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Zhu S, Liu B, Fu G, Yang L, Wei D, Zhang L, Zhang Q, Gao Y, Sun D, Wei W. PKC-θ is an important driver of fluoride-induced immune imbalance of regulatory T cells/effector T cells. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 934:173081. [PMID: 38754514 DOI: 10.1016/j.scitotenv.2024.173081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/28/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
Fluoride is unnecessary in the human body. Long-term fluoride exposure may lead to immune system abnormalities. However, the mechanism remains unclear. This study aim to explore the mechanism of fluoride interference in the immune system and also identify the key indicators of fluoride-induced immune damage. Questionnaires were used to collect basic information. Multiple linear analyses and other statistical methods were used in order to process the data. Flow cytometry was used to detect relevant immunomarkers and analyze immune damage. Simultaneously, Wistar rats and cell models exposed to fluoride were established to detect the effects of fluoride on immune homeostasis. The results showed that sex, residence time, smoking, and Corona Virus Disease 2019 (COVID-19) infection may indirectly influence fluoride-induced immune damage. In residents of fluoride-exposed areas, there was a significant decrease in CD3+ T lymphocytes and CD4+ and CD8+ cells and a downward trend in the CD4+/CD8+ cell ratio. CD4+CD8+/CD4+, regulatory T cells (Tregs), and Tregs/effector T cells (Teffs) ratios showed opposite changes. Fluoride inhibits T cell activation by inhibiting the expression and phosphorylation of Protein Kinase C-θ (PKC-θ), hinders the internalization of T cell receptors, and affects NF-kB and c-Jun protein expression, leading to homeostatic Treg/Teff imbalance in vivo and in vitro experiments. This study represents the first evidence suggesting that PKC-θ may be the key to immune imbalance in the body under fluoride exposure. It is possible that Tregs/Teffs cell ratio provide a reference point for the diagnosis and treatment of fluoride-induced immune damage.
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Affiliation(s)
- Siqi Zhu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Bingshu Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Guiyu Fu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Liu Yang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Dan Wei
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Liwei Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin Medical University, Harbin 150081, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health Harbin Medical University, Harbin 150081, China
| | - Qiong Zhang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Yanhui Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin Medical University, Harbin 150081, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health Harbin Medical University, Harbin 150081, China.
| | - Dianjun Sun
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin Medical University, Harbin 150081, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health Harbin Medical University, Harbin 150081, China.
| | - Wei Wei
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang 150081, China; Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Harbin Medical University, Harbin 150081, China; Heilongjiang Provincial Key Lab of Trace Elements and Human Health Harbin Medical University, Harbin 150081, China.
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2
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Krčmová LK, Javorská L, Matoušová K, Šmahel P, Skála M, Kopecký M, Suwanvecho C, Přívratská N, Turoňová D, Melichar B. Evaluation of inflammatory biomarkers and vitamins in hospitalized patients with SARS-CoV-2 infection and post-COVID syndrome. Clin Chem Lab Med 2024; 62:1217-1227. [PMID: 38374668 DOI: 10.1515/cclm-2023-1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVES Concentrations of neopterin, kynurenine and kynurenine/tryptophan ratios predict prognosis and the need for oxygen therapy in patients hospitalized for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aims of the present study were to evaluate the changes of these biomarkers early in the course of infection, the association with the prior coronavirus disease (COVID-19) vaccination and therapeutic administration of Anti-SARS-CoV-2 monoclonal antibodies, investigation of other potential biomarkers including neuropilin, 8-hydroxy-2-deoxyguanosine and 8-hydroxyguanosine in patients hospitalized with SARS-CoV-2 infection and an assessment of these biomarkers and vitamins A, E and D in patients with post-COVID syndrome. METHODS Urine and blood samples were obtained on the 1st to the 4th day and 4th to 7th day from 108 patients hospitalized with COVID-19. Chromatography tandem mass spectrometry methods were used to analyse neopterin, kynurenine, tryptophan, liposoluble vitamins, and DNA damage biomarkers. RESULTS A statistically significant decrease of neopterin, kynurenine and kynurenine/tryptophan ratios was observed on after 4th to 7th day of hospitalization, and concentrations of these biomarkers were increased in patients with poor prognosis and subsequent post-COVID syndrome. The concentrations of remaining biomarker and vitamins were not associated with outcomes, although markedly decreased concentrations of vitamin A, E and D were noted. CONCLUSIONS The concentrations of neopterin, kynurenine and kynurenine/tryptophan ratios decrease during the course of infection SARS-CoV-2 and are associated with the post-COVID syndrome. No other prognostic biomarkers were identified.
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Affiliation(s)
- Lenka Kujovská Krčmová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Lenka Javorská
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Kateřina Matoušová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Petr Šmahel
- Deparment of Infectious Diseases, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Mikuláš Skála
- Department of Pneumology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Michal Kopecký
- Department of Pneumology, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Chaweewan Suwanvecho
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Nikola Přívratská
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
| | - Dorota Turoňová
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Bohuslav Melichar
- Department of Oncology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
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Gheban-Roșca IA, Gheban BA, Pop B, Mironescu DC, Siserman VC, Jianu EM, Drugan T, Bolboacă SD. Immunohistochemical and Morphometric Analysis of Lung Tissue in Fatal COVID-19. Diagnostics (Basel) 2024; 14:914. [PMID: 38732328 PMCID: PMC11082993 DOI: 10.3390/diagnostics14090914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
The primary targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the lungs are type I pneumocytes, macrophages, and endothelial cells. We aimed to identify lung cells targeted by SARS-CoV-2 using viral nucleocapsid protein staining and morphometric features on patients with fatal COVID-19. We conducted a retrospective analysis of fifty-one autopsy cases of individuals who tested positive for SARS-CoV-2. Demographic and clinical information were collected from forensic reports, and lung tissue was examined for microscopic lesions and the presence of specific cell types. Half of the evaluated cohort were older than 71 years, and the majority were male (74.5%). In total, 24 patients presented diffuse alveolar damage (DAD), and 50.9% had comorbidities (56.9% obesity, 33.3% hypertension, 15.7% diabetes mellitus). Immunohistochemical analysis showed a similar pattern of infected macrophages, infected type I pneumocytes, and endothelial cells, regardless of the presence of DAD (p > 0.5). The immunohistochemical reactivity score (IRS) was predominantly moderate but without significant differences between patients with and without DAD (p = 0.633 IRS for type I pneumocytes, p = 0.773 IRS for macrophage, and p = 0.737 for IRS endothelium). The nucleus/cytoplasm ratio shows lower values in patients with DAD (median: 0.29 vs. 0.35), but the difference only reaches a tendency for statistical significance (p = 0.083). Our study confirms the presence of infected macrophages, type I pneumocytes, and endothelial cells with a similar pattern in patients with and without diffuse alveolar damage.
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Affiliation(s)
- Ioana-Andreea Gheban-Roșca
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (I.-A.G.-R.); (T.D.)
- Clinical Hospital for Infectious Diseases, 400348 Cluj-Napoca, Romania
| | - Bogdan-Alexandru Gheban
- County Emergency Clinical Hospital, 400006 Cluj-Napoca, Romania
- Department of Histology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
| | - Bogdan Pop
- The Oncology Institute “Prof. Dr. Ion Chiricuță”, 400015 Cluj-Napoca, Romania;
- Department of Anatomic Pathology, Iuliu Hațieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Daniela-Cristina Mironescu
- Forensic Institute, 400006 Cluj-Napoca, Romania; (D.-C.M.); (V.C.S.)
- Department of Forensic Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Vasile Costel Siserman
- Forensic Institute, 400006 Cluj-Napoca, Romania; (D.-C.M.); (V.C.S.)
- Department of Forensic Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Elena Mihaela Jianu
- Department of Histology, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
| | - Tudor Drugan
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (I.-A.G.-R.); (T.D.)
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (I.-A.G.-R.); (T.D.)
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Chrostek L, Gan K, Kazberuk M, Kralisz M, Janicka K, Gruszewska E, Panasiuk A, Cylwik B. The Association of Serum Profile of Transferrin Isoforms with COVID-19 Disease Severity. J Clin Med 2024; 13:2446. [PMID: 38673719 PMCID: PMC11050942 DOI: 10.3390/jcm13082446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objective: Bearing in mind the relationship of transferrin (TRF) microheterogeneity with the biological activity of its isoforms, we propose, in this study, to determine the association of the profile of TRF isoforms with COVID-19 disease severity and to compare this profile to the profiles of other diseases. Methods: The disease group consisted of 96 patients from whom blood was collected twice, upon admission to the ward and after treatment (on average on the ninth day). TRF isoforms were separated by capillary electrophoresis. The analysis included disease severity, cytokine storm, comorbidities, patient survival, oxygen therapy, and modified early warning scores (MEWSs). Results: The concentration of 5-sialoTRF was higher in patients compared to controls at the beginning and during COVID-19 treatment. The concentration of this isoform varies with the severity of disease and was higher in critical patients than those with a moderate condition. Additionally, the level of 5-sialoTRF was lower and the level of 4-sialoTRF was higher in patients with comorbidities than that in patients without them. The concentration of 5-sialoTRF was lower and the concentration of 4-sialoTRF was higher in surviving patients than in non-surviving patients. There were no statistical changes in TRF isoforms according to presence of cytokine storm, MEWS, and oxygen therapy. Conclusions: We conclude that the profile of TRF isoforms in COVID-19 patients differs from that in other diseases. An increase in the concentration of a sialic acid-rich isoform, 5-sialoTRF, may be a compensatory mechanism, the goal of which is to increase oxygen delivery to tissues and is dependent on the severity of the disease. Additionally, the concentration of 5-sialoTRF may be a prognostic marker of the survival of COVID-19 patients.
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Affiliation(s)
- Lech Chrostek
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Kacper Gan
- Department of Gastroenterology, Hepatology and Internal Diseases, Voivodeship Hospital in Bialystok, 15-278 Bialystok, Poland (A.P.)
| | - Marcin Kazberuk
- Department of Gastroenterology, Hepatology and Internal Diseases, Voivodeship Hospital in Bialystok, 15-278 Bialystok, Poland (A.P.)
| | - Michal Kralisz
- Department of Gastroenterology, Hepatology and Internal Diseases, Voivodeship Hospital in Bialystok, 15-278 Bialystok, Poland (A.P.)
| | - Katarzyna Janicka
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, 15-274 Bialystok, Poland
| | - Ewa Gruszewska
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Anatol Panasiuk
- Department of Gastroenterology, Hepatology and Internal Diseases, Voivodeship Hospital in Bialystok, 15-278 Bialystok, Poland (A.P.)
- Department of Clinical Medicine, Medical University of Bialystok, 15-254 Bialystok, Poland
| | - Bogdan Cylwik
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, 15-274 Bialystok, Poland
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Eusébio D, Paul M, Biswas S, Cui Z, Costa D, Sousa Â. Mannosylated polyethylenimine-cholesterol-based nanoparticles for targeted delivery of minicircle DNA vaccine against COVID-19 to antigen-presenting cells. Int J Pharm 2024; 654:123959. [PMID: 38430949 DOI: 10.1016/j.ijpharm.2024.123959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/25/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
DNA vaccines can be a potential solution to protect global health, triggering both humoral and cellular immune responses. DNA vaccines are valuable in preventing intracellular pathogen infections, and therefore can be explored against coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). This work explored different systems based on polyethylenimine (PEI), functionalized for the first time with both cholesterol (CHOL) and mannose (MAN) to deliver parental plasmid (PP) and minicircle DNA (mcDNA) vectors encoding the receptor-binding domain (RBD) of SARS-CoV-2 to antigen-presenting cells (APCs). For comparative purposes, three different systems were evaluated: PEI, PEI-CHOL and PEI-CHOL-MAN. The systems were prepared at various nitrogen-to-phosphate group (N/P) ratios and characterized in terms of encapsulation efficiency, surface charge, size, polydispersity index (PDI), morphology, and stability over time. Moreover, in vitro transfection studies of dendritic cells (JAWS II) and human fibroblast cells were performed. Viability studies assured the biocompatibility of all nanocarriers. Confocal microscopy studies confirmed intracellular localization of systems, resulting in enhanced cellular uptake using PEI-CHOL and PEI-CHOL-MAN systems when compared with the PEI system. Regarding the RBD expression, PEI-CHOL-MAN was the system that led to the highest levels of transcripts and protein expression in JAWS II cells. Furthermore, the nanosystems significantly stimulated pro-inflammatory cytokines production and dendritic cell maturation in vitro. Overall, mannosylated systems can be considered a valuable tool in the delivery of plasmid DNA or mcDNA vaccines to APCs.
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Affiliation(s)
- Dalinda Eusébio
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Milan Paul
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science-Pilani, Hyderabad Campus. Jawahar Nagar, Medchal, Hyderabad 500078, India
| | - Swati Biswas
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science-Pilani, Hyderabad Campus. Jawahar Nagar, Medchal, Hyderabad 500078, India
| | - Zhengrong Cui
- The University of Texas at Austin, College of Pharmacy, Division of Molecular Pharmaceutics and Drug Delivery, Austin, TX 78712, USA
| | - Diana Costa
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Ângela Sousa
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
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Mahroum N, Habra M, Alrifaai MA, Shoenfeld Y. Antiphospholipid syndrome in the era of COVID-19 - Two sides of a coin. Autoimmun Rev 2024:103543. [PMID: 38604461 DOI: 10.1016/j.autrev.2024.103543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
In addition to the respiratory symptoms associated with COVID-19, the disease has consistently been linked to many autoimmune diseases such as systemic lupus erythematous and antiphospholipid syndrome (APS). APS in particular was of paramount significance due to its devastating clinical sequela. In fact, the hypercoagulable state seen in patients with acute COVID-19 and the critical role of anticoagulant treatment in affected individuals shed light on the possible relatedness between APS and COVID-19. Moreover, the role of autoimmunity in the assumed association is not less important especially with the accumulated data available regarding the autoimmunity-triggering effect of SARS-CoV-2 infection. This is furtherly strengthened at the time patients with COVID-19 manifested antiphospholipid antibodies of different types following infection. Additionally, the severe form of the APS spectrum, catastrophic APS (CAPS), was shown to have overlapping characteristics with severe COVID-19 such as cytokine storm and multi-organ failure. Interestingly, COVID vaccine-induced autoimmune phenomena described in the medical literature have pointed to an association with APS. Whether the antiphospholipid antibodies were present or de novo, COVID vaccine-induced vascular thrombosis in certain individuals necessitates further investigations regarding the possible mechanisms involved. In our current paper, we aimed to focus on the associations mentioned, their implications, importance, and consequences.
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Affiliation(s)
- Naim Mahroum
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
| | - Mona Habra
- International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | | | - Yehuda Shoenfeld
- Zabludowicz Center for autoimmune diseases, Sheba Medical Center, Ramat-Gan, Israel; Reichman University, Herzliya, Israel
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Sayed AA. Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:602. [PMID: 38674248 PMCID: PMC11052014 DOI: 10.3390/medicina60040602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/23/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
COVID-19 has been notoriously unpredictable in its clinical course. Such unpredictability poses a challenge to clinicians in predicting patients who will develop severe cases and possibly die from the infection. This study aims to assess and compare the diagnostic value of the NLR and SII as biomarkers in predicting COVID-19 severity, represented by mortality, with a multicentre comparative study including 855 patients in Saudi Arabia. Descriptive and analytical statistics were used to compare haematological indices between survivors and non-survivors. The median age of patients included was 41 years old, with an almost equal ratio of men to women. Most participants were Saudis, and the mortality rate in the study cohort was 13.22%. Non-survivors, as compared to survivors, were significantly older, had lower RBC counts, haemoglobin and haematocrit levels, as well as significantly higher WBC and neutrophil counts. Both the NLR and SII were capable of differentiating between survivors and non-survivors, with the latter having significantly higher values. However, the NLR was superior to the SII in such differentiation, as it had a larger area under the curve. This study further confirms the diagnostic values of the NLR and SII as biomarkers in predicting COVID-19 severity and mortality, with the NLR being more sensitive and specific. Clinical guidelines on managing COVID-19 cases should benefit from these findings by harnessing the value of the NLR in COVID-19 management.
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Affiliation(s)
- Anwar A Sayed
- Department of Basic Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia
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8
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de Azambuja Pias Weber A, Viero FT, Pillat MM, de Lima Gonçalves T. Changes in markers of inflammation and their correlation with death in patients with COVID-19 in the intensive care unit. Cytokine 2024; 175:156509. [PMID: 38241964 DOI: 10.1016/j.cyto.2024.156509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/07/2023] [Accepted: 01/16/2024] [Indexed: 01/21/2024]
Abstract
This study aimed to characterize the changes in serum inflammatory mediators in hospitalized patients with COVID-19 correlating with death. The study includes 58 participants: i) inpatients (n = 37): patients suffering from severe acute respiratory syndrome due to COVID-19, who were admitted at Intensive Care Unit (ICU) recovered and who died and ii) control group (n = 21): community volunteers. Inflammatory mediators evaluated interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17 (IL-17), interferon-gamma (IFN-γ) and interferon-gamma protein levels (IFN-γ), as well as, Urea, LDH, D-dimer, TAP/INR, AST, ALT and lymphocytes. Our results suggest that high levels of inflammatory markers, such as pro-inflammatory cytokines, and laboratory parameters, such as low levels of lymphocytes and high levels of IL-6, are associated with disease severity, especially in individuals who died. Constant measurement and monitoring of these inflammatory parameters is an effective tool in clinical practice, and it can help choosing appropriate therapies during the course of the disease.
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Affiliation(s)
- Andressa de Azambuja Pias Weber
- Postgraduate Program in Pharmaceutical Sciences, Department of Clinical and Toxicology Analysis, Center of Healthy Sciences, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Fernanda Tibolla Viero
- Postgraduate Program in Pharmacology, Department of Microbiology and Parasitology, Center of Healthy Sciences, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Micheli Mainardi Pillat
- Postgraduate Program in Pharmacology, Department of Microbiology and Parasitology, Center of Healthy Sciences, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
| | - Thissiane de Lima Gonçalves
- Postgraduate Program in Pharmaceutical Sciences, Department of Clinical and Toxicology Analysis, Center of Healthy Sciences, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
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Stroz S, Kosiorek P, Zbroch E, Mikoluc B, Stasiak-Barmuta A. Immune response variation in mild and severe COVID-19 patients. Qatar Med J 2024; 2024:11. [PMID: 38468605 PMCID: PMC10925834 DOI: 10.5339/qmj.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/04/2024] [Indexed: 03/13/2024] Open
Abstract
Sixty patients with COVID-19 infection were categorized into mild and severe groups, and their immune response was analyzed using flow cytometry and complete blood count. An observed increase in immune activation parameters, notably a higher percentage of CD4 lymphocytes co-expressing CD69 and CD25 molecules, and enhanced activity of the macrophage-monocyte cell line was noted in the mild group. Although Group 2 (severe COVID) had fewer CD4 cells, significant migration and proliferation were evident, with increased CD4CD69, CD8 HLA-DR+, and CD8CD69 lymphocytes. The CD4 to CD8 ratio in Group 1 suggested potential autoimmune reactions, while Group 2 indicated potential immunosuppression from severe infection and employing immunosuppressive drugs. Additionally, Group 2 exhibited an increased neutrophil count, hinting at possible bacterial co-infection. Group 1 showed differences in CD4RO and CD8RA lymphocyte populations, implying that cellular immunity plays a role in developing efficient postinfectious immunity. This intimation suggests that vaccination might mitigate the severity of the coronavirus infection and prevent complications, including long-term COVID-19.
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Affiliation(s)
- Samuel Stroz
- Department of Clinical Immunology, Medical University of Bialystok, Bialystok, Poland
| | - Piotr Kosiorek
- Department of Clinical Immunology, Medical University of Bialystok, Bialystok, Poland
| | - Edyta Zbroch
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, Bialystok, Poland
| | - Bozena Mikoluc
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Anna Stasiak-Barmuta
- Department of Clinical Immunology, Medical University of Bialystok, Bialystok, Poland
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10
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Petrov S, Taskov H, Murdjeva M. Guardians of immunity: NK cell-mediated defense in COVID-19 and post-COVID scenarios. Folia Med (Plovdiv) 2024; 66:12-18. [PMID: 38426460 DOI: 10.3897/folmed.66.e113356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/10/2023] [Indexed: 03/02/2024] Open
Abstract
The COVID-19 pandemic has left a lasting impact on global health, challenging communities, healthcare systems, and researchers worldwide. As we navigate this unprecedented crisis, this paper embarks on a multifaceted exploration of the pivotal role played by natural killer (NK) cells in the context of COVID-19. A significant portion of this paper is devoted to dissecting the nuanced role that NK cells assume in the context of COVID-19. From the initial acute infection to post-recovery immunity, NK cells emerge as critical players. We scrutinize the activation and dysregulation of NK cells during SARS-CoV-2 infection, shedding light on their potential contribution to disease severity. Moreover, we explore the fascinating landscape of post-COVID immunity, where NK cells are known to interact with adaptive immune responses, providing a foundation for long-term protection. In light of their central role, we investigate therapeutic strategies targeting NK cells in COVID-19 management, presenting an overview of current research efforts and their promise in mitigating disease progression. Lastly, we draw attention to research gaps, emphasizing the need for further investigation into NK cell dynamics during COVID-19. These gaps represent opportunities for advancing our understanding of NK cell biology and, by extension, enhancing our strategies for combating this global health crisis. This comprehensive exploration not only highlights the intricate interplay between NK cells and the COVID-19 pandemic but also underscores the importance of these innate immune warriors in shaping both the acute response and long-term immunity, ultimately contributing to the broader discourse surrounding the pandemic's pathophysiology and therapeutic approaches.
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11
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Psenicka O, Brutvan T, Kratky J, Krizova J. Muscle Dysfunction and Functional Status in COVID-19 Patients during Illness and after Hospital Discharge. Biomedicines 2024; 12:460. [PMID: 38398063 PMCID: PMC10887156 DOI: 10.3390/biomedicines12020460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND COVID-19 pneumonia is associated with SIRS and hypercatabolism. The aim of this study was to determine muscle loss during the acute phase of COVID-19 pneumonia and evaluate long-term sequelae in discharged patients. METHODS A total of 16 patients with COVID-19 pneumonia and respiratory insufficiency were included in the study. Selected parameters (weight, BMI, LBM = lean body mass, albumin, CRP, NLR = neutrophil-to-lymphocyte ratio, ultrasound measured thickness of rectus femoris muscle = US RF and rectus femoris + vastus intermedius = US RF + VI, handgrip strength, quality of life = EQ-5D questionnaire, and activities of daily living = Barthel's ADLs) were recorded on admission, discharge, and 1, 3, and 6 months after discharge. RESULTS The most significant changes were between hospital admission and discharge: US RF and RF + VI (-1.28 ± 1.97 mm, p = 0.046; -1.76 ± 2.94 mm, p = 0.05), EQ-5D score (14.6 ± 19.2, p = 0.02), and ADLs (17.1 ± 22.6; p = 0.02). There was a significant positive correlation between US RF + VI and handgrip strength (p = 0.014) and a negative correlation between weight and Barthel index (p = 0.012). There was an association between muscle function with an EQ-5D score and ADLs during outpatient check-ups, most noticeably between handgrip strength, US RF+VI, and ADLs (p = 0.08; p = 0.1, respectively). Conclusions: In patients with COVID-19 pneumonia, there is a significant reduction of health-related quality of life, impaired even 6 months after hospital discharge, influenced mainly by muscle loss. During the hospital stay, there was a significant muscle mass reduction. Ultrasound measurement of thigh muscle thickness may be a useful method to monitor muscle loss.
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Affiliation(s)
- Otakar Psenicka
- 3rd Department of Internal Medicine, General University Hospital, 120 00 Prague, Czech Republic; (T.B.); (J.K.); (J.K.)
- 1st Faculty of Medicine, Charles University, 120 00 Prague, Czech Republic
| | - Tomas Brutvan
- 3rd Department of Internal Medicine, General University Hospital, 120 00 Prague, Czech Republic; (T.B.); (J.K.); (J.K.)
- 1st Faculty of Medicine, Charles University, 120 00 Prague, Czech Republic
| | - Jan Kratky
- 3rd Department of Internal Medicine, General University Hospital, 120 00 Prague, Czech Republic; (T.B.); (J.K.); (J.K.)
- 1st Faculty of Medicine, Charles University, 120 00 Prague, Czech Republic
| | - Jarmila Krizova
- 3rd Department of Internal Medicine, General University Hospital, 120 00 Prague, Czech Republic; (T.B.); (J.K.); (J.K.)
- 1st Faculty of Medicine, Charles University, 120 00 Prague, Czech Republic
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12
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Bastidas-Goyes AR, Tuta-Quintero E, Aguilar MF, Mora AV, Aponte HC, Villamizar JM, Galeano S, Mejia P, Muñoz M, Paredes S, Pumarejo D, Barragan MDM. Performance of oxygenation indices and risk scores to predict invasive mechanical ventilation and mortality in COVID-19. BMC Pulm Med 2024; 24:68. [PMID: 38308270 PMCID: PMC10835882 DOI: 10.1186/s12890-023-02807-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/07/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Information on the performance of oxygenation indices (OIs) and risk scores in patients requiring invasive mechanical ventilation (IMV) is limited. We determine the performance of the OIs and risk scores in hospitalized patients with COVID-19 to predict the requirement of IMV and death at 28 days after admission. METHODS A retrospective study of diagnostic tests in patients admitted to the emergency department, hospitalization, and intensive care unit diagnosed with COVID-19. The receiver operating characteristic curve (ROC-curve) were built with the OIs and risk scores to predict IMV and mortality. RESULTS A total of 1402 subjects entered the final analysis, of whom 19.5% (274/1402) received IMV and 23.0% (323/1402) died at 28 days. The ROC-curve of the delta PaO2/FiO2 ratio for the requirement of IMV and mortality at 28-day was 0.589 (95% CI: 0.546-0.632) and 0.567 (95% CI: 0.526-0.608), respectively. PaO2/FiO2 ≤ 300 shows a ROC curve of 0.669 (95% CI: 0.628-0.711) to predict IMV. PaO2/FiO2 ≤ 300 and 4 C mortality score in mortality at 28 days showed an ROC-curve of 0.624 (95% CI: 0.582-0.667) and 0.706 (95% CI: 0.669-0.742), respectively. CONCLUSION PaO2/FiO2 ≤ 300, 4 C mortality score ≥ 8, SOFA score ≥ 4 y SaO2/FiO2 ≤ 300 were weak predictors of the IMV requirement from admission, and 4 C mortality score ≥ 8 was weak predictors of the mortality from admission in patients with pulmonary involvement by COVID-19.
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Affiliation(s)
- Alirio R Bastidas-Goyes
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia.
| | - Eduardo Tuta-Quintero
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Maria F Aguilar
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Angélica V Mora
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | | | - Jesus M Villamizar
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Susana Galeano
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Paola Mejia
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Maria Muñoz
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Sara Paredes
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Doris Pumarejo
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
| | - Maria Del Mar Barragan
- School of Medicine, Internal Medicine Department, Universidad de La Sabana, Km 7, Northern highway. Chía, Chía, Cundinamarca 140013, Colombia
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13
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Kang Y, Lu S, Zhong R, You J, Chen J, Li L, Huang R, Xie Y, Chen F, Chen J, Chen L. The immune inflammation factors associated with disease severity and poor prognosis in patients with COVID-19: A retrospective cohort study. Heliyon 2024; 10:e23583. [PMID: 38173531 PMCID: PMC10761779 DOI: 10.1016/j.heliyon.2023.e23583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) is associated with immune dysregulation and cytokine storm. It is essential to explore the immune response characteristics of peripheral circulation in COVID-19 patients to reveal pathogenesis and predict disease progression. In this study, the levels of total immunoglobulins (IgG, IgM, IgA), complement (C3, C4),lymphocyte subsets (CD3+ cell,CD4+ cell,CD8+ cell, NK cell, CD19+ cell and CD45+ cell) and cytokines (IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IL-12p, IL-1β, TNF-α, IFN-α and IFN-γ) were retrospectively analyzed in COVID-19 patients. A total of 513 patients were enrolled in this study, cases were distributed according to clinical status as mild or moderate (n = 212), severe survivors (n = 197) and severe non-survivors (n = 104). IL-6, IL-8, IL-10 and IFN-γ were increased in severe patients compared with non-severe patients, despite decreased CD45+ cell, CD3+ cell, CD4+ cell, CD8+ cell, CD19+ cell, and NK cell. Compared with severe survivors, the levels of L-6, IL-8 and IL-10 in non-survivors increased significantly, and levels of C3, CD45+ cell, CD3+ cell,CD4+ cell,CD8+ cell, and NK cell decreased. Moreover, age, IL-8, IL-10, CD8+cells and NK cell were independent risk factors for the severity of COVID-19. Multivariable regression showed increasing odds ratio of in-hospital death associated with tumor, older age, higher IL-8 level, and decreasing odds ratio of in-hospital death associated with increased levels of CD8+cell and NK cell. Finally, patients with tumor, or high IL-6 or high IL-10 expression and lower CD8+ or lower NK levels exhibited a significantly shorter survival time. In conclusion, our study provides findings of the immunological characteristics associated with disease severity to predict the progression of COVID-19. The immune inflammation factors, such as IL-6, IL-8, IL-10, CD8+ cell and NK cell, could serve as excellent biomarkers for monitoring or predicting COVID-19 progression therapeutic to COVID-19 patients.
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Affiliation(s)
- Yanli Kang
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Shifa Lu
- Department of Clinical Laboratory, JianOu Municipal Hospital of Fujian Province, Nanping, China
| | - Ruifang Zhong
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jianbin You
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jiahao Chen
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Ling Li
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Rongbin Huang
- Department of Clinical Laboratory, JianOu Municipal Hospital of Fujian Province, Nanping, China
| | - Yanyan Xie
- Department of Clinical Laboratory, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Falin Chen
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jinhua Chen
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Liangyuan Chen
- Department of Clinical Laboratory, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
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14
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Sati H, Alzraikat N, Milan M, Saliba M, Fawaz A, Boueri M, Semaan S, Chedid ML, Yakdan S. Skin manifestations in children with MIS-C and COVID-19: a narrative review. Int J Dermatol 2024; 63:32-40. [PMID: 38018155 DOI: 10.1111/ijd.16912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/31/2023] [Accepted: 11/05/2023] [Indexed: 11/30/2023]
Abstract
This review aims to highlight the diverse skin manifestations in children and adolescents with COVID induced multisystem inflammatory syndrome in children (MIS-C). The symptoms of COVID-19 can vary greatly in severity between different age groups. Although most children infected with SARS-CoV-2 experience either no symptoms or only mild symptoms, some reported cases of severely affected children with a clinical presentation similar to incomplete Kawasaki disease have led to the definition of a new condition called MIS-C. MIS-C can involve multiple organs, including the skin, and may pose a life-threatening risk to affected children. Such cases highlight the need for continuous research into the possible skin manifestations associated with COVID-19 in pediatric populations to aid in early diagnosis and prompt treatment. We conducted a search of PubMed, Scopus, and ScienceDirect databases for studies published up until October 1, 2022. Three reviewers independently examined each study, and a fourth reviewer resolved any disagreements. A narrative review of all relevant papers was conducted. We present an overview of the clinical presentation, pathophysiology, diagnosis, and treatment of the various skin manifestations in children and adolescents with COVID-19 or MIS-C. The skin manifestations of COVID-19 and MIS-C can be diverse and are frequently overlooked. It is important to conduct further research to better understand the impact of this disease on children to provide appropriate care for these at-risk populations.
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Affiliation(s)
- Heba Sati
- Faculty of Medicine and Medical Sciences, University of Balamand, Koura, Lebanon
| | - Noor Alzraikat
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Milanie Milan
- Faculty of Medicine and Medical Sciences, University of Balamand, Koura, Lebanon
| | - Marita Saliba
- Faculty of Medicine and Medical Sciences, University of Balamand, Koura, Lebanon
| | - Ala'a Fawaz
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Myriam Boueri
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Samar Semaan
- Faculty of Medicine and Medical Sciences, University of Balamand, Koura, Lebanon
| | | | - Salim Yakdan
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
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15
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Fung CYJ, Scott M, Lerner-Ellis J, Taher J. Applications of SARS-CoV-2 serological testing: impact of test performance, sample matrices, and patient characteristics. Crit Rev Clin Lab Sci 2024; 61:70-88. [PMID: 37800891 DOI: 10.1080/10408363.2023.2254390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/29/2023] [Indexed: 10/07/2023]
Abstract
Laboratory testing has been a key tool in managing the SARS-CoV-2 global pandemic. While rapid antigen and PCR testing has proven useful for diagnosing acute SARS-CoV-2 infections, additional testing methods are required to understand the long-term impact of SARS-CoV-2 infections on immune response. Serological testing, a well-documented laboratory practice, measures the presence of antibodies in a sample to uncover information about host immunity. Although proposed applications of serological testing for clinical use have previously been limited, current research into SARS-CoV-2 has shown growing utility for serological methods in these settings. To name a few, serological testing has been used to identify patients with past infections and long-term active disease and to monitor vaccine efficacy. Test utility and result interpretation, however, are often complicated by factors that include poor test sensitivity early in infection, lack of immune response in some individuals, overlying infection and vaccination responses, lack of standardization of antibody titers/levels between instruments, unknown titers that confer immune protection, and large between-individual biological variation following infection or vaccination. Thus, the three major components of this review will examine (1) factors that affect serological test utility: test performance, testing matrices, seroprevalence concerns and viral variants, (2) patient factors that affect serological response: timing of sampling, age, sex, body mass index, immunosuppression and vaccination, and (3) informative applications of serological testing: identifying past infection, immune surveillance to guide health practices, and examination of protective immunity. SARS-CoV-2 serological testing should be beneficial for clinical care if it is implemented appropriately. However, as with other laboratory developed tests, use of SARS-CoV-2 serology as a testing modality warrants careful consideration of testing limitations and evaluation of its clinical utility.
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Affiliation(s)
- Chun Yiu Jordan Fung
- Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Mackenzie Scott
- Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Taher
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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16
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Dams K, De Meyer GR, Jacobs R, Schepens T, Perkisas S, Moorkens G, Jorens P. Combined ultrasound of m. quadriceps and diaphragm to determine the occurrence of sarcopenia and prolonged ventilation in a COVID-19 ICU cohort: The COVID-SARCUS trial. Nutrition 2024; 117:112250. [PMID: 37918311 DOI: 10.1016/j.nut.2023.112250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/29/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE The aim of this study was to determine the development of sarcopenia in a COVID-19 intensive care unit population by sequential quadriceps and diaphragm ultrasound and its relationship with hospital outcomes. METHODS We assessed muscle thickness, cross-sectional area, fascicle length, pennation angle, and echo intensity within 48 h after intubation, at days 5 and 10 and at discharge from the intensive care unit in 30 critically ill patients with confirmed COVID-19. RESULTS A different evolution of muscle thickness of the diaphragm and m. rectus femoris was observed; the changes between the two muscles were not correlated (Pearson's χ2 3.91, P = 0.419). The difference in muscle thickness was linked to the outcome for both m. rectus femoris and diaphragm, with the best survival seen in the group with stable muscle thickness. The greatest loss of muscle thickness occurred between days 5 and 10. The echo intensity was higher in the patients with increased muscle thickness, who also had a worse prognosis. There was a correlation between cross-sectional area on day 5 and handgrip strength (r = 0.290, P = 0.010). Only 31% of patients were able to return to their preadmission residence without any additional rehabilitation. CONCLUSIONS Muscle atrophy and decline in muscle strength appear in the earliest stages after admission to the intensive care unit and are related to functional outcome.
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Affiliation(s)
- Karolien Dams
- Intensive Care Department, Antwerp University Hospital, Edegem, Belgium; Laboratory of Experimental Medicine and Paediatrics (LEMP), Faculty of Medicine and Health Sciences, Antwerp, Belgium.
| | - Gregory Ra De Meyer
- Intensive Care Department, Antwerp University Hospital, Edegem, Belgium; Laboratory of Experimental Medicine and Paediatrics (LEMP), Faculty of Medicine and Health Sciences, Antwerp, Belgium; Department of Anaesthesiology, Antwerp University Hospital, Edegem, Belgium
| | - Rita Jacobs
- Intensive Care Department, Antwerp University Hospital, Edegem, Belgium
| | - Tom Schepens
- Intensive Care Department, Antwerp University Hospital, Edegem, Belgium; Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium; Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Stany Perkisas
- University Centre of Geriatrics, University of Antwerp, Antwerp, Belgium
| | - Greta Moorkens
- Department of Internal Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Philippe Jorens
- Intensive Care Department, Antwerp University Hospital, Edegem, Belgium; Laboratory of Experimental Medicine and Paediatrics (LEMP), Faculty of Medicine and Health Sciences, Antwerp, Belgium
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17
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Ho M, Levy TJ, Koulas I, Founta K, Coppa K, Hirsch JS, Davidson KW, Spyropoulos AC, Zanos TP. Longitudinal dynamic clinical phenotypes of in-hospital COVID-19 patients across three dominant virus variants in New York. Int J Med Inform 2024; 181:105286. [PMID: 37956643 PMCID: PMC10843635 DOI: 10.1016/j.ijmedinf.2023.105286] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/20/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND COVID-19 is a challenging disease to characterize given its wide-ranging heterogeneous symptomatology. Several studies have attempted to extract clinical phenotypes but often relied on data from small patient cohorts, usually limited to only one viral variant and utilizing a static snapshot of patient data. OBJECTIVE This study aimed to identify clinical phenotypes of hospitalized COVID-19 patients and investigate their longitudinal dynamics throughout the pandemic, with the goal to relate these phenotypes to clinical outcomes and treatment strategies. METHODS We utilized routinely collected demographic and clinical data throughout the hospitalization of 38,077 patients admitted between 3/2020 to 5/2022, in 12 New York hospitals. Uniform Manifold Approximation and Projection and agglomerative hierarchical clustering were used to derive the clusters, followed by exploratory data analysis to compare the prevalence of comorbidities and treatments per cluster. RESULTS 4 distinct clinical phenotypes remained robust in multi-site validation and were associated with different mortality rates. The temporal progression of these phenotypes throughout the COVID-19 pandemic demonstrated increased variability across the waves of the three dominant viral variants (alpha, delta, omicron). Longitudinal analysis evaluating changes in clinical phenotypes of each patient throughout the course of a 4-week hospital stay exemplified the dynamic nature of the disease progression. Factors such as sex, race/ethnicity and specific treatment modalities revealed significant and clinically relevant differences between the observed phenotypes. CONCLUSIONS Our proposed methodology has the potential of enabling clinicians and policy makers to draw evidence-based conclusions for guiding treatment modalities in a dynamic fashion.
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Affiliation(s)
- Matthew Ho
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Todd J Levy
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030
| | - Ioannis Koulas
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030
| | - Kyriaki Founta
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Kevin Coppa
- Department of Clinical Digital Solutions, Northwell Health, New Hyde Park, NY 11042
| | - Jamie S Hirsch
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549; Department of Clinical Digital Solutions, Northwell Health, New Hyde Park, NY 11042
| | - Karina W Davidson
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Alex C Spyropoulos
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549
| | - Theodoros P Zanos
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY 11549.
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18
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Wu Y, Li Y, Wu T, Huang D, Wu J, Zhang W, Jiang X, Yao C, Liang X, Cheng L, Liao Z, Xu F, Tan C, Liu Y, Herrmann M. COVID-19 in Systemic Lupus Erythematosus patients treated with belimumab: a retrospective clinical study. Immunol Res 2023:10.1007/s12026-023-09449-2. [PMID: 38133855 DOI: 10.1007/s12026-023-09449-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Routine use of immunosuppressive agents in systemic lupus erythematosus (SLE) patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) potentially increases the risk of adverse outcomes. belimumab, a monoclonal antibody for the treatment of SLE, remains untested for its specific impact on coronavirus disease 2019 (COVID-19) symptoms in these patients. Here, this research investigated the effect of belimumab on COVID-19 symptoms in SLE patients infected with SARS-CoV-2. METHODS This study enrolled SLE patients who underwent treatment with belimumab. After thorough screening based on the inclusion and exclusion criteria, data pertaining to COVID-19 for both the participants and their cohabitants were obtained through telephone follow-up. The potential impact of belimumab on COVID-19 was evaluated by comparing COVID-19 symptoms and medication use across various groups to investigate the association between belimumab treatment and COVID-19 in SLE. RESULTS This study involved 123 SLE patients, of whom 89.4% tested positive for SARS-CoV-2. Among cohabitants of SLE patients, the SARS-CoV-2 positive rate was 87.2% (p = 0.543). Patients treated with belimumab exhibited a lower incidence of multiple COVID-19 symptoms than their cohabitating counterparts (p < 0.001). This protective effect was found to be partially related to the time of last belimumab administration. Among those with COVID-19, 30 patients opted to discontinue their anti-SLE drugs, and among them, 53% chose to discontinue belimumab. Discontinuing drugs did not increase the risk of hospitalization due to SARS-CoV-2 infection. CONCLUSION This study concluded that treatment with belimumab did not increase susceptibility to COVID-19 and beneficially alleviated the symptoms of COVID-19.
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Affiliation(s)
- Yinlan Wu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Yanhong Li
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Tong Wu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Deying Huang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | | | | | | | | | - Xiuping Liang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Lu Cheng
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China
| | - Zehui Liao
- Meishan People's Hospital, Meishan, China
| | - Fang Xu
- Meishan People's Hospital, Meishan, China
| | - Chunyu Tan
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China.
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China.
| | - Yi Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
- Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China.
- Institute of Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Chengdu, China.
| | - Martin Herrmann
- Department of Medicine 3, Universitäts-klinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie DZI, Universitätsklinikum Erlangen, Erlangen, Germany
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19
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da Silva ALG, Vieira LDP, Dias LS, Prestes CV, Back GD, Goulart CDL, Arena R, Borghi-Silva A, Trimer R. Impact of long COVID on the heart rate variability at rest and during deep breathing maneuver. Sci Rep 2023; 13:22695. [PMID: 38123689 PMCID: PMC10733257 DOI: 10.1038/s41598-023-50276-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
While the majority of individuals with coronavirus disease 2019 (COVID-19) recover completely, a significant percentage experience persistent symptom, which has been characterized as Long COVID and may be associated with cardiac and autonomic dysfunction. We evaluated heart rate variability (HRV) at rest and during deep-breathing (M-RSA) in patients with Long COVID. Case-control design involved 21 patients with Long COVID and 20 controls; the HRV was evaluated (POLAR system) at rest in the supine position and during M-RSA and expressed in time domain and non-linear analysis. In the supine position we found a reduction HRV measures in Long COVID' patients compared to controls for: Mean_iRR (p < 0.001), STD_iRR (p < 0.001); STD_HR (p < 0.001); SD1 (p < 0.001); SD2 (p < 0.001); alpha2 (p < 0.001). In the M-RSA we found reduction Mean_iRR (p < 0.001), STD_iRR (p < 0.001), STD_HR (p < 0.001), rMSSD (p < 0.001), RR_tri-index (p < 0.001) in Long COVID' patients except for highest Mean_HR p < 0.001. In conclusion, Long COVID reduced HRV at rest and during deep breathing. These findings may imply impairment of cardiac autonomic control when symptoms of COVID-19 persist following initial recovery.
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Affiliation(s)
- Andréa Lúcia Gonçalves da Silva
- Department of Health Sciences, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil.
- Nucleus of Research in Surveillance, Prevention and Rehabilitation in Cardiorespiratory Diseases, Rio Grande do Sul, Brazil.
| | - Luana Dos Passos Vieira
- Scientific Initiation Scholarship at Laboratory of Cardiorespiratory Rehabilitation, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Luiza Scheffer Dias
- Scientific Initiation Scholarship at Laboratory of Cardiorespiratory Rehabilitation, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Cecília Vieira Prestes
- Scientific Initiation Scholarship at Laboratory of Cardiorespiratory Rehabilitation, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Guilherme Dionir Back
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Cassia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Physiotherapy Department, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Renata Trimer
- Department of Health Sciences, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
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20
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Walters ET, Palackic A, Franco-Mesa C, Shah NR, Erickson MJ, Wolf SE. The impact of COVID-19 on clinical outcomes of burn patients. BURNS & TRAUMA 2023; 11:tkad042. [PMID: 38074193 PMCID: PMC10699731 DOI: 10.1093/burnst/tkad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 03/30/2023] [Accepted: 07/20/2023] [Indexed: 02/12/2024]
Abstract
Background Multiple studies have shown the SARS-CoV-2 virus (COVID-19) to be associated with deleterious outcomes in a wide range of patients. The impact of COVID-19 has not been well investigated among burned patients. We suspect that patients will have worsened respiratory and thrombotic complications, ultimately leading to increased mortality. The objective of this study is to determine the impact a concurrent infection of COVID-19 has on clinical outcomes after a burn injury. Methods This is a retrospective, propensity matched, cohort study. We examined a de-identified database of electronic medical records of over 75 million patients across 75 health care associations in the United States for patients treated for thermal burns from 1 January 2020, to 31 July 2021, and those who also were diagnosed with COVID-19 infection within one day before or after injury based on International Classification of Disease, tenth revision (ICD-10) codes. Study participants included adults who were treated for a burn injury during the study period. Results We included 736 patients with burn injury and concomitant COVID-19 infection matched to 736 patients with burn injury and no concurrent COVID-19 infection (total 1472 patients, mean age 36.3 ± 24.3). We found no significant increase in mortality observed for patients with concurrent COVID-19 (OR 1.203, 95% CI 0.517-2.803; p = 0.6675). We did observe significant increase in infections (OR 3.537, 95% CI 2.798-4.471; p = 0.0001), thrombotic complications (OR 2.342, 95% CI 1.351-4.058; p = 0.0018), as was the incidence of hypertrophic scarring (OR 3.368, 95% CI 2.326-4.877; p = 0.0001). Conclusions We observed that concurrent COVID-19 infection was associated with an increase in infections, thrombosis and hypertrophic scarring but no increase in mortality in our cohort of burn patients.
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Affiliation(s)
- Elliot T Walters
- Department of Surgery, University of Texas Medical Branch, 301 University, Galveston, TX, USA
| | - Alen Palackic
- Department of Surgery, University of Texas Medical Branch, 301 University, Galveston, TX, USA
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Camila Franco-Mesa
- Department of Surgery, University of Texas Medical Branch, 301 University, Galveston, TX, USA
| | - Nikhil R Shah
- Department of Surgery, University of Texas Medical Branch, 301 University, Galveston, TX, USA
| | - Michael J Erickson
- Department of Surgery, University of Texas Medical Branch, 301 University, Galveston, TX, USA
| | - Steven E Wolf
- Department of Surgery, University of Texas Medical Branch, 301 University, Galveston, TX, USA
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21
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Bergeron AJ, Emeshiobi C, Nwankwo N, Doraiswamy M. A Case of Bilateral Pneumothorax With COVID-19 Infection. Cureus 2023; 15:e51081. [PMID: 38269241 PMCID: PMC10807931 DOI: 10.7759/cureus.51081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/26/2024] Open
Abstract
Bilateral spontaneous pneumothorax is a serious complication of coronavirus disease 2019 (COVID-19). The incidence of any spontaneous pneumothorax in patients with the aforementioned viral infection when hospitalized is about 1%. Treatment can involve management such as oxygen support, tube thoracostomy, pleurodesis, or even invasive surgery. The associated mortality with this complication is about 33% to 52%. We present a case of bilateral pneumothorax in a patient diagnosed with COVID-19 without any history of smoking or underlying lung disease. Careful vigilance and close monitoring of this serious complication are mandatory in inpatients.
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22
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Li T, Wang D, Wei H, Xu X. Cytokine storm and translating IL-6 biology into effective treatments for COVID-19. Front Med 2023; 17:1080-1095. [PMID: 38157195 DOI: 10.1007/s11684-023-1044-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
As of May 3, 2023, the Coronavirus disease 2019 (COVID-19) pandemic has resulted in more than 760 million confirmed cases and over 6.9 million deaths. Several patients have developed pneumonia, which can deteriorate into acute respiratory distress syndrome. The primary etiology may be attributed to cytokine storm, which is triggered by the excessive release of proinflammatory cytokines and subsequently leads to immune dysregulation. Considering that high levels of interleukin-6 (IL-6) have been detected in several highly pathogenic coronavirus-infected diseases, such as severe acute respiratory syndrome in 2002, the Middle East respiratory syndrome in 2012, and COVID-19, the IL-6 pathway has emerged as a key in the pathogenesis of this hyperinflammatory state. Thus, we review the history of cytokine storm and the process of targeting IL-6 signaling to elucidate the pivotal role played by tocilizumab in combating COVID-19.
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Affiliation(s)
- Tiantian Li
- Department of Geriatric Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Dongsheng Wang
- Respiratory and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Haiming Wei
- Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, 230001, China
- Hefei National Laboratory for Physical Sciences at Microscale, University of Science and Technology of China, Hefei, 230001, China
| | - Xiaoling Xu
- Respiratory and Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
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23
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Castro-Santos P, Rojas-Martinez A, Riancho JA, Lapunzina P, Flores C, Carracedo Á, Díaz-Peña R. HLA-A*11:01 and HLA-C*04:01 are associated with severe COVID-19. HLA 2023; 102:731-739. [PMID: 37528566 DOI: 10.1111/tan.15160] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/04/2023] [Accepted: 07/09/2023] [Indexed: 08/03/2023]
Abstract
We analyzed the association between HLA polymorphisms and susceptibility to SARS-CoV-2 infection and disease severity. Genotyping data from a total of 9373 COVID-19-positive cases from the Spanish Coalition to Unlock Research on Host Genetics on COVID-19 (SCOURGE) consortium and 5943 population controls were included in the study. We found an association of the alleles HLA-B*14:02 and HLA-C*08:02 with a lower risk to COVID-19 infection (p = 0.006, OR = 0.84, 95% CI = [0.75-0.95], p = 0.024, OR = 0.86, 95% CI = [0.78-0.95], respectively). We also found the alleles HLA-A*11:01 and HLA-C*04:01 associated with disease severity (p = 0.033, OR = 1.16, 95% CI = [1.04-1.31], p = 0.045, OR = 1.14, 95% CI = [1.05-1.25], respectively). These results suggest that an effective presentation of viral peptides by HLA class I alleles involve a faster infection clearance, decreasing the susceptibility and severity of COVID-19.
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Affiliation(s)
- Patricia Castro-Santos
- Fundación Pública Galega de Medicina Xenómica (SERGAS), Centro Nacional de Genotipado, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| | | | - José A Riancho
- IDIVAL, Cantabria, Spain
- Universidad de Cantabria, Cantabria, Spain
- Hospital U M Valdecilla, Cantabria, Spain
| | - Pablo Lapunzina
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz-IDIPAZ, Madrid, Spain
- ERN-ITHACA-European Reference Network, Paris, France
| | - Carlos Flores
- Genomics Division, Instituto Tecnológico y de Energías Renovables (ITER), Santa Cruz de Tenerife, Spain
- Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, University of Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Ángel Carracedo
- Fundación Pública Galega de Medicina Xenómica (SERGAS), Centro Nacional de Genotipado, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Grupo de Medicina Xenómica-CIMUS-Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Roberto Díaz-Peña
- Fundación Pública Galega de Medicina Xenómica (SERGAS), Centro Nacional de Genotipado, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
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24
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Zhang Y, Zhao Y, Liang H, Xu Y, Zhou C, Yao Y, Wang H, Yang X. Innovation-driven trend shaping COVID-19 vaccine development in China. Front Med 2023; 17:1096-1116. [PMID: 38102402 DOI: 10.1007/s11684-023-1034-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/15/2023] [Indexed: 12/17/2023]
Abstract
Confronted with the Coronavirus disease 2019 (COVID-19) pandemic, China has become an asset in tackling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and mutation, with several innovative platforms, which provides various technical means in this persisting combat. Derived from collaborated researches, vaccines based on the spike protein of SARS-CoV-2 or inactivated whole virus are a cornerstone of the public health response to COVID-19. Herein, we outline representative vaccines in multiple routes, while the merits and plights of the existing vaccine strategies are also summarized. Likewise, new technologies may provide more potent or broader immunity and will contribute to fight against hypermutated SARS-CoV-2 variants. All in all, with the ultimate aim of delivering robust and durable protection that is resilient to emerging infectious disease, alongside the traditional routes, the discovery of innovative approach to developing effective vaccines based on virus properties remains our top priority.
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Affiliation(s)
- Yuntao Zhang
- China National Biotec Group Company Limited, Beijing, 100029, China
| | - Yuxiu Zhao
- China National Biotec Group Company Limited, Beijing, 100029, China
| | - Hongyang Liang
- China National Biotec Group Company Limited, Beijing, 100029, China
| | - Ying Xu
- China National Biotec Group Company Limited, Beijing, 100029, China
| | - Chuge Zhou
- China National Biotec Group Company Limited, Beijing, 100029, China
| | - Yuzhu Yao
- China National Biotec Group Company Limited, Beijing, 100029, China
| | - Hui Wang
- China National Biotec Group Company Limited, Beijing, 100029, China.
| | - Xiaoming Yang
- China National Biotec Group Company Limited, Beijing, 100029, China.
- National Engineering Technology Research Center of Combined Vaccines, Wuhan, 430207, China.
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25
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Paduano S, Granata M, Turchi S, Modenese A, Galante P, Poggi A, Marchesi I, Frezza G, Dervishaj G, Vivoli R, Verri S, Marchetti S, Gobba F, Bargellini A. Factors Associated with SARS-CoV-2 Infection Evaluated by Antibody Response in a Sample of Workers from the Emilia-Romagna Region, Northern Italy. Antibodies (Basel) 2023; 12:77. [PMID: 38131799 PMCID: PMC10740768 DOI: 10.3390/antib12040077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/18/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Factors associated with SARS-CoV-2 infection risk are still debated. This case-control study aims to investigate the possible relationship between SARS-CoV-2 infection, evaluated through antibody response, and the main sociodemographic, occupational, clinical-anamnestic, and biochemical factors in a population of Modena province (Northern Italy), mainly workers. Both workers who voluntarily joined the screening campaign proposed by companies and self-referred individuals who underwent serological testing were enrolled. Subjects with antibody positivity were recruited as cases (n = 166) and subjects tested negative (n = 239) as controls. A questionnaire on sociodemographic, occupational, and clinical data was administered through telephone interviews. Serum zinc/iron/copper/chromium/nickel, vitamins D/B12, folates, triglycerides, and LDL/HDL/total cholesterol were measured. Cases lived more often in urban areas (61.8% vs. 57%). Cases and controls did not differ significantly by working macrocategories, but the percentage of workers in the ceramic sector was higher among cases. Low adherence to preventive measures in the workplace was more frequent among seropositives. Folate concentration was significantly lower among cases. Therefore, adequate folate levels, living in rural areas, and good adherence to preventive strategies seem protective against infection. Workers in the ceramic sector seem to be at greater risk; specific factors involved are not defined, but preventive interventions are needed.
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Affiliation(s)
- Stefania Paduano
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Michele Granata
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Sara Turchi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Pasquale Galante
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Alessandro Poggi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Isabella Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Giuseppina Frezza
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Giulia Dervishaj
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Roberto Vivoli
- Test Laboratory, 41100 Modena, Italy; (R.V.); (S.V.); (S.M.)
| | - Sara Verri
- Test Laboratory, 41100 Modena, Italy; (R.V.); (S.V.); (S.M.)
| | | | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
| | - Annalisa Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (M.G.); (S.T.); (A.M.); (P.G.); (A.P.); (I.M.); (G.F.); (G.D.); (F.G.); (A.B.)
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26
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Ghaempanah F, Nikouei M, Cheraghi M, Jahangiri A, Moradi Y. Does tocilizumab have an effect on the clinical outcomes in COVID-19 patients? A meta-analysis of randomized control trials. J Pharm Policy Pract 2023; 16:151. [PMID: 37986199 PMCID: PMC10658795 DOI: 10.1186/s40545-023-00662-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND This meta-analysis was conducted to investigate the impact of tocilizumab on clinical outcomes associated with COVID-19. METHODS A comprehensive search was conducted across Scopus, PubMed (Medline), Cochrane Library, EMBASE (Elsevier), ClinicalTrials.gov, and Web of Sciences to identify pertinent studies published until May 2022. The primary search terms included "tocilizumab" and "COVID-19". Following the formulation of the search strategy, all identified studies were screened, and the data extraction process was initiated. Subsequently, the Cochrane risk of bias checklist was employed to evaluate the risk of bias. The effects of tocilizumab were assessed utilizing the pooled risk ratio (RR) and the fixed effect model in STATA (version 17). RESULTS In this meta-analysis, we analyzed 17 clinical trial studies to assess the impact of tocilizumab on mortality in patients with COVID-19. The pooled risk ratio (RR) for mortality was 0.93 (RR: 0.93; 95% CI: 0.86, 1.00; I2: 72.39%; P value: 0.001). The findings indicated that tocilizumab use was associated with a 4% increase in ICU hospitalization (RR: 1.04; 95% CI: 0.90, 1.20; I2: 0.00%; P value: 0.65). Additionally, tocilizumab administration was linked to a 2% reduction in the requirement for a ventilator (RR: 0.98; 95% CI: 0.90, 1.08; I2: 26.87%; P value: 0.16). CONCLUSION The administration of tocilizumab during the COVID-19 pandemic, prescribed to patients with the virus, exerted a noteworthy impact on reducing outcomes associated with COVID-19.
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Affiliation(s)
- Faezeh Ghaempanah
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maziar Nikouei
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mojtaba Cheraghi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Arman Jahangiri
- Department of Emergency Medicine, School of Medicine, Besat Hospital, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, 66179-13446, Iran.
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27
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Nakayama R, Bunya N, Tagami T, Hayakawa M, Yamakawa K, Endo A, Ogura T, Hirayama A, Yasunaga H, Uemura S, Narimatsu E. Associated organs and system with COVID-19 death with information of organ support: a multicenter observational study. BMC Infect Dis 2023; 23:814. [PMID: 37986049 PMCID: PMC10662555 DOI: 10.1186/s12879-023-08817-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The organ dysfunction that is associated with death in COVID-19 patients has not been determined in multicenter epidemiologic studies. In this study, we evaluated the major association with death, concomitant organ dysfunction, and proportion of multiple organ failure in deaths in patients with COVID-19, along with information on organ support. METHODS We performed an observational cohort study using the Japanese multicenter research of COVID-19 by assembling a real-world data (J-RECOVER) study database. This database consists of data on patients discharged between January 1 and September 31, 2020, with positive SARS-CoV-2 test results, regardless of intensive care unit admission status. These data were collected from the Diagnosis Procedure Combination and electronic medical records of 66 hospitals in Japan. The clinician identified and recorded the organ responsible for the death of COVID-19. RESULTS During the research period, 4,700 patients with COVID-19 were discharged from 66 hospitals participating in the J-RECOVER study; of which, 272 patients (5.8%) from 47 institutions who died were included in this study. Respiratory system dysfunction (87.1%) was the leading association with death, followed by cardiovascular (4.8%), central nervous (2.9%), gastrointestinal (2.6%), and renal (1.1%) dysfunction. Most patients (96.7%) who died of COVID-19 had respiratory system damage, and about half (48.9%) had multi-organ damage. Of the patients whose main association with death was respiratory dysfunction, 120 (50.6%) received mechanical ventilation. CONCLUSION This study showed that although respiratory dysfunction was the most common association with death in many cases, multi-organ dysfunction was associated with death due to COVID-19.
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Affiliation(s)
- Ryuichi Nakayama
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Naofumi Bunya
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
| | - Takashi Tagami
- Department of Emergency and Critical Care Medicine, Nippon Medical School Musashikosugi Hospital, Tokyo, Japan
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Mineji Hayakawa
- Department of Emergency Medicine, Hokkaido University Hospital, Hokkaido, Japan
| | - Kazuma Yamakawa
- Department of Emergency Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Akira Endo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Takayuki Ogura
- Department of Emergency Medicine and Critical Care Medicine, Tochigi Prefectural Emergency and Critical Care Centre, Imperial Foundation Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Atsushi Hirayama
- Department of Social Medicine, Graduate School of Medicine, Public Health, Osaka University, Osaka, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Shuji Uemura
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Eichi Narimatsu
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, 291, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
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Fonseca L, Pereira FM, Moura L, Brito A, Lobo F, Amaral AP, Costa M. COVID-19 in a Portuguese whole blood donor population. Heliyon 2023; 9:e20570. [PMID: 38027845 PMCID: PMC10651442 DOI: 10.1016/j.heliyon.2023.e20570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to pneumonia and acute respiratory distress syndrome. The COVID-19 pandemic had a major impact on the stock of blood banks worldwide. This study aims to assess the prevalence of COVID-19 in a population of whole blood donors and analyze the possible association between blood group and susceptibility to the disease and the impact of adopting preventive measures against SARS-CoV-2 infection. Material and methods: This retrospective study included all whole blood donors from a Portuguese hospital between July and September 2021. A self-assessment questionnaire was used to collect data on COVID-19 infection, vaccination, and preventive measures. Statistical analysis was performed using Chi-square and Mann-Whitney U tests. Results: The prevalence of COVID-19 in the donor population was 11.96% (n = 97), with only 2 cases of serious illness requiring hospitalization. No association was found between blood group and disease susceptibility. Older men were less likely to adopt preventive measures. The vaccination rate was high, with 84.26% of donors having received at least one dose of the vaccine. Seven donors declined COVID-19 vaccination. Preventive measures did not differ based on COVID-19 infection status or vaccination. Discussion: Although there was a higher frequency of COVID-19 in group A donors, the blood group was not associated with susceptibility to infection. The donor population consisted of young individuals without comorbidities, showing a COVID-19 prevalence like the general population and few severe cases. The high vaccination rate and adoption of preventive measures likely contributed to these findings.
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Affiliation(s)
- Liliana Fonseca
- Serviço de Sangue e Medicina Transfusional, Centro Hospitalar Tondela-Viseu, Portugal
| | | | - Luís Moura
- Serviço de Sangue e Medicina Transfusional, Centro Hospitalar Tondela-Viseu, Portugal
| | - Arnaldo Brito
- Serviço de Sangue e Medicina Transfusional, Centro Hospitalar Tondela-Viseu, Portugal
| | - Filipe Lobo
- Serviço de Sangue e Medicina Transfusional, Centro Hospitalar Tondela-Viseu, Portugal
| | - Ana Palmira Amaral
- Serviço de Sangue e Medicina Transfusional, Centro Hospitalar Tondela-Viseu, Portugal
| | - Marina Costa
- Serviço de Sangue e Medicina Transfusional, Centro Hospitalar Tondela-Viseu, Portugal
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van Loon OR, van Loon AJT. A future with sustainable healthcare requires fundamental medical rethinking - Comment on the editorial by Kathi Kemper. Complement Ther Med 2023; 78:102989. [PMID: 37769926 DOI: 10.1016/j.ctim.2023.102989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023] Open
Affiliation(s)
- O R van Loon
- Privat Klinik im Park, Therapy Department, Badstrasse 50, CH-5116 Schinznach-Bad, Switzerland.
| | - A J Tom van Loon
- College of Earth Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, Shandong, China.
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30
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Hunakova L, Sabaka P, Zvarik M, Mikolaskova I, Gidron Y, Bucova M. Linear and non‑linear indices of vagal nerve in relation to sex and inflammation in patients with Covid‑19. Biomed Rep 2023; 19:80. [PMID: 37829259 PMCID: PMC10565716 DOI: 10.3892/br.2023.1662] [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: 03/17/2023] [Accepted: 07/18/2023] [Indexed: 10/14/2023] Open
Abstract
Hyperinflammation is one of the most important pathophysiological risk factors for poor prognosis in patients with coronavirus disease-2019 (Covid-19). Low vagal neuro-immune modulation can lead into this kind of immune dysregulation. The association between vagal activity, sex and inflammatory markers were investigated in patients with Covid-19. A total of 19 patients with Covid-19 were included in the present study. Vagus nerve activity was indexed by heart rate variability (HRV) derived from electrocardiogram at hospital admission. Linear HRV parameters included the root mean square of successive RR interval differences (RMSSD) and high-frequency HRV (HF-HRV), while non-linear parameters included 2 UV%. Immune/inflammatory parameters included C-reactive protein (CRP), interleukin-6 (IL-6), neutrophil/lymphocyte ratio (NLR), systemic inflammatory index (SII), and procalcitonin (PCT). It has been revealed that both linear HRV indices HF-HRV and RMSSD, are significantly negatively correlated with CRP and IL-6, independent of age. The non-linear index of 2 UV% is significantly negatively correlated with NLR and SII, which reflect subtle changes in the response of immunocompetent cells. Patients that received high-flow nasal oxygen therapy had significantly higher IL-6 and CRP levels and lower levels of HF-HRV and RMSSD. These patients also had a significantly longer length of stay in hospital (LOS) than patients receiving low-flow oxygen therapy. Men had higher plasma PCT levels and longer LOS in hospital than women, and PCT statistically explained (mediated) the association between sex and LOS. The present study showed different correlations of linear and non-linear vagal indexes of HRV and inflammatory markers in patients with Covid-19. Significant sex differences in certain inflammatory markers were also observed, which may very well verify previous findings of poor prognosis in men with Covid-19. HRV reflects a continuous interaction between the sympathetic and parasympathetic autonomic nervous systems, which are affected by mental or physical stress, and certain disease states. The increased sympathetic and decreased parasympathetic vagal tone contribute to a higher risk of diseases associated with inflammation, cardiovascular disease, cancer, pulmonary diseases and other pathologies, including infectious diseases such as Covid-19. The present study showed that higher RMSSD (a marker of vagal activity) in Covid-19 patients is associated with lower levels of inflammatory biomarkers, a lower need for treatment and is negatively correlated with intensive care unit admission, leading to a shorter hospital stay. These findings support the idea that activation of vagus nerve may help certain Covid-19 patients by reducing the cytokine storm and excessive inflammation.
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Affiliation(s)
- Luba Hunakova
- Institute of Immunology, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
| | - Peter Sabaka
- Department of Infectology and Geographical Medicine, Faculty of Medicine, Comenius University, 833 05 Bratislava, Slovakia
- Department of Infectology and Geographical Medicine, University Hospital Bratislava, 833 05 Bratislava, Slovakia
| | - Milan Zvarik
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Computer Science, Comenius University, 84248 Bratislava, Slovakia
| | - Iveta Mikolaskova
- Institute of Immunology, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
| | - Yori Gidron
- Department of Nursing, Faculty of Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel
| | - Maria Bucova
- Institute of Immunology, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
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Marseglia GL, Ciprandi G. Clinical use of ketoprofen lysine salt: a reappraisal in adolescents with acute respiratory infections. Allergol Immunopathol (Madr) 2023; 51:76-82. [PMID: 37937499 DOI: 10.15586/aei.v51i6.918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/23/2023] [Indexed: 11/09/2023]
Abstract
Upper respiratory infections are widespread, and they are mainly of viral etiology. It has to be remarked that every infection is always associated with an inflammatory response. Inflammation implicates a cascade of bothersome symptoms, including fever, pain (headache, myalgia, and arthralgia), malaise, and respiratory complaints. As a result, anti-inflammatory medications could be beneficial as they act on different pathogenetic pathways. The ketoprofen lysine salt (KLS) has a potent anti-inflammatory activity associated with effective analgesic and antipyretic effects and has a valuable safety profile. However, adolescents present peculiar psychological characteristics that determine their difficulty to be managed. In this regard, an adolescent with a respiratory infection requires a prompt and adequate cure. KLS, thanks to its pharmacologic profile, could be favorably used in this regard. A recent primary-care experience outlined its effectiveness in this issue.
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Affiliation(s)
- Gian Luigi Marseglia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy;
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32
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Xie Z, Jiang N, Lin M, He X, Li B, Dong Y, Chen S, Lv G. The Mechanisms of Polysaccharides from Tonic Chinese Herbal Medicine on the Enhancement Immune Function: A Review. Molecules 2023; 28:7355. [PMID: 37959774 PMCID: PMC10648855 DOI: 10.3390/molecules28217355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Tonic Chinese herbal medicine is a type of traditional Chinese medicine, and its primary function is to restore the body's lost nutrients, improve activity levels, increase disease resistance, and alleviate physical exhaustion. The body's immunity can be strengthened by its polysaccharide components, which also have a potent immune-system-protecting effect. Several studies have demonstrated that tonic Chinese herbal medicine polysaccharides can improve the body's immune response to tumor cells, viruses, bacteria, and other harmful substances. However, the regulatory mechanisms by which various polysaccharides used in tonic Chinese herbal medicine enhance immune function vary. This study examines the regulatory effects of different tonic Chinese herbal medicine polysaccharides on immune organs, immune cells, and immune-related cytokines. It explores the immune response mechanism to understand the similarities and differences in the effects of tonic Chinese herbal medicine polysaccharides on immune function and to lay the foundation for the future development of tonic Chinese herbal medicine polysaccharide products.
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Affiliation(s)
- Zhiyi Xie
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Huzhou 313200, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou 313200, China
| | - Ninghua Jiang
- The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, China;
| | - Minqiu Lin
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Huzhou 313200, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou 313200, China
| | - Xinglishang He
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Huzhou 313200, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou 313200, China
| | - Bo Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Huzhou 313200, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou 313200, China
| | - Yingjie Dong
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Huzhou 313200, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou 313200, China
| | - Suhong Chen
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Huzhou 313200, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou 313200, China
| | - Guiyuan Lv
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
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Silveira MAD, Menezes MDA, de Souza SP, Galvão EBDS, Berretta AA, Caldas J, Teixeira MB, Gomes MMD, Damiani LP, Bahiense BA, Cabral JB, De Oliveira CWLM, Mascarenhas TR, Pinheiro PCG, Alves MS, de Melo RMV, Leite FM, Nonaka CKV, Souza BSDF, Baptista NU, Teles F, da Guarda SF, Mendes AVA, Passos RDH. Standardized Brazilian green propolis extract (EPP-AF®) in COVID-19 outcomes: a randomized double-blind placebo-controlled trial. Sci Rep 2023; 13:18405. [PMID: 37891178 PMCID: PMC10611696 DOI: 10.1038/s41598-023-43764-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
SARS-CoV-2 and its different variants caused a "wave and wave" pandemic pattern. During the first wave we demonstrated that standardized Brazilian green propolis extract (EPP-AF®) reduces length of hospital stay in adult patients with COVID-19. Afterwards, we decided to evaluate the impact of EPP-AF in hospitalized patients during the third wave of the pandemic. BeeCovid2 was a randomized, double-blind, placebo-controlled clinical trial in hospitalized COVID-19 adult patients. Patients were allocated to receive an oral dose of 900 mg/day of EPP-AF® or placebo for 10 days. The primary outcome was length of hospital stay. Secondary outcomes included safety, secondary infection rate, duration of oxygen therapy dependency, acute kidney injury and need for intensive care. Patients were followed up for 28 days after admission. We enrolled 188 patients; 98 were assigned to the propolis group and 90 to the placebo group. The post-intervention length of hospital stay was of 6.5 ± 6.0 days in the propolis group versus 7.7 ± 7.1 days in the control group (95% CI - 0.74 [- 1.94 to 0.42]; p = 0.22). Propolis did not have significant impact on the need for oxygen supplementation or frequency of AKI. There was a significant difference in the incidence of secondary infection between groups, with 6.1% in the propolis group versus 18.9% in the control group (95% CI - 0.28 [0.1-0.76], p = 0.01). The use of EPP-AF was considered safe and associated with a decrease in secondary infections. The drug was not associated with a significant reduction in length of hospital stay. ClinicalTrials.gov (NCT04800224).
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Affiliation(s)
- Marcelo Augusto Duarte Silveira
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil.
| | - Matheus de Alencar Menezes
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Sergio Pinto de Souza
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Erica Batista Dos Santos Galvão
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Andresa Aparecida Berretta
- Development and Innovation Department, Apis Flora Indl. Coml. Ltda, Rua Triunfo 945, Subsetor Sul 3, Ribeirão Preto, SP, 14020-670, Brazil
| | - Juliana Caldas
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Maurício Brito Teixeira
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Marcel Miranda Dantas Gomes
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Lucas Petri Damiani
- Academic Research Organization, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Morumbi, São Paulo, SP, 05652-000, Brazil
| | - Bruno Andrade Bahiense
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Julia Barros Cabral
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | | | - Talita Rocha Mascarenhas
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Priscila Carvalho Guedes Pinheiro
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Milena Souza Alves
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Rodrigo Morel Vieira de Melo
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
- School of Medicine, Federal University of Bahia, Rua Augusto Viana s/n, Canela, Salvador, BA, 40110-909, Brazil
| | - Flávia Mendes Leite
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Carolina Kymie Vasques Nonaka
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Bahia, 40296-710, Brazil
| | - Bruno Solano de Freitas Souza
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Bahia, 40296-710, Brazil
| | - Nathália Ursoli Baptista
- Development and Innovation Department, Apis Flora Indl. Coml. Ltda, Rua Triunfo 945, Subsetor Sul 3, Ribeirão Preto, SP, 14020-670, Brazil
| | - Flávio Teles
- School of Medicine, Federal University of Alagoas, Av. Lourival de Melo Mota S/N, Tabuleiro do Martins, Maceió, Alagoas, 57072-900, Brazil
| | - Suzete Farias da Guarda
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
- School of Medicine, Federal University of Bahia, Rua Augusto Viana s/n, Canela, Salvador, BA, 40110-909, Brazil
| | - Ana Verena Almeida Mendes
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
| | - Rogério da Hora Passos
- D'Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador, BA, 41253-190, Brazil
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Souza KM, Carrasco G, Rojas-Cortés R, Michel Barbosa M, Bambirra EHF, Castro JL, Alvares-Teodoro J. Effectiveness of nirmatrelvir-ritonavir for the treatment of patients with mild to moderate COVID-19 and at high risk of hospitalization: Systematic review and meta-analyses of observational studies. PLoS One 2023; 18:e0284006. [PMID: 37824507 PMCID: PMC10569636 DOI: 10.1371/journal.pone.0284006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE To assess the effectiveness of nirmatrelvir-ritonavir in the treatment of outpatients with mild to moderate COVID-19 who are at higher risk of developing severe illness, through a systematic review with meta-analyses of observational studies. METHODS A systematic search was performed, in accordance with the Cochrane search methods, to identify observational studies that met the inclusion criteria. The outcomes of mortality and hospitalization were analyzed. Search was conducted on PubMed, EMBASE, and The Cochrane Library. Two reviewers independently screened references, selected the studies, extracted the data, assessed the risk of bias using ROBINS-I tool and evaluated the quality of evidence using the GRADE tool. This study followed the PRISMA reporting guideline. RESULTS A total of 16 observational studies were finally included. The results of the meta-analysis showed that in comparison to standard treatment without antivirals, nirmatrelvir-ritonavir reduced the risk of death by 59% (OR = 0.41; 95% CI: 0.35-0.52; moderate certainty of evidence). In addition, a 53% reduction in the risk of hospital admission was observed (OR = 0.47; 95% CI: 0.36-0.60, with very low certainty of evidence). For the composite outcome of hospitalization and/or mortality, there was a 56% risk reduction (OR = 0.44; 95% CI: 0.31-0.64, moderate certainty of evidence). CONCLUSION The results suggest that nirmatrelvir-ritonavir could be effective in reducing mortality and hospitalization. The results were valid in vaccinated or unvaccinated high-risk individuals with COVID-19. Data from ongoing and future trials may further advance our understanding of the effectiveness and safety of nirmatrelvir-ritonavir and help improve treatment guidelines for COVID-19.
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Affiliation(s)
| | - Gabriela Carrasco
- Red Argentina Pública de Evaluación de Tecnologías Sanitarias (REDARETS), Neuquén, Argentina
| | - Robin Rojas-Cortés
- Department of Health Systems and Services, Pan American Health Organization, Unit of Medicines and Health Technologies, Washington, DC, United States of America
| | - Mariana Michel Barbosa
- Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - José Luis Castro
- Fundación Para la Innovación, la Formación, la Investigación y el Desarrollo Comunitário (FÜNDEC), San Isidro, S/C de Tenerife, España
| | - Juliana Alvares-Teodoro
- Postgraduate Program in Medicines and Pharmaceutical Services, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Pharmacy, Department of Social Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Liu Y, Huang X, Li P, Wang D, Yin H, Wang N, Luo Y, Li H, Sun S. Clinical Profile and Outcome Analysis of Ear-Nose-Throat Symptoms in SARS-CoV-2 Omicron Subvariant Infections. Int J Public Health 2023; 68:1606403. [PMID: 37920846 PMCID: PMC10619212 DOI: 10.3389/ijph.2023.1606403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 11/04/2023] Open
Abstract
Objective: This study aimed to investigate the clinical characteristics and outcomes of ear-nose-throat (ENT) symptoms in SARS-CoV-2 Omicron infected patients resulting from local transmission. Methods: A convenience sampling network survey was conducted among individuals infected with SARS-CoV-2 to examine the characteristics and progression of ENT symptoms associated with local transmission. The survey comprised 52 questions, and univariable and multivariable logistic regression analyses were employed to assess the rate, severity, and outcome of ENT symptoms across different genders and age groups. Results: Among the 1,366 individuals included in the investigation, a peak in new infections occurred on 20th December, and the majority (78.4%) were female. The most common symptoms reported were coughing (90.6%), nasal congestion (77.2%), and runny nose (74.3%). Otologic symptoms were predominantly represented by tinnitus (29.7%). Conclusion: The rate of specific symptoms showed a significant correlation with age and gender. It is crucial to provide timely medical intervention, especially for female patients. This study offers a comprehensive understanding of the symptom spectrum in individuals infected with the virus, providing valuable insights for the development of targeted symptom management strategies.
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Affiliation(s)
- Yixuan Liu
- Scientific Research Division, Eye & ENT Hospital, Shanghai, China
- Otolaryngology Research Institute, Eye & ENT Hospital, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Xiaoling Huang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated, Hospital of Anhui Medical University, Hefei, China
| | - Peifan Li
- Scientific Research Division, Eye & ENT Hospital, Shanghai, China
- Otolaryngology Research Institute, Eye & ENT Hospital, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Di Wang
- Scientific Research Division, Eye & ENT Hospital, Shanghai, China
- Clinical Research Unit of Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Haoning Yin
- No. 2 High School of East China Normal University, Shanghai, China
| | - Na Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Yan Luo
- Medical Dean’s Reception Office, Fudan University, Shanghai, China
| | - Huawei Li
- Scientific Research Division, Eye & ENT Hospital, Shanghai, China
- Otolaryngology Research Institute, Eye & ENT Hospital, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated, Hospital of Anhui Medical University, Hefei, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Shan Sun
- Scientific Research Division, Eye & ENT Hospital, Shanghai, China
- Otolaryngology Research Institute, Eye & ENT Hospital, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Clinical Research Unit of Eye & ENT Hospital, Fudan University, Shanghai, China
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Yu T, Sun S. Role and mechanism of ferroptosis in acute lung injury. Cell Cycle 2023; 22:2119-2129. [PMID: 37946318 PMCID: PMC10732650 DOI: 10.1080/15384101.2023.2278328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
Ferroptosis is a new non-apoptotic cell death caused by the accumulation of dysregulated metabolism of ferric iron, amino acids or lipid peroxidation. Increasing studies suggest that ferroptosis is involved in the acute lung injury (ALI). This article aims to review the role of ferroptosis in ALI. ALI is a common respiratory disease and presents a high mortality rate. Inhibiting cell ferroptosis of lung improves the ALI. In addition, several signaling pathways are related to ferroptosis in ALI, involving in iron homeostasis, lipid peroxidation, and amino acid metabolism. Moreover, there are various key factors to regulate the occurrence of ferroptosis in ALI, such as ACSL4, NRF2, and P53. The ACSL4 promotes the ferroptosis, while the NRF2 alleviates the ferroptosis in ALI. The main effect of P53 is to promote ferroptosis. Accordingly, ferroptosis is involved in ALI and may be an important therapeutic target for ALI.
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Affiliation(s)
- Tingting Yu
- Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital, Kunming Medical University, Kunming, China
- Pediatrics Class 1, Kunming Medical University, Kunming, China
| | - Shibo Sun
- Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital, Kunming Medical University, Kunming, China
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Franco-Mesa C, Walters ET, Shah NR, Palackic A, Wolf SE, Silva MB. Implications of COVID-19 Infection on Arteriovenous Fistula Thrombosis. Vasc Endovascular Surg 2023; 57:732-737. [PMID: 37159054 DOI: 10.1177/15385744231174664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Objective: This study aims to identify and analyze implications of COVID-19 positivity on AVF occlusion, subsequent treatment patterns, and ESRD patient outcomes. Our aim is to provide a quantitative context for vascular access surgeons in order to optimize surgical decision making and minimize patient morbidity. Methods: The de-identified national TriNetX database was queried to extracted all adult patients who had a known AVF between January 1, 2020 and December 31, 2021. From this cohort individuals who also were diagnosed with COVID-19 prior to creation of their AVF were identified. Cohorts were propensity score matched according to age at AVF surgery, gender, ethnicity, diabetes mellitus, nicotine dependence, tobacco use, use of anticoagulant medications, and use of platelet aggregation inhibitors, hypertensive diseases, hyperlipidemia, and prothrombotic states. Results: After propensity score matching there were 5170 patients; 2585 patients in each group. The total patient population had 3023 (58.5%) males and 2147 (41.5%) females. The overall rate of thrombosis of AV fistulas was 300 (11.6%) in the cohort with COVID-19 and 256 (9.9%) in the control group (OR 1.199, CI 1.005-1.43, P =.0453). Open revisions of AVF with thrombectomy were significantly higher in the COVID-19 cohort compared to the non-COVID-19 group (1.5% vs .5% P = .0002, OR 3.199, CI 1.668-6.136). Regarding the time from AVF creation to intervention, the median days for open thrombectomy in COVID-19 patients was 72 vs 105 days in controls. For endovascular thrombectomy, the median was 175 vs 168 days for the COVID-19 and control cohorts respectively. Conclusion: As for this study, there were significant differences in rates of thrombosis and open revisions of recent created AVF, however endovascular interventions remained remarkably low. As noted in this study, the persistent prothrombotic state of patients with a history of COVID-19 may persist beyond the acute infectious period of the disease.
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Affiliation(s)
- Camila Franco-Mesa
- Department of Surgery, University of Texas Medical Branch, Galveston TX, USA
| | - Elliot T Walters
- Department of Surgery, University of Texas Medical Branch, Galveston TX, USA
| | - Nikhil R Shah
- Department of Surgery, University of Texas Medical Branch, Galveston TX, USA
| | - Alen Palackic
- Department of Surgery, University of Texas Medical Branch, Galveston TX, USA
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Steven E Wolf
- Department of Surgery, University of Texas Medical Branch, Galveston TX, USA
| | - Michael B Silva
- Department of Surgery, University of Texas Medical Branch, Galveston TX, USA
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Lebioda LA, Pedroso B, dos Santos MEC, Pinto GMC, Welling LC. Neurological telerehabilitation in the COVID-19 era - current perspectives through a bibliometric analysis. Front Neurol 2023; 14:1227846. [PMID: 37794878 PMCID: PMC10546771 DOI: 10.3389/fneur.2023.1227846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 10/06/2023] Open
Abstract
Objective To identify bibliometric parameters and research trends regarding to telerehabilitation of patients with stroke in the COVID-19 era. Methodology This is an integrative review carried out in the Scopus database, from June to July 2021, through the Biblioshiny graphical interface, provided by the Bibliometrix program. The search terms used were "Stroke," "COVID-19" and "Telerehabilitation." Results were filtered by publication date from 2019 onwards. No language restrictions were imposed. Results Twenty two articles were included in the study and the results were presented in the form of figures demonstrating that the journal Frontiers in Neurology was the one with the most relevant studies and the author with the highest number of citations. The Brazilian Academy of Neurology was the institution with the greatest number of studies and China ranked first as the country with the greatest scientific production. The authors used recent references in their work. A thematic map showed the centrality and density of the words presented and, finally, a three-field graph showed a strong intimacy between countries, keywords and authors. Conclusion A greater interest in the subject was observed in China with greater relevance of journals and institutions focused on neurology. However, despite telerehabilitation being an effective alternative in the context of the pandemic, few studies have explored this modality.
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Cao L, Sun Y, Chen F. Pulmonary nocardiosis following COVID-19 in a patient with idiopathic pulmonary fibrosis and lung transplantation: a case report. Front Med (Lausanne) 2023; 10:1266857. [PMID: 37766921 PMCID: PMC10520695 DOI: 10.3389/fmed.2023.1266857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Background Nocardiosis is an opportunistic infection that primarily affects immunocompromised patients. Pulmonary nocardiosis is the most prevalent form, but can also spread to other organs. Potential causes contributing to opportunistic infection may include immunosuppression and disruption of tight junctions, both of which can result from COVID-19. Case presentation We reported a case of a 68-year-old male patient who presented with a 10-day history of fever, cough, and productive sputum. Upon physical examination, velcro rales were detected in the right lung, while breath sounds in the left lung were clear. The patient had previously undergone left lung transplantation due to idiopathic pulmonary fibrosis four years ago. He was initially hospitalized and treated for COVID-19 but was readmitted due to worsening symptoms. Subsequently, pulmonary nocardiosis was diagnosed utilizing metagenomic next-generation sequencing of bronchoalveolar lavage fluid. The above-mentioned condition was improved following treatment with cancidas and linezolid. Now, he is under regular follow-up. Conclusion This case highlights the complexity of COVID-19 and the occurrence of secondary opportunistic infections, which require further investigation.
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Affiliation(s)
| | | | - Fei Chen
- Cancer Center, Department of Pulmonary and Critical Care Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Liu X, Tian Y, Jiang C, Dong M, Li M, Sun H, Han X, Li F. The impact of SARS-Cov-2 infection on the periocular injection pain and hypersensitive reaction to botulinum toxin type A: results from clinical questionnaires. Front Cell Infect Microbiol 2023; 13:1240303. [PMID: 37731822 PMCID: PMC10508337 DOI: 10.3389/fcimb.2023.1240303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/01/2023] [Indexed: 09/22/2023] Open
Abstract
Background The COVID-19 pandemic has brought about significant changes in the medical field, yet the use of botulinum toxin type A has remained uninterrupted. Plastic surgeons must carefully consider the timing of administering botulinum toxin type A to patients who have recovered from COVID-19. Methods A questionnaire survey was conducted among patients who had contracted and recovered from SARS-CoV-2 within a month. The survey aimed to investigate various indicators in patients who had received botulinum toxin A injections at the same site before and after their infection, including pain scores and allergic reactions and the occurrence of complications. Results The pain scores of patients who contracted SARS-CoV-2 infection between 14-21 days post-infection exhibited significant variation from previous injections. However, patients who contracted the infection between 22-28 days post-infection did not exhibit significant variation from previous injections. Furthermore, the incidence of allergic reactions and complications following botulinum toxin injection within one month after contracting the infection did not significantly differ from that observed prior to infection. Conclusion Administering botulinum toxin type A three weeks after COVID-19 recovery is a justifiable and comparatively secure approach.
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Affiliation(s)
- Xiangyu Liu
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yanli Tian
- ADD+ Medical Esthetic Clinic, Beijing, China
| | - Chanyuan Jiang
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Miao Dong
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ming Li
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Hefeng Sun
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xuefeng Han
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Facheng Li
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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Bassanello M, Geppini R, Bonsembiante E, Coli U, Farencena A, D’Aquino M, Gambaro A, Buja A, Baldovin T. Risk of SARS-CoV-2 transmission in the close contacts in a small rural area in the Veneto Region (NE-Italy): past evidence for future scenarios. Front Public Health 2023; 11:1223109. [PMID: 37732097 PMCID: PMC10507707 DOI: 10.3389/fpubh.2023.1223109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Background During the first pandemic phase of COVID-19, an epidemiological study, named First survey, was conducted on the population of a small rural area in northern Italy. In spring 2020, the results showed how a prolonged lockdown slowed down the spread of the virus. Methods After contacting positive First Survey subjects and their families, those who decided to join voluntarily underwent a blood test to assess the presence of qualitative lgG about 2 months after the previous one. This was to determine if IgG persisted in individuals who tested positive in the First Survey as well as to assess the antibody status of their close family members, to determine if they were unintentionally infected. Results Based on serological analysis, 35.1% of the samples contained blood IgG. In subjects who tested positive during the First Survey, 62.5% remained IgG positive more than 2 months later. Among family members who were exposed to a positive relative, 23.7% were infected. Linear regression analysis showed that the presence of an infected person within a household resulted in the infection spreading to the others, but not excessively. Induced isolation extinguished the infection regardless of the extent of the contagion (intra-family or extra-family). Micro-outbreaks of SARS-Cov-2 infection which arose in the same household from extra-familial infections played a decisive role on the statistical significance of IgG-positive subjects (p < 0.001). Discussion The study reveal 52.6% of the IgG-positive subjects in the Second Survey came from the First Survey and 47.4% were family members previously in contact with positive subjects. Data suggest that there have been undiagnosed patients feeding the spread of the virus since the beginning of the pandemic. In conclusion, for future pandemics, it will be necessary: i) to ensure the rapid isolation of symptomatic patients and the early identification of their close contacts, ii) to carry out the maximum number of tests in the shortest possible time, both on symptomatic and asymptomatic subjects, and iii) to implement information campaigns to make people aware of their risks, and implement clear, non-conflicting communication.
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Affiliation(s)
- Marco Bassanello
- Emergency and Health Department, Monastier di Treviso Hospital, Treviso, Italy
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Ruggero Geppini
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | | | - Ugo Coli
- Health Department, Monastier di Treviso Hospital, Treviso, Italy
| | - Aldo Farencena
- Laboratory and Microbiology Monastier di Treviso Hospital, Treviso, Italy
| | | | - Andrea Gambaro
- Department of Environmental Sciences, Informatics and Statistics (DAIS), Ca’ Foscari University of Venice, Venice, Italy
| | - Alessandra Buja
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Tatjana Baldovin
- Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
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Zhang YD, He TW, Chen YR, Xiong BD, Zhe Z, Liu P, Tang BQ. A Model for Predicting the Duration of Viral Shedding in Patients Who Had Been Hospitalized with Mild COVID-19: A Single-Center Retrospective Study. Infect Drug Resist 2023; 16:5799-5813. [PMID: 37692465 PMCID: PMC10492566 DOI: 10.2147/idr.s421938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023] Open
Abstract
Background Clinical decision-making is enhanced by the development of a mathematical model for prognosis prediction. Screening criteria associated with viral shedding time and developing a prediction model facilitate clinical decision-making and are, thus, of great medical value. Methods This study comprised 631 patients who were hospitalized with mild COVID-19 from a single center and 30 independent variables included. The data set was randomly divided into the training set (80%) and the validation set (20%). The outcome variable included viral shedding time and whether the viral shedding time >14 days, LASSO was used to screen the influencing factors. Results There were 321 males and 310 females among the 631 cases, with an average age of 62.1 years; the median viral shedding time was 12 days, and 68.8% of patients experienced viral shedding within 14 days, with fever (50.9%) and cough (44.2%) being the most common clinical manifestations. Using LASSO with viral shedding time as the outcome variable, the model with lambda as 0.1592 (λ = 0.1592) and 13 variables (eg the time from diagnosis to admission, constipation, cough, hs-CRP, IL-8, IL-1β, etc.) was more accurate. Factors were screened by LASSO and multivariable logistic regression with whether the viral shedding time >14 days as the outcome variable, five variables, including the time from diagnosis to admission, CD4 cell count, Ct value of ORF1ab, constipation, and IL-8, were included, and a nomogram was drawn; after model validation, the consistency index was 0.888, the AUC was 0.847, the sensitivity was 0.744, and the specificity was 0.830. Conclusion A clinical model developed after LASSO regression was used to identify the factors that influence the viral shedding time. The predicted performance of the model was good, and it was useful for the allocation of medical resources.
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Affiliation(s)
- Ya-Da Zhang
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Tai-Wen He
- Department of Ophthalmology, Shanghai Public Health Clinical Center, Shanghai, 201500, People’s Republic of China
| | - Yi-Ren Chen
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Bi-Dan Xiong
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Zhe Zhe
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
| | - Ping Liu
- Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, 201500, People’s Republic of China
| | - Bin-Qing Tang
- Department of Pneumology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China
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Xiao K, Liu C, Wang H, Hou F, Shi Y, Qian ZR, Zhang H, Deng DYB, Xie L. Umbilical cord mesenchymal stem cells overexpressing CXCR7 facilitate treatment of ARDS-associated pulmonary fibrosis via inhibition of Notch/Jag1 mediated by the Wnt/β-catenin pathway. Biomed Pharmacother 2023; 165:115124. [PMID: 37454589 DOI: 10.1016/j.biopha.2023.115124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023] Open
Abstract
The therapeutic efficacy of umbilical cord mesenchymal stem cells (UCMSCs) in acute respiratory distress syndrome (ARDS) is mainly limited by the efficiency of homing of UCMSCs toward tissue damage. C-X-C chemokine receptor type 7 (CXCR7), which is involved in the mobilization of UCMSCs, is only expressed on the surface of a small proportion of UCMSCs. This study examined whether overexpression of CXCR7 in UCMSCs (UCMSCsOE-CXCR7) could improve their homing efficiency, and therefore, improve their effectiveness in fibrosis repair at the site of lung injury caused by ARDS. A lentiviral vector expressing CXCR7 was built and then transfect into UCMSCs. The impacts of CXCR7 expression of the proliferationand homing of UCMSCs were examined in a lipopolysaccharide-induced ARDS mouse model. The potential role and underlying mechanism of CXCR7 were examined by performing scratch assays, transwell assays, and immunoassays. The therapeutic dose and treatment time of UCMSCsOE-CXCR7 were directly proportional to their therapeutic effect on lung injury. In addition, overexpression of CXCR7 increased SDF-1-induced proliferation and migration of lung epithelial cells (Base-2b cells), and upregulation of CXCR7 inhibited α-SMA expression, suggesting that CXCR7 may have a role in alleviating pulmonary fibrosis caused by ARDS. Overexpression of CXCR7 in UCMSCs may improve their therapeutic effect of acute lung injury mouse, The mechanism of fibrosis repair by CXCR7 is inhibition of Jag1 via suppression of the Wnt/β-catenin pathway under the chemotaxis of SDF-1.
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Affiliation(s)
- Kun Xiao
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Chang Liu
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China; School of medicine Nankai university, Tianjin 300071, China
| | - Heming Wang
- Hainan Key Laboratory for Sustainable Utilization of Tropical Bioresource, Hainan University, Haikou 570228, China
| | - Fei Hou
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Yinghan Shi
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhi Rong Qian
- Department of Scientific Research Center, The Seventh Affiliated Hospital of Sun YatSen University, Shenzhen 518106, China; Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Hao Zhang
- Institute of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, China.
| | - David Y B Deng
- Department of Scientific Research Center, The Seventh Affiliated Hospital of Sun YatSen University, Shenzhen 518106, China.
| | - Lixin Xie
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China.
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Li J, Guo S, Tan Y, Zhang J, Wu Z, Stalin A, Zhang F, Huang Z, Wu C, Liu X, Huang J, Wu J. Integrated network pharmacology analysis and in vitro validation revealed the underlying mechanism of Xiyanping injection in treating coronavirus disease 2019. Medicine (Baltimore) 2023; 102:e34866. [PMID: 37653800 PMCID: PMC10470725 DOI: 10.1097/md.0000000000034866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, leading to a pandemic. In China, Xiyanping injection (XYP) has been recommended as a drug for COVID-19 treatment in the Guideline on Diagnosis and Treatment of COVID-19 by the National Health Commission of the People Republic of China and National Administration of Traditional Chinese Medicine (Trial eighth Edition). However, the relevant mechanisms at the molecular-level need to be further elucidated. METHODS In this study, XYP related active ingredients, potential targets and COVID-19 related genes were searched in public databases. Protein-protein interaction network and module analyzes were used to screen for key targets. gene ontology and Kyoto encyclopedia of genes and genomes were performed to investigate the potentially relevant signaling pathways. Molecular docking was performed using Autodock Tools and Vina. For the validation of potential mechanism, PolyI:C was used to induce human lung epithelial cells for an inflammation model. Subsequently, CCK-8 assays, enzyme-linked immunosorbent assay, reverse transcription quantitative polymerase chain reaction and western blot were employed to determine the effect of XYP on the expression of key genes. RESULTS Seven effective active ingredients in XYP were searched for 123 targets in the relevant databases. Furthermore, 6446 COVID-19 disease targets were identified. Sodium 9-dehydro-17-hydro-andrographolide-19-yl sulfate was identified as the vital active compounds, and IL-6, TNF, IL-1β, CXCL8, STAT3, MAPK1, MAPK14, and MAPK8 were considered as the key targets. In addition, molecular docking revealed that the active compound and the targets showed good binding affinities. The enrichment analysis predicted that the XYP could regulate the IL-17, Toll-like receptor, PI3K-Akt and JAK-STAT signaling pathways. Consistently, further in vitro experiments demonstrated that XYP could slow down the cytokine storm in the lung tissue of COVID-19 patients by down-regulating IL-6, TNF-α, IL-1β, CXCL8, and p-STAT3. CONCLUSION Through effective network pharmacology analysis and molecular docking, this study suggests that XYP contains many effective compounds that may target COVID-19 related signaling pathways. Moreover, the in vitro experiment confirmed that XYP could inhibit the cytokine storm by regulating genes or proteins related to immune and inflammatory responses.
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Affiliation(s)
- Jialin Li
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
- College of Pharmacy, Harbin Medical University-Daqing, Daqing, China
| | - Siyu Guo
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Yingying Tan
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Jingyuan Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Zhishan Wu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Antony Stalin
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Fanqin Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Zhihong Huang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Chao Wu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Xinkui Liu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Jiaqi Huang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Jiarui Wu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
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Karlafti E, Tsavdaris D, Kotzakioulafi E, Protopapas AA, Kaiafa G, Netta S, Savopoulos C, Michalopoulos A, Paramythiotis D. The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1500. [PMID: 37629790 PMCID: PMC10456782 DOI: 10.3390/medicina59081500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 caused the coronavirus disease of 2019 (COVID-19), which rapidly became a pandemic, claiming millions of lives. Apart from the main manifestations of this infection concerning the respiratory tract, such as pneumonia, there are also many manifestations from the gastrointestinal tract. Of these, bleeding from the gastrointestinal tract is a significant complication quite dangerous for life. This bleeding is divided into upper and lower, and the primary pathophysiological mechanism is the entering of the virus into the host cells through the Angiotensin-converting enzyme 2 receptors. Also, other comorbidities and the medication of corticosteroids and anticoagulants are considered to favor the occurrence of gastrointestinal bleeding (GIB). Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the studies were searched in two different databases (Scopus and PubMed) from November 2019 until February 2023. All studies that reported GIB events among COVID-19 patients were included. Results: 33 studies were selected and reviewed to estimate the prevalence of GIB. A total of 134,905 patients with COVID-19 were included in these studies, and there were 1458 episodes of GIB. The prevalence of GIB, in these 33 studies, ranges from 0.47% to 19%. This range of prevalence is justified by the characteristics of the COVID-19 patients. These characteristics are the severity of COVID-19, anticoagulant and other drug treatments, the selection of only patients with gastrointestinal manifestations, etc. The pooled prevalence of gastrointestinal bleeding was estimated to be 3.05%, rising to 6.2% when only anticoagulant patients were included. Conclusions: GIB in COVID-19 patients is not a rare finding, and its appropriate and immediate treatment is necessary as it can be life-threatening. The most common clinical findings are melena and hematemesis, which characterize upper GIB. Treatment can be conservative; however, endoscopic management of bleeding with embolization is deemed necessary in some cases.
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Affiliation(s)
- Eleni Karlafti
- Emergency Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- 1st Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (A.A.P.); (G.K.); (C.S.)
| | - Dimitrios Tsavdaris
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
| | - Evangelia Kotzakioulafi
- 1st Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (A.A.P.); (G.K.); (C.S.)
| | - Adonis A. Protopapas
- 1st Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (A.A.P.); (G.K.); (C.S.)
| | - Georgia Kaiafa
- 1st Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (A.A.P.); (G.K.); (C.S.)
| | - Smaro Netta
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
| | - Christos Savopoulos
- 1st Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (A.A.P.); (G.K.); (C.S.)
| | - Antonios Michalopoulos
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
| | - Daniel Paramythiotis
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
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Duś-Ilnicka I, Mazur M, Rybińska A, Radwan-Oczko M, Jurczyszyn K, Paradowska-Stolarz A. SARS CoV-2 IgG seropositivity post-vaccination among dental professionals: a prospective study. BMC Infect Dis 2023; 23:539. [PMID: 37596519 PMCID: PMC10436388 DOI: 10.1186/s12879-023-08534-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/11/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has spread very rapidly around the world. Various regional and national lockdowns were imposed to control the spread. Meanwhile, vaccine development and population vaccination were the next steps for pandemic control. Workers in the dental field, both dentists and dental assistants, however, were close to the sources of aerosol generated during dental procedures and thus were the group of workers the most exposed to COVID-19 infection. The aim of our study was to monitor the immune response before and after the vaccine in a high-risk population, composed by dental professionals. METHODS A clinical prospective study was carried out among dental professionals at the Academic Dental Polyclinic, Wroclaw Medical University (Wrocław, Lower Silesia region, Poland). Blood samples were collected at an interval of one year - March/April 2020, before the vaccination against COVID-19, and April 2021, after the vaccination. The analysis was performed on serum with four different methods: qualitative, semi-quantitative, and quantitative IgG count for SARS-CoV-2, and SARS-CoV-2 neutralizing antibodies. RESULTS A total of 42 healthy adult volunteers participated in the study. The results showed a statistically significant difference (p < 0.05) in antibody levels before and after vaccination (1st and 2nd measurement) for each test method. The tests that were used affected the results and the test that showed the strongest relationship with the result was the Qualitative test. CONCLUSIONS Dental professionals are the adult working population most at risk for COVID-19. Monitoring SARS-CoV-2-status-related seropositivity can provide useful information occupational risk factors for dental professionals.
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Affiliation(s)
- Irena Duś-Ilnicka
- Oral Pathology Department, Wroclaw Medical University, ul. Krakowska 26, Wrocław, 52-425, Poland
| | - Marta Mazur
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy.
| | - Anna Rybińska
- Oral Pathology Department, Wroclaw Medical University, ul. Krakowska 26, Wrocław, 52-425, Poland
| | - Małgorzata Radwan-Oczko
- Oral Pathology Department, Wroclaw Medical University, ul. Krakowska 26, Wrocław, 52-425, Poland
| | - Kamil Jurczyszyn
- Department of Oral Surgery, Wroclaw Medical University, Krakowska 26, Wrocław, 50-425, Poland
| | - Anna Paradowska-Stolarz
- Division of Dentofacial Anomalies, Department of Orthodontics and Dentofacial Orhopedics, Wroclaw Medical University, Krakowska 26, Wrocław, 52-425, Poland
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Zhu Y, Sharma L, Chang D. Pathophysiology and clinical management of coronavirus disease (COVID-19): a mini-review. Front Immunol 2023; 14:1116131. [PMID: 37646038 PMCID: PMC10461092 DOI: 10.3389/fimmu.2023.1116131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/24/2023] [Indexed: 09/01/2023] Open
Abstract
An unprecedented global pandemic caused by a novel coronavirus named SARS-CoV-2 has created a severe healthcare threat and become one of the biggest challenges to human health and the global economy. As of July 2023, over 767 million confirmed cases of COVID-19 have been diagnosed, including more than 6.95 million deaths. The S protein of this novel coronavirus binds to the ACE2 receptor to enter the host cells with the help of another transmembrane protease TMPRSS2. Infected subjects that can mount an appropriate host immune response can quickly inhibit the spread of infection into the lower respiratory system and the disease may remain asymptomatic or a mild infection. The inability to mount a strong initial response can allow the virus to replicate unchecked and manifest as severe acute pneumonia or prolonged disease that may manifest as systemic disease manifested as viremia, excessive inflammation, multiple organ failure, and secondary bacterial infection among others, leading to delayed recovery, hospitalization, and even life-threatening consequences. The clinical management should be targeted to specific pathogenic mechanisms present at the specific phase of the disease. Here we summarize distinct phases of COVID-19 pathogenesis and appropriate therapeutic paradigms associated with the specific phase of COVID-19.
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Affiliation(s)
- Ying Zhu
- College of Pulmonary and Critical Care Medicine, 8th Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of Pulmonary and Critical Care Medicine, 7th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lokesh Sharma
- Section of Pulmonary and Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - De Chang
- College of Pulmonary and Critical Care Medicine, 8th Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of Pulmonary and Critical Care Medicine, 7th Medical Center of Chinese PLA General Hospital, Beijing, China
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48
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Shi W, Jin M, Chen H, Wu Z, Yuan L, Liang S, Wang X, Memon FU, Eldemery F, Si H, Ou C. Inflammasome activation by viral infection: mechanisms of activation and regulation. Front Microbiol 2023; 14:1247377. [PMID: 37608944 PMCID: PMC10440708 DOI: 10.3389/fmicb.2023.1247377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/13/2023] [Indexed: 08/24/2023] Open
Abstract
Viral diseases are the most common problems threatening human health, livestock, and poultry industries worldwide. Viral infection is a complex and competitive dynamic biological process between a virus and a host/target cell. During viral infection, inflammasomes play important roles in the host and confer defense mechanisms against the virus. Inflammasomes are polymeric protein complexes and are considered important components of the innate immune system. These immune factors recognize the signals of cell damage or pathogenic microbial infection after activation by the canonical pathway or non-canonical pathway and transmit signals to the immune system to initiate the inflammatory responses. However, some viruses inhibit the activation of the inflammasomes in order to replicate and proliferate in the host. In recent years, the role of inflammasome activation and/or inhibition during viral infection has been increasingly recognized. Therefore, in this review, we describe the biological properties of the inflammasome associated with viral infection, discuss the potential mechanisms that activate and/or inhibit NLRP1, NLRP3, and AIM2 inflammasomes by different viruses, and summarize the reciprocal regulatory effects of viral infection on the NLRP3 inflammasome in order to explore the relationship between viral infection and inflammasomes. This review will pave the way for future studies on the activation mechanisms of inflammasomes and provide novel insights for the development of antiviral therapies.
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Affiliation(s)
- Wen Shi
- College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Mengyun Jin
- College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Hao Chen
- College of Animal Science and Technology, Guangxi University, Nanning, China
| | | | - Liuyang Yuan
- College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Si Liang
- College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Xiaohan Wang
- College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Fareed Uddin Memon
- College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Fatma Eldemery
- Department of Hygiene and Zoonoses, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Hongbin Si
- College of Animal Science and Technology, Guangxi University, Nanning, China
- Guangxi Zhuang Autonomous Region Engineering Research Center of Veterinary Biologics, Nanning, China
- Guangxi Key Laboratory of Animal Reproduction, Breeding and Disease Control, Nanning, China
| | - Changbo Ou
- College of Animal Science and Technology, Guangxi University, Nanning, China
- Guangxi Zhuang Autonomous Region Engineering Research Center of Veterinary Biologics, Nanning, China
- Guangxi Key Laboratory of Animal Reproduction, Breeding and Disease Control, Nanning, China
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Alam Z, Mohamed S, Nauman J, Al-Rifai RH, Ahmed LA, Elbarazi I. Hesitancy toward vaccination against COVID-19: A scoping review of prevalence and associated factors in the Arab world. Hum Vaccin Immunother 2023; 19:2245720. [PMID: 37594508 PMCID: PMC10443971 DOI: 10.1080/21645515.2023.2245720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023] Open
Abstract
Despite widespread availability of vaccines against SARS-CoV-2 virus, the cause of Coronavirus Disease 2019 (COVID-19), its uptake in many Arab countries is relatively low. This literature review aimed to scope evidence on COVID-19 vaccine hesitancy (VH) in the Arab world. A total of 134 articles reporting prevalence of COVID-19 VH and associated factors, conducted in any of the 22 Arab League countries, were reviewed. COVID-19 VH prevalence ranged from 5.4% to 83.0%. Female gender, young age, low education level and lack of previous influenza vaccine uptake were most commonly reported to be associated with COVID-19 VH. The most-reported personal concerns contributing toward VH were related to the rapid development, safety and side effects of vaccine, as well as an overall lack of trust in government policies toward pandemic control and widespread conspiracy theories. Tailored interventions to enable the distribution of trusted information and enhance public acceptance of immunization are warranted.
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Affiliation(s)
- Zufishan Alam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Salma Mohamed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Javaid Nauman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, College of Applied Health Sciences, University of Illinois, Chicago, IL, USA
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Badaro R, Barbosa JDV, de Araujo Neto CA, Machado BAS, Soares MBP, de Senna V, Taddeo M, de Araújo LT, Durkee S, Donninger R, Judge K, Saiyed Z. A randomized clinical trial to evaluate the efficacy of L-carnitine L-tartrate to modulate the effects of SARS-CoV-2 infection. Front Nutr 2023; 10:1134162. [PMID: 37545576 PMCID: PMC10400325 DOI: 10.3389/fnut.2023.1134162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/22/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction L-carnitine (LC) has been associated with inflammatory mediator reduction and with downregulating the angiotensin-converting enzyme-2 (ACE2) receptor, which is the target of SARS-CoV-2 attachment. Methods This pilot phase 2 randomized, double-blind placebo-controlled trial contained two cohorts. Cohort 1 comprised 101 individuals with negative RT-PCR SARS-CoV-2 test results who cohabitated with an individual diagnosed with SARS-CoV-2 infection. Cohort 2 comprised 122 individuals with positive SARS-CoV-2 RT-PCR test results who were asymptomatic or had mild COVID-19 pneumonia symptoms. Participants in each cohort were randomized 1:1 to receive either 2 g elemental oral LC supplementation or placebo daily for 21 days. Primary endpoints included adverse events, SARS-CoV-2 infection incidence in Cohort 1, and disease progressions in Cohort 2. Secondary endpoints included between-group laboratory profile comparisons and Cohort 2 ACE1/ACE2 plasma levels. Disease progression was compared between the Cohort 2 groups using chest computed tomography. Results In Cohort 1, two SARS-CoV-2 infections occurred in each group. The common adverse events included headache, dyspnea, and tiredness. In Cohort 2, platelet counts were elevated, and fibrinogen levels reduced in the LC group compared with those of the placebo group. Conclusion Our study showed that LC was well-tolerated and suggests it modulates coagulation pathways. Furthermore, chest computed tomography images of the Cohort 2 LC group showed significant lung lesion improvement, suggesting that LC may slow COVID-19 progression.
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Affiliation(s)
- Roberto Badaro
- Institute of Health Technologies (ITS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | | | - Cesar Augusto de Araujo Neto
- Institute of Health Technologies (ITS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
- Image Diagnosis, Salvador, Bahia, Brazil
| | | | - Milena Botelho Pereira Soares
- Institute of Health Technologies (ITS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
- Gonçalo Moniz Institute, FIOCRUZ, Salvador, Bahia, Brazil
| | - Valter de Senna
- Institute of Health Technologies (ITS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Marcelo Taddeo
- Institute of Health Technologies (ITS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
- Federal University of Bahia, Salvador, Bahia, Brazil
| | - Lila Teixeira de Araújo
- Institute of Health Technologies (ITS), University Center SENAI/CIMATEC, Salvador, Bahia, Brazil
| | - Shane Durkee
- Research and Development, Lonza Greenwood, LLC, Greenwood, SC, United States
| | | | - Kevin Judge
- Research and Development, Lonza Greenwood, LLC, Greenwood, SC, United States
| | - Zainulabedin Saiyed
- Research and Development, Lonza Greenwood, LLC, Greenwood, SC, United States
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