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Piticchio T, Le Moli R, Tumino D, Frasca F. Relationship between betacoronaviruses and the endocrine system: a new key to understand the COVID-19 pandemic-A comprehensive review. J Endocrinol Invest 2021; 44:1553-1570. [PMID: 33583003 PMCID: PMC7882054 DOI: 10.1007/s40618-020-01486-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 12/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND A new harmful respiratory disease, called COVID-19 emerged in China in December 2019 due to the infection of a novel coronavirus, called SARS-Coronavirus 2 (SARS-CoV-2), which belongs to the betacoronavirus genus, including SARS-CoV-1 and MERS-CoV. SARS-CoV-2 shares almost 80% of the genome with SARS-CoV-1 and 50% with MERS-CoV. Moreover, SARS-CoV-2 proteins share a high degree of homology (approximately 95%) with SARS-CoV-1 proteins. Hence, the mechanisms of SARS-Cov-1 and SARS-Cov-2 infection are similar and occur via binding to ACE2 protein, which is widely distributed in the human body, with a predominant expression in endocrine tissues including testis, thyroid, adrenal and pituitary. PURPOSE On the basis of expression pattern of the ACE2 protein among different tissues, similarity between SARS-Cov-1 and SARS-Cov-2 and the pathophysiology of COVID-19 disease, we aimed at discussing, after almost one-year pandemic, about the relationships between COVID-19 infection and the endocrine system. First, we discussed the potential effect of hormones on the susceptibility to COVID-19 infection; second, we examined the evidences regarding the effect of COVID-19 on the endocrine system. When data were available, a comparative discussion between SARS and COVID-19 effects was also performed. METHODS A comprehensive literature search within Pubmed was performed. This review has been conducted according to the PRISMA statements. RESULTS Among 450, 100 articles were selected. Tissue and vascular damages have been shown on thyroid, adrenal, testis and pituitary glands, with multiple alterations of endocrine function. CONCLUSION Hormones may affect patient susceptibility to COVID-19 infection but evidences regarding therapeutic implication of these findings are still missing. SARS and COVID-19 may affect endocrine glands and their dense vascularization, impairing endocrine system function. A possible damage of endocrine system in COVID-19 patients should be investigated in both COVID-19 acute phase and recovery to identify both early and late endocrine complications that may be important for patient's prognosis and well-being after COVID-19 infection.
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Affiliation(s)
- T Piticchio
- Endocrinology Section, Department of Clinical and Experimental Medicine, Garibaldi Nesima Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - R Le Moli
- Endocrinology Section, Department of Clinical and Experimental Medicine, Garibaldi Nesima Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - D Tumino
- Endocrinology Section, Department of Clinical and Experimental Medicine, Garibaldi Nesima Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - F Frasca
- Endocrinology Section, Department of Clinical and Experimental Medicine, Garibaldi Nesima Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy.
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Zheng F, Li L, Zhang X, Song Y, Huang Z, Chong Y, Chen Z, Zhu H, Wu J, Chen W, Lu Y, Yang Y, Zha Y, Zhao H, Shen J. Accurately Discriminating COVID-19 from Viral and Bacterial Pneumonia According to CT Images Via Deep Learning. Interdiscip Sci 2021; 13:273-285. [PMID: 33641077 PMCID: PMC7914048 DOI: 10.1007/s12539-021-00420-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 01/22/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022]
Abstract
Abstract Computed tomography (CT) is one of the most efficient diagnostic methods for rapid diagnosis of the widespread COVID-19. However, reading CT films brings a lot of concentration and time for doctors. Therefore, it is necessary to develop an automatic CT image diagnosis system to assist doctors in diagnosis. Previous studies devoted to COVID-19 in the past months focused mostly on discriminating COVID-19 infected patients from healthy persons and/or bacterial pneumonia patients, and have ignored typical viral pneumonia since it is hard to collect samples for viral pneumonia that is less frequent in adults. In addition, it is much more challenging to discriminate COVID-19 from typical viral pneumonia as COVID-19 is also a kind of virus. In this study, we have collected CT images of 262, 100, 219, and 78 persons for COVID-19, bacterial pneumonia, typical viral pneumonia, and healthy controls, respectively. To the best of our knowledge, this was the first study of quaternary classification to include also typical viral pneumonia. To effectively capture the subtle differences in CT images, we have constructed a new model by combining the ResNet50 backbone with SE blocks that was recently developed for fine image analysis. Our model was shown to outperform commonly used baseline models, achieving an overall accuracy of 0.94 with AUC of 0.96, recall of 0.94, precision of 0.95, and F1-score of 0.94. The model is available in https://github.com/Zhengfudan/COVID-19-Diagnosis-and-Pneumonia-Classification. Graphic Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s12539-021-00420-z.
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Affiliation(s)
- Fudan Zheng
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, 510006, China
| | - Liang Li
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xiang Zhang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510530, China
| | - Ying Song
- School of Systems Science and Engineering, Sun Yat-sen University, Guangzhou, 510006, China
| | - Ziwang Huang
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, 510006, China
| | - Yutian Chong
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510220, China
| | - Zhiguang Chen
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, 510006, China.,National Supercomputing Center in Guangzhou, Guangzhou, 510006, China
| | - Huiling Zhu
- College of Information Science and Technology, Jinan University, Guangzhou, 510632, China
| | - Jiahao Wu
- School of Intelligent Systems Engineering, Sun Yat-sen University, Guangzhou, 510006, China
| | - Weifeng Chen
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, 510006, China
| | - Yutong Lu
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, 510006, China.,National Supercomputing Center in Guangzhou, Guangzhou, 510006, China
| | - Yuedong Yang
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, 510006, China. .,National Supercomputing Center in Guangzhou, Guangzhou, 510006, China.
| | - Yunfei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| | - Huiying Zhao
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510530, China.
| | - Jun Shen
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510530, China.
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SARS-CoV‑2, a virus with many faces: a series of cases with prolonged persistence of COVID-19 symptoms. Wien Med Wochenschr 2020; 171:3-6. [PMID: 33315163 PMCID: PMC7734614 DOI: 10.1007/s10354-020-00793-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/16/2020] [Indexed: 01/15/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as the causative agent of the ongoing pandemic, has spread into more than 200 countries to date. The disease which is caused by the virus is termed COVID-19. In most cases, it presents at first like common flu with cough and other respiratory symptoms. Nevertheless, other symptoms have been reported, such as a feeling of extreme fatigue, gastrointestinal symptoms, or acute onset of olfactory and gustatory dysfunction. Here we report a series of 10 cases (1 male, 9 females) observed between February and April 2020, with an undulating appearance and disappearance of symptoms. Weeks passed before the diagnosis was established. Symptoms resolved rapidly after treatment with hydroxychloroquine. It seems that the course of COVID-19 can be mild or moderate but with a long persistence of symptoms, and may therefore remain obscure. This may cause a public health issue because of the long infectivity of these patients.
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Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol 2020; 20:355-362. [PMID: 32376901 PMCID: PMC7201395 DOI: 10.1038/s41577-020-0331-4] [Citation(s) in RCA: 1682] [Impact Index Per Article: 420.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to more than 200,000 deaths worldwide. Several studies have now established that the hyperinflammatory response induced by SARS-CoV-2 is a major cause of disease severity and death in infected patients. Macrophages are a population of innate immune cells that sense and respond to microbial threats by producing inflammatory molecules that eliminate pathogens and promote tissue repair. However, a dysregulated macrophage response can be damaging to the host, as is seen in the macrophage activation syndrome induced by severe infections, including in infections with the related virus SARS-CoV. Here we describe the potentially pathological roles of macrophages during SARS-CoV-2 infection and discuss ongoing and prospective therapeutic strategies to modulate macrophage activation in patients with COVID-19. This Progress article from Merad and Martin examines our current understanding of the excessive inflammatory responses seen in patients with severe COVID-19. The authors focus on the emerging pathological roles of monocytes and macrophages and discuss the inflammatory pathways that are currently being targeted in the clinic.
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