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Chen X, Ma B, Yang Y, Zhang M, Xu F. Predicting the potentially exacerbation of severe viral pneumonia in hospital by MuLBSTA score joint CD4 + and CD8 +T cell counts: construction and verification of risk warning model. BMC Pulm Med 2024; 24:261. [PMID: 38811907 PMCID: PMC11137986 DOI: 10.1186/s12890-024-03073-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/22/2024] [Indexed: 05/31/2024] Open
Abstract
PURPOSE This study mainly focuses on the immune function and introduces CD4+, CD8+ T cells and their ratios based on the MuLBSTA score, a previous viral pneumonia mortality risk warning model, to construct an early warning model of severe viral pneumonia risk. METHODS A retrospective single-center observational study was operated from January 2021 to December 2022 at the People's Hospital of Liangjiang New Area, Chongqing, China. A total of 138 patients who met the criteria for viral pneumonia in hospital were selected and their data, including demographic data, comorbidities, laboratory results, CT scans, immunologic and pathogenic tests, treatment regimens, and clinical outcomes, were collected and statistically analyzed. RESULTS Forty-one patients (29.7%) developed severe or critical illness. A viral pneumonia severe risk warning model was successfully constructed, including eight parameters: age, bacterial coinfection, CD4+, CD4+/CD8+, multiple lung lobe infiltrations, smoking, hypertension, and hospital admission days. The risk score for severe illness in patients was set at 600 points. The model had good predictive performance (AUROC = 0.94397), better than the original MuLBSTA score (AUROC = 0.8241). CONCLUSION A warning system constructed based on immune function has a good warning effect on the risk of severe conversion in patients with viral pneumonia.
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Affiliation(s)
- Xi Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
- Department of Critical Care Medicine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401120, China
| | - Bei Ma
- Department of Critical Care Medicine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401120, China
| | - Yu Yang
- Department of Critical Care Medicine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, 401120, China
| | - Mu Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
| | - Fang Xu
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
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Poisson J, El-Sissy C, Serret-Larmande A, Smith N, Lebraud M, Augy JL, Conti C, Gonnin C, Planquette B, Arlet JB, Hermann B, Charbit B, Pastre J, Devaux F, Ladavière C, Lim L, Ober P, Cannovas J, Biard L, Gulczynski MC, Blumenthal N, Péré H, Knosp C, Gey A, Benhamouda N, Murris J, Veyer D, Tartour E, Diehl JL, Duffy D, Paillaud E, Granier C. Increased levels of GM-CSF and CXCL10 and low CD8 + memory stem T Cell count are markers of immunosenescence and severe COVID-19 in older people. Immun Ageing 2024; 21:28. [PMID: 38715114 PMCID: PMC11075216 DOI: 10.1186/s12979-024-00430-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Ageing leads to altered immune responses, resulting in higher susceptibility to certain infections in the elderly. Immune ageing is a heterogeneous process also associated with inflammaging, a low-grade chronic inflammation. Altered cytotoxic T cell responses and cytokine storm have previously been described in severe COVID-19 cases, however the parameters responsible for such immune response failures are not well known. The aim of our study was to characterize CD8+ T cells and cytokines associated with ageing, in a cohort of patients aged over 70 years stratified by COVID-19 severity. RESULTS One hundred and four patients were included in the study. We found that, in older people, COVID-19 severity was associated with (i) higher level of GM-CSF, CXCL10 (IP-10), VEGF, IL-1β, CCL2 (MCP-1) and the neutrophil to lymphocyte ratio (NLR), (ii) increased terminally differentiated CD8+T cells, and (ii) decreased early precursors CD8+ T stem cell-like memory cells (TSCM) and CD27+CD28+. The cytokines mentioned above were found at higher concentrations in the COVID-19+ older cohort compared to a younger cohort in which they were not associated with disease severity. CONCLUSIONS Our results highlight the particular importance of the myeloid lineage in COVID-19 severity among older people. As GM-CSF and CXCL10 were not associated with COVID-19 severity in younger patients, they may represent disease severity specific markers of ageing and should be considered in older people care.
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Affiliation(s)
- Johanne Poisson
- Université Paris Cité, Paris, France
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
- Inserm U1149, Center for Research on Inflammation, Paris, France
| | - Carine El-Sissy
- INSERM, Laboratory of Integrative Cancer Immunology, Paris, France
- Cordeliers Research Center, Sorbonne University, University Paris Cité, Paris, France
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Arnaud Serret-Larmande
- ECSTRRA Team, UMR-1153, Université Paris Cité, INSERM, AP-HP, Saint Louis Hospital, Paris, France
| | - Nikaïa Smith
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Morgane Lebraud
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Jean-Loup Augy
- Medical intensive care unit, Hopital Delafontaine, 2 rue du Dr Delafontaine, Saint-Denis, 93200, France
| | - Catherine Conti
- Université Paris Cité, Paris, France
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
| | - Cécile Gonnin
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
- Université Paris Cité, INSERM, PARCC, Paris, France
| | - Benjamin Planquette
- Service de Pneumologie Et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Jean-Benoît Arlet
- Internal Medicine Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Faculty of Medicine, Université Paris Cité, Paris, 75006, France
| | - Bertrand Hermann
- Medical Intensive Care Unit, AP-HP. Centre Université Paris Cité, Georges Pompidou European Hospital, Paris, 75015, France
- INSERM UMR 1266, Institut de Psychiatrie Et Neurosciences de Paris (IPNP), Université Paris Cité, Paris, France
| | - Bruno Charbit
- Institute of Ophthalmology, University College London (UCL), London, UK
| | - Jean Pastre
- Service de Pneumologie Et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Floriane Devaux
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Cyrielle Ladavière
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Lydie Lim
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Pauline Ober
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Johanna Cannovas
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
| | - Lucie Biard
- ECSTRRA Team, UMR-1153, Université Paris Cité, INSERM, AP-HP, Saint Louis Hospital, Paris, France
| | - Marie-Christelle Gulczynski
- Gérontologie 1, GHU AP-HP. Centre Université Paris Cité, Corentin Celton Hospital, Issy-Les-Moulineaux, 92130, France
| | - Noémie Blumenthal
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Hélène Péré
- Virology Laboratory, Hôpital Européen Georges-Pompidou, APHP.Centre - Université Paris Cité, Paris, France
- Centre de Recherche Des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Functional Genomics of Solid Tumors Laboratory, Équipe Labellisée Ligue Nationale Contre Le Cancer, Labex OncoImmunology, Paris, France
- Université Paris Cité, Faculté de Santé, UFR de Médecine, Paris, France
| | | | - Alain Gey
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Nadine Benhamouda
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Juliette Murris
- HeKA, Inria Paris, Inserm, Université Paris Cité, Paris, France
| | - David Veyer
- Virology Laboratory, Hôpital Européen Georges-Pompidou, APHP.Centre - Université Paris Cité, Paris, France
- Centre de Recherche Des Cordeliers, Sorbonne Université, Inserm, Université de Paris, Functional Genomics of Solid Tumors Laboratory, Équipe Labellisée Ligue Nationale Contre Le Cancer, Labex OncoImmunology, Paris, France
| | - Eric Tartour
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France
| | - Jean-Luc Diehl
- Medical Intensive Care Unit, AP-HP. Centre Université Paris Cité, Georges Pompidou European Hospital, Paris, 75015, France
- University Paris Cité, Innovative Therapies in Hemostasis, INSERM, Paris, 75006, France
| | - Darragh Duffy
- Translational Immunology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Elena Paillaud
- Université Paris Cité, Paris, France.
- Department of Geriatric Medicine, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France.
- Univ. Paris Est Créteil, Inserm U955, IMRB, Créteil, France.
| | - Clémence Granier
- Department of Immunology, APHP, Hôpital Européen Georges Pompidou (HEGP), Paris, France.
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Atieh O, Durieux JC, Baissary J, Mouchati C, Labbato D, Thomas A, Merheb A, Ailstock K, Funderburg N, McComsey GA. The Long-Term Effect of COVID-19 Infection on Body Composition. Nutrients 2024; 16:1364. [PMID: 38732609 PMCID: PMC11085433 DOI: 10.3390/nu16091364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/16/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND The effect of COVID-19 infection versus the indirect effect of the pandemic on body composition remains unclear. This study investigates the long-term changes in body composition in COVID-19 survivors compared to a contemporary control group. METHOD This is a prospective study involving adults who underwent a pre-pandemic whole-body DXA scan (DXA#1) between 2017 and 2019. Participants were asked to return for a repeat whole-body DXA scan (DXA#2) after the pandemic. Detailed data were collected including their medical and COVID-19 history. Inflammation markers and fasting lipids were measured. For those participants who experienced a COVID-19 infection between the two DXAs, DXA#2 was acquired at least one year after COVID-19 infection. RESULTS Overall, 160 adults were enrolled; 32.5% females, 51.8% non-white, with mean age of 43.2 years. Half (n = 80) of the participants experienced a COVID-19 infection between their two DXA scans (COVID-19+ group), and the other half had never had COVID-19. COVID-19-negative participants displayed an increase in annualized trunk fat (g) [922.5 vs. 159.7; p = 0.01], total fat (g) [1564.3 vs. 199.9; p = 0.2], and LBM (g) [974.9 vs. -64.5; p = 0.0002] when compared to the COVID-19+ group. However, among the COVID-19+ group, no differences were seen in annualized trunk fat, total fat mass, or LBM between those with PASC and without (p > 0.05). CONCLUSION During the pandemic, both the COVID-19 survivors and the COVID-19-negative group exhibited increases in weight, total fat, and trunk fat, likely associated with pandemic-linked lifestyle modifications. However, only COVID-19 survivors displayed a decline in lean body mass over the same period, regardless of PASC symptoms.
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Affiliation(s)
- Ornina Atieh
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (O.A.); (J.B.); or (A.T.)
| | - Jared C. Durieux
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (J.C.D.); (D.L.)
| | - Jhony Baissary
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (O.A.); (J.B.); or (A.T.)
| | - Christian Mouchati
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (O.A.); (J.B.); or (A.T.)
| | - Danielle Labbato
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (J.C.D.); (D.L.)
| | - Alicia Thomas
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (O.A.); (J.B.); or (A.T.)
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (J.C.D.); (D.L.)
| | - Alexander Merheb
- Faculty of Arts and Sciences, Harvard College, Cambridge, MA 02138, USA;
| | - Kate Ailstock
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH 43210, USA; (K.A.); (N.F.)
| | - Nicholas Funderburg
- School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH 43210, USA; (K.A.); (N.F.)
| | - Grace A. McComsey
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; (O.A.); (J.B.); or (A.T.)
- Center for Clinical Research, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (J.C.D.); (D.L.)
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Hamdy DA, Eid RA, Abdel-Tawab H, El-Badry MA, Abdallah AM, El Wahab WMA. Impact of latent toxoplasmosis on pneumonic and non-pneumonic COVID-19 patients with estimation of relevant oxidative stress biomarkers. Folia Parasitol (Praha) 2024; 71:2024.008. [PMID: 38628099 DOI: 10.14411/fp.2024.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/16/2024] [Indexed: 04/19/2024]
Abstract
Susceptibility to COVID-19, the most devastating global pandemic, appears to vary widely across different population groups. Exposure to toxoplasmosis has been proposed as a theory to explain the diversity of these populations. The aim of the present study was to investigate the possible association between latent toxoplasmosis and COVID-19 and its probable correlation with markers of oxidative stress, C-reactive protein (CRP) and ferritin. In a case-control study, blood samples were collected from 91 confirmed (48 non-pneumonic; NP, and 43 pneumonic; P) COVID-19 patients and 45 healthy controls. All participants were tested for IgG anti-Toxoplasma gondii antibodies and oxidative stress markers (nitric oxide [NO], superoxide dismutase [SOD] and reduced glutathione [GSH]), and CRP and serum ferritin levels were determined. In COVID-19 patients, IgG anti-T. gondii antibodies were found in 54% compared to 7% in the control group, with the difference being statistically significant (P ˂ 0.001). However, no significant correlation was found between the severity of COVID-19 and latent T. gondii infection. Latent toxoplasmosis had a strong influence on the risk of COVID-19. NO and SOD levels were significantly increased in COVID-19 patients, while GSH levels decreased significantly in them compared to control subjects (P ˂ 0.001 for both values). CRP and ferritin levels were also significantly elevated in P COVID-19 patients infected with toxoplasmosis. This is the first study to look at the importance of oxidative stress indicators in co-infection between COVID-19 and T. gondii. The high prevalence of latent toxoplasmosis in COVID-19 suggests that T. gondii infection can be considered a strong indicator of the high risk of COVID-19.
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Affiliation(s)
- Doaa A Hamdy
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Ragaey A Eid
- Department of Gastroenterology, Hepatology and infectious diseases (Tropical Medicine Department), College of Medicine, Beni-Suef University, Beni-Suef,Egypt
| | - Heba Abdel-Tawab
- Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed A El-Badry
- Research Institute of Medical Entomology, General Organisation for Teaching Hospitals and Institutes (GOTHI), Giza, Egypt
| | - Abdelrahman M Abdallah
- Department of Chest Diseases, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Wegdan M Abd El Wahab
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Singh R, Singh V, Ahmad MA, Pasricha C, Kumari P, Singh TG, Kaur R, Mujwar S, Wani TA, Zargar S. Unveiling the Role of PAR 1: A Crucial Link with Inflammation in Diabetic Subjects with COVID-19. Pharmaceuticals (Basel) 2024; 17:454. [PMID: 38675414 PMCID: PMC11055094 DOI: 10.3390/ph17040454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Inflammation is a distinguished clinical manifestation of COVID-19 and type 2 diabetes mellitus (T2DM), often associated with inflammatory dysfunctions, insulin resistance, metabolic dysregulation, and other complications. The present study aims to test the hypothesis that serum concentrations of PAR-1 levels differ between COVID-19 diabetic patients (T2DM) and non-diabetic COVID-19 patients and determine their association with different biochemical parameters and inflammatory biomarkers. T2DM patients with COVID-19 (n = 50) with glycated hemoglobin (HbA1c) levels of (9.23 ± 1.66) and non-diabetic COVID-19 patients (n = 50) with HbA1c levels (4.39 ± 0.57) were recruited in this study. The serum PAR-1 levels (ELISA method) were determined in both groups and correlated with parameters such as age, BMI, inflammatory markers including CRP, interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), D-dimer, homocysteine, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Demographic variables such as BMI (29.21 ± 3.52 vs. controls 21.30 ± 2.11) and HbA1c (9.23 ± 1.66 vs. controls 4.39 ± 0.57) were found to be statistically elevated in COVID-19 T2DM patients compared to non-diabetic COVID-19 patients. The concentrations of several inflammatory biomarkers and PAR-1 were remarkably increased in the COVID-19 T2DM group when compared with the non-diabetic COVID-19 group. The univariate analysis revealed that increased serum PAR-1 estimations were positively correlated with enhanced HbA1c, BMI, inflammatory cytokines, D-dimer, homocysteine, and NT-proBNP. The findings in the current study suggest that increased levels of serum PAR-1 in the bloodstream could potentially serve as an independent biomarker of inflammation in COVID-19 patients with T2DM.
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Affiliation(s)
- Ravinder Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Varinder Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Md. Altamash Ahmad
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Chirag Pasricha
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Pratima Kumari
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Thakur Gurjeet Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Rupinder Kaur
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Somdutt Mujwar
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India; (V.S.); (M.A.A.); (C.P.); (P.K.); (T.G.S.); (R.K.); (S.M.)
| | - Tanveer A. Wani
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Seema Zargar
- Department of Biochemistry, College of Science, King Saud University, Riyadh 11495, Saudi Arabia;
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Grant WB. Vitamin D and viral infections: Infectious diseases, autoimmune diseases, and cancers. ADVANCES IN FOOD AND NUTRITION RESEARCH 2024; 109:271-314. [PMID: 38777416 DOI: 10.1016/bs.afnr.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Viruses can cause many human diseases. Three types of human diseases caused by viruses are discussed in this chapter: infectious diseases, autoimmune diseases, and cancers. The infectious diseases included in this chapter include three respiratory tract diseases: influenza, COVID-19, and respiratory syncytial virus. In addition, the mosquito-borne dengue virus diseases are discussed. Vitamin D can reduce risk, severity, and mortality of the respiratory tract diseases and possibly for dengue virus. Many autoimmune diseases are initiated by the body's reaction to a viral infection. The protective role of vitamin D in Epstein-Barr virus-related diseases such as multiple sclerosis is discussed. There are a few cancers linked to viral infections. Such cancers include cervical cancer, head and neck cancers, Hodgkin's and non-Hodgkin's lymphoma, and liver cancer. Vitamin D plays an important role in reducing risk of cancer incidence and mortality, although not as strongly for viral-linked cancers as for other types of cancer.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, USA.
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Campanari DD, Cipriano UG, Fraga-Silva TFDC, Ramalho LNZ, Ovidio PP, Jordão Júnior AA, Bonato VLD, Ferriolli E. Effect of Dietary Supplementation with Omega-3 Fatty Acid on the Generation of Regulatory T Lymphocytes and on Antioxidant Parameters and Markers of Oxidative Stress in the Liver Tissue of IL-10 Knockout Mice. Nutrients 2024; 16:634. [PMID: 38474762 DOI: 10.3390/nu16050634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/05/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION chronic low-grade inflammation, or inflammaging, emerges as a crucial element in the aging process and is associated with cardiovascular and neurological diseases, sarcopenia, and malnutrition. Evidence suggests that omega-3 fatty acids present a potential therapeutic agent in the prevention and treatment of inflammatory diseases, mitigating oxidative stress, and improving muscle mass, attributes that are particularly relevant in the context of aging. The objective of the present study was to evaluate the effectiveness of supplementation with omega-3 fish oil in improving the immune response and oxidative stress in knockout mice for interleukin IL-10 (IL-10-/-). MATERIAL AND METHODS female C57BL/6 wild-type (WT) and interleukin IL-10 knockout (IL-10-/-) mice were fed during 90 days with a standard diet (control groups), or they were fed/supplemented with 10% of the omega-3 polyunsaturated fatty acid diet (omega-3 groups). Muscle, liver, intestinal, and mesenteric lymph node tissue were collected for analysis. RESULTS the IL-10-/-+O3 group showed greater weight gain compared to the WT+O3 (p = 0.001) group. The IL-10-/-+O3 group exhibited a higher frequency of regulatory T cells than the IL-10-/- group (p = 0.001). It was found that animals in the IL-10-/-+O3 group had lower levels of steatosis when compared to the IL-10-/- group (p = 0.017). There was even greater vitamin E activity in the WT group compared to the IL-10-/-+O3 group (p = 0.001) and WT+O3 compared to IL-10-/-+O3 (p = 0.002), and when analyzing the marker of oxidative stress, MDA, an increase in lipid peroxidation was found in the IL-10-/-+O3 group when compared to the IL-10-/- group (p = 0.03). Muscle tissue histology showed decreased muscle fibers in the IL-10-/-+O3, IL-10-/-, and WT+O3 groups. CONCLUSION the findings show a decrease in inflammation, an increase in oxidative stress markers, and a decrease in antioxidant markers in the IL-10-/-+O3 group, suggesting that supplementation with omega-3 fish oil might be a potential intervention for inflammaging that characterizes the aging process and age-related diseases.
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Affiliation(s)
- Daniela Dalpubel Campanari
- Postgraduate Program in Clinical Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
| | - Ualter Guilherme Cipriano
- Basic and Applied Immunology Program, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
| | - Thais Fernanda de Campos Fraga-Silva
- Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
- Institute of Biological Sciences and Health, Federal University of Alagoas, Maceio 57072-900, Alagoas, Brazil
| | - Leandra Náira Zambelli Ramalho
- Department of Pathology and Legal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
| | - Paula Payão Ovidio
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
| | - Alceu Afonso Jordão Júnior
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
| | - Vânia Luiza Deperon Bonato
- Basic and Applied Immunology Program, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
- Department of Biochemistry and Immunology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
| | - Eduardo Ferriolli
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto 14049-900, Sao Paulo, Brazil
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Pelagatti L, Fabiani G, De Paris A, Lagomarsini A, Paolucci E, Pepe F, Villanti M, Todde F, Matteini S, Caldi F, Pini R, Innocenti F. 4C mortality score and COVID-19 mortality risk score: an analysis in four different age groups of an Italian population. Intern Emerg Med 2024:10.1007/s11739-024-03551-5. [PMID: 38393501 DOI: 10.1007/s11739-024-03551-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
To evaluate the prognostic stratification ability of 4C Mortality Score and COVID-19 Mortality Risk Score in different age groups. Retrospective study, including all patients, presented to the Emergency Department of the University Hospital Careggi, between February, 2020 and May, 2021, and admitted for SARS-CoV2. Patients were divided into four subgroups based on the quartiles of age distribution: patients < 57 years (G1, n = 546), 57-71 years (G2, n = 508), 72-81 years (G3, n = 552), and > 82 years (G4, n = 578). We calculated the 4C Mortality Score and COVID-19 Mortality Risk Score. The end-point was in-hospital mortality. In the whole population (age 68 ± 16 years), the mortality rate was 19% (n = 424), and increased with increasing age (G1: 4%, G2: 11%, G3: 22%, and G4: 39%, p < 0.001). Both scores were higher among non-survivors than survivors in all subgroups (4C-MS, G1: 6 [3-7] vs 3 [2-5]; G2: 10 [7-11] vs 7 [5-8]; G3: 11 [10-14] vs 10 [8-11]; G4: 13 [12-15] vs 11 [10-13], all p < 0.001; COVID-19 MRS, G1: 8 [7-9] vs 9 [9-11], G2: 10 [8-11] vs 11 [10-12]; G3: 11 [10-12] vs 12 [11-13]; G4: 11 [10-13] vs 13 [12-14], all p < 0.01). The ability of both scores to identify patients at higher risk of in-hospital mortality, was similar in different age groups (4C-MS: G1 0.77, G2 0.76, G3 0.68, G4 0.72; COVID-19 MRS: G1 0.67, G2 0.69, G3 0.69, G4 0.72, all p for comparisons between subgroups = NS). Both scores confirmed their good performance in predicting in-hospital mortality in all age groups, despite their different mortality rate.
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Affiliation(s)
- Lorenzo Pelagatti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Ginevra Fabiani
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Anna De Paris
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Alessia Lagomarsini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Elisa Paolucci
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesco Pepe
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Maurizio Villanti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesca Todde
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Simona Matteini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesca Caldi
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Riccardo Pini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesca Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy.
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9
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Laguarta-Val S, Varillas-Delgado D, Lizcano-Álvarez Á, Molero-Sánchez A, Melian-Ortiz A, Cano-de-la-Cuerda R, Jiménez-Antona C. Effects of Aerobic Exercise Therapy through Nordic Walking Program in Lactate Concentrations, Fatigue and Quality-of-Life in Patients with Long-COVID Syndrome: A Non-Randomized Parallel Controlled Trial. J Clin Med 2024; 13:1035. [PMID: 38398348 PMCID: PMC10889227 DOI: 10.3390/jcm13041035] [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: 01/23/2024] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Long-COVID syndrome comprises a variety of signs and symptoms that develop during or after infection with COVID-19 which may affect the physical capabilities. However, there is a lack of studies investigating the effects of Long-COVID syndrome in sport capabilities after suffering from COVID-19 infection. The purpose of the study was to evaluate and compare lactate concentration and quality of life (QoL) in patients with Long-COVID with those who have not developed non-Long-COVID during Nordic walking exercise therapy. METHODS Twenty-nine patients (25.5 ± 7.1 years) took part in a non-randomized controlled trial, divided into two groups: a Long-COVID group (n = 16) and a non-Long-COVID control (n = 13). Patients were confirmed as having Long-COVID syndrome if they experienced fatigue or tiredness when performing daily activities and worsening of symptoms after vigorous physical or mental activity. All participants underwent a 12-week Nordic Walking program. Lactate concentration after exercise and distance covered during all sessions were measured. Pre- and Long-Nordic Walking program, the Modified Fatigue Impact Scale (MFIS), the Short Form 36 Health Survey (SF-36), and EURO QoL-5D (EQ-ED) were administered to assess fatigue and quality of life, respectively. RESULTS There was a lactate concentration effect between groups (F = 5.604; p = 0.024). However, there was no significant effect as a result of the session (F = 3.521; p = 0.121) with no interaction of group × session (F = 1.345; p = 0.414). The group main effect (F = 23.088; p < 0.001), time effect (F = 6.625; p = 0.026), and group × time (F = 4.632; p = 0.002) interaction on the SF-36 scale were noted. Also, there were a significant group main effect (F = 38.372; p < 0.001), time effect (F = 12.424; p = 0.005), and group × time interaction (F = 4.340; p = 0.014) on EQ-5D. However, there was only a significant group main effect (F = 26.235; p < 0.001) with no effect on time (F = 2.265; p = 0.160) and group × time (F = 1.584; p = 0.234) interaction on the MFIS scale. CONCLUSIONS The Long-COVID group showed higher lactate concentration compared with the control group during the 12 weeks of the Nordic Walking program. The Long-COVID group presented a decrease in fatigue with respect to the control group according to the MFIS scale, as well as improvement in quality of life after aerobic exercise therapy.
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Affiliation(s)
- Sofía Laguarta-Val
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922 Madrid, Spain; (S.L.-V.); (A.M.-S.); (R.C.-d.-l.-C.); (C.J.-A.)
| | - David Varillas-Delgado
- Department of Exercise and Sport Science, Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Pozuelo, Spain
| | - Ángel Lizcano-Álvarez
- Department of Nursing and Stomatology, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922 Madrid, Spain;
| | - Alberto Molero-Sánchez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922 Madrid, Spain; (S.L.-V.); (A.M.-S.); (R.C.-d.-l.-C.); (C.J.-A.)
| | - Alberto Melian-Ortiz
- Faculty of Nursing and Physiotherapy, Universidad Pontificia de Salamanca, 28015 Madrid, Spain;
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922 Madrid, Spain; (S.L.-V.); (A.M.-S.); (R.C.-d.-l.-C.); (C.J.-A.)
| | - Carmen Jiménez-Antona
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922 Madrid, Spain; (S.L.-V.); (A.M.-S.); (R.C.-d.-l.-C.); (C.J.-A.)
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10
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Inoue LH, Baccon WC, Pesce GB, Pereira ND, Silva IVTC, Salci MA, Vissoci JRN, Facchini LA, Carreira L. Prevalence and factors associated with the death of older people hospitalized due to Covid-19 in the state of Paraná. Rev Esc Enferm USP 2024; 57:e20230036. [PMID: 38265117 PMCID: PMC10807406 DOI: 10.1590/1980-220x-reeusp-2023-0036en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/14/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE To estimate the prevalence and to analyze the factors associated with the death of older people hospitalized due to Covid-19 in the state of Paraná. METHOD Cross-sectional study conducted with secondary data from older people with a positive diagnosis of Covid-19 living in the State of Paraná, collected from March 1, 2020 to August 31, 2021. Prevalence ratios were obtained by adjusting the regression model. RESULTS A total of 16,153 deaths of older people hospitalized in the State of Paraná were analyzed. The adjusted model revealed an association between death and some factors such as: belonging to the age group of 75 to 84 years (PR = 1.28; CI95% = 1.24-1.32) and 85 years or over (PR = 1.52; CI95% = 1.45-1.59); male (PR = 1.17; CI95% = 1.13-1.21); obesity (PR = 1.23; CI95% = 1.16-1.29); other morbidities (PR = 1.25; CI95% = 1.20-1.30); and having used ventilatory support (PR = 2.60; CI95% = 2.33-2.86). Older people vaccinated against influenza had a probability of death reduced by 11% (PR = 0.89; CI95% = 0.86-0.93). CONCLUSION The association of age, sex, and diagnosis of previous comorbidities with unfavorable outcomes from Covid-19 was identified. Having received the flu vaccine provided protection to elderly people who contracted SARS-CoV-2.
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11
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Fabiani G, Cogozzo C, De Paris A, Di Maria V, Lagomarsini A, Masotti O, Matteini S, Paolucci E, Pelagatti L, Pepe F, Villanti M, Todde F, Pini R, Innocenti F. Clinical characteristics of patients hospitalized for COVID-19: comparison between different age groups. BMC Geriatr 2024; 24:51. [PMID: 38212683 PMCID: PMC10785440 DOI: 10.1186/s12877-023-04626-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND To test whether known prognosticators of COVID-19 maintained their stratification ability across age groups. METHODS We performed a retrospective study. We included all patients (n = 2225), who presented to the Emergency Department of the Careggi University Hospital for COVID-19 in the period February 2020-May 2021, and were admitted to the hospital. The following parameters were analyzed as dichotomized: 1) SpO2/FiO2 ≤ or > 214; 2) creatinine < or ≥ 1.1 mg/dL; 3) Lactic dehydrogenase (LDH) < or ≥ 250 U/mL; 4) C Reactive Protein (CRP) < or ≥ 60 mg/100 mL. We divided the study population in four subgroups, based on the quartiles of distribution of age (G1 18-57 years, G2 57-71 years, G3 72-81 years, G4 > 82). The primary end-point was in-hospital mortality. RESULTS By the univariate analysis, the aforementioned dichotomized variables demonstrated a significant association with in-hospital mortality in all subgroups. We introduced them in a multivariate model: in G1 SpO2/FiO2 ≤ 214 (Relative Risk, RR 15.66; 95%CI 3.98-61,74), in G2 creatinine ≥ 1.1 mg/L (RR 2.87, 95%CI 1.30-6.32) and LDH ≥ 250 UI/L (RR 8.71, 95%CI 1,15-65,70), in G3 creatinine ≥ 1.1 mg/L (RR 1.98, 95%CI 1,17-3.36) and CRP ≥ 60 ng/L (RR 2.14, 95%CI 1.23-3.71), in G4 SpO2/FiO2 ≤ 214 (RR 5.15, 95%CI 2.35-11.29), creatinine ≥ 1.1 mg/L (RR 1.75, 95%CI 1.09-2.80) and CRP ≥ 60 ng/L (RR 1.82, 95%CI 1.11-2.98) were independently associated with an increased in-hospital mortality. CONCLUSIONS A mild to moderate respiratory failure showed an independent association with an increased mortality rate only in youngest and oldest patients, while kidney disease maintained a prognostic role regardless of age.
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Affiliation(s)
- Ginevra Fabiani
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Carolina Cogozzo
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Anna De Paris
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Valentina Di Maria
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Alessia Lagomarsini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Olimpia Masotti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Simona Matteini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Elisa Paolucci
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Lorenzo Pelagatti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesco Pepe
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Maurizio Villanti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesca Todde
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Riccardo Pini
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy
| | - Francesca Innocenti
- High-Dependency Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Lg. Brambilla 3, 50134, Florence, Italy.
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12
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Georgakopoulou VE, Gkoufa A, Makrodimitri S, Tsakanikas A, Basoulis D, Voutsinas PM, Karamanakos G, Eliadi I, Samara S, Triantafyllou M, Eleftheriadou I, Kampouropoulou O, Papageorgiou CV, Anastasopoulou A, Papalexis P, Trakas I, Trakas N, Spandidos DA, Steiropoulos P, Sipsas NV. Risk factors for the in‑hospital and 1‑year mortality of elderly patients hospitalized due to COVID‑19‑related pneumonia. Exp Ther Med 2024; 27:22. [PMID: 38125348 PMCID: PMC10728907 DOI: 10.3892/etm.2023.12310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by poor outcomes and a high mortality rate, particularly among elderly patients. Since the beginning of the pandemic, an older age has been recognized as a critical risk factor for disease severity, with increasing mortality rates in each decade of life. This phenomenon may be a consequence of a poor previous health status, with a higher prevalence of pre-existing comorbidities and a higher degree of frailty. The majority of studies on the outcomes and risk factors of elderly patients refer to the first waves of the pandemic and the predictors of in-hospital mortality in these patients. The aim of the present study was to provide a detailed description of the clinical characteristics and management of a cohort of elderly patients (≥65 years of age) who were hospitalized with COVID-19-related pneumonia in all phases of the pandemic, presenting their outcomes, and investigating predictors of in-hospital and out-of-hospital mortality over a period of 1 year in this particularly vulnerable population. A total of 1,124 elderly patients (603 males, 53.7%) with a mean age of 78.51±7.42 years and a median Charlson comorbidity index (CCI) of 5 were included in the study. Of these patients, 104 (9.3%) were hospitalized during the period of prevalence of the original strain Wuhan, 385 (34.3%) were hospitalized during the period of prevalence of the Alpha variant, 221 (19.7%) were hospitalized during the period of prevalence of the Delta variant, and 414 (36.8%) were hospitalized during the period of prevalence of the Omicron variant. Overall, the in-hospital mortality rate was 33.4% (375 patients), and the 1-year mortality rate was 44.7% (502 patients). The majority of patients had not been vaccinated or had not completed full vaccination against severe acute respiratory syndrome coronavirus-2 (843 patients, 75%), given the period of infection. Age, immature granulocytes, lactate dehydrogenase (LDH) levels, ferritin levels, chest X-ray score, as well as the absence of full vaccination, cough and fatigue, were statistically significantly and independently associated with in-hospital mortality, while age, LDH levels, ferritin levels, alanine aminotransferase levels, CCI, chest X-ray score, the absence of cough and fatigue, and a history of dementia were statistically significantly and independently associated with 1-year mortality. On the whole, the present study demonstrates that both the in-hospital mortality and 1-year mortality rates of elderly patients hospitalized due to COVID-19-related pneumonia are high.
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Affiliation(s)
- Vasiliki Epameinondas Georgakopoulou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aikaterini Gkoufa
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Sotiria Makrodimitri
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Aristeidis Tsakanikas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Basoulis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pantazis M. Voutsinas
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Karamanakos
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Eliadi
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stamatia Samara
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Triantafyllou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioanna Eleftheriadou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Kampouropoulou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Chrysovalantis V. Papageorgiou
- Pulmonology Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Amalia Anastasopoulou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Ilias Trakas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Paschalis Steiropoulos
- Department of Pulmonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Nikolaos V. Sipsas
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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13
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Dwivedi J, Wal P, Dash B, Ovais M, Sachan P, Verma V. Diabetic Pneumopathy- A Novel Diabetes-associated Complication: Pathophysiology, the Underlying Mechanism and Combination Medication. Endocr Metab Immune Disord Drug Targets 2024; 24:1027-1052. [PMID: 37817659 DOI: 10.2174/0118715303265960230926113201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND The "diabetic lung" has been identified as a possible target organ in diabetes, with abnormalities in ventilation control, bronchomotor tone, lung volume, pulmonary diffusing capacity, and neuroadrenergic bronchial innervation. OBJECTIVE This review summarizes studies related to diabetic pneumopathy, pathophysiology and a number of pulmonary disorders including type 1 and type 2 diabetes. METHODS Electronic searches were conducted on databases such as Pub Med, Wiley Online Library (WOL), Scopus, Elsevier, ScienceDirect, and Google Scholar using standard keywords "diabetes," "diabetes Pneumopathy," "Pathophysiology," "Lung diseases," "lung infection" for review articles published between 1978 to 2023 very few previous review articles based their focus on diabetic pneumopathy and its pathophysiology. RESULTS Globally, the incidence of diabetes mellitus has been rising. It is a chronic, progressive metabolic disease. The "diabetic lung" may serve as a model of accelerated ageing since diabetics' rate of respiratory function deterioration is two to three-times higher than that of normal, non-smoking people. CONCLUSION Diabetes-induced pulmonary dysfunction has not gained the attention it deserves due to a lack of proven causality and changes in cellular properties. The mechanism underlying a particular lung illness can still only be partially activated by diabetes but there is evidence that hyperglycemia is linked to pulmonary fibrosis in diabetic people.
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Affiliation(s)
- Jyotsana Dwivedi
- PSIT- Pranveer Singh Institute of Technology (Pharmacy), Kanpur, India
| | - Pranay Wal
- PSIT- Pranveer Singh Institute of Technology (Pharmacy), Kanpur, India
| | - Biswajit Dash
- Department of Pharmaceutical Technology, ADAMAS University, West Bengal, India
| | | | - Pranjal Sachan
- PSIT- Pranveer Singh Institute of Technology (Pharmacy), Kanpur, India
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14
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Hornung F, Köse-Vogel N, Le Saux CJ, Häder A, Herrmann L, Schulz L, Radosa L, Lauf T, Sandhaus T, Samson P, Doenst T, Wittschieber D, Mall G, Löffler B, Deinhardt-Emmer S. Uncovering a unique pathogenic mechanism of SARS-CoV-2 omicron variant: selective induction of cellular senescence. Aging (Albany NY) 2023; 15:13593-13607. [PMID: 38095608 PMCID: PMC10756098 DOI: 10.18632/aging.205297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/03/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND SARS-CoV-2 variants are constantly emerging with a variety of changes in the conformation of the spike protein, resulting in alterations of virus entry mechanisms. Solely omicron variants use the endosomal clathrin-mediated entry. Here, we investigate the influence of defined altered spike formations to study their impact on premature cellular senescence. METHODS In our study, in vitro infections of SARS-CoV-2 variants delta (B.1.617.2) and omicron (B.1.1.529) were analyzed by using human primary small alveolar epithelial cells and human ex vivo lung slices. We confirmed cellular senescence in human lungs of COVID-19 patients. Hence, global gene expression patterns of infected human primary alveolar epithelial cells were identified via mRNA sequencing. RESULTS Solely omicron variants of SARS-CoV-2 influenced the expression of cell cycle genes, highlighted by an increased p21 expression in human primary lung cells and human ex vivo lungs. Additionally, an upregulated senescence-associated secretory phenotype (SASP) was detected. Transcriptomic data indicate an increased gene expression of p16, and p38 in omicron-infected lung cells. CONCLUSIONS Significant changes due to different SARS-CoV-2 infections in human primary alveolar epithelial cells with an overall impact on premature aging could be identified. A substantially different cellular response with an upregulation of cell cycle, inflammation- and integrin-associated pathways in omicron infected cells indicates premature cellular senescence.
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Affiliation(s)
- Franziska Hornung
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
| | - Nilay Köse-Vogel
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
| | - Claude Jourdan Le Saux
- Medicine/Pulmonary and Critical Care Division, University of California San Francisco, San Francisco, CA 94110, USA
| | - Antje Häder
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
| | - Lea Herrmann
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
| | - Luise Schulz
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
- Else Kröner Graduate School for Medical Students “JSAM” Jena University Hospital, Jena 07747, Germany
| | - Lukáš Radosa
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
| | - Thurid Lauf
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
- Else Kröner Graduate School for Medical Students “JSAM” Jena University Hospital, Jena 07747, Germany
| | - Tim Sandhaus
- Klinik für Herz- und Thoraxchirurgie, Jena 07747, Germany
| | - Patrick Samson
- Klinik für Herz- und Thoraxchirurgie, Jena 07747, Germany
| | - Torsten Doenst
- Klinik für Herz- und Thoraxchirurgie, Jena 07747, Germany
| | - Daniel Wittschieber
- Institute of Forensic Medicine, Jena University Hospital, Jena 07747, Germany
- Institute of Forensic Medicine, University Hospital Bonn, University of Bonn, Bonn 53111, Germany
| | - Gita Mall
- Institute of Forensic Medicine, Jena University Hospital, Jena 07747, Germany
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
| | - Stefanie Deinhardt-Emmer
- Institute of Medical Microbiology, Jena University Hospital, Jena 07747, Germany
- Member of the Leibniz Centre for Photonics in Infection Research (LPI), Jena 07747, Germany
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15
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Schmidt D, Margarites AG, Alvarenga LPKB, Paesi PM, Friedman G, Sbruzzi G. Post-COVID-19 Intensive Care Unit-Acquired Weakness Compromises Long-Term Functional Status. Phys Ther 2023; 103:pzad117. [PMID: 37658771 DOI: 10.1093/ptj/pzad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 05/06/2023] [Accepted: 07/09/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the impact of intensive care unit (ICU)-acquired weakness (ICUAW) on the functional independence of patients hospitalized for coronavirus disease 2019 (COVID-19) over 6 months after ICU discharge. METHODS This was a prospective cohort study that included patients who were admitted to the ICU because of COVID-19 and who were monitored for 6 months after discharge from the ICU via telephone. Patients were evaluated at 3 times (30 days, 3 months, and 6 months after discharge from the ICU) for functional independence for personal care and mobility activities (Barthel Scale), independence for self-care (Katz Index), impact of COVID-19 on functional status (post-COVID-19 Functional Status Scale [PCFS]), and mobility level (ICU Mobility Scale). The existence of some degree of dependence was considered when the Barthel Scale score was <100 points, the Katz Index was ≥1, and the PCFS score was ≥1. A PCFS score of ≥3 indicated moderate or severe dependence. Patients with a Medical Research Council score of <48 at discharge from the ICU were diagnosed with ICUAW. RESULTS Sixty-eight patients were included, with a mean age of 51 (SD = 13) years. The ICUAW rate at ICU discharge was 35%. In the evaluation with the PCFS, the values for the presence of any functional limitation at 30 days, 3 months, and 6 months after ICU discharge were 89.7%, 57.4%, and 38.2%, respectively. The rate of persistence of functional limitations after 6 months was higher in patients with ICUAW than in those without ICUAW (66.7% vs 22.8%; P = .000); the same was true for moderate or severe limitations (20.8% vs 4.5%; P = .035). Likewise, functional independence for personal care, mobility, and self-care activities was poorer in patients with ICUAW. CONCLUSIONS In patients surviving an ICU stay due to COVID-19, decreased functional independence persists even 6 months after discharge, and patients with ICUAW have worse outcomes. IMPACT Patients who survive ICU stays due to COVID-19 continue to have greater functional dependence even 6 months after ICU discharge.
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Affiliation(s)
- Débora Schmidt
- Physical Therapy Service, Hospital de Clínicas de Porto Alegre (HCPA), Santa Cecília, Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Human Movement Science (PPGCMH), Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre, Rio Grande do Sul, Brazil
| | - Ane Glauce Margarites
- Physical Therapy Service, Hospital de Clínicas de Porto Alegre (HCPA), Santa Cecília, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Priscilla Moliterni Paesi
- Physical Therapy Service, Hospital de Clínicas de Porto Alegre (HCPA), Santa Cecília, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gilberto Friedman
- Intensive Care Services, HCPA, Hospital de Clínicas de Porto Alegre (HCPA), Santa Cecília, Porto Alegre, Rio Grande do Sul, Brazil
| | - Graciele Sbruzzi
- Physical Therapy Service, Hospital de Clínicas de Porto Alegre (HCPA), Santa Cecília, Porto Alegre, Rio Grande do Sul, Brazil
- Graduate Program in Human Movement Science (PPGCMH), Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre, Rio Grande do Sul, Brazil
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Ahsan N, Imran M, Mohammed Y, Al Anouti F, Khan MI, Banerjee T, Adnan M, Ashfaq F, Kieliszek M, Ashraf SA, Haq A. Mechanistic Insight into the role of Vitamin D and Zinc in Modulating Immunity Against COVID-19: A View from an Immunological Standpoint. Biol Trace Elem Res 2023; 201:5546-5560. [PMID: 36890344 PMCID: PMC9995175 DOI: 10.1007/s12011-023-03620-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/01/2023] [Indexed: 03/10/2023]
Abstract
The pathophysiology of coronavirus disease-19 (COVID-19) is characterized by worsened inflammation because of weakened immunity, causing the infiltration of immune cells, followed by necrosis. Consequently, these pathophysiological changes may lead to a life-threatening decline in perfusion due to hyperplasia of the lungs, instigating severe pneumonia, and causing fatalities. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause mortality due to viral septic shock, resulting from unrestrained and backfiring immune reactions to the pathogen. Sepsis can cause premature organ failure in COVID-19 patients, as well. Notably, vitamin D and its derivatives and minerals, such as zinc and magnesium, have been reported to improve the immune system against respiratory illnesses. This comprehensive review aims to provide updated mechanistic details of vitamin D and zinc as immunomodulators. Additionally, this review also focuses on their role in respiratory illnesses, while specifically delineating the plausibility of employing them as a preventive and therapeutic agent against current and future pandemics from an immunological perspective. Furthermore, this comprehensive review will attract the attention of health professionals, nutritionists, pharmaceuticals, and scientific communities, as it encourages the use of such micronutrients for therapeutic purposes, as well as promoting their health benefits for a healthy lifestyle and wellbeing.
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Affiliation(s)
- Nuzhat Ahsan
- Quantum Biphotonics Division, Quantlase Laboratory LLC, Abu Dhabi, UAE
| | - Mohammad Imran
- Therapeutic Research Group, Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, 4102, Australia
| | - Yousuf Mohammed
- Therapeutic Research Group, Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, 4102, Australia
| | - Fatme Al Anouti
- College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | - Mohammad Idreesh Khan
- Department of Clinical Nutrition, College of Applied Health Sciences in Ar Rass, Qassim University, Ar Rass, 51921, Saudi Arabia
| | - Tanushree Banerjee
- Infosys Ltd. SEZ Unit VI, Plot No. 1, Rajiv Gandhi Infotech Park, Hinjawadi Phase I, Pune, Maharashtra, 57, India
| | - Mohd Adnan
- Department of Biology, College of Science, University of Ha'il, P.O. Box 2440, Ha'il, Saudi Arabia
| | - Fauzia Ashfaq
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia
| | - Marek Kieliszek
- Department of Food Biotechnology and Microbiology, Institute of Food Sciences, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159 C, 02-776, Warsaw, Poland.
| | - Syed Amir Ashraf
- Department of Clinical Nutrition, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia.
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17
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Nawaiseh HK, Abdelrahim DN, Al-Domi H, Al-Assaf MS, Al-Nawaiseh FK. The impact of vitamin D, vitamin C, and zinc supplements on immune status among Jordanian adults during COVID-19: cross-sectional study findings. BMC Public Health 2023; 23:2251. [PMID: 37968651 PMCID: PMC10652433 DOI: 10.1186/s12889-023-17172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND AND AIMS Nutritional status is essential for the maintenance of the immune system, with malnutrition suppressing immunity. The aims of the current study were to assess the immune status of a group of Jordanian adults and to evaluate the association between vitamin C, vitamin D, and zinc consumption and the Immune Status during the COVID-19 pandemic. METHODS A total of 615 adults Jordanian participants were enrolled in this study, an online- based cross sectional survey was used as a tool for this study. Data was collected by distributing the questionnaire form link through social media platforms. The association between ISQ score and the supplement intake pattern (daily, weekly, monthly and rarely) was assessed using multinomial logistic regression analysis, described as Odds ratio and 95% CI. RESULTS Data have indicated that the majority of the participants did not take Vitamin D supplements during the pandemic (46.3%). Also, there was a significant association between the frequency of Vitamin D supplement intake and ISQ (r = 12.777; P < 0.05). Data showed that the majority of participants used vitamin C supplementation (49.4%). Also, there was a significant association between the frequency of Vitamin C supplement intake and ISQ (r = 12.797; P < 0.05). Data also have indicated that the majority of the participants did not increase their consumption of Zinc during the COVID-19 pandemic (55.6%). CONCLUSIONS The findings of this study suggest a significant association between the frequency of Vitamin D, and vitamin C supplement intake and ISQ. Nutritional status is essential for the maintenance of the immune system, with malnutrition suppressing immunity.
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Affiliation(s)
- Hala K Nawaiseh
- Department of nutrition and food technology, Faculty of Agriculture, The University of Jordan, 11942, Amman, Jordan.
| | - Dana N Abdelrahim
- Research Institute for Medical and Health Sciences, Sharjah University, 27272, Sharjah, United Arab Emirates
| | - Hayder Al-Domi
- Department of nutrition and food technology, Faculty of Agriculture, The University of Jordan, 11942, Amman, Jordan
| | - Mohammad S Al-Assaf
- Department of Ears, Nose and Throat, King Hussein Medical Centre (KHMC), Amman, Jordan
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Silva ECGE, Schmitt ACB, de Godoy CG, de Oliveira DB, Tanaka C, Toufen C, de Carvalho CRR, Carvalho CRF, Fu C, Hill KD, Pompeu JE. Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7057. [PMID: 37998288 PMCID: PMC10671138 DOI: 10.3390/ijerph20227057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/04/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Some older people hospitalized with COVID-19 have experienced reduced ambulation capacity. However, the prevalence of the impairment of ambulation capacity still needs to be established. Objective: To estimate the prevalence of, and identify the risk factors associated with, the impairment of ambulation capacity at the point of hospital discharge for older people with COVID-19. (2) Methods: A retrospective cohort study. Included are those with an age > 60 years, of either sex, hospitalized due to COVID-19. Clinical data was collected from patients' medical records. Ambulation capacity prior to COVID-19 infection was assessed through the patients' reports from their relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data for 429 older people hospitalized with COVID-19 were randomly collected from the medical records. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were a hospital stay longer than 20 days (Odds Ratio (OR): 3.5) and dependent ambulation capacity prior to COVID-19 (Odds Ratio (OR): 11.3). (4) Conclusion: More than half of the older people who survived following hospitalization due to COVID-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection and a longer hospital stay were risks factors for reduced ambulation capacity.
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Affiliation(s)
- Erika Christina Gouveia e Silva
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Ana Carolina Basso Schmitt
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Caroline Gil de Godoy
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Danielle Brancolini de Oliveira
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Clarice Tanaka
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Carlos Toufen
- Division of Pulmonology, Heart Institute (InCor), School of Medicine—University of Sao Paulo, Brazil. Av. Dr. Eneas Carvalho de Aguiar, 44-Cerqueira Cesar, São Paulo 05403-900, Brazil (C.R.R.d.C.)
| | - Carlos Roberto Ribeiro de Carvalho
- Division of Pulmonology, Heart Institute (InCor), School of Medicine—University of Sao Paulo, Brazil. Av. Dr. Eneas Carvalho de Aguiar, 44-Cerqueira Cesar, São Paulo 05403-900, Brazil (C.R.R.d.C.)
| | - Celso R. F. Carvalho
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Carolina Fu
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Keith D. Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, VIC 3199, Australia;
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
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19
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Amadoro G, Latina V, Stigliano E, Micera A. COVID-19 and Alzheimer's Disease Share Common Neurological and Ophthalmological Manifestations: A Bidirectional Risk in the Post-Pandemic Future. Cells 2023; 12:2601. [PMID: 37998336 PMCID: PMC10670749 DOI: 10.3390/cells12222601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
A growing body of evidence indicates that a neuropathological cross-talk takes place between the coronavirus disease 2019 (COVID-19) -the pandemic severe pneumonia that has had a tremendous impact on the global economy and health since three years after its outbreak in December 2019- and Alzheimer's Disease (AD), the leading cause of dementia among human beings, reaching 139 million by the year 2050. Even though COVID-19 is a primary respiratory disease, its causative agent, the so-called Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), is also endowed with high neuro-invasive potential (Neurocovid). The neurological complications of COVID-19, resulting from the direct viral entry into the Central Nervous System (CNS) and/or indirect systemic inflammation and dysregulated activation of immune response, encompass memory decline and anosmia which are typically associated with AD symptomatology. In addition, patients diagnosed with AD are more vulnerable to SARS-CoV-2 infection and are inclined to more severe clinical outcomes. In the present review, we better elucidate the intimate connection between COVID-19 and AD by summarizing the involved risk factors/targets and the underlying biological mechanisms shared by these two disorders with a particular focus on the Angiotensin-Converting Enzyme 2 (ACE2) receptor, APOlipoprotein E (APOE), aging, neuroinflammation and cellular pathways associated with the Amyloid Precursor Protein (APP)/Amyloid beta (Aβ) and tau neuropathologies. Finally, the involvement of ophthalmological manifestations, including vitreo-retinal abnormalities and visual deficits, in both COVID-19 and AD are also discussed. Understanding the common physiopathological aspects linking COVID-19 and AD will pave the way to novel management and diagnostic/therapeutic approaches to cope with them in the post-pandemic future.
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Affiliation(s)
- Giuseppina Amadoro
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), Via Fosso del Cavaliere 100, 00133 Rome, Italy;
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Valentina Latina
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), Via Fosso del Cavaliere 100, 00133 Rome, Italy;
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Egidio Stigliano
- Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;
| | - Alessandra Micera
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS-Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184 Rome, Italy
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20
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Asghari F, Asghary A, Majidi Zolbanin N, Faraji F, Jafari R. Immunosenescence and Inflammaging in COVID-19. Viral Immunol 2023; 36:579-592. [PMID: 37797216 DOI: 10.1089/vim.2023.0045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Despite knowledge gaps in understanding the full spectrum of the hyperinflammatory phase caused by SARS-CoV-2, according to the World Health Organization (WHO), COVID-19 is still the leading cause of death worldwide. Susceptible people to severe COVID-19 are those with underlying medical conditions or those with dysregulated and senescence-associated immune responses. As the immune system undergoes aging in the elderly, such drastic changes predispose them to various diseases and affect their responsiveness to infections, as seen in COVID-19. At-risk groups experience poor prognosis in terms of disease recovery. Changes in the quantity and quality of immune cell function have been described in numerous literature sites. Impaired immune cell function along with age-related metabolic changes can lead to features such as hyperinflammatory response, immunosenescence, and inflammaging in COVID-19. Inflammaging is related to the increased activity of the most inflammatory factors and is the main cause of age-related diseases and tissue failure in the elderly. Since hyperinflammation is a common feature of most severe cases of COVID-19, this pathway, which is not fully understood, leads to immunosenescence and inflammaging in some individuals, especially in the elderly and those with comorbidities. In this review, we shed some light on the age-related abnormalities of innate and adaptive immune cells and how hyperinflammatory immune responses contribute to the inflammaging process, leading to clinical deterioration. Further, we provide insights into immunomodulation-based therapeutic approaches, which are potentially important considerations in vaccine design for elderly populations.
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Affiliation(s)
- Faezeh Asghari
- Department of Immunology, School of Medicine, Tarbiat Modares University, Tehran, Iran
| | - Amir Asghary
- Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Naime Majidi Zolbanin
- Experimental and Applied Pharmaceutical Research Center, Urmia University of Medical Sciences, Urmia, Iran
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Faraji
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Jafari
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
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Dankl L, Crepaz-Eger U, Arora R, Schneider F. Retrospective Analysis of Nosocomial SARS-CoV-2 Infections in Orthopedic and Traumatological Inpatients. Healthcare (Basel) 2023; 11:2765. [PMID: 37893839 PMCID: PMC10606212 DOI: 10.3390/healthcare11202765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
SARS-CoV-2 has had a measurable impact on the field of orthopedic and traumatological surgery. To date, scarce data on intramural SARS-CoV-2 infections in orthopedic and traumatological patients have been reported. Therefore, the aim of our study was to investigate the effect of nosocomial SARS-CoV-2 infections in orthopedic and traumatological inpatients regarding symptoms of infection, mortality, duration of hospitalization, and other relevant patient-dependent factors. Patients admitted to hospital for an orthopedic or traumatological indication were screened retrospectively for nosocomial SARS-CoV-2 infections and included in this study. An age-, sex-, and ICD 10-matched control group was assigned and demographic data, clinical symptoms of a SARS-CoV-2 infection as well as mortality, length of hospital stays, time to surgery, pre-existing conditions, LKF-points representing the financial effort, and the Charlson Comorbidity Index were collected. A significantly higher length of stay was observed in the SARS-CoV-2 group (25 days; 4-60; SD 12.5) when compared to the control group (11 days; 2-36; SD 7; p < 0.05). LKF points were significantly higher in the SARS-CoV-2 group (13,939 points vs. 8542 points). No significant difference in mortality could be observed. An infection with SARS-CoV-2 in inpatients significantly increases length of hospital stay and cost of treatment. Although no significant difference in mortality was found, care should be taken to avoid intramural SARS-CoV-2 infections, resulting in prolonged hospitalization, higher costs, and potentially further individual risks.
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Affiliation(s)
| | | | | | - Friedemann Schneider
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (L.D.)
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Zhao Y, Shao W, Zhu Q, Zhang R, Sun T, Wang B, Hu X. Association between systemic immune-inflammation index and metabolic syndrome and its components: results from the National Health and Nutrition Examination Survey 2011-2016. J Transl Med 2023; 21:691. [PMID: 37794370 PMCID: PMC10548719 DOI: 10.1186/s12967-023-04491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), a worldwide public health problem, affects human health and quality of life in a dramatic manner. A growing evidence base suggests that MetS is strongly associated with levels of systemic immune inflammation. The present study aimed to investigate the possible relationship between the systemic immune-inflammation index (SII), a novel inflammatory marker, and MetS to provide data support for effective MetS prevention by reducing the systemic inflammatory response. METHODS We included adult participants with complete SII and MetS information from the 2011-2016 National Health and Nutrition Examination Survey (NHANES). MetS was defined as using the criteria developed by the Adult Treatment Program III of the National Cholesterol Education Program. The formula for SII was as follows: SII = platelet counts × neutrophil counts/ lymphocyte counts. Weighted linear regression was used to assess differences in variables across SII quartile groups after the SII score was divided into 4 quartiles. The independent interaction between SII and MetS was investigated using weighted multivariate logistic regression analysis and subgroup analysis, and the relationship between SII levels and 5 particular MetS items was further explored in depth. RESULTS A total of 12,402 participants, 3,489 of whom were diagnosed with MetS, were included in this study. After correcting for covariates, the results of a logistic regression of multistage weighted complex sampling data revealed that participants with higher SII scores had a higher chance of developing MetS (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14-1.55) and that SII levels could be used as an independent risk factor to predict that likelihood of MetS onset. In the Q1-Q4 SII quartile group, the risk of developing MetS was 1.33 times higher in the Q4 group, which had the highest level of systemic immune inflammation than in the Q1 group. After adjusting for all confounding factors, SII scores were found to have a negative correlation with high-density lipoprotein cholesterol (OR = 1.29; 95% CI, 0.99-1.67, P = 0.056) and a significant positive correlation with waist circumference (OR = 2.17; 95% CI, 1.65-2.87, P < 0.001) and blood pressure (BP) (OR = 1.65; 95% CI, 1.20-2.27, P = 0.003). Gender, age, and smoking status were shown to alter the positive association between SII and MetS in subgroup analyses and interaction tests (p for interaction < 0.05). Additionally, we demonstrated a nonlinear correlation between SII and MetS. The findings of the restricted cubic spline indicated that there was an inverted U-shaped association between SII and MetS. CONCLUSIONS Our findings imply that increased SII levels are related to MetS, and SII may be a simple and cost-effective method to identify individuals with MetS. Therefore, protective measures such as early investigation and anti-inflammatory interventions are necessary to reduce the overall incidence of MetS.
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Affiliation(s)
- Yang Zhao
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenyu Shao
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qihan Zhu
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Rui Zhang
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tao Sun
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China.
| | - Bijia Wang
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Xiaofei Hu
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
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23
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Silvestrini A, Giordani C, Bonacci S, Giuliani A, Ramini D, Matacchione G, Sabbatinelli J, Di Valerio S, Pacetti D, Procopio AD, Procopio A, Rippo MR. Anti-Inflammatory Effects of Olive Leaf Extract and Its Bioactive Compounds Oleacin and Oleuropein-Aglycone on Senescent Endothelial and Small Airway Epithelial Cells. Antioxidants (Basel) 2023; 12:1509. [PMID: 37627504 PMCID: PMC10451521 DOI: 10.3390/antiox12081509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Olive tree by-products have been deeply studied as an invaluable source of bioactive compounds. Several in vitro and in vivo studies showed that olive leaf extract (OLE) has anti-inflammatory and antioxidant properties. Here, we wanted to assess the valuable benefits of two less-studied OLE components-3,4-DHPEA-EDA (Oleacin, OC) and 3,4-DHPEA-EA (Oleuropein-Aglycone, OA)-directly purified from OLE using a cost-effective and environmentally sustainable method, in line with the principles of circular economy. OLE, OC and OA were then tested in human cellular models involved in acute and chronic inflammation and in the pathogenesis of viral infections, i.e., lipopolysaccharide (LPS)-treated monocyte/macrophages (THP-1) and endothelial cells (HUVECs), senescent HUVECs and Poly(I:C)-treated small airway epithelial cells (hSAECs). Results showed that OC and OA are efficient in ameliorating almost all of the pro-inflammatory readouts (IL-1β, TNF-α, IL-8, ICAM, VCAM) and reducing the release of IL-6 in all the cellular models. In hSAECs, they also modulate the expression of SOD2, NF-kB and also ACE2 and TMPRSS2, whose expression is required for SARS-CoV-2 virus entry. Overall, these data suggest the usefulness of OLE, OC and OA in controlling or preventing inflammatory responses, in particular those associated with viral respiratory infections and aging.
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Affiliation(s)
- Andrea Silvestrini
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
| | - Chiara Giordani
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
| | - Sonia Bonacci
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Angelica Giuliani
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
| | - Deborah Ramini
- Clinic of Laboratory and Precision Medicine, IRCCS—National Institute for the Care of the Elderly (INRCA), 60121 Ancona, Italy;
| | - Giulia Matacchione
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
| | - Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
| | - Silvia Di Valerio
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
| | - Deborah Pacetti
- Department of Agricultural, Food and Environmental Sciences, Marche Polytechnic University, Via Brecce Bianche, 60131 Ancona, Italy
| | - Antonio Domenico Procopio
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
- Clinic of Laboratory and Precision Medicine, IRCCS—National Institute for the Care of the Elderly (INRCA), 60121 Ancona, Italy;
| | - Antonio Procopio
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Maria Rita Rippo
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, 60126 Ancona, Italy (J.S.)
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Brière O, Otekpo M, Asfar M, Gautier J, Sacco G, Annweiler C. Initial functional disability as a 1-year prognostic factor in geriatric patients hospitalized with SARS-CoV-2 infection. PLoS One 2023; 18:e0289297. [PMID: 37498909 PMCID: PMC10374042 DOI: 10.1371/journal.pone.0289297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND SARS-CoV2 infection has affected many older people and has required us to adapt our practices to this new pathology. Initial functional capacity is already considered an important prognostic marker in older patients particularly during infections. AIM The objective of this longitudinal study was to determine whether baseline functional disability was associated with mortality risk after 1 year in older patients hospitalized for COVID-19. METHODS All COVID-19 patients admitted to the geriatric acute care unit of Angers University Hospital, France, between March-June 2020 received a group iso-ressource (GIR) assessment upon admission. Disability was defined as a GIR score≤3. All-cause mortality was collected after 1 year of follow-up. Covariables were age, sex, history of malignancies, hypertension, cardiomyopathy, number of acute diseases at baseline, and use of antibiotics or respiratory treatments during COVID-19 acute phase. RESULTS In total, 97 participants (mean±SD 88.0+5.4 years; 49.5% women; 46.4% GIR score≤3) were included. 24 of the 36 patients who did not survive 1 year had a GIR score ≤ 3 (66.7%; P = 0.003). GIR score≤3 was directly associated with 1-year mortality (fully adjusted HR = 2.27 95% CI: 1.07-4.89). Those with GIR≤3 at baseline had shorter survival time than the others (log-rank P = 0.0029). CONCLUSIONS Initial functional disability was associated with poorer survival in hospitalized frail elderly COVID-19 patients. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT04560608 registered on September 23, 2022.
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Affiliation(s)
- Olivier Brière
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Marie Otekpo
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Marine Asfar
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Jennifer Gautier
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Guillaume Sacco
- University Côte d'Azur, Nice, France
- Department of Geriatric Medecine and Brain Clinic, Nice, France
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
- UNIV ANGERS, University of Angers, Angers, France
- Gérontopôle Autonomie Longévité des Pays de la Loire, Nantes, France
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, The University of Western Ontario, London, ON, Canada
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25
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Smail SW, Babaei E, Amin K, Abdulahad WH. Serum IL-23, IL-10, and TNF-α predict in-hospital mortality in COVID-19 patients. Front Immunol 2023; 14:1145840. [PMID: 37283736 PMCID: PMC10239952 DOI: 10.3389/fimmu.2023.1145840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/05/2023] [Indexed: 06/08/2023] Open
Abstract
Objective The hyperinflammatory response, caused by severe acute respiratory syndrome-2 (SARS-CoV-2), is the most common cause of death in patients with coronavirus disease 2019 (COVID-19). The etiopathogenesis of this illness is not fully understood. Macrophages appear to play a key part in COVID-19's pathogenic effects. Therefore, this study aims to examine serum inflammatory cytokines associated with the activation state of macrophages in COVID-19 patients and attempt to find accurate predictive markers for disease severity and mortality risk in hospital. Methods 180 patients with COVID-19 and 90 healthy controls (HCs) participated in this study. Patients were divided into three different subgroups, mild (n=81), severe (n=60), and critical groups (n=39). Serum samples were collected and IL (Interleukin)-10, IL-23, tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), IL-17, monocyte chemoattractant protein-1 (MCP-1) and chemokine ligand 3 (CCL3) were determined by ELISA. In parallel, myeloperoxidase (MPO) and C-reactive protein (CRP) were measured using colorimetric and electrochemiluminescence methods, respectively. Data were collected, and their associations with disease progression and mortality were assessed using regression models and receiver operating characteristic (ROC) curves. Results Compared to HCs, a significant increase in IL-23, IL-10, TNF-α, IFN-γ and MCP-1, were observed in COVID-19 patients. Serum levels of IL-23, IL-10, and TNF-α were significantly higher in COVID-19 patients with critical cases compared to mild and severe cases, and correlated positively with CRP level. However, non-significant changes were found in serum MPO and CCL3 among the studied groups. Moreover, significant positive association has been observed among increased IL-10, IL-23 and TNF-α in serum of COVID-19 patients. Furthermore, a binary logistic regression model was applied to predict death's independent factors. Results showed that IL-10 alone or in combination with IL23 and TNF-α are strongly linked with non-survivors in COVID-19 patients. Finally, ROC curve results uncovered that IL-10, IL-23 and TNF-α were excellent predictors for prognosing COVID-19. Conclusion The elevations of IL-10, IL-23, and TNF-α levels were seen in severe and critical cases of COVID-19 patients and their elevations were linked to the in-hospital mortality of the disease. A prediction model shows that the determination of these cytokines upon admission is important and should be done on COVID-19 patients as a way of evaluating the prognosis of the disease. COVID-19 Patients with high IL-10, IL-23, and TNF-α on admission are more likely to experience a severe form of the disease; therefore, those patients should be cautionary monitored and treated.
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Affiliation(s)
- Shukur Wasman Smail
- Department of Biology, College of Science, Salahaddin University, Erbil, Iraq
| | - Esmaeil Babaei
- Department of Biology, School of Natural Sciences, University of Tabriz, Tabriz, Iran
- Department of Pharmacognosy, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Kawa Amin
- College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq
- Department of Medical Science, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Wayel H. Abdulahad
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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26
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Soegiarto G, Purnomosari D. Challenges in the Vaccination of the Elderly and Strategies for Improvement. PATHOPHYSIOLOGY 2023; 30:155-173. [PMID: 37218912 DOI: 10.3390/pathophysiology30020014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/05/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
In recent years, the elderly has become a rapidly growing proportion of the world's population as life expectancy is extending. Immunosenescence and inflammaging contribute to the increased risk of chronic non-communicable and acute infectious diseases. Frailty is highly prevalent in the elderly and is associated with an impaired immune response, a higher propensity to infection, and a lower response to vaccines. Additionally, the presence of uncontrolled comorbid diseases in the elderly also contributes to sarcopenia and frailty. Vaccine-preventable diseases that threaten the elderly include influenza, pneumococcal infection, herpes zoster, and COVID-19, which contribute to significant disability-adjusted life years lost. Previous studies had shown that conventional vaccines only yielded suboptimal protection that wanes rapidly in a shorter time. This article reviews published papers on several vaccination strategies that were developed for the elderly to solve these problems: more immunogenic vaccine formulations using larger doses of antigen, stronger vaccine adjuvants, recombinant subunit or protein conjugated vaccines, newly developed mRNA vaccines, giving booster shots, and exploring alternative routes of administration. Included also are several publications on senolytic medications under investigation to boost the immune system and vaccine response in the elderly. With all those in regard, the currently recommended vaccines for the elderly are presented.
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Affiliation(s)
- Gatot Soegiarto
- Allergy and Clinical Immunology Division, Department of Internal Medicine, Dr. Soetomo Academic General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60286, Indonesia
- Master Program in Immunology, Postgraduate School, Universitas Airlangga, Surabaya 60286, Indonesia
| | - Dewajani Purnomosari
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gajah Mada, Yogyakarta 55281, Indonesia
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27
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Musavi H, Abazari O, Barartabar Z, Kalaki-Jouybari F, Hemmati-Dinarvand M, Esmaeili P, Mahjoub S. The benefits of Vitamin D in the COVID-19 pandemic: biochemical and immunological mechanisms. Arch Physiol Biochem 2023; 129:354-362. [PMID: 33030073 DOI: 10.1080/13813455.2020.1826530] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In December 2019, a new infectious complication called CoronaVirus Infectious Disease-19, briefly COVID-19, caused by SARS-COV-2, is identified in Wuhan, China. It spread all over the world and became a pandemic. In many individuals who had suffered SARS-COV-2 infection, cytokine storm starts through cytokine overproduction and leads to Acute Respiratory Syndrome (ARS), organ failure, and death. According to the obtained evidence, Vitamin D (VitD) enhances the ACE2/Ang(1-7)/MasR pathway activity, and it also reduces cytokine storms and the ARS risk. Therefore, VitD intake may be beneficial for patients with SARS-COV-2 infection exposed to cytokine storm but do not suffer hypotension. In the present review, we have explained the effects of VitD on the renin-angiotensin system (RAS) function and angiotensin-converting enzyme2 (ACE2) expression. Furthermore, we have reviewed the biochemical and immunological effects of VitD on immune function in the underlying diseases and its role in the COVID-19 pandemic.
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Affiliation(s)
- Hadis Musavi
- Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Omid Abazari
- Department of Clinical Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zeinab Barartabar
- Department of Clinical Biochemistry, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Fatemeh Kalaki-Jouybari
- Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Hemmati-Dinarvand
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Esmaeili
- Department of Immunology and Microbiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Soleiman Mahjoub
- Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Pathology, University of Kiel, Kiel, Germany
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28
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Fraser R, Orta-Resendiz A, Dockrell D, Müller-Trutwin M, Mazein A. Severe COVID-19 versus multisystem inflammatory syndrome: comparing two critical outcomes of SARS-CoV-2 infection. Eur Respir Rev 2023; 32:32/167/220197. [PMID: 36889788 PMCID: PMC10032586 DOI: 10.1183/16000617.0197-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/31/2022] [Indexed: 03/10/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with diverse host response immunodynamics and variable inflammatory manifestations. Several immune-modulating risk factors can contribute to a more severe coronavirus disease 2019 (COVID-19) course with increased morbidity and mortality. The comparatively rare post-infectious multisystem inflammatory syndrome (MIS) can develop in formerly healthy individuals, with accelerated progression to life-threatening illness. A common trajectory of immune dysregulation forms a continuum of the COVID-19 spectrum and MIS; however, severity of COVID-19 or the development of MIS is dependent on distinct aetiological factors that produce variable host inflammatory responses to infection with different spatiotemporal manifestations, a comprehensive understanding of which is necessary to set better targeted therapeutic and preventative strategies for both.
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Affiliation(s)
- Rupsha Fraser
- The University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK
| | - Aurelio Orta-Resendiz
- Institut Pasteur, Université Paris Cité, HIV, Inflammation and Persistence Unit, Paris, France
| | - David Dockrell
- The University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK
| | - Michaela Müller-Trutwin
- Institut Pasteur, Université Paris Cité, HIV, Inflammation and Persistence Unit, Paris, France
| | - Alexander Mazein
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
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29
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Low RN, Low RJ, Akrami A. A review of cytokine-based pathophysiology of Long COVID symptoms. Front Med (Lausanne) 2023; 10:1011936. [PMID: 37064029 PMCID: PMC10103649 DOI: 10.3389/fmed.2023.1011936] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/27/2023] [Indexed: 04/03/2023] Open
Abstract
The Long COVID/Post Acute Sequelae of COVID-19 (PASC) group includes patients with initial mild-to-moderate symptoms during the acute phase of the illness, in whom recovery is prolonged, or new symptoms are developed over months. Here, we propose a description of the pathophysiology of the Long COVID presentation based on inflammatory cytokine cascades and the p38 MAP kinase signaling pathways that regulate cytokine production. In this model, the SARS-CoV-2 viral infection is hypothesized to trigger a dysregulated peripheral immune system activation with subsequent cytokine release. Chronic low-grade inflammation leads to dysregulated brain microglia with an exaggerated release of central cytokines, producing neuroinflammation. Immunothrombosis linked to chronic inflammation with microclot formation leads to decreased tissue perfusion and ischemia. Intermittent fatigue, Post Exertional Malaise (PEM), CNS symptoms with "brain fog," arthralgias, paresthesias, dysautonomia, and GI and ophthalmic problems can consequently arise as result of the elevated peripheral and central cytokines. There are abundant similarities between symptoms in Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). DNA polymorphisms and viral-induced epigenetic changes to cytokine gene expression may lead to chronic inflammation in Long COVID patients, predisposing some to develop autoimmunity, which may be the gateway to ME/CFS.
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Affiliation(s)
| | - Ryan J. Low
- Gatsby Computational Neuroscience Unit, University College London, London, United Kingdom
- Sainsbury Wellcome Centre, University College London, London, United Kingdom
| | - Athena Akrami
- Sainsbury Wellcome Centre, University College London, London, United Kingdom
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30
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Sánchez-Díez S, Gómez-Ollés C, Cruz MJ, de Homdedeu M, Espejo D, Ferrer J, Roca O, Pacheco A, Muñoz X. Biomarker Profiles Associated with COVID-19 Severity and Mortality. Curr Issues Mol Biol 2023; 45:1998-2012. [PMID: 36975498 PMCID: PMC10047501 DOI: 10.3390/cimb45030128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
Introduction: The aim of this study was to analyze biomarkers that might predict the severity and progression of the SARS-CoV-2 infection, both in the acute phase and after recovery. Methods: Unvaccinated patients infected with the original strain of COVID-19 requiring ward (Group 1, n = 48) or ICU (Group 2, n = 41) admission were included. At the time of admission (visit 1), a clinical history was acquired, and blood samples were obtained. One and six months after discharge from the hospital (visits 2 and 3, respectively), a clinical history, lung function tests, and blood samples were carried out. At visit 2, patients also underwent a chest CT scan. Different cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, IL-17A, G-CSF, GM-CSF, IFN-ɣ, MCP-1, MIP-1β, and TNF-α) and lung fibrosis biomarkers (YKL-40 and KL-6) were measured in blood samples obtained at visits 1, 2, and 3. Results: At visit 1, IL-4, IL-5, and IL-6 levels were higher in Group 2 (p = 0.039, 0.011, and 0.045, respectively), and IL-17 and IL-8 levels were higher in Group 1 (p = 0.026 and 0.001, respectively). The number of patients in Groups 1 and 2 who died during hospitalization was 8 and 11, respectively. YKL-40 and KL-6 levels were higher in patients who died. Serum YKL-40 and KL-6 levels determined at visit 2 correlated negatively with FVC (p = 0.022 and p = 0.024, respectively) and FEV1 (p = 0.012 and p = 0.032, respectively) measured at visit 3. KL-6 levels also correlated negatively with the diffusing capacity of the lungs for carbon monoxide (DLCO, p = 0.001). Conclusions: Patients who required ICU admission had higher levels of Th2 cytokines, while patients admitted to the ward showed an innate immune response activation, with IL-8 release and Th1/Th17 lymphocyte contribution. Increased levels of YKL-40 and KL-6 were associated with mortality in COVID-19 patients.
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Affiliation(s)
- Silvia Sánchez-Díez
- Pulmonology Service, Department of Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, 08035 Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
| | - Carlos Gómez-Ollés
- Pulmonology Service, Department of Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, 08035 Barcelona, Spain
| | - María-Jesús Cruz
- Pulmonology Service, Department of Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, 08035 Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Correspondence:
| | - Miquel de Homdedeu
- Pulmonology Service, Department of Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, 08035 Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
| | - David Espejo
- Pulmonology Service, Department of Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, 08035 Barcelona, Spain
| | - Jaume Ferrer
- Pulmonology Service, Department of Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, 08035 Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
| | - Oriol Roca
- Intensive Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, Barcelona 08035, Spain
| | - Andrés Pacheco
- Intensive Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, Barcelona 08035, Spain
| | - Xavier Muñoz
- Pulmonology Service, Department of Medicine, Vall d’Hebron University Hospital, Autonomous University of Barcelona, 08035 Barcelona, Spain
- CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
- Department of Cell Biology and Physiology and Immunology, Autonomous University of Barcelona, 08193 Barcelona, Spain
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31
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Courtois-Amiot P, Allart H, de Cathelineau C, Legué C, Eischen P, Chetaille F, Lepineux D, Raynaud-Simon A, Sanchez M. COVID-19 as an Independent Risk Factor for Weight Loss in Older Adults Living in Nursing Homes. Gerontology 2023; 69:818-825. [PMID: 36807249 DOI: 10.1159/000529357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/20/2023] [Indexed: 02/19/2023] Open
Abstract
INTRODUCTION In nursing homes, where residents are at elevated risk for malnutrition, the specific additive effect of the coronavirus disease 2019 (COVID-19) on weight loss has not yet been adequately evaluated. This study aimed to determine the factors independently associated with weight loss in nursing home residents who survived the first wave of the COVID-19 pandemic, whether they have contracted COVID-19 or not. METHODS This research was a retrospective study conducted in three nursing homes. Residents who survived the first French COVID-19 lockdown (March to May 2020) were included, provided their weight records were available. Baseline data included the body mass index (BMI), capacity to self-feed, need for texture-modified food, disability, and legal guardianship status. The diagnosis of COVID-19 was based on the results of a positive reverse transcriptase-polymerase chain reaction test. Univariate and multivariate logistic regression analyses were used to investigate associations between resident characteristics, COVID-19 status, and at least 5% weight loss. RESULTS Of the 316 included residents (72% female, mean age of 88 years, 48% severely disabled, and 38% under legal guardianship), 111 (35%) contracted COVID-19 and 102 (32%) lost at least 5% of their body weight. No difference was observed between the baseline characteristics of residents subsequently affected or unaffected by COVID-19. In the univariate analysis, old age, severe disability, texture-modified food, the need for close mealtime supervision, and COVID-19 were significantly associated with at least 5% weight loss. In the multivariate logistic regression analysis, COVID-19 (p = 0.02) and the need for close mealtime supervision (p = 0.02) were associated with weight loss in a model that also included age, BMI, texture-modified food, disability, and nursing home. CONCLUSION For nursing home residents, COVID-19 was an independent risk factor for weight loss. Weight loss was most common in residents needing close mealtime supervision, suggesting that organizational issues may have affected the quality of the nutritional care provided during the lockdown.
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Affiliation(s)
| | - Hélène Allart
- AP-HP, Geriatric Department, Bichat University Hospital, Paris, France
| | | | - Catherine Legué
- AP-HP, Geriatric Department, Bichat University Hospital, Paris, France
| | | | | | | | - Agathe Raynaud-Simon
- AP-HP, Geriatric Department, Bichat University Hospital, Paris, France
- University Paris Cité, Paris, France
- Gérond'if, Paris, France
| | - Manuel Sanchez
- AP-HP, Geriatric Department, Bichat University Hospital, Paris, France
- University Paris Cité, Paris, France
- Gérond'if, Paris, France
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32
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Hasankhani A, Bahrami A, Tavakoli-Far B, Iranshahi S, Ghaemi F, Akbarizadeh MR, Amin AH, Abedi Kiasari B, Mohammadzadeh Shabestari A. The role of peroxisome proliferator-activated receptors in the modulation of hyperinflammation induced by SARS-CoV-2 infection: A perspective for COVID-19 therapy. Front Immunol 2023; 14:1127358. [PMID: 36875108 PMCID: PMC9981974 DOI: 10.3389/fimmu.2023.1127358] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/08/2023] [Indexed: 02/19/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a severe respiratory disease caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that affects the lower and upper respiratory tract in humans. SARS-CoV-2 infection is associated with the induction of a cascade of uncontrolled inflammatory responses in the host, ultimately leading to hyperinflammation or cytokine storm. Indeed, cytokine storm is a hallmark of SARS-CoV-2 immunopathogenesis, directly related to the severity of the disease and mortality in COVID-19 patients. Considering the lack of any definitive treatment for COVID-19, targeting key inflammatory factors to regulate the inflammatory response in COVID-19 patients could be a fundamental step to developing effective therapeutic strategies against SARS-CoV-2 infection. Currently, in addition to well-defined metabolic actions, especially lipid metabolism and glucose utilization, there is growing evidence of a central role of the ligand-dependent nuclear receptors and peroxisome proliferator-activated receptors (PPARs) including PPARα, PPARβ/δ, and PPARγ in the control of inflammatory signals in various human inflammatory diseases. This makes them attractive targets for developing therapeutic approaches to control/suppress the hyperinflammatory response in patients with severe COVID-19. In this review, we (1) investigate the anti-inflammatory mechanisms mediated by PPARs and their ligands during SARS-CoV-2 infection, and (2) on the basis of the recent literature, highlight the importance of PPAR subtypes for the development of promising therapeutic approaches against the cytokine storm in severe COVID-19 patients.
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Affiliation(s)
- Aliakbar Hasankhani
- Department of Animal Science, College of Agriculture and Natural Resources, University of Tehran, Karaj, Iran
| | - Abolfazl Bahrami
- Department of Animal Science, College of Agriculture and Natural Resources, University of Tehran, Karaj, Iran
- Faculty of Agricultural Sciences and Engineering, University of Tehran, Karaj, Iran
| | - Bahareh Tavakoli-Far
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Physiology and Pharmacology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Setare Iranshahi
- School of Pharmacy, Shahid Beheshty University of Medical Sciences, Tehran, Iran
| | - Farnaz Ghaemi
- Department of Biochemistry, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Majid Reza Akbarizadeh
- Department of Pediatric, School of Medicine, Amir al momenin Hospital, Zabol University of Medical Sciences, Zabol, Iran
| | - Ali H. Amin
- Zoology Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Bahman Abedi Kiasari
- Virology Department, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Alireza Mohammadzadeh Shabestari
- Department of Dental Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
- Khorasan Covid-19 Scientific Committee, Mashhad, Iran
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Conti V, Corbi G, Sabbatino F, De Pascale D, Sellitto C, Stefanelli B, Bertini N, De Simone M, Liguori L, Di Paola I, De Bernardo M, Tesse A, Rosa N, Pagliano P, Filippelli A. Long COVID: Clinical Framing, Biomarkers, and Therapeutic Approaches. J Pers Med 2023; 13:334. [PMID: 36836568 PMCID: PMC9959656 DOI: 10.3390/jpm13020334] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
More than two years after the onset of the COVID-19 pandemic, healthcare providers are facing an emergency within an emergency, the so-called long COVID or post-COVID-19 syndrome (PCS). Patients diagnosed with PCS develop an extended range of persistent symptoms and/or complications from COVID-19. The risk factors and clinical manifestations are many and various. Advanced age, sex/gender, and pre-existing conditions certainly influence the pathogenesis and course of this syndrome. However, the absence of precise diagnostic and prognostic biomarkers may further complicate the clinical management of patients. This review aimed to summarize recent evidence on the factors influencing PCS, possible biomarkers, and therapeutic approaches. Older patients recovered approximately one month earlier than younger patients, with higher rates of symptoms. Fatigue during the acute phase of COVID-19 appears to be an important risk factor for symptom persistence. Female sex, older age, and active smoking are associated with a higher risk of developing PCS. The incidence of cognitive decline and the risk of death are higher in PCS patients than in controls. Complementary and alternative medicine appears to be associated with improvement in symptoms, particularly fatigue. The heterogeneous nature of post-COVID symptoms and the complexity of patients with PCS, who are often polytreated due to concomitant clinical conditions, suggest a holistic and integrated approach to provide useful guidance for the treatment and overall management of long COVID.
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Affiliation(s)
- Valeria Conti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Domenico De Pascale
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Berenice Stefanelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Nicola Bertini
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
| | - Matteo De Simone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Luigi Liguori
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy
| | - Ilenia Di Paola
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Maddalena De Bernardo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Angela Tesse
- CNRS, INSERM, L'institut du Thorax, Université de Nantes, F-44000 Nantes, France
| | - Nicola Rosa
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081 Baronissi, Italy
- Clinical Pharmacology and Pharmacogenetics Unit, University Hospital "San Giovanni di Dio e Ruggi, D'Aragona", 84131 Salerno, Italy
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Salimian J, Ahmadi A, Amani J, Olad G, Halabian R, Saffaei A, Arabfard M, Nasiri M, Nazarian S, Abolghasemi H, Alishiri G. Safety and immunogenicity of a recombinant receptor-binding domain-based protein subunit vaccine (Noora vaccine™) against COVID-19 in adults: A randomized, double-blind, placebo-controlled, Phase 1 trial. J Med Virol 2023; 95:10.1002/jmv.28097. [PMID: 36029105 PMCID: PMC9539327 DOI: 10.1002/jmv.28097] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/01/2022] [Accepted: 08/25/2022] [Indexed: 11/11/2022]
Abstract
The development of a safe and effective vaccine is essential to protect populations against coronavirus disease 2019 (COVID-19). There are several vaccine candidates under investigation with different mechanisms of action. In the present study, we have evaluated the safety and immunogenicity of a recombinant receptor-binding domain (RBD)-based protein subunit vaccine (Noora vaccine) against COVID-19 in adults. This Phase 1 trial is a randomized, double-blind, placebo-controlled study to evaluate the safety and immunogenicity of the recombinant RBD-based protein subunit vaccine (Noora vaccine) against COVID-19 in healthy adults volunteers. Eligible participants were included in this study after evaluating their health status and considering the exclusion criteria. They were then randomized into three groups and received three doses of vaccine (80 µg, 120 µg, and placebo) on Days 0, 21, and 35. Primary outcomes including solicited, unsolicited, and medically attended adverse events were recorded during this study. Secondary outcomes including the humoral and cellular immunity (including anti-RBD IgG antibody and neutralizing antibody) were measured on Days 0, 21, 28, 35, 42, and 49 by using the ELISA kit and the Virus Neutralization Test (VNT) was performed on day 49. Totally 70 cases were included in this Phase 1 trial and 60 of them completed the study. Safety assessments showed no severe adverse events. Local pain at the vaccine injection site occurred in 80% of the vaccinated volunteers. Induration and redness at the injection site were the other adverse reactions of this vaccine. There was no significant difference between the studied groups regarding adverse reactions. Anti-RBD IgG antibody and neutralizing antibody assessment showed significant seroconversion in comparison to the placebo group (80%, and 100% respectively, p < 0.001). The cellular immunity panel also showed mild to moderate induction of TH1 responses and the VNT showed 78% of seroprotection. The results of this Phase 1 trial showed acceptable safety without serious adverse events and significant seroconversions in the humoral and cellular immunity panel. The dose of 80 µg is an appropriate dose for injection in the next phases of the trial.
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Affiliation(s)
- Jafar Salimian
- Applied Microbiology Research Center, Systems Biology and Poisonings InstituteBaqiyatallah University of Medical SciencesTehranIran
- Chemical Injuries Research CenterBaqiyatallah University of Medical SciencesTehranIran
| | - Ali Ahmadi
- Molecular Biology Research Center, Systems Biology and Poisonings InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Jafar Amani
- Applied Microbiology Research Center, Systems Biology and Poisonings InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Gholamreza Olad
- Applied Biotechnology Research CenterBaqiyatallah University of Medical SciencesTehranIran
| | - Raheleh Halabian
- Applied Microbiology Research Center, Systems Biology and Poisonings InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Ali Saffaei
- Department of Clinical Pharmacy, School of PharmacyShahid Beheshti University of Medical SciencesTehranIran
- Student Research CommitteeShahid Beheshti University of Medical SciencesTehranIran
- Skull Base Research Center, Loghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Masoud Arabfard
- Chemical Injuries Research CenterBaqiyatallah University of Medical SciencesTehranIran
| | - Mojtaba Nasiri
- Clinical Trial CenterTehran University of Medical SciencesTehranIran
| | - Shahram Nazarian
- Department of Biology, Faculty of ScienceImam Hossein UniversityTehranIran
| | - Hassan Abolghasemi
- Applied Microbiology Research Center, Systems Biology and Poisonings InstituteBaqiyatallah University of Medical SciencesTehranIran
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35
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Hsu CY, Chang JC, Chen SLS, Chang HH, Lin ATY, Yen AMF, Chen HH. Primary and booster vaccination in reducing severe clinical outcomes associated with Omicron Naïve infection. J Infect Public Health 2023; 16:55-63. [PMID: 36470007 PMCID: PMC9708104 DOI: 10.1016/j.jiph.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Little is known about long-term effectiveness of COVID-19 vaccine in reducing severity and deaths associated with Omicron VOC not perturbed by prior infection and independent of oral anti-viral therapy and non-pharmaceutical (NPI). METHODS A retrospective observational cohort study was applied to Taiwan community during the unprecedent large-scale outbreaks of Omicron BA.2 between April and August, 2022. Primary vaccination since March, 2021 and booster vaccination since January, 2022 were offered on population level. Oral Anti-viral therapy was also offered as of mid-May 2022. The population-based effectiveness of vaccination in reducing the risk of moderate and severe cases of and death from Omicron BA.2 with the consideration of NPI and oral anti-viral therapy were assessed by using Bayesian hierarchical models. RESULTS The risks of three clinical outcomes associated with Omicron VOC infection were lowest for booster vaccination, followed by primary vaccination, and highest for incomplete vaccination with the consistent trends of being at increased risk for three outcomes from the young people aged 12 years or below until the elderly people aged 75 years or older with 7 age groups. Before the period using oral anti-viral therapy, complete primary vaccination with the duration more than 9 months before outbreaks conferred the statistically significant 47 % (23-64 %) reduction of death, 48 % (30-61 %) of severe disease, and 46 % (95 % CI: 37-54 %) of moderate disease after adjusting for 10-20 % independent effect of NPI. The benefits of booster vaccination within three months were further enhanced to 76 % (95 % CI: 67-86 %), 74 % (95 % CI: 67-80 %), and 61 % (95 % CI: 56-65 %) for three corresponding outcomes. The additional effectiveness of oral anti-viral therapy in reducing moderate disease was 13 % for the booster group and 5.8 % for primary vaccination. CONCLUSIONS We corroborated population effectiveness of primary vaccination and its booster vaccination, independent of oral anti-viral therapy and NPI, in reducing severe clinical outcomes associated with Omicron BA.2 naïve infection population.
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Affiliation(s)
- Chen-Yang Hsu
- Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan; Daichung Hospital, Miaoli, Taiwan
| | - Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei,Taiwan
| | - Sam Li-Shen Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hao-Hsiang Chang
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Abbie Ting-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Amy Ming-Feng Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
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36
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Cunha MCA, Schardong J, Righi NC, Lunardi AC, Sant'Anna GN, Isensee LP, Xavier RF, Pompeu JE, Weigert RM, Matte DL, Cardoso RA, Abras ACV, Silva AMV, Dorneles CC, Werle RW, Starke AC, Ferreira JC, Plentz RDM, Carvalho CRF. Aging-related predictive factors for oxygenation improvement and mortality in COVID-19 and acute respiratory distress syndrome (ARDS) patients exposed to prone position: A multicenter cohort study. Clinics (Sao Paulo) 2023; 78:100180. [PMID: 36972632 PMCID: PMC9995337 DOI: 10.1016/j.clinsp.2023.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/31/2023] [Accepted: 02/17/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Elderly patients are more susceptible to Coronavirus Disease-2019 (COVID-19) and are more likely to develop it in severe forms, (e.g., Acute Respiratory Distress Syndrome [ARDS]). Prone positioning is a treatment strategy for severe ARDS; however, its response in the elderly population remains poorly understood. The main objective was to evaluate the predictive response and mortality of elderly patients exposed to prone positioning due to ARDS-COVID-19. METHODS This retrospective multicenter cohort study involved 223 patients aged ≥ 65 years, who received prone position sessions for severe ARDS due to COVID-19, using invasive mechanical ventilation. The PaO2/FiO2 ratio was used to assess the oxygenation response. The 20-point improvement in PaO2/FiO2 after the first prone session was considered for good response. Data were collected from electronic medical records, including demographic data, laboratory/image exams, complications, comorbidities, SAPS III and SOFA scores, use of anticoagulants and vasopressors, ventilator settings, and respiratory system mechanics. Mortality was defined as deaths that occurred until hospital discharge. RESULTS Most patients were male, with arterial hypertension and diabetes mellitus as the most prevalent comorbidities. The non-responders group had higher SAPS III and SOFA scores, and a higher incidence of complications. There was no difference in mortality rate. A lower SAPS III score was a predictor of oxygenation response, and the male sex was a risk predictor of mortality. CONCLUSION The present study suggests the oxygenation response to prone positioning in elderly patients with severe COVID-19-ARDS correlates with the SAPS III score. Furthermore, the male sex is a risk predictor of mortality.
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Affiliation(s)
- Marieta C A Cunha
- Pulmonary Division, Heart Institute, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jociane Schardong
- Physiotherapy Service, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Natiele C Righi
- Physiotherapy Service, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Adriana C Lunardi
- Department of Physical Therapy, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Guadalupe N Sant'Anna
- Department of Physical Therapy, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Larissa P Isensee
- Department of Physical Therapy, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rafaela F Xavier
- Department of Physical Therapy, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jose E Pompeu
- Department of Physical Therapy, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ranata M Weigert
- Department of Physical Therapy, Tacchini Hospital, Bento Gonçalves, RS, Brazil
| | - Darlan L Matte
- Department of Neuroscience, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
| | - Rozana A Cardoso
- Department of Physical Therapy, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Ana C V Abras
- Department of Physical Therapy, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Antonio M V Silva
- Department of Physiotherapy and Rehabilitation, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Camila C Dorneles
- Santa Maria University Hospital, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Roberta W Werle
- Santa Maria University Hospital, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Ana C Starke
- University Hospital Polydoro Ernani de São Thiago, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Juliana C Ferreira
- Pulmonary Division, Heart Institute, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rodrigo D M Plentz
- Physiotherapy Service, Irmandade Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Celso R F Carvalho
- Department of Physical Therapy, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
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Sun R, Jiang K, Zeng C, Zhu R, Chu H, Liu H, Du J. Synergism of TNF-α and IFN-β triggers human airway epithelial cells death by apoptosis and pyroptosis. Mol Immunol 2023; 153:160-169. [PMID: 36508750 PMCID: PMC9733417 DOI: 10.1016/j.molimm.2022.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/19/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022]
Abstract
Cytokine release syndrome, also called cytokine storm, could cause lung tissue damage, acute respiratory distress syndrome (ARDS) and even death during SARS-CoV-2 infection. However, the underlying mechanisms of cytokine storm still remain unknown. Among these cytokines, the function of TNF-α and type I IFNs especially deserved further investigation. Here, we first found that TNF-α and IFN-β synergistically induced human airway epithelial cells BEAS-2B death. Mechanistically, the combination of TNF-α and IFN-β led to the activation of caspase-8 and caspase-3, which initiated BEAS-2B apoptosis. The activated caspase-8 and caspase-3 could further induce the cleavage and activation of gasdermin D (GSDMD) and gasdermin E (GSDME), which finally resulted in pro-inflammatory pyroptosis. The knock-down of caspase-8 and caspase-3 could effectively block the activation of GSDMD and GSDME, and then the death of BEAS-2B induced by TNF-α and IFN-β. In addition, pan-caspase inhibitor Z-VAD-FMK (ZVAD) and necrosulfonamide (NSA) could inhibit BEAS-2B death induced by TNF-α and IFN-β. Overall, our work revealed one possible mechanism that cytokine storm causes airway epithelial cells (AECs) damage and ARDS. These results indicated that blocking TNF-α and IFN-β-mediated AECs death may be a potential target to treat related viral infectious diseases, such as COVID-19.
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Affiliation(s)
- Rui Sun
- Department of Clinical Immunology, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Kaimin Jiang
- Department of Clinical Immunology, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Chengyue Zeng
- Department of Clinical Immunology, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Rui Zhu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Hanyu Chu
- Department of Clinical Immunology, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Huiyong Liu
- Department of Clinical Immunology, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Jingchun Du
- Department of Clinical Immunology, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510182, China,Guangzhou Key Laboratory of Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, Guangzhou Medical University, Guangzhou, Guangdong 510182, China,Corresponding author at: Department of Clinical Immunology, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510182, China
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38
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Gil S, de Oliveira Júnior GN, Sarti FM, Filho WJ, Longobardi I, Turri JAO, Shinjo SK, Ferriolli E, Avelino-Silva TJ, Busse AL, Gualano B, Roschel H. Acute Muscle Mass Loss Predicts Long-Term Fatigue, Myalgia, and Health Care Costs in COVID-19 Survivors. J Am Med Dir Assoc 2023; 24:10-16. [PMID: 36493804 PMCID: PMC9682050 DOI: 10.1016/j.jamda.2022.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/07/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We examined the impact of loss of skeletal muscle mass in post-acute sequelae of SARS-CoV-2 infection, hospital readmission rate, self-perception of health, and health care costs in a cohort of COVID-19 survivors. DESIGN Prospective observational study. SETTING AND PARTICIPANTS Tertiary Clinical Hospital. Eighty COVID-19 survivors age 59 ± 14 years were prospectively assessed. METHODS Handgrip strength and vastus lateralis muscle cross-sectional area were evaluated at hospital admission, discharge, and 6 months after discharge. Post-acute sequelae of SARS-CoV-2 were evaluated 6 months after discharge (main outcome). Also, health care costs, hospital readmission rate, and self-perception of health were evaluated 2 and 6 months after hospital discharge. To examine whether the magnitude of muscle mass loss impacts the outcomes, we ranked patients according to relative vastus lateralis muscle cross-sectional area reduction during hospital stay into either "high muscle loss" (-18 ± 11%) or "low muscle loss" (-4 ± 2%) group, based on median values. RESULTS High muscle loss group showed greater prevalence of fatigue (76% vs 46%, P = .0337) and myalgia (66% vs 36%, P = .0388), and lower muscle mass (-8% vs 3%, P < .0001) than low muscle loss group 6 months after discharge. No between-group difference was observed for hospital readmission and self-perceived health (P > .05). High muscle loss group demonstrated greater total COVID-19-related health care costs 2 ($77,283.87 vs. $3057.14, P = .0223, respectively) and 6 months ($90,001.35 vs $12, 913.27, P = .0210, respectively) after discharge vs low muscle loss group. Muscle mass loss was shown to be a predictor of total COVID-19-related health care costs at 2 (adjusted β = $10, 070.81, P < .0001) and 6 months after discharge (adjusted β = $9885.63, P < .0001). CONCLUSIONS AND IMPLICATIONS COVID-19 survivors experiencing high muscle mass loss during hospital stay fail to fully recover muscle health. In addition, greater muscle loss was associated with a higher frequency of post-acute sequelae of SARS-CoV-2 and greater total COVID-19-related health care costs 2 and 6 months after discharge. Altogether, these data suggest that the loss of muscle mass resulting from COVID-19 hospitalization may incur in an economical burden to health care systems.
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Affiliation(s)
- Saulo Gil
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Gersiel Nascimento de Oliveira Júnior
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Flavia Mori Sarti
- School of Arts, Sciences and Humanities, University of São Paulo (USP), São Paulo, Brazil, SP, BR
| | - Wilson Jacob Filho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Igor Longobardi
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | | | - Samuel Katsuyuki Shinjo
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Eduardo Ferriolli
- Division of Internal and Geriatric Medicine, Department of Internal Medicine - Ribeirão Preto Medical School, Universidade de Sao Paulo, Ribeirao Preto, SP, BR
| | - Thiago Junqueira Avelino-Silva
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Alexandre Leopold Busse
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil; Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
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Zhang Y, Zhang J, Fu Z. Role of autophagy in lung diseases and ageing. Eur Respir Rev 2022; 31:31/166/220134. [PMID: 36543345 PMCID: PMC9879344 DOI: 10.1183/16000617.0134-2022] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022] Open
Abstract
The lungs face ongoing chemical, mechanical, biological, immunological and xenobiotic stresses over a lifetime. Advancing age progressively impairs lung function. Autophagy is a "housekeeping" survival strategy involved in numerous physiological and pathological processes in all eukaryotic cells. Autophagic activity decreases with age in several species, whereas its basic activity extends throughout the lifespan of most animals. Dysregulation of autophagy has been proven to be closely related to the pathogenesis of several ageing-related pulmonary diseases. This review summarises the role of autophagy in the pathogenesis of pulmonary diseases associated with or occurring in the context of ageing, including acute lung injury, chronic obstructive pulmonary disease, asthma and pulmonary fibrosis, and describes its potential as a therapeutic target.
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Affiliation(s)
- Yan Zhang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jin Zhang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhiling Fu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China,Corresponding author: Zhiling Fu ()
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Gobbi M, Brunani A, Arreghini M, Baccalaro G, Dellepiane D, La Vela V, Lucchetti E, Barbaglia M, Cova A, Fornara E, Galli S, Cimolin V, Brugliera L, Capodaglio P. Nutritional status in post SARS-Cov2 rehabilitation patients. Clin Nutr 2022; 41:3055-3060. [PMID: 34049750 PMCID: PMC8056781 DOI: 10.1016/j.clnu.2021.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/22/2020] [Accepted: 04/07/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS After prolonged hospitalization, the assessment of nutritional status and the identification of adequate nutritional support is of paramount importance. In this observational study, we aimed at assessing the presence of a malnutrition condition in SARS-Cov2 patients after the acute phase and the effects of a multidisciplinary rehabilitation program on nutritional and functional status. METHODS We recruited 48 patients (26 males/22 females) admitted to our Rehabilitation Unit after discharge from acute Covid Hospitals in northern Italy with negative swab for SARS-Cov2. We used the Global Leadership Initiative on Malnutrition (GLIM) criteria to identify patients with different degrees of malnutrition. Patients underwent a 3 to 4-week individual multidisciplinary rehabilitation program consisting of nutritional intervention (energy intake 27to30 kcal/die/kg and protein intake 1-1.3 g/die/kg), exercise for total body conditioning and progressive aerobic exercise with cycle- and arm-ergometer (45 min, 5 days/week). At admission and discharge from our Rehabilitation Unit, body composition and phase angle (PhA) (BIA101 Akern), muscle strength (handgrip, HG) and physical performance (Timed-Up-and-Go, TUG) were assessed. RESULTS At admission in all patients the mean weight loss, as compared to the habitual weight, was -12.1 (7.6)%, mean BMI was 25.9 (7.9) kg/m2, mean Appendicular Skeletal Muscle Index (ASMI) was 6.6 (1.7) kg/m2 for males and 5.4 (1.4) kg/m2 for females, mean phase angle was 2.9 (0.9)°, mean muscle strength (HG) was 21.1 (7.8) kg for males and 16.4 (5.9) kg for females, mean TUG value was 23.7 (19.2) s. Based on GLIM criteria 29 patients (60% of the total) showed a malnutrition condition. 7 out of those 29 patients (24%) presented a mild/moderate grade and 22 patients (76%) a severe grade. After a rehabilitation program of an average duration of 25 days (range 13-46) ASMI increased, with statistically significant differences only in females (p = 0.001) and HG improved only in males (p = 0.0014). In all of the patients, body weight did not change, CRP/albumin (p < 0.05) and TUG (p < 0.001) were reduced and PhA increased (p < 0.01). CONCLUSIONS We diagnosed a malnutrition condition in 60% of our post SARS-Cov2 patients. An individualized nutritional intervention with adequate energy and protein intake combined with tailored aerobic and strengthening exercise improved nutritional and functional status.
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Affiliation(s)
- M. Gobbi
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy,Corresponding author
| | - A. Brunani
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - M. Arreghini
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - G. Baccalaro
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - D. Dellepiane
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - V. La Vela
- Department of Clinical Nutrition and Eating Disorder, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - E. Lucchetti
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - M. Barbaglia
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - A. Cova
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - E. Fornara
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - S. Galli
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - V. Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico of Milano, Milan, Italy
| | - L. Brugliera
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - P. Capodaglio
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy,Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, Turin, Italy
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Charles J, Ploplis VA. COVID-19 Induces Cytokine Storm and Dysfunctional Hemostasis. Curr Drug Targets 2022; 23:1603-1610. [PMID: 36284376 DOI: 10.2174/1389450124666221025102929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Infection with SARS-CoV-2 leads to COVID-19 which can manifest in various ways from asymptomatic or mild disease to acute respiratory distress syndrome. The occurrence of dysregulated inflammatory responses in the form of a cytokine storm has been reported in patients with severe COVID-19. Infection can also lead to dysfunctional hemostasis reflected in elevated circulating D-dimer and fibrin degradation products. Components of hemostasis and the immune system during infection can result in a procoagulation and/or proinflammatory state. The interplay between coagulation and inflammation has been elucidated in a number of diseases. OBJECTIVE In this article, we discuss the occurrence of cytokine storms and dysfunctional hemostasis induced in COVID-19. METHODS This review was written using literature from the past two to three years investigating coagulation and inflammation in COVID-19. Additional literature, both clinical and basic research, related to pathogen infection and host responses were also considered in this review. RESULTS/CONCLUSIONS Infection with SARS-CoV-2 can lead to dysregulated inflammatory responses that may be detrimental to the host. The increased expression of various inflammatory factors can ultimately create an environment that promotes thrombosis.
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Affiliation(s)
- Jermilia Charles
- W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN 46556, USA
| | - Victoria A Ploplis
- W.M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN 46556, USA
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42
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Tizazu AM, Mengist HM, Demeke G. Aging, inflammaging and immunosenescence as risk factors of severe COVID-19. IMMUNITY & AGEING 2022; 19:53. [PMID: 36369012 PMCID: PMC9650172 DOI: 10.1186/s12979-022-00309-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/13/2022] [Indexed: 11/13/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is characterized by having a heterogeneous disease course, ranging from asymptomatic and mild symptoms to more severe and critical cases. In most cases the severity of COVID-19 is related to host factors, especially deregulation of the immune response in patients. Even if COVID-19 indiscriminately affects individuals of different age group, ethnicity and economic status; most severe cases and disproportional mortality occur in elderly individuals. This point out that aging is one risk factor for unfavourable clinical outcomes among COVID-19 patients. The biology of aging is a complex process; Aging can alter the structure and function of cells, tissues, and organs resulting in impaired response to stress. Alongside with other systems, the immune system is also affected with the aging process. Immunosenescence is an age associated change in the immune system that affects the overall response to immunological challenges in the elderly. Similarly, apart from the normal inflammatory process, aging is associated with a low grade, sterile, chronic inflammation which is termed as inflammaging. We hypothesized that inflammaging and immunosenescence could play an important role in SARS-CoV-2 pathogenesis and poor recovery from COVID-19 in elderly individuals. This review summarizes the changes in the immune system with age and how these changes play part in the pathogenesis of SARS-CoV-2 and clinical outcome of COVID-19 which could add to the understanding of age associated targeted immunotherapy in the elderly.
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43
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Wu S, Lin S, Zhang X, Alizada M, Wang L, Zheng Y, Ke Q, Xu J. Recent advances in cell-based and cell-free therapeutic approaches for sarcopenia. FASEB J 2022; 36:e22614. [PMID: 36250337 DOI: 10.1096/fj.202200675r] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/02/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022]
Abstract
Sarcopenia is a progressive loss of muscle mass and function that is connected with increased hospital expenditures, falls, fractures, and mortality. Although muscle loss has been related to aging, injury, hormonal imbalances, and diseases such as malignancies, chronic obstructive pulmonary disease, heart failure, and kidney failure, the underlying pathogenic mechanisms of sarcopenia are unclear. Exercise-based interventions and multimodal strategies are currently being considered as potential therapeutic approaches to prevent or treat these diseases. Although drug therapy research is ongoing, no drug has yet been proven to have a substantial safety and clinical value to be the first drug therapy to be licensed for sarcopenia. To better understand the molecular alterations underlying sarcopenia and effective treatments, we review leading research and available findings from the systemic change to the muscle-specific microenvironment. Furthermore, we explore possible mechanisms of sarcopenia and provide new knowledge for the development of novel cell-free and cell-based therapeutics. This review will assist researchers in developing better therapies to improve muscle health in the elderly.
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Affiliation(s)
- Shiqiang Wu
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Group of Neuroendocrinology, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Xiaolu Zhang
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Mujahid Alizada
- Department of Neurosurgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Liangmin Wang
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yiqiang Zheng
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qingfeng Ke
- Department of Orthopedic, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jie Xu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Orthopedic, Fujian Provincial Hospital, Fuzhou, China
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44
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Neuro–Immune Interactions in Severe COVID-19 Infection. Pathogens 2022; 11:pathogens11111256. [PMID: 36365007 PMCID: PMC9699641 DOI: 10.3390/pathogens11111256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 is a new coronavirus that has affected the world since 2019. Interstitial pneumonia is the most common clinical presentation, but additional symptoms have been reported, including neurological manifestations. Severe forms of infection, especially in elderly patients, present as an excessive inflammatory response called “cytokine storm”, which can lead to acute respiratory distress syndrome (ARDS), multiorgan failure and death. Little is known about the relationship between symptoms and clinical outcomes or the characteristics of virus–host interactions. The aim of this narrative review is to highlight possible links between neurological involvement and respiratory damage mediated by pathological inflammatory pathways in SARS-CoV-2 infection. We will focus on neuro–immune interactions and age-related immunity decline and discuss some pathological mechanisms that contribute to negative outcomes in COVID-19 patients. Furthermore, we will describe available therapeutic strategies and their effects on COVID-19 neurological symptoms.
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45
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Tarantino U, Visconti VV, Bonanni R, Gatti A, Marcozzi M, Calabrò D, Cariati I. Osteosarcopenia and Long-COVID: a dangerous combination. Ther Adv Musculoskelet Dis 2022; 14:1759720X221130485. [PMID: 36317068 PMCID: PMC9614591 DOI: 10.1177/1759720x221130485] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
SARS-CoV-2 has caused a global pandemic and an unprecedented public health crisis, infecting more than 580 million people worldwide. Moreover, recent evidence has suggested the emergence of a new syndrome known as Long-COVID, a term used to describe a diverse set of physical and mental symptoms that persist after a diagnosed SARS-CoV-2 infection. Epidemiological data have identified myalgias, muscle and joint dysfunction, and bone fragility as common sequelae in patients with moderate and severe forms of this disease. Significant musculoskeletal dysfunction has also been detected in some healed patients, although knowledge about pathophysiological mechanisms of Long-COVID is still rather scarce. In this context, SARS-CoV-2 infection has been suggested to amplify the effects of aging on the musculoskeletal system by aggravating the osteosarcopenic state. Based on this evidence, our review focused on the muscle and bone tissue alterations induced by SARS-CoV-2 infection and Long-COVID, summarizing the current knowledge on the underlying biological mechanisms and highlighting the need for a multidisciplinary approach to predict the musculoskeletal targets and long-term consequences of COVID-19 disease.
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Affiliation(s)
- Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, University of Rome ‘Tor Vergata’, Rome, Italy,Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
| | - Virginia V. Visconti
- Department of Clinical Sciences and Translational Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
| | - Roberto Bonanni
- Department of Clinical Sciences and Translational Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
| | - Andrea Gatti
- Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
| | - Martina Marcozzi
- Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
| | - Davide Calabrò
- Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
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Pushpalata Zanwar P, Perianayagam A, Zazdravnykh E, Omar Z, Vinod Joseph KJ, Santos FH, Negm AM, Reistetter TA, Heyn PC, Kelekar U. Examining the Impacts of Coronavirus Disease 2019 Mitigation Policies on Health Outcomes of Older Adults: Lessons Learned From Six High-Income or Middle-Income Countries. THE PUBLIC POLICY AND AGING REPORT 2022; 32:121-130. [PMID: 36349280 PMCID: PMC9619694 DOI: 10.1093/ppar/prac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Preeti Pushpalata Zanwar
- Address correspondence to: Preeti Zanwar, PhD, MPH, MS, Jefferson College of Population Health, Thomas Jefferson University, 901 Walnut Street, 10th Floor, Philadelphia, Pennsylvania, 19107, USA.
| | - Arokiasamy Perianayagam
- International Institute for Population Sciences, Mumbai, India,National Council of Applied Economic Research (NCAER), Delhi, India
| | - Evguenii Zazdravnykh
- Department of Management, International Centre of Health Economics, Policy, and Management, HSE University, St. Petersburg, Russia
| | - Zaliha Omar
- Department of Rehabilitation Medicine, Fujita Health University, Toyoake, Aichi, Japan,Department of Rehabilitation Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - K J Vinod Joseph
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Flavia H Santos
- Centre for Disability Studies, University College Dublin, Ireland
| | - Ahmed M Negm
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Timothy A Reistetter
- Department of Occupational Therapy, School of Health Professions, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Patricia C Heyn
- Marymount Center for Optimal Aging, Marymount University, Arlington, Virginia, USA
| | - Uma Kelekar
- Marymount Center for Optimal Aging, Marymount University, Arlington, Virginia, USA,School of Business, Innovation, Leadership and Technology, Marymount University, Arlington, Virginia, USA
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47
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Lewis ED, Wu D, Meydani SN. Age-associated alterations in immune function and inflammation. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110576. [PMID: 35588939 DOI: 10.1016/j.pnpbp.2022.110576] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Immunosenescence is a term used to describe the age-related changes in the immune system. Immunosenescence is associated with complex alterations and dysregulation of immune function and inflammatory processes. Age-related changes in innate immune responses including alterations in chemotactic, phagocytic, and natural killing functions, impaired antigen presenting capacity, and dysregulated inflammatory response have been described. The most striking and best characterized feature of immunosenescence is the decline in both number and function of T cells. With age there is decreased proliferation, decreased number of antigen-naïve T cells, and increased number of antigen-experienced memory T cells. This decline in naïve T cell population is associated with impaired immunity and reduced response to new or mutated pathogens. While the absolute number of peripheral B cells appears constant with age, changes in B cell functions including reduced antibody production and response and cell memory have been described. However, the main alteration in cell-mediated function that has been reported across all species with aging is those observed in in T cell. These T cell mediated changes have been shown to contribute to increased susceptibility to infection and cancer in older adults. In addition to functional and phenotype alterations in immune cells, studies demonstrate that circulating concentrations of inflammatory mediators in older adults are higher than those of young. This low grade, chronic inflammatory state that occurs in the context of aging has been termed "inflammaging". This review will focus on age-related changes in the immune system including immunosenescence and inflammation as well as the functional consequences of these age-related alterations for the aged.
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Affiliation(s)
- Erin Diane Lewis
- Nutritional Immunology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, United States of America
| | - Dayong Wu
- Nutritional Immunology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, United States of America
| | - Simin Nikbin Meydani
- Nutritional Immunology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, United States of America.
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Khoshmirsafa M, Assarehzadegan MA, Fallahpour M, Azimi M, Faraji F, Riahi T, Minaeian S, Fassahat D, Divsalar F, Abbasi MA. Expression Pattern of Inflammatory and Anti-Inflammatory Cytokines and Key Differential Transcription Factors in Peripheral Blood Mononuclear Cells of Iranian Coronavirus Disease 2019 Patients with Different Disease Severity. Viral Immunol 2022; 35:474-482. [PMID: 35997599 DOI: 10.1089/vim.2021.0224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of this research was to investigate the gene expression levels of inflammatory cytokines interferon (IFN)γ, tumor necrosis factor (TNF)α, interleukin (IL)1β, IL2, IL6, IL8, and IL17, and anti-inflammatory cytokines IL4, IL10, IFNα, and IFNβ, as well as relevant key transcription factors (TFs), including GATA3, PU1, NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells), IRF3 (interferon regulatory factor 3), BCL6 (B cell lymphoma 6 protein), FOXP3 (forkhead box P3), RORγt, and T-bet (T-box expressed in T cell) in Iranian patients with moderate and severe coronavirus disease 2019 (COVID-19). Fifty-six patients with COVID-19, and 25 healthy controls (HCs) age and sex matched were investigated. Based on the interim guidance of COVID-19 from the World Health Organization, the patients were classified into 33 moderate and 23 severe patients with COVID-19. The gene expression levels of cytokines and relevant TFs were quantified in peripheral blood mononuclear cells by quantitative real-time polymerase chain reaction (qRT-PCR). The gene expression levels of TFs RoRγ (RAR-related orphan nuclear receptor γ), NF-κB, and T-bet were significantly higher in patients with COVID-19 compared with HCs. Furthermore, the gene expression levels of cytokines, including IL2, IFNγ, IL6, TNFα, IL1β, IL8, and IL17, were significantly higher in patients with COVID-19 than HCs. However, there was a significant increase for IL6, TNFα, and IL17 in severe compared with moderate patients with COVID-19. Finally, The Spearman correlation analysis revealed a significantly positive correlation for IL6 and TNFα, IL6 and IL2, IL6, IFNγ, and IL2 and IFNγ. These data suggest that expression of IL6, TNFα, and IL17 as well as the synergic effect of elevated values of IL2 and IFNγ should be considered in the treatment and management of patients with severe COVID-19.
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Affiliation(s)
- Majid Khoshmirsafa
- Immunology Research Center, Institute of Immunology and Infectious Diseases; Iran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine; Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Ali Assarehzadegan
- Immunology Research Center, Institute of Immunology and Infectious Diseases; Iran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine; Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Fallahpour
- Allergy and Clinical Immunology Department, Rasool e Akram Hospital; Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Azimi
- Immunology Research Center, Institute of Immunology and Infectious Diseases; Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Faraji
- Immunology Research Center, Institute of Immunology and Infectious Diseases; Iran University of Medical Sciences, Tehran, Iran
| | - Taghi Riahi
- Rasoul-e-Akram Hospital; Iran University of Medical Sciences, Tehran, Iran
| | - Sara Minaeian
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases; Iran University of Medical Sciences, Tehran, Iran
| | - Davood Fassahat
- Firoozabadi Clinical Research Development (FCRDU); Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Divsalar
- Firoozabadi Clinical Research Development (FCRDU); Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Abbasi
- Firoozabadi Clinical Research Development (FCRDU); Iran University of Medical Sciences, Tehran, Iran
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Matysek A, Studnicka A, Smith WM, Hutny M, Gajewski P, Filipiak KJ, Goh J, Yang G. Influence of Co-morbidities During SARS-CoV-2 Infection in an Indian Population. Front Med (Lausanne) 2022; 9:962101. [PMID: 35979209 PMCID: PMC9377050 DOI: 10.3389/fmed.2022.962101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Since the outbreak of COVID-19 pandemic the interindividual variability in the course of the disease has been reported, indicating a wide range of factors influencing it. Factors which were the most often associated with increased COVID-19 severity include higher age, obesity and diabetes. The influence of cytokine storm is complex, reflecting the complexity of the immunological processes triggered by SARS-CoV-2 infection. A modern challenge such as a worldwide pandemic requires modern solutions, which in this case is harnessing the machine learning for the purpose of analysing the differences in the clinical properties of the populations affected by the disease, followed by grading its significance, consequently leading to creation of tool applicable for assessing the individual risk of SARS-CoV-2 infection. Methods Biochemical and morphological parameters values of 5,000 patients (Curisin Healthcare (India) were gathered and used for calculation of eGFR, SII index and N/L ratio. Spearman's rank correlation coefficient formula was used for assessment of correlations between each of the features in the population and the presence of the SARS-CoV-2 infection. Feature importance was evaluated by fitting a Random Forest machine learning model to the data and examining their predictive value. Its accuracy was measured as the F1 Score. Results The parameters which showed the highest correlation coefficient were age, random serum glucose, serum urea, gender and serum cholesterol, whereas the highest inverse correlation coefficient was assessed for alanine transaminase, red blood cells count and serum creatinine. The accuracy of created model for differentiating positive from negative SARS-CoV-2 cases was 97%. Features of highest importance were age, alanine transaminase, random serum glucose and red blood cells count. Conclusion The current analysis indicates a number of parameters available for a routine screening in clinical setting. It also presents a tool created on the basis of these parameters, useful for assessing the individual risk of developing COVID-19 in patients. The limitation of the study is the demographic specificity of the studied population, which might restrict its general applicability.
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Affiliation(s)
- Adrian Matysek
- Immunidex Ltd., London, United Kingdom
- Cognescence Ltd., London, United Kingdom
| | - Aneta Studnicka
- Clinical Analysis Laboratory, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Wade Menpes Smith
- Immunidex Ltd., London, United Kingdom
- Cognescence Ltd., London, United Kingdom
| | - Michał Hutny
- Faculty of Medical Sciences in Katowice, Students’ Scientific Society, Medical University of Silesia, Katowice, Poland
| | - Paweł Gajewski
- AGH University of Science and Technology, Krakow, Poland
| | | | - Jorming Goh
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- National University Health System (NUHS), Centre for Healthy Longevity, Singapore, Singapore
| | - Guang Yang
- Cardiovascular Research Centre, Royal Brompton Hospital, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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50
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Developing New Treatments for COVID-19 through Dual-Action Antiviral/Anti-Inflammatory Small Molecules and Physiologically Based Pharmacokinetic Modeling. Int J Mol Sci 2022; 23:ijms23148006. [PMID: 35887353 PMCID: PMC9325261 DOI: 10.3390/ijms23148006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 01/27/2023] Open
Abstract
Broad-spectrum antiviral agents that are effective against many viruses are difficult to develop, as the key molecules, as well as the biochemical pathways by which they cause infection, differ largely from one virus to another. This was more strongly highlighted by the COVID-19 pandemic, which found health systems all over the world largely unprepared and proved that the existing armamentarium of antiviral agents is not sufficient to address viral threats with pandemic potential. The clinical protocols for the treatment of COVID-19 are currently based on the use of inhibitors of the inflammatory cascade (dexamethasone, baricitinib), or inhibitors of the cytopathic effect of the virus (monoclonal antibodies, molnupiravir or nirmatrelvir/ritonavir), using different agents. There is a critical need for an expanded armamentarium of orally bioavailable small-molecular medicinal agents, including those that possess dual antiviral and anti-inflammatory (AAI) activity that would be readily available for the early treatment of mild to moderate COVID-19 in high-risk patients. A multidisciplinary approach that involves the use of in silico screening tools to identify potential drug targets of an emerging pathogen, as well as in vitro and in vivo models for the determination of a candidate drug’s efficacy and safety, are necessary for the rapid and successful development of antiviral agents with potentially dual AAI activity. Characterization of candidate AAI molecules with physiologically based pharmacokinetics (PBPK) modeling would provide critical data for the accurate dosing of new therapeutic agents against COVID-19. This review analyzes the dual mechanisms of AAI agents with potential anti-SARS-CoV-2 activity and discusses the principles of PBPK modeling as a conceptual guide to develop new pharmacological modalities for the treatment of COVID-19.
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