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Fernandes LP, Murai IH, Fernandes AL, Sales LP, Rogero MM, Gualano B, Barroso LP, Milne GL, Pereira RMR, Castro IA. The severity of COVID-19 upon hospital admission is associated with plasma omega-3 fatty acids. Sci Rep 2024; 14:10238. [PMID: 38702342 PMCID: PMC11068876 DOI: 10.1038/s41598-024-60815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024] Open
Abstract
Fatty acids are precursors of inflammatory oxylipins. In the context of COVID-19, an excessive production of pro-inflammatory cytokines is associated with disease severity. The objective was to investigate whether the baseline omega 3/omega 6 fatty acids ratio and the oxylipins were associated with inflammation and oxidative stress in unvaccinated patients with COVID-19, classified according to the severity of the disease during hospitalization. This Prospective population-based cohort study included 180 hospitalized patients with COVID-19. The patients were classified into five groups according to the severity of their disease. Group 1 was the least severe and Group 5 was the most severe. Three specific types of fatty acids-eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid (AA)-as well as their enzymatic and non-enzymatic oxylipins were determined using chromatography coupled mass spectrometry. There was no difference in the ratio of omega-3 to omega-6 fatty acids between the groups (p = 0.276). However, the EPA/AA ratio was lower in Group 4 compared to Group 1 (p = 0.015). This finding was associated with an increase in both C-Reactive Protein (p < 0.001) and Interleukin-6 (p = 0.002). Furthermore, the concentration of F2-Isoprostanes was higher in Group 4 than in Group 1 (p = 0.009), while no significant changes were observed for other oxylipins among groups. Multivariate analysis did not present any standard of biomarkers, suggesting the high complexity of factors involved in the disease severity. Our hypothesis was confirmed in terms of EPA/AA ratio. A higher EPA/AA ratio upon hospital admission was found to be associated with lower concentration of C-Reactive Protein and Interleukin-6, leading to a better prognosis of hospitalized SARS-CoV-2 patients. Importantly, this beneficial outcome was achieved without any form of supplementation. The trial also provides important information that can be further applied to reduce the severity of infections associated with an uncontrolled synthesis of pro-inflammatory cytokines.Trial registration: https://clinicaltrials.gov/study/NCT04449718 -01/06/2020. ClinicalTrials.gov Identifier: NCT04449718.
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Affiliation(s)
- Ligia P Fernandes
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, LADAF, University of São Paulo, Av. Lineu Prestes, 580, B14, São Paulo, SP, 05508-900, Brazil
| | - Igor H Murai
- Bone Metabolism Laboratory, Rheumatology Division, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Alan L Fernandes
- Bone Metabolism Laboratory, Rheumatology Division, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Lucas P Sales
- Bone Metabolism Laboratory, Rheumatology Division, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Marcelo M Rogero
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil
- Food Research Center (FoRC), CEPID-FAPESP, Research Innovation and Dissemination Centers São Paulo Research Foundation, São Paulo, 05468-140, Brazil
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Food Research Center (FoRC), CEPID-FAPESP, Research Innovation and Dissemination Centers São Paulo Research Foundation, São Paulo, 05468-140, Brazil
| | - Lúcia P Barroso
- Statistics Department, Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Ginger L Milne
- Eicosanoid Core Laboratory, Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Rosa M R Pereira
- Bone Metabolism Laboratory, Rheumatology Division, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Inar A Castro
- Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, LADAF, University of São Paulo, Av. Lineu Prestes, 580, B14, São Paulo, SP, 05508-900, Brazil.
- Food Research Center (FoRC), CEPID-FAPESP, Research Innovation and Dissemination Centers São Paulo Research Foundation, São Paulo, 05468-140, Brazil.
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2
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Kitselman A K, Bédard-Matteau J, Rousseau S, Tabrizchi R, Daneshtalab N. Sex differences in vascular endothelial function related to acute and long COVID-19. Vascul Pharmacol 2024; 154:107250. [PMID: 38043758 DOI: 10.1016/j.vph.2023.107250] [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: 09/13/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has been at the forefront of health sciences research since its emergence in China in 2019 that quickly led to a global pandemic. As a result of this research, and the large numbers of infected patients globally, there were rapid enhancements made in our understanding of Coronavirus disease 2019 (COVID-19) pathology, including its role in the development of uncontrolled immune responses and its link to the development of endotheliitis and endothelial dysfunction. There were also some noted differences in the rate and severity of infection between males and females with acute COVID. Some individuals infected with SARS-CoV-2 also experience long-COVID, an important hallmark symptom of this being Myalgic Encephalomyelitis-Chronic Fatigue Syndrome (ME-CFS), also experienced differently between males and females. The purpose of this review is to discuss the impact of sex on the vasculature during acute and long COVID-19, present any link between ME-CFS and endothelial dysfunction, and provide evidence for the relationship between ME-CFS and the immune system. We also will delineate biological sex differences observed in other post viral infections and, assess if sex differences exist in how the immune system responds to viral infection causing ME-CFS.
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Affiliation(s)
- Kayla Kitselman A
- Faculty of Medicine, Division of Biomedical Sciences at Memorial University of Newfoundland and Labrador, Canada
| | - Jérôme Bédard-Matteau
- Faculty of Medicine, Department of Pharmacology and Therapeutics, McGill University, Québec, Canada; Meakins-Christie Laboratories, RI-MUHC, Block EOffice EM3.2244Lab E03.21371001 Decarie Blvd., Montreal, QC H4A 3J1, Canada
| | - Simon Rousseau
- Faculty of Medicine, Department of Pharmacology and Therapeutics, McGill University, Québec, Canada; Faculty of Medicine, Department of Experimental Medicine, McGill University, Québec, Canada; Meakins-Christie Laboratories, RI-MUHC, Block EOffice EM3.2244Lab E03.21371001 Decarie Blvd., Montreal, QC H4A 3J1, Canada
| | - Reza Tabrizchi
- Faculty of Medicine, Division of Biomedical Sciences at Memorial University of Newfoundland and Labrador, Canada
| | - Noriko Daneshtalab
- School of Pharmacy at Memorial University of Newfoundland and Labrador, Canada.
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3
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Nikiforuk AM, Kuchinski KS, Short K, Roman S, Irvine MA, Prystajecky N, Jassem AN, Patrick DM, Sekirov I. Nasopharyngeal angiotensin converting enzyme 2 (ACE2) expression as a risk-factor for SARS-CoV-2 transmission in concurrent hospital associated outbreaks. BMC Infect Dis 2024; 24:262. [PMID: 38408924 PMCID: PMC10898082 DOI: 10.1186/s12879-024-09067-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/28/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Widespread human-to-human transmission of the severe acute respiratory syndrome coronavirus two (SARS-CoV-2) stems from a strong affinity for the cellular receptor angiotensin converting enzyme two (ACE2). We investigate the relationship between a patient's nasopharyngeal ACE2 transcription and secondary transmission within a series of concurrent hospital associated SARS-CoV-2 outbreaks in British Columbia, Canada. METHODS Epidemiological case data from the outbreak investigations was merged with public health laboratory records and viral lineage calls, from whole genome sequencing, to reconstruct the concurrent outbreaks using infection tracing transmission network analysis. ACE2 transcription and RNA viral load were measured by quantitative real-time polymerase chain reaction. The transmission network was resolved to calculate the number of potential secondary cases. Bivariate and multivariable analyses using Poisson and Negative Binomial regression models was performed to estimate the association between ACE2 transcription the number of SARS-CoV-2 secondary cases. RESULTS The infection tracing transmission network provided n = 76 potential transmission events across n = 103 cases. Bivariate comparisons found that on average ACE2 transcription did not differ between patients and healthcare workers (P = 0.86). High ACE2 transcription was observed in 98.6% of transmission events, either the primary or secondary case had above average ACE2. Multivariable analysis found that the association between ACE2 transcription (log2 fold-change) and the number of secondary transmission events differs between patients and healthcare workers. In health care workers Negative Binomial regression estimated that a one-unit change in ACE2 transcription decreases the number of secondary cases (β = -0.132 (95%CI: -0.255 to -0.0181) adjusting for RNA viral load. Conversely, in patients a one-unit change in ACE2 transcription increases the number of secondary cases (β = 0.187 (95% CI: 0.0101 to 0.370) adjusting for RNA viral load. Sensitivity analysis found no significant relationship between ACE2 and secondary transmission in health care workers and confirmed the positive association among patients. CONCLUSION Our study suggests that ACE2 transcription has a positive association with SARS-CoV-2 secondary transmission in admitted inpatients, but not health care workers in concurrent hospital associated outbreaks, and it should be further investigated as a risk-factor for viral transmission.
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Affiliation(s)
- Aidan M Nikiforuk
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Kevin S Kuchinski
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Katy Short
- Fraser Health Authority, V3L 3C2, New Westminster, BC, Canada
| | - Susan Roman
- Fraser Health Authority, V3L 3C2, New Westminster, BC, Canada
| | - Mike A Irvine
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, V5A 1S6, Burnaby, BC, Canada
| | - Natalie Prystajecky
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - David M Patrick
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada
| | - Inna Sekirov
- British Columbia Centre for Disease Control, V5Z 4R4, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, V6T 1Z4, Vancouver, BC, Canada.
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Wang YL, Cheng ST, Shen CF, Huang SW, Cheng CM. Impact of the COVID-19 vaccine booster strategy on vaccine protection: a pilot study of a military hospital in Taiwan. Clin Exp Vaccine Res 2023; 12:337-345. [PMID: 38025918 PMCID: PMC10655154 DOI: 10.7774/cevr.2023.12.4.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The global fight against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to widespread vaccination efforts, yet the optimal dosing schedule for SARS-CoV-2 vaccines remains a subject of ongoing research. This study aims to investigate the effectiveness of administering two booster doses as the third and fourth doses at different intervals to enhance vaccine protection. Materials and Methods This study was conducted at a military regional hospital operated by the Ministry of National Defense in Taiwan. A cohort of vaccinated individuals was selected, and their vaccine potency was assessed at various time intervals following their initial vaccine administration. The study participants received booster doses as the third and fourth doses, with differing time intervals between them. The study monitored neutralizing antibody titers and other relevant parameters to assess vaccine efficacy. Results Our findings revealed that the potency of the SARS-CoV-2 vaccine exhibited a significant decline 80 days after the initial vaccine administration. However, a longer interval of 175 days between booster injections resulted in significantly higher neutralizing antibody titers. The individuals who received the extended interval boosters exhibited a more robust immune response, suggesting that a vaccine schedule with a 175-day interval between injections may provide superior protection against SARS-CoV-2. Conclusion This study underscores the importance of optimizing vaccine booster dosing schedules to maximize protection against SARS-CoV-2. The results indicate that a longer interval of 175 days between the third and fourth doses of the vaccine can significantly enhance the neutralizing antibody response, potentially offering improved protection against the virus. These findings have important implications for vaccine distribution and administration strategies in the ongoing battle against the SARS-CoV-2 pandemic. Further research and large-scale trials are needed to confirm and extend these findings for broader public health implications.
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Affiliation(s)
- Yu-Li Wang
- Department of Emergent Room, Armed Force Hualien General Hospital, Hualien, Taiwan
- International Intercollegiate Ph.D. Program, National Tsing Hua University, Hsinchu, Taiwan
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Shu-Tsai Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shu-Wei Huang
- Department of Orthopedics, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan
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5
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Abha Mishra KM, Podili R, Pathlavath TS, Sethi KK. A critical review on brain and heart axis response in COVID-19 patients: Molecular mechanisms, mediators, biomarkers, and therapeutics. J Biochem Mol Toxicol 2023; 37:e23409. [PMID: 37341157 DOI: 10.1002/jbt.23409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023]
Abstract
Since the outbreak of highly virulent coronaviruses, significant interest was assessed to the brain and heart axis (BHA) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-affected patients. The majority of clinical reports accounted for unusual symptoms associated with SARS-CoV-2 infections which are of the neurological type, such as headache, nausea, dysgeusia, anosmia, and cerebral infarction. The SARS-CoV-2 enters the cells through the angiotensin-converting enzyme (ACE-2) receptor. Patients with prior cardiovascular disease (CVD) have a higher risk of COVID-19 infection and it has related to various cardiovascular (CV) complications. Infected patients with pre-existing CVDs are also particularly exposed to critical health outcomes. Overall, COVID-19 affected patients admitted to intensive care units (ICU) and exposed to stressful environmental constraints, featured with a cluster of neurological and CV complications. In this review, we summarized the main contributions in the literature on how SARS-CoV-2 could interfere with the BHA and its role in affecting multiorgan disorders. Specifically, the central nervous system involvement, mainly in relation to CV alterations in COVID-19-affected patients, is considered. This review also emphasizes the biomarkers and therapy options for COVID-19 patients presenting with CV problems.
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Affiliation(s)
- K M Abha Mishra
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Runesh Podili
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Teja S Pathlavath
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Kalyan K Sethi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
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6
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Zhang J, He L, Huang R, Alvarez JF, Yang DH, Sun Q, Wang F, Peng Z, Jiang N, Su L. Synergistic effect of elevated glucose levels with SARS-CoV-2 spike protein induced NOX-dependent ROS production in endothelial cells. Mol Biol Rep 2023:10.1007/s11033-023-08504-3. [PMID: 37289363 DOI: 10.1007/s11033-023-08504-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/04/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Diabetic patients infected with coronavirus disease 2019 (COVID-19) often have a higher probability of organ failure and mortality. The potential cellular mechanisms through which blood glucose exacerbates tissue damage due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still unclear. METHODS AND RESULTS We cultured endothelial cells within differing glucose mediums with an increasing concentration gradient of SARS-CoV-2 Spike protein (S protein). S protein can cause the reduction of ACE2 and TMPRSS2, and activation of NOX2 and NOX4. A high glucose medium was shown to aggravate the decrease of ACE2 and activation of NOX2 and NOX4 in cultured cells, but had no effect on TMPRSS2. S protein mediated activation of the ACE2-NOX axis induced oxidative stress and apoptosis within endothelial cells, leading to cellular dysfunction via the reduction of NO and tight junction proteins which may collectively be exacerbated by elevated glucose. In addition, the glucose variability model demonstrated activation of the ACE2-NOX axis in a similar manner observed in the high glucose model in vitro. CONCLUSIONS Our present study provides evidence for a mechanism through which hyperglycemia aggravates endothelial cell injury resulting from S protein mediated activation of the ACE2-NOX axis. Our research thus highlights the importance of strict monitoring and control of blood glucose levels within the context of COVID-19 treatment to potentially improve clinical outcomes.
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Affiliation(s)
- Jiahao Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Province, Wuhan 430071, China
- Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
- Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei, 430000, China
| | - Li He
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Province, Wuhan 430071, China
- Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Rong Huang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Province, Wuhan 430071, China
| | - Juan Felipe Alvarez
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - David H Yang
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Qihao Sun
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Fengqin Wang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Province, Wuhan 430071, China
- Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Zhiyong Peng
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Province, Wuhan 430071, China
- Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Nanhui Jiang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Province, Wuhan 430071, China.
- Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei, 430000, China.
| | - Lianjiu Su
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Province, Wuhan 430071, China.
- Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China.
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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7
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Gui Y, Palanza Z, Fu H, Zhou D. Acute kidney injury in diabetes mellitus: Epidemiology, diagnostic, and therapeutic concepts. FASEB J 2023; 37:e22884. [PMID: 36943403 PMCID: PMC10602403 DOI: 10.1096/fj.202201340rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 02/16/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
Acute kidney injury (AKI) and diabetes mellitus (DM) are public health problems that cause a high socioeconomic burden worldwide. In recent years, the landscape of AKI etiology has shifted: Emerging evidence has demonstrated that DM is an independent risk factor for the onset of AKI, while an alternative perspective considers AKI as a bona fide complication of DM. Therefore, it is necessary to systematically characterize the features of AKI in DM. In this review, we summarized the epidemiology of AKI in DM. While focusing on circulation- and tissue-specific microenvironment changes after DM, we described the active cellular and molecular mechanisms of increased kidney susceptibility to AKI under DM stress. We also reviewed the current diagnostic and therapeutic strategies for AKI in DM recommended in the clinic. Updated recognition of the epidemiology, pathophysiology, diagnosis, and medications of AKI in DM is believed to reveal a path to mitigate the frequency of AKI and DM comorbidity that will ultimately improve the quality of life in DM patients.
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Affiliation(s)
- Yuan Gui
- Division of Nephrology, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, 06030, USA
| | - Zachary Palanza
- Division of Nephrology, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, 06030, USA
| | - Haiyan Fu
- State Key Laboratory of Organ Failure Research, National Clinical Research Center of Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15261, USA
| | - Dong Zhou
- Division of Nephrology, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, 06030, USA
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Hilbold E, Bär C, Thum T. COVID-19: Insights into long-term manifestations and lockdown impacts. JOURNAL OF SPORT AND HEALTH SCIENCE 2023:S2095-2546(23)00019-4. [PMID: 36868374 PMCID: PMC9977467 DOI: 10.1016/j.jshs.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/23/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Coronaviruses are pathogens thought to primarily affect the respiratory tracts of humans. The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 was also marked mainly by its symptoms of respiratory illness, which were named coronavirus disease 2019 (COVID-19). Since its initial discovery, many other symptoms have been linked to acute SARS-CoV-2 infections as well as to the long-term outcomes of COVID-19 patients. Among these symptoms are different categories of cardiovascular diseases (CVDs), which continue to be the main cause of death worldwide. The World Health Organization estimates that 17.9 million people die from CVDs each year, accounting for ∼32% of all deaths globally. Physical inactivity is one of the most important behavioral risk factors for CVDs. The COVID-19 pandemic has affected CVDs as well as the physical activity in different ways. Here, we provide an overview of the current status as well as future challenges and possible solutions.
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Affiliation(s)
- Erika Hilbold
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover 30625, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover 30625, Germany; Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Hannover 30625, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover 30625, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover 30625, Germany; Fraunhofer Cluster of Excellence Immune-Mediated Diseases (CIMD), Hannover 30625, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover 30625, Germany.
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9
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Murali R, Wanjari UR, Mukherjee AG, Gopalakrishnan AV, Kannampuzha S, Namachivayam A, Madhyastha H, Renu K, Ganesan R. Crosstalk between COVID-19 Infection and Kidney Diseases: A Review on the Metabolomic Approaches. Vaccines (Basel) 2023; 11:vaccines11020489. [PMID: 36851366 PMCID: PMC9959335 DOI: 10.3390/vaccines11020489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a respiratory disorder. Various organ injuries have been reported in response to this virus, including kidney injury and, in particular, kidney tubular injury. It has been discovered that infection with the virus does not only cause new kidney disease but also increases treatment difficulty and mortality rates in people with kidney diseases. In individuals hospitalized with COVID-19, urinary metabolites from several metabolic pathways are used to distinguish between patients with acute kidney injury (AKI) and those without. This review summarizes the pathogenesis, pathophysiology, treatment strategies, and role of metabolomics in relation to AKI in COVID-19 patients. Metabolomics is likely to play a greater role in predicting outcomes for patients with kidney disease and COVID-19 with varying levels of severity in the near future as data on metabolic profiles expand rapidly. Here, we also discuss the correlation between COVID-19 and kidney diseases and the available metabolomics approaches.
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Affiliation(s)
- Reshma Murali
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Uddesh Ramesh Wanjari
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Anirban Goutam Mukherjee
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
- Correspondence: (A.V.G.); (R.G.)
| | - Sandra Kannampuzha
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Arunraj Namachivayam
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, Tamil Nadu, India
| | - Harishkumar Madhyastha
- Department of Cardiovascular Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan
| | - Kaviyarasi Renu
- Center of Molecular Medicine and Diagnostics (COMMAND), Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Raja Ganesan
- Institute for Liver and Digestive Diseases, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
- Correspondence: (A.V.G.); (R.G.)
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10
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Khansary S, Tavilani H, Ghasemi H. Gender, Bladder Cancer Healthcare and Burden of COVID-19. Cancer Invest 2023; 41:58-69. [PMID: 36282109 DOI: 10.1080/07357907.2022.2140351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Bladder cancer as one of the main comorbid diseases might be more susceptible to develop COVID-19 infection with a higher mortality risk during the COVID-19 pandemic. The European Association of Urology (EAU) recommended a comprehensive panel for bladder cancer diagnosis and treatment during this global health problem. The urgent need for treatments of COVID-19 during the pandemic has persuaded researchers to evaluate the different medications, which may lead to drug shortages. Therefore, in this review paper, we have focused on the least recommendations of EAU about bladder cancer during of COVID-19 pandemic to provide a comprehensive panel for high-risk patients.
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Affiliation(s)
- Shahede Khansary
- Department of Gynecology, Faculty of Medicine, Hamadan university of Medical Sciences, Hamadan, Iran
| | - Heidar Tavilani
- Department of Clinical Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hadi Ghasemi
- Autophagy Research Center, Department of Biochemistry, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran
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Marozzi MS, Mancini F, Loponte L, Solimando AG, Vacca A, Cicco S. Block of the Angiotensin Pathways Affects Flow-Volume Spirometry in Patients with SARS-CoV-2 Infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1438:223-229. [PMID: 37845465 DOI: 10.1007/978-3-031-42003-0_35] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
BACKGROUND Angiotensin Converting Enzyme 2 (ACE2) is an endothelial cell receptor used by SARS-CoV- 2 virus to enter cells. Pulmonary function tests (PFTs), mainly spirometry, are the main diagnostic tools for most respiratory diseases. PFTs are mandatory for assessing the response to therapy. AIM We evaluated patients after the SARS-CoV-2 infection through flow-volume spirometry that evaluates the role of drugs inhibiting the ACE2 pathway. MATERIAL AND METHODS We evaluated 112 Caucasian patients 3-6 months after COVID-19 disease, i.e. after the date of negative molecular or antigenic nasopharyngeal swab. The series of patients showed a great variability due to a wide spectrum of age, the severity of disease manifestations, hospitalization, invasive/non-invasive ventilation, comorbidities, the presence/absence of a previous pneumological diagnosis and the variants of the virus. Patients were divided into those who were being treated with angiotensin receptor blocker (ARB) or ACE2 inhibitors (ACEi) (ARB/ACEi, group 1, 23 females and 12 males, aged 63.63 ± 10.40), and those who were not treated with these drugs (group 2, 38 females and 37 males, aged 55.12 ± 16.51). Distal airflow obstruction (DAO) was evaluate as forced expiratory flow (FEF) at 25%, 50% and 75% of total flow. RESULTS Group 1 presented lower peripheral oxygen saturation percentage vs group 2 (96.54 ± 3.06 vs 97.30 ± 1.19%, p < 0.05). Spirometry data were worst in group1: Forced expiratory volume at first minute (FEV1) (91.20 ± 17.09 vs 97.56 ± 16.40%, p < 0.05), Forced vital capacity (94.06 ± 17.48 vs 99.13 ± 17.71%, p < 0.05), and Tiffenau Index (0.78 ± 0.12 vs 0.84 ± 0.10, p < 0.05). There was a DAO in group1. In group 1, we found also a reduction in FEF 25 (73.97 ± 27.28 vs 86.89 ± 22.44%, p < 0.05), FEF 50 (74.69 ± 33.01 vs 85.67 ± 23.74%, p < 0.05), and FEF 25-75 (74.14 ± 35.03 vs 83.92 ± 25.38%, p < 0.05) but not in FEF 75 (73.06 ± 39.37 vs 82.27 ± 43.33%, p < 0.05). DISCUSSION In patients treated with ARB/ACEi the indexes of respiratory function were shifted towards the lower limits (albeit within normal limits). These parameters were significantly reduced compared to patients not treated with these drugs. This indicates that the COVID-19 disease is not only a pulmonary disease, but also a vascular one.
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Affiliation(s)
- Marialuisa Sveva Marozzi
- Unit of Internal Medicine "G. Baccelli" Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, A.O.U.C. Policlinico di Bari, Bari, Italy
| | - Francesca Mancini
- Unit of Internal Medicine "G. Baccelli" Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, A.O.U.C. Policlinico di Bari, Bari, Italy
| | - Luciana Loponte
- Unit of Internal Medicine "G. Baccelli" Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, A.O.U.C. Policlinico di Bari, Bari, Italy
| | - Antonio Giovanni Solimando
- Unit of Internal Medicine "G. Baccelli" Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, A.O.U.C. Policlinico di Bari, Bari, Italy
| | - Angelo Vacca
- Unit of Internal Medicine "G. Baccelli" Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, A.O.U.C. Policlinico di Bari, Bari, Italy
| | - Sebastiano Cicco
- Unit of Internal Medicine "G. Baccelli" Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, A.O.U.C. Policlinico di Bari, Bari, Italy
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García Martínez JJ, Wozniak H, Salamin P, Giraud R, Le Terrier C, Bendjelid K. Is the prognosis of non-hypertensive, COVID-19 patients treated with renin-angiotensin-aldosterone system inhibitors more uncertain? Physiol Rep 2022; 10:e15512. [PMID: 36397298 PMCID: PMC9672383 DOI: 10.14814/phy2.15512] [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: 08/10/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023] Open
Abstract
Previous studies suggested that ongoing treatment with renin-angiotensin-aldosterone system (RAAS) inhibitor drugs may alter the course of SARS-CoV-2 infection and promote the development of more severe forms of the disease. The authors conducted a comparative, observational study to retrospectively analyze data collected from 394 patients admitted to ICU due to SARS-CoV-2 pneumonia. The primary aim of the study was to establish an association between the use of RAAS inhibitor drugs and mortality in the ICU. The secondary aims of the study were to establish an association between the use of RAAS inhibitor drugs and clinical severity at ICU admission, the need for tracheal intubation, total days of mechanical ventilation, and the ICU length of stay. The authors found no statistically significant difference in ICU mortality between patients on RAAS inhibitor drugs at admission and those who were not (31.3% versus 26.2% mortality, p-value 0.3). However, the group of patients taking RAAS inhibitor drugs appeared to be more critical at ICU admission, and this difference became statistically significant in the subgroup of non-hypertensive patients. ICU mortality in the subgroup of non-hypertensive patients treated with RAAS inhibitor drugs also tended to be higher. Overexpression of the angiotensin-converting enzyme 2 (ACE2) in human cells, induced by RAAS inhibitor drugs, promotes viral entry-replication of SARS-CoV-2 and alters the basal balance of the RAAS, which may explain the findings observed in the present study. These phenomena may be amplified in non-hypertensive patients treated with RAAS inhibitor therapy.
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Affiliation(s)
- Juan José García Martínez
- Intensive Care UnitHôpital du ValaisSionSwitzerland
- Intensive Care DivisionGeneva University HospitalsGenevaSwitzerland
| | - Hannah Wozniak
- Intensive Care DivisionGeneva University HospitalsGenevaSwitzerland
| | | | - Raphaël Giraud
- Intensive Care DivisionGeneva University HospitalsGenevaSwitzerland
- Geneva Hemodynamic Research GroupGenevaSwitzerland
- Faculty of MedicineGeneva University HospitalsGenevaSwitzerland
| | | | - Karim Bendjelid
- Intensive Care DivisionGeneva University HospitalsGenevaSwitzerland
- Geneva Hemodynamic Research GroupGenevaSwitzerland
- Faculty of MedicineGeneva University HospitalsGenevaSwitzerland
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13
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Ullah SF, Moreira G, Datta SPA, McLamore E, Vanegas D. An Experimental Framework for Developing Point-of-Need Biosensors: Connecting Bio-Layer Interferometry and Electrochemical Impedance Spectroscopy. BIOSENSORS 2022; 12:938. [PMID: 36354449 PMCID: PMC9688365 DOI: 10.3390/bios12110938] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Biolayer interferometry (BLI) is a well-established laboratory technique for studying biomolecular interactions important for applications such as drug development. Currently, there are interesting opportunities for expanding the use of BLI in other fields, including the development of rapid diagnostic tools. To date, there are no detailed frameworks for implementing BLI in target-recognition studies that are pivotal for developing point-of-need biosensors. Here, we attempt to bridge these domains by providing a framework that connects output(s) of molecular interaction studies with key performance indicators used in the development of point-of-need biosensors. First, we briefly review the governing theory for protein-ligand interactions, and we then summarize the approach for real-time kinetic quantification using various techniques. The 2020 PRISMA guideline was used for all governing theory reviews and meta-analyses. Using the information from the meta-analysis, we introduce an experimental framework for connecting outcomes from BLI experiments (KD, kon, koff) with electrochemical (capacitive) biosensor design. As a first step in the development of a larger framework, we specifically focus on mapping BLI outcomes to five biosensor key performance indicators (sensitivity, selectivity, response time, hysteresis, operating range). The applicability of our framework was demonstrated in a study of case based on published literature related to SARS-CoV-2 spike protein to show the development of a capacitive biosensor based on truncated angiotensin-converting enzyme 2 (ACE2) as the receptor. The case study focuses on non-specific binding and selectivity as research goals. The proposed framework proved to be an important first step toward modeling/simulation efforts that map molecular interactions to sensor design.
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Affiliation(s)
- Sadia Fida Ullah
- Division of Glycoscience, Department of Chemistry, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, 106 91 Stockholm, Sweden
- Department of Environmental Engineering and Earth Sciences, Clemson University, Clemson, SC 29634, USA
| | - Geisianny Moreira
- Department of Environmental Engineering and Earth Sciences, Clemson University, Clemson, SC 29634, USA
- Global Alliance for Rapid Diagnostics, Michigan State University, East Lancing, MI 48824, USA
| | - Shoumen Palit Austin Datta
- MIT Auto-ID Labs, Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA
- Medical Device (MDPnP) Interoperability and Cybersecurity Labs, Biomedical Engineering Program, Deparment of Anesthesiology, Massachusetts General Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA
| | - Eric McLamore
- Department of Environmental Engineering and Earth Sciences, Clemson University, Clemson, SC 29634, USA
- Global Alliance for Rapid Diagnostics, Michigan State University, East Lancing, MI 48824, USA
- Agricultural Sciences, Clemson University, 821 McMillan Rd, Clemson, SC 29631, USA
| | - Diana Vanegas
- Department of Environmental Engineering and Earth Sciences, Clemson University, Clemson, SC 29634, USA
- Global Alliance for Rapid Diagnostics, Michigan State University, East Lancing, MI 48824, USA
- Interdisciplinary Group for Biotechnology Innovation and Ecosocial Change-BioNovo, Universidad del Valle, Cali 76001, Colombia
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14
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Edwards J, Russo E, Auld R. A Comparison of the Incidence and Type of Ocular Motility Defects in Patients Presenting to Birmingham Midland Eye Centre Emergency Department during 2019 and 2020 to Assess the Impact of the Covid-19 Pandemic. BRITISH AND IRISH ORTHOPTIC JOURNAL 2022; 18:121-129. [PMID: 36212513 PMCID: PMC9503892 DOI: 10.22599/bioj.258] [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: 11/03/2021] [Accepted: 08/23/2022] [Indexed: 01/08/2023] Open
Abstract
Aim: This audit aimed to investigate whether COVID-19 had any impact on the incidence and type of ocular motility defects in patients presenting to Birmingham Midland Eye Centre (BMEC) Emergency Department (ED) during the COVID-19 pandemic in 2020 compared to the previous year. Methods: Medical records were reviewed for all patients presenting to BMEC ED during 2019 and 2020. Patients were classified depending on their diagnosis. The incidence and classification of ocular motility defect were analysed. Factors considered during analysis were number of presentations by year and month; COVID-19 tests; and pre-existing conditions. Results: Two hundred and twenty-one patients presented in 2019, and 260 patients in 2020, an increase in incidence of 17.6% was observed. One hundred and eighty-five patients were classified with new-onset neurogenic conditions in 2019, and 222 patients in 2020, an increase of 20.0%. In 2020, most patients presented in July, November, and December. Overall, there was a 91.3% increase in new-onset fourth cranial nerve palsies in 2020. Fifty-seven patients in 2020 had a Polymerase Chain Reaction COVID-19 test, of these 5 were COVID-19 positive. Conclusion: There was a higher incidence of ocular motility defects in 2020 compared to 2019. The majority of ocular motility defects were classified as neurogenic. It is difficult to attribute this increase to COVID-19 due to lack of testing and results, and confounding variables such as pre-existing conditions and lockdown restrictions. Some potential explanations for the change in presentations across the year of 2020 are proposed.
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15
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Rizk JG, Sanchis-Gomar F, Henry BM, Lippi G, Lavie CJ. Coronavirus disease 2019, hypertension, and renin-angiotensin-aldosterone system inhibitors. Curr Opin Cardiol 2022; 37:419-423. [PMID: 35913369 DOI: 10.1097/hco.0000000000000982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mostly uses the angiotensin-converting enzyme 2 (ACE-2) as cellular receptor for entering the host cells. Some, but not all, animal studies have shown that renin-angiotensin-aldosterone system (RAAS) inhibitors can increase ACE-2 expression. On that premise, it was hypothesized that these agents could make it more likely to develop coronavirus disease 2019 (COVID-19). On the other hand, there was also evidence that being on these agents could lessen the severity of the lung injury in patients with severe SARS-CoV-2 infection. Herein, we review the available evidence on the role of RAAS inhibitors on SARS-CoV-2 and COVID-19 development. RECENT FINDINGS Recent randomized controlled trials demonstrate that RAAS blockade or withdrawal does not influence the severity of COVID-19 in patients who are already on these medications. Currently, there is no evidence to support stopping RAAS inhibitors in patients hospitalized for COVID-19. Several questions still need to be addressed. Ongoing studies are currently evaluating the de novo use of RAAS inhibitors in patients with COVID-19. Another area that needs to be investigated is whether or not using these medications increase the risk of infection. SUMMARY The wealth of evidence indicates that ACE inhibitors and angiotensin-receptor blocker administration has no harmful effects on hospitalizations and severity of COVID-19 in patients already on these medications and might even reduce mortality among hypertensive patients diagnosed with COVID-19. More evidence and data need to be collected, and at this time, these agents should not be discontinued.
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Affiliation(s)
- John G Rizk
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland
| | - Fabian Sanchis-Gomar
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
| | - Brandon M Henry
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana, USA
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16
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Podzolkov VI, Tarzimanova AI, Bragina AE, Shvedov II, Bykova EE, Ivannikov AA, Vasilyeva LV. Damage to the Cardiovascular System in Patients with SARS-CoV-2 Coronavirus Infection. Part 2: Correction of Myocardial Systolic Dysfunction. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2022-04-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study changes in myocardial contractile function when prescribing mineralocorticoid receptor antagonists of spironolactone in patients after coronavirus infection SARS-CoV-2 with symptoms of chronic heart failure (CHF).Materials and methods. The study included 90 hospitalized patients with a diagnosis of SARS-CoV-2 coronavirus infection. The inclusion criteria were: age from 18 to 85 years; the presence of CHF with a preserved or mildly reduced left ventricular ejection fraction (LVEF). The patients were randomized into two groups: group I (n=60) included patients who, for 6 months after discharge from the hospital, in addition to standard drug therapy for CHF, took spironolactone at a dose of 25 mg per day; group II (comparison group; n=30) included patients who received standard drug therapy without additional prescription of spironolactone. The study groups were comparable in age, gender, prevalence of hypertension, coronary heart disease, diabetes mellitus, obesity and severity of CHF; the drug therapy given to the patients had no significant differences. Assessment of LV systolic function, exercise tolerance (six-minute walk test, TSW), quality of life (questionnaire EQ-5D-5L) were performed.Results. When repeated echocardiography was performed after 6 months of treatment, there was a significant improvement in LV systolic function in group I patients. In group I, after 6 months of treatment, there was a significant decrease in the proportion of patients with moderately reduced LVEF (from 30 [50%] to 12 [20%]; p<0.001), and a significant increase in the number of patients with preserved LVEF (from 30 [50%] to 48 [80%], p=0.002). In group II, the number of patients with moderately reduced LVEF did not significantly change. After 6 months of treatment, all patients showed an increase in exercise tolerance. During the test with a six-minute walk, group I patients showed an increase in the index from 316.8±63.5 to 432.9±41.3 meters; group II patients from 337.6±42.7 to 407.6±38.9 meters. The values of the six-minute walking test after 6 months of treatment were significantly higher in group I patients when compared with group II patients. When assessing the quality of life using the EQ-5D-5L questionnaire, it was found that at the time of inclusion of patients in the study, all patients noted the presence of any health problems in one or more components. The average indicator of health status, measured by a 100-point visual analog scale, after 6 months was 71.8±9.2 in patients of group I and was significantly higher than the same indicator in group II – 63.7±9.1. There were no adverse events in the study groups during the entire observation period.Conclusion. A significantly more pronounced improvement in systolic and diastolic left ventricle function, as well as quality of life, was found in the group of CHF patients with preserved or moderately reduced LVEF, who received spironolactone for 6 months after the SARS-CoV-2 infection in addition to standard therapy, compared with patients without aldosterone antagonists.
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Affiliation(s)
- V. I. Podzolkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. I. Tarzimanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. E. Bragina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - I. I. Shvedov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - E. E. Bykova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. A. Ivannikov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - L. V. Vasilyeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Martínez-Salazar B, Holwerda M, Stüdle C, Piragyte I, Mercader N, Engelhardt B, Rieben R, Döring Y. COVID-19 and the Vasculature: Current Aspects and Long-Term Consequences. Front Cell Dev Biol 2022; 10:824851. [PMID: 35242762 PMCID: PMC8887620 DOI: 10.3389/fcell.2022.824851] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/20/2022] [Indexed: 12/11/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first identified in December 2019 as a novel respiratory pathogen and is the causative agent of Corona Virus disease 2019 (COVID-19). Early on during this pandemic, it became apparent that SARS-CoV-2 was not only restricted to infecting the respiratory tract, but the virus was also found in other tissues, including the vasculature. Individuals with underlying pre-existing co-morbidities like diabetes and hypertension have been more prone to develop severe illness and fatal outcomes during COVID-19. In addition, critical clinical observations made in COVID-19 patients include hypercoagulation, cardiomyopathy, heart arrythmia, and endothelial dysfunction, which are indicative for an involvement of the vasculature in COVID-19 pathology. Hence, this review summarizes the impact of SARS-CoV-2 infection on the vasculature and details how the virus promotes (chronic) vascular inflammation. We provide a general overview of SARS-CoV-2, its entry determinant Angiotensin-Converting Enzyme II (ACE2) and the detection of the SARS-CoV-2 in extrapulmonary tissue. Further, we describe the relation between COVID-19 and cardiovascular diseases (CVD) and their impact on the heart and vasculature. Clinical findings on endothelial changes during COVID-19 are reviewed in detail and recent evidence from in vitro studies on the susceptibility of endothelial cells to SARS-CoV-2 infection is discussed. We conclude with current notions on the contribution of cardiovascular events to long term consequences of COVID-19, also known as “Long-COVID-syndrome”. Altogether, our review provides a detailed overview of the current perspectives of COVID-19 and its influence on the vasculature.
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Affiliation(s)
- Berenice Martínez-Salazar
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Melle Holwerda
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Chiara Stüdle
- Theodor Kocher Institute, University of Bern, Bern, Switzerland
| | - Indre Piragyte
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland.,Institute of Anatomy, University of Bern, Bern, Switzerland
| | - Nadia Mercader
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland.,Institute of Anatomy, University of Bern, Bern, Switzerland.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Bern Center of Precision Medicine BCPM, University of Bern, Bern, Switzerland
| | | | - Robert Rieben
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Yvonne Döring
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland.,Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University Munich (LMU), Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
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An insight into the mechanisms of COVID-19, SARS-CoV2 infection severity concerning β-cell survival and cardiovascular conditions in diabetic patients. Mol Cell Biochem 2022; 477:1681-1695. [PMID: 35235124 PMCID: PMC8889522 DOI: 10.1007/s11010-022-04396-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/16/2022] [Indexed: 01/08/2023]
Abstract
A significantly high percentage of hospitalized COVID-19 patients with diabetes mellitus (DM) had severe conditions and were admitted to ICU. In this review, we have delineated the plausible molecular mechanisms that could explain why there are increased clinical complications in patients with DM that become critically ill when infected with SARS-CoV2. RNA viruses have been classically implicated in manifestation of new onset diabetes. SARS-CoV2 infection through cytokine storm leads to elevated levels of pro-inflammatory cytokines creating an imbalance in the functioning of T helper cells affecting multiple organs. Inflammation and Th1/Th2 cell imbalance along with Th17 have been associated with DM, which can exacerbate SARS-CoV2 infection severity. ACE-2-Ang-(1-7)-Mas axis positively modulates β-cell and cardiac tissue function and survival. However, ACE-2 receptors dock SARS-CoV2, which internalize and deplete ACE-2 and activate Renin-angiotensin system (RAS) pathway. This induces inflammation promoting insulin resistance that has positive effect on RAS pathway, causes β-cell dysfunction, promotes inflammation and increases the risk of cardiovascular complications. Further, hyperglycemic state could upregulate ACE-2 receptors for viral infection thereby increasing the severity of the diabetic condition. SARS-CoV2 infection in diabetic patients with heart conditions are linked to worse outcomes. SARS-CoV2 can directly affect cardiac tissue or inflammatory response during diabetic condition and worsen the underlying heart conditions.
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19
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Abdi A, AlOtaiby S, Badarin FA, Khraibi A, Hamdan H, Nader M. Interaction of SARS-CoV-2 with cardiomyocytes: Insight into the underlying molecular mechanisms of cardiac injury and pharmacotherapy. Biomed Pharmacother 2022; 146:112518. [PMID: 34906770 PMCID: PMC8654598 DOI: 10.1016/j.biopha.2021.112518] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/15/2021] [Accepted: 12/06/2021] [Indexed: 01/07/2023] Open
Abstract
SARS-CoV-2 causes respiratory illness with a spectrum of systemic complications. However, the mechanism for cardiac infection and cardiomyocyte injury in COVID-19 patients remains unclear. The current literature supports the notion that SARS-CoV-2 particles access the heart either by the circulating blood cells or by extracellular vesicles, originating from the inflamed lungs, and encapsulating the virus along with its receptor (ACE2). Both cardiomyocytes and pericytes (coronary arteries) express the necessary accessory proteins for access of SARS-CoV-2 particles (i.e. ACE2, NRP-1, TMPRSS2, CD147, integrin α5β1, and CTSB/L). These proteins facilitate the SARS-CoV-2 interaction and entry into the pericytes and cardiomyocytes thus leading to cardiac manifestations. Subsequently, various signaling pathways are altered in the infected cardiomyocytes (i.e. increased ROS production, reduced contraction, impaired calcium homeostasis), causing cardiac dysfunction. The currently adopted pharmacotherapy in severe COVID-19 subjects exhibited side effects on the heart, often manifested by electrical abnormalities. Nonetheless, cardiovascular adverse repercussions have been associated with the advent of some of the SARS-CoV-2 vaccines with no clear mechanisms underlining these complications. We provide herein an overview of the pathways involved with cardiomyocyte in COVID-19 subjects to help promoting pharmacotherapies that can protect against SARS-CoV-2-induced cardiac injuries.
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Affiliation(s)
- Abdulhamid Abdi
- Department of Physiology and Immunology, College of Medicine and Health Sciences, and Biotechnology Center, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Shahad AlOtaiby
- Research Center, King Fahad Medical City, Central Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Firas Al Badarin
- Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Ali Khraibi
- Department of Physiology and Immunology, College of Medicine and Health Sciences, and Biotechnology Center, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Hamdan Hamdan
- Department of Physiology and Immunology, College of Medicine and Health Sciences, and Biotechnology Center, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Moni Nader
- Department of Physiology and Immunology, College of Medicine and Health Sciences, and Biotechnology Center, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
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The impact of COVID-19 on the comorbidities: A review of recent updates for combating it. Saudi J Biol Sci 2022; 29:3586-3599. [PMID: 35165505 PMCID: PMC8828435 DOI: 10.1016/j.sjbs.2022.02.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/01/2022] [Accepted: 02/06/2022] [Indexed: 02/07/2023] Open
Abstract
SARS-CoV-2 can also affect organs other than the lungs, including the brain, heart, and gastrointestinal system. Patients with Cancer, HIV, COPD, neurological, and CVDs are more prone to the COVID-19 associated complications, leading to a drastic rise in morbidity and mortality. Elderly and pre-existing polypharmacy patients have worsened COVID-19 associated complications. When a person with comorbidity is infected with SARS-CoV-2, it becomes more dangerous, and managing these patients with adequate medical care is critical to their survival. A co-morbid person should adhere to preventive measures to reduce mortality, including regular handwashing with soap or using an alcohol-based hand sanitizer, minimizing in person contact and practicing social distance, wearing a face mask in public places, and avoiding going to public places unless essential are among the precautional measures.
Coronavirus disease is caused by the SARS-CoV-2 virus. The virus first appeared in Wuhan (China) in December 2019 and has spread globally. Till now, it affected 269 million people with 5.3 million deaths in 224 countries and territories. With the emergence of variants like Omicron, the COVID-19 cases grew exponentially, with thousands of deaths. The general symptoms of COVID-19 include fever, sore throat, cough, lung infections, and, in severe cases, acute respiratory distress syndrome, sepsis, and death. SARS-CoV-2 predominantly affects the lung, but it can also affect other organs such as the brain, heart, and gastrointestinal system. It is observed that 75 % of hospitalized COVID-19 patients have at least one COVID-19 associated comorbidity. The most common reported comorbidities are hypertension, NDs, diabetes, cancer, endothelial dysfunction, and CVDs. Moreover, older and pre-existing polypharmacy patients have worsened COVID-19 associated complications. SARS-CoV-2 also results in the hypercoagulability issues like gangrene, stroke, pulmonary embolism, and other associated complications. This review aims to provide the latest information on the impact of the COVID-19 on pre-existing comorbidities such as CVDs, NDs, COPD, and other complications. This review will help us to understand the current scenario of COVID-19 and comorbidities; thus, it will play an important role in the management and decision-making efforts to tackle such complications.
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Meijs DAM, van Bussel BCT, Stessel B, Mehagnoul-Schipper J, Hana A, Scheeren CIE, Peters SAE, van Mook WNKA, van der Horst ICC, Marx G, Mesotten D, Ghossein-Doha C. Better COVID-19 Intensive Care Unit survival in females, independent of age, disease severity, comorbidities, and treatment. Sci Rep 2022; 12:734. [PMID: 35031644 PMCID: PMC8760268 DOI: 10.1038/s41598-021-04531-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022] Open
Abstract
Although male Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients have higher Intensive Care Unit (ICU) admission rates and a worse disease course, a comprehensive analysis of female and male ICU survival and underlying factors such as comorbidities, risk factors, and/or anti-infection/inflammatory therapy administration is currently lacking. Therefore, we investigated the association between sex and ICU survival, adjusting for these and other variables. In this multicenter observational cohort study, all patients with SARS-CoV-2 pneumonia admitted to seven ICUs in one region across Belgium, The Netherlands, and Germany, and requiring vital organ support during the first pandemic wave were included. With a random intercept for a center, mixed-effects logistic regression was used to investigate the association between sex and ICU survival. Models were adjusted for age, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, comorbidities, and anti-infection/inflammatory therapy. Interaction terms were added to investigate effect modifications by sex with country and sex with obesity. A total of 551 patients (29% were females) were included. Mean age was 65.4 ± 11.2 years. Females were more often obese and smoked less frequently than males (p-value 0.001 and 0.042, respectively). APACHE II scores of females and males were comparable. Overall, ICU mortality was 12% lower in females than males (27% vs 39% respectively, p-value < 0.01) with an odds ratio (OR) of 0.62 (95%CI 0.39-0.96, p-value 0.032) after adjustment for age and APACHE II score, 0.63 (95%CI 0.40-0.99, p-value 0.044) after additional adjustment for comorbidities, and 0.63 (95%CI 0.39-0.99, p-value 0.047) after adjustment for anti-infection/inflammatory therapy. No effect modifications by sex with country and sex with obesity were found (p-values for interaction > 0.23 and 0.84, respectively). ICU survival in female SARS-CoV-2 patients was higher than in male patients, independent of age, disease severity, smoking, obesity, comorbidities, anti-infection/inflammatory therapy, and country. Sex-specific biological mechanisms may play a role, emphasizing the need to address diversity, such as more sex-specific prediction, prognostic, and therapeutic approach strategies.
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Affiliation(s)
- Daniek A M Meijs
- Department of Intensive Care Medicine, Maastricht University Medical Center + (Maastricht UMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
- Department of Intensive Care Medicine, Laurentius Ziekenhuis, Roermond, the Netherlands.
| | - Bas C T van Bussel
- Department of Intensive Care Medicine, Maastricht University Medical Center + (Maastricht UMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Björn Stessel
- Department of Intensive Care Medicine, Jessa Hospital, Hasselt, Belgium
- Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium
| | | | - Anisa Hana
- Department of Intensive Care Medicine, Laurentius Ziekenhuis, Roermond, the Netherlands
| | - Clarissa I E Scheeren
- Department of Intensive Care Medicine, Zuyderland Medisch Centrum, Heerlen/Sittard, the Netherlands
| | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Walther N K A van Mook
- Department of Intensive Care Medicine, Maastricht University Medical Center + (Maastricht UMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
- Maastricht UMC+ Academy for Postgraduate Medical Education, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center + (Maastricht UMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Gernot Marx
- Department of Intensive Care Medicine, University Hospital Rheinisch Westfälische Hochschule (RWTH) Aachen, Aachen, Germany
| | - Dieter Mesotten
- Department of Intensive Care Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium
- Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium
| | - Chahinda Ghossein-Doha
- Department of Intensive Care Medicine, Maastricht University Medical Center + (Maastricht UMC+), P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
- Department of Cardiology, Maastricht UMC+, Maastricht, the Netherlands
- School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands
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22
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Podzolkov VI, Tarzimanova AI, Bragina AE, Shvedov II, Bykova EE, Ivannikov AA, Vasilyeva LV. Damage to the Cardiovascular System in Patients with SARS-CoV-2 Coronavirus Infection. Part 1: Predictors of the Development of an Unfavorable Prognosis. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2021-11-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To evaluate the effect of sinus tachycardia and reduced left ventricular ejection fraction (LVEF) on the prognosis of patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2.Material and methods. The study included 1,637 patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2. The average age of the patients was 58.8±16.1 years. More than half of the patients admitted to the hospital had a history of cardiovascular diseases: hypertension was diagnosed in 915 (56%) patients, coronary artery disease – in 563 (34%), chronic heart failure – in 410 (25%). 294 (17.9%) patients suffered from diabetes mellitus. The unfavorable course of new coronavirus infection was assessed by the fact of being in the intensive care unit (ICU), the use of mechanical ventilation and death.Results. An unfavorable course of coronavirus infection was observed in 160 (9.8%) patients. Statistical analysis revealed that 341 (20.8%) patients with COVID-19 were diagnosed with sinus tachycardia, which required the appointment of pulse-reducing therapy. The occurrence of sinus tachycardia in patients with COVID-19 significantly increased the risk of death (odds ratio [OR] 1.248, confidence interval [CI] 1.038-1.499, p=0.018), increased the likelihood of mechanical ventilation use (OR 1.451, CI 1.168-1.803, p<0.001) and stay in the ICU (OR 1.440, CI 1.166-1.778, p<0.001).In 97 (5.9%) patients during hospital stay during echocardiography, a decrease in LVEF of less than 50% was diagnosed. A decrease in myocardial contractile function in patients with COVID-19 with high reliability increased the risk of death (OR 1.744, CI 1.348-2.256, p<0.001), increased the likelihood of using the mechanical ventilation (OR 1.372, CI 1.047-1.797, p=0.022) and stay in the ICU (OR 1.360, CI 1.077-1.716, p=0.010).Conclusion. The appearance of sinus tachycardia and reduced LVEF are in dependent predictors of the unfavorable course of COVID-19 in relation to factors such as death, the use of mechanical ventilation and the stay of patients in the ICU. Early pharmacological correction of cardiovascular lesions should be one of the goals of the management theese patients.
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Affiliation(s)
- V. I. Podzolkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. I. Tarzimanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. E. Bragina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - I. I. Shvedov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - E. E. Bykova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. A. Ivannikov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - L. V. Vasilyeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Gryksa K, Neumann ID. Consequences of pandemic-associated social restrictions: Role of social support and the oxytocin system. Psychoneuroendocrinology 2022; 135:105601. [PMID: 34837776 PMCID: PMC8605825 DOI: 10.1016/j.psyneuen.2021.105601] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/15/2022]
Abstract
During pandemics, governments take drastic actions to prevent the spreading of the disease, as seen during the present COVID-19 crisis. Sanctions of lockdown, social distancing and quarantine urge people to exclusively work and teach at home and to restrict social contacts to a minimum; lonely people get into further isolation, while families` nerves are strained to the extreme. Overall, this results in a dramatic and chronic increase in the level of psychosocial stress over several months mainly caused by i) social isolation and ii) psychosocial stress associated with overcrowding, social tension in families, and domestic violence. Moreover, pandemic-associated social restrictions are accompanied by loss of an essential stress buffer and important parameter for general mental and physical health: social support. Chronic psychosocial stress and, in particular, social isolation and lack of social support affect not only mental health, but also the brain oxytocin system and the immune system. Hence, pandemic-associated social restrictions are expected to increase the risk of developing psychopathologies, such as depression, anxiety-related and posttraumatic stress disorders, on the one hand, but also to induce a general inflammatory state and to impair the course of infectious disorders on the other. Due to its pro-social and stress-buffering effects, resulting in an anti-inflammatory state in case of disease, the role of the neuropeptide oxytocin will be discussed and critically considered as an emerging treatment option in cases of pandemic-induced psychosocial stress, viral infection and during recovery. In this review, we aim to critically focus on possible short- and long-term consequences of social restrictions on mental health and the immune system, while discussion oxytocin as a possible treatment option.
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Affiliation(s)
- Katharina Gryksa
- Department of Behavioural and Molecular Neurobiology, University of Regensburg, Regensburg, Germany.
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Prior fluid and electrolyte imbalance is associated with COVID-19 mortality. COMMUNICATIONS MEDICINE 2021; 1:51. [PMID: 35602191 PMCID: PMC9053234 DOI: 10.1038/s43856-021-00051-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022] Open
Abstract
Abstract
Background
The COVID-19 pandemic represents a major public health threat. Risk of death from the infection is associated with age and pre-existing comorbidities such as diabetes, dementia, cancer, and impairment of immunological, hepatic or renal function. It remains incompletely understood why some patients survive the disease, while others do not. As such, we sought to identify novel prognostic factors for COVID-19 mortality.
Methods
We performed an unbiased, observational retrospective analysis of real world data. Our multivariable and univariable analyses make use of U.S. electronic health records from 122,250 COVID-19 patients in the early stages of the pandemic.
Results
Here we show that a priori diagnoses of fluid, pH and electrolyte imbalance during the year preceding the infection are associated with an increased risk of death independently of age and prior renal comorbidities.
Conclusions
We propose that future interventional studies should investigate whether the risk of death can be alleviated by diligent and personalized management of the fluid and electrolyte balance of at-risk individuals during and before COVID-19.
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Šikić J, Planinić Z, Matišić V, Friščić T, Molnar V, Jagačić D, Vujičić L, Tudorić N, Postružin Gršić L, Ljubičić Đ, Primorac D. COVID-19: The Impact on Cardiovascular System. Biomedicines 2021; 9:1691. [PMID: 34829920 PMCID: PMC8615470 DOI: 10.3390/biomedicines9111691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 has been circulating in population worldwide for the past year and a half, and thus a vast amount of scientific literature has been produced in order to study the biology of the virus and the pathophysiology of COVID-19, as well as to determine the best way to prevent infection, treat the patients and eliminate the virus. SARS-CoV-2 binding to the ACE2 receptor is the key initiator of COVID-19. The ability of SARS-CoV-2 to infect various types of cells requires special attention to be given to the cardiovascular system, as it is commonly affected. Thorough diagnostics and patient monitoring are beneficial in reducing the risk of cardiovascular morbidity and to ensure the most favorable outcomes for the infected patients, even after they are cured of the acute disease. The multidisciplinary nature of the fight against the COVID-19 pandemic requires careful consideration from the attending clinicians, in order to provide fast and reliable treatment to their patients in accordance with evidence-based medicine principles. In this narrative review, we reviewed the available literature on cardiovascular implications of COVID-19; both the acute and the chronic.
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Affiliation(s)
- Jozica Šikić
- Department of Cardiology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia; (Z.P.); (T.F.)
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Zrinka Planinić
- Department of Cardiology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia; (Z.P.); (T.F.)
| | - Vid Matišić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Tea Friščić
- Department of Cardiology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia; (Z.P.); (T.F.)
| | - Vilim Molnar
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Dorijan Jagačić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Lovro Vujičić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | - Neven Tudorić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
| | | | - Đivo Ljubičić
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
- Clinical Hospital Dubrava, 10000 Zagreb, Croatia
| | - Dragan Primorac
- St. Catherine Specialty Hospital, 10000 Zagreb, Croatia; (V.M.); (V.M.); (D.J.); (L.V.); (N.T.); (Đ.L.); (D.P.)
- Eberly College of Science, The Pennsylvania State University, University Park, State College, PA 16802, USA
- The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, West Haven, CT 06516, USA
- Medical School, University of Split, 21000 Split, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School, University of Rijeka, 51000 Rijeka, Croatia
- Medical School REGIOMED, 96 450 Coburg, Germany
- Medical School, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
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Giri R, Kumar A, Saini M, Sharma RK. Living with the virus: Infection and epidemiology of COVID-19 in hotspot area of India. JOURNAL OF PUBLIC AFFAIRS 2021; 21:e2651. [PMID: 33786027 PMCID: PMC7994984 DOI: 10.1002/pa.2651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/06/2021] [Accepted: 02/10/2021] [Indexed: 05/12/2023]
Abstract
The coronavirus disease (COVID-19) has been identified as a pandemic and affected almost whole world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of this disease, is infecting Indian population since the last week of January 2020. The data were collected from January 30, 2020, to May 23, 2020, to analyze basic trend of COVID-19 cases in India targeting hotspot regions. To find the linear relationship between variables, that is, age, total positive cases, population, and population density data have been statistically analyzed. COVID-19 caused more than 5000 deaths till May 2020 in India. SARS-CoV-2 spread to several Indian cities with more than 100,000 positive cases. Total number of COVID-19 cases and total recovered cases followed the exponential distribution, while number of deaths showed linear behavior. Nearly 50% of the youth, that is, 20-40 years of age had been found to recover from the infection. As a lockdown cannot be a permanent solution, it is important to understand the nature of virus and learn "living with the virus" while minimizing its spreading at the same time.
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Affiliation(s)
- Rajat Giri
- Department of BiosciencesManipal University JaipurJaipurIndia
| | - Ashish Kumar
- Department of Mathematics and StatisticsManipal University JaipurJaipurIndia
| | - Monika Saini
- Department of Mathematics and StatisticsManipal University JaipurJaipurIndia
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Legrand M, Bell S, Forni L, Joannidis M, Koyner JL, Liu K, Cantaluppi V. Pathophysiology of COVID-19-associated acute kidney injury. Nat Rev Nephrol 2021; 17:751-764. [PMID: 34226718 PMCID: PMC8256398 DOI: 10.1038/s41581-021-00452-0] [Citation(s) in RCA: 231] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 02/06/2023]
Abstract
Although respiratory failure and hypoxaemia are the main manifestations of COVID-19, kidney involvement is also common. Available evidence supports a number of potential pathophysiological pathways through which acute kidney injury (AKI) can develop in the context of SARS-CoV-2 infection. Histopathological findings have highlighted both similarities and differences between AKI in patients with COVID-19 and in those with AKI in non-COVID-related sepsis. Acute tubular injury is common, although it is often mild, despite markedly reduced kidney function. Systemic haemodynamic instability very likely contributes to tubular injury. Despite descriptions of COVID-19 as a cytokine storm syndrome, levels of circulating cytokines are often lower in patients with COVID-19 than in patients with acute respiratory distress syndrome with causes other than COVID-19. Tissue inflammation and local immune cell infiltration have been repeatedly observed and might have a critical role in kidney injury, as might endothelial injury and microvascular thrombi. Findings of high viral load in patients who have died with AKI suggest a contribution of viral invasion in the kidneys, although the issue of renal tropism remains controversial. An impaired type I interferon response has also been reported in patients with severe COVID-19. In light of these observations, the potential pathophysiological mechanisms of COVID-19-associated AKI may provide insights into therapeutic strategies.
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Affiliation(s)
- Matthieu Legrand
- Department of Anesthesia and Perioperative Care, Division of Critical Care Medicine, University of California, San Francisco, CA, USA.
- Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists network, Nancy, France.
| | - Samira Bell
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
| | - Lui Forni
- Intensive Care Unit, Royal Surrey Hospital NHS Foundation Trust, Surrey, UK
- Department of Clinical and Experimental Medicine, Faculty of Health Sciences, University of Surrey, Surrey, UK
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Jay L Koyner
- Divisions of Nephrology, Departments of Medicine, University of Chicago, Chicago, IL, USA
| | - Kathleen Liu
- Divisions of Nephrology and Critical Care Medicine, Departments of Medicine and Anesthesia, University of San Francisco, San Francisco, CA, USA
| | - Vincenzo Cantaluppi
- Nephrology and Kidney Transplantation Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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ACE2 and Innate Immunity in the Regulation of SARS-CoV-2-Induced Acute Lung Injury: A Review. Int J Mol Sci 2021; 22:ijms222111483. [PMID: 34768911 PMCID: PMC8583933 DOI: 10.3390/ijms222111483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 01/08/2023] Open
Abstract
Despite the protracted battle against coronavirus acute respiratory infection (COVID-19) and the rapid evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), no specific and effective drugs have to date been reported. Angiotensin-converting enzyme 2 (ACE2) is a zinc metalloproteinase and a critical modulator of the renin-angiotensin system (RAS). In addition, ACE2 has anti-inflammatory and antifibrosis functions. ACE has become widely known in the past decade as it has been identified as the primary receptor for SARS-CoV and SARS-CoV-2, being closely associated with their infection. SARS-CoV-2 primarily targets the lung, which induces a cytokine storm by infecting alveolar cells, resulting in tissue damage and eventually severe acute respiratory syndrome. In the lung, innate immunity acts as a critical line of defense against pathogens, including SARS-CoV-2. This review aims to summarize the regulation of ACE2, and lung host cells resist SARS-CoV-2 invasion by activating innate immunity response. Finally, we discuss ACE2 as a therapeutic target, providing reference and enlightenment for the clinical treatment of COVID-19.
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Banerjee A, Ganguly U, Saha S, Chakrabarti S, Saini RV, Rawal RK, Saso L, Chakrabarti S. Vitamin D and immuno-pathology of COVID-19: many interactions but uncertain therapeutic benefits. Expert Rev Anti Infect Ther 2021; 19:1245-1258. [PMID: 33739215 PMCID: PMC8022339 DOI: 10.1080/14787210.2021.1905519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023]
Abstract
Introduction: COVID-19 pandemic has caused huge loss of human lives and extensive socio-economic damages. The immuno-pathology of this disease is neither clearly understood nor there are effective drugs for severe cases of COVID-19. Repurposing of available drugs for the treatment of COVID-19 is imperative.Areas Covered: This review has gathered the evidence from PubMed, Google Scholar, WHO, and other reliable websites on COVID-19 and summarized the existing knowledge of the immuno-pathology of COVID-19. We elucidated how vitamin D through its diverse actions on immune effector cells, epithelial cells, or renin-angiotensin-aldosterone system could have a modulatory role on the pathogenic mechanisms of COVID-19. The epidemiological evidence associating vitamin D deficiency with the severity and incidence of COVID-19 is also presented. However, the evidence of clinical benefit to patients of COVID-19 from randomized controlled trials with vitamin D has not come as yet.Expert opinion: It is now established that fatality of COVID-19 is primarily determined by hyperactivation of the host's innate immune system in response to SARS-CoV-2 invasion, and thus the research on the immuno-modulatory and other roles of vitamin D against viral infections should be pursued vigorously. This would be also useful for future pandemics caused by other novel viruses.
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Affiliation(s)
- Anindita Banerjee
- Department of Biochemistry, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Upasana Ganguly
- Department of Biochemistry & Central Research Cell, M.M. Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to Be University), Mullana, India
| | - Sarama Saha
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Reena V Saini
- Department of Biotechnology, M.M Engineering College, Maharishi Markandeshwar (Deemed to Be University), Mullana, India
| | - Ravindra K Rawal
- Department of Chemistry, M.M Engineering College, Maharishi Markandeshwar (Deemed to Be University), Mullana, India
| | - Luciano Saso
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Sasanka Chakrabarti
- Department of Biochemistry & Central Research Cell, M.M. Institute of Medical Sciences and Research, Maharishi Markandeshwar (Deemed to Be University), Mullana, India
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Labarrere CA, Kassab GS. Pattern Recognition Proteins: First Line of Defense Against Coronaviruses. Front Immunol 2021; 12:652252. [PMID: 34630377 PMCID: PMC8494786 DOI: 10.3389/fimmu.2021.652252] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 08/31/2021] [Indexed: 01/08/2023] Open
Abstract
The rapid outbreak of COVID-19 caused by the novel coronavirus SARS-CoV-2 in Wuhan, China, has become a worldwide pandemic affecting almost 204 million people and causing more than 4.3 million deaths as of August 11 2021. This pandemic has placed a substantial burden on the global healthcare system and the global economy. Availability of novel prophylactic and therapeutic approaches are crucially needed to prevent development of severe disease leading to major complications both acutely and chronically. The success in fighting this virus results from three main achievements: (a) Direct killing of the SARS-CoV-2 virus; (b) Development of a specific vaccine, and (c) Enhancement of the host's immune system. A fundamental necessity to win the battle against the virus involves a better understanding of the host's innate and adaptive immune response to the virus. Although the role of the adaptive immune response is directly involved in the generation of a vaccine, the role of innate immunity on RNA viruses in general, and coronaviruses in particular, is mostly unknown. In this review, we will consider the structure of RNA viruses, mainly coronaviruses, and their capacity to affect the lungs and the cardiovascular system. We will also consider the effects of the pattern recognition protein (PRP) trident composed by (a) Surfactant proteins A and D, mannose-binding lectin (MBL) and complement component 1q (C1q), (b) C-reactive protein, and (c) Innate and adaptive IgM antibodies, upon clearance of viral particles and apoptotic cells in lungs and atherosclerotic lesions. We emphasize on the role of pattern recognition protein immune therapies as a combination treatment to prevent development of severe respiratory syndrome and to reduce pulmonary and cardiovascular complications in patients with SARS-CoV-2 and summarize the need of a combined therapeutic approach that takes into account all aspects of immunity against SARS-CoV-2 virus and COVID-19 disease to allow mankind to beat this pandemic killer.
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Affiliation(s)
| | - Ghassan S Kassab
- California Medical Innovations Institute, San Diego, CA, United States
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Chammas J, Delaney D, Chabaytah N, Abdulkarim S, Schwertani A. COVID-19 and the cardiovascular system: insights into effects and treatments. Can J Physiol Pharmacol 2021; 99:1119-1127. [PMID: 34546123 DOI: 10.1139/cjpp-2021-0093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19), an acute and highly transmissible infectious disease, has reached a pandemic level since 11 March 2020 and continues to challenge the healthcare system worldwide. The pathogenesis of COVID-19 is a complex process involving mechanisms that suppress the host antiviral and innate immune response, while triggering marked activation of coagulation and hyperinflammation leading to cytokine storm in severe COVID-19. This review summarizes current evidence related to COVID-19-associated cardiovascular severe illness and mortality, which encompasses life-threatening clinical manifestations, including myocardial injury, fulminant myocarditis, cardiac arrhythmia, and ischemic stroke. The onset of hypercoagulable state is consistent with increased venous thromboembolism including deep vein thrombosis and pulmonary embolism. Thromboembolic manifestations include arterial thrombotic events such as stroke, myocardial infarction, and limb ischemia. Several treatment strategies have been investigated to mitigate COVID-19-associated cardiovascular clinical manifestations. The prevalence of thrombo-inflammatory syndrome and subsequent cardiovascular dysfunction prompted the implementation of antithrombotic therapy and strategies targeting major pro-inflammatory cytokines involved in COVID-19 cytokine storm. The development of new guidelines for effective treatment strategies requires concerted efforts to refine our understanding of the mechanisms underlying cardiovascular disease and large-scale clinical trials to reduce the burden of COVID-19 hospitalization and mortality.
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Affiliation(s)
- Joey Chammas
- Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dylan Delaney
- Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Naim Chabaytah
- Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Sarah Abdulkarim
- Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Adel Schwertani
- Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
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Dragomiretskaya NA, Tarzimanova AI, Kucherova JS, Podzolkov VI. New clinical opportunities for mineralocorticoid receptor antagonists: focus on antifibrotic effects. TERAPEVT ARKH 2021; 93:1132-1137. [DOI: 10.26442/00403660.2021.09.201016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 10/10/2021] [Indexed: 11/22/2022]
Abstract
Mineralocorticoid receptor antagonists have been successfully used for many years to treat patients with primary hyperaldosteronism, refractory arterial hypertension and chronic heart failure. The increased interest in this drug in recent years is due to new information about its antifibrotic and antiproliferative effects, both cardiac and extracardiac. The article also discusses the possibility of using spironolactone in patients with the new coronavirus infection SARS-CoV-2 (COVID-19).
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Singh J, Bhagaloo L, Sy E, Lavoie AJ, Dehghani P, Neary P. Novel effects of acute COVID-19 on cardiac mechanical function: Two case studies. Physiol Rep 2021; 9:e14998. [PMID: 34448551 PMCID: PMC8391984 DOI: 10.14814/phy2.14998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/10/2021] [Accepted: 07/16/2021] [Indexed: 11/24/2022] Open
Abstract
The spread of the novel coronavirus 2019 (COVID-19) has caused a global pandemic. The disease has spread rapidly, and research shows that COVID-19 can induce long-lasting cardiac damage. COVID-19 can result in elevated cardiac biomarkers indicative of acute cardiac injury, and research utilizing echocardiography has shown that there is mechanical dysfunction in these patients as well, especially when observing the isovolumic, systolic, and diastolic portions of the cardiac cycle. The purpose of this study was to present two case studies on COVID-19 positive patients who had their cardiac mechanical function assessed every day during the acute period to show that cardiac function in these patients was altered, and the damage occurring can change from day-to-day. Participant 1 showed compromised cardiac function in the systolic time, diastolic time, isovolumic time, and the calculated heart performance index (HPI), and these impairments were sustained even 23 days post-symptom onset. Furthermore, Participant 1 showed prolonged systolic periods that lasted longer than the diastolic periods, indicative of elevated pulmonary artery pressure. Participant 2 showed decreases in systole and consequently, increases in HPI during the 3 days post-symptom onset, and these changes returned to normal after day 4. These results showed that daily observation of cardiac function can provide detailed information about the overall mechanism by which cardiac dysfunction is occurring and that COVID-19 can induce cardiac damage in unique patterns and thus can be studied on a case-by-case basis, day-to-day during infection. This could allow us to move toward more personalized cardiovascular medical treatment.
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Affiliation(s)
- Jyotpal Singh
- Faculty of Kinesiology and Health StudiesUniversity of ReginaReginaSaskatchewanCanada
| | - Lanishen Bhagaloo
- Gateway Alliance Medical ClinicReginaSaskatchewanCanada
- Faculty of MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Eric Sy
- Department of Critical CareSaskatchewan Health AuthorityReginaSaskatchewanCanada
- College of MedicineUniversity of SaskatchewanReginaSaskatchewanCanada
| | - Andrea J. Lavoie
- College of MedicineUniversity of SaskatchewanReginaSaskatchewanCanada
- Department of CardiologyPrairie Vascular Research IncSaskatchewan Health AuthorityReginaSaskatchewanCanada
| | - Payam Dehghani
- College of MedicineUniversity of SaskatchewanReginaSaskatchewanCanada
- Department of CardiologyPrairie Vascular Research IncSaskatchewan Health AuthorityReginaSaskatchewanCanada
| | - Patrick Neary
- Faculty of Kinesiology and Health StudiesUniversity of ReginaReginaSaskatchewanCanada
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Bär C, Derda AA, Thum T. MicroRNAs bei COVID-19: kleine Moleküle mit großem Potenzial? BIOSPEKTRUM 2021; 27:485-487. [PMID: 34511734 PMCID: PMC8417673 DOI: 10.1007/s12268-021-1620-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Christian Bär
- Institut für Molekulare und Translationale Therapiestrategien, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Deutschland
- Rebirth - Forschungszentrum für Translationale Regenerative Medizin, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Anselm A. Derda
- Institut für Molekulare und Translationale Therapiestrategien, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Deutschland
- Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Thomas Thum
- Institut für Molekulare und Translationale Therapiestrategien, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Deutschland
- Rebirth - Forschungszentrum für Translationale Regenerative Medizin, Medizinische Hochschule Hannover, Hannover, Deutschland
- Fraunhofer-Institut für Toxikologie und Experimentelle Medizin, Hannover, Deutschland
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Paidas MJ, Mohamed AB, Norenberg MD, Saad A, Barry AF, Colon C, Kenyon NS, Jayakumar AR. Multi-Organ Histopathological Changes in a Mouse Hepatitis Virus Model of COVID-19. Viruses 2021; 13:1703. [PMID: 34578284 PMCID: PMC8473123 DOI: 10.3390/v13091703] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 01/08/2023] Open
Abstract
Infection with SARS-CoV-2, the virus responsible for the global COVID-19 pandemic, causes a respiratory illness that can severely impact other organ systems and is possibly precipitated by cytokine storm, septic shock, thrombosis, and oxidative stress. SARS-CoV-2 infected individuals may be asymptomatic or may experience mild, moderate, or severe symptoms with or without pneumonia. The mechanisms by which SARS-CoV-2 infects humans are largely unknown. Mouse hepatitis virus 1 (MHV-1)-induced infection was used as a highly relevant surrogate animal model for this study. We further characterized this animal model and compared it with SARS-CoV-2 infection in humans. MHV-1 inoculated mice displayed death as well as weight loss, as reported earlier. We showed that MHV-1-infected mice at days 7-8 exhibit severe lung inflammation, peribronchiolar interstitial infiltration, bronchiolar epithelial cell necrosis and intra-alveolar necrotic debris, alveolar exudation (surrounding alveolar walls have capillaries that are dilated and filled with red blood cells), mononuclear cell infiltration, hyaline membrane formation, the presence of hemosiderin-laden macrophages, and interstitial edema. When compared to uninfected mice, the infected mice showed severe liver vascular congestion, luminal thrombosis of portal and sinusoidal vessels, hepatocyte degeneration, cell necrosis, and hemorrhagic changes. Proximal and distal tubular necrosis, hemorrhage in interstitial tissue, and the vacuolation of renal tubules were observed. The heart showed severe interstitial edema, vascular congestion, and dilation, as well as red blood cell extravasation into the interstitium. Upon examination of the MHV-1 infected mice brain, we observed congested blood vessels, perivascular cavitation, cortical pericellular halos, vacuolation of neuropils, darkly stained nuclei, pyknotic nuclei, and associated vacuolation of the neuropil in the cortex, as well as acute eosinophilic necrosis and necrotic neurons with fragmented nuclei and vacuolation in the hippocampus. Our findings suggest that the widespread thrombotic events observed in the surrogate animal model for SARS-CoV-2 mimic the reported findings in SARS-CoV-2 infected humans, representing a highly relevant and safe animal model for the study of the pathophysiologic mechanisms of SARS-CoV-2 for potential therapeutic interventions.
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Affiliation(s)
- Michael J Paidas
- Departments of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, FL 33136, USA
| | - Adhar B Mohamed
- Departments of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, FL 33136, USA
| | - Michael D Norenberg
- Division of Neuropathology, Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Ali Saad
- Division of Neuropathology, Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Ariel Faye Barry
- Departments of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, FL 33136, USA
| | - Cristina Colon
- Departments of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, FL 33136, USA
| | - Norma Sue Kenyon
- Microbiology & Immunology and Biomedical Engineering, Diabetes Research Institute, University of Miami, Miami, FL 33136, USA
| | - Arumugam R Jayakumar
- Departments of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miami, FL 33136, USA
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Mozafar M, Mirmotalebisohi SA, Sameni M, Zali H. Investigating Neurological Manifestations of SARS-CoV-2. J Neuroimmune Pharmacol 2021; 16:695-698. [PMID: 34431023 PMCID: PMC8384098 DOI: 10.1007/s11481-021-10006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/31/2021] [Indexed: 11/01/2022]
Affiliation(s)
- Maryam Mozafar
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Tehran University of Medical Science, Tehran, Iran
| | - Seyed Amir Mirmotalebisohi
- Student Research Committee, Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Sameni
- Student Research Committee, Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hakimeh Zali
- Proteomics Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran. .,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Who Is the Most Vulnerable to Anxiety at the Beginning of the COVID-19 Outbreak in China? A Cross-Sectional Nationwide Survey. Healthcare (Basel) 2021; 9:healthcare9080970. [PMID: 34442107 PMCID: PMC8394659 DOI: 10.3390/healthcare9080970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/23/2022] Open
Abstract
(1) Background: The COVID-19 pandemic has not only changed people’s health behavior, but also induced a psychological reaction among the public. Research data is needed to develop scientific evidence-driven strategies to reduce adverse mental health effects. The aims of this study are to evaluate the anxiety reaction of Chinese people and the related determinants during the earliest phase of the COVID-19 outbreak in China. Evidence from this survey will contribute to a targeted reference on how to deliver psychological counseling service in the face of outbreaks. (2) Methods: A cross-sectional, population-based online survey was conducted from 28 January to 5 February 2020 using an open online questionnaire for people aged 18 years or above, residing in China and abroad. The socio-demographic information of the respondents was collected, and anxiety scores were calculated. A direct standardization method was used to standardize anxiety scores and a general linear model was used to identify associations between some factors (e.g., sex, age, education, etc.) and anxiety scores. (3) Results: A total of 10,946 eligible participants were recruited in this study, with a completion rate of 98.16% (10,946/11,151). The average anxiety score was 6.46 ± 4.12 (total score = 15); women (6.86 ± 4.11) scored higher than men (5.67 ± 4.04). The age variable was inversely and significantly associated with the anxiety score (β = −2.12, 95% CI: −2.47–−1.78). People possessing higher education (β = 1.15, 95% CI: 0.88–1.41) or a higher awareness of cognitive risk (β = 4.89, 95% CI: 4.33–5.46) reported higher levels of anxiety. There was a close association between poor subjective health and anxiety status (β = 2.83, 95% CI: 2.58–3.09). With the increase of confidence, the anxiety of the population exhibited a gradual decline (β = −2.45, 95% CI: −2.77–−2.13). (4) Conclusion: Most people were vulnerable to anxiety during the earliest phase of the COVID-19 outbreak in China. Younger women, individuals with high education, people with high cognitive risk and subjective poor health were vulnerable to anxiety during the epidemic. In addition, increasing confidence in resisting this pandemic is a protective determinant for individuals to develop anxiety. The findings suggest that policymakers adopt psychosocial interventions to reduce anxiety during the pandemic.
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Nath KA, Singh RD, Grande JP, Garovic VD, Croatt AJ, Ackerman AW, Barry MA, Agarwal A. Expression of ACE2 in the Intact and Acutely Injured Kidney. KIDNEY360 2021; 2:1095-1106. [PMID: 35368365 PMCID: PMC8786087 DOI: 10.34067/kid.0001562021] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/14/2021] [Indexed: 02/04/2023]
Abstract
Background The actions of angiotensin-converting enzyme 2 (ACE2) oppose those of the renin-angiotensin-aldosterone system. ACE2 may be a cytoprotectant in some tissues. This study examined ACE2 expression in models of AKI. Methods ACE2 mRNA and protein expression and ACE2 activity were assessed in murine ischemic AKI. Renal ACE2 mRNA expression was evaluated in LPS-induced AKI in wild-type (C57BL/6J) mice, in heme oxygenase-1+/+ and heme oxygenase-1-/- mice, and after unilateral ureteral obstruction (UUO) in wild-type mice. The effect of sex and age on renal ACE2 protein expression was also assessed. Results In ischemic AKI, ACE2 mRNA and protein expression and ACE2 activity were reduced as compared with such indices in the intact kidney. In ischemic AKI, ACE2, which, in health, is prominently expressed in the tubular epithelium, especially proximal tubules, is decreased in expression in these segments. Decreased ACE2 expression in AKI did not reflect reduced GFR, because ACE2 mRNA expression was unaltered after UUO. LPS induced renal ACE2 mRNA expression in wild-type mice, but this effect did not occur in heme oxygenase-1-deficient mice. In ischemic and LPS-induced AKI, renal expression of the Mas receptor was increased. In the intact kidney, renal ACE2 protein expression decreased in female mice as compared with male mice, but was unaltered with age. Conclusion We conclude that renal ACE2 expression is decreased in ischemic AKI, characterized by decreased GFR and abundant cell death, but is upregulated in LPS-induced AKI, an effect requiring heme oxygenase-1. Determining the significance of ACE2 expression in experimental AKI merits further study. We suggest that understanding the mechanism underlying ACE2 downregulation in AKI may offer insights relevant to COVID-19: ACE2 expression is downregulated after ACE2 mediates SARS-CoV-2 cellular entry; such downregulation is proinflammatory; and AKI commonly occurs and determines outcomes in COVID-19.
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Affiliation(s)
- Karl A. Nath
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Raman Deep Singh
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Joseph P. Grande
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Vesna D. Garovic
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Anthony J. Croatt
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Allan W. Ackerman
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michael A. Barry
- Division of Infectious Diseases, Mayo Clinic Rochester, Minnesota
| | - Anupam Agarwal
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Incidence and Outcomes of Pulmonary Embolism among Hospitalized COVID-19 Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147645. [PMID: 34300096 PMCID: PMC8307735 DOI: 10.3390/ijerph18147645] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Patients with COVID-19 may be at high risk for thrombotic complications due to excess inflammatory response and stasis of blood flow. This study aims to assess the incidence of pulmonary embolism among hospitalized patients with COVID-19, risk factors, and the impact on survival. METHODS A retrospective case-control study was conducted at Al-Noor Specialist Hospital in Saudi Arabia between 15 March 2020 and 15 June 2020. Patients with confirmed COVID-19 diagnosis by a real-time polymerase chain reaction (PCR) and confirmed diagnosis of pulmonary embolism by Computed Tomography pulmonary angiogram (CTPA) formed the case group. Patients with confirmed COVID-19 diagnosis by a real-time polymerase chain reaction (PCR) and without confirmed diagnose of pulmonary embolism formed the control group. Logistic regression analysis was used to identify predictors of pulmonary embolism and survival. RESULTS A total of 159 patients participated were included in the study, of which 51 were the cases (patients with pulmonary embolism) and 108 patients formed the control group (patients without pulmonary embolism). The incidence of PE among those hospitalized was around 32%. Smoking history, low level of oxygen saturation, and higher D-dimer values were important risk factors that were associated with a higher risk of developing PE (p < 0.05). Higher respiratory rate was associated with higher odds of death, and decreased the possibility of survival among hospitalized patients with PE. CONCLUSIONS Pulmonary embolism is common among hospitalized patients with COVID-19. Preventive measures should be considered for hospitalized patients with smoking history, low level of oxygen saturation, high D-dimer values, and high respiratory rate.
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Badimon L, Robinson EL, Jusic A, Carpusca I, deWindt LJ, Emanueli C, Ferdinandy P, Gu W, Gyöngyösi M, Hackl M, Karaduzovic-Hadziabdic K, Lustrek M, Martelli F, Nham E, Potočnjak I, Satagopam V, Schneider R, Thum T, Devaux Y. Cardiovascular RNA markers and artificial intelligence may improve COVID-19 outcome: a position paper from the EU-CardioRNA COST Action CA17129. Cardiovasc Res 2021; 117:1823-1840. [PMID: 33839767 PMCID: PMC8083253 DOI: 10.1093/cvr/cvab094] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 04/08/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has been as unprecedented as unexpected, affecting more than 105 million people worldwide as of 8 February 2020 and causing more than 2.3 million deaths according to the World Health Organization (WHO). Not only affecting the lungs but also provoking acute respiratory distress, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is able to infect multiple cell types including cardiac and vascular cells. Hence a significant proportion of infected patients develop cardiac events, such as arrhythmias and heart failure. Patients with cardiovascular comorbidities are at highest risk of cardiac death. To face the pandemic and limit its burden, health authorities have launched several fast-track calls for research projects aiming to develop rapid strategies to combat the disease, as well as longer-term projects to prepare for the future. Biomarkers have the possibility to aid in clinical decision-making and tailoring healthcare in order to improve patient quality of life. The biomarker potential of circulating RNAs has been recognized in several disease conditions, including cardiovascular disease. RNA biomarkers may be useful in the current COVID-19 situation. The discovery, validation, and marketing of novel biomarkers, including RNA biomarkers, require multi-centre studies by large and interdisciplinary collaborative networks, involving both the academia and the industry. Here, members of the EU-CardioRNA COST Action CA17129 summarize the current knowledge about the strain that COVID-19 places on the cardiovascular system and discuss how RNA biomarkers can aid to limit this burden. They present the benefits and challenges of the discovery of novel RNA biomarkers, the need for networking efforts, and the added value of artificial intelligence to achieve reliable advances.
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Affiliation(s)
- Lina Badimon
- Cardiovascular Science Program-ICCC, IR-Hospital de la Santa Creu i Santa Pau, Ciber CV, Autonomous University of Barcelona, Barcelona, Spain
| | - Emma L Robinson
- Department of Cardiology, School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Amela Jusic
- Cardiovascular Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B rue Edison, L-1445 Strassen, Luxembourg
| | - Irina Carpusca
- Cardiovascular Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B rue Edison, L-1445 Strassen, Luxembourg
| | - Leon J deWindt
- Department of Molecular Genetics, Faculty of Science and Engineering, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Costanza Emanueli
- National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Péter Ferdinandy
- Cardiometabolic Research Group and MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest,Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Wei Gu
- Luxembourg Center for Systems Biomedicine, University of Luxembourg, Esch sur Alzette, Luxembourg
| | - Mariann Gyöngyösi
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | | | | | - Mitja Lustrek
- Department of Intelligent Systems, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Fabio Martelli
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy
| | - Eric Nham
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ines Potočnjak
- Institute for Clinical Medical Research and Education, University Hospital Centre Sisters of Charity, Zagreb, Croatia
| | - Venkata Satagopam
- Luxembourg Center for Systems Biomedicine, University of Luxembourg, Esch sur Alzette, Luxembourg
| | - Reinhard Schneider
- Luxembourg Center for Systems Biomedicine, University of Luxembourg, Esch sur Alzette, Luxembourg
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover,Germany
- REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
| | - Yvan Devaux
- Cardiovascular Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B rue Edison, L-1445 Strassen, Luxembourg
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Fakhoury HMA, Kvietys PR, Shakir I, Shams H, Grant WB, Alkattan K. Lung-Centric Inflammation of COVID-19: Potential Modulation by Vitamin D. Nutrients 2021; 13:2216. [PMID: 34203190 PMCID: PMC8308422 DOI: 10.3390/nu13072216] [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: 06/15/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 02/06/2023] Open
Abstract
SARS-CoV-2 infects the respiratory tract and leads to the disease entity, COVID-19. Accordingly, the lungs bear the greatest pathologic burden with the major cause of death being respiratory failure. However, organs remote from the initial site of infection (e.g., kidney, heart) are not spared, particularly in severe and fatal cases. Emerging evidence indicates that an excessive inflammatory response coupled with a diminished antiviral defense is pivotal in the initiation and development of COVID-19. A common finding in autopsy specimens is the presence of thrombi in the lungs as well as remote organs, indicative of immunothrombosis. Herein, the role of SARS-CoV-2 in lung inflammation and associated sequelae are reviewed with an emphasis on immunothrombosis. In as much as vitamin D is touted as a supplement to conventional therapies of COVID-19, the impact of this vitamin at various junctures of COVID-19 pathogenesis is also addressed.
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Affiliation(s)
- Hana. M. A. Fakhoury
- Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia
| | - Peter R. Kvietys
- Department of Physiology, College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia; (P.R.K.); (I.S.); (H.S.)
| | - Ismail Shakir
- Department of Physiology, College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia; (P.R.K.); (I.S.); (H.S.)
| | - Hashim Shams
- Department of Physiology, College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia; (P.R.K.); (I.S.); (H.S.)
| | - William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA;
| | - Khaled Alkattan
- Department of Surgery, College of Medicine, Alfaisal University, P.O. Box 50927, Riyadh 11533, Saudi Arabia;
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42
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Liang C, Zhang W, Li S, Qin G. Coronary heart disease and COVID-19: A meta-analysis. ACTA ACUST UNITED AC 2021; 156:547-554. [PMID: 34109276 PMCID: PMC8178966 DOI: 10.1016/j.medcle.2020.12.021] [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: 10/08/2020] [Accepted: 12/16/2020] [Indexed: 12/28/2022]
Abstract
Objective Since the World Health Organization (WHO) announced coronavirus disease 2019 (COVID-19) had become a global pandemic on March 11, 2020, the number of infections has been increasing. The purpose of this meta-analysis was to investigate the prognosis of COVID-19 in patients with coronary heart disease. Method Pubmed, Embase, and Cochrane Library databases were searched to collect the literature concerning coronary heart disease and COVID-19. The retrieval time was from inception to Nov 20, 2020, using Stata version 14.0 for meta-analysis. Results A total of 22,148 patients from 40 studies were included. The meta-analysis revealed that coronary heart disease was associated with poor prognosis of COVID-19 (OR=3.42, 95%CI [2.83, 4.13], P < 0.001). After subgroup analysis, coronary heart disease was found to be related to mortality (OR = 3.75, 95%CI [2.91, 4.82], P < 0.001), severe/critical COVID-19 (OR = 3.23, 95%CI [2.19, 4.77], P < 0.001), ICU admission (OR = 2.25, 95%CI [1.34, 3.79], P = 0.002), disease progression (OR = 3.01, 95%CI [1.46, 6.22], P = 0.003); Meta-regression showed that the association between coronary heart disease and poor prognosis of COVID-19 was affected by hypertension (P = 0.004), and subgroup analysis showed that compared with the proportion of hypertension >30% (OR = 2.85, 95%CI [2.33, 3.49]), the proportion of hypertension <30% (OR = 4.78, 95%CI [3.50, 6.51]) had a higher risk of poor prognosis. Conclusion Coronary heart disease is a risk factor for poor prognosis in patients with COVID-19.
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Affiliation(s)
- Chendi Liang
- Shanxi Medical University, Taiyuan, Shanxi, China
| | - Weijun Zhang
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Shuzhen Li
- Baoan District Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Gang Qin
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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43
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Hashemi P, Pezeshki S. Repurposing metformin for covid-19 complications in patients with type 2 diabetes and insulin resistance. Immunopharmacol Immunotoxicol 2021; 43:265-270. [PMID: 34057870 DOI: 10.1080/08923973.2021.1925294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Understanding the exact role of current drugs in Covid-19 disease is essential in the era of global pandemics. Metformin which prescribed as the first-line treatment of type 2 diabetes has beneficial effects on Sars-cov2 infection. These effects are including regulation of immune system, Renin-Angiotensin System and Dipeptidyl Peptidase 4 function in Covid-19 infection. It also activates ACE2, the main receptor of Sars-cov2, in the epithelial cells of respiratory tissue through AMPK signaling and subsequently decreases the rate of viral adhesion. Metformin also declines the adherence of Sars-cov2 to DPP4 (the other receptor of the virus) on T cells. Hence, regulatory effects of metformin on membranous ACE2, and DPP4 can modulate immune reaction against Sars-cov2. Also, immunometabolic effects of metformin on inflammatory cells impair hyper-reactive immune response against the virus through reduction of glycolysis and propagation of mitochondrial oxidation. Metformin also decreases platelet aggravation and risk of thrombosis. In this article, we argue that metformin has beneficial effects on Covid-19 infection in patients with type 2 diabetes and insulin resistance. This opinion should be investigated in future clinical trials.
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Affiliation(s)
- Payam Hashemi
- Faculty of Medicine, Tehran University of Medical Science (TUMS), Tehran, Iran
| | - Shaghayegh Pezeshki
- Department of Immunology, School of Medicine, Iran University of Medical Science (IUMS), Tehran, Iran
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44
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Batkai S, Genschel C, Viereck J, Rump S, Bär C, Borchert T, Traxler D, Riesenhuber M, Spannbauer A, Lukovic D, Zlabinger K, Hašimbegović E, Winkler J, Garamvölgyi R, Neitzel S, Gyöngyösi M, Thum T. CDR132L improves systolic and diastolic function in a large animal model of chronic heart failure. Eur Heart J 2021; 42:192-201. [PMID: 33089304 PMCID: PMC7813625 DOI: 10.1093/eurheartj/ehaa791] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/16/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022] Open
Abstract
Aims Cardiac miR-132 activation leads to adverse remodelling and pathological hypertrophy. CDR132L is a synthetic lead-optimized oligonucleotide inhibitor with proven preclinical efficacy and safety in heart failure (HF) early after myocardial infarction (MI), and recently completed clinical evaluation in a Phase 1b study (NCT04045405). The aim of the current study was to assess safety and efficacy of CDR132L in a clinically relevant large animal (pig) model of chronic heart failure following MI. Methods and results In a chronic model of post-MI HF, slow-growing pigs underwent 90 min left anterior descending artery occlusion followed by reperfusion. Animals were randomized and treatment started 1-month post-MI. Monthly intravenous (IV) treatments of CDR132L over 3 or 5 months (3× or 5×) were applied in a blinded randomized placebo-controlled fashion. Efficacy was evaluated based on serial magnetic resonance imaging, haemodynamic, and biomarker analyses. The treatment regime provided sufficient tissue exposure and CDR132L was well tolerated. Overall, CDR132L treatment significantly improved cardiac function and reversed cardiac remodelling. In addition to the systolic recovery, diastolic function was also ameliorated in this chronic model of HF. Conclusion Monthly repeated dosing of CDR132L is safe and adequate to provide clinically relevant exposure and therapeutic efficacy in a model of chronic post-MI HF. CDR132L thus should be explored as treatment for the broad area of chronic heart failure. ![]()
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Affiliation(s)
- Sandor Batkai
- CARDIOR Pharmaceuticals GmbH, Feodor-Lynen-Str. 15, Hannover 30625, Germany
| | - Celina Genschel
- CARDIOR Pharmaceuticals GmbH, Feodor-Lynen-Str. 15, Hannover 30625, Germany
| | - Janika Viereck
- CARDIOR Pharmaceuticals GmbH, Feodor-Lynen-Str. 15, Hannover 30625, Germany
| | - Steffen Rump
- CARDIOR Pharmaceuticals GmbH, Feodor-Lynen-Str. 15, Hannover 30625, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
| | - Tobias Borchert
- CARDIOR Pharmaceuticals GmbH, Feodor-Lynen-Str. 15, Hannover 30625, Germany
| | - Denise Traxler
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Martin Riesenhuber
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Andreas Spannbauer
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Dominika Lukovic
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Katrin Zlabinger
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Ena Hašimbegović
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Johannes Winkler
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Rita Garamvölgyi
- Department of Diagnostic Imaging and Oncoradiology, University of Kaposvár, Guba S. Street 40, Kaposvár 7400, Hungary
| | - Sonja Neitzel
- Axolabs GmbH, Fritz-Hornschuch-Straße 9, Kulmbach 95326, Germany
| | - Mariann Gyöngyösi
- Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
| | - Thomas Thum
- CARDIOR Pharmaceuticals GmbH, Feodor-Lynen-Str. 15, Hannover 30625, Germany.,Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
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45
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Al-Karmalawy AA, Dahab MA, Metwaly AM, Elhady SS, Elkaeed EB, Eissa IH, Darwish KM. Molecular Docking and Dynamics Simulation Revealed the Potential Inhibitory Activity of ACEIs Against SARS-CoV-2 Targeting the hACE2 Receptor. Front Chem 2021; 9:661230. [PMID: 34017819 PMCID: PMC8129187 DOI: 10.3389/fchem.2021.661230] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/24/2021] [Indexed: 12/28/2022] Open
Abstract
The rapid and global spread of a new human coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has produced an immediate urgency to discover promising targets for the treatment of COVID-19. Here, we consider drug repurposing as an attractive approach that can facilitate the drug discovery process by repurposing existing pharmaceuticals to treat illnesses other than their primary indications. We review current information concerning the global health issue of COVID-19 including promising approved drugs, e.g., human angiotensin-converting enzyme inhibitors (hACEIs). Besides, we describe computational approaches to be used in drug repurposing and highlight examples of in-silico studies of drug development efforts against SARS-CoV-2. Alacepril and lisinopril were found to interact with human angiotensin-converting enzyme 2 (hACE2), the host entranceway for SARS-CoV-2 spike protein, through exhibiting the most acceptable rmsd_refine values and the best binding affinity through forming a strong hydrogen bond with Asn90, which is assumed to be essential for the activity, as well as significant extra interactions with other receptor-binding residues. Furthermore, molecular dynamics (MD) simulations followed by calculation of the binding free energy were also carried out for the most promising two ligand-pocket complexes from docking studies (alacepril and lisinopril) to clarify some information on their thermodynamic and dynamic properties and confirm the docking results as well. These results we obtained probably provided an excellent lead candidate for the development of therapeutic drugs against COVID-19. Eventually, animal experiments and accurate clinical trials are needed to confirm the potential preventive and treatment effect of these compounds.
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Affiliation(s)
- Ahmed A Al-Karmalawy
- Department of Pharmaceutical Medicinal Chemistry, Faculty of Pharmacy, Horus University-Egypt, Damietta, Egypt
| | - Mohammed A Dahab
- Pharmaceutical Medicinal Chemistry & Drug Design Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, Egypt
| | - Ahmed M Metwaly
- Pharmacognosy Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, Egypt
| | - Sameh S Elhady
- Department of Natural Products, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Eslam B Elkaeed
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
- Department of Pharmaceutical Organic Chemistry, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, Egypt
| | - Ibrahim H Eissa
- Pharmaceutical Medicinal Chemistry & Drug Design Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, Egypt
| | - Khaled M Darwish
- Department of Medicinal Chemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
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46
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Turek M, Różycka-Sokołowska E, Koprowski M, Marciniak B, Bałczewski P. Role of Hydrogen Bonds in Formation of Co-amorphous Valsartan/Nicotinamide Compositions of High Solubility and Durability with Anti-hypertension and Anti-COVID-19 Potential. Mol Pharm 2021; 18:1970-1984. [PMID: 33792313 PMCID: PMC8029446 DOI: 10.1021/acs.molpharmaceut.0c01096] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 01/11/2023]
Abstract
Physicochemical properties, in particular solubility and the associated bioavailability, are key factors in determining efficacy of poorly water-soluble drugs, which constitute 40% of new drugs in the market, and improving them is an important challenge for modern pharmacy. A recent strategy to achieve this goal is formation of stable co-amorphous solid dispersions with co-formers of low molecular weight. Here, the amorphization strategy was applied for low-soluble anti-hypertensive valsartan (VAL), an angiotensin II receptor blocker, and nicotinamide, which exhibits lung- and cardio-protective effects. Through interactions with the renin-angiotensin-aldosteron system, VAL may be used to treat both hypertension and the current pandemic coronavirus SARS-CoV-2 infection. Using mechanochemical and liquid- and solid-state approaches, solvated co-amorphous solid dispersions of VAL with nicotinamide were obtained. They were characterized by spectroscopic, thermal, and X-ray analyses. The density functional theory, quantum theory of atoms in molecules, and non-covalent interaction index calculations revealed the presence of two types of hydrogen bonds between VAL and NIC (i.e., N-H···O and O-H···O). One of them had a partially covalent character, which caused conformational changes in the flexible VAL molecule, restricting contribution of the tetrazolyl N-H donor and thus limiting the possibility of co-crystal formation. The recognized VAL/NIC1- and VAL/NIC2-type heterodimeric interactions were responsible for the excellent durability of the solid compositions and up to 24-fold better solubility than VAL alone. The synthesized dispersions constitute a new class of dually acting drugs, containing an active pharmaceutical ingredient (VAL) and supporting nutraceutical (nicotinamide).
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Affiliation(s)
- Marika Turek
- Institute
of Chemistry, Faculty of Science and Technology, Jan Długosz University in Częstochowa, Armii Krajowej 13/15, Częstochowa 42-201, Poland
| | - Ewa Różycka-Sokołowska
- Institute
of Chemistry, Faculty of Science and Technology, Jan Długosz University in Częstochowa, Armii Krajowej 13/15, Częstochowa 42-201, Poland
| | - Marek Koprowski
- Division
of Organic Chemistry, Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, Sienkiewicza 112, Łódź 90-363, Poland
| | - Bernard Marciniak
- Institute
of Chemistry, Faculty of Science and Technology, Jan Długosz University in Częstochowa, Armii Krajowej 13/15, Częstochowa 42-201, Poland
| | - Piotr Bałczewski
- Institute
of Chemistry, Faculty of Science and Technology, Jan Długosz University in Częstochowa, Armii Krajowej 13/15, Częstochowa 42-201, Poland
- Division
of Organic Chemistry, Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, Sienkiewicza 112, Łódź 90-363, Poland
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47
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Lio D, Scola L, Giarratana RM, Candore G, Colonna-Romano G, Caruso C, Balistreri CR. SARS CoV2 infection _The longevity study perspectives. Ageing Res Rev 2021; 67:101299. [PMID: 33607290 PMCID: PMC7885677 DOI: 10.1016/j.arr.2021.101299] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 01/08/2023]
Abstract
Like other infectious diseases, COVID-19 shows a clinical outcome enormously variable, ranging from asymptomatic to lethal. In Italy, like in other countries, old male individuals, with one or more comorbidity, are the most susceptible group, and show, consequently, the highest mortality, and morbidity, including lethal respiratory distress syndrome, as the most common complication. In addition, another extraordinary peculiarity, that is a surprising resistance to COVID-19, characterizes some Italian nonagenarians/centenarians. Despite having the typical COVID-19 signs and/or symptoms, such exceptional individuals show a surprising tendency to recover from illness and complications. On the other hand, long-lived people have an optimal performance of immune system related to an overexpression of anti-inflammatory variants in immune/inflammatory genes, as demonstrated by our and other groups. Consequently, we suggest long-lived people as an optimal model for detecting genetic profiles associated with the susceptibility and/or protection to COVID-19, to utilize as potential pharmacological targets for preventing or reducing viral infection in more vulnerable individuals.
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Affiliation(s)
- Domenico Lio
- Immunosenescence Study Group, Department of Biomedicine, Neuroscience and Advanced, Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Letizia Scola
- Immunosenescence Study Group, Department of Biomedicine, Neuroscience and Advanced, Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy; Cellular/Molecular Biology and Clinical Pathology Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Rosa Maria Giarratana
- Cellular/Molecular Biology and Clinical Pathology Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Giuseppina Candore
- Immunosenescence Study Group, Department of Biomedicine, Neuroscience and Advanced, Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Giuseppina Colonna-Romano
- Immunosenescence Study Group, Department of Biomedicine, Neuroscience and Advanced, Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Calogero Caruso
- Immunosenescence Study Group, Department of Biomedicine, Neuroscience and Advanced, Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Carmela Rita Balistreri
- Immunosenescence Study Group, Department of Biomedicine, Neuroscience and Advanced, Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy; Cellular/Molecular Biology and Clinical Pathology Laboratory, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy.
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48
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Flinn B, Royce N, Gress T, Chowdhury N, Santanam N. Dual role for angiotensin-converting enzyme 2 in Severe Acute Respiratory Syndrome Coronavirus 2 infection and cardiac fat. Obes Rev 2021; 22:e13225. [PMID: 33660398 PMCID: PMC8013367 DOI: 10.1111/obr.13225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/25/2021] [Accepted: 02/04/2021] [Indexed: 12/15/2022]
Abstract
Angiotensin-converting enzyme 2 (ACE2) has been an increasingly prevalent target for investigation since its discovery 20 years ago. The finding that it serves a counterregulatory function within the traditional renin-angiotensin system, implicating it in cardiometabolic health, has increased its clinical relevance. Focus on ACE2's role in cardiometabolic health has largely centered on its apparent functions in the context of obesity. Interest in ACE2 has become even greater with the discovery that it serves as the cell receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), opening up numerous mechanisms for deleterious effects of infection. The proliferation of ACE2 within the literature coupled with its dual role in SARS-CoV-2 infection and obesity necessitates review of the current understanding of ACE2's physiological, pathophysiological, and potential therapeutic functions. This review highlights the roles of ACE2 in cardiac dysfunction and obesity, with focus on epicardial adipose tissue, to reconcile the data in the context of SARS-CoV-2 infection.
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Affiliation(s)
- Brendin Flinn
- Department of Biomedical Sciences, Joan C Edwards School of Medicine, Huntington, West Virginia, USA
| | - Nicholas Royce
- Department of Biomedical Sciences, Joan C Edwards School of Medicine, Huntington, West Virginia, USA
| | - Todd Gress
- Research Service, Hershel "Woody" Williams VA Medical Center, Huntington, West Virginia, USA
| | - Nepal Chowdhury
- Department of Cardiovascular and Thoracic Surgery, St. Mary's Heart Center, Huntington, WV, USA
| | - Nalini Santanam
- Department of Biomedical Sciences, Joan C Edwards School of Medicine, Huntington, West Virginia, USA
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49
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Devnath P, Masud H. Nipah virus: a potential pandemic agent in the context of the current severe acute respiratory syndrome coronavirus 2 pandemic. New Microbes New Infect 2021; 41:100873. [PMID: 33758670 PMCID: PMC7972828 DOI: 10.1016/j.nmni.2021.100873] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
For centuries, zoonotic diseases have been responsible for various outbreaks resulting in the deaths of millions of people. The best example of this is the current coronavirus disease 2019 (COVID-19) pandemic. Like severe acute respiratory syndrome coronavirus, Nipah virus is another deadly virus which has caused several outbreaks in the last few years. Though it causes a low number of infections, disease severity results in a higher death rate. In the context of the recent COVID-19 pandemic, we speculate that many countries will be unable to deal with the sudden onset of such a viral outbreak. Thus, further research and attention to the virus are needed to address future outbreaks.
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Affiliation(s)
- P. Devnath
- Department of Microbiology, Faculty of Sciences, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - H.M.A.A. Masud
- Department of Microbiology, Faculty of Biological Sciences, University of Chittagong, Chattogram, Bangladesh
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50
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Herman-Edelstein M, Guetta T, Barnea A, Waldman M, Ben-Dor N, Barak Y, Kornowski R, Arad M, Hochhauser E, Aravot D. Expression of the SARS-CoV-2 receptorACE2 in human heart is associated with uncontrolled diabetes, obesity, and activation of the renin angiotensin system. Cardiovasc Diabetol 2021; 20:90. [PMID: 33906662 PMCID: PMC8078096 DOI: 10.1186/s12933-021-01275-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/15/2021] [Indexed: 12/13/2022] Open
Abstract
Background Diabetic and obese patients are at higher risk of severe disease and cardiac injury in corona virus 2 (SARS-CoV-2) infections. Cellular entry of SARS-CoV-2 is mainly via the angiotensin-converting enzyme 2 (ACE2) receptor, which is highly expressed in normal hearts. There is a disagreement regarding the effect of factors such as obesity and diabetes on ACE2 expression in the human heart and whether treatment with renin–angiotensin system inhibitors or anti-diabetic medications increases ACE2 expression and subsequently the susceptibility to infection. We designed this study to elucidate factors that control ACE2 expression in human serum, human heart biopsies, and mice. Methods Right atrial appendage biopsies were collected from 79 patients that underwent coronary artery bypass graft (CABG) surgery. We investigated the alteration in ACE2 mRNA and protein expression in heart tissue and serum. ACE2 expression was compared with clinical risk factors: diabetes, obesity and different anti-hypertensive or anti-diabetic therapies. WT or db/db mice were infused with Angiotensin II (ATII), treated with different anti-diabetic drugs (Metformin, GLP1A and SGLT2i) were also tested. Results ACE2 gene expression was increased in diabetic hearts compared to non-diabetic hearts and was positively correlated with glycosylated hemoglobin (HbA1c), body mass index (BMI), and activation of the renin angiotensin system (RAS), and negatively correlated with ejection fraction. ACE2 was not differentially expressed in patients who were on angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) prior to the operation. We found no correlation between plasma free ACE2 and cardiac tissue ACE2 expression. Transmembrane serine protease 2 (TMPRSS2), metalloprotease ADAM10 and ADAM17 that facilitate viral-ACE2 complex entry and degradation were increased in diabetic hearts. ACE2 expression in mice was increased with ATII infusion and attenuated following anti-diabetic drugs treatment. Conclusion Patients with uncontrolled diabetes or obesity with RAS activation have higher ACE2 expressions therefore are at higher risk for severe infection. Since ACEi or ARBs show no effect on ACE2 expression in the heart further support their safety.
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Affiliation(s)
- Michal Herman-Edelstein
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Nephrology Department, Rabin Medical Center, Petach Tikva, Israel
| | - Tali Guetta
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Amir Barnea
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Department of Cardiothoracic Surgery, Rabin Medical Center, Petach Tikva, Israel
| | - Maayan Waldman
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Department of Cardiothoracic Surgery, Rabin Medical Center, Petach Tikva, Israel
| | - Naomi Ben-Dor
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Nephrology Department, Rabin Medical Center, Petach Tikva, Israel
| | - Yaron Barak
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Department of Cardiothoracic Surgery, Rabin Medical Center, Petach Tikva, Israel
| | - Ran Kornowski
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Department of Cardiology, Rabin Medical Center, 49100, Petach Tikva, Israel
| | - Michael Arad
- Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Edith Hochhauser
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel. .,Department of Cardiothoracic Surgery, Rabin Medical Center, Petach Tikva, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Dan Aravot
- Cardiac Research Laboratory, Felsenstein Medical Research Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv, Israel.,Department of Cardiothoracic Surgery, Rabin Medical Center, Petach Tikva, Israel
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