The role of COVID-19 in myopathy: incidence, causes, treatment, and prevention

Persistent Neurological Deficits in Mouse PASC Reveal Antiviral Drug Limitations

Post-Acute Sequelae of COVID-19 (PASC) encompasses persistent neurological symptoms, including olfactory and autonomic dysfunction. Here, we report chronic neurological dysfunction in mice infected with a virulent mouse-adapted SARS-CoV-2 that does not infect the brain. Long after recovery from nasal infection, we observed loss of tyrosine hydroxylase (TH) expression in olfactory bulb glomeruli and neurotransmitter levels in the substantia nigra (SN) persisted. Vulnerability of dopaminergic neurons in these brain areas was accompanied by increased levels of proinflammatory cytokines and neurobehavioral changes. RNAseq analysis unveiled persistent microglia activation, as found in human neurodegenerative diseases. Early treatment with antivirals (nirmatrelvir and molnupiravir) reduced virus titers and lung inflammation but failed to prevent neurological abnormalities, as observed in patients. Together these results show that chronic deficiencies in neuronal function in SARS-CoV-2-infected mice are not directly linked to ongoing olfactory epithelium dysfunction. Rather, they bear similarity with neurodegenerative disease, the vulnerability of which is exacerbated by chronic inflammation.

Statin-Associated Liver Dysfunction and Muscle Injury: epidemiology, Mechanisms, and Management Strategies

Surveillance of drug safety is an important aspect in the routine medical care. Adverse events caused by real-world drug utilization has become one of the leading causes of death and an urgent issue in the field of toxicology. Cardiovascular disease is now the leading cause of fatal diseases in most countries, especially in the elderly population who often suffer from multiple diseases and need long-term multidrug therapy. Among which, statins have been widely used to lower bad cholesterol and regress coronary plaque mainly in patients with hyperlipidemia and atherosclerotic cardiovascular diseases (ASCVD). Although the real-world benefits of statins are significant, different degrees and types of adverse drug reactions (ADR) such as liver dysfunction and muscle injury, have a great impact on the original treatment regimens as well as the quality of life. This review describes the epidemiology, mechanisms, early identification and post-intervention of statin-associated liver dysfunction and muscle injury based on the updated clinical evidence. It provides systematic and comprehensive guidance and necessary supplement for the clinical safety of statin use in cardiovascular diseases.

Variations of blood viscosity in acute typhoid fever: A cross-sectional study

Typhoid fever (TF) is a systemic infection caused by Salmonella Typhi (Salmonella Enterica) transmitted through contaminated water, food, or contact with infected individuals. In various infectious diseases, blood viscosity (BV) is affected by changes in hemoglobin concentrations and acute phase reactants. Inflammatory responses can lead to elevated plasma protein levels and further affect BV. This study aimed to investigate BV changes in patients with acute TF. A cross-sectional study was performed involving 55 patients with acute TF compared to 38 healthy controls. BV and inflammatory parameters were measured in both groups. TF patients showed reduced blood cells compared to healthy controls (p=0.001). Additionally, plasma total protein (TP) levels significantly increased to 10.79±1.05 g/L in TF patients compared to 7.035±1.44 g/L in healthy controls (p=0.03). Hematocrit (HCT) levels were 11.67±2.89% in TF patients and 12.84±2.02% in healthy controls (p=0.07), suggesting a trend towards increased BV in TF patients. Elevated BV is involved in the pathogenesis of different inflammatory and infectious diseases. The increased BV in TF patients may raise the risk of complications. Therefore, monitoring BV might be a crucial tool in TF patients, mainly in the high-risk group, for early detection of cardiovascular complications.

Potential anti-obesity effects of two-graded doses of Iraqi Hibiscus tiliaceus leaves extract, alone and in combination with orlistat, on high-fat diet-induced obesity in male rats

Obesity is a world health concern and a serious risk factor for several chronic diseases. Hibiscus tiliaceus is a plant with reported anti-obesity properties. However, the preclinical anti-obesity effect of ethanolic extract of Iraqi Hibiscus tiliaceus has not been studied yet. This study aimed to evaluate the preclinical anti-obesity properties of Iraqi Hibiscus tiliaceus extract, alone or in combination with orlistat, on high-fat diet-induced obesity in male rats. Male rats were divided into five groups: control, induction, ethanolic extract of Iraqi Hibiscus tiliaceus (250 mg/kg and 500 mg/kg), orlistat (Xenical) alone (10 mg/kg), and a combination of the extract (250 mg/kg) with Xenical. The rats were fed a high-fat diet to induce obesity, and treatments were given orally for 8 weeks. Body weight, food intake, serum lipid profile, and liver enzymes were measured. Administration of ethanolic extract of Iraqi Hibiscus tiliaceus (250 mg/kg and 500 mg/kg), Xenical alone (10 mg/kg), and combination with the extract (250 mg/kg) for 8 weeks significantly reduced body weight, food intake, serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, and liver enzymes (aspartate transaminase and alanine transaminase) when compared to the induction group. The ethanolic extract of Iraqi Hibiscus tiliaceus showed anti-obesity effects and could be a potential therapeutic agent in managing obesity. However, further studies are needed to evaluate its clinical efficacy and safety.

Clinical Characteristics Profile of COVID-19 Patients with Omicron Variant Admitted in a Tertiary Hospital, Central China

Purpose

Omicron, a variant of COVID-19, is becoming a major issue of global concern. Its high transmissibility may bring challenges to the distribution of health care in a large population country like China. Investigating the behavior of the virus in the Chinese population will certainly help to plan for the upcoming surge of Omicron. Therefore, we made a preliminary analysis of the clinical and epidemiological characteristics of suspected cases of Omicron at the early stage of the surge.

Patients and Methods

The study was conducted in Nanyang Central Hospital, a tertiary hospital, from 21st December, 2022 to 8th January, 2023. A total of 210 patients underwent demographic characteristics and clinical symptom collection from their medical records. Moreover, sputum culture was also conducted to explore the types of bacterial or fungal infections.

Results

Our results showed that 5 patients (4.1%) were aged 16-49, 40 patients (32.5%) were aged 50-70, and 78 patients (63.4%) were aged 70 or more in the severe group. The proportion of male patients with severe diseases infected with Omicron is higher than that of female patients and the proportion of severe cases increases with age. The main symptoms of patients infected with Omicron are cough (91, 74.0%), fever (90, 73.2%), and asthma (73, 59.3%). The pathogens Streptococcus pneumoniae (71, 31.0%), Staphylococcus aureus (46, 20.1%), Mycoplasma pneumoniae (26, 11.4%), Klebsiella pneumoniae (18, 7.9%), Acinetobacter baumannii (13, 5.7%), and Haemophilus influenzae were detected in lower respiratory tract.

Conclusion

This study suggests that age >70 is a risk factor for severe COVID-19 and that patients often have bacterial or fungal infections. Our research results may help to provide effective treatment for patients with Omicron infection and also contribute to health economic analysis and research to assist future public health decision-making.

Chemotherapy-induced cardiotoxicity: a new perspective on the role of Digoxin, ATG7 activators, Resveratrol, and herbal drugs

Cancer is a major public health problem, and chemotherapy plays a significant role in the management of neoplastic diseases. However, chemotherapy-induced cardiotoxicity is a serious side effect secondary to cardiac damage caused by antineoplastic's direct and indirect toxicity. Currently, there are no reliable and approved methods for preventing or treating chemotherapy-induced cardiotoxicity. Understanding the mechanisms of chemotherapy-induced cardiotoxicity may be vital to improving survival. The independent risk factors for developing cardiotoxicity must be considered to prevent myocardial damage without decreasing the therapeutic efficacy of cancer treatment. This systematic review aimed to identify and analyze the evidence on chemotherapy-induced cardiotoxicity, associated risk factors, and methods to decrease or prevent it. We conducted a comprehensive search on PubMed, Google Scholar, and Directory of Open Access Journals (DOAJ) using the following keywords: "doxorubicin cardiotoxicity", "anthracycline cardiotoxicity", "chemotherapy", "digoxin decrease cardiotoxicity", "ATG7 activators", retrieving 59 articles fulfilling the inclusion criteria. Therapeutic schemes can be changed by choosing prolonged infusion application over boluses. In addition, some agents like Dexrazoxane can reduce chemotherapy-induced cardiotoxicity in high-risk groups. Recent research found that Digoxin, ATG7 activators, Resveratrol, and other medical substances or herbal compounds have a comparable effect on Dexrazoxane in anthracycline-induced cardiotoxicity.