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Igwe JK, Alaribe U. Cannabis use associated with lower mortality among hospitalized Covid-19 patients using the national inpatient sample: an epidemiological study. J Cannabis Res 2024; 6:18. [PMID: 38582889 PMCID: PMC10998318 DOI: 10.1186/s42238-024-00228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/20/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown. METHODS In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical ventilation (MV), and acute pulmonary embolism (PE) compared to all-cause admissions; for CU vs N-CU; and for ACU vs N-ACU. RESULTS There were 1,698,560 Covid-19-related hospitalizations which were associated with higher mortality (13.44% vs 2.53%, p ≤ 0.001) and worse secondary outcomes generally. Among all-cause hospitalizations, 1.56% of CU and 6.29% of N-CU were hospitalized with Covid-19 (p ≤ 0.001). ACU was associated with lower odds of MV, PE, and death among the Covid-19 population. On PSM, ACU(N(unweighted) = 2,382) was associated with 83.97% lower odds of death compared to others(N(unweighted) = 282,085) (2.77% vs 3.95%, respectively; aOR:0.16, [0.10-0.25], p ≤ 0.001). CONCLUSIONS These findings suggest that the ECS may represent a viable target for modulation of Covid-19. Additional studies are needed to further explore these findings.
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Affiliation(s)
- Joseph-Kevin Igwe
- Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Ugo Alaribe
- Caribbean Medical University School of Medicine, 5600 N River Rd Suite 800, Rosemont, IL, 60018, USA
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2
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Batiha GES, Al-Gareeb AI, Elekhnawy E, Al-kuraishy HM. Potential role of lipoxin in the management of COVID-19: a narrative review. Inflammopharmacology 2022; 30:1993-2001. [PMID: 36114383 PMCID: PMC9483298 DOI: 10.1007/s10787-022-01070-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/20/2022] [Indexed: 01/18/2023]
Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection leads to the development of coronavirus disease 2019 (COVID-19), which causes endothelial dysfunction (ED), oxidative stress (OS), and inflammatory disorders. These changes cause hypoxia and cytokine storm with the development of cardio-pulmonary complications. Bioactive lipids and other polyunsaturated fatty acids participate in a vital role in the SARS-CoV-2 infection process. One of these mediators is the anti-inflammatory compound, lipoxin (LX). LXs are produced from arachidonic acid (AA) by collaboration between 5-lipoxygenase (5-LO) and 12-15 LO during cell interactions. Thus, our goal was to review the probable role of LXs in COVID-19 regarding the effects of LXs on the inflammatory signaling pathways that are linked with COVID-19 pathogenesis and complications.
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Affiliation(s)
- Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511 AlBeheira Egypt
| | - Ali I. Al-Gareeb
- Department of Pharmacology, Toxicology and Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, 14132 Iraq
| | - Engy Elekhnawy
- Pharmaceutical Microbiology Department, Faculty of Pharmacy, Tanta University, Tanta, 31527 Egypt
| | - Hayder M. Al-kuraishy
- Department of Pharmacology, Toxicology and Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, 14132 Iraq
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3
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Sulfonic acid pyridinium chloride-functionalized nanoparticles (MnCoFe2O4@Niacin-SO3H)+Cl− as a novel and reusable catalyst for synthesis of tetrahydrodipyrazolopyridines and pyranopyrazoles. RESEARCH ON CHEMICAL INTERMEDIATES 2022. [DOI: 10.1007/s11164-022-04800-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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4
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Deeba F, Shahar Yar M, Rafi Haidar M, Sharma AK, Sharma M. Synthesis, molecular docking, and pharmacological evaluation of 5-(4-(2-(5-ethyl pyridine-2-yl) ethoxy) benzyl)-3-(phenylsulfonyl) thiazolidine-2, 4-dione against HFD-induced diabesity via interaction with the CB1 receptor. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2022; 25:1028-1036. [PMID: 36159331 PMCID: PMC9464343 DOI: 10.22038/ijbms.2022.65649.14443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/10/2022] [Indexed: 11/08/2022]
Abstract
Objectives CB1 antagonism arbitrates a dormant shape to the endocannabinoid system that alleviates diverse pathological incidents of diabesity. The present study pursued the synthesis and evaluation of thiazolidine derivative (BAC) having pleiotropic action on CB1R, with or without AM251 (selective antagonist of the CB1 receptor) against high-fat diet (HFD) induced diabesity in C57BL/6 mice. Materials and Methods A molecular docking study for CB1 antagonistic potential was conducted by Maestro 11.4 program (Schrodinger Inc., USA), and the thiazolidine derivative BAC was synthesized. The assessment of varied parameters including anthropometric, neurobehavioral, hyperglycemia, dyslipidemia, oxidative stress, and inflammatory cytokines was evaluated in HFD-fed animals as compared with individual and combined treatments of BAC and AM251. Results Incomparable to AM251, the treatment of BAC was reported for a significant reduction in food intake and obesity, diabetic biomarkers, lipid profile, oxidative stress, and proinflammatory cytokine release. Moreover, the BAC treatment showed no significant alteration in neurobehavioral activity, including anxiety and depression. Conclusion The preliminary in silico study suggests that BAC has a close interaction with CB1 antagonism but has no sign of neurobehavioral alteration. Simultaneously, this compound showed significant ability to ameliorate diversity by the underlying mechanisms of minimizing oxidative stress, regularizing the lipid profile, and reducing pro-inflammatory cytokines.
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Affiliation(s)
- Farah Deeba
- Department of Pharmacology, School of Pharmaceutical Education and Research, (SPER) Jamia Hamdard, Delhi-110062, India
| | - Mohammad Shahar Yar
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, (SPER) Jamia Hamdard, Delhi-110062, India
| | | | - Arun K. Sharma
- Department of Pharmacology, Amity University Haryana, Gurugram-122413, India,Corresponding authors: Manju Sharma. Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, Delhi-110062, India. , Arun K. Sharma. Department of Pharmacology, Amity University Haryana, Gurugram-122413, India.
| | - Manju Sharma
- Department of Pharmacology, School of Pharmaceutical Education and Research, (SPER) Jamia Hamdard, Delhi-110062, India,Corresponding authors: Manju Sharma. Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, Delhi-110062, India. , Arun K. Sharma. Department of Pharmacology, Amity University Haryana, Gurugram-122413, India.
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5
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Wang H, Wang H, Sun Y, Ren Z, Zhu W, Li A, Cui G. Potential Associations Between Microbiome and COVID-19. Front Med (Lausanne) 2022; 8:785496. [PMID: 35004750 PMCID: PMC8727742 DOI: 10.3389/fmed.2021.785496] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/22/2021] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has plunged the world into a major crisis. The disease is characterized by strong infectivity, high morbidity, and high mortality. It is still spreading in some countries. Microbiota and their metabolites affect human physiological health and diseases by participating in host digestion and nutrition, promoting metabolic function, and regulating the immune system. Studies have shown that human microecology is associated with many diseases, including COVID-19. In this research, we first reviewed the microbial characteristics of COVID-19 from the aspects of gut microbiome, lung microbime, and oral microbiome. We found that significant changes take place in both the gut microbiome and airway microbiome in patients with COVID-19 and are characterized by an increase in conditional pathogenic bacteria and a decrease in beneficial bacteria. Then, we summarized the possible microecological mechanisms involved in the progression of COVID-19. Intestinal microecological disorders in individuals may be involved in the occurrence and development of COVID-19 in the host through interaction with ACE2, mitochondria, and the lung-gut axis. In addition, fecal bacteria transplantation (FMT), prebiotics, and probiotics may play a positive role in the treatment of COVID-19 and reduce the fatal consequences of the disease.
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Affiliation(s)
- Huifen Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Gene Hospital of Henan Province, Zhengzhou, China.,Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Haiyu Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Gene Hospital of Henan Province, Zhengzhou, China.,Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Sun
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Gene Hospital of Henan Province, Zhengzhou, China.,Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhigang Ren
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Gene Hospital of Henan Province, Zhengzhou, China.,Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weiwei Zhu
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Gene Hospital of Henan Province, Zhengzhou, China.,Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ang Li
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Gene Hospital of Henan Province, Zhengzhou, China.,Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guangying Cui
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Gene Hospital of Henan Province, Zhengzhou, China.,Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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6
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Soffer S, Glicksberg BS, Zimlichman E, Efros O, Levin MA, Freeman R, Reich DL, Klang E. The association between obesity and peak antibody titer response in COVID-19 infection. Obesity (Silver Spring) 2021; 29:1547-1553. [PMID: 33945220 PMCID: PMC8242567 DOI: 10.1002/oby.23208] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/16/2021] [Accepted: 04/29/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Obesity is associated with severe coronavirus disease 2019 (COVID-19) infection. Disease severity is associated with a higher COVID-19 antibody titer. The COVID-19 antibody titer response of patients with obesity versus patients without obesity was compared. METHODS The data of individuals tested for COVID-19 serology at the Mount Sinai Health System in New York City between March 1, 2020, and December 14, 2021, were retrospectively retrieved. The primary outcome was peak antibody titer, assessed as a binary variable (1:2,880, which was the highest detected titer, versus lower than 1:2,880). In patients with a positive serology test, peak titer rates were compared between BMI groups (<18.5, 18.5 to 25, 25 to 30, 30 to 40, and ≥40 kg/m2 ). A multivariable logistic regression model was used to analyze the independent association between different BMI groups and peak titer. RESULTS Overall, 39,342 individuals underwent serology testing and had BMI measurements. A positive serology test was present in 12,314 patients. Peak titer rates were associated with obesity (BMI < 18.5 [34.5%], 18.5 to 25 [29.2%], 25 to 30 [37.7%], 30 to 40 [44.7%], ≥40 [52.0%]; p < 0.001). In a multivariable analysis, severe obesity had the highest adjusted odds ratio for peak titer (95% CI: 2.1-3.0). CONCLUSION COVID-19 neutralizing antibody titer is associated with obesity. This has implications on the understanding of the role of obesity in COVID-19 severity.
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Affiliation(s)
- Shelly Soffer
- Internal Medicine BAssuta Medical CenterAshdodIsrael
- Goldman Medical SchoolBen‐Gurion University of the NegevBe'er ShevaIsrael
| | - Benjamin S. Glicksberg
- Hasso Plattner Institute for Digital Health at Mount SinaiIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Eyal Zimlichman
- Hospital managementSheba Medical CenterTel HashomerIsrael
- Sackler Medical SchoolTel Aviv UniversityTel AvivIsrael
- Sheba Talpiot Medical Leadership ProgramTel HashomerIsrael
| | - Orly Efros
- Sackler Medical SchoolTel Aviv UniversityTel AvivIsrael
- Thrombosis & Hemostasis UnitSheba Medical CenterTel HashomerIsrael
| | - Matthew A. Levin
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Institute for Healthcare Delivery ScienceDepartment of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of AnesthesiologyPerioperative and Pain MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Robert Freeman
- Institute for Healthcare Delivery ScienceDepartment of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - David L. Reich
- Department of AnesthesiologyPerioperative and Pain MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Eyal Klang
- Sackler Medical SchoolTel Aviv UniversityTel AvivIsrael
- Sheba Talpiot Medical Leadership ProgramTel HashomerIsrael
- Department of Diagnostic ImagingSheba Medical CenterTel HashomerIsrael
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7
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Papadopoulou SK, Mantzorou M, Koutridou D, Tassoulas E, Sakellaropoulou S, Biskanaki F, Xatziapostolou E, Papandreou D. COVID-19 disease, obesity and micronutrients: an updated narrative review of the literature. NUTRITION & FOOD SCIENCE 2021; 51:808-824. [DOI: 10.1108/nfs-08-2020-0310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
PurposeThe purpose of this paper is to critically summarize the current data concerning the impact of obesity and micronutrient adequacy and supplementation on the risk and severity of COVID-19 disease, and their potential impact on treatment and rehabilitation.Design/methodology/approachPubMed, Scopus and Google Scholar databases were thoroughly searched to identify studies concerning obesity and nutritional status, vitamin and other micronutrients adequacy with COVID-19 severity.FindingsIndividuals with higher body mass index are in greater risk of severe disease and need for mechanical ventilation. Concerning micronutrient adequacy, no published studies at the present time have evaluated the effect of supplementation on the risk and the treatment of the novel disease.Originality/valueRecently, COVID-19 has monopolized the interest of the medical community regarding diet and nutritional status and it possibly plays an important role in disease severity.
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8
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What Role Does the Endocannabinoid System Play in the Pathogenesis of Obesity? Nutrients 2021; 13:nu13020373. [PMID: 33530406 PMCID: PMC7911032 DOI: 10.3390/nu13020373] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 02/07/2023] Open
Abstract
The endocannabinoid system (ECS) is an endogenous signaling system formed by specific receptors (cannabinoid type 1 and type 2 (CB1 and CB2)), their endogenous ligands (endocannabinoids), and enzymes involved in their synthesis and degradation. The ECS, centrally and peripherally, is involved in various physiological processes, including regulation of energy balance, promotion of metabolic process, food intake, weight gain, promotion of fat accumulation in adipocytes, and regulation of body homeostasis; thus, its overactivity may be related to obesity. In this review, we try to explain the role of the ECS and the impact of genetic factors on endocannabinoid system modulation in the pathogenesis of obesity, which is a global and civilizational problem affecting the entire world population regardless of age. We also emphasize that the search for potential new targets for health assessment, treatment, and the development of possible therapies in obesity is of great importance.
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Salles J, Briand-Mésange F, Trudel S, Ausseil J, Salles JP, Chap H. Can antidepressants unlock prescription of rimonabant in the fight against COVID-19? Mol Psychiatry 2021; 26:7091-7092. [PMID: 34282263 PMCID: PMC8287274 DOI: 10.1038/s41380-021-01221-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/17/2021] [Accepted: 06/29/2021] [Indexed: 01/06/2023]
Affiliation(s)
- Juliette Salles
- grid.15781.3a0000 0001 0723 035XInfinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France ,grid.411175.70000 0001 1457 2980CHU de Toulouse, Service de psychiatrie et psychologie, psychiatrie, Toulouse, France
| | - Fabienne Briand-Mésange
- grid.15781.3a0000 0001 0723 035XInfinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France
| | - Stéphanie Trudel
- grid.15781.3a0000 0001 0723 035XInfinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France ,grid.411175.70000 0001 1457 2980CHU Toulouse, Institut Fédératif de Biologie, Laboratoire de Biochimie, Toulouse, France
| | - Jérôme Ausseil
- grid.15781.3a0000 0001 0723 035XInfinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France ,grid.411175.70000 0001 1457 2980CHU Toulouse, Institut Fédératif de Biologie, Laboratoire de Biochimie, Toulouse, France
| | - Jean-Pierre Salles
- grid.15781.3a0000 0001 0723 035XInfinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France ,grid.411175.70000 0001 1457 2980CHU de Toulouse, Centre de référence du Syndrome de Prader–Willi et autres syndromes avec troubles du comportement alimentaire, Unité d’endocrinologie, obésités, maladies osseuses, génétique et gynécologie médicale, Toulouse, France
| | - Hugues Chap
- Infinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France.
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10
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Villapol S. Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome. Transl Res 2020; 226:57-69. [PMID: 32827705 PMCID: PMC7438210 DOI: 10.1016/j.trsl.2020.08.004] [Citation(s) in RCA: 197] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the greatest worldwide pandemic since the 1918 flu. The consequences of the coronavirus disease 2019 (COVID-19) are devastating and represent the current major public health issue across the globe. At the onset, SARS-CoV-2 primarily attacks the respiratory system as it represents the main point of entry in the host, but it also can affect multiple organs. Although most of the patients do not present symptoms or are mildly symptomatic, some people infected with SARS-CoV-2 that experience more severe multiorgan dysfunction. The severity of COVID-19 is typically combined with a set of comorbidities such as hypertension, diabetes, obesity, and/or advanced age that seriously exacerbates the consequences of the infection. Also, SARS-CoV-2 can cause gastrointestinal symptoms, such as vomiting, diarrhea, or abdominal pain during the early phases of the disease. Intestinal dysfunction induces changes in intestinal microbes, and an increase in inflammatory cytokines. Thus, diagnosing gastrointestinal symptoms that precede respiratory problems during COVID-19 may be necessary for improved early detection and treatment. Uncovering the composition of the microbiota and its metabolic products in the context of COVID-19 can help determine novel biomarkers of the disease and help identify new therapeutic targets. Elucidating changes to the microbiome as reliable biomarkers in the context of COVID-19 represent an overlooked piece of the disease puzzle and requires further investigation.
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Key Words
- ards, acute respiratory distress syndrome
- ace2, angiotensin-converting enzyme ii
- cns, central nervous system
- covid-19, coronavirus disease 2019
- cpr, c-reactive protein
- h1n1, influenza a virus
- il, interleukin
- mers, middle east respiratory syndrome
- prs, proteomic risk score
- sars, severe acute respiratory syndrome
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
- scfa, short-chain fatty acids
- ras, renin-angiotensin system
- ros, reactive oxygen species
- rt-pcr, reverse transcription-polymerase chain reaction
- tmprss2, transmembrane serine protease 2
- tnfα, tumor necrosis factor alpha
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Affiliation(s)
- Sonia Villapol
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, Texas; Department of Neuroscience in Neurological Surgery, Weill Cornell Medical College, New York.
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11
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Abrishami A, Eslami V, Baharvand Z, Khalili N, Saghamanesh S, Zarei E, Sanei-Taheri M. Epicardial adipose tissue, inflammatory biomarkers and COVID-19: Is there a possible relationship? Int Immunopharmacol 2020; 90:107174. [PMID: 33208293 PMCID: PMC7654386 DOI: 10.1016/j.intimp.2020.107174] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/17/2020] [Accepted: 10/31/2020] [Indexed: 12/13/2022]
Abstract
Adipose tissue is a biologically active organ with pro-immunogenic properties. Inflammation plays a major role in the pathogenesis and progression of COVID-19. Data representing status of inflammation could convey useful prognostic information. EAT volume was significantly correlated with other systemic inflammatory biomarkers. This correlation might explain the more severe disease in obese patients with COVID-19.
Background & Aims Adipose tissue is a biologically active organ with pro-immunogenic properties. We aimed to evaluate the prognostic value of epicardial adipose tissue (EAT) in COVID-19 and its correlation with other inflammatory biomarkers. Material and Methods One-hundred patients with COVID-19 were enrolled. C-reactive protein (CRP), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-CRP ratio (LCR), and platelet-to-lymphocyte ratio (PLR) were evaluated on admission. EAT volume and density were measured by computed tomography. Patients were followed until death or discharge. Univariate and multivariate analysis was performed and ROC curve analysis was used to assess the ability of inflammatory markers in predicting survival. The relationship between EAT and other inflammatory markers was also investigated. Results The mean ± SD age of patients was 55.5 ± 15.2 years old; 68% were male. Univariate analysis revealed that increased lung involvement, blood urea nitrogen, LDH and NLR, and decreased platelet count were significantly associated with death. After adjustment, LDH was independently predictive of death (OR = 1.013, p-value = 0.03). Among inflammatory markers, LCR had the best ability for predicting survival with 79.7% sensitivity and 64.3% specificity at an optimal cut-off value of 20.8 (AUC = 0.744, 95% CI = 0.612–0.876, p-value = 0.004). EAT volume demonstrated positive correlation with NLR and PLR (p = 0.001 and 0.01), and a negative correlation with LCR (p = 0.02). EAT density was significantly different between decedents and survivors (p = 0.008). Conclusion Routine laboratory tests that represent status of inflammation can be used as cost-effective prognostic markers of COVID-19. Also, the significant association between EAT volume and other inflammatory biomarkers might explain the more severe disease in obese patients.
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Affiliation(s)
- Alireza Abrishami
- Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Eslami
- Department of Cardiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zahra Baharvand
- Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Cancer Immunology Project, Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Somayeh Saghamanesh
- Center for X-ray Analytics, Empa, Swiss Federal Laboratories for Materials Science and Technology, 8600 Dubendorf, Switzerland
| | - Ehsan Zarei
- Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Sanei-Taheri
- Iranian Society of Radiology, Tehran, Iran; Department of Radiology, Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Cadegiani FA. Repurposing existing drugs for COVID-19: an endocrinology perspective. BMC Endocr Disord 2020; 20:149. [PMID: 32993622 PMCID: PMC7523486 DOI: 10.1186/s12902-020-00626-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/14/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) is a multi-systemic infection caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), that has become a pandemic. Although its prevailing symptoms include anosmia, ageusia, dry couch, fever, shortness of brief, arthralgia, myalgia, and fatigue, regional and methodological assessments vary, leading to heterogeneous clinical descriptions of COVID-19. Aging, uncontrolled diabetes, hypertension, obesity, and exposure to androgens have been correlated with worse prognosis in COVID-19. Abnormalities in the renin-angiotensin-aldosterone system (RAAS), angiotensin-converting enzyme-2 (ACE2) and the androgen-driven transmembrane serine protease 2 (TMPRSS2) have been elicited as key modulators of SARS-CoV-2. MAIN TEXT While safe and effective therapies for COVID-19 lack, the current moment of pandemic urges for therapeutic options. Existing drugs should be preferred over novel ones for clinical testing due to four inherent characteristics: 1. Well-established long-term safety profile, known risks and contraindications; 2. More accurate predictions of clinical effects; 3. Familiarity of clinical management; and 4. Affordable costs for public health systems. In the context of the key modulators of SARS-CoV-2 infectivity, endocrine targets have become central as candidates for COVID-19. The only endocrine or endocrine-related drug class with already existing emerging evidence for COVID-19 is the glucocorticoids, particularly for the use of dexamethasone for severely affected patients. Other drugs that are more likely to present clinical effects despite the lack of specific evidence for COVID-19 include anti-androgens (spironolactone, eplerenone, finasteride and dutasteride), statins, N-acetyl cysteine (NAC), ACE inhibitors (ACEi), angiotensin receptor blockers (ARB), and direct TMPRSS-2 inhibitors (nafamostat and camostat). Several other candidates show less consistent plausibility. In common, except for dexamethasone, all candidates have no evidence for COVID-19, and clinical trials are needed. CONCLUSION While dexamethasone may reduce mortality in severely ill patients with COVID-19, in the absence of evidence of any specific drug for mild-to-moderate COVID-19, researchers should consider testing existing drugs due to their favorable safety, familiarity, and cost profile. However, except for dexamethasone in severe COVID-19, drug treatments for COVID-19 patients must be restricted to clinical research studies until efficacy has been extensively proven, with favorable outcomes in terms of reduction in hospitalization, mechanical ventilation, and death.
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Affiliation(s)
- Flavio A Cadegiani
- Adrenal and Hypertension Unit, Division of Endocrinology and Metabolism, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Pedro de Toledo 781 - 13th floor, São Paulo, SP, 04039-032, Brazil.
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