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Roy J, Heath SM, Wang S, Ramkrishna D. Modeling COVID-19 transmission between age groups in the United States considering virus mutations, vaccinations, and reinfection. Sci Rep 2022; 12:20098. [PMID: 36418377 PMCID: PMC9684451 DOI: 10.1038/s41598-022-21559-9] [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: 03/02/2022] [Accepted: 09/28/2022] [Indexed: 11/25/2022] Open
Abstract
The in-depth understanding of the dynamics of COVID-19 transmission among different age groups is of great interest for governments and health authorities so that strategies can be devised to reduce the pandemic's detrimental effects. We developed the SIRDV-Virulence (Susceptible-Infected-Recovered-Dead-Vaccinated-Virulence) epidemiological model based on a population balance equation to study the effects virus mutants, vaccination strategies, 'Anti/Non Vaxxer' proportions, and reinfection rates to provide methods to mitigate COVID-19 transmission among the United States population. Based on publicly available data, we obtain the key parameters governing the spread of the pandemic. The results show that a large fraction of infected cases comes from the adult and children populations in the presence of a highly infectious COVID-19 mutant. Given the situation at the end of July 2021, the results show that prioritizing children and adult vaccinations over that of seniors can contain the spread of the active cases, thereby preventing the healthcare system from being overwhelmed and minimizing subsequent deaths. The model suggests that the only option to curb the effects of this pandemic is to reduce the population of unvaccinated individuals. A higher fraction of 'Anti/Non-vaxxers' and a higher reinfection rate can both independently lead to the resurgence of the pandemic.
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Affiliation(s)
- Jyotirmoy Roy
- grid.417971.d0000 0001 2198 7527Department of Chemical Engineering, Indian Institute of Technology Bombay, Mumbai, 400076 India ,grid.214458.e0000000086837370Present Address: Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109 USA
| | - Samuel M. Heath
- grid.169077.e0000 0004 1937 2197Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN 47907 USA ,grid.116068.80000 0001 2341 2786Present Address: Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139 USA
| | - Shiyan Wang
- grid.169077.e0000 0004 1937 2197Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN 47907 USA
| | - Doraiswami Ramkrishna
- grid.169077.e0000 0004 1937 2197Charles D. Davidson School of Chemical Engineering, Purdue University, West Lafayette, IN 47907 USA
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Feizollahi P, Matin S, Roghani SA, Mostafaei S, Safarzadeh E, Taghadosi M. Evaluation serum levels of Insulin Growth Factor-1 (IGF-1) and its association with clinical parameters in severe COVID-19. Inflammopharmacology 2022; 30:199-205. [PMID: 35098386 PMCID: PMC8801278 DOI: 10.1007/s10787-021-00908-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/30/2021] [Indexed: 12/27/2022]
Abstract
Background Severe coronavirus disease-2019 (COVID-19) is associated with dysregulated immune response and extreme inflammatory injury. Considering the role of insulin growth factor-1 (IGF-1) in immune-mediated and inflammatory reactions, this study was conducted to investigate the IGF-1 contribution to the pathogenesis of severe form of COVID-19. Material and methods Sixty-two patients with severe COVID-19 and 52 healthy subjects were enrolled in this study. The serum levels of IGF-1 were measured using a solid-phase enzyme-linked chemiluminescent immunoassay on an Immulite 2000 system (Siemens Healthcare Diagnostics. Result The serum levels of IGF-1 had no significant difference in COVID-19 patients compared to the healthy subjects (p = 0.359). There was a positive correlation between IGF-1 and age in the severe COVID-19 patients, while a negative correlation was observed for the serum levels of IGF-1 and age in the control group (r = 0.364, p = 0.036, r = − 0.536, p = 0.001, respectively). Moreover, IGF-1 was remarkably associated with hypertension, neurogenic disease, shock, and nausea in patients with the severe form of COVID-19 (p = 0.031, p = 0.044, p = 0.01, p = 0.03, respectively). Conclusion Our results pointed to the complex role of IGF-1 in the severe form of COVID-19, and its association with clinical parameters, and some risk factors in the severe form of COVID-19.
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Affiliation(s)
- Parisa Feizollahi
- Immunology Department, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Somaieh Matin
- Department of Internal Medicine, Emam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
- Gastrointestinal and Liver Disease Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Askar Roghani
- Immunology Department, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shayan Mostafaei
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Elham Safarzadeh
- Department of Microbiology, Parasitology, and Immunology, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Mahdi Taghadosi
- Department of Immunology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Cheng W, Peng Y, Zhou A, Lin L, Liao X, Deng D, Huang P, Liu W, Jiang M, Xiang X, Shuang Q, Cai S, Chen P, Liao X. Comparative clinical characteristics among different age group of adult COVID-19 patients: A multicenter study. IMMUNITY INFLAMMATION AND DISEASE 2021; 10:130-142. [PMID: 34708557 PMCID: PMC8652767 DOI: 10.1002/iid3.550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 01/08/2023]
Abstract
Background Coronavirus disease (COVID‐19) is a global infectious disease with a large burden of illness and high health care costs. This study aimed to compare clinical features among adult COVID‐19 patients in different age groups. Methods Laboratory‐confirmed adult COVID‐19 infection cases between December 31, 2019 to March 8, 2020 obtained from Neighboring Cities. Patients were divided into five age groups. Clinical characteristics were compared among different age groups. Results Of 299 cases, median age was 44 and 158 (53%) were male. A total of 53.3% of 30–40 years, 50% of 40–50 years, 36.6% of <30 years and 36.2% of 50–60 years were primary case, none of the elderly were primary case. Among all the observed symptoms, only symptom of dyspnea was significantly different between the elderly group and other groups (p < .001). Proportion of severe or critical type was 2.4%, 5.3%, 9.5%, 14.5%, and 35% in patients with age <30, 30–40, 40–50, 50–65, ≥65, respectively. A total of 285 patients (95.3%) were cured and discharged, 12 patients (4.0%) were still on medical treatment in hospital. There were 2 (0.7%) deaths which occurred among persons ≥65 years. Patients with a history of chronic heart disease had a more than a 56 times higher risk for severe or critical type of COVID‐19 than those without a history of chronic heart disease (odds ratio [OR]: 56.038, 95% confidence interval [CI]: 2.764–1136.053, p = .009). Old age (OR: 1.055, 95% CI: 1.016–1.095, p = .006), high heart rate in admission (OR: 1.085, 95% CI: 1.03–1.144, p = .002), high respiratory rate in admission (OR: 1.635, 95% CI: 1.093–2.431, p = .017) were independently associated with severe or critical type in COVID‐19. Conclusions Proportion of severe or critical type increased with old age groups. Adults with old age and high heart rate, respiratory rate in admission and history of chronic heart disease were associated with severe or critical type in COVID‐19.
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Affiliation(s)
- Wei Cheng
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yating Peng
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Aiyuan Zhou
- Department of Pulmonary and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ling Lin
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xin Liao
- Department of Respiratory Medicine, Affiliated Shaoyang Central Hospital of University of South China, Shaoyang, Hunan, China
| | - Dingding Deng
- Department of Respiratory Medicine, The First Attached Hospital of Shaoyang University, Shaoyang, Hunan, China
| | - Peng Huang
- Department of Respiratory Medicine, Zhuzhou Central Hospital, Zhuzhou, Hunan, China
| | - Wenlong Liu
- Department of Respiratory Medicine, Yueyang Second People's Hospital, Designated Hospital of Junshan District, Yueyang, Hunan, China
| | - Mingyan Jiang
- Department of Respiratory and Critical Medicine, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Xudong Xiang
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qingcui Shuang
- Department of Respiratory Medicine, The First Attached Hospital of Shaoyang University, Shaoyang, Hunan, China
| | - Shan Cai
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ping Chen
- Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xucai Liao
- Department of Respiratory Medicine, The First Attached Hospital of Shaoyang University, Shaoyang, Hunan, China
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Islam MS, Larpruenrudee P, Saha SC, Pourmehran O, Paul AR, Gemci T, Collins R, Paul G, Gu Y. How severe acute respiratory syndrome coronavirus-2 aerosol propagates through the age-specific upper airways. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2021; 33:081911. [PMID: 34552312 PMCID: PMC8450910 DOI: 10.1063/5.0061627] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/24/2021] [Indexed: 05/22/2023]
Abstract
The recent outbreak of the COVID-19 causes significant respirational health problems, including high mortality rates worldwide. The deadly corona virus-containing aerosol enters the atmospheric air through sneezing, exhalation, or talking, assembling with the particulate matter, and subsequently transferring to the respiratory system. This recent outbreak illustrates that the severe acute respiratory syndrome (SARS) coronavirus-2 is deadlier for aged people than for other age groups. It is evident that the airway diameter reduces with age, and an accurate understanding of SARS aerosol transport through different elderly people's airways could potentially help the overall respiratory health assessment, which is currently lacking in the literature. This first-ever study investigates SARS COVID-2 aerosol transport in age-specific airway systems. A highly asymmetric age-specific airway model and fluent solver (ANSYS 19.2) are used for the investigation. The computational fluid dynamics measurement predicts higher SARS COVID-2 aerosol concentration in the airway wall for older adults than for younger people. The numerical study reports that the smaller SARS coronavirus-2 aerosol deposition rate in the right lung is higher than that in the left lung, and the opposite scenario occurs for the larger SARS coronavirus-2 aerosol rate. The numerical results show a fluctuating trend of pressure at different generations of the age-specific model. The findings of this study would improve the knowledge of SARS coronavirus-2 aerosol transportation to the upper airways which would thus ameliorate the targeted aerosol drug delivery system.
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Affiliation(s)
- Mohammad S. Islam
- School of Mechanical and Mechatronic Engineering, University of Technology Sydney (UTS), 15 Broadway, Ultimo, New South Wales 2007, Australia
- Authors to whom correspondence should be addressed: and
| | - Puchanee Larpruenrudee
- School of Mechanical and Mechatronic Engineering, University of Technology Sydney (UTS), 15 Broadway, Ultimo, New South Wales 2007, Australia
| | - Suvash C. Saha
- School of Mechanical and Mechatronic Engineering, University of Technology Sydney (UTS), 15 Broadway, Ultimo, New South Wales 2007, Australia
- Authors to whom correspondence should be addressed: and
| | - Oveis Pourmehran
- School of Mechanical Engineering, The University of Adelaide, Adelaide, South Australia 5005, Australia and Department of Surgery—Otolaryngology Head and Neck Surgery, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Akshoy Ranjan Paul
- Department of Applied Mechanics, Motilal Nehru National Institute of Technology Allahabad, Prayagraj 211004, Uttar Pradesh, India
| | | | - Richard Collins
- Biomechanics International, Cranberry Township, Pennsylvania 16066, USA
| | - Gunther Paul
- James Cook University, Australian Institute of Tropical Health and Medicine, Townsville, Queensland 4810, Australia
| | - Yuantong Gu
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane 4000, Australia
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Israfil SMH, Sarker MMR, Rashid PT, Talukder AA, Kawsar KA, Khan F, Akhter S, Poh CL, Mohamed IN, Ming LC. Clinical Characteristics and Diagnostic Challenges of COVID-19: An Update From the Global Perspective. Front Public Health 2021; 8:567395. [PMID: 33505949 PMCID: PMC7831046 DOI: 10.3389/fpubh.2020.567395] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022] Open
Abstract
Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.
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Affiliation(s)
| | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Pharmacology and Toxicology Research Division, Health Med Science Research Limited, Dhaka, Bangladesh
| | | | - Ali Azam Talukder
- Department of Microbiology, Jahangirnagar University, Savar, Bangladesh
| | | | - Farzana Khan
- Pharmacology and Toxicology Research Division, Health Med Science Research Limited, Dhaka, Bangladesh
| | - Selina Akhter
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Chit Laa Poh
- Centre for Virus and Vaccine Research, School of Science and Technology, Sunway University, Petaling Jaya, Malaysia
| | - Isa Naina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia (The National University of Malaysia), Cheras, Malaysia
| | - Long Chiau Ming
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
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Cytokine Storm and Failed Resolution in COVID-19: Taking a Cue from Multiple Sclerosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1352:211-222. [PMID: 35132603 PMCID: PMC9798045 DOI: 10.1007/978-3-030-85109-5_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Excessive inflammatory responses and failed resolution are major common causes of tissue injury and organ dysfunction in a variety of diseases, including multiple sclerosis (MS), diabetes, and most recently, COVID-19, despite the distinct pathoetiology of the diseases. The promotion of the natural process of inflammatory resolution has been long recognized to improve functional recovery and disease outcomes effectively. To mitigate the excessive inflammation in MS, scientific investigations identified a group of derivatives of omega fatty acids, known as specialized pro-resolving lipid mediators (SPM) that have been significantly effective in treating preclinical disease models of MS. METHODS This chapter is based on our observations from MS. It is being increasingly deliberated that the ongoing COVID-19 infection induces severe cytokine storm that ultimately triggers rampant inflammation. The impact of infection and associated mortality is much higher in patients with co-morbid diseases. Also, reports suggest a better outcome in diabetic patients with reasonable glycemic control, which certainly hints towards a hidden role of anti-hyperglycemic drugs such as metformin in alleviating disease pathology through its anti-inflammatory feature. Notably, SPM and metformin share common therapeutic features in exerting a broad-spectrum anti-inflammatory activity in human patients with a superior safety profile. RESULTS When there is an immediate need to encounter the fast-rampant infection of COVID-19 and control the viral-infection associated morbid inflammatory cytokine storm causing severe organ damage, SPM and metformin should be seriously considered as a potential adjunctive treatment. CONCLUSION Given the fact that current treatment for COVID-19 is only supportive, global research is aimed at developing safe and effective therapeutic options that can result in a better clinical course in patients with comorbid conditions. Accordingly, taking a cue from our experiences in controlling robust inflammatory response in MS and diabetes by simultaneously inhibiting inflammatory process and stimulating its resolution, combinatorial therapy of metformin and SPM in COVID-19 holds significant promise in treating this global health crisis.
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Brown R, McKelvey MC, Ryan S, Creane S, Linden D, Kidney JC, McAuley DF, Taggart CC, Weldon S. The Impact of Aging in Acute Respiratory Distress Syndrome: A Clinical and Mechanistic Overview. Front Med (Lausanne) 2020; 7:589553. [PMID: 33195353 PMCID: PMC7649269 DOI: 10.3389/fmed.2020.589553] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/01/2020] [Indexed: 12/27/2022] Open
Abstract
Acute respiratory distress syndrome (ARDS) is associated with increased morbidity and mortality in the elderly population (≥65 years of age). Additionally, age is widely reported as a risk factor for the development of ARDS. However, the underlying pathophysiological mechanisms behind the increased risk of developing, and increased severity of, ARDS in the elderly population are not fully understood. This is compounded by the significant heterogeneity observed in patients with ARDS. With an aging population worldwide, a better understanding of these mechanisms could facilitate the development of therapies to improve outcomes in this population. In this review, the current clinical evidence of age as a risk factor and prognostic indicator in ARDS and the potential underlying mechanisms that may contribute to these factors are outlined. In addition, research on age-dependent treatment options and biomarkers, as well as future prospects for targeting these underlying mechanisms, are discussed.
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Affiliation(s)
- Ryan Brown
- Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Michael C McKelvey
- Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Sinéad Ryan
- Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Shannice Creane
- Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Dermot Linden
- Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Joseph C Kidney
- Department of Respiratory Medicine, Mater Hospital Belfast, Belfast, United Kingdom
| | - Daniel F McAuley
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom
| | - Clifford C Taggart
- Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Sinéad Weldon
- Airway Innate Immunity Research (AiiR) Group, Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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Dhama K, Patel SK, Kumar R, Rana J, Yatoo MI, Kumar A, Tiwari R, Dhama J, Natesan S, Singh R, Harapan H. Geriatric Population During the COVID-19 Pandemic: Problems, Considerations, Exigencies, and Beyond. Front Public Health 2020; 8:574198. [PMID: 33072713 PMCID: PMC7536316 DOI: 10.3389/fpubh.2020.574198] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/21/2020] [Indexed: 12/28/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic wreaked havoc worldwide, with more than 20 million confirmed cases and nearly 0. 75 million deaths as of 10th August 2020. Various factors determine the severity and symptoms of this infection. Older age and underlying diseases are the challenges being faced in controlling and treating COVID-19. In 2019, 703 million of the global population was older than 65 years of age. The estimated mortality due to COVID-19 in people older than 76 years of age is reportedly 18%. Frequent infections in older people, higher disease severity, and increased mortality are major challenges in the implementation of appropriate preventive measures and future strategies to protect against this disease in geriatric population. Poor health status, weak immune function, lowered organ function, increased probability of multiple underlying diseases, and poor attention to personal health can increase the susceptibility to various diseases in the geriatric population. Concerning inadequate immunity, the decrease expression of receptors and exaggerated pathophysiologic responses can be debilitating. However, future studies will reveal the hidden facets in these aspects in this COVID-19 catastrophe. In this article, we reviewed the main concerns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the geriatric population, including the risk of acquiring severe COVID-19 resulting in mortality, variation in clinical manifestations, and other pandemic-related concerns. We also discussed the need for increasing attention toward the elderly, taking appropriate prevention and control measures, and considering geriatric-related adjustments in vaccine design and development.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Shailesh Kumar Patel
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Rakesh Kumar
- Department of Veterinary Pathology, Dr. G.C. Negi College of Veterinary and Animal Sciences, GSK Himachal Pradesh Agricultural University, Palampur, India
| | - Jigyasa Rana
- Department of Veterinary Anatomy, Faculty of Veterinary and Animal Sciences, Rajiv Gandhi South Campus Banaras Hindu University, Mirzapur, India
| | - Mohd. Iqbal Yatoo
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, India
| | - Akshay Kumar
- Department of Cardiothoracic Surgery, Medanta Hospital, Gurgaon, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Uttar Pradesh Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | | | | | - Rajendra Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
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Alda-1 attenuates hyperoxia-induced mitochondrial dysfunction in lung vascular endothelial cells. Aging (Albany NY) 2020; 11:3909-3918. [PMID: 31209184 PMCID: PMC6628993 DOI: 10.18632/aging.102012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/31/2019] [Indexed: 12/19/2022]
Abstract
Acute lung injury (ALI) is a major cause of morbidity and mortality worldwide, especially in aged populations. Mitochondrial damage is one of the key features of ALI. Hyperoxia-induced lung injury model in mice has been widely used for ALI study because it features many ALI phenotypes including, but not limited to, mitochondrial and vascular endothelial cell damage. Recently, accumulating evidence has shown that mitochondrial aldehyde dehydrogenase 2 (ALDH2) has a protective effect against oxidative stress mediated cell damage in epithelial cells. However, it is not known whether ALDH2 protects against oxidative stress in vascular endothelial cells. In this current study, we attempted to find the capacity of Alda-1 [(N-(1,3benzodioxol-5-ylmethyl)-2,6- dichloro-benzamide), an ALDH2 activator] to protect against oxidative stress in human microvascular endothelial cells (HMVEC). HMVEC pretreated with Alda-1 prior to hyperoxic exposure vs non-treated controls showed i) lower 4-hydroxynonenal (4-HNE) levels, ii) significantly decreased expressions of Bax and Cytochrome C, iii) partially restored activity and expression of ALDH2 and iv) significantly improved mitochondrial membrane potential. These results suggest that ALDH2 protein in lung vascular endothelial cells is a promising therapeutic target for the treatment of ALI and that Alda-1 is a potential treatment option.
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Polidoro RB, Hagan RS, de Santis Santiago R, Schmidt NW. Overview: Systemic Inflammatory Response Derived From Lung Injury Caused by SARS-CoV-2 Infection Explains Severe Outcomes in COVID-19. Front Immunol 2020; 11:1626. [PMID: 32714336 PMCID: PMC7344249 DOI: 10.3389/fimmu.2020.01626] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/17/2020] [Indexed: 01/12/2023] Open
Abstract
Most SARS-CoV2 infections will not develop into severe COVID-19. However, in some patients, lung infection leads to the activation of alveolar macrophages and lung epithelial cells that will release proinflammatory cytokines. IL-6, TNF, and IL-1β increase expression of cell adhesion molecules (CAMs) and VEGF, thereby increasing permeability of the lung endothelium and reducing barrier protection, allowing viral dissemination and infiltration of neutrophils and inflammatory monocytes. In the blood, these cytokines will stimulate the bone marrow to produce and release immature granulocytes, that return to the lung and further increase inflammation, leading to acute respiratory distress syndrome (ARDS). This lung-systemic loop leads to cytokine storm syndrome (CSS). Concurrently, the acute phase response increases the production of platelets, fibrinogen and other pro-thrombotic factors. Systemic decrease in ACE2 function impacts the Renin-Angiotensin-Kallikrein-Kinin systems (RAS-KKS) increasing clotting. The combination of acute lung injury with RAS-KKS unbalance is herein called COVID-19 Associated Lung Injury (CALI). This conservative two-hit model of systemic inflammation due to the lung injury allows new intervention windows and is more consistent with the current knowledge.
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Affiliation(s)
- Rafael B. Polidoro
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Robert S. Hagan
- Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | | | - Nathan W. Schmidt
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, United States
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Liu Y, Mao B, Liang S, Yang JW, Lu HW, Chai YH, Wang L, Zhang L, Li QH, Zhao L, He Y, Gu XL, Ji XB, Li L, Jie ZJ, Li Q, Li XY, Lu HZ, Zhang WH, Song YL, Qu JM, Xu JF. Association between age and clinical characteristics and outcomes of COVID-19. Eur Respir J 2020; 55:13993003.01112-2020. [PMID: 32312864 PMCID: PMC7173682 DOI: 10.1183/13993003.01112-2020] [Citation(s) in RCA: 240] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/11/2020] [Indexed: 02/07/2023]
Abstract
The rapid outbreak of coronavirus disease 2019 (COVID-19) has been a matter of international concern as the disease is spreading fast [1, 2]. Considering that the contagious disease has led to an enormous impact globally, there is an urgent need to identify the risk populations with poor prognosis. Ageing is associated with certain changes in pulmonary physiology, pathology and function, during the period of lung infection. Therefore, age-related differences in responsiveness and tolerance become obvious and lead to worse clinical outcomes in elderly individuals [3]. Previous studies have mentioned that older COVID-19 patients are at an increased risk of death [4–7]. However, the age-related clinical characteristics, disease courses and outcomes other than death in COVID-19 patients remain unclear. Age significantly determined the clinical features and prognosis of COVID-19. The prognosis was worse in patients older than 60 years, calling for clinicians to pay more attention to patients of this age.https://bit.ly/34DTI05
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Affiliation(s)
- Yang Liu
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,These authors contributed equally
| | - Bei Mao
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,These authors contributed equally
| | - Shuo Liang
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,These authors contributed equally
| | - Jia-Wei Yang
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,These authors contributed equally
| | - Hai-Wen Lu
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,These authors contributed equally
| | - Yan-Hua Chai
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,These authors contributed equally
| | - Lan Wang
- Dept of Pulmonary Circulation Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Zhang
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qiu-Hong Li
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lan Zhao
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan He
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao-Long Gu
- Dept of Respiratory Medicine, Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Xiao-Bin Ji
- Dept of Respiratory Medicine, Zhoupu Hospital of Pudong New District, Shanghai, China
| | - Li Li
- Dept of Respiratory Medicine, Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Zhi-Jun Jie
- Dept of Respiratory and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Qiang Li
- Dept of Respiratory and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Xiang-Yang Li
- Dept of Respiratory and Critical Care Medicine, Huadong Hospital, Fudan University, Shanghai, China
| | - Hong-Zhou Lu
- Shanghai Public Health Clinical Center, Shanghai, China
| | - Wen-Hong Zhang
- Dept of Infectious Disease, Huashan Hospital Fudan University, Shanghai, China
| | - Yuan-Lin Song
- Dept of Respiratory and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China
| | - Jie-Ming Qu
- Dept of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,These authors contributed equally
| | - Jin-Fu Xu
- Dept of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,These authors contributed equally
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12
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Chen SL, Feng HY, Xu H, Huang SS, Sun JF, Zhou L, He JL, Song WL, Wang RJ, Li X, Fang M. Patterns of Deterioration in Moderate Patients With COVID-19 From Jan 2020 to Mar 2020: A Multi-Center, Retrospective Cohort Study in China. Front Med (Lausanne) 2020; 7:567296. [PMID: 33344469 PMCID: PMC7744800 DOI: 10.3389/fmed.2020.567296] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/27/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Around the globe, moderate cases account for the largest proportion of all coronavirus disease 2019 (COVID-19) patients, and deteriorated moderate patients contribute the most in mortality. However, published articles failed to address the deterioration details of moderate cases, especially on when and how they deteriorated. Methods: All moderate COVID-19 patients hospitalized in Guangdong Province from January 14 to March 16, 2020, were included in this multicenter retrospective cohort study and were divided into deteriorated and non-deteriorated groups according to clinical status. Symptoms and demographic, therapeutic, and laboratory test result characteristics were collected to explore the features of disease deterioration. Results: Of 1,168 moderate patients included, 148 (13%) deteriorated to severe (130 cases) or critical (18 cases) status. Over 20% of the older subgroup (>50 years old) showed deterioration. The median time for deterioration was 11 days after onset [interquartile range (IQR) 9-14 days]. In addition, 12.2% severe cases could further develop to critical status after 3 days (IQR 2-6.5 days) of having a severe condition. Respiratory dysfunction and hypoxia were the major manifestations as disease deterioration, while 76 cases (52.1%) showed respiratory rate >30 breaths/min, 119 cases (80.4%) showed SaO2 <93%, 100 cases (67.5%) had 201 < PaO2/FiO2 < 300, and 27 cases (18.9%) had blood lactic acid >2.0 mmol/L. In view of multiple organ dysfunction, 87.8% of acute respiratory distress syndrome (ARDS), 20.2% of acute kidney injury (AKI), 6.8% of coagulopathy, 4% of acute heart failure (AHF), 3.4% of acute hepatic injury (AHI), and 5.4% of shock occurred in deteriorated patients, while organ injury occurred in the following sequence: ARDS, AKI, AHF, coagulopathy, AHI, and shock. Conclusions: The deteriorated pattern of moderate COVID-19 patients is characterized as the 11th day from onset (IQR 9-14 days) being an important time point of disease deterioration with further exacerbation to critical condition in 3 days (IQR 2-6.5 days), A RDS followed by AKI being the typical modes of sequential organ damage.
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Affiliation(s)
- Sheng-long Chen
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hui-ying Feng
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Hui Xu
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Shan-shan Huang
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Jiu-feng Sun
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong Provincial Institute of Public Health, Guangzhou, China
| | - Lin Zhou
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Jun-lei He
- Center for Tuberculosis Control of Guangdong Province, Guangzhou, China
| | - Wen-liang Song
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Rui-jie Wang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Xin Li
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- *Correspondence: Xin Li
| | - Ming Fang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Guangdong Provincial People's Hospital-Nanhai Hospital, Foshan, China
- Ming Fang
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13
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Martins EC, Silveira LDF, Viegas K, Beck AD, Fioravantti Júnior G, Cremonese RV, Lora PS. Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study. Rev Bras Ter Intensiva 2019; 31:64-70. [PMID: 30916236 PMCID: PMC6443306 DOI: 10.5935/0103-507x.20190010] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 12/04/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate the neutrophil-lymphocyte ratio as a predictor of sepsis and mortality in patients admitted to an intensive care unit. METHODS Case-control study of adult patients admitted to an intensive care unit. Patients who had sepsis as the reason for admission and who had a previous complete blood count examination were included as case patients. The following statistical analyses were performed: ROC curves, binary logistic regression, and Mann-Whitney and Pearson's chi-square tests. p < 0.05 was considered significant. RESULTS The ROC curve values were 0.62 for neutrophil-lymphocyte ratio, 0.98 for band neutrophils and 0.51 for total leukocytes. The presence of a neutrophil-lymphocyte ratio greater than 5.0, leukocyte count above 12,000mm3/mL and band neutrophil percentage above 10% were risk factors for sepsis; however, only the SAPS 3 and SOFA score were related to patient mortality. CONCLUSION The neutrophil-lymphocyte ratio and band neutrophils in combination with other parameters may be markers for the early detection of sepsis in intensive care units.
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Affiliation(s)
| | | | - Karin Viegas
- Universidade do Vale do Rio dos Sinos - Porto Alegre (RS), Brasil
| | - Andrea Diez Beck
- Universidade do Vale do Rio dos Sinos - Porto Alegre (RS), Brasil
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Abstract
INTRODUCTION Flask-shaped plasma membrane (PM) invaginations called caveolae and their constitutive caveolin and cavin proteins regulate cellular function via plasma membrane and intracellular signal transduction pathways. Caveolae are present in a variety of cells in the lung including airway smooth muscle (ASM) where they interact with other proteins, receptors, and ion channels and thereby have the potential to affect both normal and disease processes such as inflammation, contractility, and fibrosis. Given their involvement in cell signaling, caveolae may play important roles in mediating and modulating aging processes, and contribute to lung diseases of aging. Areas covered: This review provides a broad overview of the current state of knowledge regarding caveolae and their constituent proteins in lung diseases in the elderly and identifies potential mechanisms that can be targeted for future therapies. Expert Commentary: Caveolin-1 may play a protective role in lung disease. What is less clear is whether altered caveolin-1 with aging is a natural process, or a biomarker of disease progression in the elderly.
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Affiliation(s)
- Sarah A Wicher
- a Department of Physiology and Biomedical Engineering , Mayo Clinic , Rochester , MN , USA
| | - Y S Prakash
- a Department of Physiology and Biomedical Engineering , Mayo Clinic , Rochester , MN , USA.,b Department of Anesthesiology& Perioperative Medicine , Mayo Clinic , Rochester , MN , USA
| | - Christina M Pabelick
- a Department of Physiology and Biomedical Engineering , Mayo Clinic , Rochester , MN , USA.,b Department of Anesthesiology& Perioperative Medicine , Mayo Clinic , Rochester , MN , USA
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