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Chinese pregnant women's knowledge, attitude, and practice of self-protection against coronavirus disease 2019 during the post-pandemic period: A structural equation modeling-based survey. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 87:103559. [PMID: 36714184 PMCID: PMC9869621 DOI: 10.1016/j.ijdrr.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 01/03/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the Chinese pregnant women's levels of knowledge, attitude, and practice (KAP) of self-protection against coronavirus disease 2019 (COVID-19) during the post-pandemic period, to aid the development of targeted health education. An online questionnaire was conducted for 2156 Chinese pregnant women from October 1, 2021, to December 31, 2021, to collect socio-demographic and KAP information. Structural equation modeling (SEM) was used to determine self-protection-related factors. The mean age of the participants was 30 ± 4.1 years. SEM indicated that pregnant women's level of knowledge can directly and indirectly affect the practice of self-protection (r = 0.23) through their belief, with a correlation coefficient of 0.56 and 0.46 between knowledge and belief and belief and practice, respectively. The "basic protection" and "hospital visits after infection" exerted the greatest impact on knowledge formation, with correlation coefficients of 0.85 and 0.89, respectively. Attitude had a direct effect on practice with a correlation coefficient of 0.46. "Awareness of prevention and control" and "family and social support" had the greatest impact on belief formation, with correlation coefficients of 0.77 and 0.73, respectively. Pregnant Chinese women were generally familiar with COVID-19 knowledge, and their levels of knowledge and beliefs particularly affect the practice of self-protection. Health education aimed at improving pregnant women's knowledge and belief toward self-protection against COVID-19 may be an effective way to guide them toward positive practices and promote their health and that of their babies.
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Key Words
- AGFI, adjusted goodness of fit index
- BMI, body mass index
- CFI, comparative fix index
- CMIN/DF, Chi-square fit statistics/degree of freedom
- COVID-19
- COVID-19, coronavirus disease 2019
- GFI, goodness-of-fit index
- I-CVI, individual-item content validity index
- IFI, incremental fix index
- KAP theory
- KAP, knowledge attitude and practice
- MERS, Middle eastern respiratory syndrome
- Post-pandemic period
- Pregnant women
- RMSEA, root mean square error of approximation
- S-CVI, scale-content validity index
- SARS, severe acute respiratory syndrome
- SEM, structural equation modeling
- Self-protection
- TLI, Tucker-Lewis index
- UA, universal agreement
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Complex Hallucinations in Hospitalized Rehabilitation Patients With COVID-19. Arch Rehabil Res Clin Transl 2022; 4:100234. [PMID: 36277732 PMCID: PMC9574548 DOI: 10.1016/j.arrct.2022.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives To explore the characteristics of hallucinations in hospitalized rehabilitation patients with COVID-19. Design Retrospective review using medical records of patients with COVID-19 and admitted to the acute inpatient rehabilitation unit (ARU). Setting A public hospital in southern California, specializing in rehabilitation medicine. Participants: Patients with COVID-19 and hallucinations who were consecutively admitted from January 1st to April 30th, 2021. Interventions Not applicable. Main Outcome Measures Types and themes of hallucinations. Results Eight of the 37 patients (21.6%) admitted to the ARU with COVID-19 exhibited hallucinations. All were Hispanic and 7 of them were men; their average age was 56.5 (range: 38-71). Seven patients had COVID-19 pneumonia and 1 developed respiratory distress secondary to Guillain-Barre Syndrome. One patient had posterior reversible encephalopathy syndrome. The average length of stay in the intensive care unit (ICU) was 31.3 days (range: 8-48). Most of the hallucinations occurred during their ICU stay and 2 continued to their ARU stay. All recalled details of hallucinations with 7 exhibiting visual hallucinations, consistent with peduncular hallucinosis with or without auditory and/or tactile components. One patient experienced tactile hallucinations. The themes of hallucinations identified to reflect the contents of the hallucinations were patients' comfort-seeking, fearfulness, and seeing deceased family members. All patients had impaired cognition at the ARU admission but improved at discharge. Four patients had depressed mood/anxiety and 1 had depressed mood alone but without a history of psychiatric illness. ICU delirium was documented in 5 patients. The negative experience of hallucinations seemed to affect their participation of the ARU stay. Conclusions More than 20% of patients with COVID-19 who were transferred to attend inpatient rehabilitation exhibited hallucinations. It remains uncertain if these hallucinations were related to the SARS-CoV-2 infection. Multidisciplinary rehabilitation team should be aware to support patients with COVID-19 who experience hallucinations.
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Artificial intelligence model on chest imaging to diagnose COVID-19 and other pneumonias: A systematic review and meta-analysis. Eur J Radiol Open 2022; 9:100438. [PMID: 35996746 PMCID: PMC9385733 DOI: 10.1016/j.ejro.2022.100438] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives When diagnosing Coronavirus disease 2019(COVID‐19), radiologists cannot make an accurate judgments because the image characteristics of COVID‐19 and other pneumonia are similar. As machine learning advances, artificial intelligence(AI) models show promise in diagnosing COVID-19 and other pneumonias. We performed a systematic review and meta-analysis to assess the diagnostic accuracy and methodological quality of the models. Methods We searched PubMed, Cochrane Library, Web of Science, and Embase, preprints from medRxiv and bioRxiv to locate studies published before December 2021, with no language restrictions. And a quality assessment (QUADAS-2), Radiomics Quality Score (RQS) tools and CLAIM checklist were used to assess the quality of each study. We used random-effects models to calculate pooled sensitivity and specificity, I2 values to assess heterogeneity, and Deeks' test to assess publication bias. Results We screened 32 studies from the 2001 retrieved articles for inclusion in the meta-analysis. We included 6737 participants in the test or validation group. The meta-analysis revealed that AI models based on chest imaging distinguishes COVID-19 from other pneumonias: pooled area under the curve (AUC) 0.96 (95 % CI, 0.94–0.98), sensitivity 0.92 (95 % CI, 0.88–0.94), pooled specificity 0.91 (95 % CI, 0.87–0.93). The average RQS score of 13 studies using radiomics was 7.8, accounting for 22 % of the total score. The 19 studies using deep learning methods had an average CLAIM score of 20, slightly less than half (48.24 %) the ideal score of 42.00. Conclusions The AI model for chest imaging could well diagnose COVID-19 and other pneumonias. However, it has not been implemented as a clinical decision-making tool. Future researchers should pay more attention to the quality of research methodology and further improve the generalizability of the developed predictive models.
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Key Words
- 2D, two-dimensional
- 3D, three-dimensional
- AI, artificial intelligence
- AUC, area under the curve
- Artificial Intelligence
- CNN, Convolutional neural network
- COVID-19
- COVID-19, Coronavirus disease 2019
- CRP, C-reactive protein
- CT, Computed tomography
- CXR, Chest X-Ray
- Diagnostic Imaging
- GGO, ground-glass opacities
- KNN, K-nearest neighbor
- LASSO, least absolute shrinkage and selection operator
- MEERS-COV, Middle East respiratory syndrome coronavirus
- ML, machine learning
- Machine learning
- PLR, negative likelihood ratio
- PLR, positive likelihood ratio
- Pneumonia
- ROI, regions of interest
- RT-PCR, Reverse transcriptase polymerase chain reaction
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SROC, summary receiver operating characteristic
- SVM, Support vector machine
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Clinical features and prognosis of COVID-19 patients with metabolic syndrome: A multicenter, retrospective study. MEDICINA CLINICA (ENGLISH ED.) 2022; 158:458-465. [PMID: 35702719 PMCID: PMC9181760 DOI: 10.1016/j.medcle.2021.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/21/2021] [Indexed: 01/08/2023]
Abstract
Background Few studies have investigated the impacts of metabolic syndrome (MS) on coronavirus disease 2019 (COVID-19). We described the clinical features and prognosis of confirmed COVID-19 patients with MS during hospitalization and after discharge. Methods Two hundred and thirty-three COVID-19 patients from the hospitals in 8 cities of Jiangsu, China were retrospectively included. Clinical characteristics of COVID-19 patients were described and risk factors of severe illness were analyzed by logistic regression analysis. Results Forty-five (19.3%) of 233 COVID-19 patients had MS. The median age of COVID-19 patients with MS was significantly higher than non-MS patients (53.0 years vs. 46.0 years, P = 0.004). There were no significant differences of clinical symptoms, abnormal chest CT images, and treatment drugs between two groups. More patients with MS had severe illness (33.3% vs. 6.4%, P < 0.001) and critical illness (4.4% vs. 0.5%, P = 0.037) than non-MS patients. The proportions of respiratory failure and acute respiratory distress syndrome in MS patients were also higher than non-MS patients during hospitalization. Multivariate analysis showed that concurrent MS (odds ratio [OR] 7.668, 95% confidence interval [CI] 3.062–19.201, P < 0.001) and lymphopenia (OR 3.315, 95% CI 1.306–8.411, P = 0.012) were independent risk factors of severe illness of COVID-19. At a median follow-up of 28 days after discharge, bilateral pneumonia was found in 95.2% of MS patients, while only 54.7% of non-MS patients presented bilateral pneumonia. Conclusions 19.3% of COVID-19 patients had MS in our study. COVID-19 patients with MS are more likely to develop severe complications and have worse prognosis. More attention should be paid to COVID-19 patients with MS.
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Key Words
- ARDS, acute respiratory distress syndrome
- BMI, body mass index
- COVID-19, coronavirus disease 2019
- Coronavirus disease 2019
- FBG, fasting blood glucose
- ICU, intensive care units
- IQR, interquartile range
- MS, metabolic syndrome
- Metabolic syndrome
- Prognosis
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- TC, total cholesterol
- TG, triglycerides
- WHO, world Health Organization
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Comparative performances of seven quantitative Reverse-Transcription Polymerase Chain Reaction assays (RT-qPCR) for detecting SARS-CoV-2 infection in samples from individuals suspected of COVID-19 in São Paulo, Brazil. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 1:100012. [PMID: 35262000 PMCID: PMC8019594 DOI: 10.1016/j.jcvp.2021.100012] [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: 11/17/2020] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction Brazil is the second largest country with COVID-19 positive cases worldwide. Due to the potent spread of the virus and the scarcity of kits and supplies, the Brazilian Ministry of Health has granted authorization for the use of kits available during this emergency, without an accurate evaluation of their performance. This study compared the performance and cost-effectiveness of seven molecular assays/kits available in São Paulo, Brazil, for SARS-CoV-2 diagnosis Materials and methods A total of 205 nasopharyngeal/oropharyngeal samples from suspected cases of COVID-19, were tested using the following assays: (i) GeneFinder COVID-19 plus RealAmp kit; (ii) 2019-nCoV RNA PCR-Fluorescence Probing, Da An Gene Co.; (iii) in-house RT-qPCR SARS-CoV-2 IAL; (iv) 2019-nCoV kit, IDT; (v) molecular SARS-CoV-2 (E) kit, Bio-Manguinhos; (vi) Allplex 2019-nCoV modified Assay, Seegene Inc, and (vii) Biomol one-step COVID-19 kit, IBMP. The criteria for determining a SARS-CoV-2 true positive result included the cycle threshold cut-off values, the characteristics of exponential/linear curves, the gene target diversity, and a positive result in at least two assays Results The overall sensitivity of the assays listed were GeneFinder 83.6%, Da An Gene 100.0%, IAL 90.4%, IDT 94.6%, Bio-Manguinhos 87.7%, Allplex 97.3%, and IBMP 87.7%. The minor sensitive gene target was RdRP. Although all assays had a Cohen's Kappa index ≥0.893, the best tests used multiplex assays identifying N-gene and/or E-gene targets Conclusion All assays tested accurate for diagnosis, but considering cost-effectiveness (cost, time consumption, number of samples tested, and performance), the in-house IAL assay was ideal for COVID-19 diagnosis in São Paulo, Brazil.
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Key Words
- Assay performances
- CDC, center for disease control
- CI, confidence interval
- COVID-19, Coronavirus disease 2019
- CV, coefficient of variation in percentage
- Coronavirus disease 2019 (COVID-19)
- Cost-effectiveness
- Ct, cycle threshold
- Cut-off, Ct limit of positivity
- Cy5, Cyanine 5
- Diagnosis
- E, envelope
- FAM, fluorescein amidite
- HE, hemagglutinin esterase
- HEX, hexachloro fluorescein
- IAL, Instituto Adolfo Lutz
- IC, internal control
- M, membrane
- MERS-CoV, Middle East respiratory syndrome
- N, nucleocapsid
- ORF1ab, open-reading frame of ORF1ab region
- PAHO, Pan American Health Organization
- ROX, carboxy-X-rhodamine
- RP, human ribonuclease p
- RT-qPCR, reverse transcription-quantitative polymerase chain reaction
- RdRP, RNA-dependent RNA polymerase
- Reverse transcription-quantitative polymerase chain reaction (RT-qPCR)
- S, spike
- SARS, severe acute respiratory syndrome
- SARS-CoV-2
- SD, standard deviation
- Severe acute respiratory syndrome (SARS)
- VIC, 2′-chloro-7′-phenyl-1,4-dichloro-6-carboxyfluorescein
- WHO, World Health Organization
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Equipment-free, salt-mediated immobilization of nucleic acids for nucleic acid lateral flow assays. SENSORS AND ACTUATORS. B, CHEMICAL 2022; 351:130975. [PMID: 36568876 PMCID: PMC9758654 DOI: 10.1016/j.snb.2021.130975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 06/16/2023]
Abstract
As the world has been facing several deadly virus crises, including Zika virus disease, Ebola virus disease, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and Coronavirus disease 2019 (COVID-19), lateral flow assays (LFAs), which require minimal equipment for point-of-care of viral infectious diseases, are garnering much attention. Accordingly, there is an increasing demand to reduce the time and cost required for manufacturing LFAs. The current study introduces an equipment-free method of salt-mediated immobilization of nucleic acids (SAIoNs) for LFAs. Compared to general DNA immobilization methods such as streptavidin-biotin, UV-irradiation, and heat treatment, our method does not require special equipment (e.g., centrifuge, UV-crosslinker, heating device); therefore, it can be applied in a resource-limited environment with reduced production costs. The immobilization process was streamlined and completed within 30 min. Our method improved the color intensity signal approximately 14 times compared to the method without using SAIoNs and exhibited reproducibility with the long-term storage stability. The proposed method can be used to detect practical targets (e.g., SARS-CoV-2) and facilitates highly sensitive and selective detection of target nucleic acids with multiplexing capability and without any cross-reactivity. This novel immobilization strategy provides a basis for easily and inexpensively developing nucleic acid LFAs combined with various types of nucleic acid amplification.
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Key Words
- AuNPs, gold nanoparticles
- BSA, bovine serum albumin
- Biotin
- Equipment-free
- Immobilization
- LAMP, loop-mediated isothermal amplification
- LF, lateral flow
- LFA, lateral flow assay
- LFIA, lateral flow immuno-assay
- LOD, limit of detection
- Lateral flow assay
- MERS, Middle East respiratory syndrome
- Metal salt
- NALFA, nucleic acid lateral flow assay
- NC, nitrocellulose
- NTC, no-template control
- Nucleic acid lateral flow assay
- POC, point-of-care
- RPA, recombinase polymerase amplification
- RT-qPCR, quantitative reverse transcription-polymerase chain reaction
- SAIoNs, salt-mediated immobilization of nucleic acids
- SARS, severe acute respiratory syndrome
- Streptavidin
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Implications of WHO COVID-19 interim guideline 2020.5 on the comprehensive care for infected persons in Africa Before, during and after clinical management of cases. SCIENTIFIC AFRICAN 2021; 15:e01083. [PMID: 34957351 PMCID: PMC8683379 DOI: 10.1016/j.sciaf.2021.e01083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/11/2021] [Accepted: 12/16/2021] [Indexed: 01/08/2023] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) is one of the biggest public health crises globally. Although Africa did not display the worst-case scenario compared to other continents, fears were still at its peak since Africa was already suffering from a heavy load of other life-threatening infectious diseases such as HIV/AIDS and malaria. Other factors that were anticipated to complicate Africa's outcomes include the lack of resources for diagnosis and contact tracing along with the low capacity of specialized management facilities per capita. The current review aims at assessing and generating discussions on the realities, and pros and cons of the WHO COVID-19 interim guidance 2020.5 considering the known peculiarities of the African continent. A comprehensive evaluation was done for COVID-19-related data published across PubMed and Google Scholar (date of the last search: August 17, 2020) with emphasis on clinical management and psychosocial aspects. Predefined filters were then applied in data screening as detailed in the methods. Specifically, we interrogated the WHO 2020.5 guideline viz-a-viz health priority and health financing in Africa, COVID-19 case contact tracing and risk assessment, clinical management of COVID-19 cases as well as strategies for tackling stigmatization and psychosocial challenges encountered by COVID-19 survivors. The outcomes of this work provide links between these vital sub-themes which may impact the containment and management of COVID-19 cases in Africa in the long-term. The chief recommendation of the current study is the necessity of prudent filtration of the global findings along with regional modelling of the global care guidelines for acting properly in response to this health threat on the regional level without exposing our populations to further unnecessary adversities.
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Key Words
- AFCOR, Africa Task Force for Novel Coronavirus
- AIDS, acquired immune deficiency syndrome
- ARDS, acute respiratory distress syndrome
- Africa
- C02, carbon dioxide
- COVID-19
- Clinical management
- Contact tracing
- ECMO, extracorporeal membrane oxygenation
- GGE, general government expenditure
- GGHE, general government health expenditure
- H2O, Hydrogen
- HIV, Human immunodeficiency virus
- MERS, Middle East Respiratory Syndrome
- NHS, national health services
- O2, Oxygen
- PCR, polymerase chain reaction
- PTSD, post-traumatic stress disorder
- RECOVERY, Randomized Evaluation of COVID-19 Therapy
- SARS, severe acute respiratory syndrome
- Stigmatization
- US-CDC, United States Centre for Disease Control
- WHO guidelines
- WHO, World Health Organization
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The fatty acid site is coupled to functional motifs in the SARS-CoV-2 spike protein and modulates spike allosteric behaviour. Comput Struct Biotechnol J 2021; 20:139-147. [PMID: 34934478 PMCID: PMC8670790 DOI: 10.1016/j.csbj.2021.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022] Open
Abstract
The SARS-CoV-2 spike protein is the first contact point between the SARS-CoV-2 virus and host cells and mediates membrane fusion. Recently, a fatty acid binding site was identified in the spike (Toelzer et al. Science 2020). The presence of linoleic acid at this site modulates binding of the spike to the human ACE2 receptor, stabilizing a locked conformation of the protein. Here, dynamical-nonequilibrium molecular dynamics simulations reveal that this fatty acid site is coupled to functionally relevant regions of the spike, some of them far from the fatty acid binding pocket. Removal of a ligand from the fatty acid binding site significantly affects the dynamics of distant, functionally important regions of the spike, including the receptor-binding motif, furin cleavage site and fusion-peptide-adjacent regions. Simulations of the D614G mutant show differences in behaviour between these clinical variants of the spike: the D614G mutant shows a significantly different conformational response for some structural motifs relevant for binding and fusion. The simulations identify structural networks through which changes at the fatty acid binding site are transmitted within the protein. These communication networks significantly involve positions that are prone to mutation, indicating that observed genetic variation in the spike may alter its response to linoleate binding and associated allosteric communication.
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Key Words
- ACE2, angiotensin-converting 2 enzyme
- CD, connector domain
- CH, central helix
- FA, fatty acid
- FP, fusion peptide
- FPPR, fusion-peptide proximal region
- HR1, heptad repeat 1
- LA, Linoleic acid
- MD, Molecular dynamics
- MERS, middle east respiratory syndrome
- NTD, N-terminal domain
- RBD, receptor binding domain
- RBM, receptor-binding motif
- RMB, receptor binding motif
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome 2
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Nanomedicine for acute respiratory distress syndrome: The latest application, targeting strategy, and rational design. Acta Pharm Sin B 2021; 11:3060-3091. [PMID: 33977080 PMCID: PMC8102084 DOI: 10.1016/j.apsb.2021.04.023] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023] Open
Abstract
Acute respiratory distress syndrome (ARDS) is characterized by the severe inflammation and destruction of the lung air-blood barrier, leading to irreversible and substantial respiratory function damage. Patients with coronavirus disease 2019 (COVID-19) have been encountered with a high risk of ARDS, underscoring the urgency for exploiting effective therapy. However, proper medications for ARDS are still lacking due to poor pharmacokinetics, non-specific side effects, inability to surmount pulmonary barrier, and inadequate management of heterogeneity. The increased lung permeability in the pathological environment of ARDS may contribute to nanoparticle-mediated passive targeting delivery. Nanomedicine has demonstrated unique advantages in solving the dilemma of ARDS drug therapy, which can address the shortcomings and limitations of traditional anti-inflammatory or antioxidant drug treatment. Through passive, active, or physicochemical targeting, nanocarriers can interact with lung epithelium/endothelium and inflammatory cells to reverse abnormal changes and restore homeostasis of the pulmonary environment, thereby showing good therapeutic activity and reduced toxicity. This article reviews the latest applications of nanomedicine in pre-clinical ARDS therapy, highlights the strategies for targeted treatment of lung inflammation, presents the innovative drug delivery systems, and provides inspiration for strengthening the therapeutic effect of nanomedicine-based treatment.
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Key Words
- ACE2, angiotensin-converting enzyme 2
- AEC II, alveolar type II epithelial cells
- AM, alveolar macrophages
- ARDS, acute respiratory distress syndrome
- Acute lung injury
- Acute respiratory distress syndrome
- Anti-inflammatory therapy
- BALF, bronchoalveolar lavage fluid
- BSA, bovine serum albumin
- CD, cyclodextrin
- CLP, cecal ligation and perforation
- COVID-19
- COVID-19, coronavirus disease 2019
- DOPE, phosphatidylethanolamine
- DOTAP, 1-diolefin-3-trimethylaminopropane
- DOX, doxorubicin
- DPPC, dipalmitoylphosphatidylcholine
- Drug delivery
- ECM, extracellular matrix
- ELVIS, extravasation through leaky vasculature and subsequent inflammatory cell-mediated sequestration
- EPCs, endothelial progenitor cells
- EPR, enhanced permeability and retention
- EVs, extracellular vesicles
- EphA2, ephrin type-A receptor 2
- Esbp, E-selectin-binding peptide
- FcgR, Fcγ receptor
- GNP, peptide-gold nanoparticle
- H2O2, hydrogen peroxide
- HO-1, heme oxygenase-1
- ICAM-1, intercellular adhesion molecule-1
- IKK, IκB kinase
- IL, interleukin
- LPS, lipopolysaccharide
- MERS, Middle East respiratory syndrome
- MPMVECs, mouse pulmonary microvascular endothelial cells
- MPO, myeloperoxidase
- MSC, mesenchymal stem cells
- NAC, N-acetylcysteine
- NE, neutrophil elastase
- NETs, neutrophil extracellular traps
- NF-κB, nuclear factor-κB
- Nanomedicine
- PC, phosphatidylcholine
- PCB, poly(carboxybetaine)
- PDA, polydopamine
- PDE4, phosphodiesterase 4
- PECAM-1, platelet-endothelial cell adhesion molecule
- PEG, poly(ethylene glycol)
- PEI, polyetherimide
- PEVs, platelet-derived extracellular vesicles
- PLGA, poly(lactic-co-glycolic acid)
- PS-PEG, poly(styrene-b-ethylene glycol)
- Pathophysiologic feature
- RBC, red blood cells
- RBD, receptor-binding domains
- ROS, reactive oxygen species
- S1PLyase, sphingosine-1-phosphate lyase
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SDC1, syndecan-1
- SORT, selective organ targeting
- SP, surfactant protein
- Se, selenium
- Siglec, sialic acid-binding immunoglobulin-like lectin
- TLR, toll-like receptor
- TNF-α, tumor necrosis factor-α
- TPP, triphenylphosphonium cation
- Targeting strategy
- YSA, YSAYPDSVPMMS
- cRGD, cyclic arginine glycine-d-aspartic acid
- iNOS, inducible nitric oxide synthase
- rSPANb, anti-rat SP-A nanobody
- scFv, single chain variable fragments
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Lung Function, Radiological Findings and Biomarkers of Fibrogenesis in a Cohort of COVID-19 Patients Six Months After Hospital Discharge. Arch Bronconeumol 2021; 58:142-149. [PMID: 34497426 PMCID: PMC8414844 DOI: 10.1016/j.arbres.2021.08.014] [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: 08/03/2021] [Accepted: 08/13/2021] [Indexed: 02/09/2023]
Abstract
Introduction Impairment in pulmonary function tests and radiological abnormalities are a major concern in COVID-19 survivors. Our aim is to evaluate functional respiratory parameters, changes in chest CT, and correlation with peripheral blood biomarkers involved in lung fibrosis at two and six months after SARS-CoV-2 pneumonia. Methods COVID-FIBROTIC (clinicaltrials.gov NCT04409275) is a multicenter prospective observational cohort study aimed to evaluate discharged patients. Pulmonary function tests, circulating serum biomarkers, chest radiography and chest CT were performed at outpatient visits. Results In total, 313, aged 61.12 ± 12.26 years, out of 481 included patients were available. The proportion of patients with DLCO < 80% was 54.6% and 47% at 60 and 180 days. Associated factors with diffusion impairment at 6 months were female sex (OR: 2.97, 95%CI 1.74–5.06, p = 0.001), age (OR: 1.03, 95% CI: 1.01–1.05, p = 0.005), and peak RALE score (OR: 1.22, 95% CI 1.06–1.40, p = 0.005). Patients with altered lung diffusion showed higher levels of MMP-7 (11.54 ± 8.96 vs 6.71 ± 4.25, p = 0.001), and periostin (1.11 ± 0.07 vs 0.84 ± 0.40, p = 0.001). 226 patients underwent CT scan, of whom 149 (66%) had radiological sequelae of COVID-19. In severe patients, 68.35% had ground glass opacities and 38.46% had parenchymal bands. Early fibrotic changes were associated with higher levels of MMP7 (13.20 ± 9.20 vs 7.92 ± 6.32, p = 0.001), MMP1 (10.40 ± 8.21 vs 6.97 ± 8.89, p = 0.023), and periostin (1.36 ± 0.93 vs 0.87 ± 0.39, p = 0.001). Conclusion Almost half of patients with moderate or severe COVID-19 pneumonia had impaired pulmonary diffusion six months after discharge. Severe patients showed fibrotic lesions in CT scan and elevated serum biomarkers involved in pulmonary fibrosis.
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Key Words
- 6-MWT, 6 minute-walk test
- ARDS, acute respiratory distress syndrome
- BMI, body mass index
- COPD, chronic obstructive pulmonary disease
- COVID-19 sequelae
- COVID-19, coronavirus disease 2019
- CT, computed tomography
- Chest CT
- DLCO, diffusing capacity for carbon monoxide
- Fibrotic changes
- GGO, ground-glass opacity
- HFNC, high flow nasal cannula oxygen
- ILD, interstitial lung disease
- IMV, mechanical ventilation
- Interstitial lung disease
- Lung diffusion
- MMP, matrix metalloproteinases
- NIV, non-invasive ventilation
- RALE, radiographic assessment of lung edema
- RT-PCR, reverse transcriptase-polymerase chain reaction
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- Serum biomarkers
- VEGF, vascular endothelial growth factor
- mMRC, modified British Medical Research Council
- sEGFR, soluble epidermal growth factor receptor
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The potential of glycyrrhizin and licorice extract in combating COVID-19 and associated conditions. PHYTOMEDICINE PLUS : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 1:100043. [PMID: 35399823 PMCID: PMC7886629 DOI: 10.1016/j.phyplu.2021.100043] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 04/28/2023]
Abstract
BACKGROUND Several recent studies have stated that glycyrrhizin and licorice extract are present in most traditional Chinese medicine formulas used against SARS-CoV-2 in China. Significant data are showing that glycyrrhizin and licorice extract have multiple beneficial activities in combating most features of SARS-CoV-2. PURPOSE The aim of current review was to highlight recent progresses in research that showed the evidence of the potential use of glycyrrhizin and licorice extract against COVID-19. METHODOLOGY We have reviewed the information published from 1979 to October 2020. These studies demonstrated the effects , use and safety of glycyrrhizin and icorice extract against viral infections,bacterial infections, inflammatory disorders of lung ( in vitro and in vivo). These studies were collated through online electronic databases research (Academic libraries as PubMed, Scopus, Web of Science and Egyptian Knowledge Bank). RESULTS Pooled effect size of articles provides information about the rationale for using glycyrrhizin and licorice extract to treat COVID-19. Fifty studies demonstrate antiviral activity of glycyrrhizin and licorice extract. The most frequent mechanism of the antiviral activity is due to disrupting viral uptake into the host cells and disrupting the interaction between receptor- binding domain (RBD) of SARS-COV2 and ACE2 in recent articles. Fifty studies indicate that glycyrrhizin and licorice extract have significant antioxidant, anti-inflammatory and immunomodulatory effects. Twenty five studies provide evidence for the protective effect of glycyrrhizin and licorice extract against inflammation-induced acute lung injury and cardiovascular disorders. CONCLUSION The current study showed several evidence regarding the beneficial effects of glycyrrhizin and licorice extract in combating COVID-19. More randomized clinical trials are needed to obtain a precise conclusion.
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Key Words
- 18β-GA, 18β-glycyrrhetinic acid
- : ACE2, angiotensin-converting enzyme 2
- ALI, acute lung injury
- ARDS, acute Respiratory Distress Syndrome
- Acute lung injury protector
- COVID-19
- COVID-19, Coronavirus disease 2019
- COX-2, cyclooxygenase-2
- DCs, dendritic cells
- Gl, glycyrrhizin
- Glycyrrhizin and licorice extract;Antiviral and antimicrobial, Anti-inflammatory and antioxidant
- HBsAg, hepatitis B surface antigen
- HCV, hepatitis C virus
- HMGB1, high-mobility group box 1
- IL, interleukin
- Immunododulator
- MAPKs, mitogen-activated protein kinases
- MERS, Middle East respiratory syndrome
- MR, mineralocorticoid receptor
- MRSA, Methicillin-resistant Staphylococcus aureus
- NO, nitric oxide
- RBD, receptor-binding domain
- ROS, reactive oxygen species
- S, Spike
- SARS, severe acute respiratory syndrome
- TCM, traditional Chinese medicine
- TLR, toll-like receptor
- TMPRSS2, type 2 transmembrane serine protease
- TNF-α, tumor necrosis factor alpha
- h, hour
- iNOS, inducible nitric oxide synthase
- licorice extract, LE
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Comparative and quantitative analysis of COVID-19 epidemic interventions in Chinese provinces. RESULTS IN PHYSICS 2021; 25:104305. [PMID: 34002128 PMCID: PMC8117536 DOI: 10.1016/j.rinp.2021.104305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
A mathematical model was developed to evaluate and compare the effects and intensity of the coronavirus disease 2019 prevention and control measures in Chinese provinces. The time course of the disease with government intervention was described using a dynamic model. The estimated government intervention parameters and area difference between with and without intervention were considered as the intervention intensity and effect, respectively. The model of the disease time course without government intervention predicted that by April 30, 2020, about 3.08% of the population would have been diagnosed with coronavirus disease 2019 in China. Guangdong Province averted the most cases. Comprehensive intervention measures, in which social distancing measures may have played a greater role than isolation measures, resulted in reduced infection cases. Shanghai had the highest intervention intensity. In the context of the global coronavirus disease 2019 pandemic, the prevention and control experience of some key areas in China (such as Shanghai and Guangdong) can provide references for outbreak control in many countries.
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Improvement in Walking Distance Lags Raise in Lung Function in Post-COVID Patients. Arch Bronconeumol 2021; 58:261-263. [PMID: 34054195 PMCID: PMC8150358 DOI: 10.1016/j.arbres.2021.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022]
Key Words
- 6-MWD, 6-minute walk distance
- 6-MWT, 6-minute walk test
- COVID-19, coronavirus disease-2019
- DLCO, diffusing lung capacity for carbon monoxide
- FEV1, forced expiratory volume in the first second
- FT, pulmonary function tests
- FVC, forced vital capacity
- HHR, heart rate recovery
- IMV, invasive mechanical ventilation
- LLN, lower limit of normal
- MEP, maximal expiratory pressure
- MERS, Middle East respiratory syndrome
- MIP, maximal inspiratory pressure
- SARS, severe acute respiratory syndrome
- SpO2, oxygen blood saturation measured by pulse oximeter
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Increased levels of ferritin on admission predicts intensive care unit mortality in patients with COVID-19. ACTA ACUST UNITED AC 2021; 156:324-331. [PMID: 33824908 PMCID: PMC8016043 DOI: 10.1016/j.medcle.2020.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/27/2020] [Indexed: 12/27/2022]
Abstract
Background The aim of this study was to evaluate hyperferritinemia could be a predicting factor of mortality in hospitalized patients with coronavirus disease-2019 (COVID-19). Methods A total of 100 hospitalized patients with COVID-19 in intensive care unit (ICU) were enrolled and classified into moderate (n = 17), severe (n = 40) and critical groups (n = 43). Clinical information and laboratory results were collected and the concentrations of ferritin were compared among different groups. The association between ferritin and mortality was evaluated by logistic regression analysis. Moreover, the efficiency of the predicting value was assessed using receiver operating characteristic (ROC) curve. Results The amount of ferritin was significantly higher in critical group compared with moderate and severe groups. The median of ferritin concentration was about three times higher in death group than survival group (1722.25 μg/L vs. 501.90 μg/L, p < 0.01). The concentration of ferritin was positively correlated with other inflammatory cytokines, such as interleukin (IL)-8, IL-10, C-reactive protein (CRP) and tumor necrosis factor (TNF)-α. Logistic regression analysis demonstrated that ferritin was an independent predictor of in-hospital mortality. Especially, high-ferritin group was associated with higher incidence of mortality, with adjusted odds ratio of 104.97 [95% confidence interval (CI) 2.63–4185.89; p = 0.013]. Moreover, ferritin had an advantage of discriminative capacity with the area under ROC (AUC) of 0.822 (95% CI 0.737–0.907) higher than procalcitonin and CRP. Conclusion The ferritin measured at admission may serve as an independent factor for predicting in-hospital mortality in patients with COVID-19 in ICU.
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Key Words
- ALT, alanine aminotransferase
- AOSD, adult-onset Still's disease
- APTT, activated partial thromboplastin time
- ARDS, acute respiratory distress syndrome
- AST, aspartate aminotransferase
- AUC, area under the curve
- BUN, urea nitrogen
- CAPS, catastrophic anti-phospholipid syndrome
- CHD, coronary heart diseases
- CK-MB, creatine kinase-MB
- COVID-19
- COVID-19, coronavirus disease-2019
- CRP, C-reactive protein
- DBP, diastolic pressure
- DM, diabetes mellitus
- Ferritin
- FiO2, fraction of inspired oxygen
- HP, hypertension
- HR, heart rate
- Hs-TnI, high sensitive troponin I
- ICU, intensive care unit
- IL, interleukin
- INR, international normalized ratio
- IQR, interquartile range
- Inflammation markers
- MAS, macrophage activation syndrome
- MERS, Middle East respiratory syndrome
- MOF, multiple organ failure
- MV, mechanical ventilation
- Mortality
- NT-proBNP, N-terminal pro-B-type natriuretic peptide
- PCT, procalcitonin
- PT, prothrombin time
- PTA, prothrombin activity
- PaO2, partial pressure of arterial oxygen
- RBC, red blood cells
- ROC, receiver operating characteristic
- RR, respiration rate
- RT-PCR, reverse transcription-polymerase chain reaction
- SARS, severe acute respiratory syndrome
- SARS-CoV-2
- SBP, systolic blood pressure
- SpO2, percutaneous oxygen saturation
- TNF, tumor necrosis factor
- TT, plasma thrombin time
- WBC, white blood cells
- eGFR, ovulated glomerular filtration rate
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Psychological impact of the COVID-19 pandemic on patients with allergic diseases. World Allergy Organ J 2021; 14:100510. [PMID: 33520081 PMCID: PMC7826023 DOI: 10.1016/j.waojou.2021.100510] [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: 07/15/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND On March 2020, World Health Organization (WHO) declared COVID-19 to be a pandemic disease. Interactions between allergy-related inflammatory and psychiatric disorders including depression, anxiety, and post-traumatic stress disorder (PTSD) have been documented. Therefore, those who have pre-existing allergic conditions may have an increased psychiatric reaction to the stresses of the COVID-19 pandemic. OBJECTIVE Identify the psychological impact of COVID-19 in patients with allergic diseases and determine if these individuals have a greater risk of presenting with post-traumatic stress disorder (PTSD). METHODS It is a cross-sectional, survey-based study designed to assess the degree of symptoms of depression and the risk of PTSD using the Patient Health Questionnaire (PHQ-9) and the Impact of Event Scale-Revised (IES-R), respectively, in allergic patients. RESULTS A total of 4106 surveys were evaluated; 1656 (40.3%) were patients with allergic disease, and 2450 (59.7%) were non-allergic (control) individuals. Of those with allergies, 76.6% had respiratory allergic disease including asthma and allergic rhinitis. Individuals with allergic disease reported higher scores regarding symptoms of PTSD on the IES-R scale (p = 0.052, OR 1.24 CI 0.99-1.55) as well as a higher depression risk score in the PHQ-9 questionnaire (mean 6.82 vs. 5.28) p = 0.000 z = -8.76.The allergy group presented a higher score in the IES-R questionnaire (mean 25.42 vs. 20.59), being more susceptible to presenting PTSD (p = 0.000, z = -7.774).The individuals with allergic conditions were further divided into subgroups of those with respiratory allergies such as allergic rhinitis and asthma vs those with non-respiratory allergies such as drug and food allergy, urticaria and atopic dermatitis. This subgroup analysis compares respiratory versus non-respiratory allergic patients, with similar results on the IES-R (mean 25.87 vs 23.9) p = 0.0124, z = -1.539. There was no significant difference on intrusion (p = 0.061, z = -1.873) and avoidance (p = 0.767, z = -0.297), but in the hyperarousal subscale, patients with respiratory allergy had higher scores (mean 1.15 vs. 0.99) p = 0.013 z = -2.486. CONCLUSIONS Psychological consequences such as depression and reported PTSD are present during the COVID-19 pandemic causing an impact particularly in individuals with allergic diseases. If we acknowledge the impact and how it is affecting our patients, we are able to implement interventions, follow up, and contribute to their overall well-being.
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Key Words
- Allergic
- COVID 19, coronavirus disease 2019
- COVID-19
- CoV-2, coronavirus 2
- DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, fourth edition
- IFN-g, interferon gamma
- IL-1, interleukin 1
- IL-4, interleukin 4
- IL-6, interleukin 6
- Impact
- NK cells, natural killer cells
- OR, odds ratio
- Psychologic
- SARS, severe acute respiratory syndrome
- TNF- α, tumoral necrosis factor alfa
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Nitric oxide and viral infection: Recent developments in antiviral therapies and platforms. APPLIED MATERIALS TODAY 2021; 22:100887. [PMID: 38620577 PMCID: PMC7718584 DOI: 10.1016/j.apmt.2020.100887] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 05/09/2023]
Abstract
Nitric oxide (NO) is a gasotransmitter of great significance to developing the innate immune response to many bacterial and viral infections, while also modulating vascular physiology. The generation of NO from the upregulation of endogenous nitric oxide synthases serves as an efficacious method for inhibiting viral replication in host defense and warrants investigation for the development of antiviral therapeutics. With increased incidence of global pandemics concerning several respiratory-based viral infections, it is necessary to develop broad therapeutic platforms for inhibiting viral replication and enabling more efficient host clearance, as well as to fabricate new materials for deterring viral transmission from medical devices. Recent developments in creating stabilized NO donor compounds and their incorporation into macromolecular scaffolds and polymeric substrates has created a new paradigm for developing NO-based therapeutics for long-term NO release in applications for bactericidal and blood-contacting surfaces. Despite this abundance of research, there has been little consideration of NO-releasing scaffolds and substrates for reducing passive transmission of viral infections or for treating several respiratory viral infections. The aim of this review is to highlight the recent advances in developing gaseous NO, NO prodrugs, and NO donor compounds for antiviral therapies; discuss the limitations of NO as an antiviral agent; and outline future prospects for guiding materials design of a next generation of NO-releasing antiviral platforms.
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Key Words
- ACE, angiotensin converting enzyme
- AP1, activator protein 1
- COVID-19
- COVID-19, coronavirus disease 2019
- ECMO, extracorporeal membrane oxygenation, FDA, United States Food and Drug Administration
- GNSO, S-nitrosoglutathione
- H1N1, influenza A virus subtype H1N1
- HI, Host Immunology
- HIV, human immunodeficiency virus
- HPV, human papillomavirus
- HSV, herpes simplex virus
- I/R, pulmonary ischemia-reperfusion
- IC50, inhibitory concentration 50
- IFN, interferon
- IFNγ, interferon gamma
- IKK, inhibitor of nuclear factor kappa B kinase
- IRF-1, interferon regulatory factor 1
- Inhalation therapy
- Medical Terminology: ARDS, acute respiratory distress syndrome
- NF-κB, nuclear factor kappa-light-chain enhancer of activated B cells
- NO, nitric oxide
- NOS, nitric oxide synthase
- Nitric Oxide and Related Compounds: eNOS/NOS 3, endothelial nitric oxide synthase
- Nitric oxide
- Other: DNA, deoxyribonucleic acid
- P38-MAPK, P38 mitogen-activated protein kinases
- PAMP, pathogen-associated molecular pattern
- PCV2, porcine circovirus type 2
- PHT, pulmonary hypertension
- PKR, protein kinase R
- RNA, ribonucleic acid
- RNI, reactive nitrogen intermediate
- RSNO, S-nitrosothiol
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SNAP, S-nitroso-N-acetyl-penicillamine
- STAT-1, signal transducer and activator of transcription 1
- Severe acute respiratory distress
- TAK1, transforming growth factor β-activated kinases-1
- TLR, toll-like receptor
- VAP, ventilator associated pneumonia
- Viral infection
- Viruses: CVB3, coxsackievirus
- dsRNA, double stranded (viral) ribonucleic acid
- gNO, gaseous nitric oxide
- iNOS/NOS 2, inducible nitric oxide synthase
- mtALDH, mitochondrial aldehyde dehydrogenase
- nNOS/NOS 1, neuronal nitric oxide synthase
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SARS-CoV-2 spillover transmission due to recombination event. GENE REPORTS 2021; 23:101045. [PMID: 33615041 PMCID: PMC7884226 DOI: 10.1016/j.genrep.2021.101045] [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: 11/20/2020] [Revised: 01/21/2021] [Accepted: 01/31/2021] [Indexed: 01/08/2023]
Abstract
In late 2019, a novel Coronavirus emerged in China. Perceiving the modulating factors of cross-species virus transmission is critical to elucidate the nature of virus emergence. Using bioinformatics tools, we analyzed the mapping of the SARS-CoV-2 genome, modeling of protein structure, and analyze the evolutionary origin of SARS-CoV-2, as well as potential recombination events. Phylogenetic tree analysis shows that SARS-CoV-2 has the closest evolutionary relationship with Bat-SL-CoV-2 (RaTG13) at the scale of the complete virus genome, and less similarity to Pangolin-CoV. However, the Receptor Binding Domain (RBD) of SARS-CoV-2 is almost identical to Pangolin-CoV at the aa level, suggesting that spillover transmission probably occurred directly from pangolins, but not bats. Further recombination analysis revealed the pathway for spillover transmission from Bat-SL-CoV-2 and Pangolin-CoV. Here, we provide evidence for recombination event between Bat-SL-CoV-2 and Pangolin-CoV that resulted in the emergence of SARS-CoV-2. Nevertheless, the role of mutations should be noted as another influencing factor in the continuing evolution and resurgence of novel SARS-CoV-2 variants.
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Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19. IJC HEART & VASCULATURE 2021; 32:100719. [PMID: 33521240 PMCID: PMC7830223 DOI: 10.1016/j.ijcha.2021.100719] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 12/15/2022]
Abstract
Background The incidence of acute cardiac injury in COVID-19 patients is very often subclinical and can be detected by cardiac magnetic resonance imaging. The aim of this study was to assess if subclinical myocardial dysfunction could be identified using left ventricular global longitudinal strain (LV-GLS) in patients hospitalized with COVID-19. Methods We performed a search of COVID-19 patients admitted to our institution from January 1st, 2020 to June 8th, 2020, which revealed 589 patients (mean age = 66 ± 18, male = 56%). All available 60 transthoracic echocardiograms (TTE) were reviewed and off-line assessment of LV-GLS was performed in 40 studies that had sufficient quality images and the views required to calculate LV-GLS. We also analyzed electrocardiograms and laboratory findings including inflammatory markers, Troponin-I, and B-type natriuretic peptide (BNP). Results Of 589 patients admitted with COVID-19 during our study period, 60 (10.1%) underwent TTE during hospitalization. Findings consistent with overt myocardial involvement included reduced ejection fraction (23%), wall motion abnormalities (22%), low stroke volume (82%) and increased LV wall thickness (45%). LV-GLS analysis was available for 40 patients and was abnormal in 32 patients (80%). All patients with LV dysfunction had elevated cardiac enzymes and positive inflammatory biomarkers. Conclusions Subclinical myocardial dysfunction as measured via reduced LV-GLS is frequent, occurring in 80% of patients hospitalized with COVID-19, while prevalent LV function parameters such as reduced EF and wall motion abnormalities were less frequent findings. The mechanism of cardiac injury in COVID-19 infection is the subject of ongoing research.
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Key Words
- AV, atrioventricular
- BNP, B-type natriuretic peptide
- CMRI, cardiac magnetic resonance imaging
- COPD, chronic obstructive pulmonary disease
- COVID-19
- COVID-19, coronavirus disease 2019
- CRP, C-reactive protein
- ECG, electrocardiogram
- Echocardiography
- Global longitudinal strain
- HTN, hypertension
- ICU, intensive care unit
- IL-6, interleukin-6
- LA, left atrium
- LDH, lactate dehydrogenase
- LV, left ventricle
- LV-GLS, left ventricular global longitudinal strain
- LVEF, left ventricular ejection fraction
- LVOT, left ventricular outflow tract
- RV, right ventricle
- SARS, severe acute respiratory syndrome
- T2DM, type-2 diabetes mellitus
- TAPSE, tricuspid annular plane systolic excursion
- TTE, transthoracic echocardiogram
- VTI, velocity-time integral
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Abstract
Objective The objective of this report is to highlight the possible but little-known association between coronavirus disease 2019 (COVID-19) and delayed onset of central hypocortisolism, which may be of significant clinical importance. Methods We describe a patient who developed new-onset central hypocortisolism in the convalescent phase of mild COVID-19, which has not been previously reported. Results A 47-year-old man with recent COVID-19 upper respiratory tract infection developed new-onset persistent dyspepsia and eosinophilia for which multiple investigations were normal. He was eventually diagnosed with central hypocortisolism, as evidenced by 8 AM cortisol level of 19 nmol/L (normal, 133-537 nmol/L) and adrenocorticotropic hormone of 7.1 ng/mL (normal, 10.0-60.0 ng/mL). He was started on hydrocortisone, which led to resolution of both dyspepsia and eosinophilia. At the same time, an interesting thyroid function trend was observed—an initial increase in both free thyroxine and thyroid stimulating hormone was followed by temporary central hypothyroidism before subsequent spontaneous recovery. On follow-up 3 weeks later, the patient remained hypocortisolemic. Conclusion COVID-19 may be associated with the delayed onset of central hypocortisolism in its convalescent phase. Although various mechanisms are possible, hypothalamic-pituitary activation during systemic illness, followed by a rebound decrease in activity after recovery, is consistent with the clinical course and thyroid function trend in this patient. It is essential that physicians consider endocrinopathies in the differential diagnosis of such cases, given the risk of life-threatening adrenal crises and their possible contribution to persistent symptoms following recovery from COVID-19.
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Abstract
The novel severe acute respiratory syndrome coronavirus 2, the causal agent of coronavirus disease 2019 (COVID-19), quickly spread around the world, resulting in the most aggressive pandemic experienced in more than 100 years. Research on targeted therapies and vaccines has been initiated on an unprecedented scale and speed but will take months and even years to come to fruition. Meanwhile, the efficacy of emerging therapeutics for use in treating COVID-19 is feverishly being investigated to identify the best available treatment options for dealing with the current wave of disease. This review of publications with a "treatment" tag through June 29, 2020 in the National Library of Medicine's LitCovid literature hub, provides frontline clinicians with a pragmatic summary of the current state of the rapidly evolving evidence supporting emerging candidate therapeutics for COVID-19. Two main categories of pharmaceutical therapeutics are showing promise: those with antiviral activity directly addressing infection and those that counteract the inflammatory cytokine storm induced by severe disease. Preliminary results suggest that other approaches such as convalescent plasma therapy and lung radiation therapy may have some efficacy. The current clinical evidence for potential treatments is preliminary-often small retrospective series or early results of randomized trials-and the science is evolving rapidly. The long-term results from large, well-designed randomized controlled trials will provide definitive evidence for therapeutic effectiveness and are likely months away. The trial landscape for promising therapies is described.
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Key Words
- COVID-19, coronavirus disease 2019
- CPT, convalescent plasma therapy
- CQ, chloroquine
- EC50, half-maximal effective concentration
- HCQ, hydroxychloroquine
- ICU, intensive care unit
- IL-6, interleukin 6
- JAK, Janus kinase
- LPV/RTV, lopinavir/ritonavir
- MERS, Middle East respiratory syndrome
- RCT, randomized controlled trial
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- WHO, World Health Organization
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Stay Connected and Up To Date: GI Meetings and Seminars and the Coronavirus Disease 2019 Pandemic. TECHNIQUES AND INNOVATIONS IN GASTROINTESTINAL ENDOSCOPY 2020; 23:207-211. [PMID: 33225320 PMCID: PMC7671932 DOI: 10.1016/j.tige.2020.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The novel coronavirus disease 2019 has become an unprecedented global health and societal problem. The rapid spreading of this pandemic, together with the absence of effective treatments or vaccines, has led governments around the world to take drastic actions, including limiting the free movement of citizens, establishing maximum capacities and enforcing social distancing measures, among others. Consequently, major medical congresses, meetings, conferences, and workshops have been either cancelled or delayed. This situation has forced rapid changes in how the medical and scientific communities interact, and they now mainly meet using online technology. While political leaders have closed the borders of their countries as a logical public health measure, we have witnessed medical societies, clinicians, and scientists breaking other barriers and creating a new reality of global technological collaboration unlike anything seen before. An immense variety of webinars, online conferences, podcasts, courses, and many other forms of uploaded content can be seen from the comfort of one's own workplace or home at any time, and this has exponentially increased our reach; however, this great number of possibilities can be overwhelming, and it is more important than ever to separate wheat from chaff when deciding what online event to attend. The purpose of this article is to describe the impact of coronavirus disease 2019 on congresses and meetings, to examine how GI physicians feel about the emerging trend of online initiatives and to offer suggestions on how to balance web-based meetings and daily work.
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Key Words
- AGA, American Gastroenterological Association
- COVID-19
- COVID-19, coronavirus disease 2019
- DDW, Digestive Disease Week
- ESD, endoscopic submucosal dissection
- ESGE, European Society of Gastrointestinal Endoscopy
- GI, GastroIntestinal
- KOL, key opinion leaders
- Live event
- SARS, severe acute respiratory syndrome
- SARS-CoV-2
- Streaming
- UEGW, United European Gastroenterology Week
- WHO, World Health Organization
- Webinar
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The COVID-19 pandemic - from great challenge to unique opportunity: Perspective ☆. Ann Med Surg (Lond) 2020; 59:68-71. [PMID: 32904485 PMCID: PMC7455173 DOI: 10.1016/j.amsu.2020.08.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 12/13/2022] Open
Abstract
The 2019 novel coronavirus (SARS-CoV-2) and the disease it causes - coronavirus disease 2019 (COVID-19) have rapidly swept across the world since the first known human manifestation on December 8, 2019 in Wuhan (Hubei Province, China)1,2. The epidemic of the COVID-19 has presented as a grim and complex situation, causing great impact on economy and society, and seriously interfering with ordinary medical practice, threatening to exceed healthcare capacity in many countries over the globe. With no doubt, dealing with the COVID-19 has caused great social and medical crisis that presented great challenges to the medical and healthcare society, forcing it to face unprecedented times, and to reconceptualize how to provide quality health care while enforcing public health measures necessary for pandemic containment and optimal allocation of healthcare resources. However, along with this unparalleled time challenges, came great opportunities for changes and improvements, for innovations and creative solutions, some of which should be adopted and incorporated to the daily medical practices and social routine, even in the post-COVID-19 pandemic era.
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COVID-19 pneumonia complicated by bilateral pneumothorax: A case report. Respir Med Case Rep 2020; 31:101230. [PMID: 32999855 PMCID: PMC7515586 DOI: 10.1016/j.rmcr.2020.101230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/20/2020] [Indexed: 01/27/2023] Open
Abstract
Background Pneumothorax is a rare but life-threatening complication associated with pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Case presentation Informed consent was obtained from the patient himself.A 50-year-old man presented with a 9-day history of fever, cough, and dyspnoea. He was diagnosed with coronavirus disease 2019 (COVID-19) pneumonia and was admitted to the Medical Hospital, Tokyo Medical and Dental University. Chest CT showed diffuse patchy ground-glass opacities (GGOs). His state of oxygenation deteriorated, and mechanical ventilation was initiated on day 4 after admission (12th day from onset). He improved gradually and was weaned from ventilation on day 15. Sudden onset of bilateral pneumothorax occurred on day 21 with severe respiratory failure, and chest CT revealed pneumatocele formation on both lower lobes. Conclusions Pneumothorax is a notable complication in cases of severe COVID-19 pneumonia, especially in those who require positive-pressure ventilation.
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Potential mechanisms of Chinese Herbal Medicine that implicated in the treatment of COVID-19 related renal injury. Saudi Pharm J 2020; 28:1138-1148. [PMID: 32837217 PMCID: PMC7416081 DOI: 10.1016/j.jsps.2020.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023] Open
Abstract
Clinical studies have shown that renal injury in Corona Virus Disease 2019 (COVID-19) patients has been a real concern, which is associated with high mortality and an inflammation/apoptosis-related causality. Effective target therapy for renal injury has yet been developed. Besides, potential anti-COVID-19 medicines have also been reported to cause adverse side effects to kidney. Chinese Herbal Medicine (CHM), however, has rich experience in treating renal injury and has successfully applied in China in the battle of COVID-19. Nevertheless, the molecular mechanisms of CHM treatment are still unclear. In this study, we searched prescriptions in the treatment of renal injury extensively and the potential mechanisms to treat COVID-19 related renal injury were investigated. The association rules analysis showed that the core herbs includes Huang Qi, Fu Ling, Bai Zhu, Di Huang, Shan Yao. TCM herbs regulate core pathways, such as AGE-RAGE, PI3K-AKT, TNF and apoptosis pathway, etc. The ingredients (quercetin, formononetin, kaempferol, etc.,) from core herbs could modulate targets (PTGS2 (COX2), PTGS1 (COX1), IL6, CASP3, NOS2, and TNF, etc.), and thereby prevent the pharmacological and non-pharmacological renal injury comparable to that from COVID-19 infection. This study provides therapeutic potentials of CHM to combat COVID-19 related renal injury to reduce complications and mortality.
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Key Words
- AGE, Advanced Glycation End products
- AKT, Protein Kinase B
- Association rules
- CHM, Chinese Herbal medicine
- CNKI, China National Knowledge Infrastructure
- COVID-19
- COVID-19, Corona Virus Disease 2019
- CRRT, continuous renal replacement therapy
- Chinese Herbal Medicine
- IL6, interleukin 6
- KEGG, Kyoto Encyclopedia of Genes and Genomes
- MERS, Middle East respiratory syndrome
- NCBI, National Coalition Building Institute
- NHC, National Health Commission
- NOS2, Nitric Oxide synthase
- Network pharmacology
- PI3K, Phosphatidylinositol 3-kinase
- PPI, protein–protein interaction
- PTGS1, Prostaglandin G/H synthase 1
- PTGS2, Prostaglandin G/H synthase 2
- RAGE, Receptor of Advanced Glycation End products
- Renal/kidney injury
- SARS, severe acute respiratory syndrome
- TCMSP, Traditional Chinese Medicine Systems Pharmacology
- TNF, Tumor Necrosis Factor
- Traditional Chinese Medicine
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Vanadium: Risks and possible benefits in the light of a comprehensive overview of its pharmacotoxicological mechanisms and multi-applications with a summary of further research trends. J Trace Elem Med Biol 2020; 61:126508. [PMID: 32305626 PMCID: PMC7152879 DOI: 10.1016/j.jtemb.2020.126508] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/25/2020] [Accepted: 03/19/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Vanadium (V) is an element with a wide range of effects on the mammalian organism. The ability of this metal to form organometallic compounds has contributed to the increase in the number of studies on the multidirectional biological activity of its various organic complexes in view of their application in medicine. OBJECTIVE This review aims at summarizing the current state of knowledge of the pharmacological potential of V and the mechanisms underlying its anti-viral, anti-bacterial, anti-parasitic, anti-fungal, anti-cancer, anti-diabetic, anti-hypercholesterolemic, cardioprotective, and neuroprotective activity as well as the mechanisms of appetite regulation related to the possibility of using this element in the treatment of obesity. The toxicological potential of V and the mechanisms of its toxic action, which have not been sufficiently recognized yet, as well as key information about the essentiality of this metal, its physiological role, and metabolism with certain aspects on the timeline is collected as well. The report also aims to review the use of V in the implantology and industrial sectors emphasizing the human health hazard as well as collect data on the directions of further research on V and its interactions with Mg along with their character. RESULTS AND CONCLUSIONS Multidirectional studies on V have shown that further analyses are still required for this element to be used as a metallodrug in the fight against certain life-threatening diseases. Studies on interactions of V with Mg, which showed that both elements are able to modulate the response in an interactive manner are needed as well, as the results of such investigations may help not only in recognizing new markers of V toxicity and clarify the underlying interactive mechanism between them, thus improving the medical application of the metals against modern-age diseases, but also they may help in development of principles of effective protection of humans against environmental/occupational V exposure.
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Key Words
- 3-HMG-CoA, 3-hydroxy-3-methyl-glutaryl-CoA
- AIDS, acquired immune deficiency syndrome
- ALB, albumin
- ALP, alkaline phosphatase
- AS, antioxidant status
- Akt, protein kinase B (PKB)
- AmD, Assoc American Dietetic Association
- Anti-B, anti-bacterial
- Anti-C, anti-cancer
- Anti-D, anti-diabetic
- Anti-F, anti-fungal
- Anti-O, anti-obesity
- Anti-P, anti-parasitic
- Anti-V, anti-viral
- Anti−HC, anti-hypercholesterolemic
- ApoA-I, apolipoprotein A
- ApoB, apolipoprotein B
- B, bone
- BCOV, bis(curcumino)oxavanadyl
- BEOV, bis(ethylmaltolato)oxovanadium
- BMOV, bis(maltolato)oxavanadium(IV)
- Bim, Blc-2 interacting mediator of cell death
- Biological role
- BrOP, bromoperoxidase
- C, cholesterol
- C/EBPα, CCAAT-enhancer-binding protein α
- CD4, CD4 receptor
- CH, cerebral hemisphere
- CHO-K1, Chinese hamster ovary cells
- CXCR-4, CXCR-4 chemokine co-receptor
- Cardio-P, cardioprotective
- Citrate-T, citrate transporter
- CoA, coenzyme A
- Cyt c, cytochrome c
- DM, diabetes mellitus
- ELI, extra low interstitial
- ERK, extracellular regulated kinase
- FHR, fructose hypertensive rats
- FKHR/FKHR1/AFX, class O members of the forkhead transcription factor family
- FLIP, FLICE-inhibitory protein
- FOXOs, forkhead box class O family member proteins
- FPP, farnesyl-pyrophosphate
- FasL, Fas ligand, FER: ferritin
- GI, gastrointestinal
- GLU, glucose
- GLUT-4, glucose transporter type 4
- GPP, geranyl-pyrophosphate
- GPT, glutamate-pyruvate transaminase
- GR, glutathione reductase
- GSH, reduced glutathione
- GSSG, disulfide glutathione
- HDL, high-density lipoproteins
- HDL-C, HDL cholesterol
- HIV, human immunodeficiency virus
- HMMF, high molecular mass fraction
- HOMA-IR, insulin resistance index
- Hb, hemoglobin
- HbF, hemoglobin fraction
- Hyper-LEP, hyperleptynemia
- IDDM, insulin-dependent diabetes mellitus
- IGF-IR, insulin-like growth factor receptor
- IL, interleukin
- INS, insulin
- INS-R, insulin resistance
- INS-S, insulin sensitivity
- IPP, isopentenyl-5-pyrophosphate
- IRS, insulin receptor tyrosine kinase substrate
- IgG, immunoglobulin G
- Industrial importance
- Interactions
- JAK2, Janus kinase 2
- K, kidney
- L, liver
- L-AA, L-ascorbic acid
- LDL, low-density lipoproteins
- LDL-C, LDL cholesterol
- LEP, leptin
- LEP-R, leptin resistance
- LEP-S, leptin sensitivity
- LEPS, the concentration of leptin in the serum
- LMMF, low molecular mass fraction
- LPL, lipoprotein lipase
- LPO, lipid peroxidation
- Lactate-T, lactate transporter
- M, mitochondrion
- MEK, ERK kinase activator
- MRC, mitochondrial respiratory chain
- NAC, N-acetylcysteine
- NEP, neutral endopeptidase
- NIDDM, noninsulin-dependent diabetes mellitus
- NO, nitric oxide
- NPY, neuropeptide Y
- NaVO3, sodium metavanadate
- Neuro-P, neuroprotective
- OXPHOS, oxidative phosphorylation
- Organic-AT, organic anion transporter
- Over-W, over-weight
- P, plasma
- PANC-1, pancreatic ductal adenocarcinoma cells
- PARP, poly (ADP-ribose) polymerase
- PLGA, (Poly)Lactide-co-Glycolide copolymer
- PO43−, phosphate ion
- PPARγ, peroxisome-activated receptor γ
- PTK, tyrosine protein kinase
- PTP, protein tyrosine phosphatase
- PTP-1B, protein tyrosine phosphatase 1B
- Pharmacological activity
- Pi3K, phosphoinositide 3-kinase (phosphatidylinositol 3-kinase)
- RBC, erythrocytes
- ROS, reactive oxygen species
- RT, reverse transcriptase
- SARS, severe acute respiratory syndrome
- SAcP, acid phosphatase secreted by Leshmania
- SC-Ti-6Al-4V, surface-coated Ti-6Al-4V
- SHR, spontaneously hypertensive rats
- SOD, superoxide dismutase
- STAT3, signal transducer/activator of transcription 3
- Sa, mean roughness
- Sq, root mean square roughness
- Sz, ten-point height
- TC, total cholesterol
- TG, triglycerides
- TS, transferrin saturation
- Tf, transferrin
- TfF, transferrin fraction
- TiO2, nHA:Ag-Ti-6Al-4V: titanium oxide-based coating containing hydroxyapatite nanoparticle and silver particles
- Top-IB, IB type topoisomerase
- Toxicological potential
- V, vanadium
- V-BrPO, vanadium bromoperoxidase
- V-DLC, diamond-like layer with vanadium
- V5+/V4+, pentavalent/tetravalent vanadium
- VO2+, vanadyl cation
- VO2+-FER, vanadyl-ferritin complex
- VO4-/VO3-, vanadate anion
- VO43-, vanadate ion
- VS, vanadyl sulfate
- Vanadium
- WB, whole blood
- ZDF rats, Zucker diabetic fatty rats
- ZF rats, Zucker fatty rats
- breakD, breakdown
- eNOS, endothelial nitric oxide synthase
- mo, months
- n-HA, nano-hydroxyapatite
- pRb, retinoblastoma protein
- wk, weeks
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Bioactive natural compounds against human coronaviruses: a review and perspective. Acta Pharm Sin B 2020; 10:1163-1174. [PMID: 32834947 PMCID: PMC7278644 DOI: 10.1016/j.apsb.2020.06.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 02/08/2023] Open
Abstract
Coronaviruses (CoVs), a family of enveloped positive-sense RNA viruses, are characterized by club-like spikes that project from their surface, unusually large RNA genome, and unique replication capability. CoVs are known to cause various potentially lethal human respiratory infectious diseases, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and the very recent coronavirus disease 2019 (COVID-19) outbreak. Unfortunately, neither drug nor vaccine has yet been approved to date to prevent and treat these diseases caused by CoVs. Therefore, effective prevention and treatment medications against human coronavirus are in urgent need. In the past decades, many natural compounds have been reported to possess multiple biological activities, including antiviral properties. In this article, we provided a comprehensive review on the natural compounds that interfere with the life cycles of SARS and MERS, and discussed their potential use for the treatment of COVID-19.
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Key Words
- 3CLpro, chymotrypsin-like protease
- ACE2, angiotensin-converting enzyme 2
- BALF, bronchoalveolar lavage fluid
- COVID-19
- COVID-19, coronavirus disease 2019
- CoVs, coronaviruses
- Coronavirus
- DAT, desaminotyrosine
- ER, endoplasmic reticulum
- ERGIC, endoplasmic reticulum–Golgi intermediate compartment
- HCoVs, human coronaviruses
- HLH, hemophagocytic lymphohistiocytosis
- HR, heptad repeats
- HSV, herpes simplex virus
- IL, interleukin
- LHQWC, Lian-Hua-Qing-Wen Capsule
- MAPK, mitogen-activated protein kinase
- MERS, Middle East respiratory syndrome
- MERS-CoV
- MERS-CoV, Middle East respiratory syndrome coronavirus
- N protein, nucleocapsid protein
- NCIP, novel coronavirus-infected pneumonia
- NF-κB, nuclear factor-κB
- Natural compounds
- PI3K, phosphoinositide 3-kinases
- PLpro, papain-like protease
- RNA-Virus
- RTC, replication transcription complex
- RdRp, RNA-dependent RNA polymerase
- S protein, spike protein
- SARS, severe acute respiratory syndrome
- SARS-CoV
- SARS-CoV, severe acute respiratory syndrome coronavirus
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- STAT, signal transducer and activator of transcription
- TCM, traditional Chinese medicine
- WHO, World Health Organization
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Review of chest CT manifestations of COVID-19 infection. Eur J Radiol Open 2020; 7:100239. [PMID: 32550256 PMCID: PMC7276000 DOI: 10.1016/j.ejro.2020.100239] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023] Open
Abstract
Coronavirus disease-19 (COVID-19) is a viral pandemic that started in China and has rapidly expanded worldwide. Typical clinical manifestations include fever, cough and dyspnea after an incubation period of 2-14 days. The diagnosis is based on RT-PCR test through a nasopharyngeal swab. Because of the pulmonary tropism of the virus, pneumonia is often encountered in symptomatic patients. Here, we review the pertinent clinical findings and the current published data describing chest CT findings in COVID-19 pneumonia, the diagnostic performance of CT for diagnosis, including differential diagnosis, as well the evolving role of imaging in this disease.
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Key Words
- ARDS, acute respiratory distress syndrome
- CAP, community-acquired pneumonia
- COVID-19
- COVID-19, coronavirus disease 2019
- CRP, C-Reactive Protein
- CT chest
- Coronavirus
- GGO, ground-glass opacity
- MERS, Middle East respiratory syndrome
- PUI, patient under investigation
- RT-PCR
- RT-PCR, reverse transcription polymerase chain reaction
- SARS, severe acute respiratory syndrome
- SARSCoV-2, severe acute respiratory syndrome coronavirus 2
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Abstract
Coronavirus disease -19 is a novel pandemic contagious respiratory infection that frequently presents with fever and dry cough. However, it can present with other rare symptoms. As this disease is a new disease, the full picture of the disease presentation is not yet clear, and it might present with symptoms and signs of other common diseases. Here, we report a 40 year old female who presented with acute onset nausea, vomiting, loss of appetite and vague abdominal pain as a clinical picture of appendicitis, but her CT abdomen image showed normal appendix, bilateral patchy peripheral lung basal consolidation, and ground-glass attenuation, so she was tested for coronavirus disease-19, which was positive.
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Neurological manifestations of COVID-19 and other coronaviruses: A systematic review. ACTA ACUST UNITED AC 2020; 37:27-32. [PMID: 32834527 PMCID: PMC7261450 DOI: 10.1016/j.npbr.2020.05.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/28/2020] [Indexed: 12/26/2022]
Abstract
COVID-19 is a common pathology that may affect diverse organs, including the central and peripheral nervous system. Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild to severe. CoV may affect any age group; the main symptoms are headache, dizziness, and altered consciousness. The neurological symptoms caused by CoV (MERS-CoV, SARS-CoV and SARS-CoV2) are similar.
Objective To describe the main neurological manifestations related to coronavirus infection in humans. Methodology A systematic review was conducted regarding clinical studies on cases that had neurological manifestations associated with COVID-19 and other coronaviruses. The search was carried out in the electronic databases PubMed, Scopus, Embase, and LILACS with the following keywords: “coronavirus” or “Sars-CoV-2” or “COVID-19” and “neurologic manifestations” or “neurological symptoms” or “meningitis” or “encephalitis” or “encephalopathy,” following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Seven studies were included. Neurological alterations after CoV infection may vary from 17.3% to 36.4% and, in the pediatric age range, encephalitis may be as frequent as respiratory disorders, affecting 11 % and 12 % of patients, respectively. The Investigation included 409 patients diagnosed with CoV infection who presented neurological symptoms, with median age range varying from 3 to 62 years. The main neurological alterations were headache (69; 16.8 %), dizziness (57, 13.9 %), altered consciousness (46; 11.2 %), vomiting (26; 6.3 %), epileptic crises (7; 1.7 %), neuralgia (5; 1.2 %), and ataxia (3; 0.7 %). The main presumed diagnoses were acute viral meningitis/encephalitis in 25 (6.1 %) patients, hypoxic encephalopathy in 23 (5.6 %) patients, acute cerebrovascular disease in 6 (1.4 %) patients, 1 (0.2 %) patient with possible acute disseminated encephalomyelitis, 1 (0.2 %) patient with acute necrotizing hemorrhagic encephalopathy, and 2 (1.4 %) patients with CoV related to Guillain-Barré syndrome. Conclusion Coronaviruses have important neurotropic potential and they cause neurological alterations that range from mild to severe. The main neurological manifestations found were headache, dizziness and altered consciousness.
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Key Words
- ACE2, angiotensin converting enzyme 2
- ADEM, acute disseminated encephalomyelitis
- ANHE, acute necrotizing hemorrhagic encephalopathy
- BBE, Bickerstaff’s encephalitis
- COVID-19
- COVID-19, coronavirus disease 2019
- CoV, coronavirus
- Coronavirus
- DPP4, dipeptidil peptidase 4
- Encephalopathy
- G-CSF, granulocyte colony stimulating factor (G-CSF)
- GBS, Guillain-Barré syndrome
- GM-CSF, granulocyte-macrophage colony-stimulating factor
- HCoV, Human coronavirus
- HCoV-229E, Human coronavirus 229E
- HCoV-OC43, Human coronavirus OC43
- ICU, intensive care unit
- IL, interleukin
- MCP-1, monocyte chemoattractant protein-1
- MERS, Middle East respiratory syndrome
- MERS-CoV, Middle East respiratory syndrome coronavirus
- Neurologic manifestations
- PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
- SARS, severe acute respiratory syndrome
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SARS‐CoV, severe acute respiratory syndrome coronavirus
- βCoV, betacoronavírus
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Abstract
There is a desperate search to discover effective therapies against coronavirus disease-2019 (COVID-19). Patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) comprise a unique population whose clinical course may provide insights into the effects of antiretroviral therapy on COVID-19. We describe the case of a patient with HIV/AIDS on left ventricular assist device support who was hospitalized and recovered from COVID-19. (Level of Difficulty: Intermediate.)
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Abstract
Asthma is increasingly recognized as an underlying risk factor for severe respiratory disease in patients with coronavirus disease 2019 (COVID-19), particularly in the United States. Here, we report the postmortem lung findings from a 37-year-old man with asthma, who met the clinical criteria for severe acute respiratory distress syndrome and died of COVID-19 less than 2 weeks after presentation to the hospital. His lungs showed mucus plugging and other histologic changes attributable to asthma, as well as early diffuse alveolar damage and a fibrinous pneumonia. The presence of diffuse alveolar damage is similar to descriptions of autopsy lung findings from patients with severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus, and the absence of a neutrophil-rich acute bronchopneumonia differs from the histologic changes typical of influenza. The relative contribution of mucus plugging to his hypoxemia is unknown.
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Vanadium: History, chemistry, interactions with α-amino acids and potential therapeutic applications. Coord Chem Rev 2018; 372:117-140. [PMID: 32226092 PMCID: PMC7094547 DOI: 10.1016/j.ccr.2018.06.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 06/03/2018] [Indexed: 12/11/2022]
Abstract
In the last 30 years, since the discovery that vanadium is a cofactor found in certain enzymes of tunicates and possibly in mammals, different vanadium-based drugs have been developed targeting to treat different pathologies. So far, the in vitro studies of the insulin mimetic, antitumor and antiparasitic activity of certain compounds of vanadium have resulted in a great boom of its inorganic and bioinorganic chemistry. Chemical speciation studies of vanadium with amino acids under controlled conditions or, even in blood plasma, are essential for the understanding of the biotransformation of e.g. vanadium antidiabetic complexes at the physiological level, providing clues of their mechanism of action. The present article carries out a bibliographical research emphaticizing the chemical speciation of the vanadium with different amino acids and reviewing also some other important aspects such as its chemistry and therapeutical applications of several vanadium complexes.
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Key Words
- 2,2′-bipy, 2,2-bipyridine
- 6-mepic, 6-methylpicolinic acid
- Ad, adenosine
- Ala, alanine
- Ala-Gly, alanylglycine
- Ala-His, alanylhistidine
- Ala-Ser, alanylserine
- Amino acids
- Antidiabetics
- Antitumors
- Asp, aspartic acid
- BEOV, bis(ethylmaltolate)oxovanadium(IV)
- Chemical speciation
- Cys, cysteine
- Cyt, citrate
- DMF, N,N-dimethylformamide
- DNA, deoxyribonucleic acid
- EPR, Electron Paramagnetic Resonance
- G, Gauss
- Glu, glutamic acid
- Gly, glycine
- GlyAla, glycylalanine
- GlyGly, glycylglycine
- GlyGlyCys, glycylglycylcysteine
- GlyGlyGly, glycylglycylglycine
- GlyGlyHis, glycylglycylhistidine
- GlyPhe, glycylphenylalanine
- GlyTyr, glycyltyrosine
- GlyVal, glycylvaline
- HIV, human immunodeficiency virus
- HSA, albumin
- Hb, hemoglobin
- His, histidine
- HisGlyGly, histidylglycylglycine
- Ig, immunoglobulins
- Im, imidazole
- L-Glu(γ)HXM, l-glutamic acid γ-monohydroxamate
- LD50, the amount of a toxic agent (such as a poison, virus, or radiation) that is sufficient to kill 50 percent of population of animals
- Lac, lactate
- MeCN, acetonitrile
- NADH and NAD+, nicotinamide adenine dinucleotide
- NEP, neutral endopeptidas
- NMR, Nuclear Magnetic Resonance
- Ox, oxalate
- PI3K, phosphoinositide 3-kinase
- PTP1B, protein tyrosine phosphatase 1B
- Pic, picolinic acid
- Pro, proline
- Pro-Ala, prolylalanine
- RNA, ribonucleic acid
- SARS, severe acute respiratory syndrome
- Sal-Ala, N-salicylidene-l-alaninate
- SalGly, salicylglycine
- SalGlyAla, salicylglycylalanine
- Ser, serine
- T, Tesla
- THF, tetrahydrofuran
- Thr, threonine
- VBPO, vanadium bromoperoxidases
- VanSer, Schiff base formed from o-vanillin and l-serine
- Vanadium complexes
- acac, acetylacetone
- dhp, 1,2-dimethyl-3-hydroxy-4(1H)-pyridinone
- dipic, dipicolinic acid
- dmpp, 1,2-dimethyl-3-hydroxy-4-pyridinonate
- hTf, transferring
- hpno, 2-hydroxypyridine-N-oxide
- l.m.m., low molecular mass
- mal, maltol
- py, pyridine
- sal-l-Phe, N-salicylidene-l-tryptophanate
- salGlyGly, N-salicylideneglycylglycinate
- salSer, N-salicylideneserinate
- salTrp, N-salicylidene-L tryptophanate
- salVal, N-salicylidene-l-valinate
- salophen, N,N′-bis(salicylidene)-o-phenylenediamine
- saltrp, N-salicylidene-l-tryptophanate
- γ-PGA, poly-γ-glutamic acid
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The application of self-assembled nanostructures in peptide-based subunit vaccine development. Eur Polym J 2017; 93:670-681. [PMID: 32226094 PMCID: PMC7094324 DOI: 10.1016/j.eurpolymj.2017.02.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/19/2017] [Accepted: 02/08/2017] [Indexed: 02/06/2023]
Abstract
Smaller polymer-peptide conjugates-based nanoparticles are often more immunogenic. Lipid-antigen conjugates-based nanoparticles can interact with immune receptors. Peptides with β-sheet conformation usually form nanofibers. α-Helical and random coil peptides tend to self-assemble into nanoparticles. Peptide-based nanostructures are usually poorer inducers of immune responses.
Peptide based-vaccines are becoming one of the most widely investigated prophylactic and therapeutic health care interventions against a variety of diseases, including cancer. However, the lack of a safe and highly efficient adjuvant (immune stimulant) is regarded as the biggest obstacle to vaccine development. The incorporation of a peptide antigen in a nanostructure-based delivery system was recently shown to overcome this obstacle. Nanostructures are often formed from antigens conjugated to molecules such as polymers, lipids, and peptide, with the help of self-assembly phenomenon. This review describes the application of self-assembly process for the production of peptide-based vaccine candidates and the ability of these nanostructures to stimulate humoral and cellular immune responses.
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Key Words
- (C18)2, N,N-dioctadecyl succinamic acid
- APC, antigen-presenting cell
- BMA, butyl methacrylate
- C16, 2-(R/S)-hexadecanoic acid
- CFA, complete Freund's adjuvant
- Conjugation
- CuAAC, copper-catalyzed azide-alkyne cycloaddition
- DLS, dynamic light scattering
- ELISA, enzyme-linked immunosorbent assay
- FDA, Food and Drug Administration
- GAS, group A streptococcus
- HCV, hepatitis C virus
- HIV, human immunodeficiency virus
- HPV, human papilloma virus
- IFA, incomplete Freund’s adjuvant
- IgG, immunoglobulin G
- LCP, lipid core peptide
- Lipopeptide
- Nanofiber
- Nanoparticle
- OVA, ovalbumin
- PADRE, pan DR epitope
- PBS, phosphate-buffered saline
- PDSMA, pyridyl disulfide methacrylamide
- PEG-PPS, poly(ethylene glycol)-stabilized poly(propylene sulfide) core nanoparticle
- Pam2Cys, dipalmitoyl-S-glyceryl cysteine
- Pam3Cys, tripalmitoyl-S-glyceryl cysteine
- PbCSP, Plasmodium berghei circumsporozoite protein
- Polymer
- SAP, self-assembling polypeptide
- SARS, severe acute respiratory syndrome
- Self-assembly
- T-VEC, talimogene laherparepvec
- TEM, transmission electron microscopy
- TLR2, toll-like receptor 2
- TLR4, toll-like receptor 4
- TLR9, toll-like receptor 9
- VLP, virus-like particle
- Vaccine
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Contact networks in the emergency department: Effects of time, environment, patient characteristics, and staff role. SOCIAL NETWORKS 2017; 48:181-191. [PMID: 32288125 PMCID: PMC7126867 DOI: 10.1016/j.socnet.2016.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Emergency departments play a critical role in the public health system, particularly in times of pandemic. Infectious patients presenting to emergency departments bring a risk of cross-infection to other patients and staff through close proximity interactions or contacts. To understand factors associated with cross-infection risk, we measured close proximity interactions of emergency department staff and patients by radiofrequency identification in a working emergency department. The number of contacts (degree) is not related to patient demographic characteristics. However, the amount of time in close proximity (weighted degree) of patients with ED personnel did differ, with black patients having approximately 15 min more contact with staff than non-white patients. Patients arriving by EMS had fewer contacts with other patients than patients arriving by other means. There are differences in the number of contacts based on staff role and arrival mode. When crowding is low, providers have the most contact time with patients, while administrative staff have the least. However, when crowding is high, this differential is reversed. The effect of arrival mode is modified by the extent of crowding. When crowding is low, patients arriving by EMS had longer contact with administrative staff, compared to patients arriving by other means. However, when crowding is high, patients arriving by EMS had less contact with administrative staff compared to patients arriving by other means. Our findings should help designers of emergency care focus on higher risk situations for transmission of dangerous pathogens in an emergency department. For instance, the effects of arrival and crowding should be considered as targets for engineering or architectural interventions that could artificially increase social distances.
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Key Words
- ED, emergency department
- EHR, electronic health record
- EMS, emergency medical services
- Emergency medicine
- GI, gastrointestinal
- Infectious disease
- PP, patient with patient
- PS, patient with staff
- RFID, radiofrequency identification
- RTLS, real time location sensing
- SARS, severe acute respiratory syndrome
- SP, staff with patient
- SS, staff with staff
- Social network
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Qingfei Xiaoyan Wan, a traditional Chinese medicine formula, ameliorates Pseudomonas aeruginosa-induced acute lung inflammation by regulation of PI3K/AKT and Ras/MAPK pathways. Acta Pharm Sin B 2016; 6:212-21. [PMID: 27175332 PMCID: PMC4856955 DOI: 10.1016/j.apsb.2016.03.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/04/2016] [Accepted: 02/22/2016] [Indexed: 12/27/2022] Open
Abstract
Gram-negative pathogen–induced nosocomial infections and resistance are a most serious menace to global public health. Qingfei Xiaoyan Wan (QF), a traditional Chinese medicine (TCM) formula, has been used clinically in China for the treatment of upper respiratory tract infections, acute or chronic bronchitis and pulmonary infection. In this study, the effects of QF on Pseudomonas aeruginosa–induced acute pneumonia in mice were evaluated. The mechanisms by which four typical anti-inflammatory ingredients from QF, arctigenin (ATG), cholic acid (CLA), chlorogenic acid (CGA) and sinapic acid (SPA), regulate anti-inflammatory signaling pathways and related targets were investigated using molecular biology and molecular docking techniques. The results showed that pretreatment with QF significantly inhibits the release of cytokines (TNF-α and IL-6) and chemokines (IL-8 and RANTES), reduces leukocytes recruitment into inflamed tissues and ameliorates pulmonary edema and necrosis. In addition, ATG was identified as the primary anti-inflammatory agent with action on the PI3K/AKT and Ras/MAPK pathways. CLA and CGA enhanced the actions of ATG and exhibited synergistic NF-κB inactivation effects possibly via the Ras/MAPK signaling pathway. Moreover, CLA is speculated to target FGFR and MEK firstly. Overall, QF regulated the PI3K/AKT and Ras/MAPK pathways to inhibit pathogenic bacterial infections effectively.
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Key Words
- ATG, arctigenin
- Anti-inflammatory
- CGA, chlorogenic acid
- CLA, cholic acid
- DMSO, dimethylsulfoxide
- Dex, dexamethasone
- ELISA, enzyme-linked immunosorbent assay
- ESI, electrospray ionization
- GA, genetic algorithm
- HE, hematoxylin and eosin
- KEGG, Kyoto Encyclopedia of Genes and Genomes
- LB, Luria–Bertani
- LEV, levofloxacin
- Lung
- MAPK, mitogen activated protein kinase
- Mouse
- NFATc1, nuclear factor of activated T cells c1
- Network pharmacology
- Ninj1, ninjurin1
- PBS, phosphate-buffered saline
- PI3K, phosphoinositide 3-kinase
- PI3K/AKT pathway
- Pathogenic bacterial infection
- QF, Qingfei Xiaoyan Wan
- Ras/MAPK pathway
- SARS, severe acute respiratory syndrome
- SPA, sinapic acid
- TCM, traditional Chinese medicine
- TTBS, Tween 20/Tris-buffered saline
- UPLC, ultra-performance liquid chromatography
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Detection of viral acute lower respiratory tract infection in hospitalized infants using real-time PCR. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2015; 64:13-19. [PMID: 32288487 PMCID: PMC7110902 DOI: 10.1016/j.epag.2015.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/28/2015] [Indexed: 11/05/2022] Open
Abstract
Introduction Acute lower respiratory tract infection in children causes significant morbidity in the developing countries. Documentation of virus infection using PCR and clinical characteristics of patients affected with viral pneumonia are reviewed in this study. Methods 51 children less than three years admitted to the Pediatric Hospital, Cairo University with viral pneumonia were included. All patients had undergone nasopharyngeal aspirate for PCR viral detection. Results A total of 51 cases were enrolled in the study, of which 7 cases were negative while 44 children were positive for viruses. The most common respiratory virus was Rhinovirus in 32 patients (72.2%), then parainfluenza virus (PIV) in 12 (27.3%), of which subtypes PIV1 were 2 (4.5%), PIV3 were 5 (11.4%) and PIV4 were 5 (11.4%) cases. The third common viruses were respiratory syncytial virus (RSV) in 9 (20.5%) cases of which 3 (6.8%) were RSVA and 6 (13.6%) were RSVB and adenovirus in 9 cases (20.5%). Boca virus was found in 8 (18.2%) patients, corona virus 2 (4.5%) patients, H1N1 2 (4.5%) patients, enterovirus 2 patients (4.5%) and human metapneumovirus in one case (2.3%). Influenza B and PIV2 were not detected. Coinfection was found in 28 (63.7%). Mortality occurred in 12 (23.5%). There was no significant relation between virus type or coinfection with disease severity. Conclusions RV was the most commonly detected virus in children under 3 years admitted with acute lower respiratory tract infections. Coinfection was present in the majority of our patients; however it was not related significantly to parameters of disease severity.
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Key Words
- ALRTI, acute lower respiratory tract infection
- Acute lower respiratory tract infection
- Ad, adenovirus
- CMTA, Catcher Melting Temperature Analysis
- CRP, C reactive protein
- CRX, chest X ray
- Infants
- PCR
- PIV, parainfluenza virus
- PaO2, partial pressure of oxygen
- RSV, respiratory syncytial virus
- RV, rhinovirus
- SARS, severe acute respiratory syndrome
- TLC, total leucocytic count
- Viral
- WHO, World Health Organization
- hMPV, human metapneumovirus
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The ventilation of multiple-bed hospital wards in the tropics: A review. BUILDING AND ENVIRONMENT 2011; 46:1125-1132. [PMID: 32288016 PMCID: PMC7116949 DOI: 10.1016/j.buildenv.2010.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/05/2010] [Accepted: 11/19/2010] [Indexed: 05/05/2023]
Abstract
Hospital and healthcare facilities have diverse indoor environment due to the different comfort and health needs of its occupants. Currently, most ventilation studies revolve around specialised areas such as operating rooms and isolation rooms. This paper focuses on the ventilation of multiple-bed hospital wards in the tropical climate, taking into account the design, indoor conditions and engineering controls. General ward layouts are described briefly. The required indoor conditions such as temperature, humidity, air movements and indoor air quality in the ward spaces are summarized based on the current guidelines and practices. Also, recent studies and engineering practices in the hospital indoor environment are elaborated. Usage of computational fluid dynamics tools for the ventilation studies is discussed as well. As identified during the review, there is an apparent knowledge gap for ventilation studies in the tropics compared with temperate climates, as fact studies have only been published for hospital wards in countries with a temperate climate. Therefore, it is highlighted that specific tropical studies along with novel engineering controls are required in addressing the ventilation requirements for the tropics.
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Key Words
- ACH, air changes per hour
- ASHRAE, American society of heating, refrigerating and air-conditioning engineers
- CDC, centers for disease control
- CFD, computational fluid dynamic
- Engineering control
- HCW, healthcare workers
- HEPA, high efficiency particulate air
- HICPAC, healthcare infection control practices advisory committee
- Hospital wards
- IAQ, indoor air quality
- Indoor air quality
- MRSA, methicillin-resistant Staphylococcus aureus
- Numerical method
- RANS, Reynolds averaged Navier–Stokes
- RNG, re-normalisation group
- SARS, severe acute respiratory syndrome
- SBS, sick building syndrome
- Tropical climates
- UV, ultraviolet
- UVGI, ultraviolet germicidal irradiation
- WHO, World Health Organization
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Abstract
(1) Seroepidemiological analysis of influenza pandemics (1986-2003) in Shizuoka Prefecture and all Japan revealed differences in geographical, annual, seasonal, and age distributions. (2) For 17 years, the pandemics generally began at the 50th week every year showing over 1.0 patient/clinic, reached the peak at 5th week the following year, and ended over 10-15th week. Two big A/H3N2 pandemics were seen in 1989/1990 and 1997/1998 seasons, claiming over 1 million patients in Japan. (3) As herald strains, A/H3N2 strains (A/Sydney-like) were found in October 1999, and B strains (B/Victoria- and B/Yamagata-like) were detected in July and November 1998 and, in August and December 2000 in Shizuoka. B/Shizuoka/1/98 strain was registered internationally as a vaccine-recommended strain. (4) A/H3N2 and B viruses were detected in 55-78% of flu patients (almost under 10 years) with encephalopathy in 1999/2000 and 78-91% in 2000/2001 by MDCK and reverse transcription polymerase chain reaction (RT-PCR) methods. (5) High hemagglutination inhibition (HI) titers over 40 in 250 persons were shown against A/Sydney/5/97 (H3N2), A/Yokohama/8/98 (H3N2), A/Panama/2007/99 (H3N2) and A/Moscow/10/99 (H1N1) strains, while low titers showed against A/Beijing/262/95 (H1N1) and A/New Caledonia/20/99 (H1N1), and B/Beijing/243/97, B/Shangdong/7/97 and B/Yamanashi/106/98 strains in 1998-2000. (6) In anti-HA titers against A/H3N2, A/H1N1 and B subtypes, clear generation gaps were observed between children (0-19 years), adults (20-59 years) and old men (over 60 years). (7) The pandemics are dependent on host immunity (acquired and vaccinated) and climatic conditions (low temperature, low humidity and limited rainfall), considering highly pathogenic avian influenza (HPAI) viruses (A/H5N1, A/H7N7) like severe acute respiratory syndrome (SARS) corona virus in 2002-2003.
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