1
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Chen C, Chen Q, Zhang T, Ling Y. Coronary artery lesions in children with Kawasaki disease: status quo and nursing care. Front Cardiovasc Med 2024; 11:1272475. [PMID: 38711795 PMCID: PMC11070497 DOI: 10.3389/fcvm.2024.1272475] [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: 08/04/2023] [Accepted: 02/27/2024] [Indexed: 05/08/2024] Open
Abstract
Aim Coronary artery lesion (CAL) is a common yet serious complication in children with Kawasaki disease. The aim of the present study was to evaluate the influencing factors of CAL in children with Kawasaki disease, to provide reference for the clinical treatment and care of children with Kawasaki disease. Design A retrospective cohort study. Methods Children with Kawasaki disease treated in a tertiary hospital in China between 1 January 2021 and 31 December 2022 were selected. The characteristics and clinical data of children with Kawasaki disease were analyzed. Spearman's correlation analysis was conducted to evaluate the relationship between CAL and the characteristics of children with Kawasaki disease. A logistic regression analysis was used to analyze the influencing factors of CAL in children with Kawasaki disease. Results In total, 185 children with Kawasaki disease were included; the incidence of CAL in children with Kawasaki disease was 18.38%. Pearson's correlation analysis showed that gender (r = 0.504), age (r = 0.611), duration of fever ≥10 days (r = 0.579), hemoglobin (Hb) (r = 0.623), and C-reactive protein (CRP) (r = 0.558) were all correlated with the CAL in children with Kawasaki disease (all p < 0.05). Logistic regression analyses showed that male [odds ratio (OR) = 2.543, 95% confidence interval (CI): 1.801-3.077, p = 0.040], age ≤2 years (OR = 3.002, 95% CI: 2.744-3.641, p = 0.012), duration of fever ≥10 days (OR = 2.089, 95% CI: 1.624-2.515, p = 0.028), Hb ≤105 g/L (OR = 1.914, 95% CI: 1.431-2.406, p = 0.013), and CRP ≥100 mg/L (OR = 2.168, 95% CI: 1.893-2.531, p = 0.035) were the risk factors of CAL in children with Kawasaki disease (all p < 0.05). Conclusions The incidence of CAL in children with Kawasaki disease is high and there are many related risk factors. Clinical medical workers should take early warning and carry out interventions and nursing care according to these risk factors to improve the prognosis of children with Kawasaki disease.
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Affiliation(s)
| | | | | | - Yanping Ling
- Department of Nursing, Children’s Hospital of Nanjing Medical University, Nanjing, China
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2
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Abdeladim B, Massilia B, Aziza E, Zohair E, Ayad G, Maria R. Multisystem Inflammatory Syndrome in Children (MIS-C) in a Low-income Country: What Treatment Should be Adopted in Case of a Lack of Immunoglobulin? Rev Recent Clin Trials 2024; 19:150-157. [PMID: 38151848 DOI: 10.2174/0115748871257131231204114803] [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: 05/13/2023] [Revised: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 12/29/2023]
Abstract
INTRODUCTION In multisystem inflammatory syndrome (MIS-C), children typically present high-grade fever, gastrointestinal symptoms, Kawasaki-like symptoms, and even a toxic shock-like syndrome days to weeks after recovering from SARS-CoV-2 infection. It is important to raise awareness of this condition in order to have early diagnosis and immediate treatment of patients. We have, herein, reported 44 cases of MIS-C with various risk factors and symptoms. Furthermore, we have emphasized the efficacy of experience in treating children with MIS-C with high-dose corticosteroids as an alternative to immunoglobulin in low-income countries. METHODS We conducted a targeted survey of MIS-C from early May 2020 to October 2022 on 44 children and adolescents with characteristics of multisystem inflammatory syndrome admitted to the pediatric department of the university hospital center in Oujda, Morocco, to which patients diagnosed with MIS-C were referred. The case definition included six criteria: serious illness leading to hospitalization, age under 18 years, fever of at least 24 hours, laboratory evidence of inflammation, multi-organ involvement, biological inflammatory syndrome, and evidence of coronavirus infection based on polymerase chain reaction, antibody testing or exposure to people with COVID-19 in the past month. The criteria used to diagnose myocarditis were impaired left ventricular function, central mitral leak, and elevation of BNP or pro-BNP. Coronary involvement was assessed by the z-score and the criteria for its presence was a z-score equal to or greater than 2.5. RESULTS Our study included 44 children and adolescents with MIS-C in our hospital, with male predominance (79%) and a median age of six years. Cardiovascular involvement was present in 91%, mucocutaneous in 78%, gastrointestinal in 70%, hematologic in 84%, and respiratory in 2% of patients. Coronary abnormalities (z-score ≥ 2.5) were documented in 21 cases (48%). Glucocorticoids were frequently used in comparison to immunoglobulin, which were uncommonly available and expensive. CONCLUSION The therapeutic protocol that was adopted was high doses of short-term prednisone (Cortancyl) at 4mg/kg/day for 4 days. Favorable outcome was noted in all patients over a 2-year period.
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Affiliation(s)
| | - Bouhmidi Massilia
- Department of Pediatrics, University Hospital Center Mohamed VI OUJDA, Morocco
| | - Elouali Aziza
- Department of Pediatrics, University Hospital Center Mohamed VI OUJDA, Morocco
| | - Elhaddar Zohair
- Department of Pediatrics, University Hospital Center Mohamed VI OUJDA, Morocco
| | - Ghanam Ayad
- Department of Pediatrics, University Hospital Center Mohamed VI OUJDA, Morocco
| | - Rkain Maria
- Department of Pediatrics, University Hospital Center Mohamed VI OUJDA, Morocco
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3
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Johnson JN, Pouraliakbar H, Mahdavi M, Ranjbar A, Pfirman K, Mehra V, Ahmed S, Ba-Atiyah W, Galal MO, Zahr RA, Hussain N, Tadikamalla RR, Farah V, Dzelebdzic S, Muniz JC, Lee M, Williams J, Lee S, Aggarwal SK, Clark DE, Hughes SG, Ganigara M, Nagiub M, Hussain T, Kwok C, Lim HS, Nolan M, Kikuchi DS, Goulbourne CA, Sahu A, Sievers B, Sievers B, Sievers B, Garg R, Armas CR, Paleru V, Agarwal R, Rajagopal R, Bhagirath P, Kozor R, Aneja A, Tunks R, Chen SSM. Society for Cardiovascular Magnetic Resonance 2022 Cases of SCMR case series. J Cardiovasc Magn Reson 2023; 26:100007. [PMID: 38211509 DOI: 10.1016/j.jocmr.2023.100007] [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: 11/27/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024] Open
Abstract
"Cases of SCMR" is a case series on the SCMR website (https://www.scmr.org) for the purpose of education. The cases reflect the clinical presentation, and the use of cardiovascular magnetic resonance (CMR) in the diagnosis and management of cardiovascular disease. The 2022 digital collection of cases are presented in this manuscript.
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Affiliation(s)
- Jason N Johnson
- Division of Pediatric Cardiology and Pediatric Radiology, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdavi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolmohammad Ranjbar
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kristopher Pfirman
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Vishal Mehra
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Shahzad Ahmed
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Wejdan Ba-Atiyah
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammed Omar Galal
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Riad Abou Zahr
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Nasir Hussain
- Department of Advanced Cardiac Imaging, Allegheny General Hospital, Pittsburgh, PA, USA
| | | | - Victor Farah
- Department of Advanced Cardiac Imaging, Allegheny General Hospital, Pittsburgh, PA, USA
| | | | | | - Marc Lee
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jason Williams
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Simon Lee
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Daniel E Clark
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sean G Hughes
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Madhusudan Ganigara
- Division of Pediatric Cardiology, The University of Chicago & Biological Sciences, Chicago, IL, USA
| | - Mohamed Nagiub
- Division of Pediatric Cardiology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Cecilia Kwok
- Cardiology Department, Western Health, St Albans, Victoria, Australia
| | - Han S Lim
- Cardiology Department, Austin and Northern Health, University of Melbourne, Victoria, Australia
| | - Mark Nolan
- Cardiology Department, Western Health, St Albans, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Daniel S Kikuchi
- Osler Medical Residency, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Clive A Goulbourne
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Anurag Sahu
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Berge Sievers
- International School Düsseldorf, Düsseldorf, Germany
| | - Berk Sievers
- International School Düsseldorf, Düsseldorf, Germany
| | - Burkhard Sievers
- Department of Internal Medicine, Divisions of Cardiology, Pulmonology, Vascular Medicine, Nephrology and Intensive Care Medicine, Sana Klinikum Remscheid, Germany
| | - Rimmy Garg
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Carlos Requena Armas
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Vijayasree Paleru
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Ritu Agarwal
- Department of Radiology, Eternal Hospital, Jaipur, India
| | - Rengarajan Rajagopal
- Department of Radiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Pranav Bhagirath
- Department of Cardiology, St. Thomas Hospital, London, England, UK
| | - Rebecca Kozor
- Department of Cardiology, Royal North Shore Hospital, The University of Sydney, St Leonards, Australia
| | - Ashish Aneja
- Department of Cardiology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Robert Tunks
- Division of Pediatric Cardiology, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Sylvia S M Chen
- Adult Congenital Heart Disease, The Prince Charles Hospital, Australia.
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4
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Nasiri K, Tehrani S, Mohammadikhah M, Banakar M, Alaeddini M, Etemad‐Moghadam S, Fernandes GVO, Heboyan A, Imannezhad S, Abbasi F. Oral manifestations of COVID-19 and its management in pediatric patients: A systematic review and practical guideline. Clin Exp Dent Res 2023; 9:922-934. [PMID: 37602892 PMCID: PMC10582234 DOI: 10.1002/cre2.776] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023] Open
Abstract
OBJECTIVES The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causes coronavirus disease 2019 (COVID-19), a respiratory infection that has spread worldwide and is responsible for a high death toll. Although respiratory symptoms are the most common, there is growing evidence that oral signs of COVID-19 can also be seen in children. The purpose of this systematic review is to provide a comprehensive analysis of the available data on the oral manifestations of COVID-19 in children and to recommend appropriate methods of diagnosis and treatment. METHODS A systematic search of the MEDLINE, EMBASE, Scopus, and Web of Science databases was done to discover relevant papers published between their establishment and January 2023. Articles detailing oral symptoms in pediatric patients with confirmed COVID-19 infection were included, and data on clinical characteristics, diagnosis, treatment, and outcomes were extracted and evaluated. RESULTS A total of 24 studies involving 2112 pediatric patients with COVID-19 were included in the review. The most common presentations are oral lesions, taste and smell disorders, oral candidiasis, hemorrhagic crust, tongue discoloration, lip and tongue fissuring, gingivitis, and salivary gland inflammation. These manifestations were sometimes associated with multi-system inflammatory syndrome in children (MIS-C) or Kawasaki disease (KD). Management strategies varied depending on the severity of the oral manifestation and ranged from symptomatic relief with topical analgesics to systemic medications. CONCLUSION Oral symptoms of COVID-19 are relatively prevalent in juvenile patients and can be accompanied by severe systemic diseases, such as MIS-C or Kawasaki illness. Early detection and adequate care of these oral symptoms are critical for the best patient results. Understanding the underlying pathophysiology and developing targeted treatments requires more investigation.
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Affiliation(s)
- Kamyar Nasiri
- Department of DentistryIslamic Azad UniversityTehranIran
| | - Sahar Tehrani
- Department of Pediatric Dentistry, School of DentistryAhvaz Jundishapour University of Medical SciencesAhvazIran
| | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial SurgerySchool of Dentistry, Alborz University of Medical SciencesKarajIran
| | - Morteza Banakar
- Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
- Department of Pediatric Dentistry, Faculty of DentistryShahed UniversityTehranIran
| | - Mojgan Alaeddini
- Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Shahroo Etemad‐Moghadam
- Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Gustavo V. O. Fernandes
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Centre for Interdisciplinary Research in Health (CIIS)Universidade Católica PortuguesaViseuPortugal
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of StomatologyYerevan State Medical University after Mkhitar HeratsiArmenia
| | - Shima Imannezhad
- Department of Pediatrics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Farid Abbasi
- Department of Oral Medicine, Faculty of DentistryShahed UniversityTehranIran
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5
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Rojas M, Herrán M, Ramírez-Santana C, Leung PSC, Anaya JM, Ridgway WM, Gershwin ME. Molecular mimicry and autoimmunity in the time of COVID-19. J Autoimmun 2023; 139:103070. [PMID: 37390745 PMCID: PMC10258587 DOI: 10.1016/j.jaut.2023.103070] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/26/2023] [Accepted: 06/03/2023] [Indexed: 07/02/2023]
Abstract
Infectious diseases are commonly implicated as potential initiators of autoimmune diseases (ADs) and represent the most commonly known factor in the development of autoimmunity in susceptible individuals. Epidemiological data and animal studies on multiple ADs suggest that molecular mimicry is one of the likely mechanisms for the loss of peripheral tolerance and the development of clinical disease. Besides molecular mimicry, other mechanisms such as defects in central tolerance, nonspecific bystander activation, epitope-determinant spreading, and/or constant antigenic stimuli, may also contribute for breach of tolerance and to the development of ADs. Linear peptide homology is not the only mechanism by which molecular mimicry is established. Peptide modeling (i.e., 3D structure), molecular docking analyses, and affinity estimation for HLAs are emerging as critical strategies when studying the links of molecular mimicry in the development of autoimmunity. In the current pandemic, several reports have confirmed an influence of SARS-CoV-2 on subsequent autoimmunity. Bioinformatic and experimental evidence support the potential role of molecular mimicry. Peptide dimensional analysis requires more research and will be increasingly important for designing and distributing vaccines and better understanding the role of environmental factors related to autoimmunity.
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Affiliation(s)
- Manuel Rojas
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, 95616, USA; Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
| | - María Herrán
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Carolina Ramírez-Santana
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Patrick S C Leung
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, 95616, USA
| | - Juan-Manuel Anaya
- Health Research and Innovation Center at Coosalud, Cartagena, 130001, Colombia
| | - William M Ridgway
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, 95616, USA
| | - M Eric Gershwin
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, 95616, USA
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6
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Boor PJ, Srinivasan M, Stevenson HL, Gong B, Nyong E, Dong J, Popov V, Sherman M, Bopp N, Felicella MM, Zhao B, Buja M, Nickels J, Aronson JF. Necrotizing plasma cell-rich aortitis and sudden cardiac death: Late sequelae of COVID-19? Cardiovasc Pathol 2023; 66:107558. [PMID: 37419163 DOI: 10.1016/j.carpath.2023.107558] [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: 01/13/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/09/2023] Open
Abstract
The ongoing epidemic caused by the coronavirus SARS-CoV-2 is characterized by a variety of pathologic processes within the syndrome of COVID-19. Usually beginning as an upper respiratory infection with potential progression to a pneumonitis, many cases of COVID-19 that show minimal signs or symptoms initially may develop adverse systemic sequelae later, such as widespread thrombo-embolic phenomena, systemic inflammatory disorders (especially in children), or vasculitis. Here, we present a patient who suffered a sudden cardiac death following persistent SARS-CoV-2 viral positivity for four-and-one-half months after a mild clinical viral course. At routine autopsy, a remarkable plasma cell-rich necrotizing aortitis was uncovered. The aortic intima displayed diffuse, circumferential ongoing chronic intimal edema, inflammation, and neo-vascularization. The plasma cell-rich inflammatory process also involved the origin of the left main coronary artery (LM) causing a coronary arteritis accompanied by subacute, stenosing intimal vascular smooth muscle cell (VSMC) proliferation resulting in acute myocardial necrosis as a cause of death. A similar vasculitis and plaque were noted during the routine autopsy at the ostium of the celiac artery; vasculitis was not found systemically or in smaller caliber vessels. Through a variety of techniques including extensive histopathologic and immunohistochemical characterization, immunostaining localization of viral antigen, and transmission electron microscopy we present highly suggestive evidence that this unique necrotizing, plasma cell-rich aortitis is a rare sequela of COVID-19.
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Affiliation(s)
- Paul J Boor
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA.
| | - Mukund Srinivasan
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Heather L Stevenson
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Bin Gong
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Emmanuel Nyong
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Jianli Dong
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Vsevolod Popov
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Michael Sherman
- Department of Biochemistry and Molecular Biology, Sealy Center for Structural Biology and Molecular Biophysics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Nathen Bopp
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Michelle M Felicella
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
| | - Bihong Zhao
- Departments of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Maximilian Buja
- Departments of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Jaclyn Nickels
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA.
| | - Judith F Aronson
- Department of Pathology, University of Texas Medical Branch (UTMB), Galveston, Texas, USA
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7
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Reuben RC, Beugnon R, Jurburg SD. COVID-19 alters human microbiomes: a meta-analysis. Front Cell Infect Microbiol 2023; 13:1211348. [PMID: 37600938 PMCID: PMC10433767 DOI: 10.3389/fcimb.2023.1211348] [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: 04/24/2023] [Accepted: 06/23/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected a substantial portion of the world's population, and novel consequences of COVID-19 on the human body are continuously being uncovered. The human microbiome plays an essential role in host health and well-being, and multiple studies targeting specific populations have reported altered microbiomes in patients infected with SARS-CoV-2. Given the global scale and massive incidence of COVID on the global population, determining whether the effects of COVID-19 on the human microbiome are consistent and generalizable across populations is essential. Methods We performed a synthesis of human microbiome responses to COVID-19. We collected 16S rRNA gene amplicon sequence data from 11 studies sampling the oral and nasopharyngeal or gut microbiome of COVID-19-infected and uninfected subjects. Our synthesis included 1,159 respiratory (oral and nasopharyngeal) microbiome samples and 267 gut microbiome samples from patients in 11 cities across four countries. Results Our reanalyses revealed communitywide alterations in the respiratory and gut microbiomes across human populations. We found significant overall reductions in the gut microbial diversity of COVID-19-infected patients, but not in the respiratory microbiome. Furthermore, we found more consistent community shifts in the gut microbiomes of infected patients than in the respiratory microbiomes, although the microbiomes in both sites exhibited higher host-to-host variation in infected patients. In respiratory microbiomes, COVID-19 infection resulted in an increase in the relative abundance of potentially pathogenic bacteria, including Mycoplasma. Discussion Our findings shed light on the impact of COVID-19 on the human-associated microbiome across populations, and highlight the need for further research into the relationship between long-term effects of COVID-19 and altered microbiota.
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Affiliation(s)
- Rine Christopher Reuben
- German Centre of Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig, Germany
- Institute of Biology, Leipzig University, Leipzig, Germany
| | - Rémy Beugnon
- German Centre of Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig, Germany
- Leipzig Institute for Meteorology, Universität Leipzig, Leipzig, Germany
- CEFE, Université de Montpellier, CNRS, EPHE, IRD, Montpellier, France
| | - Stephanie D. Jurburg
- German Centre of Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig, Germany
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
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8
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Ba H, Zhang L, Peng H, He X, Lin Y, Li X, Li S, Zhu L, Qin Y, Zhang X, Wang Y. Identification of Hub Biomarkers and Immune and Inflammation Pathways Contributing to Kawasaki Disease Progression with RT-qPCR Verification. J Immunol Res 2023; 2023:1-15. [DOI: 10.1155/2023/1774260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background. Kawasaki disease (KD) is characterized by a disordered inflammation response of unknown etiology. Immune cells are closely associated with its onset, although the immune-related genes’ expression and possibly involved immune regulatory mechanisms are little known. This study aims to identify KD-implicated significant immune- and inflammation-related biomarkers and pathways and their association with immune cell infiltration. Patients and Methods. Gene microarray data were collected from the Gene Expression Omnibus database. Differential expression analysis, weighted gene coexpression network analysis (WGCNA), least absolute shrinkage and selection operator (LASSO) regression, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) were used to find KD hub markers. GSEA was used to assess the infiltration by 28 immune cell types and their connections to essential gene markers. Receiver operating characteristic (ROC) curves were used to examine hub markers’ diagnostic effectiveness. Finally, hub genes’ expressions were validated in Chinese KD patients by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Results. One hundred and fifty-one unique genes were found. Among 10 coexpression modules at WGCNA, one hub module exhibited the strongest association with KD. Thirty-six overlapping genes were identified. Six hub genes were potential biomarkers according to LASSO analysis. Immune infiltration revealed connections among activated and effector memory CD4+ T cells, neutrophils, activated dendritic cells, and macrophages. The six hub genes’ diagnostic value was shown by ROC curve analysis. Hub genes were enriched in immunological and inflammatory pathways. RT-qPCR verification results of FCGR1B (
), GPR84 (
), KREMEN1 (
), LRG1 (
), and TDRD9 (
) upregulated expression in Chinese KD patients are consistent with our database analysis. Conclusion. Neutrophils, macrophages, and activated dendritic cells are strongly linked to KD pathophysiology. Through immune-related signaling pathways, hub genes such as FCGR1B, GPR84, KREMEN1, LRG1, and TDRD9 may be implicated in KD advancement.
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Affiliation(s)
- Hongjun Ba
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
- Key Laboratory on Assisted Circulation, Ministry of Health, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Lili Zhang
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Huimin Peng
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Xiufang He
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Yuese Lin
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Xuandi Li
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Shujuan Li
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Ling Zhu
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Youzhen Qin
- Department of Pediatric Cardiology, Heart Center, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou 510080, China
| | - Xing Zhang
- Department of Cardiology, Kunming Children’s Hospital, 288 Qianxing Road, Xishan District, Kunming 650034, Yunnan, China
| | - Yao Wang
- Cancer Hospital, Guangzhou Medical University, Guangzhou 510095, China
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Arrifano GDP, Augusto-Oliveira M, Lopes-Araújo A, Santos-Sacramento L, Macchi BM, do Nascimento JLM, Crespo-Lopez ME. Global Human Threat: The Potential Synergism between Mercury Intoxication and COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054207. [PMID: 36901217 PMCID: PMC10001942 DOI: 10.3390/ijerph20054207] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 05/22/2023]
Abstract
The COVID-19 pandemic affected billions of people worldwide, and exposure to toxic metals has emerged as an important risk factor for COVID-19 severity. Mercury is currently ranked as the third toxic substance of global concern for human health, and its emissions to the atmosphere have increased globally. Both COVID-19 and mercury exposure present a high prevalence in similar regions: East and Southeast Asia, South America and Sub-Saharan Africa. Since both factors represent a multiorgan threat, a possible synergism could be exacerbating health injuries. Here, we discuss key aspects in mercury intoxication and SARS-CoV-2 infection, describing the similarities shared in clinical manifestations (especially neurological and cardiovascular outcomes), molecular mechanisms (with a hypothesis in the renin-angiotensin system) and genetic susceptibility (mainly by apolipoprotein E, paraoxonase 1 and glutathione family genes). Literature gaps on epidemiological data are also highlighted, considering the coincident prevalence. Furthermore, based on the most recent evidence, we justify and propose a case study of the vulnerable populations of the Brazilian Amazon. An understanding of the possible adverse synergism between these two factors is crucial and urgent for developing future strategies for reducing disparities between developed and underdeveloped/developing countries and the proper management of their vulnerable populations, particularly considering the long-term sequelae of COVID-19.
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Affiliation(s)
- Gabriela de Paula Arrifano
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
- Correspondence: (G.d.P.A.); (M.E.C.-L.)
| | - Marcus Augusto-Oliveira
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Amanda Lopes-Araújo
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Letícia Santos-Sacramento
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Barbarella Matos Macchi
- Laboratory of Neurochemistry and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - José Luiz Martins do Nascimento
- Laboratory of Neurochemistry and Cellular Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
| | - Maria Elena Crespo-Lopez
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil
- Correspondence: (G.d.P.A.); (M.E.C.-L.)
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Oral Manifestations in Children Diagnosed with COVID-19: A Narrative Review. Healthcare (Basel) 2023; 11:healthcare11030288. [PMID: 36766863 PMCID: PMC9914393 DOI: 10.3390/healthcare11030288] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 disease has many symptoms, including fever, dry cough, tachypnea, and shortness of breath, but other symptoms can accompany the disease. The disease can also have oral manifestations. The aim of this narrative review is to describe the oral manifestations of COVID-19 in children and adolescents by summarizing the current knowledge as it was described in various case reports and original articles. A review of the literature was carried out by searching the online databases PubMed, Web of Science and Scopus, between October 2022 and 12 November 2022. For this narrative review, 890 articles from three databases and manual search were screened. Saliva was discovered to be a potential screening tool for the infection with the SARS-CoV-2, although it is most reliable in the first few days of infection. Different alteration of the oral mucosa, such as ulcers, erosions and gingivitis were reported. Oral manifestations accompanied children with COVID-19-related multisystem inflammatory syndrome, Kawasaki disease, thrombocytopenic purpura and erythema multiforme. COVID-19 had an indirect effect on oral harmful habits by decreasing their frequency during the lockdown. Although they occur more rarely, oral manifestations can accompany COVID-19 disease in children and adolescents, and they can be an early sign of the disease.
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Martínez-García JJ, López-Acosta JR, Arce-Cabrera D, León-Sicairos N, Hernández-Parra AC, Cuen-Diaz HM, Zatarain-Lopez R, Canizalez-Roman A. Case report: Multisystem inflammatory syndrome in children associated with COVID-19, macrophage activation syndrome, and incomplete Kawasaki disease. Front Pediatr 2023; 11:1167828. [PMID: 37138560 PMCID: PMC10149839 DOI: 10.3389/fped.2023.1167828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/24/2023] [Indexed: 05/05/2023] Open
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C), is a severe complication of coronavirus disease 2019 (COVID-19), characterized by persistent fever, systemic inflammatory response, and organ failure. MIS-C with a history of COVID-19 may share clinical features with other well-defined syndromes such as macrophage activation syndrome, Kawasaki disease, hemophagocytic syndrome and toxic shock syndrome. Case 1 An 11-year-old male with a history of hypothyroidism and precocious puberty with positive antibody test for COVID-19 was admitted for fever, poor general condition, severe respiratory distress, refractory shock, and multiple organ failure. His laboratory examination showed elevated inflammatory parameters, and bone marrow aspirate showed hemophagocytosis. Case 2 A 13-year-old male with a history of attention deficit hyperactivity disorder and cognitive delay presented clinical manifestations of Kawasaki disease, fever, conjunctival congestion, exanthema, and hyperemia in oral mucosa, tongue, and genitals, with refractory shock and multiple organ failure. Reverse transcriptase polymerase chain reaction (RT-PCR) and antibodies for COVID-19 were negative, inflammation parameters were elevated, and bone marrow aspirate showed hemophagocytosis. Patients required intensive care with invasive mechanical ventilation, vasopressor support, intravenous gamma globulin, systemic corticosteroids, low molecular weight heparin, antibiotics, and monoclonal antibodies and, patient 2 required renal replacement therapy. Conclusions Multisystemic inflammatory syndrome in children can have atypical manifestations, and identifying them early is very important for the timely treatment and prognosis of patients.
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Affiliation(s)
- Jesús Javier Martínez-García
- Pediatric Intensive Care Unit, Pediatric Hospital of Sinaloa, Culiacan, Mexico
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Mexico
| | | | | | - Nidia León-Sicairos
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Mexico
- Research Department, Pediatric Hospital of Sinaloa, Culiacan, Mexico
| | | | | | | | - Adrian Canizalez-Roman
- School of Medicine, Autonomous University of Sinaloa, Culiacan, Mexico
- Research Department, The Women’s Hospital, Secretariat of Health, Culiacan, Mexico
- Correspondence: Adrian Canizalez Roman
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Sadeghi P, Gorji M, Assari R, Tahghighi F, Raeeskarami SR, Ziaee V. Methylprednisolone pulses as an initial treatment in hyperinflammatory syndrome after COVID-19 in children: evaluation of laboratory data, serial echocardiography and outcome: a case series. Intensive Care Med Exp 2022; 10:56. [PMID: 36585531 PMCID: PMC9803403 DOI: 10.1186/s40635-022-00484-1] [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: 09/11/2022] [Accepted: 12/17/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hyper-inflammatory syndrome in children and young adult occur 2-6 weeks after COVID-19 infection or closed contact with COVID-19 persons. In this study, the laboratory data and echocardiography and abdominal ultrasonography assessments were evaluated before and after Methylprednisolone pulse as an initial treatment of hyper-inflammatory syndrome. Therefore, the aim of this study is to assessment the clinical manifestations and laboratory data and outcome after methylprednisolone pulse as an initial treatment. METHOD In this retrospective study, the demographic status, clinical features, laboratory data, echocardiography, abdominal ultrasound, treatment and outcome of 31 pediatric patients under 16 years old, with inflammatory process after COVID-19 were evaluated. The clinical assessments, laboratory data, sonography and echocardiography were evaluated before and after methylprednisolone pulse. The patients were divided in two age group < and ≥ 7 years old and the clinical manifestations were compared with each other. The Mann-Whitney U test was used to assess the difference in quantitative variables between two groups. To compare pre- and post- treatment values, Wilcoxol test was used. To assess the correlation between qualitative variables chi-square test was used. The level of significant was considered 0.05. These patients with fever and hyper-inflammation features admitted to the referral pediatric rheumatology ward in Children Medical Center of Tehran University of medical sciences, from April 2020 to May 2021 were assessed. RESULT The mean age ± SD were (5.94 ± 3) and 51.6% (16) patients were male and 48.4% (15) patients were female. The most documented of previous COVID infection were antibody positive in about 27 (87%) patients. Moreover, 1 (3.8%) was PCR positive, 2 (7.7%) were positive in both PCR and serology and 3(11.5%) had closed contact with COVID-19 patients. About 9(29%) of patients were admitted in Intensive Care Unit (ICU). There were significant correlation between days of delay in starting treatment and ICU admission (P-value = 0.02). The mortality rate was negative in patients and no re-hospitalization was documented. There were significant differences (P-value < 0.05) between lymphocytes, platelet, Erythrocyte Sedimentation rate, C-reactive protein, Aspartate transaminase, Alanine transaminase and ferritin before and after treatment. Skin rashes and cardiac involvement totally as carditis (myocarditis, vulvulitis and pericarditis) (33.3%) and coronary involvements (53.3%) were the most prominent initial presentation in patients. There were near significant correlation (P-value = 0.066) between ferritin level and carditis before treatment. Cervical lymphadenopathy was seen significantly more in ≥ 7 years old (P-value = 0.01). CONCLUSION Multisystem inflammatory system in children as a hyperinflammatory syndrome could be treated with first step methylprednisolone pulse with decreasing inflammation in laboratory data and cardiac involvements and good outcome. Furthermore, the ferritin level may be one of the predictor of severe hyper-inflammatory syndrome leading to aggressive and urgent treatment with methylprednisolone pulse.
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Affiliation(s)
- Payman Sadeghi
- grid.411705.60000 0001 0166 0922Department of Pediatric Rheumatology, Pediatric Center of Excellence, Children’s Medical Center of Tehran University of Medical Science, No 63, Gharib Ave., Keshavarz Blv., Tehran, Iran
| | - Mojtaba Gorji
- grid.411705.60000 0001 0166 0922Department of Pediatric Cardiology, Pediatric Center of Excellence, Children’s Medical Center of Tehran University of Medical Science, Tehran, Iran
| | - Raheleh Assari
- grid.411705.60000 0001 0166 0922Department of Pediatric Rheumatology, Pediatric Center of Excellence, Children’s Medical Center of Tehran University of Medical Science, No 63, Gharib Ave., Keshavarz Blv., Tehran, Iran
| | - Fatemeh Tahghighi
- grid.411705.60000 0001 0166 0922Department of Pediatric Rheumatology, Pediatric Center of Excellence, Children’s Medical Center of Tehran University of Medical Science, No 63, Gharib Ave., Keshavarz Blv., Tehran, Iran
| | - Seyed Reza Raeeskarami
- grid.411705.60000 0001 0166 0922Department of Pediatric Rheumatology, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
| | - Vahid Ziaee
- grid.411705.60000 0001 0166 0922Department of Pediatric Rheumatology, Pediatric Center of Excellence, Children’s Medical Center of Tehran University of Medical Science, No 63, Gharib Ave., Keshavarz Blv., Tehran, Iran
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刘 嘉, 杨 照, 王 杰, 焦 富. 论文导读:川崎病与川崎样综合征的细胞因子级联反应. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:1315-1317. [PMID: 36544411 PMCID: PMC9785085 DOI: 10.7499/j.issn.1008-8830.2208140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | | | | | - 富勇 焦
- 陕西省人民医院儿童病院,陕西西安710068,焦富勇,男,主任医师。Email:。
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Cardiac MRI in patients with COVID-19 infection. Eur Radiol 2022; 33:3867-3877. [PMID: 36512043 PMCID: PMC9745285 DOI: 10.1007/s00330-022-09325-x] [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: 05/09/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
Objective COVID-19 infection is a systemic disease with various cardiovascular symptoms and complications. Cardiac MRI with late gadolinium enhancement is the modality of choice for the assessment of myocardial involvement. T1 and T2 mapping can increase diagnostic accuracy and improve further management. Our study aimed to evaluate the different aspects of myocardial damage in cases of COVID-19 infection using cardiac MRI. Methods This descriptive retrospective study included 86 cases, with a history of COVID-19 infection confirmed by positive RT-PCR, who met the inclusion criteria. Patients had progressive chest pain or dyspnoea with a suspected underlying cardiac cause, either by an abnormal electrocardiogram or elevated troponin levels. Cardiac MRI was performed with late contrast-enhanced (LGE) imaging, followed by T1 and T2 mapping. Results Twenty-four patients have elevated hsTnT with a median hsTnT value of 133 ng/L (IQR: 102 to 159 ng/L); normal value < 14 ng/L. Other sixty-two patients showed elevated hsTnI with a median hsTnI value of 1637 ng/L (IQR: 1340 to 2540 ng/L); normal value < 40 ng/L. CMR showed 52 patients with acute myocarditis, 23 with Takotsubo cardiomyopathy, and 11 with myocardial infarction. Invasive coronary angiography was performed only in selected patients. Conclusion Different COVID-19-related cardiac injuries may cause similar clinical symptoms. Cardiac MRI is the modality of choice to differentiate between the different types of myocardial injury such as Takotsubo cardiomyopathy and infection-related cardiomyopathy or even acute coronary syndrome secondary to vasculitis or oxygen-demand mismatch. Key Points • It is essential to detect early COVID-related cardiac injury using different cardiac biomarkers and cardiac imaging, as it has a significant impact on patient management and outcome. • Cardiac MRI is the modality of choice to differentiate between the different aspects of COVID-related myocardial injury.
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15
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Vielleux MJ, Swartwood S, Nguyen D, James KE, Barbeau B, Bonkowsky JL. SARS-CoV-2 Infection and Increased Risk for Pediatric Stroke. Pediatr Neurol 2022; 142:89-94. [PMID: 36418211 PMCID: PMC9675636 DOI: 10.1016/j.pediatrneurol.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/22/2022] [Accepted: 10/09/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND There is an increased risk of stroke in adults with severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) infection, but whether there is a similar association with stroke in children is unclear. Our objective was to determine whether there is a correlation between COVID-19 infection, multisystem inflammatory syndrome in children (MIS-C), and pediatric ischemic stroke. METHODS This was a retrospective, population-based cohort analysis between March 1, 2020, and June 30, 2021, conducted at a children's hospital. Pediatric patients with a diagnosis of ischemic stroke were identified using ICD-10 diagnoses of ischemic stroke, cerebrovascular accident, or cerebral infarction. RESULTS We identified 16 patients, seven male and nine female, with ischemic stroke. Ages were 8 months to 17 years (median 11.5 years). More Asian (6%) and black (13%) patients had strokes compared with population prevalence (2% each, respectively). No patients had active COVID-19 infection. COVID-19 antibodies were identified in five of 11 patients tested (45%), of whom three were diagnosed with MIS-C. 82% of the strokes occurred between February and May 2021. The peak incidence was in February 2021, which was two months after peak incidence of pediatric cases of COVID-19 and one month after the peak of MIS-C cases. CONCLUSIONS Our study suggests that prior COVID-19 infection, but not acute infection, is correlated with a risk for stroke in the pediatric population. The risk for stroke appears to be distinct from the risk for MIS-C.
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Affiliation(s)
- MaryGlen J. Vielleux
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine,Brain and Spine Center, Primary Children's Hospital, Intermountain Healthcare
| | - Shanna Swartwood
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine,Brain and Spine Center, Primary Children's Hospital, Intermountain Healthcare
| | - Dan Nguyen
- Department of Neurology, University of Utah School of Medicine
| | - Karen E. James
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Utah School of Medicine
| | - Bree Barbeau
- Disease Response, Evaluation, Analysis, & Monitoring Program, Bureau of Epidemiology, Utah Department of Health
| | - Joshua L. Bonkowsky
- Division of Pediatric Neurology, Department of Pediatrics, University of Utah School of Medicine,Brain and Spine Center, Primary Children's Hospital, Intermountain Healthcare,Communications should be addressed to: Dr. Bonkowsky; Division of Pediatric Neurology; Department of Pediatrics; University of Utah School of Medicine; 295 Chipeta Way; Salt Lake City, Utah 84108
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Aelami MH, Malek A, Saeidinia A. Coronavirus disease 2019-related Kawasaki syndrome: a case report. J Med Case Rep 2022; 16:432. [PMID: 36352417 PMCID: PMC9645345 DOI: 10.1186/s13256-022-03589-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 has changed the pattern of some diseases in the world, especially in pediatrics. Despite data suggesting that the pediatric population is less affected by coronavirus disease-19 infection, new concerns have been raised owing to reported cases with hyperinflammatory conditions such as Kawasaki disease. CASE PRESENTATION We report herein the case of a pediatric patient diagnosed and treated for classic Kawasaki disease in the setting of confirmed coronavirus disease 2019 infection. She was an 8-year-old, previously healthy, and fully immunized Iranian girl who initially presented to the pediatric emergency department with 5 days of intermittent fever, followed by abdominal pain, nausea, and vomiting. She was admitted for fever and abdominal pain to the surgery service of Akbar Hospital with suspected appendicitis. CONCLUSIONS This case report may serve as a useful reference to other clinicians caring for pediatric patients affected by coronavirus disease 2019 infection. Standard therapeutic interventions for Kawasaki disease must be performed to prevent critical coronary aneurysm-related complications in the coronavirus disease 2019 era.
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Affiliation(s)
- Mohammad Hasan Aelami
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolreza Malek
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Saeidinia
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmaceutical Research Center, Fakouri Boulevard, Booali Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Dos Santos PG, Vieira HCVS, Wietholter V, Gallina JP, Andrade TR, Marinowic DR, Zanirati GG, da Costa JC. When to test for COVID-19 using real-time reverse transcriptase polymerase chain reaction: a systematic review. Int J Infect Dis 2022; 123:58-69. [PMID: 35760382 PMCID: PMC9233872 DOI: 10.1016/j.ijid.2022.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the time in days between symptom onset and first positive real-time reverse transcriptase polymerase chain reaction (RT-PCR) result for COVID-19. METHODS This systematic review was conducted in the MEDLINE (PubMed), Embase, and Scopus databases using the following descriptors: "COVID-19", "SARS-CoV-2", "coronavirus", "RT-PCR", "real time PCR", and "diagnosis". RESULTS The included studies were conducted in 31 different countries and reported on a total of 6831 patients. The median age of the participants was 49.95 years. The three most common symptoms were fever, cough, and dyspnea, which affected 4012 (58.68%), 3192 (46.69%), and 2009 patients (29.38%), respectively. Among the 90 included studies, 13 were prospective cohorts, 15 were retrospective cohorts, 36 were case reports, 20 were case series, and six were cross-sectional studies. The overall mean time between symptom onset and positive test result was 6.72 days. Fourteen articles were analyzed separately for the temporal profile of RT-PCR test results; the best performance was on days 22-24, when 98% of test results were positive. CONCLUSION These findings corroborate the RT-PCR COVID-19 testing practices of some health units. In addition, the most frequently described symptoms of these patients can be considered the initial symptoms of infection and used in decision-making about RT-PCR testing.
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Affiliation(s)
- Paula Gabrielli Dos Santos
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Graduate Program in Biomedical Gerontology, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS) School of Medicine, Porto Alegre, Brazil
| | - Helena Cristina Valentini Speggiorin Vieira
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Undergraduate Research Program, School of Medicine and Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Vinícius Wietholter
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Undergraduate Research Program, School of Medicine and Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - João Pedro Gallina
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Undergraduate Research Program, School of Medicine and Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Thomás Ranquetat Andrade
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Undergraduate Research Program, School of Medicine and Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Daniel Rodrigo Marinowic
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Graduate Program in Biomedical Gerontology, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS) School of Medicine, Porto Alegre, Brazil; Graduate Program in Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul (PUCRS) School of Medicine, Porto Alegre, Brazil
| | - Gabriele Goulart Zanirati
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Graduate Program in Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul (PUCRS) School of Medicine, Porto Alegre, Brazil
| | - Jaderson Costa da Costa
- Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Graduate Program in Biomedical Gerontology, Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS) School of Medicine, Porto Alegre, Brazil; Graduate Program in Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul (PUCRS) School of Medicine, Porto Alegre, Brazil.
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Tufek M, Capraz M, Kaya AT, Aydin N, Nalcacioglu P. Retrobulbar Ocular Blood Flow and Choroidal Vascular Changes in Patients Recovering from COVID-19 Infection. Photodiagnosis Photodyn Ther 2022; 39:102976. [PMID: 35724935 PMCID: PMC9212774 DOI: 10.1016/j.pdpdt.2022.102976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/28/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
Background To evaluate the effects of COVID-19 infection on the ocular vascular structure including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjects. Methods Ninety eyes of 90 patients were included in this study. Participants were divided into Group 1 (n = 30) with mild COVID-19 infection, Group 2 (n = 31) with moderate disease, and Group 3 with age- and sex-matched healthy subjects (n = 29). Choroidal thickness was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm, using the enhanced depth imaging (EDI) technique of spectral coherence tomography (SD-OCT). The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography (CDU). Results The choroidal thickness was significantly thinner in Group 1 and Group 2 than in Group 3 at all measurement points (p <0.001). This difference was not present between Group 1 and Group 2 who had COVID-19 disease of different severity (p>0.05).Among the retrobulbar blood flow parameters, OA PSV value was significantly lower in Group 1 and Group 2 compared to Group 3 (p = 0.025, p = 0.016, respectively). However, the CRA PSV and EDV and OA EDV values, and the CRA and OA PI and RI values were not statistically different between the groups (p> 0.05). Conclusion COVID-19 infection may predispose patients to ocular vascular pathologies by affecting both choroidal and retrobulbar blood flow.
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Affiliation(s)
- Melek Tufek
- Department of Ophthalmology, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey.
| | - Mustafa Capraz
- Department of Internal Medicine, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Ahmet Turan Kaya
- Department of Radiology, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Nihat Aydin
- Department of Ophthalmology, Amasya University, Sabuncuoglu Serafeddin Training and Research Hospital, Amasya, Turkey
| | - Pinar Nalcacioglu
- Department of Ophthalmology, Yıldırım Beyazıt University Medical School, Ankara, Turkey
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BORDEA M, COSTACHE C, GRAMA A, FLORIAN A, LUPAN I, SAMAȘCA G, DELEANU D, MAKOVICKY P, MAKOVICKY P, RIMAROVA K. Cytokine Cascade in Kawasaki Disease Versus Kawasaki-Like Syndrome. Physiol Res 2022; 71:17-27. [DOI: 10.33549/physiolres.934672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Kawasaki disease (KD) is a medium vessel systemic vasculitis that predominantly occurs in children below five years of age. It is an acute febrile condition in which coronary artery aneurysms and myocarditis are the most common cardiovascular complications. It is most often characterized by hypercytoki-nemia. The etiopathogenesis of KD is not fully understood. The present review synthesizes the recent advances in the pathophysiology and treatment options of KD. According to different studies, the genetic, infections and autoimmunity factors play a major role in pathogenesis. Several susceptibility genes (e.g. caspase 3) and cytokines (e.g. IL-2, IL-4, IL-6, IL-10, IFN-γ and TNF-α) have been identified in KD. Patients with high cytokine levels are predisposed to KD shock syndrome. The importance of respiratory viruses in the pathogenesis of the disease is unclear. Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce in children and adults an abnormal systemic inflammatory response. This syndrome shares characteristics with KD. It has been called by many terms like MIS-C (Multisystem Inflammatory Syndrome in Children), PIMS-TS (pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2), hyperinflammatory shock syndrome, cytokine storm (cytokine release syndrome) or simply, Kawasaki-like syndrome. The cytokine’s role in the development of KD or Kawasaki-like syndrome being triggered by COVID-19 is controversial. The presences of the antiendothelial cell autoantibodies (AECAs) together with the newly developed hypothesis of immunothrombosis are considered potential pathogenic mechanisms for KD. In consequence, the diagnosis and treatment of KD and Kawasaki-like syndrome, one of the most common causes of acquired heart disease in developed countries, are challenging without a clearly defined protocol.
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Affiliation(s)
- M BORDEA
- Emergency Hospital for Children, Cluj-Napoca, Romania
| | - C COSTACHE
- Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A GRAMA
- Emergency Hospital for Children, Cluj-Napoca, Romania
| | - A FLORIAN
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - I LUPAN
- Department of Molecular Biology, Babes Bolyai University, Cluj-Napoca, Romania
| | - G SAMAȘCA
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - D DELEANU
- Department of Immunology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - P MAKOVICKY
- Cancer Research Institute, Biomedical Research Centre of the Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - P MAKOVICKY
- Department of Biology, Faculty of Education, J. Selye University, Komárno, Slovak Republic
| | - K RIMAROVA
- Department of Public Health and Hygiene, Faculty of Medicine, P. J. Šafárik University, Košice, Slovak Republic
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20
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Çelikel E, Tekin ZE, Aydin F, Emeksiz S, Uyar E, Özcan S, Perk O, Sezer M, Tekgöz N, Coşkun S, Güngörer V, Gül AEK, Bayhan Gİ, Özbek N, Azili MN, Acar BÇ. Role of Biological Agents in the Treatment of SARS-CoV-2-Associated Multisystem Inflammatory Syndrome in Children. J Clin Rheumatol 2022; 28:e381-e387. [PMID: 33843774 DOI: 10.1097/rhu.0000000000001734] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate the role of biological agents in the treatment of severe multisystem inflammatory syndrome in children (MIS-C) and to assess the current application, outcomes, and adverse effects in patients who are followed up in a pediatric intensive care unit (PICU). PATIENTS AND METHODS This observational, descriptive, medical records review study was performed on patients with MIS-C admitted to the PICU between September 1 and November 1, 2020. Through medical records review, we confirmed that patients were positive for current or recent SARS-CoV-2 infection or for COVID-19 exposure history within the 4 weeks before the onset of symptoms. RESULTS A total of 33 patients with severe MIS-C were included (21 male) with a median age of 9 years. The most common signs and symptoms during disease course were fever (100%) and abdominal pain (75.5%). Clinical features of 63.6% patients were consistent with Kawasaki disease/Kawasaki disease shock syndrome, and 36.4% were consistent with secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome. Myocardial dysfunction and/or coronary artery abnormalities were detected in 18 patients during the PICU stay. Intravenous immunoglobulin and corticosteroids were given to 33 patients. Anakinra was administered to 23 patients (69.6%). There was a significant increase in lymphocyte and platelet counts and a significant decrease in ferritin, B-type natriuretic peptide, and troponin levels at the end of the first week of treatment in patients who were given biological therapy. Two patients were switched to tocilizumab because of an insufficient response to anakinra. The mortality rate of MIS-C patients admitted in PICU was 6.0%. CONCLUSIONS Management of systemic inflammation and shock is important to decrease mortality and the development of persistent cardiac dysfunction in MIS-C. The aggressive treatment approach, including biological agents, may be required in patients with severe symptoms and cardiac dysfunction.
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Affiliation(s)
- Elif Çelikel
- From the Department of Pediatric Rheumatology, Ankara Children's Hospital, University of Health Sciences
| | - Zahide Ekici Tekin
- From the Department of Pediatric Rheumatology, Ankara Children's Hospital, University of Health Sciences
| | - Fatma Aydin
- From the Department of Pediatric Rheumatology, Ankara Children's Hospital, University of Health Sciences
| | - Serhat Emeksiz
- Pediatric Intensive Care Unit, Ankara Children's Hospital, Ankara Yildirim Beyazit University
| | - Emel Uyar
- Department of Pediatric Intensive Care, Ankara Children's Hospital, University of Health Sciences
| | - Serhan Özcan
- Department of Pediatric Intensive Care, Ankara Children's Hospital, University of Health Sciences
| | - Oktay Perk
- Department of Pediatric Intensive Care, Ankara Children's Hospital, University of Health Sciences
| | - Müge Sezer
- From the Department of Pediatric Rheumatology, Ankara Children's Hospital, University of Health Sciences
| | - Nilüfer Tekgöz
- From the Department of Pediatric Rheumatology, Ankara Children's Hospital, University of Health Sciences
| | - Serkan Coşkun
- From the Department of Pediatric Rheumatology, Ankara Children's Hospital, University of Health Sciences
| | - Vildan Güngörer
- Department of Pediatric Rheumatology, Faculty of Medicine, Selçuk University
| | - Ayşe Esin Kibar Gül
- Department of Pediatric Cardiology, Ankara Children's Hospital, University of Health Sciences
| | - Gülsüm İclal Bayhan
- Department of Pediatric Infectious Diseases, Ankara Children's Hospital, Ankara Yildirim Beyazit University
| | - Namik Özbek
- Department of Pediatric Hematology, Ankara Children's Hospital, University of Health Sciences
| | - Müjdem Nur Azili
- Department of Pediatric Surgery, Ankara Children's Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Banu Çelikel Acar
- From the Department of Pediatric Rheumatology, Ankara Children's Hospital, University of Health Sciences
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21
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An H, Eun M, Yi J, Park J. CRESSP: a comprehensive pipeline for prediction of immunopathogenic SARS-CoV-2 epitopes using structural properties of proteins. Brief Bioinform 2022; 23:6539139. [PMID: 35226074 DOI: 10.1093/bib/bbac056] [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] [Received: 10/25/2021] [Revised: 01/04/2022] [Accepted: 02/03/2022] [Indexed: 12/16/2022] Open
Abstract
The development of autoimmune diseases following SARS-CoV-2 infection, including multisystem inflammatory syndrome, has been reported, and several mechanisms have been suggested, including molecular mimicry. We developed a scalable, comparative immunoinformatics pipeline called cross-reactive-epitope-search-using-structural-properties-of-proteins (CRESSP) to identify cross-reactive epitopes between a collection of SARS-CoV-2 proteomes and the human proteome using the structural properties of the proteins. Overall, by searching 4 911 245 proteins from 196 352 SARS-CoV-2 genomes, we identified 133 and 648 human proteins harboring potential cross-reactive B-cell and CD8+ T-cell epitopes, respectively. To demonstrate the robustness of our pipeline, we predicted the cross-reactive epitopes of coronavirus spike proteins, which were recognized by known cross-neutralizing antibodies. Using single-cell expression data, we identified PARP14 as a potential target of intermolecular epitope spreading between the virus and human proteins. Finally, we developed a web application (https://ahs2202.github.io/3M/) to interactively visualize our results. We also made our pipeline available as an open-source CRESSP package (https://pypi.org/project/cressp/), which can analyze any two proteomes of interest to identify potentially cross-reactive epitopes between the proteomes. Overall, our immunoinformatic resources provide a foundation for the investigation of molecular mimicry in the pathogenesis of autoimmune and chronic inflammatory diseases following COVID-19.
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Affiliation(s)
- Hyunsu An
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Republic of Korea
| | - Minho Eun
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Republic of Korea
| | - Jawoon Yi
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Republic of Korea
| | - Jihwan Park
- School of Life Sciences, Gwangju Institute of Science and Technology (GIST), Republic of Korea.,Anti-Virus Research Center, Gwangju Institute of Science and Technology (GIST), Republic of Korea.,Laboratory for cell mechanobiology, Gwangju Institute of Science and Technology (GIST), Republic of Korea
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22
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Hu S, Wang X, Ma Y, Cheng H. Global Research Trends in Pediatric COVID-19: A Bibliometric Analysis. Front Public Health 2022; 10:798005. [PMID: 35252087 PMCID: PMC8888448 DOI: 10.3389/fpubh.2022.798005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/07/2022] [Indexed: 01/27/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) emerged in 2019 and has since caused a global pandemic. Since its emergence, COVID-19 has hugely impacted healthcare, including pediatrics. This study aimed to explore the current status and hotspots of pediatric COVID-19 research using bibliometric analysis. Methods The Institute for Scientific Information Web of Science core collection database was searched for articles on pediatric COVID-19 to identify original articles that met the criteria. The retrieval period ranged from the creation of the database to September 20, 2021. A total of 3,561 original articles written in English were selected to obtain data, such as author names, titles, source publications, number of citations, author affiliations, and countries where the studies were conducted. Microsoft Excel (Microsoft, Redmond, WA) was used to create charts related to countries, authors, and institutions. VOSviewer (Center for Science and Technology Studies, Leiden, The Netherlands) was used to create visual network diagrams of keyword, author, and country co-occurrence. Results We screened 3,561 publications with a total citation frequency of 30,528. The United States had the most published articles (1188 articles) and contributed the most with author co-occurrences. The author with the most published articles was Villani from the University of Padua, Italy. He also contributed the most co-authored articles. The most productive institution was Huazhong University of Science and Technology in China. The institution with the most frequently cited published articles was Shanghai Jiao Tong University in China. The United States cooperated most with other countries. Research hotspots were divided into two clusters: social research and clinical research. Besides COVID-19 and children, the most frequent keywords were pandemic (251 times), mental health (187 times), health (172 times), impact (148 times), and multisystem inflammatory syndrome in children (MIS-C) (144 times). Conclusion Pediatric COVID-19 has attracted considerable attention worldwide, leading to a considerable number of articles published over the past 2 years. The United States, China, and Italy have leading roles in pediatric COVID-19 research. The new research hotspot is gradually shifting from COVID-19 and its related clinical studies to studies of its psychological and social impacts on children.
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Affiliation(s)
- Siyu Hu
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Xi Wang
- Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, China
| | - Yucong Ma
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Hang Cheng
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Hang Cheng
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23
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Dotan A, David P, Arnheim D, Shoenfeld Y. The autonomic aspects of the post-COVID19 syndrome. Autoimmun Rev 2022; 21:103071. [PMID: 35182777 PMCID: PMC8848724 DOI: 10.1016/j.autrev.2022.103071] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 01/04/2023]
Abstract
The SARS-CoV-2 outbreak, responsible for the widespread COVID-19, led to one of the most rogue pandemics in modern time, yet the major effects of the pandemic may still be ahead of us. SARS-CoV-2 had been found to possess autoimmune properties. Close to 20 distinct autoantibodies which target GPCR of the nervous system and renin-angiotensin system-related molecules were found significantly associated with the clinical severity of COVID-19. The new on-set of more than 10 various autoimmune disorders were documented as well. Additionally, clinical presentations of persisted symptoms were triggered in numerous recently recovered COVID-19 patients, which led to the formulation of the novel term “post-COVID19 syndrome”. Manifestations related to post-COVID-19 syndrome exist among approximately 50–80% of symptomatic COVID-19 patients who recovered, and among patients reported more than 50 different long-term effects of the SARS-CoV-2 infection. Many of the common symptoms of the post-COVID19 syndrome are not explained by the virus-related injury alone. Similarly to chronic fatigue syndrome and fibromyalgia, autoimmune-mediated autonomic nervous system dysfunction may play a significant part in the pathogenesis of such symptoms, including chronic fatigue, cognitive impairment, mood related disorders, and numerous more. Importantly, therapeutic options such as immunomodulatory and immunosuppressive therapy may favor some post-COVID19 patients, while plasmapheresis and IVIG could be considered in severe cases. Nevertheless, as physical exercise has been found to stabilize the autonomic nervous system, exercise therapy might be a safer and more effective remedy for the post-COVID19 syndrome.
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Affiliation(s)
- Arad Dotan
- Ariel University, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Paula David
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel; Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
| | - Dana Arnheim
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehuda Shoenfeld
- Ariel University, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel; Laboratory of the Mosaics of Autoimmunity, Saint Petersburg University, 199034, Russia
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24
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Malcangi G, Inchingolo AD, Inchingolo AM, Piras F, Settanni V, Garofoli G, Palmieri G, Ceci S, Patano A, Mancini A, Vimercati L, Nemore D, Scardapane A, Rapone B, Semjonova A, D’Oria MT, Macchia L, Bordea IR, Migliore G, Scarano A, Lorusso F, Tartaglia GM, Giovanniello D, Nucci L, Maggialetti N, Parisi A, Domenico MD, Brienza N, Tafuri S, Stefanizzi P, Curatoli L, Corriero A, Contaldo M, Inchingolo F, Dipalma G. COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020249. [PMID: 35204969 PMCID: PMC8870718 DOI: 10.3390/children9020249] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/21/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023]
Abstract
Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children and infants this variation in epidemiology compared to the adult population and its impact on therapies and vaccines that are aimed towards them. A literature review, including in vitro studies, reviews, published guidelines and clinical trials was performed. Clinical trials concerned topics that allowed a descriptive synthesis to be produced. Four underlying mechanisms were found that may play a key role in providing COVID-19 protection in babies. No guidelines are available yet for therapy due to insufficient data; support therapy remains the most used. Only two vaccines are approved by the World Health Organization to be used in children from 12 years of age, and there are currently no efficacy or safety data for children below the age of 12 years. The COVID-19 clinical frame infection is milder in children and adolescents. This section of the population can act as vectors and reservoirs and play a key role in the transmission of the infection; therefore, vaccines are paramount. More evidence is required to guide safely the vaccination campaign.
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Affiliation(s)
- Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Grazia Garofoli
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Damiano Nemore
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Arnaldo Scardapane
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Alexandra Semjonova
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Maria Teresa D’Oria
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
- Department of Medical and Biological Sciences, University of Udine, Via delle Scienze, 206, 33100 Udine, Italy
| | - Luigi Macchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (I.R.B.); (F.L.); (F.I.); Tel.: +39-328-213-2586 (F.L.); +39-331-211-1104 (F.I.)
| | | | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (I.R.B.); (F.L.); (F.I.); Tel.: +39-328-213-2586 (F.L.); +39-331-211-1104 (F.I.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy;
| | - Delia Giovanniello
- Department of Toracic Surgery, Hospital “San Camillo Forlanini”, 00152 Rome, Italy;
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (M.C.)
| | - Nicola Maggialetti
- Department of Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy;
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Nicola Brienza
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70124 Bari, Italy; (N.B.); (A.C.)
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy; (S.T.); (P.S.)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy; (S.T.); (P.S.)
| | - Luigi Curatoli
- Department Neurosciences & Sensory Organs & Musculoskeletal System, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Alberto Corriero
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70124 Bari, Italy; (N.B.); (A.C.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (M.C.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
- Correspondence: (I.R.B.); (F.L.); (F.I.); Tel.: +39-328-213-2586 (F.L.); +39-331-211-1104 (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
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Sartori LF, Balamuth F. Multisystem Inflammatory Syndrome in Children: Examining Emerging Data and Identifying Key Knowledge Gaps. Pediatr Emerg Care 2022; 38:83-91. [PMID: 35100745 PMCID: PMC8855966 DOI: 10.1097/pec.0000000000002633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT Multisystem inflammatory syndrome in children (MIS-C) is a syndrome of abnormal immune response after severe acute respiratory syndrome coronavirus 2 infection that can result in organ dysfunction including severe cardiovascular compromise in children. Increased evidence supports a clinical and laboratory profile in MIS-C distinct from Kawasaki disease, with MIS-C typically occurring in older children and with more prominent gastrointestinal and neurologic symptoms, as well as increased inflammation, lymphopenia, and cardiac injury on laboratory testing. However, high-level evidence regarding best practices for treatment and long-term outcomes in MIS-C is limited.
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Affiliation(s)
- Laura F Sartori
- From the Assistant Professor and Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania; and Division of Pediatric Emergency Medicine and Pediatric Sepsis Program, Children's Hospital of Philadelphia, Philadelphia, PA
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Wong K, Farooq Alam Shah MU, Khurshid M, Ullah I, Tahir MJ, Yousaf Z. COVID-19 associated vasculitis: A systematic review of case reports and case series. Ann Med Surg (Lond) 2022; 74:103249. [PMID: 35039779 PMCID: PMC8754903 DOI: 10.1016/j.amsu.2022.103249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/31/2021] [Accepted: 01/06/2022] [Indexed: 12/20/2022] Open
Abstract
Vasculitis is one of the complications of COVID-19. We conducted a systematic review analysing the association of COVID-19 with vasculitis. We searched Google Scholar and PubMed from December 1, 2019, to October 11, 2021. The review included 8 studies (7 case reports and 1 case series) reporting 9 cases of vasculitis secondary to COVID-19. The mean age was 29.17 ± 28.2 years, ranging from 6 months to 83 years. The male to female ratio was 4:5. Maculopapular, violaceous, papular and erythematous rash were common. Heparin(n = 2), corticosteroids (n = 6) (methylprednisolone) and intravenous immunoglobulin (n = 4) were prescribed in these patients. Significant clinical improvement was observed in 8 out of 9 patients. One person died during treatment. Our study discusses vasculitis as one of the complications of COVID-19. Furthermore, the pathophysiology, clinical presentation, and management of COVID-19 associated vasculitis is discussed. This is a systematic review of all published cases of vasculitis secondary to COVID-19 from the start of COVID-19 outbreak to date. Most common forms of vasculitis reported were Kawasaki disease Vasculitis, IgA vasculitis and Leucocytoclastic Vasculitis with symptoms being predominantly skin limited. Steroids, LMWH and IVIG were the most common line of treatment. An good overall prognosis was seen following treatment.
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Affiliation(s)
| | | | - Maman Khurshid
- Dow University of Health Sciences, Karachi, 74200, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | | | - Zohaib Yousaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
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Nassih H, Belghmaidi S, El Qadiry R, Hajji I, Bourrahouat A, Moutaouakil A, Ait Sab I. Acute Vision Loss and Conjunctival Hemorrhage as Telltale Symptoms of PIMS-TS. Glob Pediatr Health 2022; 9:2333794X221108727. [PMID: 35898321 PMCID: PMC9310207 DOI: 10.1177/2333794x221108727] [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: 04/02/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
There is a global concern about children presenting with inflammatory syndrome with variable clinical features during the ongoing COVID-19 pandemic. This paper reports the first pediatric case of bilateral serous retinal detachment and conjunctival hemorrhage as a revealing pattern of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Despite the severity of multisystemic involvement, the management with steroids was very successful. Complete remission was obtained within 3 months of acute onset.
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Erbaş GS, Botsali A, Erden N, Arı C, Taşkın B, Alper S, Vural S. COVID-19-related oral mucosa lesions among confirmed SARS-CoV-2 patients: a systematic review. Int J Dermatol 2022; 61:20-32. [PMID: 34549816 PMCID: PMC8652904 DOI: 10.1111/ijd.15889] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/31/2021] [Accepted: 08/16/2021] [Indexed: 02/05/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for coronavirus disease 2019 (COVID-19), which manifests as a flu-like respiratory infection affecting multiple organ systems, including the gastrointestinal system, central nervous system, cardiovascular system, skin, and mucosa. In this review, we investigated the literature on specific manifestations of COVID-19 in the oral mucosa. An online literature search in PubMed, Scopus, Google Scholar, and Medline was conducted to retrieve relevant studies on confirmed COVID-19 patients with oral mucosa findings published between December 31, 2019, and April 07, 2021. After an independent review by two authors, 39 articles considering 59 laboratory-confirmed cases of SARS-CoV-2 infection were included in the final analysis. The most common finding, reported in 29 patients (43.9%), was Kawasaki-like syndrome. In addition, oral ulcers including aphthous, hemorrhagic, and necrotic ulcers were reported in 24 patients (36.3%). Other lesions reported included pustules, macules, bullae, maculopapular enanthema, and erythema multiforme-like lesions. Concomitant skin lesions were present in 60.6% of patients. Fever was reported in 86.2% of patients. Forty-eight patients (76.1%) were hospitalized. Loss of taste and smell was present in 30.8% of the patients. A comprehensive understanding of the dermatologic manifestations of COVID-19 can improve and facilitate patient management and referrals.
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Affiliation(s)
- Gizem S. Erbaş
- School of MedicineTechnical University of MunichMunchenGermany
| | - Aysenur Botsali
- Department of DermatologyUniversity of Health Sciences, Gülhane Training and Research HospitalAnkaraTurkey
| | - Nihan Erden
- Koç University School of MedicineİstanbulTurkey
| | - Canan Arı
- Department of Dermatology and VenereologyAnkara Dışkapı Yıldırım Bayezit Eğitim ve Araştırma HospitalAnkaraTurkey
| | - Banu Taşkın
- Department of Dermatology and VenereologyKoç University School of MedicineİstanbulTurkey
| | - Sibel Alper
- Department of Dermatology and VenereologyKoç University School of MedicineİstanbulTurkey
| | - Secil Vural
- Department of Dermatology and VenereologyKoç University School of MedicineİstanbulTurkey
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Salih AF, Hamasalih K, Rahman HS, Mohammed GA. Pediatric COVID-19 infection in Sulaimaniyah Governorate, Iraq. Am J Otolaryngol 2022; 43:103199. [PMID: 34560597 PMCID: PMC8413489 DOI: 10.1016/j.amjoto.2021.103199] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/26/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND COVID-19 is a severe acute respiratory syndrome caused by SARS-CoV-2. OBJECTIVE To study the demographic and clinical presentations of COVID-19 with their types including MIS-C and Kawasaki among children who were admitted to Doctor Jamal Ahmad Rashid Pediatric Teaching Hospital (DJARPTH) at Sulaimaniyah city, Iraq. PATIENTS AND METHODS A prospective cohort study was conducted from June to December 2020 in which 50 cases suspected of COVID-19 were enrolled in the study that was admitted at the first visit to the emergency department of DJARPTH and their age ranged between 3 months to 14 years. Then, the collected data were divided into 3 groups: COVID-19, Kawasaki disease (KD), and MIS-C. RESULTS The fever was the most common presented symptom in all cases with COVID-19 regardless of the severity. COVID-19 may be presented as KD as well as MIS-C. There is an increase in the number of Kawasaki cases since 2019 by 6.7 fold due to the increased number of COVID-19 cases in children. Death was more related to MIS-C and primary COVID-19 diseases. Most COVID-19 cases presented with pericardial effusion; although coronary involvement and LV dysfunction mostly seen with MIS-C cases. CONCLUSION COVID-19 is not uncommon in pediatric patients and it presents as either primary, MIS-C, and KD. Most of the deaths and ICU outcomes were related to MIS-C presentations.
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Sharma D, Bhaskar SMM. Prevalence of paediatric hyperinflammatory conditions in paediatric and adolescent hospitalized COVID-19 patients: a systematic review and meta-analysis. APMIS 2021; 130:101-110. [PMID: 34894016 DOI: 10.1111/apm.13199] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022]
Abstract
In the milieu of coronavirus disease 2019 (COVID-19), there are increasing reports of paediatric hyperinflammatory conditions (PHICs), including multisystem inflammatory syndrome in children (MIS-C), paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and Kawasaki disease (KD). Few analyses of PHIC prevalence in paediatric and adolescent hospitalized COVID-19 patients exist. The purpose of this study was to perform a meta-analysis to determine a pooled prevalence estimate of PHICs in paediatric and adolescent hospitalized patients admitted for treatment due to COVID-19. Individual studies were retrieved from PubMed/Medline, EMBASE and Cochrane databases. Relevant prevalence, baseline, treatment and outcome data were extracted using a standardized datasheet. The systematic review and meta-analysis were conducted as per the PRISMA and MOOSE guidelines. Overall, 14 studies with 2202 patients admitted for treatment due to COVID-19, among whom 780 were diagnosed with PHICs, were included. The crude estimate of prevalence was 35.42%, and the pooled estimate of prevalence was 29% (random pooled ES = 0.29; 95% CIs = 0.18-0.42; p < 0.0001; z = 7.45). A sizeable proportion of paediatric and adolescent hospitalized patients admitted for treatment due to COVID-19 are diagnosed with a PHIC warranting a high index of clinical suspicion for PHICs. Further studies are required to validate these findings.
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Affiliation(s)
- Divyansh Sharma
- South Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia.,Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research and Global Health Neurology and Translational Neuroscience Lab, Sydney, NSW, Australia
| | - Sonu M M Bhaskar
- Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research and Global Health Neurology and Translational Neuroscience Lab, Sydney, NSW, Australia.,NSW Brain Clot Bank, NSW Health Pathology, Sydney, NSW, Australia.,Department of Neurology and Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, NSW, Australia
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31
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Hajra K, Chakraborty U, Chatterjee K, Chandra A, Halder S. Multisystem inflammatory syndrome in adults (MIS-A): a new addition to COVID-19 puzzle. J Eur Acad Dermatol Venereol 2021; 36:e182-e185. [PMID: 34839549 PMCID: PMC9011744 DOI: 10.1111/jdv.17841] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/11/2021] [Accepted: 11/26/2021] [Indexed: 01/10/2023]
Affiliation(s)
- K Hajra
- Department of Dermatology and Venereal Disease, School of Tropical Medicine, Kolkata, India
| | - U Chakraborty
- Department of Neurology, Bangur Institute of Neurosciences, IPGMER & SSKM Hospital, Kolkata, India
| | - K Chatterjee
- Department of Dermatology and Venereal Disease, School of Tropical Medicine, Kolkata, India
| | - A Chandra
- Department of Internal Medicine, R.G.Kar Medical College and Hospital, Kolkata, India
| | - S Halder
- Department of Dermatology and Venereal Disease, School of Tropical Medicine, Kolkata, India
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Gonzalez-Gonzalez FJ, Ziccardi MR, McCauley MD. Virchow's Triad and the Role of Thrombosis in COVID-Related Stroke. Front Physiol 2021; 12:769254. [PMID: 34858214 PMCID: PMC8631516 DOI: 10.3389/fphys.2021.769254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/11/2021] [Indexed: 12/11/2022] Open
Abstract
In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as a virally transmitted disease. Three months later, SARS-CoV-2 became one of the largest pandemics in recent times, causing more than 235 million cases globally, and accounting for at least 4.8 million deaths to date. SARS-COV-2 infection was initially classified as a respiratory tract infection, but later was recognized as a multisystemic disease compromising gastrointestinal, hematological, cardiac, and neurological systems. With this Review, we aim to describe the epidemiology, risk factors, mechanisms, and management of cerebrovascular events in patients infected with COVID-19. Neurological manifestations related to thromboembolic cerebrovascular events in patients infected with COVID-19 have been frequent and associated with poor prognosis in the majority of cases. A better understanding of the mechanisms of thrombosis and etiologies of this new disease process are necessary to determine how to prevent and treat patients to reduce their length of stay, morbidity, and mortality.
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Affiliation(s)
- Francisco J. Gonzalez-Gonzalez
- Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Mary Rodriguez Ziccardi
- Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States,Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Mark D. McCauley
- Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States,Jesse Brown VA Medical Center, Chicago, IL, United States,Department of Physiology and Biophysics and the Center for Cardiovascular Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States,*Correspondence: Mark D. McCauley,
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Mohseni Afshar Z, Babazadeh A, Hasanpour A, Barary M, Sayad B, Janbakhsh A, Aryanian Z, Ebrahimpour S. Dermatological manifestations associated with COVID-19: A comprehensive review of the current knowledge. J Med Virol 2021; 93:5756-5767. [PMID: 34241899 PMCID: PMC8427109 DOI: 10.1002/jmv.27187] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Mohammad Barary
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Babak Sayad
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Alireza Janbakhsh
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of MedicineBabol University of Medical SciencesBabolIran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
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Differences and similarities of multisystem inflammatory syndrome in children, Kawasaki disease and macrophage activating syndrome due to systemic juvenile idiopathic arthritis: a comparative study. Rheumatol Int 2021; 42:879-889. [PMID: 34491393 PMCID: PMC8421714 DOI: 10.1007/s00296-021-04980-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/26/2021] [Indexed: 12/19/2022]
Abstract
To compare the clinical and laboratory findings of multisystem inflammatory syndrome in children (MIS-C), patients with Kawasaki disease (KD) and with macrophage activating syndrome due to systemic juvenile idiopathic arthritis (sJIA-MAS) on real-life data. Patients diagnosed with MIS-C, KD, and sJIA-MAS from 12 different centers in Turkey who were followed for at least 6 months were included in the study. Demographic, clinical, and laboratory findings of all patients were analyzed. A total of 154 MIS-C, 59 KD, and 31 sJIA-MAS patients were included. The median age of patients with MIS-C were higher than those with KD while lower than those with sJIA-MAS (8.2, 3, 12 years, respectively). Myalgia (39.6%), cardiac (50.6%), gastrointestinal (72.7%), and neurological (22.1%) involvements were more common in patients with MIS-C compared to others. MIS-C patients had lower levels of lymphocyte (950 vs 1700 cells/µl) and thrombocyte (173,000 vs 355,000 cells/µl) counts and higher pro-BNP (1108 vs 55 pg/ml) levels than KD. Ferritin levels were higher in patients with MIS-C compared to patients with KD while they were lower than patients with sJIA-MAS (440, 170, 10,442 ng/ml, respectively). Patients with MIS-C had a shorter duration of hospitalization than sJIA-MAS (p = 0.02) while they required intensive care unit admission more frequently (55 vs 8 patients, p < 0.001). The median MAS/sJIA score of MIS-C patients was − 1.64 (− 5.23 to 9.68) and the median MAS/sJIA score of sJIA-MAS patients was −2.81 ([− 3.79] to [− 1.27]). MIS-C patients displayed certain differences in clinical and laboratory features when compared to KD and sJIA-MAS. Definition of the differences and similarities between MIS-C and the other intense inflammatory syndromes of childhood such as KD and MAS will help the clinicians while making timely diagnosis.
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Singh A, Kainth D, Gaur S, Yadav DK, Anand S. Characteristics of Systematic Reviews and Meta-analysis on COVID-19 in the Pediatric Population: A Bibliometric Review With Emphasis on Top 5 Cited Articles. Clin Pediatr (Phila) 2021; 60:392-398. [PMID: 34293948 DOI: 10.1177/00099228211034340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
| | | | | | | | - Sachit Anand
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
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36
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Liu D, Zeng X, Ding Z, Lv F, Mehta JL, Wang X. Adverse Cardiovascular Effects of Anti-COVID-19 Drugs. Front Pharmacol 2021; 12:699949. [PMID: 34512335 PMCID: PMC8424204 DOI: 10.3389/fphar.2021.699949] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 infection is the cause of the ongoing global pandemic. Mortality from COVID-19 infection is particularly high in patients with cardiovascular diseases. In addition, COVID-19 patients with preexisting cardiovascular comorbidities have a higher risk of death. Main cardiovascular complications of COVID-19 are myocardial infarction, myocarditis, acute myocardial injury, arrhythmias, heart failure, stroke, and venous thromboembolism. Therapeutic interventions in terms of drugs for COVID-19 have many cardiac adverse effects. Here, we review the relative therapeutic efficacy and adverse effects of anti-COVID-19 drugs.
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Affiliation(s)
- Dongling Liu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Xiang Zeng
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, China
| | - Zufeng Ding
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| | - Fenghua Lv
- Department of Cardiology, Xinxiang Medical University First Affiliated Hospital, Weihui, China
| | - Jawahar L. Mehta
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| | - Xianwei Wang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
- Department of Cardiology, Xinxiang Medical University First Affiliated Hospital, Weihui, China
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Dejani NN, Elshabrawy HA, Bezerra Filho CDSM, de Sousa DP. Anticoronavirus and Immunomodulatory Phenolic Compounds: Opportunities and Pharmacotherapeutic Perspectives. Biomolecules 2021; 11:biom11081254. [PMID: 34439920 PMCID: PMC8394099 DOI: 10.3390/biom11081254] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/14/2021] [Accepted: 08/15/2021] [Indexed: 02/06/2023] Open
Abstract
In 2019, COVID-19 emerged as a severe respiratory disease that is caused by the novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The disease has been associated with high mortality rate, especially in patients with comorbidities such as diabetes, cardiovascular and kidney diseases. This could be attributed to dysregulated immune responses and severe systemic inflammation in COVID-19 patients. The use of effective antiviral drugs against SARS-CoV-2 and modulation of the immune responses could be a potential therapeutic strategy for COVID-19. Studies have shown that natural phenolic compounds have several pharmacological properties, including anticoronavirus and immunomodulatory activities. Therefore, this review discusses the dual action of these natural products from the perspective of applicability at COVID-19.
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Affiliation(s)
- Naiara Naiana Dejani
- Department of Physiology and Pathology, Federal University of Paraíba, João Pessoa 58051-900, Brazil;
| | - Hatem A. Elshabrawy
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX 77304, USA;
| | - Carlos da Silva Maia Bezerra Filho
- Department of Pharmaceutical Sciences, Federal University of Paraíba, João Pessoa 58051-900, Brazil;
- Postgraduate Program in Bioactive Natural and Synthetic Products, Federal University of Paraíba, João Pessoa 58051-900, Brazil
| | - Damião Pergentino de Sousa
- Department of Pharmaceutical Sciences, Federal University of Paraíba, João Pessoa 58051-900, Brazil;
- Postgraduate Program in Bioactive Natural and Synthetic Products, Federal University of Paraíba, João Pessoa 58051-900, Brazil
- Correspondence: ; Tel.: +55-83-3216-7347
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39
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Karami Fath M, Jahangiri A, Ganji M, Sefid F, Payandeh Z, Hashemi ZS, Pourzardosht N, Hessami A, Mard-Soltani M, Zakeri A, Rahbar MR, Khalili S. SARS-CoV-2 Proteome Harbors Peptides Which Are Able to Trigger Autoimmunity Responses: Implications for Infection, Vaccination, and Population Coverage. Front Immunol 2021; 12:705772. [PMID: 34447375 PMCID: PMC8383889 DOI: 10.3389/fimmu.2021.705772] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/23/2021] [Indexed: 12/16/2022] Open
Abstract
Autoimmune diseases (ADs) could occur due to infectious diseases and vaccination programs. Since millions of people are expected to be infected with SARS-CoV-2 and vaccinated against it, autoimmune consequences seem inevitable. Therefore, we have investigated the whole proteome of the SARS-CoV-2 for its ability to trigger ADs. In this regard, the entire proteome of the SARS-CoV-2 was chopped into more than 48000 peptides. The produced peptides were searched against the entire human proteome to find shared peptides with similar experimentally confirmed T-cell and B-cell epitopes. The obtained peptides were checked for their ability to bind to HLA molecules. The possible population coverage was calculated for the most potent peptides. The obtained results indicated that the SARS-CoV-2 and human proteomes share 23 peptides originated from ORF1ab polyprotein, nonstructural protein NS7a, Surface glycoprotein, and Envelope protein of SARS-CoV-2. Among these peptides, 21 peptides had experimentally confirmed equivalent epitopes. Amongst, only nine peptides were predicted to bind to HLAs with known global allele frequency data, and three peptides were able to bind to experimentally confirmed HLAs of equivalent epitopes. Given the HLAs which have already been reported to be associated with ADs, the ESGLKTIL, RYPANSIV, NVAITRAK, and RRARSVAS were determined to be the most harmful peptides of the SARS-CoV-2 proteome. It would be expected that the COVID-19 pandemic and the vaccination against this pathogen could significantly increase the ADs incidences, especially in populations harboring HLA-B*08:01, HLA-A*024:02, HLA-A*11:01 and HLA-B*27:05. The Southeast Asia, East Asia, and Oceania are at higher risk of AD development.
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Affiliation(s)
- Mohsen Karami Fath
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Abolfazl Jahangiri
- Applied Microbiology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahmoud Ganji
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Sefid
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Payandeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Sadat Hashemi
- Advanced Therapy Medicinal Product (ATMP) Department, Breast Cancer Research Center, Motamed Cancer Institute, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Navid Pourzardosht
- Biochemistry Department, Guilan University of Medical Sciences, Rasht, Iran
| | - Anahita Hessami
- School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maysam Mard-Soltani
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Dezful University of Medical Sciences, Dezful, Iran
| | - Alireza Zakeri
- Department of Biology Sciences, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Mohammad Reza Rahbar
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Khalili
- Department of Biology Sciences, Shahid Rajaee Teacher Training University, Tehran, Iran
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40
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Safiabadi Tali SH, LeBlanc JJ, Sadiq Z, Oyewunmi OD, Camargo C, Nikpour B, Armanfard N, Sagan SM, Jahanshahi-Anbuhi S. Tools and Techniques for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)/COVID-19 Detection. Clin Microbiol Rev 2021; 34:e00228-20. [PMID: 33980687 PMCID: PMC8142517 DOI: 10.1128/cmr.00228-20] [Citation(s) in RCA: 163] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory disease coronavirus 2 (SARS-CoV-2), has led to millions of confirmed cases and deaths worldwide. Efficient diagnostic tools are in high demand, as rapid and large-scale testing plays a pivotal role in patient management and decelerating disease spread. This paper reviews current technologies used to detect SARS-CoV-2 in clinical laboratories as well as advances made for molecular, antigen-based, and immunological point-of-care testing, including recent developments in sensor and biosensor devices. The importance of the timing and type of specimen collection is discussed, along with factors such as disease prevalence, setting, and methods. Details of the mechanisms of action of the various methodologies are presented, along with their application span and known performance characteristics. Diagnostic imaging techniques and biomarkers are also covered, with an emphasis on their use for assessing COVID-19 or monitoring disease severity or complications. While the SARS-CoV-2 literature is rapidly evolving, this review highlights topics of interest that have occurred during the pandemic and the lessons learned throughout. Exploring a broad armamentarium of techniques for detecting SARS-CoV-2 will ensure continued diagnostic support for clinicians, public health, and infection prevention and control for this pandemic and provide advice for future pandemic preparedness.
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Affiliation(s)
- Seyed Hamid Safiabadi Tali
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering, Concordia University, Montréal, Québec, Canada
- Department of Mechanical, Industrial, and Aerospace Engineering, Gina Cody School of Engineering, Concordia University, Montréal, Québec, Canada
| | - Jason J LeBlanc
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Medicine (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Zubi Sadiq
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering, Concordia University, Montréal, Québec, Canada
| | - Oyejide Damilola Oyewunmi
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering, Concordia University, Montréal, Québec, Canada
| | - Carolina Camargo
- Department of Microbiology and Immunology, McGill University, Montréal, Québec, Canada
| | - Bahareh Nikpour
- Department of Electrical and Computer Engineering, McGill University, Montréal, Québec, Canada
| | - Narges Armanfard
- Department of Electrical and Computer Engineering, McGill University, Montréal, Québec, Canada
- Mila-Quebec AI Institute, Montréal, Québec, Canada
| | - Selena M Sagan
- Department of Microbiology and Immunology, McGill University, Montréal, Québec, Canada
- Department of Biochemistry, McGill University, Montréal, Québec, Canada
| | - Sana Jahanshahi-Anbuhi
- Department of Chemical and Materials Engineering, Gina Cody School of Engineering, Concordia University, Montréal, Québec, Canada
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41
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Keshavarz P, Yazdanpanah F, Azhdari S, Kavandi H, Nikeghbal P, Bazyar A, Rafiee F, Nejati SF, Sadabad FE, Rezaei N. Coronavirus disease 2019 (COVID-19): A systematic review of 133 Children that presented with Kawasaki-like multisystem inflammatory syndrome. J Med Virol 2021; 93:5458-5473. [PMID: 33969513 PMCID: PMC8242327 DOI: 10.1002/jmv.27067] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/13/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022]
Abstract
Kawasaki-like disease (KLD) and multisystem inflammatory syndrome in children (MIS-C) are considered as challenges for pediatric patients under the age of 18 infected with coronavirus disease 2019 (COVID-19). A systematic search was performed on July 2, 2020, and updated on December 1, 2020, to identify studies on KLD/MIS-C associated with COVID-19. The databases of Scopus, PubMed, Web of Science, Embase, and Scholar were searched. The hospitalized children with a presentation of Kawasaki disease (KD), KLD, MIS-C, or inflammatory shock syndromes were included. A total number of 133 children in 45 studies were reviewed. A total of 74 (55.6%) cases had been admitted to pediatric intensive care units (PICUs). Also, 49 (36.8%) patients had required respiratory support, of whom 31 (23.3%) cases had required mechanical ventilation/intubation, 18 (13.5%) cases had required other oxygen therapies. In total, 79 (59.4%) cases had been discharged from hospitals, 3 (2.2%) had been readmitted, 9 (6.7%) had been hospitalized at the time of the study, and 9 (6.7%) patients had expired due to the severe heart failure, shock, brain infarction. Similar outcomes had not been reported in other patients. Approximately two-thirds of the children with KLD associated with COVID-19 had been admitted to PICUs, around one-fourth of them had required mechanical ventilation/intubation, and even some of them had been required readmissions. Therefore, physicians are strongly recommended to monitor children that present with the characteristics of KD during the pandemic as they can be the dominant manifestations in children with COVID-19.
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Affiliation(s)
- Pedram Keshavarz
- Department of Diagnostic and Interventional Radiology, New Hospitals LTD, Tbilisi, Georgia.,School of Science and Technology, The University of Georgia, Tbilisi, Georgia
| | - Fereshteh Yazdanpanah
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tabriz, Iran
| | - Sara Azhdari
- Department of Anatomy and Embryology, School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Hadiseh Kavandi
- Department of Rheumatology, Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Nikeghbal
- Department of Radiology, Medical ImagingResearch Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Bazyar
- Department of Radiology, Medical ImagingResearch Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faranak Rafiee
- Department of Radiology, Medical ImagingResearch Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Faraz Nejati
- Department of Radiology, Medical ImagingResearch Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faranak Ebrahimian Sadabad
- Department of Radiology, Medical ImagingResearch Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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42
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Lacina L, Brábek J, Fingerhutová Š, Zeman J, Smetana K. Pediatric Inflammatory Multisystem Syndrome (PIMS) - Potential role for cytokines such Is IL-6. Physiol Res 2021; 70:153-159. [PMID: 33992044 DOI: 10.33549/physiolres.934673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
COVID-19 is a transmissible respiratory disease caused by coronavirus SARS-CoV-2, which is similar to SARS or MERS. Its increased severity was noted in aged patients usually over 65 years of age. Children and young people have an asymptomatic or mild course of the disease.Unfortunately, the number of children with problems after mild or asymptomatic COVID-19 recovery is increasing and their troubles resemble Kawasaki disease, although the laboratory findings seem to be different. This condition is called pediatric inflammatory multisystem syndrome (PIMS), and it is a new disease seen in children directly influenced by previous SARS-CoV-2 infection. The literature reports that PIMS typically follows 2-4 weeks after SARS-CoV-2 infection. The clinical symptoms of the affected children are extremely complex, ranging from gastrointestinal to cardiovascular problems with frequent skin and mucosal manifestations, and without intensive treatment they can be fatal. The exact causes of PIMS are recently unknown, however, it is explained as hyperactivation of immunity.In this minireview, we summarize data on the prominent role of the IL-6-IL-6R-STAT3 axis in PIMS aetiopathogenesis. Therapeutic manipulation of IL-6 or IL-6 receptor could be an approach to the treatment of children with severe PIMS.
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Affiliation(s)
- L Lacina
- Charles University, First Faculty of Medicine, Institute of Anatomy, Prague, Czech Republic.
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43
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Wang L, Zhang S, Ma J, Ni J, Wang J, Li X, Mu Z, Han W, He G, Ma L, Shah J, Shah J, Jiao F. Kawasaki Disease- Management Strategies Given Symptoms Overlap to COVID-19: A Review. JNMA J Nepal Med Assoc 2021; 59:417-424. [PMID: 34508537 PMCID: PMC8369595 DOI: 10.31729/jnma.5698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 05/07/2021] [Indexed: 12/18/2022] Open
Abstract
Kawasaki disease is an acute, self-limiting vasculitis in children. Early treatment is necessary to prevent cardiovascular complications. The acute phase of Kawasaki disease may present with hemodynamic instability. An association between viral respiratory infections and Kawasaki disease has been reported. Studies have shown that Kawasaki and Kawasaki-like disease may be associated with and have symptoms overlapping COVID-19. Children with COVID-19 may present as Kawasaki-like disease with pediatric inflammatory multisystem syndrome, or macrophage activation syndrome. Clinicians need to be aware of the early diagnosis and management of Kawasaki disease to prevent the development of coronary artery aneurysms. The symptoms overlap of multisystem inflammatory disease seen in COVID-19 adds to the difficulties in timely diagnosis and treatment. Children with Kawasaki disease require regular follow-up plans for coronary artery aneurysms. This adds to the difficulties during the changed environment of COVID-19 for control and prevention. Missed diagnosis and early treatment of Kawasaki disease with immunoglobulin and aspirin results in the development of coronary artery aneurysm in up to 25% of cases, with grave consequences. Here, we briefly review the management of typical and atypical Kawasaki disease which has symptoms overlapping with the multisystem inflammatory disease as seen in COVID-19.
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Affiliation(s)
- Linna Wang
- Xi'an Medical University, Xi'an, 710068, China
| | - Sheng Zhang
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Ji Ma
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Jing Ni
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Juyan Wang
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Xiaohong Li
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Zhilong Mu
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Wei Han
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Gaitao He
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Lei Ma
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
| | - Jenifei Shah
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jay Shah
- Patan Hospital, Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Fuyong Jiao
- Children's Hospital of Shaanxi Provincial People's Hospital, 3 Affiliated Hospital of Medical College of Xi'an Jiao Tong University, Xi'an Shanxi, 710001, China
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44
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Ionescu MD, Taras R, Dombici B, Balgradean M, Berghea EC, Nicolescu A. The Challenging Diagnosis of Pediatric Multisystem Inflammatory Syndrome Associated with Sars-Cov-2 Infection-Two Case Reports and Literature Review. J Pers Med 2021; 11:jpm11040318. [PMID: 33921718 PMCID: PMC8073032 DOI: 10.3390/jpm11040318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/30/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory coronavirus 2 (SARS-CoV-2) is a novel coronavirus discovered in 2019 that caused the coronavirus disease 2019 (COVID19). During the last year, over 70 million people were infected and more than 1.5 million people died. Despite the tremendous number of people infected, children were less affected and presented milder forms of the disease. A short time after the pandemic was declared, a new hyperinflammatory syndrome resembling Kawasaki disease (KD) was described in children with confirmed or suspected SARS-CoV-2 infection named multisystem inflammatory syndrome in children (MIS-C). The incidence of MIS-C is low and it has a polymorphous clinical presentation, making the diagnosis difficult. Although the incidence is reduced, there is a high risk of cardiovascular complications. In order to raise awareness, we present the cases of two pediatric patients diagnosed with MIS-C in our clinic.
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Affiliation(s)
- Marcela Daniela Ionescu
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
| | - Roxana Taras
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
| | - Bianca Dombici
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
| | - Mihaela Balgradean
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
| | - Elena Camelia Berghea
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.D.I.); (R.T.); (B.D.); (M.B.)
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
- Correspondence:
| | - Alin Nicolescu
- Marie Curie Emergency Children’s Hospital, 041451 Bucharest, Romania;
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45
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Mavrogeni SI, Kolovou G, Tsirimpis V, Kafetzis D, Tsolas G, Fotis L. The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C). Rheumatol Int 2021; 41:1037-1044. [PMID: 33864498 PMCID: PMC8052538 DOI: 10.1007/s00296-021-04845-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/17/2021] [Indexed: 12/13/2022]
Abstract
Multisystem Inflammatory Syndrome in Children (MIS-C) recently reported in a minority of children affected by SARS-CoV-2, mimics Kawasaki disease (KD), a medium vessel vasculitis of unknown cause. In contrast to acute COVID-19 infection, which is usually mild in children, 68% of patients with MIS-C will need intensive care unit. Myocarditis and coronary artery ectasia/aneurysm are included between the main cardiovascular complications in MIS-C. Therefore, close clinical assessment is need it both at diagnosis and during follow-up. Echocardiography is the cornerstone modality for myocardial function and coronary artery evaluation in the acute phase. Cardiovascular magnetic resonance (CMR) detects diffuse myocardial inflammation including oedema/fibrosis, myocardial perfusion and coronary arteries anatomy during the convalescence and in adolescents, where echocardiography may provide inadequate images. Brain involvement in MIS-C is less frequent compared to cardiovascular disease. However, it is not unusual and should be monitored by clinical evaluation and brain magnetic resonance (MRI), as we still do not know its effect in brain development. Brain MRI in MIS-C shows T2-hyperintense lesions associated with restricted diffusion and bilateral thalamic lesions. To conclude, MIS-C is a multisystem disease affecting many vital organs, such as heart and brain. Clinical awareness, application of innovative, high technology imaging modalities and advanced treatment protocols including supportive and anti-inflammatory medication will help physicians to prevent the dreadful complications of MIS-C.
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Affiliation(s)
- Sophie I Mavrogeni
- Onassis Cardiac Surgery Center, Athens, Greece.,Department of Pediatrics, National and Kapodistrian University of Athens, 1 Rimini Str, 12462, ChaidairiAthens, Greece
| | | | | | - Dimitrios Kafetzis
- Department of Pediatrics, Metropolitan Hospital, Piraeus, Greece.,Department of Pediatrics, National and Kapodistrian University of Athens, 1 Rimini Str, 12462, ChaidairiAthens, Greece
| | - Georgios Tsolas
- Department of Pediatrics, Metropolitan Hospital, Piraeus, Greece
| | - Lampros Fotis
- Department of Pediatrics, Metropolitan Hospital, Piraeus, Greece. .,Department of Pediatrics, National and Kapodistrian University of Athens, 1 Rimini Str, 12462, ChaidairiAthens, Greece.
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46
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Veyseh M, Webster P, Blanco I. COVID-19-associated inflammatory syndrome in an adult woman with unexplained multiple organ failure: staying vigilant for COVID-19 complications as the pandemic surges. BMJ Case Rep 2021; 14:14/4/e242034. [PMID: 33846193 PMCID: PMC8047984 DOI: 10.1136/bcr-2021-242034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Since the emergence of SARS-CoV-2, clinicians have been challenged with a wide spectrum of disease severity. One of the serious complications associated with the virus is multisystem inflammatory syndrome in children (MIS-C). It is characterised by inflammation leading to organ damage, in the setting of positive SARS-CoV-2 infection. MIS-C is thought to be a postviral reaction where most children are negative on PCR testing but are positive for SARS-CoV-2 antibodies. The Centers for Disease Control and Prevention recently defined the same phenomenon occurring in adults as multisystem inflammatory syndrome in adults (MIS-A) and emphasised on the use of antibody testing in this population. Here we describe an adult woman with an exposure to SARS-CoV-2 who presented with unexplained organ failure and shock. Positive antibody testing was the only clue to the diagnosis of MIS-A. We stress the importance of SARS-CoV-2 antibody detection in order to identify these cases.
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Affiliation(s)
- Maedeh Veyseh
- Medicine, Jacobi Medical Center, Bronx, New York, USA .,Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Irene Blanco
- Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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47
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Clinical Characteristics of Paediatric Hyperinflammatory Syndrome in the Era of Corona Virus Disease 2019 (COVID-19). Indian J Clin Biochem 2021; 36:404-415. [PMID: 33716413 PMCID: PMC7936863 DOI: 10.1007/s12291-021-00963-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 02/17/2021] [Indexed: 12/12/2022]
Abstract
The pandemic of COVID-19 initially appeared to cause only a mild illness in children. However, it is now apparent that a small percentage of children can develop a hyperinflammatory syndrome labeled as Pediatric inflammatory multisystem syndrome—temporally associated with SARS-CoV-2 (PIMS-TS) with a phenotype resembling Kawasaki disease (KD) ('Kawa-COVID-19′). Features of this newly recognized condition may include fever, hypotension, severe abdominal pain and cardiac dysfunction, evidence of inflammation, and single or multi organ dysfunction in the absence of other known infections. Children emerge to have mild symptoms compared to adults, perhaps due to reduced expression of the angiotensin converting enzyme (ACE)-2 receptor (the target of SARS-CoV-2) gene, trained innate immunity, and a young and fit immune system. Some of these children may share features of Kawasaki disease, toxic shock syndrome or cytokine storm syndrome. They can deteriorate rapidly and may need intensive care support as well. The PCR test is more often negative although most of the children have antibodies to SARS-CoV-2. Although the pathogenesis is not clearly known, immune-mediated injury has been implicated.
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48
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Dotan A, Muller S, Kanduc D, David P, Halpert G, Shoenfeld Y. The SARS-CoV-2 as an instrumental trigger of autoimmunity. Autoimmun Rev 2021; 20:102792. [PMID: 33610751 PMCID: PMC7892316 DOI: 10.1016/j.autrev.2021.102792] [Citation(s) in RCA: 277] [Impact Index Per Article: 92.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 12/14/2022]
Abstract
Autoimmunity may be generated by a variety of factors by creating a hyper-stimulated state of the immune system. It had been established long ago that viruses are a substantial component of environmental factors that contribute to the production of autoimmune antibodies, as well as autoimmune diseases. Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) are viruses that withhold these autoimmune abilities. In a similar manner, SARS-CoV-2 may be counted to similar manifestations, as numerous records demonstrating the likelihood of COVID-19 patients to develop multiple types of autoantibodies and autoimmune diseases. In this review, we focused on the association between COVID-19 and the immune system concerning the tendency of patients to develop over 15 separate types of autoantibodies and above 10 distinct autoimmune diseases. An additional autoimmunity manifestation may be one of the common initial symptoms in COVID-19 patients, anosmia, the complete loss of the ability to sense smell, and other olfactory alterations. We summarize current knowledge on principal mechanisms that may contribute to the development of autoimmunity in the disease: the ability of SARS-CoV-2 to hyper-stimulate the immune system, induce excessive neutrophil extracellular traps formation with neutrophil-associated cytokine responses and the molecular resemblance between self-components of the host and the virus. Additionally, we will examine COVID-19 potential risk on the new-onsets of autoimmune diseases, such as antiphospholipid syndrome, Guillain-Barré syndrome, Kawasaki disease and numerous others. It is of great importance to recognize those autoimmune manifestations of COVID-19 in order to properly cope with their outcomes in the ongoing pandemic and the long-term post-pandemic period. Lastly, an effective vaccine against SARS-CoV-2 may be the best solution in dealing with the ongoing pandemic. We will discuss the new messenger RNA vaccination strategy with an emphasis on autoimmunity implications.
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Affiliation(s)
- Arad Dotan
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sylviane Muller
- CNRS-Strasbourg University Unit Biotechnology and cell signaling/Strasbourg Drug Discovery and Development Institute (IMS), Strasbourg, France; Federation Hospital-University (FHU) OMICARE, Federation of Translational Medicine of Strasbourg (FMTS), Strasbourg University, Strasbourg, France; University of Strasbourg Institute for Advanced Study, Strasbourg, France
| | - Darja Kanduc
- Department of Biosciences, Biotechnologies, and Biopharmaceutics, University of Bari, Italy
| | - Paula David
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Halpert
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg 199034, Russian Federation
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel. Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, Saint-Petersburg 199034, Russian Federation.
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49
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Derruau S, Bouchet J, Nassif A, Baudet A, Yasukawa K, Lorimier S, Prêcheur I, Bloch-Zupan A, Pellat B, Chardin H, Jung S. COVID-19 and Dentistry in 72 Questions: An Overview of the Literature. J Clin Med 2021; 10:779. [PMID: 33669185 PMCID: PMC7919689 DOI: 10.3390/jcm10040779] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
The outbreak of Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has significantly affected the dental care sector. Dental professionals are at high risk of being infected, and therefore transmitting SARS-CoV-2, due to the nature of their profession, with close proximity to the patient's oropharyngeal and nasal regions and the use of aerosol-generating procedures. The aim of this article is to provide an update on different issues regarding SARS-CoV-2 and COVID-19 that may be relevant for dentists. Members of the French National College of Oral Biology Lecturers ("Collège National des EnseignantS en Biologie Orale"; CNESBO-COVID19 Task Force) answered seventy-two questions related to various topics, including epidemiology, virology, immunology, diagnosis and testing, SARS-CoV-2 transmission and oral cavity, COVID-19 clinical presentation, current treatment options, vaccine strategies, as well as infection prevention and control in dental practice. The questions were selected based on their relevance for dental practitioners. Authors independently extracted and gathered scientific data related to COVID-19, SARS-CoV-2 and the specific topics using scientific databases. With this review, the dental practitioners will have a general overview of the COVID-19 pandemic and its impact on their practice.
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Affiliation(s)
- Stéphane Derruau
- UFR Odontologie, Université de Reims Champagne-Ardenne, 51100 Reims, France; (S.D.); (S.L.)
- Pôle de Médecine Bucco-dentaire, Centre Hospitalier Universitaire de Reims, 51092 Reims, France
- BioSpecT EA-7506, UFR de Pharmacie, Université de Reims Champagne-Ardenne, 51096 Reims, France
| | - Jérôme Bouchet
- UFR Odontologie-Montrouge, Université de Paris, 92120 Montrouge, France; (J.B.); (B.P.); (H.C.)
- Laboratory “Orofacial Pathologies, Imaging and Biotherapies” URP 2496, University of Paris, 92120 Montrouge, France
| | - Ali Nassif
- UFR Odontologie-Garancière, Université de Paris, 75006 Paris, France;
- AP-HP, Sites hospitaliers Pitié Salpêtrière et Rothschild, Service d’Orthopédie Dento-Faciale, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), 75013-75019 Paris, France
- INSERM, UMR_S 1138, Laboratoire de Physiopathologie Orale et Moléculaire, Centre de Recherche des Cordeliers, 75006 Paris, France
| | - Alexandre Baudet
- Faculté de Chirurgie Dentaire, Université de Lorraine, 54505 Vandœuvre-lès-Nancy, France; (A.B.); (K.Y.)
- Centre Hospitalier Régional Universitaire de Nancy, 54000 Nancy, France
| | - Kazutoyo Yasukawa
- Faculté de Chirurgie Dentaire, Université de Lorraine, 54505 Vandœuvre-lès-Nancy, France; (A.B.); (K.Y.)
- Centre Hospitalier Régional Universitaire de Nancy, 54000 Nancy, France
| | - Sandrine Lorimier
- UFR Odontologie, Université de Reims Champagne-Ardenne, 51100 Reims, France; (S.D.); (S.L.)
- Pôle de Médecine Bucco-dentaire, Centre Hospitalier Universitaire de Reims, 51092 Reims, France
- Université de Reims Champagne-Ardenne, MATIM EA, UFR Sciences, 51687 Reims, France
| | - Isabelle Prêcheur
- Faculté de Chirurgie Dentaire, Université Côte d’Azur, 06000 Nice, France;
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
- Laboratoire Microbiologie Orale, Immunothérapie et Santé (MICORALIS EA 7354), Faculté de Chirurgie Dentaire, 06300 Nice, France
| | - Agnès Bloch-Zupan
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 67000 Strasbourg, France;
- Pôle de Médecine et de Chirurgie Bucco-Dentaires, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U 1258, CNRS UMR 7104, Université de Strasbourg, 67400 Illkirch-Graffenstaden, France
| | - Bernard Pellat
- UFR Odontologie-Montrouge, Université de Paris, 92120 Montrouge, France; (J.B.); (B.P.); (H.C.)
- Laboratory “Orofacial Pathologies, Imaging and Biotherapies” URP 2496, University of Paris, 92120 Montrouge, France
| | - Hélène Chardin
- UFR Odontologie-Montrouge, Université de Paris, 92120 Montrouge, France; (J.B.); (B.P.); (H.C.)
- AP-HP, Hôpital Henri Mondor, 94010 Créteil, France
- ESPCI, UMR CBI 8231, 75005 Paris, France
| | - Sophie Jung
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 67000 Strasbourg, France;
- Pôle de Médecine et de Chirurgie Bucco-Dentaires, Centre de Référence Maladies Rares Orales et Dentaires (O-Rares), Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
- INSERM UMR_S 1109 «Molecular Immuno-Rheumatology», Institut Thématique Interdisciplinaire de Médecine de Précision de Strasbourg, Transplantex NG, Fédération hospitalo-universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France
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Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean. Clin Rheumatol 2021; 40:3227-3237. [PMID: 33576926 PMCID: PMC7879406 DOI: 10.1007/s10067-021-05631-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/31/2021] [Accepted: 02/02/2021] [Indexed: 11/04/2022]
Abstract
Objective We aimed to describe the typical clinical and laboratory features and treatment of children diagnosed with multisystem inflammatory syndrome in children (MIS-C) and to understand the differences as compared to severe/critical pediatric cases with COVID-19 in an eastern Mediterranean country. Methods Children (aged <18 years) who diagnosed with MIS-C and severe/critical pediatric cases with COVID-19 and were admitted to hospital between March 26 and November 3, 2020 were enrolled in the study. Results A total of 52 patients, 22 patients diagnosed with COVID-19 with severe/critical disease course and 30 patients diagnosed with MIS-C, were included in the study. Although severe COVID-19 cases and cases with MIS-C share many clinical and laboratory features, MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe cases (p<0.001 for each). Of all, 53.3% of MIS-C cases had the evidence of myocardial involvement as compared to severe cases (27.2%). Additionally, C-reactive protein (CRP) and white blood cell (WBC) are the independent predictors for the diagnosis of MIS-C, particularly in the existence of conjunctival injection and rash. Corticosteroids, intravenous immunoglobulin (IVIG), and biologic immunomodulatory treatments were mainly used in MIS-C cases rather than cases with severe disease course. There were only three deaths among 52 patients, one of whom had Burkitt lymphoma and the two cases with severe COVID-19 of late referral. Conclusion Differences between clinical presentations, acute phase responses, organ involvements, and management strategies indicate that MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19. Conjunctival injection and higher CRP and low WBC count are reliable diagnostic parameters for MIS-C cases.Key Points • MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe/critical pediatric cases with COVID-19. • Higher CRP and low total WBC count are the independent predictors for the diagnosis of MIS-C. • MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19. |
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