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Das S, Nath S, Shahjahan, Dey SK. Plausible mechanism of drug resistance and side-effects of COVID-19 therapeutics: a bottleneck for its eradication. Daru 2024:10.1007/s40199-024-00524-z. [PMID: 39026019 DOI: 10.1007/s40199-024-00524-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND COVID-19 pandemic has turned our world upside down by meddling with our normal lives. While there is no definitive drug against SARS-CoV-2, antiviral drugs that are already in the market, are being repurposed against it, could now complete long-term as well as all age-specific investigations, and they are successful in saving millions of lives. Nevertheless, side-effects are emergingly seen in the patients undergoing treatment, and ineffectiveness is increasingly found due to the emerging notorious variants of the virus. Many of them are also facing serious co-infections including black fungus, Zika, and H1N1 virus to name a few. OBJECTIVES Therefore, this review highlights both drug resistance, their side-effects, and the significance for proper and long-term clinical trials of all age groups including children. METHODS We have explored and proposed the mechanisms of drug resistance that may arise due to the misuse or overuse of drugs based on available experimental reports. RESULTS The review provides solutions to the aforesaid issues of drug-resistance and side-effects by providing combination therapies, ancillary treatments, and other preventive strategies that can be useful in preventing drawbacks thereby curbing COVID-19 or similar future infections to maintain our normal lives. CONCLUSION COVID-19 and its long-term effects, if any, can be eradicated with strategic and mindful use of related therapeutics in a controlled manner.
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Affiliation(s)
- Swarnali Das
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, 208016, India
| | - Sreyashi Nath
- Imaging Cell Signaling and Therapeutics Lab, Advanced Centre for Training Research and Education in Cancer, Navi Mumbai, 410210, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
| | - Shahjahan
- Laboratory for Structural Biology of Membrane Proteins, Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, 110007, India
| | - Sanjay Kumar Dey
- Laboratory for Structural Biology of Membrane Proteins, Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, 110007, India.
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Duarte MP, Joncas J, Parent S, Duval M, Chémaly O, Brassard F, Mac-Thiong JM, Barchi S, Labelle H. A Dangerous Curve: Impact of the COVID-19 Pandemic on Brace Treatment in Adolescent Idiopathic Scoliosis. Global Spine J 2024; 14:513-518. [PMID: 35816368 PMCID: PMC9274152 DOI: 10.1177/21925682221113487] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Observational Cohort study. OBJECTIVES We aim to document the abandon and irregular compliance rate towards brace treatment during the COVID-19 pandemic and its impact on AIS progression. METHODS We reviewed a database of AIS patients recruited between March and September 2020. We included AIS patients under brace treatment according to SRS criteria. The patients were divided in 2 cohorts: those with self-reported Good-Compliance (GC) to treatment and those who had a Bad-Compliance (BC). Data analysis included biometric and radiographic data at first visit and last follow-up and percentage of progression. Unpaired student-t tests and Chi2 were used for comparison. RESULTS 152 patients met inclusion criteria. 89 patients (age:12.1y.o.±1.4) reported good adherence to treatment, while 63 patients (age:12.7y.o.±1.8) were not compliant. Within the BC group, 18 patients reported irregular brace wear, while 45 had completely abandoned treatment (abandon rate of 29%). The GC cohort started treatment with a mean main thoracic (MT) curve of 26° and finished with 27°. The mean difference between measurements was +.65°±7.5; mean progression rate was -4.6%. However, the BC cohort started with a mean MT curve of 27° and finished with 32°, with a mean increase of +5°±8 and a mean progression rate of -13%. The differences between the 2 cohorts were statistically significant (P = .0002). Six patients from the BC group progressed and were offered surgery. CONCLUSION The abandon rate of brace treatment in AIS significantly increased during the first wave of COVID-19 pandemic. Patients who voluntarily discontinued treatment had significant increases in curve progression and surgical indication rates. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Matias Pereira Duarte
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
- University of Montreal, Surgery Department, Montréal, Québec, Canada
| | - Julie Joncas
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - Stefan Parent
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
- University of Montreal, Surgery Department, Montréal, Québec, Canada
| | - Mylène Duval
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - Olivier Chémaly
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
- University of Montreal, Surgery Department, Montréal, Québec, Canada
| | - Félix Brassard
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
- University of Montreal, Surgery Department, Montréal, Québec, Canada
| | - Jean-Marc Mac-Thiong
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
- University of Montreal, Surgery Department, Montréal, Québec, Canada
| | - Soraya Barchi
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
| | - Hubert Labelle
- Orthopaedic Division, Sainte-Justine University Hospital Center, Montréal, QC, Canada
- University of Montreal, Surgery Department, Montréal, Québec, Canada
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Genc S, Taghizadehghalehjoughi A, Naldan ME, Gülcü O, Caglayan C, Spanakis M, Nikolouzakis TK, Alegakis A, Docea AO, Drocas AI, Mitrut R, Hatzidaki E, Spandidos DA, Tsatsakis A. Evaluation of various blood biomarkers associated with the outcomes of patients with COVID‑19 treated in intensive care units. Exp Ther Med 2024; 27:82. [PMID: 38274343 PMCID: PMC10809360 DOI: 10.3892/etm.2024.12371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/10/2023] [Indexed: 01/27/2024] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (COVID-19) represented a global public health crisis and the most significant pandemic in modern times. Transmission characteristics, and the lack of effective antiviral treatment protocol and protective vaccines, pushed healthcare systems, particularly intensive care units (ICUs), to their limits and led to extreme quarantine measures to control the pandemic. It was evident from an early stage that patient stratification approaches needed to be developed to better predict disease progression. In the present study, the predictive value of clinical and blood biomarkers for the outcomes of patients with COVID-19 hospitalized in the ICU were investigated, taking age and sex into consideration. The present study analyzed blood samples from 3,050 patients with COVID-19 hospitalized in the ICU. The analysis revealed that the levels of procalcitonin, N-terminal pro-B-type natriuretic peptide, D-dimer, ferritin, liver enzymes, C-reactive protein and lactate dehydrogenase were increased and were associated with disease progression, resulting in a prolonged hospitalization period and severe COVID-19 related complications. Additionally, significant age and sex disparities among these biomarkers were documented and discussed in specific cases. On the whole, the results of the present study suggest a potential association of the demographic characteristics and blood biomarkers with prolonged hospitalization in the ICU and the mortality of patients with COVID-19.
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Affiliation(s)
- Sidika Genc
- Department of Medical Pharmacology, Faculty of Medicine, Bilecik Seyh Edebali University, Bilecik 11230, Turkey
| | - Ali Taghizadehghalehjoughi
- Department of Medical Pharmacology, Faculty of Medicine, Bilecik Seyh Edebali University, Bilecik 11230, Turkey
| | - Muhammet E. Naldan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Bilecik Seyh Edebali University, Bilecik 11230, Turkey
| | - Oktay Gülcü
- Department of Cardiology, Educational and Research Hospital, Faculty of Medicine, Health Science University, Erzurum 25240, Turkey
| | - Cüneyt Caglayan
- Department of Biochemistry, Faculty of Medicine, Bilecik Seyh Edebali University, Bilecik 11230, Turkey
| | - Marios Spanakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
| | | | - Athanasios Alegakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Andrei Ioan Drocas
- Department of Urology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Radu Mitrut
- Department of Cardiology, University and Emergency Hospital, Bucharest 050098, Romania
| | - Eleftheria Hatzidaki
- Department of Neonatology, University Hospital of Heraklion, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
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Shoaib MH, Sikandar M, Yousuf RI, Parkash M, Kazmi SJH, Ahmed FR, Ahmed K, Saleem MT, Zaidi SH. Graduate and postgraduate educational challenges during the COVID-19 pandemic period: its impact and innovations-a scoping review. Syst Rev 2023; 12:195. [PMID: 37833820 PMCID: PMC10571448 DOI: 10.1186/s13643-023-02359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has transformed the global view of education, including graduate and postgraduate education making the development of an alternative approach in times of social isolation an academic imperative. The present review aims to investigate the challenges experienced among undergraduate and postgraduate education and the strategies adopted to address these challenges during the pandemic. METHOD The preferred reporting items for the systematic review and meta-analyses extension for Scoping Reviews (PRISMA-ScR) were followed. The aim was to include journal articles published in the English language that discussed the influence of the pandemic on educational processes and applied innovative approaches as a solution to educational challenges. From January to August 2020, PubMed, EMBASE, and Google Scholar were searched for articles, yielding 10,019 articles. Two groups of authors examined the retrieved articles separately to avoid any risk of bias. The title and abstract of the articles were used for scrutiny, followed by full-text screening based on the established inclusion and exclusion criteria. The facts and findings of the studies were also discussed based on per capita income, literacy rate, and Internet accessibility. RESULTS Thirty of the obtained articles were included in the study. The selected articles were from North and South/Latin America, Asia & Pacific, South Africa, and Europe regions. Nineteen of the selected articles dealt with undergraduate education, ten with postgraduate, and one with both groups. The affordability of digital devices and the availability of Internet services were the major challenges for low- and middle-income economies. The ZOOM platform has been adopted by more than 90% of the education systems. CONCLUSION Means of communication, including visual media, digitized content, and other web-based platforms, have been recognized as efficient learning and training tools, but have not been fully accessible for mass application and use due to the lack of availability of resources, their cost, and insufficient training among the users. In light of this review, it is suggested that harmonized and collaborative efforts should be made to develop cost-effective and user-friendly tools to overcome the current challenges and prevent future educational crises. SYSTEMIC REVIEW REGISTRATION The review was not registered.
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Affiliation(s)
- Muhammad Harris Shoaib
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan.
| | - Muhammad Sikandar
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Rabia Ismail Yousuf
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Monica Parkash
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Syed Jamil Hassan Kazmi
- Department of Geography, Faculty of Science, University of Karachi, Karachi, 75270, Pakistan
| | - Farrukh Rafiq Ahmed
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Kamran Ahmed
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Muhammad Talha Saleem
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Syeda Hina Zaidi
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, 75270, Pakistan
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Kobayashi N, Fujisawa H, Kumagai J, Tanabe M. New-onset minimal change disease following the Moderna COVID-19 vaccine. BMJ Case Rep 2023; 16:e255144. [PMID: 37714559 PMCID: PMC10510908 DOI: 10.1136/bcr-2023-255144] [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] [Accepted: 09/04/2023] [Indexed: 09/17/2023] Open
Abstract
We report the case of nephrotic syndrome after COVID-19 vaccination. The patient was a man in his 30s with no comorbidities other than atopic dermatitis. Over the course of 2 weeks after the first COVID-19 vaccination, systemic oedema gradually appeared. He was referred to the nephrology department for investigation of the systemic oedema. On admission, he presented with pitting oedema in his lower extremities. Initial examinations revealed massive urinary protein and decreased serum albumin, at 13.9 g/g Cr and 1.5 g/dL, respectively. Renal biopsy was performed, and minimal change disease was diagnosed. Prednisolone 60 mg/day was promptly started on the 5th day of hospitalisation, and complete remission was achieved on the 12th day. Prednisolone was once tapered off in 1.5 years successfully though minimal change disease was relapsed in 1 month after the steroid withdrawal.
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Affiliation(s)
| | - Hajime Fujisawa
- Nephrology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Jiro Kumagai
- Pathology, Yokohama City Minato Red Cross Hospital, Yokohama, UK
| | - Madoka Tanabe
- Nephrology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
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6
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Tekintaş Y, Temel A. Antisense oligonucleotides: a promising therapeutic option against infectious diseases. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2023; 43:1-39. [PMID: 37395450 DOI: 10.1080/15257770.2023.2228841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
Infectious diseases have been one of the biggest health problems of humanity for centuries. Nucleic acid-based therapeutics have received attention in recent years with their effectiveness in the treatment of various infectious diseases and vaccine development studies. This review aims to provide a comprehensive understanding of the basic properties underlying the mechanism of antisense oligonucleotides (ASOs), their applications, and their challenges. The efficient delivery of ASOs is the greatest challenge for their therapeutic success, but this problem is overcome with new-generation antisense molecules developed with chemical modifications. The types, carrier molecules, and gene regions targeted by sequences have been summarized in detail. Research and development of antisense therapy is still in its infancy; however, gene silencing therapies appear to have the potential for faster and longer-lasting activity than conventional treatment strategies. On the other hand, realizing the potential of antisense therapy will require a large initial economic investment to ascertain the pharmacological properties and learn how to optimize them. The ability of ASOs to be rapidly designed and synthesized to target different microbes can reduce drug discovery time from 6 years to 1 year. Since ASOs are not particularly affected by resistance mechanisms, they come to the fore in the fight against antimicrobial resistance. The design-based flexibility of ASOs has enabled it to be used for different types of microorganisms/genes and successful in vitro and in vivo results have been revealed. The current review summarized a comprehensive understanding of ASO therapy in combating bacterial and viral infections.
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Affiliation(s)
- Yamaç Tekintaş
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir, Türkiye
| | - Aybala Temel
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir, Türkiye
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7
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Hameed NS, Arif IS, Al-Sudani BT. Preventive treatment of coronavirus disease-2019 virus using coronavirus disease-2019-receptor-binding domain 1C aptamer by suppress the expression of angiotensin-converting enzyme 2 receptor. J Adv Pharm Technol Res 2023; 14:185-190. [PMID: 37692001 PMCID: PMC10483903 DOI: 10.4103/japtr.japtr_117_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/19/2023] [Accepted: 05/13/2023] [Indexed: 09/12/2023] Open
Abstract
The cause of the worldwide coronavirus disease-2019 (COVID-19) pandemic is the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It is known to employ the same entry portal as SARS-CoV, which is the type 1 transmembrane angiotensin-converting enzyme 2 (ACE2) receptor. The receptor-binding domain (RBD) is located on the spike S-protein's S1 subunit of the spike glycoprotein. The most important and effective therapy method is inhibiting the interaction between the ACE2 receptor and the S-spike RBD. An aptamer is a small, single-chain oligonucleotide that binds strongly to the target molecule. Recently, a CoV-2-RBD-1C aptamer-based system with a 51-base hairpin structure was discovered to have substantial binding affinity against the SARS-CoV-2RBD with similar binding sites at ACE. In the current study, we will study the aptamer's effect as a SARS-CoV-2 spike blocker and inhibit its ACE2 receptors' binding by studying the toxicity of aptamer for this cell line by calcein assay and the inhibition test of CoV-2-RBD-1C aptamers on spike RBD-ACE2 binding. The results show the half-maximum inhibitory concentration of CoV-2-RBD-1C aptamer is 0.08188 μM. The inhibition effect of CoV-2-RBD-1C aptamer on spike RBD-ACE2 binding was determined at half-maximal effective concentration of 0.5 μM concentration. The percentage of spike-ACE2 binding inhibition in A549-hACE2 cells in the D614G variant after 30 s was 77%. This percentage is higher than D614 and N501Y and equals 55% and 65%, respectively, at 0.15 μM of CoV-2-RBD-1C aptamer. The CoV-2-RBD-1C aptamer prevents virus entrance through spike inhibition, which results in a 90% reduction in spike D614 virus transduction at 1.28 μM. In conclusion, the CoV-2-RBD-1C aptamer might be an effective treatment against COVID-19 infection because it directly affects the virus by blocking the S-spike of SARS-CoV-2 and preventing ACE2 receptor binding.
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Affiliation(s)
- Noor S. Hameed
- Department of Toxicology, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq
| | - Inam Sameh Arif
- Department of Toxicology, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq
| | - Basma Talib Al-Sudani
- Department of Clinical Laboratory Sciences, College of Pharmacy, Mustansiriyah University, Baghdad, Iraq
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8
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Delgado AC, Cornett B, Choi YJ, Colosimo C, Stahel VP, Dziadkowiec O, Stahel PF. Investigational medications in 9,638 hospitalized patients with severe COVID-19: lessons from the "fail-and-learn" strategy during the first two waves of the pandemic in 2020. Patient Saf Surg 2023; 17:7. [PMID: 37041643 PMCID: PMC10088131 DOI: 10.1186/s13037-023-00358-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/23/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The early surge of the novel coronavirus disease 2019 (COVID-19) pandemic introduced a significant clinical challenge due to the high case-fatality rate in absence of evidence-based recommendations. The empirical treatment modalities were relegated to historical expertise from the traditional management of acute respiratory distress syndrome (ARDS) in conjunction with off-label pharmaceutical agents endorsed under the "emergency use authorization" (EUA) paradigm by regulatory agencies. This study was designed to evaluate the insights from the "fail-and-learn" strategy in 2020 before the availability of COVID-19 vaccines and access to reliable insights from high-quality randomized controlled trials. METHODS A retrospective, multicenter, propensity-matched, case-control study was performed on a data registry comprising 186 hospitals from a national health care system in the United States, designed to investigate the efficacy of empirical treatment modalities during the early surge of the COVID-19 pandemic in 2020. Reflective of the time-windows of the initial two surges of the pandemic in 2020, patients were stratified into "Early 2020" (March 1-June 30) versus "Late 2020" (July 1-December 31) study cohorts. Logistic regression was applied to determine the efficacy of prevalent medications (remdesivir, azithromycin, hydroxychloroquine, corticosteroids, tocilizumab) and supplemental oxygen delivery modalities (invasive vs. non-invasive ventilation) on patient outcomes. The primary outcome measure was in-hospital mortality. Group comparisons were adjusted for covariates related to age, gender, ethnicity, body weight, comorbidities, and treatment modalities pertinent to organ failure replacement. RESULTS From a total of 87,788 patients in the multicenter data registry screened in this study, 9,638 patients were included who received 19,763 COVID-19 medications during the first two waves of the 2020 pandemic. The results showed a minimal, yet statistically significant, association with hydroxychloroquine in "Early 2020" and remdesivir in "Late 2020" with reduced odds of mortality (odds ratios 0.72 and 0.76, respectively; P = 0.01). Azithromycin was the only medication associated with decreased odds of mortality during both study time-windows (odds ratios 0.79 and 0.68, respectively; P < 0.01). In contrast, the necessity for oxygen supply showed significantly increased odds of mortality beyond the effect of all investigated medications. Of all the covariates associated with increased mortality, invasive mechanical ventilation had the highest odds ratios of 8.34 in the first surge and 9.46 in in the second surge of the pandemic (P < 0.01). CONCLUSION This retrospective multicenter observational cohort study on 9,638 hospitalized patients with severe COVID-19 during revealed that the necessity for invasive ventilation had the highest odds of mortality, beyond the variable effects observed by administration of the prevalent EUA-approved investigational drugs during the first two surges of the early 2020 pandemic in the United States.
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Affiliation(s)
- Adam C Delgado
- Department of Surgery, Sky Ridge Medical Center, Lone Tree, CO, 80124, USA
| | - Brendon Cornett
- Graduate Medical Education, HCA Healthcare Continental Division, Denver, CO, 80237, USA
| | - Ye Ji Choi
- Graduate Medical Education, HCA Healthcare Continental Division, Denver, CO, 80237, USA
| | - Christina Colosimo
- Department of Surgery, Sky Ridge Medical Center, Lone Tree, CO, 80124, USA
| | | | - Oliwier Dziadkowiec
- Graduate Medical Education, HCA Healthcare Continental Division, Denver, CO, 80237, USA
| | - Philip F Stahel
- Mission Health, HCA Healthcare North Carolina Division, Asheville, NC, 28803, USA.
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA.
- Department of Specialty Medicine, College of Osteopathic Medicine, Rocky Vista University, Parker, CO, 80134, USA.
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Chea C, Lee DY, Kato J, Ishiwata-Endo H, Moss J. Macrodomain Mac1 of SARS-CoV-2 Nonstructural Protein 3 Hydrolyzes Diverse ADP-ribosylated Substrates. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.07.527501. [PMID: 36945431 PMCID: PMC10028740 DOI: 10.1101/2023.02.07.527501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for a global pandemic that resulted in more than 6-million deaths worldwide. The virus encodes several non-structural proteins (Nsps) that contain elements capable of disrupting cellular processes. Among these Nsp proteins, Nsp3 contains macrodomains, e.g., Mac1, Mac2, Mac3, with potential effects on host cells. Mac1 has been shown to increase SARS-CoV-2 virulence and disrupt ADP-ribosylation pathways in mammalian cells. ADP-ribosylation results from the transfer of the ADP-ribose moiety of NAD + to various acceptors, e.g., proteins, DNA, RNA, contributing on a cell's biological processes. ADP-ribosylation is the mechanism of action of bacterial toxins, e.g., Pseudomonas toxins, diphtheria toxin that disrupt protein biosynthetic and signaling pathways. On the other hand, some viral macrodomains cleavage ADP-ribose-acceptor bond, generating free ADP-ribose. By this reaction, the macrodomain-containing proteins interfere ADP-ribose homeostasis in host cells. Here, we examined potential hydrolytic activities of SARS-CoV-2 Mac1, 2, and 3 on substrates containing ADP-ribose. Mac1 cleaved α-NAD + , but not β-NAD + , consistent with stereospecificity at the C-1" bond. In contrast to ARH1 and ARH3, Mac1 did not require Mg 2+ for optimal activity. Mac1 also hydrolyzed O -acetyl-ADP-ribose and ADP-ribose-1"-phosphat, but not Mac2 and Mac3. However, Mac1 did not cleave α-ADP-ribose-(arginine) and ADP-ribose-(serine)-histone H3 peptide, suggesting that Mac1 hydrolyzes ADP-ribose attached to O- and N-linked functional groups, with specificity at the catalytic site in the ADP-ribose moiety. We conclude that SARS-CoV-2 Mac1 may exert anti-viral activity by reversing host-mediated ADP-ribosylation. New insights on Nsp3 activities may shed light on potential SARS-CoV-2 therapeutic targets. IMPORTANCE SARS-CoV-2, the virus responsible for COVID-19, encodes 3 macrodomain-containing proteins, e.g., Mac1, Mac2, Mac3, within non-structural proteins 3 (Nsp3). Mac1 was shown previously to hydrolyze ADP-ribose-phosphate. Inactivation of Mac1 reduced viral proliferation. Here we report that Mac1, but not Mac2 and Mac3, has multiple activities, i.e., Mac1 hydrolyzed. α-NAD + and O -acetyl-ADP-ribose. However, Mac1 did not hydrolyze β-NAD + , ADP-ribose-serine on a histone 3 peptide (aa1-21), and ADP-ribose-arginine, exhibiting substrate selectivity. These data suggest that Mac1 may have multi-function as a α-NAD + consumer for viral replication and a disruptor of host-mediated ADP-ribosylation pathways. Understanding Mac1's mechanisms of action is important to provide possible therapeutic targets for COVID-19.
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Wang C, Xie A, Zhou W, Cheng F, Tian J, Xu Y. A Phenomenological Study of Nurses' Experiences in a Pediatric Fever Clinic During the COVID-19 Epidemic. Res Theory Nurs Pract 2022; 36:RTNP-2021-0003.R4. [PMID: 36137751 DOI: 10.1891/rtnp-2021-0003] [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: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE In the initial COVID-19 outbreak, nursing staff reportedly experienced high levels of psychological stress. The purpose of this study was to explore the real experience of the first cohort of pediatric fever clinic nurses during the COVID-19 epidemic. METHODS Semi-structured interviews were conducted with eight nurses who worked in a fever clinic at a children's hospital in China. The interviews were conducted by an experienced and trained interviewer. Qualitative content analysis was used to describe the experiences of the nurses. RESULTS Three themes were distilled from the interviews: 1) complex psychological experiences including positive experiences (increased sense of responsibility and honor, gaining the respect and recognition of parents, having a sense of achievement in personal growth) and negative experiences (panic and compulsion, guilt towards their family, antipathy, and dissatisfaction); 2) extreme physical discomfort; and 3) a lack of relevant knowledge. IMPLICATIONS FOR PRACTICE The nurses in the pediatric fever clinic experienced various psychological impacts and physiological discomfort. Nursing managers should improve the management of hospital emergency nursing, strengthen the psychological guidance and logistics support of frontline nurses, and provide nurses with the relevant knowledge and skills training. These improvements would support frontline nurses in their work to provide effective patient treatment during the COVID-19 epidemic.
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Affiliation(s)
- Chunjuan Wang
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - Anwei Xie
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - Weifang Zhou
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - Fangfang Cheng
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - Jianmei Tian
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - Yunqiu Xu
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
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11
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Morvay-Sey K, Trpkovici M, Ács P, Paár D, Pálvölgyi Á. Psychological Responses of Hungarian Students during the First Wave of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11344. [PMID: 36141616 PMCID: PMC9517411 DOI: 10.3390/ijerph191811344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/28/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Changes in daily life and academic training has led to uncertainty in the higher education student population during COVID-19. The goal of the study was to examine the impacts of the pandemic on Hungarian students. (2) Methods: A cross-sectional study was conducted by using self-report questionnaires collected in Google Forms. Eight-hundred-and-twenty-seven students (25.29 ± 8.09) took part anonymously. The respondents rate their overall physical and mental health on a 5-point Likert scale and validated scales were used: Well Being Index (WHO-5); Mindfulness Attention and Awareness Scale (MAAS); and Perceived Stress Scale (PSS-14). Statistical analyses were performed with IBM SPSS 24.0, results were considered at a significance level p ≤ 0.05. (3) Results: Positive correlation was found between MAAS and WHO-5 (r = 0.363, p < 0.001) negative correlation between MAAS and PSS-14 (r = -0.448, p < 0.001), and negative correlation between WHO-5 and PSS-14 (r = -0.671, p < 0.001). Females had higher PSS-14 mean score (32.51 ± 10.16) than males (27.71 ± 10.19; p < 0.001; Z = -5703), males (60.92 ± 12.10) had higher MAAS level than females (57.31 ± 12.51; p < 0.001; Z = -3589). No difference was found in gender regarding WHO-5 mean scores. Athletes (7.03 ± 3.27) differ significantly from non-athletes (6.00 ± 3.04) in WHO-5 (p < 0.001; Z = -4.349) and MAAS level (p = 0.012; Z = -2.498), but showed no difference in PSS-14 (p = 0.101; Z = -1.641). Students rated mental (3.01 ± 0.99) worse than physical health (3.49 ± 0.98; p < 0.001, r = 0.426) and the narrowing of social relationships worse (3.83 ± 1.26) than physical (p < 0.001, r = -0.212) and mental health (p < 0.001, r = -0.408). Females had worse mental health (2.96 ± 9.94) than males (3.20 ± 0.99; p = 0.003; Z = -2.924) and rated the narrowing of social relationships worse (3.90 ± 1.23) than males (3.59 ± 1.35; p = 0.006; Z = -2.730). (4) Conclusions: The pandemic has negatively impacted students, and it may have long-term consequences on their mental and physical health and education.
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Affiliation(s)
- Kata Morvay-Sey
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.3., 7621 Pécs, Hungary
| | - Melinda Trpkovici
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.4, 7621 Pécs, Hungary
| | - Pongrác Ács
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.3., 7621 Pécs, Hungary
| | - Dávid Paár
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.3., 7621 Pécs, Hungary
| | - Ágnes Pálvölgyi
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty u.4, 7621 Pécs, Hungary
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12
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Cruz-Pulido D, Ouma WZ, Kenney SP. Differing coronavirus genres alter shared host signaling pathways upon viral infection. Sci Rep 2022; 12:9744. [PMID: 35697915 PMCID: PMC9189807 DOI: 10.1038/s41598-022-13396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/24/2022] [Indexed: 11/11/2022] Open
Abstract
Coronaviruses are important viral pathogens across a range of animal species including humans. They have a high potential for cross-species transmission as evidenced by the emergence of COVID-19 and may be the origin of future pandemics. There is therefore an urgent need to study coronaviruses in depth and to identify new therapeutic targets. This study shows that distant coronaviruses such as Alpha-, Beta-, and Deltacoronaviruses can share common host immune associated pathways and genes. Differentially expressed genes (DEGs) in the transcription profile of epithelial cell lines infected with swine acute diarrhea syndrome, severe acute respiratory syndrome coronavirus 2, or porcine deltacoronavirus, showed that DEGs within 10 common immune associated pathways were upregulated upon infection. Twenty Three pathways and 21 DEGs across 10 immune response associated pathways were shared by these viruses. These 21 DEGs can serve as focused targets for therapeutics against newly emerging coronaviruses. We were able to show that even though there is a positive correlation between PDCoV and SARS-CoV-2 infections, these viruses could be using different strategies for efficient replication in their cells from their natural hosts. To the best of our knowledge, this is the first report of comparative host transcriptome analysis across distant coronavirus genres.
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Affiliation(s)
- Diana Cruz-Pulido
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, 43210, USA
- Department of Animal Sciences, Center for Food Animal Health, The Ohio State University, Wooster, OH, 44691, USA
| | | | - Scott P Kenney
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, 43210, USA.
- Department of Animal Sciences, Center for Food Animal Health, The Ohio State University, Wooster, OH, 44691, USA.
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13
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Tavakolian A, Ashrafi Shahri SH, Jafari MA, Pishbin E, Zamani Moghaddam H, Foroughian M, Reihani H. An 18-Month Epidemiologic Survey of 3364 Deceased COVID-19 Cases; a Retrospective Cross-sectional Study. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e42. [PMID: 35765617 PMCID: PMC9206827 DOI: 10.22037/aaem.v10i1.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction The COVID-19 pandemic has been considered an international problem. This study aimed to survey the demographic and clinical characteristics of the deceased COVID-19 patients. Methods The present cross-sectional study was performed on all deceased COVID-19 patients who died in Imam Reza Hospital, Mashhad, Iran, from March 20, 2020, to September 23, 2021. Their data, including age, gender, complaints, and clinical symptoms at the time of admission, as well as information at the time of death (hour, shift, holiday/non-holiday) were analyzed and reported. Results 3364 deaths due to COVID-19 have been registered during the study period (60.46% male). The patients' mean age was 66.99±16.97 (range: 1-101) years (92.7% of them were Iranian). The mortality at night shifts was less than day shifts (1643 vs. 1721). The average amount of deaths/day on holidays and workdays was (5.63 vs. 6.24). The number of deaths varied during the various hours of the day and night. Diabetes and cardiovascular diseases were the most common confounding factors, which were observed in 22.44% and 15.36% of the cases, respectively. Conclusion Based on the findings of this series, COVID-19 mortality was frequently observed in male patients, those with the mean age of 66.99 years, morning shifts, and workdays.
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Affiliation(s)
- Ayoub Tavakolian
- Department of Emergency Medicine, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Seyed Hassan Ashrafi Shahri
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ali Jafari
- Department of Emergency Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Pishbin
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Zamani Moghaddam
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Foroughian
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Reihani
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. ,Corresponding author: Hamidreza Reihani; Emam Reza Hospital, Ibn-Sina Street, Mashhad, Iran
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14
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Leretter M, Vulcanescu D, Horhat F, Matichescu A, Rivis M, Rusu LC, Roi A, Racea R, Badea I, Dehelean C, Mocanu A, Horhat D. COVID‑19: Main findings after a year and half of unease and the proper scientific progress (Review). Exp Ther Med 2022; 23:424. [PMID: 35601072 PMCID: PMC9117952 DOI: 10.3892/etm.2022.11350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/17/2021] [Indexed: 11/21/2022] Open
Abstract
Since the emergence of the disease in late December 2019, numerous studies have been published to date regarding clinical, laboratory and treatment aspects associated with COVID-19. The present study attempts to compare and unify the clinical, para-clinical and therapeutic aspects that have come to light regarding coronavirus disease-19 (COVID 19), mainly in adults. Between April 2020 and September 2021, a comprehensive systematic literature review was performed, which we added to from our own medical experiences. The search was performed on the PubMed, Scopus and Google Scholar databases, comprising studies with analyzable data that were identified alongside studies and documents containing general scientific data. All published studies were written in English, and were from different countries. A 95% confidence interval (CI95) was also calculated for almost each study using the Wilson formula. When compared with preliminary reports between December 2019 and January 2020, the most frequent symptoms were still identified as being fever (68.6%; CI95: 67.5-69.7) and cough (72.7%; CI95: 71.7-73.8). Nevertheless, asymptomatic cases also increased (by 21.4%; CI95: 16.6-27.1). Severe and critical cases accounted for 10.4% (CI95: 9.6-11.1) of all cases. The mean fatality rate was found to be 4% (CI95: 3.6-4.5). The primary co-morbidity found was hypertension (28.9%; CI95: 27-30.8), followed by other underlying cardiovascular diseases (15.4%; CI95: 13.9-16.9) and diabetes (14.5%; CI95: 13.1-16.1). The majority of studies showed lower white blood cell numbers with neutropenia and lymphopenia, and lower platelet levels. The levels of the biomarkers C-reaction protein and erythrocyte sedimentation rate were positive in all studied cases alongside other lab tests, such as examining the D-dimer levels and those of other hepatic, cardiac and renal injury markers. The procalcitonin level was also found to be elevated in many cases, resulting in high usage of antibiotics (83.7%; CI95: 81.2-85.9). Approximately 31.6% (CI95: 29.1-34.1) of the patients required non-invasive ventilation, whereas 9.9% (CI95: 8.1-12.1) of the patients were intubated or placed on extracorporeal membrane oxygenation. The most used antivirals were ribavirin (67.3%; CI95: 63.4-70.9), oseltamivir (52.5%; CI95: 49.4-55.5) and Arbidol™ (34.5%; CI95: 32-37.1). General admittance to the intensive care unit was ~7.2% (CI95: 6.5-7.9) of patients.
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Affiliation(s)
- Marius Leretter
- Department of Prosthodontics, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dan Vulcanescu
- Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance (MULTI‑REZ), ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Florin Horhat
- Department of Microbiology, Multidisciplinary Research Center on Antimicrobial Resistance (MULTI‑REZ), ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Anamaria Matichescu
- Department of Preventive Dentistry, Community and Oral Health, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Mircea Rivis
- Department of Anesthesiology and Oral Surgery, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Laura-Cristina Rusu
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Roi
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Robert Racea
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Badea
- Department of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Dehelean
- Department of Toxicology, Research Center for Pharmaco‑Toxicological Evaluation, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Mocanu
- Department XIII, Discipline of Infectious Diseases, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Delia Horhat
- Department of Otorhinolaryngology, ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Baroiu L, Anghel L, Tatu A, Iancu A, Dumitru C, Leșe AC, Drăgănescu M, Năstase F, Niculeț E, Fotea S, Nechita A, Voinescu D, Stefanopol A. Risk of hepatitis B reactivation: From biologic therapies for psoriasis to immunosuppressive therapies for COVID‑19 (Review). Exp Ther Med 2022; 23:385. [PMID: 35495599 PMCID: PMC9019722 DOI: 10.3892/etm.2022.11312] [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: 11/26/2021] [Accepted: 12/28/2021] [Indexed: 12/15/2022] Open
Abstract
The cytokine storm from the evolution of severe cases of COVID-19, requiring strong immunosuppressive therapies, has raised the issue of reactivation of hepatitis B virus (HBV) infections in these patients. An analysis of the first observational studies in patients with COVID-19 and immunosuppressive therapy and HBV infection along with special clinical cases was presented, as well as personal experience on a series of cases (a group of 958 patients with COVID-19), compared with the analysis of studies performed on patients with HBV infection that underwent biological therapies for psoriasis and personal experience (a group of 81 psoriasis patients treated with biological therapies). Clinical studies have revealed that HBV reactivation in patients undergoing biological therapies for psoriasis, can be prevented with monitoring and treatment protocols and thus, these therapies have been demonstrated to be safe and effective. In COVID-19, immunosuppressive therapies are short-lived but in high doses, and the conclusions of clinical trials are contradictory, but there are published cases of HBV reactivation, which requires a unitary attitude in the prevention of HBV reactivation in these patients. An algorithm was presented for monitoring and treatment of HBV infection for patients with psoriasis treated with biological therapy and the conditions when this protocol can be used for patients with COVID-19 and immunosuppressive therapy.
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Affiliation(s)
- Liliana Baroiu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Lucreția Anghel
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Alin Tatu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Alina Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Caterina Dumitru
- Department of Laboratory Medicine, ‘Sf. Cuv. Parascheva’ Clinical Infectious Diseases Hospital, 800179 Galati, Romania
| | - Ana-Cristina Leșe
- Faculty of Visual Arts and Design, ‘George Enescu’ National University of Arts, 700451 Iasi, Romania
| | - Miruna Drăgănescu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Florentina Năstase
- Department of Neuropsychomotor Rehabilitation, ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Elena Niculeț
- Multidisciplinary Integrated Center of Dermatological Interface Research, ‘Dunărea de Jos’ University, 800008 Galați, Romania
| | - Silvia Fotea
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Aurel Nechita
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Doina Voinescu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Anca Stefanopol
- Multidisciplinary Integrated Center of Dermatological Interface Research, ‘Dunărea de Jos’ University, 800008 Galați, Romania
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Vâţă A, Anita A, Manciuc C, Savuta G, Luca C, Roșu F, Mihai I, Anita D. Clinical significance of early IgA anti‑SARS‑CoV‑2 antibody detection in patients from a Romanian referral COVID‑19 hospital. Exp Ther Med 2022; 23:391. [PMID: 35495593 PMCID: PMC9019744 DOI: 10.3892/etm.2022.11318] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/31/2022] [Indexed: 01/08/2023] Open
Affiliation(s)
- Andrei Vâţă
- Department of Infectious Diseases, Grigore T. Popa University of Medicine and Pharmacy, Iași 700116, Romania
| | - Adriana Anita
- Ion Ionescu de la Brad University of Life Sciences, Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), Iași 700490, Romania
| | - Carmen Manciuc
- Department of Infectious Diseases, Grigore T. Popa University of Medicine and Pharmacy, Iași 700116, Romania
| | - Gheorghe Savuta
- Ion Ionescu de la Brad University of Life Sciences, Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), Iași 700490, Romania
| | - Catalina Luca
- Department of Infectious Diseases, Grigore T. Popa University of Medicine and Pharmacy, Iași 700116, Romania
| | - Florin Roșu
- Department of Infectious Diseases, Grigore T. Popa University of Medicine and Pharmacy, Iași 700116, Romania
| | - Ioana Mihai
- Department of Infectious Diseases, Grigore T. Popa University of Medicine and Pharmacy, Iași 700116, Romania
| | - Dragos Anita
- Ion Ionescu de la Brad University of Life Sciences, Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), Iași 700490, Romania
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17
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Manciuc C, Lacatusu GA, Vata A, Sapaniuc C, Arteni CM, Petrariu FD. Concomitance or consequence? Stevens-Johnson syndrome in COVID-19: A case report. Exp Ther Med 2022; 23:257. [PMID: 35261629 PMCID: PMC8855504 DOI: 10.3892/etm.2022.11182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/17/2021] [Indexed: 01/09/2023] Open
Abstract
The novel coronavirus infection has been, and still is, a pressing medical problem with a catastrophic effect, not only from a medical point of view, but also from an economic and social one. The cutaneous manifestations of the disease have a diverse morphology and can signal the presence of the infection. The present article reports the case of a 77-year-old male patient admitted at The Sf. Parascheva Clinical Hospital of Infectious Diseases in Iasi (Romania) after testing positive for SARS CoV-2 infection. Initially, the patient presented a pruriginous generalized maculopapular-erythematous eruption with a tendency towards confluence, peri-oro-nasal meliceric crusts and desquamation of the skin on the third anterosuperior and posterior thorax, scalp and forehead, which was accompanied by low back pain, headache and orbital pain. The suspicion of Stevens-Johnson syndrome (SJS) was raised, and treatment was given according to the recommendation of the hospital dermatologist. This association raises multiple questions regarding whether SJS is a cutaneous manifestation of COVID-19 or if there was a concomitance between the viral infection and the immune reaction. The combination of SJS and COVID-19 can have a fatal outcome if not recognized and promptly treated. To our knowledge, this is the first case of SJS in a patient diagnosed with SARS CoV-2 infection in Romania.
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Affiliation(s)
- Carmen Manciuc
- Department of Infectious Diseases, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Georgiana Alexandra Lacatusu
- Department of Infectious Diseases, Sf. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania,Correspondence to: Dr Georgiana Alexandra Lacatusu, Department of Infectious Diseases, Sf. Parascheva Clinical Hospital of Infectious Diseases, Str. Octav Botez 2, 700116 Iasi, Romania
| | - Andrei Vata
- Department of Infectious Diseases, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Sapaniuc
- Department of Infectious Diseases, Sf. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania
| | - Carmen Mihaela Arteni
- Department of Infectious Diseases, Sf. Parascheva Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania
| | - Florin Dumitru Petrariu
- Department of Preventive Medicine and Interdisciplinary, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
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18
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Toader M, Branisteanu D, Glod M, Esanu I, Branisteanu C, Capsa MS, Dimitriu A, Nicolescu A, Pinzariu A, Branisteanu D. Mucocutaneous lesions associated with SARS‑CoV‑2 infection (Review). Exp Ther Med 2022; 23:258. [PMID: 35251324 PMCID: PMC8892620 DOI: 10.3892/etm.2022.11183] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
The ongoing COVID-19 pandemic, declared by the World Health Organisation in March 2020, with the emergence of new, possibly more contagious and more virulent strains, remains a research subject, with the complex systemic involvement better described and understood, but also with a variety of skin and mucosal lesions described in the literature. Mucocutaneous lesions associated with SARS-CoV-2 infection are still under investigation, due to their polymorphic clinical aspect and incompletely understood pathogenic mechanism. The cutaneous inflammatory, exanthematous and purpuric rashes, erythemato-purpuric enanthems, oral ulcers, lichenoid oral lesions, conjunctivitis, conjunctival pseudomembranes, or corneal lesions have been described in patients with COVID-19. Several classifications have been proposed based on the clinical pattern, histological findings, and possible pathogenic mechanisms. The pathogenic mechanism, the diagnostic criteria, the prognostic importance of these lesions are still being debated. The diverse clinical aspects of dermatological manifestations render the diagnosis difficult. However, several clinical patterns strongly associated with COVID-19, such as chilblains, papulovesicular exanthems, and febrile rash require increased awareness and changes to the investigation protocols for these conditions, to include testing for SARS-CoV-2. In the present review, the mucocutaneous findings associated with the novel coronavirus infection, reported thus far in the literature, was provided.
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Affiliation(s)
- Mihaela Toader
- Department of Oral Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniel Branisteanu
- Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Glod
- Department of Surgery, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Irina Esanu
- Department of Internal Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | - Maria-Stefana Capsa
- Department of Dermatology, ‘Railway Clinical Hospital’, 700506 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia’ Hospitals and Medical Centers, 700620 Iasi, Romania
| | - Alin Nicolescu
- Department of Dermatology, Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | - Alin Pinzariu
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daciana Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
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Radulescu D, Tuta LA, David C, Bogeanu C, Onofrei SD, Stepan E, Cuiban E, Ciofalca A, Feier LF, Pana C, Nutu MC, Vacaroiu IA. Acute kidney injury in moderate and severe COVID-19 patients: Report of two university hospitals. Exp Ther Med 2022; 23:37. [PMID: 34849152 PMCID: PMC8613528 DOI: 10.3892/etm.2021.10959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022] Open
Abstract
Acute kidney injury (AKI) is one of the most severe complications of SARS-CoV-2 infection. In a retrospective study, we aimed to describe the influence of COVID-19-related factors on the severity, outcome and timing of AKI in 268 patients admitted in two large COVID-19-designated university hospitals over a period of 6 months. In the univariate analysis, there was a significant relationship between KDIGO stage and the extension of COVID-19 pneumonia on computed tomography (CT), need for oxygen supplementation, serum levels of ferritin, interleukin-6, and procalcitonin, but none of these variables had a value for predicting KDIGO stage in multinomial regression. The odds of recovery of renal function were significantly diminished by d-dimer values. Lack of immunomodulatory treatment was found to be correlated with increased need for renal replacement therapy (RRT). Compared with AKI at admission, hospital-acquired AKI was predicted by the severity of lung damage on CT, evolved more frequently with incomplete recovery of renal function, and was significantly associated with antiviral therapy.
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Affiliation(s)
- Daniela Radulescu
- Clinical Department No. 3, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Liliana-Ana Tuta
- Faculty of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
- Department of Nephrology, ‘Sf. Apostol Andrei’ Emergency Clinical Hospital, 900591 Constanta, Romania
| | - Cristiana David
- Clinical Department No. 3, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Carmen Bogeanu
- Clinical Department No. 3, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Simona Daniela Onofrei
- Clinical Department No. 3, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Elena Stepan
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Elena Cuiban
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Andreea Ciofalca
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Larisa Florina Feier
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
| | - Camelia Pana
- Faculty of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
- Department of Nephrology, ‘Sf. Apostol Andrei’ Emergency Clinical Hospital, 900591 Constanta, Romania
| | - Magda-Cristina Nutu
- Faculty of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
- Department of Nephrology, ‘Sf. Apostol Andrei’ Emergency Clinical Hospital, 900591 Constanta, Romania
| | - Ileana Adela Vacaroiu
- Clinical Department No. 3, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Nephrology and Dialysis, ‘Sf. Ioan’ Emergency Clinical Hospital, 421422 Bucharest, Romania
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20
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Bajdechi M, Vlad N, Dumitrascu M, Mocanu E, Dumitru I, Cernat R, Rugină S. Bacterial endocarditis masked by COVID‑19: A case report. Exp Ther Med 2021; 23:186. [DOI: 10.3892/etm.2021.11109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/15/2021] [Indexed: 01/18/2023] Open
Affiliation(s)
- Mircea Bajdechi
- Doctoral School of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
| | - Nicoleta Vlad
- Doctoral School of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
| | - Mirela Dumitrascu
- Department of Infectious Disease, Clinical Infectious Diseases Hospital, 900709 Constanta, Romania
| | - Elena Mocanu
- Department of Public Health, Faculty of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
| | - Irina Dumitru
- Doctoral School of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
| | - Roxana Cernat
- Department of Infectious Disease, Clinical Infectious Diseases Hospital, 900709 Constanta, Romania
| | - Sorin Rugină
- Doctoral School of Medicine, ‘Ovidius’ University, 900470 Constanta, Romania
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21
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Hidalgo-Lopezosa P, Cubero-Luna AM, Huertas-Marín J, Hidalgo-Maestre M, De la Torre-González AJ, Rodríguez-Borrego MA, López-Soto PJ. Vaginal birth after caesarean section before and during COVID-19 pandemic. Factors associated with successful vaginal birth. Women Birth 2021; 35:570-575. [PMID: 34972660 PMCID: PMC8702403 DOI: 10.1016/j.wombi.2021.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/25/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022]
Abstract
Background The ratio of caesarean has been increasing considerably in many countries. Planning a vaginal birth after a previous caesarean is considered an important option for women in a subsequent pregnancy. Aims To analyse obstetric and neonatal outcomes in women in labour after caesarean section before and during the COVID-19 pandemic, and to determine factors associated with successful vaginal birth after caesarean (VBAC). Methods Observational cohort study of women in labour with history of caesarean section who gave birth between March 2019 and December 2020 in a tertiary hospital in southern Spain. Consecutive sampling was performed using the maternal birth database and a descriptive and inferential analysis of the study variables was carried out. Socio-demographic, obstetric and neonatal variables were compared between the pre-pandemic and pandemic periods. Multiple logistic regression analysis was performed to determine variables associated with VBAC success. Findings The VBAC success rate was 67.4%. The caesarean section rate was significantly higher during the COVID-19 pandemic period. Factors associated with VBAC success were: birth before the pandemic (OR 0.32) and at night (OR 0.45), use of epidural analgesia (OR 2.14), and having had a previous vaginal birth (OR 1.98). Conclusions The success rate of VBAC was lower during the pandemic. Knowledge of the factors related to VBAC success is critical for practitioners when supporting women in decision-making about mode of birth after a previous caesarean section.
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Affiliation(s)
- P Hidalgo-Lopezosa
- Maimónides Institut of Biomedic Research of Córdoba (IMIBIC), Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; Department of Nursing, Farmacology and Physiotherapy, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; University Hospital Reina Sofia, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
| | - A M Cubero-Luna
- Maimónides Institut of Biomedic Research of Córdoba (IMIBIC), Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; Department of Nursing, Farmacology and Physiotherapy, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; University Hospital Reina Sofia, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
| | - J Huertas-Marín
- Maimónides Institut of Biomedic Research of Córdoba (IMIBIC), Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; Department of Nursing, Farmacology and Physiotherapy, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; University Hospital Reina Sofia, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
| | - M Hidalgo-Maestre
- Department of Nursing, Farmacology and Physiotherapy, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; University Hospital Reina Sofia, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
| | - A J De la Torre-González
- Department of Nursing, Farmacology and Physiotherapy, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; University Hospital Reina Sofia, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
| | - M A Rodríguez-Borrego
- Maimónides Institut of Biomedic Research of Córdoba (IMIBIC), Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; Department of Nursing, Farmacology and Physiotherapy, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; University Hospital Reina Sofia, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
| | - P J López-Soto
- Maimónides Institut of Biomedic Research of Córdoba (IMIBIC), Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; Department of Nursing, Farmacology and Physiotherapy, University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain; University Hospital Reina Sofia, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.
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22
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Novacescu AN, Duma G, Buzzi B, Baditoiu LM, Bedreag O, Papurica M, Sandesc D, Sorescu T, Vlad D, Licker M. Therapeutic plasma exchange followed by convalescent plasma transfusion in severe and critically ill COVID-19 patients: A single centre non-randomized controlled trial. Exp Ther Med 2021; 23:76. [PMID: 34934447 PMCID: PMC8652389 DOI: 10.3892/etm.2021.10999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 12/14/2022] Open
Abstract
Therapeutic plasma exchange (TPE) has been proposed as a rescue therapy in critically ill COVID-19 patients. The aim of the present study was to determine whether combining TPE with convalescent plasma (CVP) transfusion early in the intensive care unit (ICU) stay improves survival among this heterogeneous population. The primary endpoint was survival at 30 days. Secondary endpoints included assessing the evolution of biomarkers, such as the partial pressure of arterial oxygen to fractional inspired oxygen ratio, and C reactive protein (CRP), lactate dehydrogenase (LDH) and ferritin levels at the 7-day follow-up. This single centre, prospective, non-randomized controlled trial was conducted in an 8-bed COVID-19 ICU and included patients with severe COVID-19 pneumonia requiring intensive care treatment. A total of 19 patients were treated by performing TPE followed by CVP transfusion, in addition to standard treatment, while for another 19 patients, only standard treatment according to hospital protocols was used. TPE was initiated during the first 24 h after ICU admission, followed immediately by transfusion of CVP. Survival at 30 days was 47.37% in the TPE CVP group and 26.32% in the control group (P=0.002). Patients in the TPE CVP group also showed better oxygenation and a reduction in inflammation, with decreased CRP, LDH and ferritin levels compared with those in the control group. Overall, the study indicated that early initiation of TPE followed by CVP transfusion may be a valid rescue therapy in severe and critically ill COVID-19 patients, with a statistically significant survival benefit, improved oxygenation and a reduction in inflammatory markers. The trial was registered in the ClinicalTrials.gov database (trial registration number: NCT04973488) on July 22, 2021 (retrospectively registered).
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Affiliation(s)
- Alexandru Noris Novacescu
- Doctoral School, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Intensive Care Unit, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania
| | - Georgiana Duma
- Intensive Care Unit, 'Dr Teodor Andrei' Municipal Hospital, 305500 Lugoj, Romania
| | - Bettina Buzzi
- Intensive Care Unit, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania
| | - Luminita Mirela Baditoiu
- Department of Epidemiology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Multidisciplinary Research Centre on Antimicrobial Resistance, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ovidiu Bedreag
- Intensive Care Unit, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania.,Departments of Anaesthesia and Intensive Care, Nutrition and Metabolic Diseases, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marius Papurica
- Intensive Care Unit, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania.,Departments of Anaesthesia and Intensive Care, Nutrition and Metabolic Diseases, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dorel Sandesc
- Intensive Care Unit, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania.,Departments of Anaesthesia and Intensive Care, Nutrition and Metabolic Diseases, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Teodora Sorescu
- Department of Diabetes, Nutrition and Metabolic Diseases, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Department of Diabetes, Nutrition and Metabolic Diseases, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania
| | - Daliborca Vlad
- Department of Pharmacology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Clinical Laboratory, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania
| | - Monica Licker
- Multidisciplinary Research Centre on Antimicrobial Resistance, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Clinical Laboratory, 'Pius Brînzeu' Emergency Clinical County Hospital, 300723 Timisoara, Romania.,Department of Microbiology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
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23
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Provision of Endodontic Treatment in Dentistry amid COVID-19: A Systematic Review and Clinical Recommendations. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8963168. [PMID: 34901279 PMCID: PMC8664529 DOI: 10.1155/2021/8963168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/05/2021] [Accepted: 11/05/2021] [Indexed: 12/23/2022]
Abstract
Background The risk of acquiring COVID-19 during a pandemic is a major concern among health care workers. Dental professionals being in close proximity to the patients had been exposed more than other health care workers. Hence, all the standard operating procedures (SOPs) are strictly advised to be followed. Methods A detailed relevant literature search was conducted in international databases such as PubMed, Web of Science, and Science Direct, from January 2020 to November 2020. All the studies that provided recommendations regarding endodontic procedures during the COVID-19 pandemic were included, and those that were not in the English language, case reports, book chapters, and short communications were excluded in this review. In the end, only 6 articles were selected for the systematic review considering that complete information regarding the provision of dental care in the time of COVID-19 with diagnostic accuracy (STARD) was provided. Results Endodontic treatments were restricted to only emergency dental procedures, and all other patients have advised medications and catered through teledentistry. Endodontic emergencies were advised to be carried out with minimal aerosol production procedures. Conclusion Provision of endodontic care during COVID-19 restricted to only emergency dental procedures by strictly following standard operating procedures. A protocol for COVID-19 prevention was followed by all the dentists and the dental staff in the dental clinics.
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24
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Bontzos G, Gkiala A, Karakosta C, Maliotis N, Detorakis ET. COVID-19 in Ophthalmology. Current Disease Status and Challenges during Clinical Practice. MAEDICA 2021; 16:668-680. [PMID: 35261670 PMCID: PMC8897783 DOI: 10.26574/maedica.2020.16.4.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Purpose: The novel coronavirus disease 2019 (COVID-19) has raised a global public health concern. The purpose of this review is to summarize the evidence currently available on COVID-19 for its ocular implications and manifestations from both pathogenetic and clinical standpoints. Methods: For this narrative review, more than 100 relevant scientific articles were considered from various databases (PubMed, Google Scholar, and Science Direct) using keywords such as coronavirus outbreak, COVID-19, ophthalmology, ocular symptoms. Results:Daily healthcare both from patient and physician perspective, as well as on some guidelines regarding prevention and management have dramatically changed over the last few months. Although COVID-19 infection mainly affects the respiratory system as well as the gastrointestinal, cardiovascular, and urinary systems, it may cause a wide spectrum of ocular manifestations. Various challenges have to be faced to minimize exposure for both patients and physicians. Conclusion:The risk of COVID-19 infection should be considered and medical care should be prioritized for urgent cases. Appropriate management for patients with chronic cases that may result in adverse outcomes should not be neglected, while patients that can be monitored remotely should be identified.
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Affiliation(s)
- Georgios Bontzos
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Anastasia Gkiala
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Christina Karakosta
- Department of Ophthalmology, 'Korgialenio-Benakio' General Hospital, 11526 Athens, Greece
| | - Neofytos Maliotis
- Department of Ophthalmology, General Hospital of Nikaia "Agios Panteleimon", 18454 Athens, Greece
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25
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Zaharie G, Hasmasanu M, Muresan D, Kovacs T, Matyas M. Diagnostic challenges, management, and outcome of infants born to mothers with COVID 19 during the first wave of the pandemic. Exp Ther Med 2021; 23:102. [PMID: 34976144 PMCID: PMC8674959 DOI: 10.3892/etm.2021.11025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Severe acute respiratory distress syndrome with coronavirus 2 (SARS-CoV-2) infection affected pregnant women during the pandemic. Immunological particularity of this population and the increased need for medical assistance placed this population in a high-risk category for SARS-Cov-2 infection. Owing to high contamination risk and limited studies regarding vertical transmission, the labor and delivery of positive women required particular conditions. Cesarean section probably proved to be the optimal option for delivery of infants to reduce the risk of infection during birth. The aim of the present study was to present the management and outcome of infants born to mothers confirmed with coronavirus disease 2019 (COVID 19) prior to delivery. This is a longitudinal, retrospective study, analyzing demographics, laboratory data and management of neonates born to mothers with diagnosis of SARS-Cov-2 infection. The results showed that 5 neonates were born to SARS-Cov-2-positive mothers, all by Cesarean section and had a negative reverse transcription-quantitative polymerase chain reaction (RT-qPCR) test. None of the women breastfed during the hospital stay. The negative RT-qPCR test allowed us to reduce the hospital stay of infants and care in non-isolated areas. In summary, in the present study, vertical or perinatal transmission of the infection was not present. The testing of the pregnant women, their isolation and delivery in safe conditions for the medical staff were possible, with the latter using adequate protection equipment to limit their infection and the risk for the newborns.
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Affiliation(s)
- Gabriela Zaharie
- Department of Neonatology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
| | - Monica Hasmasanu
- Department of Neonatology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
| | - Daniel Muresan
- Department of Obstetrics and Gynecology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
| | - Tunde Kovacs
- Department of Obstetrics and Gynecology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
| | - Melinda Matyas
- Department of Neonatology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania
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26
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Akter R, Rahman MH, Bhattacharya T, Kaushik D, Mittal V, Parashar J, Kumar K, Kabir MT, Tagde P. Novel coronavirus pathogen in humans and animals: an overview on its social impact, economic impact, and potential treatments. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:68071-68089. [PMID: 34664166 PMCID: PMC8523003 DOI: 10.1007/s11356-021-16809-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/25/2021] [Indexed: 04/15/2023]
Abstract
In the light of thousands of infections and deaths, the World Health Organization (WHO) has declared the outbreak of coronavirus disease (COVID-19) a worldwide pandemic. It has spread to about 22 million people worldwide, with a total of 0.45 million expiries, limiting the movement of most people worldwide in the last 6 months. However, COVID-19 became the foremost health, economic, and humanitarian challenge of the twenty-first century. Measures intended to curb the pandemic of COVID-19 included travel bans, lockdowns, and social distances through shelter orders, which will further stop human activities suddenly and eventually impact the world and the national economy. The viral disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After SARS-CoV-2 virus and Middle East respiratory syndrome (MERS)-related CoV, COVID-19 is the third most significant lethal disease to humans. According to WHO, COVID-19 mortality exceeded that of SARS and MERS since COVID-19 was declared an international public health emergency. Genetic sequencing has recently established that COVID-19 is close to SARS-CoV and bat coronavirus which has not yet been recognized as the key cause of this pandemic outbreak, its transmission, and human pathogen mechanism. This review focuses on a brief introduction of novel coronavirus pathogens, including coronavirus in humans and animals, its taxonomic classification, symptoms, pathogenicity, social impact, economic impact, and potential treatment therapy for COVID-19.
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Affiliation(s)
- Rokeya Akter
- Department of Pharmacy, Jagannath University, Sadarghat, Dhaka-1100, Bangladesh
| | - Md Habibur Rahman
- Department of Pharmacy, Southeast University, Banani, Dhaka-1213, Bangladesh.
| | - Tanima Bhattacharya
- School of Chemistry & Chemical Engineering, Hubei University, Wuhan, People's Republic of China, 430062
| | - Deepak Kaushik
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, 124001, Haryana, India.
| | - Vineet Mittal
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, 124001, Haryana, India
| | - Jatin Parashar
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, 124001, Haryana, India
| | - Kuldeep Kumar
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
| | - Md Tanvir Kabir
- Department of Pharmacy, Brac University, 66 Mohakhali, Dhaka, 1212, Bangladesh
| | - Priti Tagde
- Bhabha Pharmacy Research Institute, Bhabha University, Bhopal, M.P, India
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27
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Udriștoiu AL, Ghenea AE, Udriștoiu Ș, Neaga M, Zlatian OM, Vasile CM, Popescu M, Țieranu EN, Salan AI, Turcu AA, Nicolosu D, Calina D, Cioboata R. COVID-19 and Artificial Intelligence: An Approach to Forecast the Severity of Diagnosis. Life (Basel) 2021; 11:1281. [PMID: 34833156 PMCID: PMC8617902 DOI: 10.3390/life11111281] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/27/2021] [Accepted: 11/18/2021] [Indexed: 12/27/2022] Open
Abstract
(1) Background: The new SARS-COV-2 pandemic overwhelmed intensive care units, clinicians, and radiologists, so the development of methods to forecast the diagnosis' severity became a necessity and a helpful tool. (2) Methods: In this paper, we proposed an artificial intelligence-based multimodal approach to forecast the future diagnosis' severity of patients with laboratory-confirmed cases of SARS-CoV-2 infection. At hospital admission, we collected 46 clinical and biological variables with chest X-ray scans from 475 COVID-19 positively tested patients. An ensemble of machine learning algorithms (AI-Score) was developed to predict the future severity score as mild, moderate, and severe for COVID-19-infected patients. Additionally, a deep learning module (CXR-Score) was developed to automatically classify the chest X-ray images and integrate them into AI-Score. (3) Results: The AI-Score predicted the COVID-19 diagnosis' severity on the testing/control dataset (95 patients) with an average accuracy of 98.59%, average specificity of 98.97%, and average sensitivity of 97.93%. The CXR-Score module graded the severity of chest X-ray images with an average accuracy of 99.08% on the testing/control dataset (95 chest X-ray images). (4) Conclusions: Our study demonstrated that the deep learning methods based on the integration of clinical and biological data with chest X-ray images accurately predicted the COVID-19 severity score of positive-tested patients.
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Affiliation(s)
- Anca Loredana Udriștoiu
- Faculty of Automation, Computers and Electronics, University of Craiova, 200776 Craiova, Romania; (A.L.U.); (Ș.U.); (M.N.)
| | - Alice Elena Ghenea
- Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Ștefan Udriștoiu
- Faculty of Automation, Computers and Electronics, University of Craiova, 200776 Craiova, Romania; (A.L.U.); (Ș.U.); (M.N.)
| | - Manuela Neaga
- Faculty of Automation, Computers and Electronics, University of Craiova, 200776 Craiova, Romania; (A.L.U.); (Ș.U.); (M.N.)
| | - Ovidiu Mircea Zlatian
- Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Corina Maria Vasile
- PhD School Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Mihaela Popescu
- Department of Endocrinology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Eugen Nicolae Țieranu
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200642 Craiova, Romania;
| | - Alex-Ioan Salan
- Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania;
| | - Adina Andreea Turcu
- Infectious Disease Department, Victor Babes University Hospital Craiova, 200515 Craiova, Romania;
| | - Dragos Nicolosu
- Pneumology Department, Victor Babes University Hospital Craiova, 200515 Craiova, Romania;
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
| | - Ramona Cioboata
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania;
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28
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Hussain S, Ali F, Salahuddin N, Karim M, Naz S, Khawaja RA, Rifaz S. Perceptions Regarding COVID-19 Vaccination Among a Representative Pakistani Population Coming to Tertiary Care Cardiac Hospital. Cureus 2021; 13:e18654. [PMID: 34790440 PMCID: PMC8583356 DOI: 10.7759/cureus.18654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The deleterious effects caused by coronavirus disease 2019 (COVID-19) infection have been compounded by COVID-19 vaccine hesitancy throughout the world, including Pakistan. We are lacking representative national data regarding the COVID-19 vaccine acceptance. This study aims to determine COVID-19 vaccination acceptance rates and predictors of its acceptance and hesitancy among a representative Pakistani population. Methods: This cross-sectional study was conducted at the National Institute of Cardiovascular Disease, Karachi, from March 2021 to April 2021. Participants included patients, and their attendants visiting the outpatient clinics and healthcare workers of the institute. Participants were labeled as ‘acceptant’ or ‘hesitant’ based on their responses of ‘yes’ or ‘no’ and ‘not sure’ on the willingness to get vaccinated, respectively. The Chi-square test was used to calculate the significant association between different variables. A p-value ≤0.05 was set as a level of significance for all statistical analyses. Results: Overall, 1500 participants were enrolled with a vaccine acceptance rate of only 49%. Factors like male gender, unmarried and employed status, higher education, high socioeconomic class, Punjabi and Sindhi ethnicity, medical professional, and self or family exposure of COVID-19 were positively related to COVID-19 vaccine acceptance. The commonest stated reason for the vaccine hesitancy was distrust in vaccine efficacy or fear of vaccine adverse effects. Conclusion: Vaccine hesitancy remains a serious challenge in our population, related to multiple demographic and thought factors. Focused actions and modification of these factors are the keys to conclude this COVID pandemic.
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Affiliation(s)
- Saba Hussain
- Non-invasive Imaging, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Farheen Ali
- Infectious Disease, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Nawal Salahuddin
- Adult Critical Care Medicine, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Musa Karim
- Statistics, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Shakeela Naz
- Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Rizwan A Khawaja
- Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Sadaf Rifaz
- Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
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29
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Neagos A, Vrinceanu D, Dumitru M, Costache A, Cergan R. Demographic, anthropometric, and metabolic characteristics of obstructive sleep apnea patients from Romania before the COVID-19 pandemic. Exp Ther Med 2021; 22:1487. [PMID: 34765028 DOI: 10.3892/etm.2021.10922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/09/2021] [Indexed: 01/02/2023] Open
Abstract
Obstructive sleep apnea (OSA) syndrome is one of the major pathologies of modern life, with multiple etiologies intertwining: the increase in life expectancy, facial and dental changes, metabolic syndrome, and others. The current diagnosis is based on sleep studies, flexible endoscopy, imaging studies and a complete differential diagnosis from other possible pathologies. We present a retrospective study of 80 cases with OSA managed in 2019 prior to the beginning of the COVID-19 pandemic. We analyzed various demographic, anthropometric and metabolic data recorded in our study group. Some of the results, such as high levels of cholesterol and triglycerides, were consistent with worldwide literature. However, regarding the anthropometric data, we underline a general decrease in height in the Romanian population. In addition, demographic data have changed in the last decade due to the work immigration in the European Union. This data will be used in a future analysis for comparison with variables recorded from cases with OSA during the COVID-19 pandemic. Current cases with OSA are not a priority for healthcare systems, and patients avoid referral to a specialist as much as possible.
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Affiliation(s)
- Adriana Neagos
- ENT Department, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Targu Mures, Romania.,ENT Department, 'Galenus' Medical Center, 540342 Targu Mures, Romania
| | - Daniela Vrinceanu
- ENT Department, Bucharest Emergency University Hospital, 010271 Bucharest, Romania
| | - Mihai Dumitru
- ENT Department, Bucharest Emergency University Hospital, 010271 Bucharest, Romania.,Department of Anatomy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adrian Costache
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Romica Cergan
- Department of Anatomy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
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30
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Vinceti M, Filippini T, Rothman KJ, Di Federico S, Orsini N. The association between first and second wave COVID-19 mortality in Italy. BMC Public Health 2021; 21:2069. [PMID: 34763690 PMCID: PMC8582237 DOI: 10.1186/s12889-021-12126-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022] Open
Abstract
Background The relation between the magnitude of successive waves of the COVID-19 outbreak within the same communities could be useful in predicting the scope of new outbreaks. Methods We investigated the extent to which COVID-19 mortality in Italy during the second wave was related to first wave mortality within the same provinces. We compared data on province-specific COVID-19 2020 mortality in two time periods, corresponding to the first wave (February 24–June 30, 2020) and to the second wave (September 1–December 31, 2020), using cubic spline regression. Results For provinces with the lowest crude mortality rate in the first wave (February–June), i.e. < 22 cases/100,000/month, mortality in the second wave (September–December) was positively associated with mortality during the first wave. In provinces with mortality greater than 22/100,000/month during the first wave, higher mortality in the first wave was associated with a lower second wave mortality. Results were similar when the analysis was censored at October 2020, before the implementation of region-specific measures against the outbreak. Neither vaccination nor variant spread had any role during the study period. Conclusions These findings indicate that provinces with the most severe initial COVID-19 outbreaks, as assessed through mortality data, faced milder second waves.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. .,Department of Epidemiology, Boston University School of Public Health, Boston, MA, US.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, US.,RTI Health Solutions, Research Triangle Park, Raleigh, NC, US
| | - Silvia Di Federico
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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31
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Pleșoianu AF, Pleșoianu CE, Bararu-Bojan Bararu I, Vlădeanu Apăvăloaei MC, Bojan A, Țăruș A, Tinică G. Extracorporeal membrane oxygenation in the management of critically ill patients with coronavirus disease 2019: A narrative review. Exp Ther Med 2021; 22:1296. [PMID: 34630651 PMCID: PMC8461514 DOI: 10.3892/etm.2021.10731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/03/2021] [Indexed: 01/08/2023] Open
Abstract
What started with 41 hospitalized patients identified as having laboratory-confirmed coronavirus disease 2019 (COVID-19) in Wuhan, China, by January 2, 2020, turned into an unprecedented pandemic with more than 113 million confirmed cases and a mortality exceeding 2.5 million deaths worldwide by the beginning of March 2021. Although the course of the disease is uneventful in most cases, there is a percentage of patients who become critically ill and need admission in the intensive care unit for severe respiratory failure. Numerous of these patients undergo invasive mechanical ventilation and have an extremely high mortality rate. For these patients, extracorporeal membrane oxygenation (ECMO) has emerged as a last standing resource. In the present study, the literature was reviewed to evaluate the worldwide data regarding the use of ECMO in the management of critically ill COVID-19 patients. ISI Thomson Web of Science was searched for articles with English language abstracts from inception to March 1, 2021, with ‘ECMO in COVID-19’ as key words. A total of 214 abstracts were screened (case reports, guidelines, reviews) and the most relevant articles were included in the present review. The use of ECMO in the management of critically ill patients with COVID-19-induced acute respiratory distress syndrome refractory to conventional mechanical invasive ventilation is increasing. By increasing the survival rate from less than 20% to more than 50%, ECMO proved to be a valuable resource in the management of the most challenging critically ill COVID-19 patients.
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Affiliation(s)
- Alexandru Florin Pleșoianu
- Department of Surgical Science, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania
| | - Carmen Elena Pleșoianu
- Department of Internal Medicine, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania.,Department of Clinical Cardiology, 'Prof. Dr. George I.M. Georgescu' Institute of Cardiovascular Diseases, Iași 700503, Romania
| | - Iris Bararu-Bojan Bararu
- Department of Pathophysiology, Morpho-Functional Sciences, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania
| | - Maria-Cristina Vlădeanu Apăvăloaei
- Department of Pathophysiology, Morpho-Functional Sciences, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania
| | - Andrei Bojan
- Department of Surgical Science, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania
| | - Andrei Țăruș
- Department of Cardiovascular Surgery, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania.,Department of Cardiovascular Surgery, 'Prof. Dr. George I.M. Georgescu' Institute of Cardiovascular Diseases, Iași 700503, Romania
| | - Grigore Tinică
- Department of Cardiovascular Surgery, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, Iași 700115, Romania.,Department of Cardiovascular Surgery, 'Prof. Dr. George I.M. Georgescu' Institute of Cardiovascular Diseases, Iași 700503, Romania
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32
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Cereda G, Ciappolino V, Boscutti A, Cantù F, Enrico P, Oldani L, Delvecchio G, Brambilla P. Zinc as a Neuroprotective Nutrient for COVID-19-Related Neuropsychiatric Manifestations: A Literature Review. Adv Nutr 2021; 13:66-79. [PMID: 34634109 PMCID: PMC8524565 DOI: 10.1093/advances/nmab110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/25/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022] Open
Abstract
The outbreak of the pandemic associated with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) led researchers to find new potential treatments, including nonpharmacological molecules such as zinc (Zn2+). Specifically, the use of Zn2+ as a therapy for SARS-CoV-2 infection is based on several findings: 1) the possible role of the anti-inflammatory activity of Zn2+ on the aberrant inflammatory response triggered by COronaVIrus Disease 19 (COVID-19), 2) properties of Zn2+ in modulating the competitive balance between the host and the invading pathogens, and 3) the antiviral activity of Zn2+ on a number of pathogens, including coronaviruses. Furthermore, Zn2+ has been found to play a central role in regulating brain functioning and many disorders have been associated with Zn2+ deficiency, including neurodegenerative diseases, psychiatric disorders, and brain injuries. Within this context, we carried out a narrative review to provide an overview of the evidence relating to the effects of Zn2+ on the immune and nervous systems, and the therapeutic use of such micronutrients in both neurological and infective disorders, with the final goal of elucidating the possible use of Zn2+ as a preventive or therapeutic intervention in COVID-19. Overall, the results from the available evidence showed that, owing to its neuroprotective properties, Zn2+ supplementation could be effective not only on COVID-19-related symptoms but also on virus replication, as well as on COVID-19-related inflammation and neurological damage. However, further clinical trials evaluating the efficacy of Zn2+ as a nonpharmacological treatment of COVID-19 are required to achieve an overall improvement in outcome and prognosis.
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Affiliation(s)
- Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Ciappolino
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Filippo Cantù
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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33
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Makvandi P, Chen M, Sartorius R, Zarrabi A, Ashrafizadeh M, Dabbagh Moghaddam F, Ma J, Mattoli V, Tay FR. Endocytosis of abiotic nanomaterials and nanobiovectors: Inhibition of membrane trafficking. NANO TODAY 2021; 40:101279. [PMID: 34518771 PMCID: PMC8425779 DOI: 10.1016/j.nantod.2021.101279] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 08/05/2021] [Accepted: 08/19/2021] [Indexed: 05/04/2023]
Abstract
Humans are exposed to nanoscopical nanobiovectors (e.g. coronavirus SARS-CoV-2) as well as abiotic metal/carbon-based nanomaterials that enter cells serendipitously or intentionally. Understanding the interactions of cell membranes with these abiotic and biotic nanostructures will facilitate scientists to design better functional nanomaterials for biomedical applications. Such knowledge will also provide important clues for the control of viral infections and the treatment of virus-induced infectious diseases. In the present review, the mechanisms of endocytosis are reviewed in the context of how nanomaterials are uptaken into cells. This is followed by a detailed discussion of the attributes of man-made nanomaterials (e.g. size, shape, surface functional groups and elasticity) that affect endocytosis, as well as the different human cell types that participate in the endocytosis of nanomaterials. Readers are then introduced to the concept of viruses as nature-derived nanoparticles. The mechanisms in which different classes of viruses interact with various cell types to gain entry into the human body are reviewed with examples published over the last five years. These basic tenets will enable the avid reader to design advanced drug delivery and gene transfer nanoplatforms that harness the knowledge acquired from endocytosis to improve their biomedical efficacy. The review winds up with a discussion on the hurdles to be addressed in mimicking the natural mechanisms of endocytosis in nanomaterials design.
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Affiliation(s)
- Pooyan Makvandi
- Istituto Italiano di Tecnologia, Centre for Materials Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Pisa, Italy
| | - Meiling Chen
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rossella Sartorius
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Naples 80131, Italy
| | - Ali Zarrabi
- Sabanci University Nanotechnology Research and Application Center (SUNUM), Tuzla, Istanbul 34956, Turkey
| | - Milad Ashrafizadeh
- Sabanci University Nanotechnology Research and Application Center (SUNUM), Tuzla, Istanbul 34956, Turkey
- Faculty of Engineering and Natural Sciences, Sabanci University, Orta Mahalle, Üniversite Caddesi No. 27, Orhanlı, Tuzla, 34956 Istanbul, Turkey
| | - Farnaz Dabbagh Moghaddam
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Virgilio Mattoli
- Istituto Italiano di Tecnologia, Centre for Materials Interfaces, Viale Rinaldo Piaggio 34, 56025 Pontedera, Pisa, Italy
| | - Franklin R Tay
- The Graduate School, Augusta University, Augusta, GA 30912, United States
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34
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Stoian A, Bajko Z, Maier S, Cioflinc RA, Grigorescu BL, Moțățăianu A, Bărcuțean L, Balașa R, Stoian M. High-dose intravenous immunoglobulins as a therapeutic option in critical illness polyneuropathy accompanying SARS-CoV-2 infection: A case-based review of the literature (Review). Exp Ther Med 2021; 22:1182. [PMID: 34475972 PMCID: PMC8406741 DOI: 10.3892/etm.2021.10616] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/27/2021] [Indexed: 01/08/2023] Open
Abstract
The still ongoing COVID-19 pandemic has exposed the medical community to a number of major challenges. A significant number of patients require admission to intensive care unit (ICU) services due to severe respiratory, thrombotic and septic complications and require long-term hospitalization. Neuromuscular weakness is a common complication in critically ill patients who are treated in ICUs and are mechanically ventilated. This complication is frequently caused by critical illness myopathy (CIM) or critical illness polyneuropathy (CIP) and leads to difficulty in weaning from the ventilator. It is thought to represent an important neurologic manifestation of the systemic inflammatory response syndrome (SIRS). COVID-19 infection is known to trigger strong immune dysregulation, with an intense cytokine storm, as a result, the frequency of CIP is expected to be higher in this setting. The mainstay in the diagnosis of this entity beside the high level of clinical awareness is the electrophysiological examination that provides evidence of axonal motor and sensory polyneuropathy. The present article presents the case of a 54-year-old woman with severe COVID 19 infection who developed neuromuscular weakness, which turned out to be secondary to CIP and was treated successfully with a high dose of human intravenous immunoglobulins. Related to this case, we reviewed the relevant literature data regarding the epidemiology, pathophysiology and clinical features of this important complication and discussed also the treatment options and prognosis.
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Affiliation(s)
- Adina Stoian
- Department of Pathophysiology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
| | - Zoltan Bajko
- Department of Neurology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
| | - Smaranda Maier
- Department of Neurology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
| | | | - Bianca Liana Grigorescu
- Department of Pathophysiology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
| | - Anca Moțățăianu
- Department of Neurology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
| | - Laura Bărcuțean
- Department of Neurology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
| | - Rodica Balașa
- Department of Neurology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
| | - Mircea Stoian
- Department of Anesthesiology and Intensive Therapy, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540136 Targu Mures, Romania
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35
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Sipos S, Vlad C, Prejbeanu R, Haragus H, Vlad D, Cristian H, Dumitrascu C, Popescu R, Dumitrascu V, Predescu V. Impact of COVID-19 prevention measures on Clostridioides difficile infections in a regional acute care hospital. Exp Ther Med 2021; 22:1215. [PMID: 34584560 PMCID: PMC8422384 DOI: 10.3892/etm.2021.10649] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/16/2021] [Indexed: 12/15/2022] Open
Abstract
Clostridioides difficile (C. difficile) is a common cause of nosocomial diarrhea. The multi-modal infection control strategies designed to contain the COVID-19 pandemic have had an unintended positive effect on other hospital-acquired infections. The aim of the present study was to analyze the impact of the COVID-19 prevention measures on healthcare-associated C. difficile infections in a large regional acute care center. Electronic databases were reviewed from the start of the pandemic (March) up to November 2020. Average values from the same months from 2019 and 2018 were used as controls. Using the ICD-10 discharge coding, 65 C. difficile cases per 25,124 patients were identified in 2020 compared to 151/43,126 from the 2018 and 2019 averages (P=0.0484). The C. difficile cases were found to be decreased after the implementation of COVID-19 infection control strategies compared to previous years, despite an increase in antibiotic use. Subset analysis during lockdown showed a clear decrease but the difference was not statistically significant. For the months of recovery after lockdown, the number of cases was comparable to previous years.
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Affiliation(s)
- Simona Sipos
- Department of Pharmacology, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Cristian Vlad
- Department of Pharmacology, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Radu Prejbeanu
- Department of Orthopedics and Trauma, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania.,Department of Orthopedics and Trauma, Premiere Hospital, 300643 Timisoara, Romania
| | - Horia Haragus
- Department of Orthopedics and Trauma, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Daliborca Vlad
- Department of Pharmacology, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Horia Cristian
- Department of Surgery II, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Cristian Dumitrascu
- Department of Cardiovascular Surgery, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Roxana Popescu
- Department of Cell and Molecular Biology, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Victor Dumitrascu
- Department of Pharmacology, 'Victor Babes' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Vlad Predescu
- Department of Orthopedics and Trauma, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Orthopedics and Trauma, 'Ponderas' Academic Hospital, 014142 Bucharest, Romania
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36
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Kostoff RN, Calina D, Kanduc D, Briggs MB, Vlachoyiannopoulos P, Svistunov AA, Tsatsakis A. Why are we vaccinating children against COVID-19? Toxicol Rep 2021; 8:1665-1684. [PMID: 34540594 PMCID: PMC8437699 DOI: 10.1016/j.toxrep.2021.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/11/2021] [Accepted: 08/29/2021] [Indexed: 12/20/2022] Open
Abstract
This article examines issues related to COVID-19 inoculations for children. The bulk of the official COVID-19-attributed deaths per capita occur in the elderly with high comorbidities, and the COVID-19 attributed deaths per capita are negligible in children. The bulk of the normalized post-inoculation deaths also occur in the elderly with high comorbidities, while the normalized post-inoculation deaths are small, but not negligible, in children. Clinical trials for these inoculations were very short-term (a few months), had samples not representative of the total population, and for adolescents/children, had poor predictive power because of their small size. Further, the clinical trials did not address changes in biomarkers that could serve as early warning indicators of elevated predisposition to serious diseases. Most importantly, the clinical trials did not address long-term effects that, if serious, would be borne by children/adolescents for potentially decades. A novel best-case scenario cost-benefit analysis showed very conservatively that there are five times the number of deaths attributable to each inoculation vs those attributable to COVID-19 in the most vulnerable 65+ demographic. The risk of death from COVID-19 decreases drastically as age decreases, and the longer-term effects of the inoculations on lower age groups will increase their risk-benefit ratio, perhaps substantially.
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Affiliation(s)
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
| | - Darja Kanduc
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Italy
| | | | | | - Andrey A. Svistunov
- Department of Pharmacology, I.M.Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece
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Tsatsakis A, Vakonaki E, Tzatzarakis M, Flamourakis M, Nikolouzakis TK, Poulas K, Papazoglou G, Hatzidaki E, Papanikolaou NC, Drakoulis N, Iliaki E, Goulielmos GN, Kallionakis M, Lazopoulos G, Kteniadakis S, Alegkakis A, Farsalinos K, Spandidos DA. Immune response (IgG) following full inoculation with BNT162b2 COVID‑19 mRNA among healthcare professionals. Int J Mol Med 2021; 48:200. [PMID: 34515322 PMCID: PMC8448546 DOI: 10.3892/ijmm.2021.5033] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
Soon after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in December, 2019, numerous research teams, assisted by vast capital investments, achieved vaccine development in a fraction of time. However, almost 8 months following the initiation of the European vaccination programme, the need for prospective monitoring of the vaccine-induced immune response, its determinants and related side-effects remains a priority. The present study aimed to quantify the immune response following full vaccination with the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine by measuring the levels of immunoglobulin G (IgG) titers in healthcare professionals. Moreover, common side-effects and factors associated with IgG titers were identified. For this purpose, blood samples from 517 individuals were obtained and analysed. Blood sampling was performed at a mean period of 69.0±23.5 days following the second dose of the vaccine. SARS-CoV-2 IgG titers had an overall mean value of 4.23±2.76. Females had higher titers than males (4.44±2.70 and 3.89 ±2.84, respectively; P=0.007), while non-smokers had higher titers than smokers (4.48±2.79 and 3.80±2.64, respectively; P=0.003). An older age was also associated with lower antibody titers (P<0.001). Moreover, the six most prevalent adverse effects were pain at the injection site (72.1%), generalized fatigue (40.5%), malaise (36.3%), myalgia (31,0%), headache (25.8%) and dizziness/weakness (21.6%). The present study demonstrated that the immune response after receiving the BNT162b2 COVID-19 mRNA vaccine is dependent on various modifiable and non-modifiable factors. Overall, the findings of the present study highlight two key aspects of the vaccination programs: First, the need for prospective immunosurveillance studies in order to estimate the duration of immunity, and second, the need to identify those individuals who are at a greater risk of developing low IgG titers in order to evaluate the need for a third dose of the vaccine.
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Affiliation(s)
- Aristidis Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Elena Vakonaki
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Manolis Tzatzarakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Matthaios Flamourakis
- Department of General Surgery, Venizeleion General Hospital, 71409 Heraklion, Greece
| | | | - Konstantinos Poulas
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500 Rio‑Patras, Greece
| | - Georgios Papazoglou
- Department of Emergency Medicine, Venizeleion General Hospital, 71409 Heraklion, Greece
| | - Eleftheria Hatzidaki
- Department of Neonatology and Neonatal Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
| | | | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Evangelia Iliaki
- Department of Internal Medicine, Venizeleion General Hospital, 71409 Heraklion, Greece
| | - Georgios N Goulielmos
- Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Manolis Kallionakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Georgios Lazopoulos
- Department of Cardiothoracic Surgery, University Hospital of Heraklion, 71500 Heraklion, Greece
| | | | - Athanasios Alegkakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Konstantinos Farsalinos
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, 26500 Rio‑Patras, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
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38
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Saied AA, Metwally AA, Madkhali NAB, Haque S, Dhama K. Egypt's COVID-19 Recent Happenings and Perspectives: A Mini-Review. Front Public Health 2021; 9:696082. [PMID: 34485226 PMCID: PMC8415352 DOI: 10.3389/fpubh.2021.696082] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/12/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected countries across the world. While the zoonotic aspects of SARS-CoV-2 are still under investigation, bats and pangolins are currently cited as the animal origin of the virus. Several types of vaccines against COVID-19 have been developed and are being used in vaccination drives across the world. A number of countries are experiencing second and third waves of the pandemic, which have claimed nearly four million lives out of the 180 million people infected globally as of June 2021. The emerging SARS-CoV-2 variants and mutants are posing high public health concerns owing to their rapid transmissibility, higher severity, and in some cases, ability to infect vaccinated people (vaccine breakthrough). Here in this mini-review, we specifically looked at the efforts and actions of the Egyptian government to slow down and control the spread of COVID-19. We also review the COVID-19 statistics in Egypt and the possible reasons behind the low prevalence and high case fatality rate (CFR%), comparing Egypt COVID-19 statistics with China (the epicenter of COVID-19 pandemic) and the USA, Brazil, India, Italy, and France (the first countries in which the numbers of patients infected with COVID-19). Additionally, we have summarized the SARS-CoV-2 variants, vaccines used in Egypt, and the use of medicinal plants as preventive and curative options.
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Affiliation(s)
- AbdulRahman A Saied
- Department of Food Establishments Licensing (Aswan Branch), National Food Safety Authority (NFSA), Aswan, Egypt.,Touristic Activities and Interior Offices Sector (Aswan Office), Ministry of Tourism and Antiquities, Aswan, Egypt
| | - Asmaa A Metwally
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Aswan University, Aswan, Egypt
| | | | - Shafiul Haque
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan, Saudi Arabia.,Bursa Uludağ University, Faculty of Medicine, Bursa, Turkey
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
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Calina D, Hernández AF, Hartung T, Egorov AM, Izotov BN, Nikolouzakis TK, Tsatsakis A, Vlachoyiannopoulos PG, Docea AO. Challenges and Scientific Prospects of the Newest Generation of mRNA-Based Vaccines against SARS-CoV-2. Life (Basel) 2021; 11:life11090907. [PMID: 34575056 PMCID: PMC8467884 DOI: 10.3390/life11090907] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 02/07/2023] Open
Abstract
In the context of the current COVID-19 pandemic, traditional, complex and lengthy methods of vaccine development and production would not have been able to ensure proper management of this global public health crisis. Hence, a number of technologies have been developed for obtaining a vaccine quickly and ensuring a large scale production, such as mRNA-based vaccine platforms. The use of mRNA is not a new concept in vaccine development but has leveraged on previous knowledge and technology. The great number of human resources and capital investements for mRNA vaccine development, along with the experience gained from previous studies on infectious diseases, allowed COVID-19 mRNA vaccines to be developed, conditionally approved and commercialy available in less than one year, thanks to decades of basic research. This review critically presents and discusses the COVID-19 mRNA vaccine-induced immunity, and it summarizes the most common anaphylactic and autoimmune adverse effects that have been identified until now after massive vaccination campaigns.
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Affiliation(s)
- Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (D.C.); (A.O.D.)
| | - Antonio F. Hernández
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, 18016 Granada, Spain;
- Biomedical Research Institute of Granada ibs.GRANADA, Avda. de las Fuerzas Armadas, 2, 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública), CIBERESP, Instituto de Salud Carlos III, Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Thomas Hartung
- CAAT-Europe, University of Konstanz, 78464 Konstanz, Germany;
- CAAT, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Alexey M. Egorov
- Chumakov Federal Scientific Center for Research and Development of Immune and Biological Products, Russian Academy of Sciences, 108819 Moscow, Russia;
- Division of Medical Sciences, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Boris Nikolaevich Izotov
- Department of Analytical and Forensic Medical Toxicology, Sechenov University, 119991 Moscow, Russia; (B.N.I.); (A.T.)
| | | | - Aristidis Tsatsakis
- Department of Analytical and Forensic Medical Toxicology, Sechenov University, 119991 Moscow, Russia; (B.N.I.); (A.T.)
- Laboratory of Toxicology, Medical School, University of Crete, 70013 Heraklion, Greece;
| | | | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (D.C.); (A.O.D.)
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40
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Albrecht L, Bishop E, Jay B, Lafoux B, Minoves M, Passaes C. COVID-19 Research: Lessons from Non-Human Primate Models. Vaccines (Basel) 2021; 9:886. [PMID: 34452011 PMCID: PMC8402317 DOI: 10.3390/vaccines9080886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). It emerged from China in December 2019 and rapidly spread across the globe, causing a pandemic with unprecedented impacts on public health and economy. Therefore, there is an urgent need for the development of curative treatments and vaccines. In humans, COVID-19 pathogenesis shows a wide range of symptoms, from asymptomatic to severe pneumonia. Identifying animal models of SARS-CoV-2 infection that reflect the clinical symptoms of COVID-19 is of critical importance. Nonhuman primates (NHPss) correspond to relevant models to assess vaccine and antiviral effectiveness. This review discusses the use of NHPs as models for COVID-19 research, with focus on the pathogenesis of SARS-CoV-2 infection, drug discovery and pre-clinical evaluation of vaccine candidates.
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Affiliation(s)
- Laure Albrecht
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Elodie Bishop
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Basile Jay
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
- Département de Biologie, École Normale Supérieure, 75005 Paris, France
| | - Blaise Lafoux
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Biologie, École Normale Supérieure, 75005 Paris, France
| | - Marie Minoves
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
| | - Caroline Passaes
- Département de Sciences du vivant, Université de Paris, 75006 Paris, France
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Badulescu OV, Popescu D, Ciocoiu M, Rezus C. Immune thrombocytopenia, severe hematological consequence in a patient with COVID-19: A case report. Exp Ther Med 2021; 22:1043. [PMID: 34373729 DOI: 10.3892/etm.2021.10475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/29/2021] [Indexed: 01/08/2023] Open
Abstract
Since the first appearance of coronavirus disease 2019 (COVID-19), multiple studies have focused on this novel coronavirus. Within a few months, the clinical and paraclinical manifestations and the mechanisms by which these changes are induced were elaborated. Clinically, the virus mainly causes the common cold, but can also result in severe or fatal pneumonia/acute respiratory syndrome. Regarding the biological changes, similar to any other virus, it can lead to a reduced lymphocyte count. The second most common change is represented by a reduced thrombocyte count. Furthermore, most patients have blood clotting abnormalities, inflammatory syndrome, raised D-dimer and lactate dehydrogenase levels. Detection of immune thrombocytopenia in asymptomatic patients who tested positive for COVID-19 justifies the need to perform differential diagnosis and testing for COVID-19. Typically, patients with severe forms of COVID-19 develop mild thrombocytopenia, while severe thrombocytopenia is rarely reported. The aim of this case report was to present the situation in which one asymptomatic patient who tested positive for COVID-19 developed severe immune thrombocytopenia.
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Affiliation(s)
- Oana-Viola Badulescu
- Department of Pathophysiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Diana Popescu
- Department of Internal Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Manuela Ciocoiu
- Department of Pathophysiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ciprian Rezus
- Department of Internal Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Mondeja B, Valdes O, Resik S, Vizcaino A, Acosta E, Montalván A, Paez A, Mune M, Rodríguez R, Valdés J, Gonzalez G, Sanchez D, Falcón V, González Y, Kourí V, Díaz A, Guzmán M. SARS-CoV-2: preliminary study of infected human nasopharyngeal tissue by high resolution microscopy. Virol J 2021; 18:149. [PMID: 34275492 PMCID: PMC8286443 DOI: 10.1186/s12985-021-01620-1] [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] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/08/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The novel coronavirus SARS-CoV-2 is the etiological agent of COVID-19. This virus has become one of the most dangerous in recent times with a very high rate of transmission. At present, several publications show the typical crown-shape of the novel coronavirus grown in cell cultures. However, an integral ultramicroscopy study done directly from clinical specimens has not been published. METHODS Nasopharyngeal swabs were collected from 12 Cuban individuals, six asymptomatic and RT-PCR negative (negative control) and six others from a COVID-19 symptomatic and RT-PCR positive for SARS CoV-2. Samples were treated with an aldehyde solution and processed by scanning electron microscopy (SEM), confocal microscopy (CM) and, atomic force microscopy. Improvement and segmentation of coronavirus images were performed by a novel mathematical image enhancement algorithm. RESULTS The images of the negative control sample showed the characteristic healthy microvilli morphology at the apical region of the nasal epithelial cells. As expected, they do not display virus-like structures. The images of the positive sample showed characteristic coronavirus-like particles and evident destruction of microvilli. In some regions, virions budding through the cell membrane were observed. Microvilli destruction could explain the anosmia reported by some patients. Virus-particles emerging from the cell-surface with a variable size ranging from 80 to 400 nm were observed by SEM. Viral antigen was identified in the apical cells zone by CM. CONCLUSIONS The integral microscopy study showed that SARS-CoV-2 has a similar image to SARS-CoV. The application of several high-resolution microscopy techniques to nasopharyngeal samples awaits future use.
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Affiliation(s)
- Brian Mondeja
- Center for Advanced Studies of Cuba (CEA), La Habana, Cuba.
| | - Odalys Valdes
- Institute of Tropical Medicine "Pedro Kourí" (IPK), La Habana, Cuba
| | - Sonia Resik
- Institute of Tropical Medicine "Pedro Kourí" (IPK), La Habana, Cuba
| | | | - Emilio Acosta
- Center for Advanced Studies of Cuba (CEA), La Habana, Cuba
| | | | - Amira Paez
- Center for Advanced Studies of Cuba (CEA), La Habana, Cuba
| | - Mayra Mune
- Institute of Tropical Medicine "Pedro Kourí" (IPK), La Habana, Cuba
| | - Roberto Rodríguez
- Institute of Cybernetics, Mathematics, and Physics of Cuba (ICIMAF), La Habana, Cuba
| | - Juan Valdés
- Center for Advanced Studies of Cuba (CEA), La Habana, Cuba
| | - Guelsys Gonzalez
- Institute of Tropical Medicine "Pedro Kourí" (IPK), La Habana, Cuba
| | - Daisy Sanchez
- Center for Advanced Studies of Cuba (CEA), La Habana, Cuba
| | - Viviana Falcón
- Center of Genetic Engineer and Biotechnology of Cuba (CIGB), La Habana, Cuba
| | | | - Vivian Kourí
- Institute of Tropical Medicine "Pedro Kourí" (IPK), La Habana, Cuba
| | | | - Angelina Díaz
- Center for Advanced Studies of Cuba (CEA), La Habana, Cuba
| | - María Guzmán
- Institute of Tropical Medicine "Pedro Kourí" (IPK), La Habana, Cuba
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Carauleanu A, Tanasa IA, Nemescu D, Socolov D. Professional ethics, VBAC and COVID-19 pandemic: A challenge to be resolved (Review). Exp Ther Med 2021; 22:956. [PMID: 34335898 PMCID: PMC8290459 DOI: 10.3892/etm.2021.10388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/11/2021] [Indexed: 11/07/2022] Open
Abstract
Since the declaration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic by the World Health Organization (WHO) on March 11, 2020, the entire healthcare system is trying to adapt its capabilities to a challenge that induces a deep and continuous metamorphosis of people, strategies and policies. The right to proper health care is universal, and the patient's autonomy must be respected even in ambiguous times. In the context of increased Cesarean section (CS) rates, the women's desire to achieve vaginal birth after Cesarean section (VBAC) is becoming more articulate, and healthcare professionals need to adapt their approaches regarding the mode of delivery. But how to balance this aspect with respect to the paucity of resources during the pandemic, without infringing the fundamental rights and ethical principles is a demanding question. This article describes a clinical ethical decision-making framework for recommending trial of labor after Cesarean section (TOLAC), and individualized management of VBAC cases tailored upon the new circumstances dictated by the SARS-CoV-2 pandemic.
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Affiliation(s)
- Alexandru Carauleanu
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ingrid Andrada Tanasa
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dragos Nemescu
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Demetra Socolov
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Șandru F, Carsote M, Petca RC, Gheorghisan-Galateanu AA, Petca A, Valea A, Dumitrașcu MC. COVID-19-related thyroid conditions (Review). Exp Ther Med 2021; 22:756. [PMID: 34035853 PMCID: PMC8135141 DOI: 10.3892/etm.2021.10188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/10/2021] [Indexed: 02/07/2023] Open
Abstract
In patients who were not previously diagnosed with any thyroid conditions, the scenario of COVID-19-related anomalies of the hypothalamus-pituitary-thyroid axes may include either: A process of central thyroid stimulating hormone (TSH) disturbances via virus-related hypophysitis; an atypical type of subacute thyroiditis which is connected to the virus spread or to excessive cytokine production including a destructive process with irreversible damage of the gland or low T3 (triiodothyronine) syndrome (so called non-thyroid illness syndrome) which is not specifically related to the COVID-19 infection, but which is associated with a very severe illness status. Our objective here was to briefly review thyroid changes due to the COVID-19 infection. Ongoing assessment of the effects of the COVID-19 pandemic will reveal more information on coronavirus-induced thyroid conditions. Routine thyroid assays performed in patients with severe infection/at acute phase of COVID-19 are encouraged in order to detect thyrotoxicosis. After recovery, thyroid function should be assessed to identify potential hypothyroidism. There remain unanswered questions related to the prognostic value of interleukin-6 in infected patients, especially in cases with cytokine storm, and the necessity of thyroid hormone replacement in subjects with hypophysitis-related central hypothyroidism.
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Affiliation(s)
- Florica Șandru
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, ‘Elias’ Emergency University Hospital, 011461 Bucharest, Romania
| | - Mara Carsote
- Department of Endocrinology, ‘C. I. Parhon’ National Institute of Endocrinology, 011863 Bucharest, Romania
| | - Răzvan Cosmin Petca
- Departament of Urology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474, Bucharest, Romania
| | | | - Aida Petca
- Department of Obstetrics and Gynecology, ‘Elias’ Emergency University Hospital, 011461 Bucharest, Romania
| | - Ana Valea
- Endocrinology Department, Clinical County Hospital, 400000 Cluj-Napoca, Romania
- Endocrinology Department, ‘I. Hatieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Mihai Cristian Dumitrașcu
- Departament of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474, Bucharest, Romania
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Stoian A, Bălașa R, Grigorescu BL, Maier S, Andone S, Cocuz IG, Bajko Z, Filep CR, Stoian M. Guillain-Barré syndrome associated with Covid-19: A close relationship or just a coincidence? (Review). Exp Ther Med 2021; 22:916. [PMID: 34306190 PMCID: PMC8281479 DOI: 10.3892/etm.2021.10348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023] Open
Abstract
Several neurological complications affecting the central and peripheral nervous system were described secondary to COVID-19 infection such as hyposmia, headache, nausea, impaired consciousness, psychosis, neurocognitive syndromes and even cerebrovascular accidents. The mechanism of these complications is not fully understood, but heterogenous mechanisms such as cytokine storm, secondary hypercoagulability and direct neurotropism of the virus are thought to be involved. Guillain-Barré syndrome is a heterogeneous disease that frequently follows a bacterial or viral infection. During the ongoing SARS-CoV-2 pandemic, several isolated case reports and case series have suggested an association between this viral infection and the occurrence of Guillain-Barré syndrome. The main mechanism of Guillain-Barré syndrome is probably post-viral dysregulation of the immune system generated by SARS-CoV-2. The clinical characteristics and disease evolution seem to be similar to those observed in Guillain-Barré syndrome secondary to other etiologies. The aim of the present review is to summarize the relevant literature regarding SARS-CoV-2-related Guillain-Barré syndrome.
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Affiliation(s)
- Adina Stoian
- Department of Pathophysiology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
| | - Rodica Bălașa
- Department of Neurology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
| | - Bianca Liana Grigorescu
- Department of Pathophysiology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
| | - Smaranda Maier
- Department of Neurology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
| | - Sebastian Andone
- Department of Neurology, 1st Neurology Clinic, Mures County Clinical Emergency Hospital, 540136 Targu Mures, Romania
| | - Iuliu Gabriel Cocuz
- Department of Pathophysiology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
| | - Zoltan Bajko
- Department of Neurology, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
| | - Cristian Rares Filep
- Department of Interventional Radiology, Mures County Clinical Emergency Hospital, 540136 Targu Mures, Romania
| | - Mircea Stoian
- Department of Anesthesiology and Intensive Therapy, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
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Maurya R, Sebastian P, Namdeo M, Devender M, Gertler A. COVID-19 Severity in Obesity: Leptin and Inflammatory Cytokine Interplay in the Link Between High Morbidity and Mortality. Front Immunol 2021; 12:649359. [PMID: 34220807 PMCID: PMC8250137 DOI: 10.3389/fimmu.2021.649359] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is one of the foremost risk factors in coronavirus infection resulting in severe illness and mortality as the pandemic progresses. Obesity is a well-known predisposed chronic inflammatory condition. The dynamics of obesity and its impacts on immunity may change the disease severity of pneumonia, especially in acute respiratory distress syndrome, a primary cause of death from SARS-CoV-2 infection. The adipocytes of adipose tissue secret leptin in proportion to individuals’ body fat mass. An increase in circulating plasma leptin is a typical characteristic of obesity and correlates with a leptin-resistant state. Leptin is considered a pleiotropic molecule regulating appetite and immunity. In immunity, leptin functions as a cytokine and coordinates the host’s innate and adaptive responses by promoting the Th1 type of immune response. Leptin induced the proliferation and functions of antigen-presenting cells, monocytes, and T helper cells, subsequently influencing the pro-inflammatory cytokine secretion by these cells, such as TNF-α, IL-2, or IL-6. Leptin scarcity or resistance is linked with dysregulation of cytokine secretion leading to autoimmune disorders, inflammatory responses, and increased susceptibility towards infectious diseases. Therefore, leptin activity by leptin long-lasting super active antagonist’s dysregulation in patients with obesity might contribute to high mortality rates in these patients during SARS-CoV-2 infection. This review systematically discusses the interplay mechanism between leptin and inflammatory cytokines and their contribution to the fatal outcomes in COVID-19 patients with obesity.
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Affiliation(s)
- Radheshyam Maurya
- Department of Animal Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Prince Sebastian
- Department of Animal Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Madhulika Namdeo
- Department of Animal Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Moodu Devender
- Department of Animal Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Arieh Gertler
- Institute of Biochemistry, Food Science and Nutrition, The Hebrew University of Jerusalem, Rehovot, Israel
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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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Singh Y, Trautwein C, Fendel R, Krickeberg N, Berezhnoy G, Bissinger R, Ossowski S, Salker MS, Casadei N, Riess O. SARS-CoV-2 infection paralyzes cytotoxic and metabolic functions of the immune cells. Heliyon 2021; 7:e07147. [PMID: 34075347 PMCID: PMC8159709 DOI: 10.1016/j.heliyon.2021.e07147] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/10/2021] [Accepted: 05/24/2021] [Indexed: 12/29/2022] Open
Abstract
The SARS-CoV-2 virus is the causative agent of the global COVID-19 infectious disease outbreak, which can lead to acute respiratory distress syndrome (ARDS). However, it is still unclear how the virus interferes with immune cell and metabolic functions in the human body. In this study, we investigated the immune response in acute or convalescent COVID-19 patients. We characterized the peripheral blood mononuclear cells (PBMCs) using flow cytometry and found that CD8+ T cells were significantly subsided in moderate COVID-19 and convalescent patients. Furthermore, characterization of CD8+ T cells suggested that convalescent patients have significantly diminished expression of both perforin and granzyme A. Using 1H-NMR spectroscopy, we characterized the metabolic status of their autologous PBMCs. We found that fructose, lactate and taurine levels were elevated in infected (mild and moderate) patients compared with control and convalescent patients. Glucose, glutamate, formate and acetate levels were attenuated in COVID-19 (mild and moderate) patients. In summary, our report suggests that SARS-CoV-2 infection leads to disrupted CD8+ T cytotoxic functions and changes the overall metabolic functions of immune cells.
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Affiliation(s)
- Yogesh Singh
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
- NGS Competence Center Tübingen (NCCT), University of Tübingen, Calwerstrasse 7, 72076 Tübingen, Germany
- Research Institute of Women’s Health, University of Tübingen, Calwerstrasse 7/6, 72076, Tübingen, Germany
| | - Christoph Trautwein
- Werner Siemens Imaging Center, University of Tübingen, Röntgenweg 13, 72076, Tübingen, Germany
| | - Rolf Fendel
- Institute of Tropical Medicine, University Hospital of Tübingen, Wilhelmstrasse 27, 72076, Tübingen, Germany
| | - Naomi Krickeberg
- Institute of Tropical Medicine, University Hospital of Tübingen, Wilhelmstrasse 27, 72076, Tübingen, Germany
| | - Georgy Berezhnoy
- Werner Siemens Imaging Center, University of Tübingen, Röntgenweg 13, 72076, Tübingen, Germany
| | - Rosi Bissinger
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital of Tübingen, Germany
| | - Stephan Ossowski
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
- NGS Competence Center Tübingen (NCCT), University of Tübingen, Calwerstrasse 7, 72076 Tübingen, Germany
| | - Madhuri S. Salker
- Research Institute of Women’s Health, University of Tübingen, Calwerstrasse 7/6, 72076, Tübingen, Germany
| | - Nicolas Casadei
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
- NGS Competence Center Tübingen (NCCT), University of Tübingen, Calwerstrasse 7, 72076 Tübingen, Germany
| | - Olaf Riess
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Calwerstrasse 7, 72076, Tübingen, Germany
- NGS Competence Center Tübingen (NCCT), University of Tübingen, Calwerstrasse 7, 72076 Tübingen, Germany
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Negrut N, Codrean A, Hodisan I, Bungau S, Tit DM, Marin R, Behl T, Banica F, Diaconu CC, Nistor-Cseppento DC. Efficiency of antiviral treatment in COVID-19. Exp Ther Med 2021; 21:648. [PMID: 33968179 PMCID: PMC8097236 DOI: 10.3892/etm.2021.10080] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/31/2021] [Indexed: 12/12/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is responsible for generating a global effort to discover urgent therapeutic solutions to limit the human damage caused by COVID-19. In the period of April to June 2020, 105 patients diagnosed with COVID-19 met the conditions for inclusion in the present study. They were treated with antiviral therapy according to local guidelines: D group (53 cases), treated with darunavir/ritonavir (DRV/r); and K group (52 cases), treated with lopinavir/ritonavir (LPV/r). Patients from the K group required 7.5 days of hospitalization less compared to those from the D group (P<0.001). The blood oxygen saturation values recorded in the groups were statistically different [K group (94.02±3.12%) vs. D group (92.13±4.24%), P=0.010]. The percentage of patients with unsatisfactory clinical evolution were non-significantly higher in the D group compared with the K group [20 (37.74%) vs. 12 (23.08%), P=0.157]. We did not note statistically significant differences between the two groups tracked considering the values for the Brescia-COVID Respiratory Severity Scale (BCRSS) of the patients with unsatisfactory clinical evolution, nor of the chest CT' evolution after 10 days of therapy. We did not register significant adverse effects after antiviral therapy in the two groups. Antiviral therapy with LPV/r had some favorable results compared to DRV/r in patients with COVID-19. Both therapies were well tolerated.
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Affiliation(s)
- Nicoleta Negrut
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Adriana Codrean
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Ioana Hodisan
- Department of infectious Diseases, ‘Gavril Curteanu’ Municipal Hospital Oradea, 410469 Oradea, Romania
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Ruxandra Marin
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, 140401 Punjab, India
| | - Florin Banica
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Camelia C. Diaconu
- Department 5, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Delia Carmen Nistor-Cseppento
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
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50
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Vinceti M, Filippini T, Rothman KJ, Di Federico S, Orsini N. SARS-CoV-2 infection incidence during the first and second COVID-19 waves in Italy. ENVIRONMENTAL RESEARCH 2021; 197:111097. [PMID: 33811866 PMCID: PMC8012166 DOI: 10.1016/j.envres.2021.111097] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 05/14/2023]
Abstract
We assessed the relation between COVID-19 waves in Italy, which was severely affected during the pandemic. We evaluated the hypothesis that a larger impact from the first wave (February-May 2020) predicts a smaller peak during the second wave (September-October 2020), in the absence of local changes in public health interventions and area-specific differences in time trends of environmental parameters. Based on publicly available data on province-specific SARS-CoV-2 infections and both crude and multivariable cubic spline regression models, we found that for provinces with the lowest incidence rates in the first wave, the incidence in the second wave increased roughly in proportion with the incidence in the first wave until an incidence of about 500-600 cases/100,000 in the first wave. Above that value, provinces with higher incidences in the first wave experienced lower incidences in the second wave. It appears that a comparatively high cumulative incidence of infection, even if far below theoretical thresholds required for herd immunity, may provide noticeable protection during the second wave. We speculate that, if real, the mechanism for this pattern could be depletion of most susceptible individuals and of superspreaders in the first wave. A population learning effect regarding cautious behavior could have also contributed. Since no area-specific variation of the national policy against the SARS-CoV-2 outbreak was allowed until early November 2020, neither individual behaviors nor established or purported environmental risk factors of COVID-19, such as air pollution and meteorological factors, are likely to have confounded the inverse trends we observed in infection incidence over time.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, US.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, US; RTI Health Solutions, Research Triangle Park, NC, US
| | - Silvia Di Federico
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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