251
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Delayed post-hypoxic leukoencephalopathy in an adult with COVID-19. J Neurovirol 2021; 27:514-518. [PMID: 33977501 PMCID: PMC8112471 DOI: 10.1007/s13365-021-00982-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/02/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022]
Abstract
As the novel coronavirus, SARS-CoV-2, has enveloped the world in a pandemic, it has become clear that the symptoms extend far beyond the respiratory system and have particularly caused a wide range of neurologic CNS complications, including diffuse leukoencephalopathy. Here, we describe a case of a 59-year-old male with severe COVID-19 infection who developed severe encephalopathy, which persisted well after his acute infection had subsided and had begun to improve from his respiratory dysfunction. He was found to have diffuse leukoencephalopathy with concomitant diffusion restriction on MR imaging. This case represents a delayed onset of leukoencephalopathy secondary to hypoxia in a small but growing cohort of COVID-related leukoencephalopathy due to similarities in imaging features and lack of superior alternate diagnosis. Patient’s clinical improvement suggests reversibility with likely pathology being demyelination rather than infarction.
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252
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Chandel V, Tripathi G, Nayar SA, Rathi B, Kumar A, Kumar D. In silico identification and validation of triarylchromones as potential inhibitor against main protease of severe acute respiratory syndrome coronavirus 2. J Biomol Struct Dyn 2021; 40:8850-8865. [PMID: 33939590 PMCID: PMC8108196 DOI: 10.1080/07391102.2021.1918255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 04/11/2021] [Indexed: 12/14/2022]
Abstract
The ongoing pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused COVID-19 has emerged as a severe threat to the life of human kind. The identification and designing of appropriate and reliable drug molecule for the treatment of COVID-19 patients is the pressing need of the present time. Among different drug targets, the main protease of SARS-CoV-2 is being considered as most effective target. In addition to the drug repurposing, different compounds of natural as well as synthetic origins are being investigated for their efficacy against different drug targets of SARS-CoV-2 virus. In that context, the chromone based natural flavonols have also exhibited significant antiviral properties against different targets of SARS-CoV-2. The in silico studies presented here discloses the efficacy of triarylchromones (TAC) as potential inhibitor against main protease of SARS-CoV-2. The molecular docking and ADMET study performed using 14 arylchromones which could easily be accessed through simple synthetic protocols, revealed best binding affinities in case of TAC-3 (-11.2 kcal/mol), TAC-4 (-10.5 kcal/mol), TAC-6 (-11.2 kcal/mol), TAC-7 (-10.0 kcal/mol). Additional validation studies including molecular dynamics simulation and binding energy calculation using MMGBSA for protein ligand complex for 100 ns revealed the best binding interaction of TAC-3, TAC-4, TAC-6, TAC-7 against main protease of SARS-CoV-2. Moreover, the in vitro and preclinical validation of identified compounds will help us to understand the molecular mechanisms of regulation of TACs against SARS-CoV-2.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Vaishali Chandel
- Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida201313, India
| | - Garima Tripathi
- Department of Chemistry, T. N. B. College, TMBU, Bhgalpur, Bihar, India
| | - Seema A. Nayar
- Department of Microbiology, Government Medical College, Trivandrum, India
- Department of Microbiology, Sree Gokulam Medical College, Trivandrum, India
| | - Brijesh Rathi
- Laboratory for Translational Chemistry and Drug Discovery, Department of Chemistry, Hansraj College, University of Delhi, New Delhi, India
| | - Abhijeet Kumar
- Department of Chemistry, Mahatma Gandhi Central UniversityMotihari845401, India
| | - Dhruv Kumar
- Amity Institute of Molecular Medicine and Stem Cell Research, Amity University Uttar Pradesh, Noida201313, India
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253
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Guenthart BA, Krishnan A, Alassar A, Madhok J, Kakol M, Miller S, Cole SP, Rao VK, Acero NM, Hill CC, Cheung C, Jackson EC, Feinstein I, Tsai AH, Mooney JJ, Pham T, Elliott IA, Liou DZ, La Francesca S, Shudo Y, Hiesinger W, MacArthur JW, Brar N, Berry GJ, McCarra MB, Desai TJ, Dhillon GS, Woo YJ. First lung and kidney multi-organ transplant following COVID-19 Infection. J Heart Lung Transplant 2021; 40:856-859. [PMID: 34059432 PMCID: PMC8088330 DOI: 10.1016/j.healun.2021.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 12/12/2022] Open
Abstract
As the world responds to the global crisis of the COVID-19 pandemic an increasing number of patients are experiencing increased morbidity as a result of multi-organ involvement. Of these, a small proportion will progress to end-stage lung disease, become dialysis dependent, or both. Herein, we describe the first reported case of a successful combined lung and kidney transplantation in a patient with COVID-19. Lung transplantation, isolated or combined with other organs, is feasible and should be considered for select patients impacted by this deadly disease.
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Affiliation(s)
| | - Aravind Krishnan
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | - Aiman Alassar
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | - Jai Madhok
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Monika Kakol
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, Stanford University, Stanford, CA
| | - Shari Miller
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | - Sheela Pai Cole
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Vidya K Rao
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Natalia Martinez Acero
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Charles C Hill
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Cindy Cheung
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Ethan C Jackson
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Igor Feinstein
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Albert H Tsai
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA
| | - Joshua J Mooney
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, Stanford University, Stanford, CA
| | - Thomas Pham
- Department of Surgery, Division of Abdominal Transplantation, Stanford University, Stanford, CA
| | - Irmina A Elliott
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | - Douglas Z Liou
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | | | - Yasuhiro Shudo
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | - William Hiesinger
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | - John W MacArthur
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA
| | - Nivaz Brar
- Department of Pathology, Stanford University, Stanford, CA
| | - Gerald J Berry
- Department of Pathology, Stanford University, Stanford, CA
| | - Matthew B McCarra
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, Stanford University, Stanford, CA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA
| | - Tushar J Desai
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, Stanford University, Stanford, CA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA
| | - Gundeep S Dhillon
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, Stanford University, Stanford, CA
| | - Y Joseph Woo
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA.
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254
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Kamel H. We stand ready … Blood collection organizations and the COVID-19 pandemic. Transfusion 2021; 61:1345-1349. [PMID: 33966274 PMCID: PMC8207090 DOI: 10.1111/trf.16400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 04/04/2021] [Indexed: 12/14/2022]
Abstract
See article on page 1471–1478, in this issue
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255
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Suklan J, Cheaveau J, Hill S, Urwin SG, Green K, Winter A, Hicks T, Boath AE, Kernohan A, Price DA, Allen AJ, Moloney E, Graziadio S. Utility of Routine Laboratory Biomarkers to Detect COVID-19: A Systematic Review and Meta-Analysis. Viruses 2021; 13:803. [PMID: 33946171 PMCID: PMC8147047 DOI: 10.3390/v13050803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 12/21/2022] Open
Abstract
No routine laboratory biomarkers perform well enough in diagnosing COVID-19 in isolation for them to be used as a standalone diagnostic test or to help clinicians prioritize patients for treatment. Instead, other diagnostic tests are needed. The aim of this work was to statistically summarise routine laboratory biomarker measurements in COVID-19-positive and -negative patients to inform future work. A systematic literature review and meta-analysis were performed. The search included names of commonly used, routine laboratory tests in the UK NHS, and focused on research papers reporting laboratory results of patients diagnosed with COVID-19. A random effects meta-analysis of the standardized mean difference between COVID-19-positive and -negative groups was conducted for each biomarker. When comparing reported laboratory biomarker results, we identified decreased white blood cell, neutrophil, lymphocyte, eosinophil, and platelet counts; while lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase were elevated in COVID-19-positive compared to COVID-19-negative patients. Differences were identified across a number of routine laboratory biomarkers between COVID-19-positive and -negative patients. Further research is required to identify whether routine laboratory biomarkers can be used in the development of a clinical scoring system to aid with triage of patients.
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Affiliation(s)
- Jana Suklan
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
| | - James Cheaveau
- Department of Infectious Diseases, Royal Victoria Infirmary, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK;
| | - Sarah Hill
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - Samuel G. Urwin
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - Kile Green
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
| | - Amanda Winter
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - Timothy Hicks
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - Anna E. Boath
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - Ashleigh Kernohan
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - D. Ashley Price
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
- Department of Infectious Diseases, Royal Victoria Infirmary, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK;
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - A. Joy Allen
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
| | - Eoin Moloney
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - Sara Graziadio
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
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256
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Knyazev S, Chhugani K, Sarwal V, Ayyala R, Singh H, Karthikeyan S, Deshpande D, Comarova Z, Lu A, Porozov Y, Wu A, Abedalthagafi MS, Nagaraj SH, Smith AL, Skums P, Ladner J, Lam TTY, Wu NC, Zelikovsky A, Knight R, Crandall KA, Mangul S. Unlocking capacities of viral genomics for the COVID-19 pandemic response. ARXIV 2021:arXiv:2104.14005v3. [PMID: 33948451 PMCID: PMC8095210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Revised: 06/04/2021] [Indexed: 12/25/2022]
Abstract
More than any other infectious disease epidemic, the COVID-19 pandemic has been characterized by the generation of large volumes of viral genomic data at an incredible pace due to recent advances in high-throughput sequencing technologies, the rapid global spread of SARS-CoV-2, and its persistent threat to public health. However, distinguishing the most epidemiologically relevant information encoded in these vast amounts of data requires substantial effort across the research and public health communities. Studies of SARS-CoV-2 genomes have been critical in tracking the spread of variants and understanding its epidemic dynamics, and may prove crucial for controlling future epidemics and alleviating significant public health burdens. Together, genomic data and bioinformatics methods enable broad-scale investigations of the spread of SARS-CoV-2 at the local, national, and global scales and allow researchers the ability to efficiently track the emergence of novel variants, reconstruct epidemic dynamics, and provide important insights into drug and vaccine development and disease control. Here, we discuss the tremendous opportunities that genomics offers to unlock the effective use of SARS-CoV-2 genomic data for efficient public health surveillance and guiding timely responses to COVID-19.
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Affiliation(s)
- Sergey Knyazev
- Department of Computer Science, College of Art and Science, Georgia State University, 1 Park Place, Room 618, Atlanta, GA 30303, USA
| | - Karishma Chhugani
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Room 713. Los Angeles, CA 90089, USA
| | - Varuni Sarwal
- Department of Computer Science, University of California Los Angeles, 580 Portola Plaza, Los Angeles, CA 90095, USA
| | - Ram Ayyala
- Department of Neuroscience, College of Life Sciences, University of California Los Angeles, 580 Portola Plaza, Los Angeles, CA 90095, USA
| | - Harman Singh
- Department of Electrical Engineering, Indian Institute of Technology, Hauz Khas, New Delhi, 110016, India
| | - Smruthi Karthikeyan
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
| | - Dhrithi Deshpande
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Room 713. Los Angeles, CA 90089, USA
| | - Zoia Comarova
- Paradigm Environmental, 3911 Old Lee Highway, Fairfax, VA 22030
| | - Angela Lu
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Room 713. Los Angeles, CA 90089-9121, USA
| | - Yuri Porozov
- World-Class Research Center "Digital biodesign and personalized healthcare", I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Computational Biology, Sirius University of Science and Technology, Sochi, Russia
| | - Aiping Wu
- Center for Systems Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100005, China
- Suzhou Institute of Systems Medicine, Suzhou, 215123, China
| | - Malak S Abedalthagafi
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City and King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Shivashankar H Nagaraj
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Translational Research Institute, Brisbane, Australia
| | - Adam L Smith
- Astani Department of Civil and Environmental Engineering, University of Southern California, 3620 South Vermont Avenue, Los Angeles, CA 90089
| | - Pavel Skums
- Department of Computer Science, College of Art and Science, Georgia State University, 1 Park Place, Floor 6, Atlanta, GA 30303, USA
| | - Jason Ladner
- The Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ 86011
| | - Tommy Tsan-Yuk Lam
- State Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong
| | - Nicholas C Wu
- Department of Biochemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Alex Zelikovsky
- Department of Computer Science, College of Art and Science, Georgia State University, 1 Park Place, Floor 6, Atlanta, GA 30303, USA
- The Laboratory of Bioinformatics, I.M. Sechenov First Moscow State Medical University, Moscow, 119991, Russia
| | - Rob Knight
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA
- Department of Computer Science & Engineering, University of California, San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, USA
| | - Keith A Crandall
- Computational Biology Institute and Department of Biostatistics & Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC 20052
| | - Serghei Mangul
- Department of Clinical Pharmacy, School of Pharmacy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA 90033, USA
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257
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Farshadpour F, Taherkhani R. Antibody-Dependent Enhancement and the Critical Pattern of COVID-19: Possibilities and Considerations. Med Princ Pract 2021; 30:422-429. [PMID: 33882487 PMCID: PMC8339023 DOI: 10.1159/000516693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/20/2021] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), a pandemic infection with profound effects on human society, has challenged our ability to control viral infections. Although at the beginning of the COVID-19 outbreak, the epidemic seemed controllable in Southern Iran, the disease presented a critical pattern as of May 2020. After a few months of the emergence of COVID-19, its severity and mortality increased dramatically. It has been proposed that antibodies produced during previous exposure to local circulating human coronaviruses or possibly severe acute respiratory syndrome coronavirus 2 might contribute to the development of more severe and lethal presentations of COVID-19 possibly by triggering antibody-dependent enhancement. The binding of virions complexed with antibodies to Fcγ receptors on the target cells initiates receptor-mediated signaling events, leading to enhanced expression of inflammatory cytokines and suppression of intracellular antiviral responses at the transcriptome level, followed by endocytosis of the virus and subsequent activation of immune cells. The activated immune cells might accumulate in the lung and promote cytokine storm and lymphopenia. Furthermore, the formation of immune complexes can promote complement activation and subsequent tissue damage. Although there are currently no clinical data to support this hypothesis, a better understanding of these immunopathologic phenomena and their relation to the disease course and severity might give insights into the development of the most efficient prophylactic and therapeutic approaches. This review demonstrates the critical pattern of COVID-19 in Southern Iran and highlights the possible interplay of factors leading to this condition.
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Affiliation(s)
- Fatemeh Farshadpour
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Taherkhani
- Department of Virology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
- Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
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258
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Wang LQ, Tan Su Yin E, Wei GQ, Hu YX, Nagler A, Huang H. Weathering the storm: COVID-19 infection in patients with hematological malignancies. J Zhejiang Univ Sci B 2021; 21:921-939. [PMID: 33843158 PMCID: PMC7759451 DOI: 10.1631/jzus.b2000423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.
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Affiliation(s)
- Lin-Qin Wang
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Elaine Tan Su Yin
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Guo-Qing Wei
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Yong-Xian Hu
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
| | - Arnon Nagler
- Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
| | - He Huang
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China.,Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou 310058, China
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259
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Mukhtar H, Rubaiee S, Krichen M, Alroobaea R. An IoT Framework for Screening of COVID-19 Using Real-Time Data from Wearable Sensors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4022. [PMID: 33921223 PMCID: PMC8070194 DOI: 10.3390/ijerph18084022] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 12/15/2022]
Abstract
Experts have predicted that COVID-19 may prevail for many months or even years before it can be completely eliminated. A major problem in its cure is its early screening and detection, which will decide on its treatment. Due to the fast contactless spreading of the virus, its screening is unusually difficult. Moreover, the results of COVID-19 tests may take up to 48 h. That is enough time for the virus to worsen the health of the affected person. The health community needs effective means for identification of the virus in the shortest possible time. In this study, we invent a medical device utilized consisting of composable sensors to monitor remotely and in real-time the health status of those who have symptoms of the coronavirus or those infected with it. The device comprises wearable medical sensors integrated using the Arduino hardware interfacing and a smartphone application. An IoT framework is deployed at the backend through which various devices can communicate in real-time. The medical device is applied to determine the patient's critical status of the effects of the coronavirus or its symptoms using heartbeat, cough, temperature and Oxygen concentration (SpO2) that are evaluated using our custom algorithm. Until now, it has been found that many coronavirus patients remain asymptomatic, but in case of known symptoms, a person can be quickly identified with our device. It also allows doctors to examine their patients without the need for physical direct contact with them to reduce the possibility of infection. Our solution uses rule-based decision-making based on the physiological data of a person obtained through sensors. These rules allow to classify a person as healthy or having a possibility of infection by the coronavirus. The advantage of using rules for patient's classification is that the rules can be updated as new findings emerge from time to time. In this article, we explain the details of the sensors, the smartphone application, and the associated IoT framework for real-time, remote screening of COVID-19.
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Affiliation(s)
- Hamid Mukhtar
- Department of Computer Science, College of Computers and Information Technology, Taif University, Taif 21944, Saudi Arabia;
| | - Saeed Rubaiee
- Department of Industrial and Systems Engineering, College of Engineering, University of Jeddah, Jeddah 21577, Saudi Arabia;
| | - Moez Krichen
- Department of Computer Science, Faculty of Computer Science and Information Technology, Al-Baha University, Al-Baha 65431, Saudi Arabia;
- ReDCAD Laboratory, National School of Engineers of Sfax, University of Sfax, Sfax 3038, Tunisia
| | - Roobaea Alroobaea
- Department of Computer Science, College of Computers and Information Technology, Taif University, Taif 21944, Saudi Arabia;
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Gloeckl R, Leitl D, Jarosch I, Schneeberger T, Nell C, Stenzel N, Vogelmeier CF, Kenn K, Koczulla AR. Benefits of pulmonary rehabilitation in COVID-19: a prospective observational cohort study. ERJ Open Res 2021; 7:00108-2021. [PMID: 34095290 PMCID: PMC7957293 DOI: 10.1183/23120541.00108-2021] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 02/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) can result in a large variety of chronic health issues such as impaired lung function, reduced exercise performance and diminished quality of life. Our study aimed to investigate the efficacy, feasibility and safety of pulmonary rehabilitation in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease. METHODS Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive 3-week inpatient pulmonary rehabilitation programme were included in this prospective, observational cohort study. Several measures of exercise performance (6-min walk distance (6MWD)), lung function (forced vital capacity (FVC)) and quality of life (36-question short-form health survey (SF-36)) were assessed before and after pulmonary rehabilitation. RESULTS 50 patients were included in the study (24 with mild/moderate and 26 with severe/critical COVID-19). On admission, patients had a reduced 6MWD (mild: median 509 m, interquartile range (IQR) 426-539 m; severe: 344 m, 244-392 m), an impaired FVC (mild: 80%, 59-91%; severe: 75%, 60-91%) and a low SF-36 mental health score (mild: 49 points, 37-54 points; severe: 39 points, 30-53 points). Patients attended a median (IQR) 100% (94-100%) of all provided pulmonary rehabilitation sessions. At discharge, patients in both subgroups improved in 6MWD (mild/moderate: +48 m, 35-113 m; severe/critical: +124 m, 75-145 m; both p<0.001), FVC (mild/moderate: +7.7%, 1.0-17.8%, p=0.002; severe/critical: +11.3%, 1.0-16.9%, p<0.001) and SF-36 mental component (mild/moderate: +5.6 points, 1.4-9.2 points, p=0.071; severe/critical: +14.4 points, -0.6-24.5, p<0.001). No adverse event was observed. CONCLUSION Our study shows that pulmonary rehabilitation is a feasible, safe and effective therapeutic option in COVID-19 patients independent of disease severity.
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Affiliation(s)
- Rainer Gloeckl
- Dept of Pulmonary Rehabilitation, Philipps-University of
Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen
Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- These authors contributed equally
| | - Daniela Leitl
- Dept of Pulmonary Rehabilitation, Philipps-University of
Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen
Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- These authors contributed equally
| | - Inga Jarosch
- Dept of Pulmonary Rehabilitation, Philipps-University of
Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen
Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Tessa Schneeberger
- Dept of Pulmonary Rehabilitation, Philipps-University of
Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen
Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Christoph Nell
- Dept of Pulmonology, Philipps-University Marburg, Marburg,
Germany
| | | | - Claus F. Vogelmeier
- Dept of Medicine, Pulmonary and Critical Care Medicine,
University Medical Centre Giessen and Marburg, Philipps-University of Marburg,
Member of the DZL, Marburg, Germany
| | - Klaus Kenn
- Dept of Pulmonary Rehabilitation, Philipps-University of
Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen
Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Andreas R. Koczulla
- Dept of Pulmonary Rehabilitation, Philipps-University of
Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany
- Institute for Pulmonary Rehabilitation Research, Schoen
Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Teaching Hospital, Paracelsus Medical University,
Salzburg, Austria
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261
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Peter AE, Sandeep BV, Rao BG, Kalpana VL. Nanotechnology to the Rescue: Treatment Perspective for the Immune Dysregulation Observed in COVID-19. FRONTIERS IN NANOTECHNOLOGY 2021. [DOI: 10.3389/fnano.2021.644023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The study of the use of nanotechnology for drug delivery has been extensive. Nanomedical approaches for therapeutics; drug delivery in particular is superior to conventional methods in that it allows for controlled targeted delivery and release, higher stability, extended circulation time, minimal side-effects, and improved pharmacokinetic clearance (of the drug) form the body, to name a few. The magnitude of COVID-19, the current ongoing pandemic has been severe; it has caused widespread the loss of human life. In individuals with severe COVID-19, immune dysregulation and a rampant state of hyperinflammation is observed. This kind of an immunopathological response is detrimental and results in rapid disease progression, development of secondary infections, sepsis and can be fatal. Several studies have pin-pointed the reason for this immune dysregulation; deviations in the signaling pathways involved in the mediation and control of immune responses. In severe COVID-19 patients, many signaling cascades including JAK/STAT, NF-κB, MAPK/ERK, TGF beta, VEGF, and Notch signaling were found to be either upregulated or inactivated. Targeting these aberrant signaling pathways in conjunction with antiviral therapy will effectuate mitigation of the hyperinflammation, hypercytokinemia, and promote faster recovery. The science of the use of nanocarriers as delivery agents to modulate these signaling pathways is not new; it has already been explored for other inflammatory diseases and in particular, cancer therapy. Numerous studies have evaluated the efficacy and potential of nanomedical approaches to modulate these signaling pathways and have been met with positive results. A treatment regime, that includes nanotherapeutics and antiviral therapies will prove effective and holds great promise for the successful treatment of COVID-19. In this article, we review different nanomedical approaches already studied for targeting aberrant signaling pathways, the host immune response to SARS-CoV-2, immunopathology and the dysregulated signaling pathways observed in severe COVID-19 and the current treatment methods in use for targeting signaling cascades in COVID-19. We then conclude by suggesting that the use of nanomedical drug delivery systems for targeting signaling pathways can be extended to effectively target the aberrant signaling pathways in COVID-19 for best treatment results.
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262
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Verma HK. Radiological and clinical spectrum of COVID-19: A major concern for public health. World J Radiol 2021; 13:53-63. [PMID: 33815683 PMCID: PMC8006056 DOI: 10.4329/wjr.v13.i3.53] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/07/2020] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
The pandemic of novel coronavirus disease 2019 (COVID-19) is an infectious disease caused by +ve strand RNA virus (SARS-CoV-2, severe acute respiratory syndrome coronavirus 2) that belongs to the corona viridae family. In March, the World Health Organization declared the outbreak of novel coronavirus for the public health emergency. Although SARS-CoV-2 infection presents with respiratory symptoms, it affects other organs such as the kidneys, liver, heart and brain. Early-stage laboratory disease testing shows many false positive or negative outcomes such as less white blood cell count and a low number of lymphocyte count. However, radiological examination and diagnosis are among the main components of the diagnosis and treatment of COVID-19. In particular, for COVID-19, chest computed tomography developed vigorous initial diagnosis and disease progression assessment. However, the accuracy is limited. Although real-time reverse transcription-polymerase chain reaction is the gold standard method for the diagnosis of COVID-19, sometimes it may give false-negative results. Due to the consequences of the missing diagnosis. This resulted in a discrepancy between the two means of examination. Conversely, based on currently available evidence, we summarized the possible understanding of the various patho-physiology, radio diagnostic methods in severe COVID-19 patients. As the information on COVID-19 evolves rapidly, this review will provide vital information for scientists and clinicians to consider novel perceptions for the comprehensive knowledge of the diagnostic approaches based on current experience.
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Affiliation(s)
- Henu Kumar Verma
- Developmental and Stem Cell Biology Lab, Institute of Experimental Endocrinology and Oncology CNR, Naples 80131, Campania, Italy
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263
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Rando HM, Bennett TD, Byrd JB, Bramante C, Callahan TJ, Chute CG, Davis HE, Deer R, Gagnier J, Koraishy FM, Liu F, McMurry JA, Moffitt RA, Pfaff ER, Reese JT, Relevo R, Robinson PN, Saltz JH, Solomonides A, Sule A, Topaloglu U, Haendel MA. Challenges in defining Long COVID: Striking differences across literature, Electronic Health Records, and patient-reported information. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.20.21253896. [PMID: 33791733 PMCID: PMC8010765 DOI: 10.1101/2021.03.20.21253896] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Since late 2019, the novel coronavirus SARS-CoV-2 has introduced a wide array of health challenges globally. In addition to a complex acute presentation that can affect multiple organ systems, increasing evidence points to long-term sequelae being common and impactful. The worldwide scientific community is forging ahead to characterize a wide range of outcomes associated with SARS-CoV-2 infection; however the underlying assumptions in these studies have varied so widely that the resulting data are difficult to compareFormal definitions are needed in order to design robust and consistent studies of Long COVID that consistently capture variation in long-term outcomes. Even the condition itself goes by three terms, most widely "Long COVID", but also "COVID-19 syndrome (PACS)" or, "post-acute sequelae of SARS-CoV-2 infection (PASC)". In the present study, we investigate the definitions used in the literature published to date and compare them against data available from electronic health records and patient-reported information collected via surveys. Long COVID holds the potential to produce a second public health crisis on the heels of the pandemic itself. Proactive efforts to identify the characteristics of this heterogeneous condition are imperative for a rigorous scientific effort to investigate and mitigate this threat.
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Affiliation(s)
- Halie M. Rando
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Tellen D. Bennett
- Center for Health AI and Section of Informatics and Data Science, Department of Pediatrics, University of Colorado School of Medicine, University of Colorado, Aurora, CO, USA
| | | | | | - Tiffany J. Callahan
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Computational Bioscience, University of Colorado Anschutz Medical Campus, Boulder, CO, USA
| | - Christopher G. Chute
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, MD, USA
| | | | - Rachel Deer
- The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Joel Gagnier
- Computational Bioscience, University of Colorado Anschutz Medical Campus, Boulder, CO, USA
| | | | - Feifan Liu
- University of Massachusetts Medical School Worcester, Worcester, MA, USA
| | - Julie A. McMurry
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Richard A. Moffitt
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Emily R. Pfaff
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Justin T. Reese
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Rose Relevo
- Oregon Health & Science University, Portland, OR, USA
| | - Peter N. Robinson
- The Jackson Laboratory For Genomic Medicine, Farmington, CT, USA
- Institute for Systems Genomics, University of Connecticut, Farmington, CT, USA
| | - Joel H. Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | | | - Anupam Sule
- Saint Joseph Mercy Health System, Ypsilanti, MI, USA
| | - Umit Topaloglu
- School of Medicine, Wake Forest University, Winston Salem, NC, USA
| | - Melissa A. Haendel
- Center for Health AI, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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264
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Welte T, Ambrose LJ, Sibbring GC, Sheikh S, Müllerová H, Sabir I. Current evidence for COVID-19 therapies: a systematic literature review. Eur Respir Rev 2021; 30:30/159/200384. [PMID: 33731328 PMCID: PMC9489065 DOI: 10.1183/16000617.0384-2020] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/10/2021] [Indexed: 01/09/2023] Open
Abstract
Effective therapeutic interventions for the treatment and prevention of coronavirus disease 2019 (COVID-19) are urgently needed. A systematic review was conducted to identify clinical trials of pharmacological interventions for COVID-19 published between 1 December 2019 and 14 October 2020. Data regarding efficacy of interventions, in terms of mortality, hospitalisation and need for ventilation, were extracted from identified studies and synthesised qualitatively. In total, 42 clinical trials were included. Interventions assessed included antiviral, mucolytic, antimalarial, anti-inflammatory and immunomodulatory therapies. Some reductions in mortality, hospitalisation and need for ventilation were seen with interferons and remdesivir, particularly when administered early, and with the mucolytic drug, bromhexine. Most studies of lopinavir/ritonavir and hydroxychloroquine did not show significant efficacy over standard care/placebo. Dexamethasone significantly reduced mortality, hospitalisation and need for ventilation versus standard care, particularly in patients with severe disease. Evidence for other classes of interventions was limited. Many trials had a moderate-to-high risk of bias, particularly in terms of blinding; most were short-term and some included low patient numbers.This review highlights the need for well-designed clinical trials of therapeutic interventions for COVID-19 to increase the quality of available evidence. It also emphasises the importance of tailoring interventions to disease stage and severity for maximum efficacy.
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Affiliation(s)
- Tobias Welte
- Dept of Pulmonary and Infectious Diseases, Hannover University School of Medicine, Germany
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265
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Abstract
Corona Virus Disease of 2019 (COVID-19) pandemic has affected more than 67.9 million individuals world-wide and led to more than 15.5 million Deaths. In the initial studies from China, 88.7 % of the patient were noted to have fever, 67 % of the patient had cough and 56.4 % had ground glass changes on the chest imaging. With time, the presentation of patients has been found to be highly variable and unpredictable. COVID-19 is reported to present with various complications, ranging from gastrointestinal (GI) manifestations, such as loss of sensation of taste, abdominal pain, diarrhea, vomiting, pancreatitis and hepatobiliary disease, to neurological manifestations of encephalitis and stroke, and cardiovascular manifestations like myocarditis, heart failure and arrythmia. We report a rare case of COVID-19 presenting with abdominal pain from aortitis.
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266
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Synowiec A, Szczepański A, Barreto-Duran E, Lie LK, Pyrc K. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Systemic Infection. Clin Microbiol Rev 2021; 34:e00133-20. [PMID: 33441314 PMCID: PMC7849242 DOI: 10.1128/cmr.00133-20] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
To date, seven identified coronaviruses (CoVs) have been found to infect humans; of these, three highly pathogenic variants have emerged in the 21st century. The newest member of this group, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected at the end of 2019 in Hubei province, China. Since then, this novel coronavirus has spread worldwide, causing a pandemic; the respiratory disease caused by the virus is called coronavirus disease 2019 (COVID-19). The clinical presentation ranges from asymptomatic to mild respiratory tract infections and influenza-like illness to severe disease with accompanying lung injury, multiorgan failure, and death. Although the lungs are believed to be the site at which SARS-CoV-2 replicates, infected patients often report other symptoms, suggesting the involvement of the gastrointestinal tract, heart, cardiovascular system, kidneys, and other organs; therefore, the following question arises: is COVID-19 a respiratory or systemic disease? This review aims to summarize existing data on the replication of SARS-CoV-2 in different tissues in both patients and ex vivo models.
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Affiliation(s)
- Aleksandra Synowiec
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Artur Szczepański
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
- Microbiology Department, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Emilia Barreto-Duran
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Laurensius Kevin Lie
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Krzysztof Pyrc
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
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267
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Fox SE, Heide RSV. COVID-19: The Heart of the Matter-Pathological Changes and a Proposed Mechanism. J Cardiovasc Pharmacol Ther 2021; 26:217-224. [PMID: 33703938 DOI: 10.1177/1074248421995356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The SARS-CoV-2 virus has resulted in over 88 million cases worldwide of COVID-19 as of January 2021. The heart is one of the most commonly affected organs in COVID-19, but the nature and extent of the cardiac pathology has remained controversial. It has been shown that patients infected with SARS-CoV-2 can sustain type 1 myocardial infarction in the absence of significant atherosclerotic coronary artery disease. However, many patients present with small elevations of troponin enzymes of unclear etiology which correlate with overall COVID-19 disease outcome. Early autopsy reports indicated variable levels of typical lymphocytic myocarditis, while radiology reports have indicated that myocarditis can be a persistent problem after recovery from acute illness, raising concern about participation in college athletics. In this communication, we review the literature to date regarding the gross and microscopic findings of COVID-19 cardiac involvement, present the findings from over 40 cases from our academic medical center, and propose mechanisms by which patients develop small elevations in troponin. .
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Affiliation(s)
- Sharon E Fox
- Department of Pathology, 12258LSU Health Sciences Center, New Orleans, LA, USA
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268
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Kostopoulos IV, Orologas-Stavrou N, Rousakis P, Panteli C, Ntanasis-Stathopoulos I, Charitaki I, Korompoki E, Gavriatopoulou M, Kastritis E, Trougakos IP, Dimopoulos MA, Tsitsilonis OE, Terpos E. Recovery of Innate Immune Cells and Persisting Alterations in Adaptive Immunity in the Peripheral Blood of Convalescent Plasma Donors at Eight Months Post SARS-CoV-2 Infection. Microorganisms 2021; 9:546. [PMID: 33800807 PMCID: PMC8000115 DOI: 10.3390/microorganisms9030546] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Persisting alterations and unique immune signatures have been previously detected in the peripheral blood of convalescent plasma (CP) donors at approximately two months after initial SARS-CoV-2 infection. This article presents the results on the sequential analysis of 47 CP donors at a median time of eight months (range 7.5-8.5 months) post infection, as assessed by flow cytometry. Interestingly, our results show a significant variation of the relevant immune subset composition among CP donors. Regarding innate immunity, both non-classical monocytes, and CD11b- granulocytes had fully recovered at eight months post COVID-19 infection. Intermediate monocytes and natural killer (NK) cells had already been restored at the two-month evaluation and remained stable. Regarding adaptive immunity, the COVID-19-related skewed Th1 and Th2 cell polarization remained at the same levels as in two months. However, low levels of total B cells were detected even after eight months from infection. A persisting reduction of CD8+ Tregs and changes in the NKT cell compartment were also remarkable. CP donors present with a unique immune landscape at eight months post COVID-19 infection, which is characterized by the notable restoration of the components of innate immunity along with a persisting imprint of SARS-CoV-2 in cells of the adaptive immunity.
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Affiliation(s)
- Ioannis V. Kostopoulos
- Department of Biology, School of Science, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (N.O.-S.); (P.R.); (C.P.); (I.P.T.); (O.E.T.)
| | - Nikolaos Orologas-Stavrou
- Department of Biology, School of Science, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (N.O.-S.); (P.R.); (C.P.); (I.P.T.); (O.E.T.)
| | - Pantelis Rousakis
- Department of Biology, School of Science, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (N.O.-S.); (P.R.); (C.P.); (I.P.T.); (O.E.T.)
| | - Chrysanthi Panteli
- Department of Biology, School of Science, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (N.O.-S.); (P.R.); (C.P.); (I.P.T.); (O.E.T.)
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (I.C.); (E.K.); (M.G.); (E.K.); (M.-A.D.)
| | - Ioanna Charitaki
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (I.C.); (E.K.); (M.G.); (E.K.); (M.-A.D.)
| | - Eleni Korompoki
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (I.C.); (E.K.); (M.G.); (E.K.); (M.-A.D.)
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (I.C.); (E.K.); (M.G.); (E.K.); (M.-A.D.)
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (I.C.); (E.K.); (M.G.); (E.K.); (M.-A.D.)
| | - Ioannis P. Trougakos
- Department of Biology, School of Science, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (N.O.-S.); (P.R.); (C.P.); (I.P.T.); (O.E.T.)
| | - Meletios-Athanasios Dimopoulos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (I.C.); (E.K.); (M.G.); (E.K.); (M.-A.D.)
| | - Ourania E. Tsitsilonis
- Department of Biology, School of Science, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (N.O.-S.); (P.R.); (C.P.); (I.P.T.); (O.E.T.)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (I.C.); (E.K.); (M.G.); (E.K.); (M.-A.D.)
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269
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Inchingolo AD, Inchingolo AM, Bordea IR, Malcangi G, Xhajanka E, Scarano A, Lorusso F, Farronato M, Tartaglia GM, Isacco CG, Marinelli G, D’Oria MT, Hazballa D, Santacroce L, Ballini A, Contaldo M, Inchingolo F, Dipalma G. SARS-CoV-2 Disease Adjuvant Therapies and Supplements Breakthrough for the Infection Prevention. Microorganisms 2021; 9:525. [PMID: 33806624 PMCID: PMC7999785 DOI: 10.3390/microorganisms9030525] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 12/17/2022] Open
Abstract
The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a high-risk viral agent involved in the recent pandemic stated worldwide by the World Health Organization. The infection is correlated to a severe systemic and respiratory disease in many cases, which is clinically treated with a multi-drug pharmacological approach. The purpose of this investigation was to evaluate through a literature overview the effect of adjuvant therapies and supplements for the SARS-CoV-2 infection. The research has analyzed the advantage of the EK1C4, by also assessing the studies on the resveratrol, vitamin D, and melatonin as adjuvant supplements for long hauler patients' prognosis. The evaluated substances reported important benefits for the improvement of the immune system and as a potential inhibitor molecules against SARS-CoV-2, highlighting the use of sartans as therapy. The adjuvant supplements seem to create an advantage for the healing of the long hauler patients affected by chronic symptoms of constant chest and heart pain, intestinal disorders, headache, difficulty concentrating, memory loss, and tachycardia.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Edit Xhajanka
- Dental Prosthesis Department, Medical University of Tirana, UMT, Rruga e Dibrës, Tirana 1001, Albania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
- Human Stem Cells Research Center HSC of Ho Chi Minh, Ho Chi Minh 70000, Vietnam
- Embryology and Regenerative Medicine and Immunology, Pham Chau Trinh University of Medicine Hoi An, Hoi An 70000, Vietnam
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Maria Teresa D’Oria
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
- Department of Medical and Biological Sciences, Via delle Scienze, Università degli Studi di Udine, 206, 33100 Udine, Italy
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario, University of Bari, 70125 Bari, Italy;
- Department of Precision Medicine, University of Campania, 80138 Naples, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy;
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (C.G.I.); (G.M.); (M.T.D.); (D.H.); (L.S.); (F.I.); (G.D.)
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270
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Araya S, Wordofa M, Mamo MA, Tsegay YG, Hordofa A, Negesso AE, Fasil T, Berhanu B, Begashaw H, Atlaw A, Niguse T, Cheru M, Tamir Z. The Magnitude of Hematological Abnormalities Among COVID-19 Patients in Addis Ababa, Ethiopia. J Multidiscip Healthc 2021; 14:545-554. [PMID: 33688198 PMCID: PMC7936683 DOI: 10.2147/jmdh.s295432] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/29/2021] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) is a systemic infection with cardiovascular, pulmonary, gastrointestinal, neurological, and hematological manifestations. Abnormal hematological findings are thought to have a role in early risk stratification and prognostication of COVID-19 patients. However, the data on hematological abnormalities associated with the disease among Ethiopian COVID-19 patients are limited. Objective To determine the magnitude of hematological abnormalities among COVID-19 patients admitted at Millennium COVID-19 referral treatment center, Addis Ababa, Ethiopia. Methods A prospective cross-sectional study was conducted among COVID-19 patients admitted to Millennium COVID-19 referral treatment center from May to July, 2020. A total of 334 COVID-19 patients were included using convenience sampling. Socio-demographic data and disease severity status of admitted patients were recorded. Three milliliters of venous blood was collected and analyzed by Beckman Coulter DXH-600 automated analyzer to determine complete blood count (CBC). The data were entered and analyzed using SPSS version 23 software. Association of age, sex, and disease severity with hematological abnormalities was analyzed using binary logistic regression. An odds ratio and 95% confidence interval were used to measure the strength of association. P-value <0.05 was considered as statistically significant. Results Of 334 admitted COVID-19 patients, the majority were males (62.3%) and 69.8% had moderate disease conditions. The overall magnitude of any cytopenia and pancytopenia was 41% and 1.8%, respectively. The magnitude of anemia, thrombocytopenia, and leukopenia was 24.9%, 21.6%, and 5.4%, respectively. Lymphopenia (72.2%) was the most common hematological abnormality. COVID-19 patients with severe and critical disease were more likely to develop anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia than those with moderate disease condition, with a significant association. Conclusion Lymphopenia was the most common hematological abnormality observed among COVID-19 patients. Hematological abnormalities such as anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia were significantly associated with disease severity. Monitoring and evaluation of hematological parameters could provide prognostic insight into the management and risk stratification of COVID-19 patients. However, further studies are required to fully understand the utility of hematological parameters for the prognosis of COVID-19 disease.
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Affiliation(s)
- Shambel Araya
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Medical Laboratory, Millennium COVID-19 Treatment and Care Centre, St. Paul Millennium Medical College, Addis Ababa, Ethiopia
| | - Moges Wordofa
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mintesnot Aragaw Mamo
- Department of Medical Laboratory, Millennium COVID-19 Treatment and Care Centre, St. Paul Millennium Medical College, Addis Ababa, Ethiopia.,Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia
| | - Yakob Gebregziabher Tsegay
- Department of Medical Laboratory, Millennium COVID-19 Treatment and Care Centre, St. Paul Millennium Medical College, Addis Ababa, Ethiopia.,Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia.,Research and Development Center, College of Health Sciences, Defense University, Addis Ababa, Ethiopia
| | - Abebe Hordofa
- Department of Medical Laboratory, Millennium COVID-19 Treatment and Care Centre, St. Paul Millennium Medical College, Addis Ababa, Ethiopia.,Department of Medical Laboratory, Legehare General Hospital, Addis Ababa, Ethiopia
| | - Abebe Edao Negesso
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Fasil
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Betelhem Berhanu
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hermela Begashaw
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Asegdew Atlaw
- Department of Medical Laboratory, Millennium COVID-19 Treatment and Care Centre, St. Paul Millennium Medical College, Addis Ababa, Ethiopia
| | - Tirhas Niguse
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mahlet Cheru
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zemenu Tamir
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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271
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Baig AM. Chronic COVID syndrome: Need for an appropriate medical terminology for long-COVID and COVID long-haulers. J Med Virol 2021; 93:2555-2556. [PMID: 33095459 DOI: 10.1002/jmv.26624] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Abdul Mannan Baig
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
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272
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Amann K, Boor P, Wiech T, Singh J, Vonbrunn E, Knöll A, Hermann M, Büttner-Herold M, Daniel C, Hartmann A. COVID-19 effects on the kidney. DER PATHOLOGE 2021; 42:76-80. [PMID: 33646362 PMCID: PMC7919237 DOI: 10.1007/s00292-020-00900-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
Apart from pulmonary disease, acute kidney injury (AKI) is one of the most frequent and most severe organ complications in severe coronavirus disease 2019 (COVID-19). The SARS-CoV‑2 virus has been detected in renal tissue. Patients with chronic kidney disease (CKD) before and on dialysis and specifically renal transplant patients represent a particularly vulnerable population. The increasing number of COVID-19 infected patients with renal involvement led to an evolving interest in the analysis of its pathophysiology, morphology and modes of virus detection in the kidney. Meanwhile, there are ample data from several autopsy and kidney biopsy studies that differ in the quantity of cases as well as in their quality. While the detection of SARS-CoV‑2 RNA in the kidney leads to reproducible results, the use of electron microscopy for visualisation of the virus is difficult and currently critically discussed due to various artefacts. The exact contribution of indirect or direct effects on the kidney in COVID-19 are not yet known and are currently the focus of intensive research.
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Affiliation(s)
- K Amann
- Department of Nephropathology, University Clinic Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Germany.
| | - P Boor
- Institute of Pathology and Department of Nephrology, Section Translational Nephropathology, University Clinic of the RWTH Aachen, Aachen, Germany
| | - T Wiech
- Institute of Pathology, Section Nephropathology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - J Singh
- Medical Clinic 3, University Clinic Erlangen, Erlangen, Germany
| | - E Vonbrunn
- Department of Nephropathology, University Clinic Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Germany
| | - A Knöll
- Institute of Virology, University Clinic Erlangen, Erlangen, Germany
| | - M Hermann
- Medical Clinic 3, University Clinic Erlangen, Erlangen, Germany
| | - M Büttner-Herold
- Department of Nephropathology, University Clinic Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Germany
| | - C Daniel
- Department of Nephropathology, University Clinic Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Germany
| | - A Hartmann
- Institute of Pathology, University Clinic Erlangen, Erlangen, Germany
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273
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Sahu T, Mehta A, Ratre YK, Jaiswal A, Vishvakarma NK, Bhaskar LVKS, Verma HK. Current understanding of the impact of COVID-19 on gastrointestinal disease: Challenges and openings. World J Gastroenterol 2021; 27:449-469. [PMID: 33642821 PMCID: PMC7896435 DOI: 10.3748/wjg.v27.i6.449] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/28/2020] [Accepted: 01/08/2021] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus disease-2019 (COVID-19) is caused by a positive-sense single-stranded RNA virus which belongs to the Coronaviridae family. In March 2019 the World Health Organization declared that COVID-19 was a pandemic. COVID-19 patients typically have a fever, dry cough, dyspnea, fatigue, and anosmia. Some patients also report gastrointestinal (GI) symptoms, including diarrhea, nausea, vomiting, and abdominal pain, as well as liver enzyme abnormalities. Surprisingly, many studies have found severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA in rectal swabs and stool specimens of asymptomatic COVID-19 patients. In addition, viral receptor angiotensin-converting enzyme 2 and transmembrane protease serine-type 2, were also found to be highly expressed in gastrointestinal epithelial cells of the intestinal mucosa. Furthermore, SARS-CoV-2 can dynamically infect and replicate in both GI and liver cells. Taken together these results indicate that the GI tract is a potential target of SARS-CoV-2. Therefore, the present review summarizes the vital information available to date on COVID-19 and its impact on GI aspects.
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Affiliation(s)
- Tarun Sahu
- Department of Physiology, All India Institute of Medical Science, Raipur 492001, Chhattisgarh, India
| | - Arundhati Mehta
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur 495001, Chhattisgarh, India
| | - Yashwant Kumar Ratre
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur 495001, Chhattisgarh, India
| | - Akriti Jaiswal
- Department of Physiology, All India Institute of Medical Science, Raipur 492001, Chhattisgarh, India
| | - Naveen Kumar Vishvakarma
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur 495001, Chhattisgarh, India
| | | | - Henu Kumar Verma
- Developmental and Stem Cell Biology Lab, Institute of Experimental Endocrinology and Oncology CNR, Naples, Campania 80131, Italy
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274
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Clinical characteristics and potential factors for recurrence of positive SARS-CoV-2 RNA in convalescent patients: a retrospective cohort study. Clin Exp Med 2021; 21:361-367. [PMID: 33543353 PMCID: PMC7860998 DOI: 10.1007/s10238-021-00687-y] [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: 06/09/2020] [Accepted: 01/18/2021] [Indexed: 01/01/2023]
Abstract
Background The recurrence of positive SARS-CoV-2 RT-PCR is frequently found in discharged COVID-19 patients but its clinical significance remains unclear. The potential cause, clinical characteristics and infectiousness of the recurrent positive RT-PCR patients need to be answered. Methods A single-centered, retrospective study of 51 discharged COVID-19 patients was carried out at a designated hospital for COVID-19. The demographic data, clinical records and laboratory findings of 25 patients with recurrent positive RT-PCR from hospitalization to follow-up were collected and compared to 26 patients with negative RT-PCR discharged regularly during the same period. Discharged patients’ family members and close contacts were also interviewed by telephone to evaluate patients’ potential infectiousness. Results The titer of both IgG and IgM antibodies was significantly lower (p = 0.027, p = 0.011) in patients with recurrent positive RT-PCR. Median duration of viral shedding significantly prolonged in patients with recurrent positive RT-PCR (36.0 days vs 9.0 days, p = 0.000). There was no significant difference in demographic features, clinical features, lymphocyte subsets count and inflammatory cytokines levels between the two groups of patients. No fatal case was noted in two groups. As of the last day of follow-up, none of the discharged patients’ family members or close contact developed any symptoms of COVID-19. Conclusions Patients with low levels of IgG and IgM are more likely to have recurrent positive SARS-CoV-2 RT-PCR results and lead to a prolonged viral shedding. The recurrent positive of SARS-CoV-2 RT-PCR may not indicate the recurrence or aggravation of COVID-19. The detection of SARS-CoV-2 by RT-PCR in the patients recovered from COVID-19 is not necessarily correlated with the ability of transmission.
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275
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Cao C, Lakshminarayanan R, McCracken J, Lai J. Ampullitis Superimposed Obstructive Jaundice in a Patient With COVID-19. Gastroenterology Res 2021; 14:41-44. [PMID: 33737998 PMCID: PMC7935611 DOI: 10.14740/gr1353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/20/2021] [Indexed: 11/11/2022] Open
Abstract
While coronavirus disease 2019 (COVID-19) is well known to cause significant lower respiratory symptoms, recent literature has documented numerous cases of multi-systemic involvement that can present with atypical symptoms. We report a case of an 83-year-old man, recovering from abdominal aortic aneurysm repair complicated by colonic injury requiring colostomy rendering him dependent on gastrostomy tube feedings for 3 years, who was transferred from a nursing care facility to the emergency department with altered mental status, fever and jaundice. Abdominal imaging and biopsy studies eventually identified duodenitis and ampullitis complicated by a suspected Klatskin tumor leading to biliary obstruction, sepsis and hepatoencephalopathy. Polymerase chain reaction (PCR) for COVID-19 was positive. Despite the severity of the initial presentation, the patient had no respiratory symptoms or abnormal chest X-ray findings on admission and developed hypoxia late into the disease course. Thus, this case is a report of an abnormal initial COVID-19 presentation with gastrointestinal and hepatobiliary involvement leading to hepatoencephalopathy but no lung findings, highlighting the importance of investigating extrapulmonary processes in COVID-19-positive patients regardless of pulmonary symptoms.
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Affiliation(s)
- Can Cao
- The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Renuka Lakshminarayanan
- Department of Pathology and Laboratory Medicine, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, USA
| | - John McCracken
- Division of Gastroenterology, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, USA
| | - Jinping Lai
- Department of Pathology and Laboratory Medicine, Kaiser Permanente Sacramento Medical Center, Sacramento, CA, USA
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276
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Amann K, Boor P, Wiech T, Singh J, Vonbrunn E, Knöll A, Hermann M, Büttner-Herold M, Daniel C, Hartmann A. [COVID-19 effects on the kidney]. DER PATHOLOGE 2021; 42:183-187. [PMID: 33527157 PMCID: PMC7849614 DOI: 10.1007/s00292-020-00899-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 02/06/2023]
Abstract
Bei einer schweren Coronavirus-Erkrankung-2019 (COVID-19) ist neben der Lungenerkrankung selbst das akute Nierenversagen (ANV) eine der häufigsten und schwerwiegendsten Komplikationen. Das SARS-CoV-2-Virus konnte hierbei auch in der Niere nachgewiesen werden. Patienten mit chronischen Nierenerkrankungen (CKD), dialysepflichtige sowie v. a. nierentransplantierte Patienten scheinen eine besonders vulnerable Population darzustellen. Die zunehmende Anzahl SARS-CoV-2-infizierter Patienten hat das Interesse an der genauen Pathophysiologie und Morphologie der Nierenschädigung sowie am direkten Virusnachweis in der Niere geweckt, der im Gegensatz zur Lunge insgesamt schwieriger zu führen ist. Hierzu liegen mittlerweile Daten aus Autopsie- und Nierenbiopsiestudien mit unterschiedlichen Patientenzahlen und von sehr unterschiedlicher Qualität vor. Während der Nachweis von SARS-CoV-2-RNA im Nierengewebe mit gut reproduzierbaren Ergebnissen erfolgt, ist insbesondere der Virusnachweis mittels Elektronenmikroskopie schwierig und wird aufgrund zahlreicher Artefakte derzeit kritisch diskutiert. Die genauen direkten oder indirekten Effekte von SARS-CoV‑2 auf die Niere sind noch nicht im Detail bekannt und derzeit der Fokus intensiver Forschung.
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Affiliation(s)
- K Amann
- Abt. Nephropathologie, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland.
| | - P Boor
- Institut für Pathologie & Medizinische Klinik II (Nephrologie), Sektion Translationale Nephropathologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
| | - T Wiech
- Institut für Pathologie, Sektion Nephropathologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20146, Hamburg, Deutschland
| | - J Singh
- Medizinische Klinik 3, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - E Vonbrunn
- Abt. Nephropathologie, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland
| | - A Knöll
- Virologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - M Hermann
- Medizinische Klinik 3, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - M Büttner-Herold
- Abt. Nephropathologie, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland
| | - C Daniel
- Abt. Nephropathologie, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland
| | - A Hartmann
- Pathologisches Institut, Universitätsklinikum Erlangen, Erlangen, Deutschland
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277
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Ratre YK, Kahar N, Bhaskar LVKS, Bhattacharya A, Verma HK. Molecular mechanism, diagnosis, and potential treatment for novel coronavirus (COVID-19): a current literature review and perspective. 3 Biotech 2021; 11:94. [PMID: 33520580 PMCID: PMC7832422 DOI: 10.1007/s13205-021-02657-3] [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: 10/03/2020] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
Novel coronavirus disease 2019 (COVID-19) is a positive-sense single-stranded RNA virus which belongs to the Coronaviridae family. COVID-19 outbreak became evident after the severe acute respiratory syndrome coronavirus and the Middle East respiratory syndrome coronavirus in the twenty-first century as the start of the third deadly coronavirus. Currently, research is at an early stage, and the exact etiological dimensions of COVID-19 are unknown. Several candidate drugs and plasma therapy have been considered and evaluated for the treatment of severe COVID-19 patients. These include clinically available drugs such as chloroquine, hydroxychloroquine, and lopinavir/ritonavir. However, understanding the pathogenic mechanisms of this virus is critical for predicting interaction with humans. Based on recent evidence, we have summarized the current virus biology in terms of the possible understanding of the various pathophysiologies, molecular mechanisms, recent efficient diagnostics, and therapeutic approaches to control the disease. In addition, we briefly reviewed the biochemistry of leading candidates for novel therapies and their current status in clinical trials. As information from COVID-19 is evolving rapidly, this review will help the researcher to consider new insights and potential therapeutic approaches based on up-to-date knowledge. Finally, this review illustrates a list of alternative therapeutic solutions for a viral infection.
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Affiliation(s)
| | - Namrata Kahar
- Department of Zoology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | | | - Antaripa Bhattacharya
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, Naples, Italy
| | - Henu Kumar Verma
- Developmental and Stem Cell Biology Lab, Institute of Experimental Endocrinology and Oncology CNR, Naples, Italy
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278
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Altered high-density lipoprotein composition and functions during severe COVID-19. Sci Rep 2021; 11:2291. [PMID: 33504824 PMCID: PMC7841145 DOI: 10.1038/s41598-021-81638-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/08/2021] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is affecting millions of patients worldwide. The consequences of initial exposure to SARS-CoV-2 go beyond pulmonary damage, with a particular impact on lipid metabolism. Decreased levels in HDL-C were reported in COVID-19 patients. Since HDL particles display antioxidant, anti-inflammatory and potential anti-infectious properties, we aimed at characterizing HDL proteome and functionality during COVID-19 relative to healthy subjects. HDLs were isolated from plasma of 8 severe COVID-19 patients sampled at admission to intensive care unit (Day 1, D1) at D3 and D7, and from 16 sex- and age-matched healthy subjects. Proteomic analysis was performed by LC-MS/MS. The relative amounts of proteins identified in HDLs were compared between COVID-19 and controls. apolipoprotein A-I and paraoxonase 1 were confirmed by Western-blot analysis to be less abundant in COVID-19 versus controls, whereas serum amyloid A and alpha-1 antitrypsin were higher. HDLs from patients were less protective in endothelial cells stiumalted by TNFα (permeability, VE-cadherin disorganization and apoptosis). In these conditions, HDL inhibition of apoptosis was blunted in COVID-19 relative to controls. In conclusion, we show major changes in HDL proteome and decreased functionality in severe COVID-19 patients.
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279
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Al-Jahdhami I, Al-Naamani K, Al-Mawali A. The Post-acute COVID-19 Syndrome (Long COVID). Oman Med J 2021; 36:e220. [PMID: 33537155 PMCID: PMC7838343 DOI: 10.5001/omj.2021.91] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
| | | | - Adhra Al-Mawali
- Centre of Studies and Research, Ministry of Health, Muscat, Oman
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280
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Sengupta S, Ince L, Sartor F, Borrmann H, Zhuang X, Naik A, Curtis A, McKeating JA. Clocks, Viruses, and Immunity: Lessons for the COVID-19 Pandemic. J Biol Rhythms 2021; 36:23-34. [PMID: 33480287 PMCID: PMC7970201 DOI: 10.1177/0748730420987669] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Circadian rhythms are evolutionarily conserved anticipatory systems that
allow the host to prepare and respond to threats in its environment.
This article summarizes a European Biological Rhythms Society (EBRS)
workshop held in July 2020 to review current knowledge of the
interplay between the circadian clock and viral infections to inform
therapeutic strategies against SARS-CoV-2 and COVID-19. A large body
of work supports the role of the circadian clock in regulating various
aspects of viral replication, host responses, and associated
pathogenesis. We review the evidence describing the multifaceted role
of the circadian clock, spanning host susceptibility, antiviral
mechanisms, and host resilience. Finally, we define the most pressing
research questions and how our knowledge of chronobiology can inform
key translational research priorities.
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Affiliation(s)
- Shaon Sengupta
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Institute of Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Chronobiology and Sleep Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Louise Ince
- Departement de Pathologie et Immunologie, Geneva, Switzerland
| | - Francesca Sartor
- Institute of Medical Psychology, Medical Faculty, Ludwig Maximilian University of Munich, Munich, Germany
| | - Helene Borrmann
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Xiaodong Zhuang
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Amruta Naik
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Annie Curtis
- School of Pharmacy and Biomolecular Sciences, Tissue Engineering Research Group, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jane A McKeating
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford, UK
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281
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García-Lledó A, Del Palacio-Salgado M, Álvarez-Sanz C, Pérez-Gil MM, Cruz-Díaz Á. [Pulmonary embolism during SARS-CoV-2 pandemic: clinical and radiological features]. Rev Clin Esp 2021; 222:354-358. [PMID: 33495655 PMCID: PMC7816576 DOI: 10.1016/j.rce.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/03/2021] [Indexed: 11/30/2022]
Abstract
Antecedentes Se ha descrito una elevada incidencia de tromboembolismo pulmonar (TEP) durante la pandemia por coronavirus. Métodos Estudio retrospectivo unicéntrico, con revisión de las angiografías pulmonares por tomografía computarizada solicitadas por sospecha de tromboembolismo pulmonar durante dos períodos, del 01 de marzo del 2020 al 31de mayo del 2020 (pandemia), e igual intervalo en 2019 (control). Resultados Se diagnosticaron 22 tromboembolismos pulmonares durante el período control y 99 en el pandémico, 74 asociados con COVID-19. El 5,3% de los pacientes hospitalizados con COVID-19 sufrió un tromboembolismo pulmonar, con un retraso entre ambos diagnósticos de 9,1 ± 8,4 días. Durante la pandemia, los pacientes con tromboembolismo pulmonar tenían menos condiciones predisponentes (tromboembolismo pulmonar previo 5,1 vs. 18,2%, p = 0,05, cirugía previa 2 vs. 35,4%, p = 0,0001, trombosis venosa profunda 11,1 vs. 45,5%, p = 0,0001), y los tromboembolismos pulmonares periféricos eran más frecuentes (73,5 vs. 50%, p = 0,029). Conclusiones Existe un riesgo incrementado de sufrir un TEP durante la pandemia por SARS-CoV-2, que afecta a pacientes con perfil clínico diferente y causa más frecuentemente TEP distales.
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Affiliation(s)
- A García-Lledó
- Servicio de Cardiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.,Departamento de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - M Del Palacio-Salgado
- Servicio de Radiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - C Álvarez-Sanz
- Departamento de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España.,Servicio de Radiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - M M Pérez-Gil
- Servicio de Cardiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - Á Cruz-Díaz
- Departamento de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España.,Servicio de Radiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
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282
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Khosla SG, Nylen ES, Khosla R. Rhabdomyolysis in Patients Hospitalized With COVID-19 Infection: Five Case Series. J Investig Med High Impact Case Rep 2021; 8:2324709620984603. [PMID: 33371733 PMCID: PMC7780065 DOI: 10.1177/2324709620984603] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The novel SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) is
now known to cause acute respiratory distress, cytokine storm, and coagulopathy.
Multiple other manifestations have been published in recent literature.
Rhabdomyolysis is a syndrome of muscle damage, with release of intracellular
contents into circulation. It is characterized by marked elevations of
creatinine kinase levels and myoglobinuria. In this article, we describe a
series of 5 cases who were admitted with COVID-19 pneumonia and had severe
muscle injury, as demonstrated by significant elevation (>5 times upper limit
of normal) of creatinine kinase levels likely secondary to SARS-CoV-2 virus. The
median age for these patients was 65 years, and most of them suffered from
diabetes and hyperlipidemia. All patients were hypertensive males. Four out of 5
patients had preserved kidney function at baseline and were chronic kidney
disease (CKD) stage 2 or better. However, most of them suffered significant
kidney injury and at the time of discharge one patient was CKD stage 2 or
better, 2 were CKD stage 3 or worse, and 2 patients had renal failure and died
due to complications of SARS-CoV-2 infection.
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Affiliation(s)
- Shikha G Khosla
- Veterans Affairs Medical Center, Washington, DC, USA.,George Washington University, Washington, DC, USA
| | - Eric S Nylen
- Veterans Affairs Medical Center, Washington, DC, USA.,George Washington University, Washington, DC, USA
| | - Rahul Khosla
- Veterans Affairs Medical Center, Washington, DC, USA.,George Washington University, Washington, DC, USA
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283
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Bergamaschi G, Borrelli de Andreis F, Aronico N, Lenti MV, Barteselli C, Merli S, Pellegrino I, Coppola L, Cremonte EM, Croce G, Mordà F, Lapia F, Ferrari S, Ballesio A, Parodi A, Calabretta F, Ferrari MG, Fumoso F, Gentile A, Melazzini F, Di Sabatino A. Anemia in patients with Covid-19: pathogenesis and clinical significance. Clin Exp Med 2021; 21:239-246. [PMID: 33417082 PMCID: PMC7790728 DOI: 10.1007/s10238-020-00679-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/07/2020] [Indexed: 01/30/2023]
Abstract
COVID-19 patients typically present with lower airway disease, although involvement of other organ systems is usually the rule. Hematological manifestations such as thrombocytopenia and reduced lymphocyte and eosinophil numbers are highly prevalent in COVID-19 and have prognostic significance. Few data, however, are available about the prevalence and significance of anemia in COVID-19. In an observational study, we investigated the prevalence, pathogenesis and clinical significance of anemia among 206 patients with COVID-19 at the time of their hospitalization in an Internal Medicine unit. The prevalence of anemia was 61% in COVID-19, compared with 45% in a control group of 71 patients with clinical and laboratory findings suggestive of COVID-19, but nasopharyngeal swab tests negative for SARS-CoV-2 RNA (p = 0.022). Mortality was higher in SARS-CoV-2 positive patients. In COVID-19, females had lower hemoglobin concentration than males and a higher prevalence of moderate/severe anemia (25% versus 13%, p = 0.032). In most cases, anemia was mild and due to inflammation, sometimes associated with iron and/or vitamin deficiencies. Determinants of hemoglobin concentration included: erythrocyte sedimentation rate, serum cholinesterase, ferritin and protein concentrations and number of chronic diseases affecting each patient. Hemoglobin concentration was not related to overall survival that was, on the contrary, influenced by red blood cell distribution width, age, lactate dehydrogenase and the ratio of arterial partial oxygen pressure to inspired oxygen fraction. In conclusion, our results highlight anemia as a common manifestation in COVID-19. Although anemia does not directly influence mortality, it usually affects elderly, frail patients and can negatively influence their quality of life.
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Affiliation(s)
- Gaetano Bergamaschi
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.
| | - Federica Borrelli de Andreis
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Nicola Aronico
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy
| | - Marco Vincenzo Lenti
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Chiara Barteselli
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Stefania Merli
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Ivan Pellegrino
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Luigi Coppola
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Elisa Maria Cremonte
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Gabriele Croce
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Francesco Mordà
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Francesco Lapia
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Sara Ferrari
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Alessia Ballesio
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Alessandro Parodi
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Francesca Calabretta
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Maria Giovanna Ferrari
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Federica Fumoso
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Antonella Gentile
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Federica Melazzini
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, San Matteo Hospital Foundation, Piazzale Golgi, 27100, Pavia, Italy.,University of Pavia School of Medicine, Pavia, Italy
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284
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Long COVID Mimicking Interstitial Lung Disease: A Case Series. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:469-473. [PMID: 35003784 PMCID: PMC8679157 DOI: 10.12865/chsj.47.03.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
Interstitial lung diseases (ILD) can occur due to various known or unknown causes. They usually present with dry cough and exertional dyspnea. On radiology usual findings are ground glass opacities (GGO's), reticular shadows, nodules etc. Some patients after acute COVID-19 (coronavirus disease 2019) suffer from persistent symptoms/manifestations. These have been called 'Long COVID'. Long COVID also has radiological features like GGO's, nodules and reticulations. Further, patients even without history of acute COVID-19, can also present with 'Long COVID'. In the present case series, we describe three such cases with no history of having suffered from COVID-19, presenting with ILD like features and diagnosed as Long COVID. We infer from these cases that 'Long COVID' can both clinically and radiologically mimic ILD's. Hence, emphasizing the fact that in the present COVID-19 pandemic situation, 'Long COVID should be a differential diagnosis to be considered while making a new diagnosis of ILD.
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285
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Hong S, Chang J, Jeong K, Lee W. Raloxifene as a treatment option for viral infections. J Microbiol 2021; 59:124-131. [PMID: 33527314 PMCID: PMC7849956 DOI: 10.1007/s12275-021-0617-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 01/31/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused corona virus disease 2019 (COVID-19) pandemic and led to mass casualty. Even though much effort has been put into development of vaccine and treatment methods to combat COVID-19, no safe and efficient cure has been discovered. Drug repurposing or drug repositioning which is a process of investigating pre-existing drug candidates for novel applications outside their original medical indication can speed up the drug development process. Raloxifene is a selective estrogen receptor modulator (SERM) that has been approved by FDA in 1997 for treatment and prevention of postmenopausal osteoporosis and cancer. Recently, raloxifene demonstrates efficacy in treating viral infections by Ebola, influenza A, and hepatitis C viruses and shows potential for drug repurposing for the treatment of SARS-CoV-2 infection. This review will provide an overview of raloxifene's mechanism of action as a SERM and present proposed mechanisms of action in treatment of viral infections.
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Affiliation(s)
- Subin Hong
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419 Republic of Korea
| | - JuOae Chang
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419 Republic of Korea
| | - Kwiwan Jeong
- Bio-center, Gyeonggido Business & Science Accelerator, Suwon, 16229 Republic of Korea
| | - Wonsik Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, 16419 Republic of Korea
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286
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A Paradigm Gap in Host–Pathogen Interaction Studies: Lesson from the COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1353:47-70. [DOI: 10.1007/978-3-030-85113-2_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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287
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Marik PE, Iglesias J, Varon J, Kory P. A scoping review of the pathophysiology of COVID-19. Int J Immunopathol Pharmacol 2021; 35:20587384211048026. [PMID: 34569339 PMCID: PMC8477699 DOI: 10.1177/20587384211048026] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/03/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 is a highly heterogeneous and complex medical disorder; indeed, severe COVID-19 is probably amongst the most complex of medical conditions known to medical science. While enormous strides have been made in understanding the molecular pathways involved in patients infected with coronaviruses an overarching and comprehensive understanding of the pathogenesis of COVID-19 is lacking. Such an understanding is essential in the formulation of effective prophylactic and treatment strategies. Based on clinical, proteomic, and genomic studies as well as autopsy data severe COVID-19 disease can be considered to be the connection of three basic pathologic processes, namely a pulmonary macrophage activation syndrome with uncontrolled inflammation, a complement-mediated endothelialitis together with a procoagulant state with a thrombotic microangiopathy. In addition, platelet activation with the release of serotonin and the activation and degranulation of mast cells contributes to the hyper-inflammatory state. Auto-antibodies have been demonstrated in a large number of hospitalized patients which adds to the end-organ damage and pro-thrombotic state. This paper provides a clinical overview of the major pathogenetic mechanism leading to severe COVID-19 disease.
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Affiliation(s)
- Paul E Marik
- Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA, USA
- Front Line Covid-19 Critical Care Alliance
| | - Jose Iglesias
- Department of Nephrology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA
- Front Line Covid-19 Critical Care Alliance
| | - Joseph Varon
- Department of Critical Care Medicine, United Memorial Medical Center, Houston, TX, USA
- Front Line Covid-19 Critical Care Alliance
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288
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Stojanović D, Ćetojević Ž, Dujaković B, Stanetić M, Kovačević-Preradović T, Stanetić B. High-sensitive troponin-T as a predictive outcome factor in COVID-19 hospitalised patients: Analysis after one-year follow-up. SCRIPTA MEDICA 2021. [DOI: 10.5937/scriptamed52-31743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction: Since December 2019, the humanity is constantly under affection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite global dissemination, neither the treatment or the specific predictive factors have been found or strictly defined yet. Aim: Aim of this study was to assess the long-term (1 year) predictive value of high-sensitive Troponin T (hsTnT) in COVID-19 affected, hospitalised patients. Methods: Between 5 March 2020 and 31 March 2020, 87 consecutive patients hospitalised at University Clinical Centre of the Republic of Srpska due to SARS-CoV2caused pneumonia, in whom hsTnT was measured, were included. The Kaplan-Meier analysis was used to assess differences in all-cause mortality between the groups. Independent predictors of all-cause mortality were identified through univariateand multivariate Cox regression analysis. Results: Compared with patients who had normal hsTnT levels, patients with raised hsTnT were significantly older (70.7 ± 13.23 vs 49 ± 15.29; p < 0.001). Glucose values were significantly increased in patients with raised hsTnT (9.29 ± 5.14 vs 6.76 ± 2.46 [4.1-5.9] mmol/L; p = 0.005), as well as serum creatinine (179.07 ± 225.58 vs 87.53 ± 18.16 µmol/L; p = 0.01), hsTnT (187.43 ± 387.29 vs 7.58 ± 3.40 pg/mL; p = 0.003), D-dimer (5.94 ± 13.78 vs 1.04 ± 1.26 [0-0.50] mg/L; p = 0.024), C-reactive protein (125.92 ± 116.82 vs 69.97 ± 73.09) [< 5.0] mg/L; p = 0.009) and calcium (1.32 ± 0.46 vs 1.03 ± 0.173 [2.20-2.65] mmol/L; p = 0.001). Kaplan-Meier analysis revealed that the number of all-cause deaths at 1 year was 19 of whom 18 were presented with elevated hsTnT (log-rank p < 0.001). When univariate Cox regression was applied, multiple predictors of all-cause mortality have been identified ie age, haemoglobin, haematocrit, urea, CK-MB as well as hsTnT. In a multiple regression model, hsTnT remained an independent predictor of poor outcome. Conclusion: Results from this study showed that the value of hsTnT during hospitalisation is possibly associated with long-term poor outcome of COVID-19 patients. Therefore, hsTnT may appear as a surrogate factor to differentiate between patients at high risk who need more intensive follow-ups.
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289
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Khadka S, Nisar S, Syed NIH, Shrestha DB, Budhathoki P. Different aspects of convalescent plasma therapy for COVID-19 treatment; a critical review. Immunopharmacol Immunotoxicol 2020; 43:30-36. [PMID: 33356684 DOI: 10.1080/08923973.2020.1863983] [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] [Indexed: 12/13/2022]
Abstract
The novel coronavirus disease (COVID-19) has been declared a pandemic by the World Health Organization (WHO) and is ominously threatening the survival of humankind on the whole planet. With a quick spread of the outbreak from its origin, Wuhan, China, to almost all over the world, it has affected more than seven million people to date, hence it has devastated every part of the infrastructural skeleton of governance. Continuously escalating disease burden and lack of proven therapeutic approaches are mounting challenges to health scientists and ultimately to healthcare providers. Although recent studies have shown benefits in decreasing the severity and duration of the illness and there are more benefits compared to risks, plasma therapy cannot be considered as a standard of care until the ongoing trials are completed and they establish definite evidence on its therapeutic efficacy and safety. Though a beneficial aspect may be there, acquiring donors and adequate availability of plasma is equally challenging, and its associated untoward effects related to biological therapeutic agents. The rational practice of CP therapy guided by risk-benefit judgment from aspects of donor and recipient can be a therapeutic option in such a global health crisis.
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Affiliation(s)
- Sitaram Khadka
- Department of Pharmacy Practice, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.,Department of Physiology and Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Shameem Nisar
- Department of Physiology and Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Nawazish-I-Husain Syed
- Department of Physiology and Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Dhan Bahadur Shrestha
- Department of Emergency Medicine and General Practice, Mangalbare Hospital, Morang, Nepal
| | - Pravash Budhathoki
- Department of Emergency Medicine and General Practice, Dr Iwamura Memorial Hospital, Bhaktapur, Nepal
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290
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Orologas-Stavrou N, Politou M, Rousakis P, Kostopoulos IV, Ntanasis-Stathopoulos I, Jahaj E, Tsiligkeridou E, Gavriatopoulou M, Kastritis E, Kotanidou A, Dimopoulos MA, Tsitsilonis OE, Terpos E. Peripheral Blood Immune Profiling of Convalescent Plasma Donors Reveals Alterations in Specific Immune Subpopulations Even at 2 Months Post SARS-CoV-2 Infection. Viruses 2020; 13:E26. [PMID: 33375675 PMCID: PMC7824046 DOI: 10.3390/v13010026] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 02/06/2023] Open
Abstract
Immune profiling of patients with COVID-19 has shown that SARS-CoV-2 causes severe lymphocyte deficiencies (e.g., lymphopenia, decreased numbers, and exhaustion of T cells) and increased levels of pro-inflammatory monocytes. Peripheral blood (PB) samples from convalescent plasma (CP) donors, COVID-19 patients, and control subjects were analyzed by multiparametric flow cytometry, allowing the identification of a wide panel of immune cells, comprising lymphocytes (T, B, natural killer (NK) and NKT cells), monocytes, granulocytes, and their subsets. Compared to active COVID-19 patients, our results revealed that the immune profile of recovered donors was restored for most subpopulations. Nevertheless, even 2 months after recovery, CP donors still had reduced levels of CD4+ T and B cells, as well as granulocytes. CP donors with non-detectable levels of anti-SARS-CoV-2-specific antibodies in their serum were characterized by higher Th9 and Th17 cells, which were possibly expanded at the expense of Th2 humoral immunity. The most noticeable alterations were identified in previously hospitalized CP donors, who presented the lowest levels of CD8+ regulatory T cells, the highest levels of CD56+CD16- NKT cells, and a promotion of a Th17-type phenotype, which might be associated with a prolonged pro-inflammatory response. A longer follow-up of CP donors will eventually reveal the time needed for full recovery of their immune system competence.
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Affiliation(s)
- Nikolaos Orologas-Stavrou
- Department of Biology, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece; (N.O.-S.); (P.R.); (I.V.K.); (O.E.T.)
| | - Marianna Politou
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Pantelis Rousakis
- Department of Biology, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece; (N.O.-S.); (P.R.); (I.V.K.); (O.E.T.)
| | - Ioannis V. Kostopoulos
- Department of Biology, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece; (N.O.-S.); (P.R.); (I.V.K.); (O.E.T.)
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (E.T.); (M.G.); (E.K.); (M.-A.D.)
| | - Edison Jahaj
- First Department of Critical Care Medicine and Pulmonary Services, Evangelismos General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.J.); (A.K.)
| | - Eleni Tsiligkeridou
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (E.T.); (M.G.); (E.K.); (M.-A.D.)
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (E.T.); (M.G.); (E.K.); (M.-A.D.)
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (E.T.); (M.G.); (E.K.); (M.-A.D.)
| | - Anastasia Kotanidou
- First Department of Critical Care Medicine and Pulmonary Services, Evangelismos General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.J.); (A.K.)
| | - Meletios-Athanasios Dimopoulos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (E.T.); (M.G.); (E.K.); (M.-A.D.)
| | - Ourania E. Tsitsilonis
- Department of Biology, School of Sciences, National and Kapodistrian University of Athens, 15784 Athens, Greece; (N.O.-S.); (P.R.); (I.V.K.); (O.E.T.)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Alexandra General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (I.N.-S.); (E.T.); (M.G.); (E.K.); (M.-A.D.)
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291
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Alzahrani AS, Mukhtar N, Aljomaiah A, Aljamei H, Bakhsh A, Alsudani N, Elsayed T, Alrashidi N, Fadel R, Alqahtani E, Raef H, Butt MI, Sulaiman O. The Impact of COVID-19 Viral Infection on the Hypothalamic-Pituitary-Adrenal Axis. Endocr Pract 2020; 27:83-89. [PMID: 33554871 PMCID: PMC7837186 DOI: 10.1016/j.eprac.2020.10.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/09/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023]
Abstract
Objective To study the adrenocortical response to an acute coronavirus disease-2019 (COVID-19) infection. Methods Morning plasma cortisol, adrenocorticotropic hormone (ACTH), and dehydroepiandrosterone sulfate levels were measured in 28 consecutive patients with COVID-19 (16 men, 12 women, median age 45.5 years, range 25-69 years) on day 1 to 2 of hospital admission. These tests were repeated twice in 20 patients and thrice in 15 patients on different days. The hormone levels were correlated with severity of the disease. Results The median morning cortisol level was 196 (31-587) nmol/L. It was <100 nmol/L in 8 patients (28.6%), <200 nmol/L in 14 patients (50%), and <300 nmol/L in 18 patients (64.3%). The corresponding ACTH values had a median of 18.5 ng/L (range 4-38 ng/L), and the ACTH level was <10 ng/L in 7 patients (26.9%), <20 ng/L in 17 patients (60.7%), and <30 ng/L in 23 patients (82.1%). The repeated testing on different days showed a similar pattern. Overall, if a cutoff level of <300 nmol/L is considered abnormal in the setting of acute disease, 9 patients (32%) had cortisol levels below this limit, regardless of whether the test was done only once (3 patients) or 3 times (6 patients). When the disease was more severe, the patients had lower cortisol and ACTH levels, suggesting a direct link between the COVID-19 infection and impaired glucocorticoid response. Conclusion Unexpectedly, the adrenocortical response in patients with COVID-19 infection was impaired, and a significant percentage of the patients had plasma cortisol and ACTH levels consistent with central adrenal insufficiency.
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Affiliation(s)
- Ali S Alzahrani
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia.
| | - Noha Mukhtar
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Abeer Aljomaiah
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Hadeel Aljamei
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Abdulmohsen Bakhsh
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Nada Alsudani
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Tarek Elsayed
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Nahlah Alrashidi
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Roqayh Fadel
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Eman Alqahtani
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Hussein Raef
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Muhammad Imran Butt
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
| | - Othman Sulaiman
- Department of Critical Care, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia
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292
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ACE2, angiotensin 1-7 and skeletal muscle: review in the era of COVID-19. Clin Sci (Lond) 2020; 134:3047-3062. [PMID: 33231620 PMCID: PMC7687025 DOI: 10.1042/cs20200486] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 12/12/2022]
Abstract
Angiotensin converting enzyme-2 (ACE2) is a multifunctional transmembrane protein recently recognised as the entry receptor of the virus causing COVID-19. In the renin–angiotensin system (RAS), ACE2 cleaves angiotensin II (Ang II) into angiotensin 1-7 (Ang 1-7), which is considered to exert cellular responses to counteract the activation of the RAS primarily through a receptor, Mas, in multiple organs including skeletal muscle. Previous studies have provided abundant evidence suggesting that Ang 1-7 modulates multiple signalling pathways leading to protection from pathological muscle remodelling and muscle insulin resistance. In contrast, there is relatively little evidence to support the protective role of ACE2 in skeletal muscle. The potential contribution of endogenous ACE2 to the regulation of Ang 1-7-mediated protection of these muscle pathologies is discussed in this review. Recent studies have suggested that ACE2 protects against ageing-associated muscle wasting (sarcopenia) through its function to modulate molecules outside of the RAS. Thus, the potential association of sarcopenia with ACE2 and the associated molecules outside of RAS is also presented herein. Further, we introduce the transcriptional regulation of muscle ACE2 by drugs or exercise, and briefly discuss the potential role of ACE2 in the development of COVID-19.
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293
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Abstract
Bei einer schweren COVID-19(„coronavirus disease 2019“)-Erkrankung ist neben der Lungenerkrankung das akute Nierenversagen eine der häufigsten und schwerwiegendsten Komplikationen. SARS-CoV‑2 („severe acute respiratory syndrome coronavirus 2“) konnte auch in der Niere nachgewiesen werden. Patienten mit chronischen Nierenerkrankungen und an der Dialyse wie auch nierentransplantierte Patienten scheinen eine besonders vulnerable Population darzustellen. Die zunehmende Anzahl SARS-CoV-2-infizierter Patienten hat das Interesse an der genauen Pathophysiologie und Morphologie der Nierenschädigung sowie am direkten Virusnachweis in der Niere geweckt, der im Gegensatz zur Lunge insgesamt schwieriger zu führen ist. Hierzu liegen mittlerweile Daten aus größeren Autopsie- und Nierenbiopsiestudien vor. Während der Nachweis von SARS-CoV-2-RNA im Gewebe zu gut reproduzierbaren Ergebnissen führt, wird insbesondere der Virusnachweis mittels Elektronenmikroskopie aufgrund zahlreicher Artefakte kritisch diskutiert. Die genauen und direkten Effekte von SARS-CoV‑2 auf die Niere sind noch nicht im Detail bekannt und derzeit im Fokus intensiver Forschung.
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294
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Tsivgoulis G, Palaiodimou L, Zand R, Lioutas VA, Krogias C, Katsanos AH, Shoamanesh A, Sharma VK, Shahjouei S, Baracchini C, Vlachopoulos C, Gournellis R, Sfikakis PP, Sandset EC, Alexandrov AV, Tsiodras S. COVID-19 and cerebrovascular diseases: a comprehensive overview. Ther Adv Neurol Disord 2020; 13:1756286420978004. [PMID: 33343709 PMCID: PMC7727052 DOI: 10.1177/1756286420978004] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022] Open
Abstract
Neurological manifestations are not uncommon during infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A clear association has been reported between cerebrovascular disease and coronavirus disease 2019 (COVID-19). However, whether this association is causal or incidental is still unknown. In this narrative review, we sought to present the possible pathophysiological mechanisms linking COVID-19 and cerebrovascular disease, describe the stroke syndromes and their prognosis and discuss several clinical, radiological, and laboratory characteristics that may aid in the prompt recognition of cerebrovascular disease during COVID-19. A systematic literature search was conducted, and relevant information was abstracted. Angiotensin-converting enzyme-2 receptor dysregulation, uncontrollable immune reaction and inflammation, coagulopathy, COVID-19-associated cardiac injury with subsequent cardio-embolism, complications due to critical illness and prolonged hospitalization can all contribute as potential etiopathogenic mechanisms leading to diverse cerebrovascular clinical manifestations. Acute ischemic stroke, intracerebral hemorrhage, and cerebral venous sinus thrombosis have been described in case reports and cohorts of COVID-19 patients with a prevalence ranging between 0.5% and 5%. SARS-CoV-2-positive stroke patients have higher mortality rates, worse functional outcomes at discharge and longer duration of hospitalization as compared with SARS-CoV-2-negative stroke patients in different cohort studies. Specific demographic, clinical, laboratory and radiological characteristics may be used as ‘red flags’ to alarm clinicians in recognizing COVID-19-related stroke.
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Affiliation(s)
- Georgios Tsivgoulis
- Second Department of Neurology, School of Medicine, National & Kapodistrian University of Athens, Rimini 1, Chaidari, Athens 12462, Greece
| | - Lina Palaiodimou
- Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, 'Attikon' University Hospital, Athens, Greece
| | - Ramin Zand
- Department of Neurology, Neuroscience Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | | | - Christos Krogias
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany
| | - Aristeidis H Katsanos
- Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, 'Attikon' University Hospital, Athens, Greece
| | - Ashkan Shoamanesh
- Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, ON, Canada
| | - Vijay K Sharma
- Division of Neurology, Department of Medicine, YLL School of Medicine, National University of Singapore, Singapore
| | - Shima Shahjouei
- Department of Neurology, Neuroscience Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - Claudio Baracchini
- Stroke Unit and Neurosonology Laboratory, Padua University Hospital, Padua, Italy
| | | | - Rossetos Gournellis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, School of Medicine, 'Attikon' University Hospital, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Andrei V Alexandrov
- Department of Neurology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Sotirios Tsiodras
- Fourth Department of Internal Medicine, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients. Molecules 2020; 25:molecules25235725. [PMID: 33291581 PMCID: PMC7731255 DOI: 10.3390/molecules25235725] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The rapid onset of a systemic pro-inflammatory state followed by acute respiratory distress syndrome is the leading cause of mortality in patients with COVID-19. We performed a retrospective observational study to explore the capacity of different complete blood cell count (CBC)-derived inflammation indexes to predict in-hospital mortality in this group. METHODS The neutrophil to lymphocyte ratio (NLR), derived NLR (dNLR), platelet to lymphocyte ratio (PLR), mean platelet volume to platelet ratio (MPR), neutrophil to lymphocyte × platelet ratio (NLPR), monocyte to lymphocyte ratio (MLR), systemic inflammation response index (SIRI), systemic inflammation index (SII), and the aggregate index of systemic inflammation (AISI) were calculated on hospital admission in 119 patients with laboratory confirmed COVID-19. RESULTS Non-survivors had significantly higher AISI, dNLR, NLPR, NLR, SII, and SIRI values when compared to survivors. Similarly, Kaplan-Meier survival curves showed significantly lower survival in patients with higher AISI, dNLR, MLR, NLPR, NLR, SII, and SIRI. However, after adjusting for confounders, only the SII remained significantly associated with survival (HR = 1.0001; 95% CI, 1.0000-1.0001, p = 0.029) in multivariate Cox regression analysis. CONCLUSIONS The SII on admission independently predicts in-hospital mortality in COVID-19 patients and may assist with early risk stratification in this group.
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Balaphas A, Gkoufa K, Meyer J, Peloso A, Bornand A, McKee TA, Toso C, Popeskou SG. COVID-19 can mimic acute cholecystitis and is associated with the presence of viral RNA in the gallbladder wall. J Hepatol 2020; 73:1566-1568. [PMID: 32890595 PMCID: PMC7467103 DOI: 10.1016/j.jhep.2020.08.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/07/2020] [Accepted: 08/16/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Alexandre Balaphas
- Department of Digestive Surgery, University Hospitals of Geneva, Switzerland.
| | - Kyriaki Gkoufa
- Department of Endocrinology, Diabetology, Nutrition and Patient Education, University Hospitals of Geneva, Switzerland
| | - Jeremy Meyer
- Department of Digestive Surgery, University Hospitals of Geneva, Switzerland
| | - Andrea Peloso
- Department of Digestive Surgery, University Hospitals of Geneva, Switzerland
| | - Aurélie Bornand
- Department of Pathology and Immunology, University Hospitals of Geneva, Switzerland
| | - Thomas A. McKee
- Department of Pathology and Immunology, University Hospitals of Geneva, Switzerland
| | - Christian Toso
- Department of Digestive Surgery, University Hospitals of Geneva, Switzerland
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297
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Risks of lung transplantation in the SARS-CoV-2 era. THE LANCET RESPIRATORY MEDICINE 2020; 9:224-226. [PMID: 33275903 PMCID: PMC7832731 DOI: 10.1016/s2213-2600(20)30561-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022]
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298
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Kosmeri C, Koumpis E, Tsabouri S, Siomou E, Makis A. Hematological manifestations of SARS-CoV-2 in children. Pediatr Blood Cancer 2020; 67:e28745. [PMID: 33009893 PMCID: PMC7646039 DOI: 10.1002/pbc.28745] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/11/2020] [Accepted: 09/18/2020] [Indexed: 12/18/2022]
Abstract
Infection from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), though mainly a respiratory disease, can impair many systems, including causing hematological complications. Lymphopenia and hypercoagulability have been reported in adults with coronavirus disease 2019 (COVID-19) and are considered markers of poor prognosis. This review summarizes the hematological findings in children with SARS-CoV-2 infection. The majority of infected children had a normal leukocyte count, while the most common white blood cell abnormality was leukopenia. Lymphopenia, which may be a marker of severe disease, was rarer in children than in adults, possibly due to their immature immune system or due to the less severe manifestation of COVID-19 in this age group. Age may have an impact, and in neonates and infants the most common abnormality was lymphocytosis. Abnormalities of red blood cells and platelets were uncommon. Anemia and hypercoagulability were reported mainly in children presenting the novel multisystem inflammatory syndrome (MIS) associated with SARS-CoV-2.
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Affiliation(s)
- Chrysoula Kosmeri
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Epameinondas Koumpis
- Department of Internal Medicine, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Sophia Tsabouri
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Ekaterini Siomou
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
| | - Alexandros Makis
- Department of Pediatrics, Faculty of MedicineUniversity of IoanninaIoanninaGreece
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299
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Terpos E, Politou M, Sergentanis TN, Mentis A, Rosati M, Stellas D, Bear J, Hu X, Felber BK, Pappa V, Pagoni M, Grouzi E, Labropoulou S, Charitaki I, Ntanasis-Stathopoulos I, Moschandreou D, Bouhla A, Saridakis S, Korompoki E, Giatra C, Bagratuni T, Pefanis A, Papageorgiou S, Spyridonidis A, Antoniadou A, Kotanidou A, Syrigos K, Stamoulis K, Panayiotakopoulos G, Tsiodras S, Alexopoulos L, Dimopoulos MA, Pavlakis GN. Anti-SARS-CoV-2 Antibody Responses in Convalescent Plasma Donors Are Increased in Hospitalized Patients; Subanalyses of a Phase 2 Clinical Study. Microorganisms 2020; 8:microorganisms8121885. [PMID: 33260775 PMCID: PMC7760522 DOI: 10.3390/microorganisms8121885] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 02/07/2023] Open
Abstract
We evaluated the antibody responses in 259 potential convalescent plasma donors for Covid-19 patients. Different assays were used: a commercial ELISA detecting antibodies against the recombinant spike protein (S1); a multiplex assay detecting total and specific antibody isotypes against three SARS-CoV-2 antigens (S1, basic nucleocapsid (N) protein and receptor-binding domain (RBD)); and an in-house ELISA detecting antibodies to complete spike, RBD and N in 60 of these donors. Neutralizing antibodies (NAb) were also evaluated in these 60 donors. Analyzed samples were collected at a median time of 62 (14-104) days from the day of first symptoms or positive PCR (for asymptomatic patients). Anti-SARS-CoV-2 antibodies were detected in 88% and 87.8% of donors using the ELISA and the multiplex assay, respectively. The multivariate analysis showed that age ≥50 years (p < 0.001) and need for hospitalization (p < 0.001) correlated with higher antibody titers, while asymptomatic status (p < 0.001) and testing >60 days after symptom onset (p = 0.001) correlated with lower titers. Interestingly, pseudotype virus-neutralizing antibodies (PsNAbs) significantly correlated with spike and with RBD antibodies by ELISA. Sera with high PsNAb also showed a strong ability to neutralize active SARS-CoV-2 virus, with hospitalized patients showing higher titers. Therefore, convalescent plasma donors can be selected based on the presence of high RBD antibody titers.
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Affiliation(s)
- Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (T.N.S.); (I.C.); (I.N.-S.); (E.K.); (T.B.); (M.A.D.)
- Correspondence: or ; Tel.: +30-213-2162846; Fax: +30-213-2162511
| | - Marianna Politou
- Hematology Laboratory Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Theodoros N. Sergentanis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (T.N.S.); (I.C.); (I.N.-S.); (E.K.); (T.B.); (M.A.D.)
| | - Andreas Mentis
- Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.M.); (S.L.)
| | - Margherita Rosati
- Human Retrovirus Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702-1201, USA; (M.R.); (D.S.); (G.N.P.)
| | - Dimitris Stellas
- Human Retrovirus Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702-1201, USA; (M.R.); (D.S.); (G.N.P.)
- Institute of Chemical Biology, National Hellenic Research Foundation, 48 Vassileos Constantinou Ave., 11635 Athens, Greece
| | - Jenifer Bear
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702-1201, USA; (J.B.); (X.H.); (B.K.F.)
| | - Xintao Hu
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702-1201, USA; (J.B.); (X.H.); (B.K.F.)
| | - Barbara K. Felber
- Human Retrovirus Pathogenesis Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702-1201, USA; (J.B.); (X.H.); (B.K.F.)
| | - Vassiliki Pappa
- Hematology Unit, Second Department of Internal Medicine, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (V.P.); (A.B.); (S.P.)
| | - Maria Pagoni
- BMT Unit, Department of Hematology and Lymphomas, Evangelismos General Hospital, 10676 Athens, Greece; (M.P.); (C.G.)
| | - Elisavet Grouzi
- Department of Transfusion Service and Clinical Hemostasis, “Saint Savvas” Oncology Hospital, 11522 Athens, Greece; (E.G.); (D.M.)
| | - Stavroula Labropoulou
- Public Health Laboratories, Hellenic Pasteur Institute, 11521 Athens, Greece; (A.M.); (S.L.)
| | - Ioanna Charitaki
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (T.N.S.); (I.C.); (I.N.-S.); (E.K.); (T.B.); (M.A.D.)
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (T.N.S.); (I.C.); (I.N.-S.); (E.K.); (T.B.); (M.A.D.)
| | - Dimitra Moschandreou
- Department of Transfusion Service and Clinical Hemostasis, “Saint Savvas” Oncology Hospital, 11522 Athens, Greece; (E.G.); (D.M.)
| | - Anthi Bouhla
- Hematology Unit, Second Department of Internal Medicine, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (V.P.); (A.B.); (S.P.)
| | | | - Eleni Korompoki
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (T.N.S.); (I.C.); (I.N.-S.); (E.K.); (T.B.); (M.A.D.)
| | - Chara Giatra
- BMT Unit, Department of Hematology and Lymphomas, Evangelismos General Hospital, 10676 Athens, Greece; (M.P.); (C.G.)
| | - Tina Bagratuni
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (T.N.S.); (I.C.); (I.N.-S.); (E.K.); (T.B.); (M.A.D.)
| | - Angelos Pefanis
- Department of Internal Medicine, Sotiria General Hospital of Chest Diseases, 11527 Athens, Greece;
| | - Sotirios Papageorgiou
- Hematology Unit, Second Department of Internal Medicine, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (V.P.); (A.B.); (S.P.)
| | - Alexandros Spyridonidis
- BMT Unit, University Hospital of Patras, School of Medicine, University of Patras, 26500 Patras, Greece;
| | - Anastasia Antoniadou
- Fourth Department of Internal Medicine, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.A.); (S.T.)
| | - Anastasia Kotanidou
- First Department of Critical Care Medicine and Pulmonary Services, Evangelismos General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Konstantinos Syrigos
- Oncology Unit, Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - George Panayiotakopoulos
- Pharmacology Laboratory, School of Medicine, University of Patras, 26500 Patras, Greece;
- National Public Health Organization, 15123 Athens, Greece
| | - Sotirios Tsiodras
- Fourth Department of Internal Medicine, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.A.); (S.T.)
- National Public Health Organization, 15123 Athens, Greece
| | - Leonidas Alexopoulos
- Biomedical Systems Laboratory, National Technical University of Athens, 11527 Athens, Greece;
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (T.N.S.); (I.C.); (I.N.-S.); (E.K.); (T.B.); (M.A.D.)
| | - George N. Pavlakis
- Human Retrovirus Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, Frederick, MD 21702-1201, USA; (M.R.); (D.S.); (G.N.P.)
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Kotta S, Aldawsari HM, Badr-Eldin SM, Alhakamy NA, Md S, Nair AB, Deb PK. Combating the Pandemic COVID-19: Clinical Trials, Therapies and Perspectives. Front Mol Biosci 2020; 7:606393. [PMID: 33282914 PMCID: PMC7705351 DOI: 10.3389/fmolb.2020.606393] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022] Open
Abstract
The coronavirus disease-19 (COVID-19) is caused due to the infection by a unique single stranded enveloped RNA virus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The COVID-19 has claimed many lives around the globe, and a promising solution to end this pandemic is still awaited. Till date neither an exact antiviral drug nor a vaccine is available in the market for public use to cure or control this pandemic. Repurposed drugs and supportive measures are the only available treatment options. This systematic review focuses on different treatment strategies based on various clinical studies. The review discusses all the current treatment plans and probable future strategies obtained as a result of a systematic search in PubMed and Science Direct database. All the possible options for the treatment as well as prophylaxis of COVID-19 are discussed. Apart from this, the article provides details on the clinical trials related to COVID-19, which are registered under ClinicalTrials.gov. Potential of drugs based on the previous researches on SARS-CoV, MERS-CoV, Ebola, influenza, etc. which fall under the same category of coronavirus are also emphasized. Information on cell-based and immunology-based approaches is also provided. In addition, miscellaneous therapeutic approaches and adjunctive therapies are discussed. The drug repurposing options, as evidenced from various in vitro and in silico models, are also covered including the possible future solutions to this pandemic.
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Affiliation(s)
- Sabna Kotta
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hibah Mubarak Aldawsari
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shaimaa M. Badr-Eldin
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pharmaceutics and Industrial Pharmacy, Cairo University, Cairo, Egypt
| | | | - Shadab Md
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anroop B. Nair
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Pran Kishore Deb
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Philadelphia University, Amman, Jordan
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