AC 2020; 28:807-812. [PMID: 32851596 PMCID: PMC7449865 DOI: 10.1007/s40199-020-00371-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022]
Abstract
Background The pandemic associated with the new SARS-CoV-2 coronavirus continues to spread worldwide. The most favorable epidemic control scenario, which provides long-term protection against COVID-19 outbreak, is the development and distribution of an effective and safe vaccine. The need to develop a new COVID-19 vaccine is pressing; however, it is likely to take a long time, possibly several years. This is due to the time required to demonstrate the safety and efficacy of the proposed vaccine. and the time required to manufacture and distribute millions of doses. Objectives To accelerate this development and associated safety testing, the deliberate infection of healthy volunteers has been suggested. The purpose of this short communication is to describe the ethical aspects of this type of testing, Results Deliberate infection of volunteers with a dangerous virus such as SARS-CoV-2 was initially considered unethical by researchers; but the current pandemic is so different from previous ones that these studies are considered ethical if certain criteria are met. Participants in human challenge studies must be relatively young, in good health and must receive the highest quality medical care, with frequent monitoring. Tests should also be performed with great caution and specialized medical supervision. Besides, the fact that obtaining vaccines faster through deliberate infection studies of healthy people has greater benefits than risks, has been demonstrated by obtaining other vaccines in other historical pandemics such as: smallpox, influenza, malaria, typhoid fever, Dengue fever and Zika. Conclusions One possibility to shorten the time required for the development of COVID-19 vaccines is to reduce clinical phases II and III by using human challenge studies through eliberate infection of healthy volunteers with SARS-CoV-2 after administration of the candidate vaccine. Accelerating the development of a COVID-19 vaccine even for a few weeks or months would have a great beneficial impact on public health by saving many lives. Graphical abstract ![]()
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Sharifi-Rad J, Rodrigues CF, Stojanović-Radić Z, Dimitrijević M, Aleksić A, Neffe-Skocińska K, Zielińska D, Kołożyn-Krajewska D, Salehi B, Milton Prabu S, Schutz F, Docea AO, Martins N, Calina D. Probiotics: Versatile Bioactive Components in Promoting Human Health. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E433. [PMID: 32867260 PMCID: PMC7560221 DOI: 10.3390/medicina56090433] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/19/2020] [Accepted: 08/25/2020] [Indexed: 02/08/2023]
Abstract
The positive impact of probiotic strains on human health has become more evident than ever before. Often delivered through food, dietary products, supplements, and drugs, different legislations for safety and efficacy issues have been prepared. Furthermore, regulatory agencies have addressed various approaches toward these products, whether they authorize claims mentioning a disease's diagnosis, prevention, or treatment. Due to the diversity of bacteria and yeast strains, strict approaches have been designed to assess for side effects and post-market surveillance. One of the most essential delivery systems of probiotics is within food, due to the great beneficial health effects of this system compared to pharmaceutical products and also due to the increasing importance of food and nutrition. Modern lifestyle or various diseases lead to an imbalance of the intestinal flora. Nonetheless, as the amount of probiotic use needs accurate calculations, different factors should also be taken into consideration. One of the novelties of this review is the presentation of the beneficial effects of the administration of probiotics as a potential adjuvant therapy in COVID-19. Thus, this paper provides an integrative overview of different aspects of probiotics, from human health care applications to safety, quality, and control.
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Affiliation(s)
- Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1991953381, Iran;
| | - Célia F. Rodrigues
- LEPABE—Department of Chemical Engineering, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal;
| | - Zorica Stojanović-Radić
- Department of Biology and Ecology, Faculty of Science and Mathematics, University of Niš, 18000 Niš, Serbia; (Z.S.-R.); (M.D.); (A.A.)
| | - Marina Dimitrijević
- Department of Biology and Ecology, Faculty of Science and Mathematics, University of Niš, 18000 Niš, Serbia; (Z.S.-R.); (M.D.); (A.A.)
| | - Ana Aleksić
- Department of Biology and Ecology, Faculty of Science and Mathematics, University of Niš, 18000 Niš, Serbia; (Z.S.-R.); (M.D.); (A.A.)
| | - Katarzyna Neffe-Skocińska
- Department of Food Gastronomy and Food Hygiene, Warsaw University of Life Sciences (WULS), 02-776 Warszawa, Poland; (K.N.-S.); (D.Z.); (D.K.-K.)
| | - Dorota Zielińska
- Department of Food Gastronomy and Food Hygiene, Warsaw University of Life Sciences (WULS), 02-776 Warszawa, Poland; (K.N.-S.); (D.Z.); (D.K.-K.)
| | - Danuta Kołożyn-Krajewska
- Department of Food Gastronomy and Food Hygiene, Warsaw University of Life Sciences (WULS), 02-776 Warszawa, Poland; (K.N.-S.); (D.Z.); (D.K.-K.)
| | - Bahare Salehi
- Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam 44340847, Iran
- Student Research Committee, School of Medicine, Bam University of Medical Sciences, Bam 44340847, Iran
| | - Selvaraj Milton Prabu
- Department of Zoology, Annamalai University, Annamalai Nagar 608002, Chidambaram, India;
| | - Francine Schutz
- Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Natália Martins
- Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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195
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Kostoff RN, Briggs MB, Porter AL, Hernández AF, Abdollahi M, Aschner M, Tsatsakis A. The under-reported role of toxic substance exposures in the COVID-19 pandemic. Food Chem Toxicol 2020; 145:111687. [PMID: 32805343 PMCID: PMC7426727 DOI: 10.1016/j.fct.2020.111687] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 12/16/2022]
Abstract
Coronavirus disease 2019 (COVID-19) and previous pandemics have been viewed almost exclusively as virology problems, with toxicology problems mostly being ignored. This perspective is not supported by the evolution of COVID-19, where the impact of real-life exposures to multiple toxic stressors degrading the immune system is followed by the SARS-CoV-2 virus exploiting the degraded immune system to trigger a chain of events ultimately leading to COVID-19. This immune system degradation from multiple toxic stressors (chemical, physical, biological, psychosocial stressors) means that attribution of serious consequences from COVID-19 should be made to the virus-toxic stressors nexus, not to any of the nexus constituents in isolation. The leading toxic stressors (identified in this study as contributing to COVID-19) are pervasive, contributing to myriad chronic diseases as well as immune system degradation. They increase the likelihood for comorbidities and mortality associated with COVID-19. For the short-term, tactical/reactive virology-focused treatments are of higher priority than strategic/proactive toxicology-focused treatments, although both could be implemented in parallel to reinforce each other. However, for long-term pandemic prevention, toxicology-based approaches should be given higher priority than virology-based approaches. Since current COVID-19 treatments globally ignore the toxicology component almost completely, only limited benefits can be expected from these treatments. Toxicology contributions to COVID-19 are mostly ignored relative to virology contributions. Exposure to myriad toxic substances degrades the immune system, whose resulting dysfunction is then exploited by SARS-CoV-2 to result in COVID-19. Attribution of serious consequences from COVID-19 should be made to the virus-toxic stressors combination nexus, not to any of the nexus constituents in isolation. Effective treatments need to address toxicology and virology interactions.
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Affiliation(s)
- Ronald N Kostoff
- Research Affiliate, School of Public Policy, Georgia Institute of Technology, Gainesville, VA, USA.
| | | | - Alan L Porter
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, USA; Search Technology, Peachtree Corners, GA, USA
| | - Antonio F Hernández
- Department of Legal Medicine and Toxicology, University of Granada School of Medicine, Health Sciences Technological Park, Granada, Spain
| | - Mohammad Abdollahi
- Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY, USA; IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Aristidis Tsatsakis
- IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Laboratory of Toxicolgy and Forensic Sciences, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece
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196
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Fu J, Huang PP, Zhang S, Yao QD, Han R, Liu HF, Yang Y, Zhang DY. The value of serum amyloid A for predicting the severity and recovery of COVID-19. Exp Ther Med 2020; 20:3571-3577. [PMID: 32855710 PMCID: PMC7444421 DOI: 10.3892/etm.2020.9114] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/07/2020] [Indexed: 01/08/2023] Open
Abstract
The present study aimed to evaluate the value of serum amyloid A (SAA) in coronavirus disease 2019 (COVID-19) and compared the efficacy of SAA and C-reactive protein (CRP) in predicting the severity and recovery of COVID-19. A retrospective study was conducted on COVID-19 patients hospitalized in Wuhan No. 1 Hospital (Hubei, China) from January 21, 2020 to March 4, 2020. A two-way ANOVA analysis was used to compare the serum CRP and SAA levels between mild group and severe group during hospitalization days. Linear regression was used to analyze the relationship between the serum CRP, SAA levels and treatment days in recovered patients. The Logistic regression analysis and the area under curve (AUC) were calculated to determine the probability for predicting the severity and recovery of COVID-19. The severe group displayed higher CRP and SAA levels compared with the mild group during hospitalization (P<0.001). Logistic regression indicated that SAA and CRP were independent risk factors for the severity of COVID-19. The corresponding AUC of CRP and SAA values for severity of COVID-19 were 0.804 and 0.818, respectively. Linear regression analysis revealed that CRP and SAA levels were negatively correlated with treatment days in recovered patients (r=-0.761, -0.795, respectively). Logistic regression demonstrated that SAA was an independent factor for predicting the recovery of COVID-19. However, CRP could not predict the recovery of COVID-19. The corresponding AUC of SAA for the recovery of COVID-19 was 0.923. The results of the present study indicated that SAA can be considered to be a biomarker for predicting the severity and recovery of COVID-19.
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Affiliation(s)
- Jun Fu
- Department of Radiology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Pian-Pian Huang
- Department of Geriatrics, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Shuang Zhang
- Department of Clinical Laboratory, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Qing-Dong Yao
- Department of Radiology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Rui Han
- Department of Radiology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Hai-Feng Liu
- Department of Radiology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Yi Yang
- Department of Radiology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Dong-You Zhang
- Department of Radiology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
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197
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Dima A, Balaban DV, Jurcut C, Berza I, Jurcut R, Jinga M. Physicians' Perspectives on COVID-19: An International Survey. Healthcare (Basel) 2020; 8:E250. [PMID: 32748880 PMCID: PMC7551682 DOI: 10.3390/healthcare8030250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has put a tremendous pressure over health care systems worldwide. Physicians were faced to fight this novel, emerging disease, without evidence-based recommendations. Our aim was to investigate physicians' point of view regarding the new coronavirus disease. We designed an on-line survey with 30 questions to assess physicians' perception of personal impact as well as epidemiology, clinical features, management, and outcome in COVID-19. A total of 194 physicians from 43 countries, of which 42.3% were male, 45.4% had more than 5 years' experience and 10.8% were heads of department/professors, filled-out the questionnaire. Although 47.4% of the physicians were currently treating patients, over 80% thought that they might get in contact with COVID-19 patients. A total of 36.6% physicians thought that they are not and 30.9% were not sure if they were being protected by the ongoing procedures. A total of 21.1% of the doctors felt that they are avoided by the persons with whom they usually interact in daily life and 24.7% were isolated from the household members they usually live with. A total of 72.7% of physicians considered that COVID-19-free patients are currently neglected. The results of the current survey raise awareness about the impact of COVID-19 on physicians' practice.
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Affiliation(s)
- Alina Dima
- Rheumatology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania; (A.D.); (I.B.)
| | - Daniel Vasile Balaban
- Internal Medicine, Gastroenterology and Cardiology Departments, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.J.); (M.J.)
- Internal Medicine and Gastroenterology Department, Dr Carol Davila Central University Emergency Military Hospital, 010825 Bucharest, Romania;
| | - Ciprian Jurcut
- Internal Medicine and Gastroenterology Department, Dr Carol Davila Central University Emergency Military Hospital, 010825 Bucharest, Romania;
| | - Ioana Berza
- Rheumatology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania; (A.D.); (I.B.)
| | - Ruxandra Jurcut
- Internal Medicine, Gastroenterology and Cardiology Departments, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.J.); (M.J.)
- Cardiology Department, Prof Dr CC Iliescu Institute of Cardiovascular Diseases, 022322 Bucharest, Romania
| | - Mariana Jinga
- Internal Medicine, Gastroenterology and Cardiology Departments, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.J.); (M.J.)
- Internal Medicine and Gastroenterology Department, Dr Carol Davila Central University Emergency Military Hospital, 010825 Bucharest, Romania;
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198
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Kostoff RN, Briggs MB, Porter AL, Aschner M, Spandidos DA, Tsatsakis A. [Editorial] COVID‑19: Post‑lockdown guidelines. Int J Mol Med 2020; 46:463-466. [PMID: 32626934 PMCID: PMC7307834 DOI: 10.3892/ijmm.2020.4640] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Since March, 2020, in response to the COVID‑19 pandemic, many countries have been on lockdown (at different levels of severity), restricting many activities and businesses that involve gatherings of large numbers of people in close proximity. Currently (early June, 2020), countries across the globe are in different stages of easing lockdown restrictions. Public policies for behaviors and actions during this transition period vary widely across countries and within country jurisdictions. The present editorial will address potential policies that could minimize resurgence of the present pandemic (the 'second‑wave') and reduce the likelihood and severity of similar future pandemics.
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Affiliation(s)
- Ronald N. Kostoff
- School of Public Policy, Georgia Institute of Technology, Gainesville, VA 20155
| | | | - Alan L. Porter
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA 30332
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Aristidis Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 70013 Heraklion, Greece
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199
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Nitulescu GM, Paunescu H, Moschos SA, Petrakis D, Nitulescu G, Ion GND, Spandidos DA, Nikolouzakis TK, Drakoulis N, Tsatsakis A. Comprehensive analysis of drugs to treat SARS‑CoV‑2 infection: Mechanistic insights into current COVID‑19 therapies (Review). Int J Mol Med 2020; 46:467-488. [PMID: 32468014 PMCID: PMC7307820 DOI: 10.3892/ijmm.2020.4608] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/18/2020] [Indexed: 12/16/2022] Open
Abstract
The major impact produced by the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) focused many researchers attention to find treatments that can suppress transmission or ameliorate the disease. Despite the very fast and large flow of scientific data on possible treatment solutions, none have yet demonstrated unequivocal clinical utility against coronavirus disease 2019 (COVID‑19). This work represents an exhaustive and critical review of all available data on potential treatments for COVID‑19, highlighting their mechanistic characteristics and the strategy development rationale. Drug repurposing, also known as drug repositioning, and target based methods are the most used strategies to advance therapeutic solutions into clinical practice. Current in silico, in vitro and in vivo evidence regarding proposed treatments are summarized providing strong support for future research efforts.
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Affiliation(s)
| | - Horia Paunescu
- Faculty of Medicine, ′Carol Davila′ University of Medicine and Pharmacy, 020956 Bucharest, Romania
| | - Sterghios A. Moschos
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University
- PulmoBioMed Ltd., Newcastle-Upon-Tyne NE1 8ST, UK
| | | | | | | | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion
| | | | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece
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Stancioiu F, Papadakis GZ, Kteniadakis S, Izotov BN, Coleman MD, Spandidos DA, Tsatsakis A. A dissection of SARS‑CoV2 with clinical implications (Review). Int J Mol Med 2020; 46:489-508. [PMID: 32626922 PMCID: PMC7307812 DOI: 10.3892/ijmm.2020.4636] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023] Open
Abstract
We are being confronted with the most consequential pandemic since the Spanish flu of 1918‑1920 to the extent that never before have 4 billion people quarantined simultaneously; to address this global challenge we bring to the forefront the options for medical treatment and summarize SARS‑CoV2 structure and functions, immune responses and known treatments. Based on literature and our own experience we propose new interventions, including the use of amiodarone, simvastatin, pioglitazone and curcumin. In mild infections (sore throat, cough) we advocate prompt local treatment for the naso‑pharynx (inhalations; aerosols; nebulizers); for moderate to severe infections we propose a tried‑and‑true treatment: the combination of arginine and ascorbate, administered orally or intravenously. The material is organized in three sections: i) Clinical aspects of COVID‑19; acute respiratory distress syndrome (ARDS); known treatments; ii) Structure and functions of SARS‑CoV2 and proposed antiviral drugs; iii) The combination of arginine‑ascorbate.
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Affiliation(s)
| | | | | | - Boris Nikovaevich Izotov
- Department of Analytical and Forensic Medical Toxicology, Sechenov University, 119991 Moscow, Russia
| | - Michael D. Coleman
- School of Life and Health Sciences, Aston University, B4 7ET Birmingham, UK
| | | | - Aristidis Tsatsakis
- Department of Analytical and Forensic Medical Toxicology, Sechenov University, 119991 Moscow, Russia
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
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