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Totan M, Matacuta-Bogdan IO, Hasegan A, Maniu I. Vitamin D Levels in COVID-19 and NonCOVID-19 Pediatric Patients and Its Relationship with Clinical and Laboratory Characteristics. Biomedicines 2024; 12:905. [PMID: 38672258 PMCID: PMC11048677 DOI: 10.3390/biomedicines12040905] [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: 03/26/2024] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
25-hydroxyvitamin D [25(OH)D] is a marker with an important role in regulating the inflammatory response. Low concentrations of this vitamin are often found among the population, correlated with increased risk of respiratory tract infections. The aim of the study is to evaluate the relationship between vitamin D levels and clinical and laboratory markers in children and adolescents hospitalized with and without COVID-19. A retrospective study, including all patients tested for SARS-CoV-2 and having vitamin D measured, was performed. All included hospitalized cases, 78 COVID-19 patients and 162 NonCOVID-19 patients, were divided into subgroups according to their 25(OH)D serum levels (<20 ng/mL-deficiency, 20-30 ng/mL-insufficiency, ≥30 ng/mL-normal or <30 ng/mL, ≥30 ng/mL) and age (≤2 years, >2 years). Vitamin D deficiency and insufficiency increased with age, in both COVID-19 and NonCOVID-19 groups. All symptoms were encountered more frequently in cases of pediatric patients with COVID-19 in comparison with NonCOVID-19 cases. The most frequently encountered symptoms in the COVID-19 group were fever, loss of appetite, and nasal congestion. In the NonCOVID-19 group, serum 25(OH)D concentrations were positively correlated with leukocytes, lymphocytes, and LMR and negatively correlated with neutrophils, NLR, and PLR while no significant correlation was observed in the case of COVID-19 group. Differences between vitamin D status and clinical and laboratory parameters were observed, but their clinical significance should be interpreted with caution. The results of this study may offer further support for future studies exploring the mechanisms of the relationship between vitamin D and clinical and laboratory markers as well as for studies investigating the implications of vitamin D deficiency/supplementation on overall health/clinical outcomes of patients with/without COVID-19.
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Affiliation(s)
- Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (M.T.); (A.H.)
- Clinical Laboratory, Pediatric Clinical Hospital Sibiu, 2-4 Pompeiu Onofreiu Str., 550166 Sibiu, Romania
| | | | - Adrian Hasegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (M.T.); (A.H.)
| | - Ionela Maniu
- Research Team, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania
- Research Center in Informatics and Information Technology, Mathematics and Informatics Department, Faculty of Sciences, Lucian Blaga University of Sibiu, 550025 Sibiu, Romania
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Vasilj M, Galic K, Zovko T, Kraljevic G, Pravdic N, Saric-Zolj B, Goluza Sesar M, Pravdic D. Lung Diffusion Capacity in Patients With Bilateral COVID-19 Pneumonia: A Three-Month Follow-Up Study. Cureus 2024; 16:e58897. [PMID: 38800334 PMCID: PMC11117186 DOI: 10.7759/cureus.58897] [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: 04/18/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The aim of this study was to determine the short-term consequences of coronavirus disease 2019 (COVID-19) infection on pulmonary diffusion in patients with severe (but not critical) and moderately severe COVID-19 pneumonia during three months after COVID-19 infection. METHODS A prospective study included 81 patients with an RT-PCR-test confirmed diagnosis of COVID-19 infection treated in the COVID Department of Lung Diseases of University Clinical Hospital Mostar. Inclusion criteria were ≥18-year-old patients, COVID-19 infection confirmed using real-time RT-PCR, radiologically confirmed bilateral COVID-19 pneumonia, and diffusion capacity of the lungs for carbon monoxide (DLCO) one and three months after COVID-19 infection. The pulmonary function was tested using the MasterScreen Body Jaeger (Jaeger Corporation, Omaha, USA) and MasterScreen PFT Jaeger (Jaeger Corporation, Omaha, USA) according to American Thoracic Society guidelines one and three months after COVID-19 infection. RESULTS Forced vital capacity significantly increased three months after COVID-19 infection compared to the first-month control (p<0.0005). Also, a statistically significant increase in the FEV1 value (p<0.0005), FEV1%FVC ratio (p<0.005), DLCO/SB (p<0.0005), DLCO/VA value (p<0.0005), and total lung capacity (TLC) (p<0.0005) was observed in all patients. CONCLUSION Our study showed that recovery of DLCO/VA and spirometry parameters was complete after three months, while DLCO/SB was below normal values even after three months. Therefore, one month after the COVID-19 infection patients had partial recovery of lung function, while a significant recovery of lung function was observed three months after the COVID-19 infection.
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Affiliation(s)
- Marina Vasilj
- Department of Lung Diseases, University Clinical Hospital Mostar, Mostar, BIH
| | - Kristina Galic
- Department of Lung Diseases, University Clinical Hospital Mostar, Mostar, BIH
| | - Tanja Zovko
- Department of Lung Diseases, University Clinical Hospital Mostar, Mostar, BIH
| | - Gordana Kraljevic
- Department of Lung Diseases, University Clinical Hospital Mostar, Mostar, BIH
| | - Nikolina Pravdic
- Department of Neurology, University Clinical Hospital Mostar, Mostar, BIH
| | - Belma Saric-Zolj
- Department of Lung Diseases, University Clinical Hospital Mostar, Mostar, BIH
| | - Marija Goluza Sesar
- Department of Lung Diseases, University Clinical Hospital Mostar, Mostar, BIH
| | - Danijel Pravdic
- Clinic for Internal Diseases, University Clinical Hospital Mostar, Mostar, BIH
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Delpino FM, Vieira YP, Duro SM, Nunes BP, Saes MDO. Multimorbidity and use of health services in a population diagnosed with COVID-19 in a municipality in the Southern Region of Brazil, 2020-2021: a cross-sectional study. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2024; 33:e2023915. [PMID: 38422235 PMCID: PMC10895700 DOI: 10.1590/s2237-96222024v33e2023915.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE To assess association between multimorbidity and use of health services in a population diagnosed with COVID-19, in southern Brazil. METHODS This was a cross-sectional study with data from a longitudinal study carried out in the city of Rio Grande, Rio Grande do Sul, Brazil, in 2021 with all adult individuals diagnosed with COVID-19; descriptive analyses were performed and presented as proportions with 95% confidence intervals (95%CI); Poisson regression was performed and reported as prevalence ratios (PR) in order to assess association between multimorbidity (3 or more diseases) and healthcare service use. RESULTS In total, 2,919 participants were included, of which 40.4% had multimorbidity (≥ 2 diseases); the adjusted results showed that individuals with multimorbidity were more likely to use most of the services assessed, PR = 3.21 (95%CI 1.40;7.37), for Emergency Rooms. CONCLUSION Multimorbidity was associated with using different types of health services.
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Affiliation(s)
- Felipe Mendes Delpino
- Universidade Federal de Pelotas, Programa de Pós-Graduação em
Enfermagem, Pelotas, RS, Brazil
| | - Yohana Pereira Vieira
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em
Ciências da Saúde, Rio Grande, RS, Brazil
| | - Suele Manjourany Duro
- Universidade Federal de Pelotas, Programa de Pós-Graduação em
Enfermagem, Pelotas, RS, Brazil
| | - Bruno Pereira Nunes
- Universidade Federal de Pelotas, Programa de Pós-Graduação em
Enfermagem, Pelotas, RS, Brazil
| | - Mirelle de Oliveira Saes
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em
Ciências da Saúde, Rio Grande, RS, Brazil
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Rong Y, Tang MZ, Liu SH, Li XF, Cai H. Comprehensive analysis of the potential pathogenesis of COVID-19 infection and liver cancer. World J Gastrointest Oncol 2024; 16:436-457. [PMID: 38425388 PMCID: PMC10900145 DOI: 10.4251/wjgo.v16.i2.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND A growing number of clinical examples suggest that coronavirus disease 2019 (COVID-19) appears to have an impact on the treatment of patients with liver cancer compared to the normal population, and the prevalence of COVID-19 is significantly higher in patients with liver cancer. However, this mechanism of action has not been clarified. AIM To investigate the disease relevance of COVID-19 in liver cancer. METHODS Gene sets for COVID-19 (GSE180226) and liver cancer (GSE87630) were obtained from the Gene Expression Omnibus database. After identifying the common differentially expressed genes (DEGs) of COVID-19 and liver cancer, functional enrichment analysis, protein-protein interaction network construction and screening and analysis of hub genes were performed. Subsequently, the validation of the differential expression of hub genes in the disease was performed and the regulatory network of transcription factors and hub genes was constructed. RESULTS Of 518 common DEGs were obtained by screening for functional analysis. Fifteen hub genes including aurora kinase B, cyclin B2, cell division cycle 20, cell division cycle associated 8, nucleolar and spindle associated protein 1, etc., were further identified from DEGs using the "cytoHubba" plugin. Functional enrichment analysis of hub genes showed that these hub genes are associated with P53 signalling pathway regulation, cell cycle and other functions, and they may serve as potential molecular markers for COVID-19 and liver cancer. Finally, we selected 10 of the hub genes for in vitro expression validation in liver cancer cells. CONCLUSION Our study reveals a common pathogenesis of liver cancer and COVID-19. These common pathways and key genes may provide new ideas for further mechanistic studies.
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Affiliation(s)
- Yao Rong
- First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
- General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Ming-Zheng Tang
- First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
- General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Song-Hua Liu
- First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
- General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Xiao-Feng Li
- First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
| | - Hui Cai
- General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
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Pradhan S, Rouster SD, Blackard JT, Dean GE, Sherman KE. Replication and Injury Associated With SARS-CoV-2 in Cultured Hepatocytes. Pathog Immun 2024; 8:59-73. [PMID: 38361525 PMCID: PMC10868721 DOI: 10.20411/pai.v8i2.648] [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: 11/07/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
Background Liver dysfunction is one of the hallmarks of SARS-CoV-2 infection. The mechanism(s) of hepatic injury in SARS-CoV-2 infection remains controversial with some reporting viral replication and cellular injury and others suggesting lack of replication and injury due to non-cytopathogenic etiologies. To investigate this further, we evaluated SARS-CoV-2 replication in immortalized hepatic cell lines and primary hepatocytes, examined whether cell injury was associated with apoptotic pathways, and also determined the effect of the antiviral remdesivir on these processes. Methods Immortalized hepatocyte cell lines (HepG2 and Huh7.5), as well as primary human hepatocytes, were exposed to SARS-CoV-2 at a multiplicity of infection of 0.1 PFU/mL. Viral replication was evaluated by plaque assays, immunohistochemical staining for the viral spike protein, and caspase-3 expression evaluated with and without exposure to remdesivir. Results All hepatocyte cell lines and primary hepatocytes supported active replication of SARS-CoV-2. Significant cytopathic effect was observed by light microscopy, and caspase-3 staining supported activation of apoptotic pathways. Remdesivir abrogated infection in a dose-dependent fashion and was not independently associated with hepatocyte injury. Conclusion Hepatocytes appear to be highly permissive of SARS-CoV-2 replication which leads to rapid cell death associated with activation of apoptotic pathways. Viral replication and hepatocytes injury are abrogated with remdesivir. We conclude that active viral replication is most likely a key contributor to liver enzyme abnormalities observed in the setting of acute SARS-CoV-2 infection.
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Affiliation(s)
- Suman Pradhan
- Department of Molecular and Cellular Biosciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Susan D. Rouster
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jason T. Blackard
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Gary E. Dean
- Department of Molecular and Cellular Biosciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kenneth E. Sherman
- Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Massachusetts General Hospital-Harvard Medical School, Boston, Massachusetts
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Huang L, Wang Y, He Y, Huang D, Wen T, Han Z. Association Between COVID-19 and Neurological Diseases: Evidence from Large-Scale Mendelian Randomization Analysis and Single-Cell RNA Sequencing Analysis. Mol Neurobiol 2024:10.1007/s12035-024-03975-2. [PMID: 38300446 DOI: 10.1007/s12035-024-03975-2] [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: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Observational studies have suggested that SARS-CoV-2 infection increases the risk of neurological diseases, but it remains unclear whether the association is causal. The present study aims to evaluate the causal relationships between SARS-CoV-2 infections and neurological diseases and analyzes the potential routes of SARS-CoV-2 entry at the cellular level. We performed Mendelian randomization (MR) analysis with CAUSE method to investigate causal relationship of SARS-CoV-2 infections with neurological diseases. Then, we conducted single-cell RNA sequencing (scRNA-seq) analysis to obtain evidence of potential neuroinvasion routes by measuring SARS-CoV-2 receptor expression in specific cell subtypes. Fast gene set enrichment analysis (fGSEA) was further performed to assess the pathogenesis of related diseases. The results showed that the COVID-19 is causally associated with manic (delta_elpd, - 0.1300, Z-score: - 2.4; P = 0.0082) and epilepsy (delta_elpd: - 2.20, Z-score: - 1.80; P = 0.038). However, no significant effects were observed for COVID-19 on other traits. Moreover, there are 23 cell subtypes identified through the scRNA-seq transcriptomics data of epilepsy, and SARS-CoV-2 receptor TTYH2 was found to be specifically expressed in oligodendrocyte and astrocyte cell subtypes. Furthermore, fGSEA analysis showed that the cell subtypes with receptor-specific expression was related to methylation of lysine 27 on histone H3 (H3K27ME3), neuronal system, aging brain, neurogenesis, and neuron projection. In summary, this study shows causal links between SARS-CoV-2 infections and neurological disorders such as epilepsy and manic, supported by MR and scRNA-seq analysis. These results should be considered in further studies and public health measures on COVID-19 and neurological diseases.
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Affiliation(s)
- Lin Huang
- Department of Bioinformatics, School of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Yongheng Wang
- Department of Bioinformatics, School of Basic Medicine, Chongqing Medical University, Chongqing, China
- International Research Laboratory of Reproduction & Development, Chongqing Medical University, Chongqing, China
| | - Yijie He
- Department of Bioinformatics, School of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Dongyu Huang
- Department of Bioinformatics, School of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Tong Wen
- Department of Bioinformatics, School of Basic Medicine, Chongqing Medical University, Chongqing, China
| | - Zhijie Han
- Department of Bioinformatics, School of Basic Medicine, Chongqing Medical University, Chongqing, China.
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Gül M, Russo GI, Kandil H, Boitrelle F, Saleh R, Chung E, Kavoussi P, Mostafa T, Shah R, Agarwal A. Male Infertility: New Developments, Current Challenges, and Future Directions. World J Mens Health 2024; 42:42.e8. [PMID: 38164030 DOI: 10.5534/wjmh.230232] [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: 08/16/2023] [Accepted: 08/27/2023] [Indexed: 01/03/2024] Open
Abstract
There have been many significant scientific advances in the diagnostics and treatment modalities in the field of male infertility in recent decades. Examples of these include assisted reproductive technologies, sperm selection techniques for intracytoplasmic sperm injection, surgical procedures for sperm retrieval, and novel tests of sperm function. However, there is certainly a need for new developments in this field. In this review, we discuss advances in the management of male infertility, such as seminal oxidative stress testing, sperm DNA fragmentation testing, genetic and epigenetic tests, genetic manipulations, artificial intelligence, personalized medicine, and telemedicine. The role of the reproductive urologist will continue to expand in future years to address different topzics related to diverse questions and controversies of pathophysiology, diagnosis, and therapy of male infertility, training researchers and physicians in medical and scientific research in reproductive urology/andrology, and further development of andrology as an independent specialty.
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Affiliation(s)
- Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Giorgio Ivan Russo
- Urology Section, University of Catania, Catania, Italy
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Hussein Kandil
- Fakih IVF Fertility Center, Abu Dhabi, UAE
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
- Ajyal IVF Center, Ajyal Hospital, Sohag, Egypt
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Parviz Kavoussi
- Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Taymour Mostafa
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- Well Women's Centre, Sir HN Reliance Foundation Hospital, Mumbai, India
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Ashok Agarwal
- Global Andrology Forum, Moreland Hills, OH, USA
- Cleveland Clinic, Cleveland, OH, USA.
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Rocha VDFD, da Silva EN, Azevedo J, Ribeiro MT, Reis MG, Barros TF, Reis JN. The impact of COVID-19 on microbiological profile and antibiotic consumption in ICU: a retrospective study in an infectious disease hospital in Brazil. Braz J Infect Dis 2024; 28:103705. [PMID: 38065221 PMCID: PMC10764251 DOI: 10.1016/j.bjid.2023.103705] [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: 08/07/2023] [Revised: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has triggered crises in the public health sector that have complex and multifaceted interrelationships with antimicrobial resistance. It is important to evaluate the impact of COVID-19 on microbiological profile, antibiotic and alcohol gel consumption in Intensive Care Units (ICU). METHODS This is a retrospective study undertaken in an infectious disease hospital located in Bahia/Brazil during three periods: from March 2019 to February 2020; from March 2020 to February 2021; and from March 2021 to February 2022. It was evaluated the incidence density of Candida spp and of multidrug-resistant Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species (ESKAPE group) in blood, urine and tracheal secretion isolated 48 h after the patient's admission to the ICU, as well as the use of alcohol gel (in milliliters) and consumption of antibiotics in Defined Daily Dose (DDD) per 1,000 ICU patient-days in the previous year and in the first two years of COVID-19 pandemic. RESULTS There was an increase in Candida spp. (5.81, p < 0.001, IRR = 10.47, 95 % CI 2.57‒42.62) and in carbapenem-resistant A. baumannii in clinical cultures (4.71, p < 0.001, IRR = 8.46, 95 % CI 2.07‒34.60), the latter mainly in tracheal secretions (3.18, p= 0.02, IRR = 11.47, 95 % CI 1.58‒83.39). A rise in the consumption of ceftriaxone and piperacillin-tazobactam, along with an increase in the utilization of alcohol gel were observed. CONCLUSION The shifting microbiological profile can be attributed to both the unique characteristics of patients with COVID-19 and the adjustments made to healthcare facilities' structural and work routines. Understanding these changes is essential in addressing the accelerated impact of antimicrobial resistance during the pandemic. Therefore, conducting thorough reviews of institutional practices and routines becomes critical in mitigating the consequences of antimicrobial resistance and its implications for patient care.
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Affiliation(s)
- Verônica de França Diniz Rocha
- Instituto Gonçalo Moniz (FIOCRUZ), Biotecnologia em Saúde e Medicina Investigativa, Salvador, BA, Brazil; Instituto Couto Maia, Salvador, BA, Brazil
| | | | - Jailton Azevedo
- Universidade Federal da Bahia, Instituto de Ciência da Saúde, Salvador, BA, Brazil
| | - Marcelo Teles Ribeiro
- Instituto Couto Maia, Salvador, BA, Brazil; Universidade Federal da Bahia, Instituto de Ciência da Saúde, Salvador, BA, Brazil
| | - Mitermayer Galvão Reis
- Instituto Gonçalo Moniz (FIOCRUZ), Laboratório de Patologia e Biologia Molecular, Salvador, BA, Brazil; Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil; Yale University, Yale School of Public Health, New Haven, United States
| | - Tania Fraga Barros
- Universidade Federal da Bahia, Faculdade de Farmácia, Salvador, BA, Brazil
| | - Joice Neves Reis
- Instituto Gonçalo Moniz (FIOCRUZ), Laboratório de Patologia e Biologia Molecular, Salvador, BA, Brazil; Universidade Federal da Bahia, Faculdade de Farmácia, Salvador, BA, Brazil.
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Marzoog BA. Gastrointestinal Tract and Kidney Injury Pathogenesis in Post-COVID-19 Syndrome. Curr Diabetes Rev 2024; 20:e051023221787. [PMID: 37815187 DOI: 10.2174/0115733998250889230919185305] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/20/2023] [Accepted: 07/18/2023] [Indexed: 10/11/2023]
Abstract
COVID-19 is a global health emergency that requires worldwide collaboration to control its spread. The scientific community is working to understand the different aspects of the post-COVID-19 syndrome and potential treatment strategies. Interestingly, there have been reports of gastrointestinal tract (GIT) involvement in the post-COVID-19 syndrome, suggesting the presence of both severe and mild GIT disorders. The development of the post-COVID-19- GIT syndrome involves various factors, such as impaired GIT mucosa cells, disruptions in the feeling of satiety, reduced blood supply due to the formation of small blood clots, and increased prostaglandin secretion caused by an excessive immune response. GIT symptoms have been observed in around 16% of COVID-19 patients. Other complications include kidney damage and prolonged impairment in the filtration and excretion functions of the glomeruli and tubules. The pathogenesis of post-COVID-19 renal syndrome involves factors, like an overactive immune response, reduced lung perfusion and oxygenation, viral infection in kidney tissues, endothelial dysfunction, and decreased blood volume. Roughly 20% of hospitalized patients experience renal manifestations after recovering from COVID-19.
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Affiliation(s)
- Basheer Abdullah Marzoog
- World-Class Research Center, Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Yamada CAO, de Paula Oliveira Santos B, Lemos RP, Batista ACS, da Conceição IMCA, de Paula Sabino A, E Lima LMTDR, de Magalhães MTQ. Applications of Mass Spectrometry in the Characterization, Screening, Diagnosis, and Prognosis of COVID-19. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1443:33-61. [PMID: 38409415 DOI: 10.1007/978-3-031-50624-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Mass spectrometry (MS) is a powerful analytical technique that plays a central role in modern protein analysis and the study of proteostasis. In the field of advanced molecular technologies, MS-based proteomics has become a cornerstone that is making a significant impact in the post-genomic era and as precision medicine moves from the research laboratory to clinical practice. The global dissemination of COVID-19 has spurred collective efforts to develop effective diagnostics, vaccines, and therapeutic interventions. This chapter highlights how MS seamlessly integrates with established methods such as RT-PCR and ELISA to improve viral identification and disease progression assessment. In particular, matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) takes the center stage, unraveling intricate details of SARS-CoV-2 proteins, revealing modifications such as glycosylation, and providing insights critical to formulating therapies and assessing prognosis. However, high-throughput analysis of MALDI data presents challenges in manual interpretation, which has driven the development of programmatic pipelines and specialized packages such as MALDIquant. As we move forward, it becomes clear that integrating proteomic data with various omic findings is an effective strategy to gain a comprehensive understanding of the intricate biology of COVID-19 and ultimately develop targeted therapeutic paradigms.
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Affiliation(s)
- Camila Akemi Oliveira Yamada
- Laboratory for Macromolecular Biophysics - LBM, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Interunit Postgraduate Program in Bioinformatics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno de Paula Oliveira Santos
- Laboratory for Macromolecular Biophysics - LBM, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rafael Pereira Lemos
- Laboratory for Macromolecular Biophysics - LBM, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Interunit Postgraduate Program in Bioinformatics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Carolina Silva Batista
- Laboratory for Macromolecular Biophysics - LBM, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Interunit Postgraduate Program in Bioinformatics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Adriano de Paula Sabino
- Interunit Postgraduate Program in Bioinformatics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratory of Clinical and Molecular Hematology - Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Mariana T Q de Magalhães
- Laboratory for Macromolecular Biophysics - LBM, Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
- Interunit Postgraduate Program in Bioinformatics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
- Biochemistry and Immunology Postgraduate Program, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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11
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Lerner A, Benzvi C, Vojdani A. HLA-DQ2/8 and COVID-19 in Celiac Disease: Boon or Bane. Microorganisms 2023; 11:2977. [PMID: 38138121 PMCID: PMC10745744 DOI: 10.3390/microorganisms11122977] [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: 11/15/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
The SARS-CoV-2 pandemic continues to pose a global threat. While its virulence has subsided, it has persisted due to the continual emergence of new mutations. Although many high-risk conditions related to COVID-19 have been identified, the understanding of protective factors remains limited. Intriguingly, epidemiological evidence suggests a low incidence of COVID-19-infected CD patients. The present study explores whether their genetic background, namely, the associated HLA-DQs, offers protection against severe COVID-19 outcomes. We hypothesize that the HLA-DQ2/8 alleles may shield CD patients from SARS-CoV-2 and its subsequent effects, possibly due to memory CD4 T cells primed by previous exposure to human-associated common cold coronaviruses (CCC) and higher affinity to those allele's groove. In this context, we examined potential cross-reactivity between SARS-CoV-2 epitopes and human-associated CCC and assessed the binding affinity (BA) of these epitopes to HLA-DQ2/8. Using computational methods, we analyzed sequence similarity between SARS-CoV-2 and four distinct CCC. Of 924 unique immunodominant 15-mer epitopes with at least 67% identity, 37 exhibited significant BA to HLA-DQ2/8, suggesting a protective effect. We present various mechanisms that might explain the protective role of HLA-DQ2/8 in COVID-19-afflicted CD patients. If substantiated, these insights could enhance our understanding of the gene-environment enigma and viral-host relationship, guiding potential therapeutic innovations against the ongoing SARS-CoV-2 pandemic.
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Affiliation(s)
- Aaron Lerner
- The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Ramat Gan 5262160, Israel;
- Research Department, Ariel University, Ariel 4077625, Israel
| | - Carina Benzvi
- The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Ramat Gan 5262160, Israel;
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12
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Nau C, Butler RK, Huang CW, Khang VK, Chen A, Creekmur B, Broder B, Subject C, Sharp AL, Moreta-Sainz LM, Park JS, Manek AJ, Cooper RM, Mendoza SM, Luo G, Gould MK. Development and validation of the COVID-19 Hospitalized Patient Deterioration Index. THE AMERICAN JOURNAL OF MANAGED CARE 2023; 29:e365-e371. [PMID: 38170527 PMCID: PMC10843847 DOI: 10.37765/ajmc.2023.89470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To develop a COVID-19-specific deterioration index for hospitalized patients: the COVID Hospitalized Patient Deterioration Index (COVID-HDI). This index builds on the proprietary Epic Deterioration Index, which was not developed for predicting respiratory deterioration events among patients with COVID-19. STUDY DESIGN A retrospective observational cohort was used to develop and validate the COVID-HDI model to predict respiratory deterioration or death among hospitalized patients with COVID-19. Deterioration events were defined as death or requiring high-flow oxygen, bilevel positive airway pressure, mechanical ventilation, or intensive-level care within 72 hours of run time. The sample included hospitalized patients with COVID-19 diagnoses or positive tests at Kaiser Permanente Southern California between May 3, 2020, and October 17, 2020. METHODS Machine learning models and 118 candidate predictors were used to generate benchmark performance. Logit regression with least absolute shrinkage and selection operator and physician input were used to finalize the model. Split-sample cross-validation was used to train and test the model. RESULTS The area under the receiver operating curve was 0.83. COVID-HDI identifies patients at low risk (negative predictive value [NPV] > 98.5%) and borderline low risk (NPV > 95%) of an event. Of all patients, 74% were identified as being at low or borderline low risk at some point during their hospitalization and could be considered for discharge with or without home monitoring. A high-risk group with a positive predictive value of 51% included 12% of patients. Model performance remained high in a recent cohort of patients. CONCLUSIONS COVID-HDI is a parsimonious, well-calibrated, and accurate model that may support clinical decision-making around discharge and escalation of care.
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Affiliation(s)
- Claudia Nau
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, 98 S Los Robles Ave, Pasadena, CA 91101.
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13
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Xu A, Zuo Z, Yang C, Ye F, Wang M, Wu J, Tao C, Xun Y, Li Z, Liu S, Huang J. A long trend of sexually transmitted diseases before and after the COVID-19 pandemic in China (2010-21). Sex Health 2023; 20:497-505. [PMID: 37649382 DOI: 10.1071/sh22172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 08/04/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The longer ongoing benefits of coronavirus disease 2019 (COVID-19) non-pharmaceutical interventions (NPIs) for sexually transmitted diseases (STDs) in China are still unclear. We aimed to explore the changes in five STDs (AIDS, hepatitis B, hepatitis C, gonorrhoea, and syphilis) before, during, and after the COVID-19 pandemic in mainland China, from 2010 to 2021. METHODS The number of the monthly reported cases of the five STDs were extracted from the website to construct the Joinpoint regression and autoregressive integrated moving average (ARIMA) models. Eight indicators reflecting NPIs were chosen from the COVID-19 Government Response Tracker system. The STDs and eight indicators were used to establish the Multivariable generalised linear model (GLM) to calculate the incidence rate ratios (IRRs). RESULTS With the exception of hepatitis B, the other four STDs (AIDS, hepatitis C, gonorrhoea, and syphilis) had a positive average annual percent change over the past 12years. All the ARIMA models had passed the Ljung-Box test, and the predicted data fit well with the data from 2010 to 2019. All five STDs were significantly reduced in 2020 compared with 2019, with significant estimated IRRs ranging from 0.88 to 0.92. In the GLM, using data for the years 2020 (February-December) and 2021, the IRRs were not significant after adjusting for the eight indicators in multivariate analysis. CONCLUSION Our study demonstrated that the incidence of the five STDs decreased rapidly during the COVID-19 pandemic in 2020. A recovery of STDs in 2021 was found to occur compared with that in 2020, but the rising trend disappeared after adjusting for the NPIs. Our study demonstrated that NPIs have an effect on STDs, but the relaxation of NPI usage might lead to a resurgence.
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Affiliation(s)
- Aifang Xu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Zhongbao Zuo
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Chunli Yang
- Department of Clinical Laboratory, The 903rd Hospital of PLA, Hangzhou, Zhejiang 310013, China
| | - Fei Ye
- Health Examination Center, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Miaochan Wang
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Jing Wu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Chengjing Tao
- Department of Obstetrics and Gynecology, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Yunhao Xun
- Department of Hepatology, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Zhaoyi Li
- Science and Education Department, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Shourong Liu
- Department of Hepatology, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
| | - Jinsong Huang
- Department of Hepatology, Hangzhou Xixi Hospital, Hangzhou, Zhejiang 310023, China
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14
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Pavlidou E, Papadopoulou SK, Antasouras G, Vorvolakos T, Alexatou O, Tsourouflis G, Angelakou EP, Serdari A, Grammatikopoulou MG, Psara E, Vadikolias K, Dakanalis A, Lefantzis N, Giaginis C. Association of COVID-19 Infection with Sociodemographic, Anthropometric and Lifestyle Factors: A Cross-Sectional Study in an Older Adults' Population Aged over 65 Years Old. Diseases 2023; 11:165. [PMID: 37987276 PMCID: PMC10660554 DOI: 10.3390/diseases11040165] [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: 10/20/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to unfavorable disruptions to daily living routines by exerting deleterious effects on several aspects of human mental and physical health and quality of life worldwide. The purpose of the current survey is to explore the potential association of COVID-19 infection with multiple sociodemographic, anthropometric, and lifestyle factors of community-dwelling older adults. METHODS This is a cross-sectional survey including 5197 older adults aged over 65 years old from 10 geographically diverse regions of Greece. Relevant questionnaires were used to record study the population sociodemographic factor, while anthropometric parameters were also measured. Validated questionnaires were also applied to assess several lifestyle factors such as depression, anxiety, stress, cognitive status, sleep quality, health-related quality of life, physical activity levels, and Mediterranean diet (MD) adherence. RESULTS In multivariate regression analysis, COVID-19 infection was significantly, independently related with urban residence (p = 0.0107), regular smoking (p = 0.0218), overweight status and obesity (p = 0.0036), as well as abdominal obesity (p = 0.0008), higher risk of depression (p = 0.0027), anxiety (p = 0.0045), stress (p = 0.0038), inadequate sleep quality (p = 0.0108), lower physical activity levels (p = 0.0012), reduced MD compliance (p = 0.0009), and poor health-related quality of life (p = 0.0002). In univariate analysis, older adults' age (p = 0.0001), male gender (p = 0.0015), living alone (p = 0.0023), lower educational and economic level (p = 0.0175 and p = 0.0294, respectively), and cognition decline (p = 0.0032) were also related with the presence of COVID-19 infection; however, these associations were considerably attenuated at a non-significant level by adjustment for several confounders in multivariate analysis. CONCLUSIONS This is one of the few available studies supporting evidence that COVID-19 infection may be associated with diverse sociodemographic, anthropometric, and lifestyle factors in an older adults' population in Greece. This study highlights the strong demand to provide psychological and nutritional counselling and support to older adults diagnosed with COVID-19 infection in order to ameliorate disease symptoms and severity, emphasizing the adaptation of healthy dietary and lifestyle habits as preventing and supplementary therapeutic factors against COVID-19.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandoupoli, Greece;
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Aspasia Serdari
- Department of Psychiatry and Child Psychiatry, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupoli, Greece;
| | - Maria G. Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupoli, Greece;
| | - Antonios Dakanalis
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
- Department of Medicine and Surgery, University of Milan Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Nikolaos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, Chaidari, 12462 Athens, Greece;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece; (E.P.); (G.A.); (O.A.); (E.-P.A.); (E.P.); (C.G.)
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15
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Cao C, Mehmood A, Li D. Molecular dynamic simulation reveals spider antimicrobial peptide Latarcin-1 and human eosinophil cationic protein as peptide inhibitors of SARS-CoV-2 variants. J Biomol Struct Dyn 2023:1-11. [PMID: 37938133 DOI: 10.1080/07391102.2023.2274514] [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: 12/06/2022] [Accepted: 06/17/2023] [Indexed: 11/09/2023]
Abstract
COVID-19 has rapidly proliferated around 180 countries, and new cases are reported frequently. No peptide medication has been developed that can reliably block SARS-CoV-2 infection. The investigation focuses on the crucial host receptors angiotensin-converting enzyme 2 (ACE2) , which can bind receptor-binding domain (RBD) on the SARS-CoV-2 spike protein (S). To investigate the inhibitory effects of human Eosinophil Cationic Protein (hECP) and Latarcin-1 (L1)on SARS-CoV-2 infection, we have selected them as research subjects. Further, we ran extensive molecular dynamics simulations to bring the docked peptide-ACE2 complex into its equilibrium state. The outcomes were then evaluated with g_MMPBSA and interaction analysis. We have also considered the Delta and Omicron variants to examine these peptides' inhibitory effects. The experimental findings revealed an enhanced capability of L1 and hECP as SARS-CoV-2 inhibitors, occupying hot spots and numerous key residues in ACE2. These include ASP30, ASP38, GLU35 and GLU75, which significantly inhibit the binding of RBD and ACE2 and are effective against two common variants in a similar manner. In addition, this study can serve as a springboard for future research on SARS-CoV-2 inhibitors.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Cheng Cao
- Institute of Biothermal Science and Technology, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, P.R. China
- AI Research Center, Peng Cheng Laboratory, Shenzhen, Guangdong, P.R. China
| | - Aamir Mehmood
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Daixi Li
- Institute of Biothermal Science and Technology, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, P.R. China
- AI Research Center, Peng Cheng Laboratory, Shenzhen, Guangdong, P.R. China
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16
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Hashimoto H, Hiyoshi Y, Kabuki T, Sasaki H, Toda M. Prognostic value of ECG monitor findings in COVID-19. Open Heart 2023; 10:e002404. [PMID: 37963684 PMCID: PMC10649884 DOI: 10.1136/openhrt-2023-002404] [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: 06/29/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023] Open
Abstract
AIMS COVID-19 can cause severe illness and multiorgan dysfunction. Acute myocardial damage has been detected in a significant portion of patients with COVID-19; therefore, several studies have reported that electrocardiographic findings could be used to evaluate the severalty of COVID-19. However, performing standard ECG for each patient hospitalised with COVID-19 can increase the level of exposure to COVID-19 among medical staff. Therefore, this study aimed to investigate the prognostic value of continuous electrocardiographic monitor findings in patients with COVID-19. METHODS Among 1612 consecutive patients with COVID-19 who were admitted to our hospital between August 2021 and May 2022, we identified 96 (76±4 years) patients who underwent electrocardiographic monitor during hospitalisation. All electrocardiographic monitors were analysed by two independent cardiologists blinded to the clinical data of the patients. The endpoint was defined as the occurrence of all-cause mortality related to COVID-19. The event data were retrospectively gathered from the patients' medical records. A multivariate Cox model was used to assess whether these electrocardiographic monitor findings and clinical data were associated with in-hospital mortality. RESULTS During a mean hospitalisation period of 22.8±3.2 days, in-hospital mortality occurred in 17 (18%) patients. Atrial fibrillation (HR: 3.95, 95% CI: 1.39 to 11.21) and lung disease complications (HR: 2.91, 95% CI: 1.06 to 7.98) were significant prognostic factors for death in multivariate analysis. Compared with the non-complicated lung disease and non-atrial fibrillation group, the risk of mortality was significantly higher in the lung disease complication and atrial fibrillation group in the multivariate Cox proportional model (HR: 8.37, 95% CI: 1.69 to 41.30, p=0.009). CONCLUSIONS The simple method of ECG monitor could adequately detect atrial fibrillation. This study demonstrated that atrial fibrillation complicated with lung disease, could have potential prognostic value among patients with COVID-19.
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Affiliation(s)
- Hidenobu Hashimoto
- Department of Cardiovascular Medicine, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yasunaga Hiyoshi
- Department of Cardiovascular Medicine, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan
| | - Takayuki Kabuki
- Department of Cardiovascular Medicine, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Hideto Sasaki
- Department of Cardiovascular Medicine, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Mikihito Toda
- Department of Cardiovascular Medicine, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
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17
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Lushington GH, Linde A, Melgarejo T. Bacterial Proteases as Potentially Exploitable Modulators of SARS-CoV-2 Infection: Logic from the Literature, Informatics, and Inspiration from the Dog. BIOTECH 2023; 12:61. [PMID: 37987478 PMCID: PMC10660736 DOI: 10.3390/biotech12040061] [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: 07/11/2023] [Revised: 08/19/2023] [Accepted: 10/18/2023] [Indexed: 11/22/2023] Open
Abstract
(1) Background: The COVID-19 pandemic left many intriguing mysteries. Retrospective vulnerability trends tie as strongly to odd demographics as to exposure profiles, genetics, health, or prior medical history. This article documents the importance of nasal microbiome profiles in distinguishing infection rate trends among differentially affected subgroups. (2) Hypothesis: From a detailed literature survey, microbiome profiling experiments, bioinformatics, and molecular simulations, we propose that specific commensal bacterial species in the Pseudomonadales genus confer protection against SARS-CoV-2 infections by expressing proteases that may interfere with the proteolytic priming of the Spike protein. (3) Evidence: Various reports have found elevated Moraxella fractions in the nasal microbiomes of subpopulations with higher resistance to COVID-19 (e.g., adolescents, COVID-19-resistant children, people with strong dietary diversity, and omnivorous canines) and less abundant ones in vulnerable subsets (the elderly, people with narrower diets, carnivorous cats and foxes), along with bioinformatic evidence that Moraxella bacteria express proteases with notable homology to human TMPRSS2. Simulations suggest that these proteases may proteolyze the SARS-CoV-2 spike protein in a manner that interferes with TMPRSS2 priming.
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Affiliation(s)
| | - Annika Linde
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA 91766, USA;
| | - Tonatiuh Melgarejo
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA 91766, USA;
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18
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Zhang Y, Zhang Y, Huang J, Dong L. Application of Internet hospitals for first-visit patients with COVID-19 during the pandemic in China. Eur J Public Health 2023; 33:789-795. [PMID: 37550253 PMCID: PMC10567245 DOI: 10.1093/eurpub/ckad138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND There has been controversy over whether to carry out online medical inquiries and electronic prescription for first-visit patients. While Internet hospitals have become crucial to ensure providing online diagnosis and prescription needs for first-visit COVID-positive patients. OBJECTIVE We describe the results and advantages of online medical treatment during the coronavirus disease 2019 (COVID-19) outbreak and analyse the results and advantages of online medical treatment. METHODS Data were collected from the patients who received online medical inquiry services through the COVID-19 Special Section of our Internet hospital. The user demographic characteristics, user behaviour, clinical symptoms and medical records were collected. Baseline data of offline outpatient patients were also collected. RESULTS A total of 16 173 online medical inquiries were included. The daily online outpatient service volume reached a peak of 2446 person-times. The median age was 29.92 years (SD 15.59), ranging from 20-39 years (n = 8870, 54.84%). A total of 89.20% (n = 14 426/16 173) patients had epidemic-related symptoms. Moreover, 23.35% of the people were diagnosed as COVID-19-positive through antigen or nucleic acid testing. Furthermore, 86.61% (14 008/16 173) of the patients visited our hospital for the first time or had no offline physical outpatient service record within the past 3 months. The demand for medical inquiries was mainly for drug dispensing, followed by medication guidance and disease diagnosis. And 2.07% (334/16 173) of the patients needed to go to the offline hospital for further treatment. CONCLUSION The service model of the COVID-19 Special Section based on Internet hospitals provided the public with the necessary medical support during the COVID-19 outbreak. It provides a reference for future pandemics or public health emergencies.
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Affiliation(s)
- Ye Zhang
- Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Ye Zhang
- Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, China
| | - Jie Huang
- Department of General Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Liang Dong
- Department of Information, Affiliated Hospital of Jiaxing University, Jiaxing, China
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19
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Olteanu GE, Pezzuto F, Lunardi F, Fortarezza F, Dubini A, Calabrese F. Exploring the pathologist's role in understanding COVID-19: from pneumonia to long-COVID lung sequelae. Pathologica 2023; 115:275-283. [PMID: 38054902 DOI: 10.32074/1591-951x-906] [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: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 12/07/2023] Open
Abstract
The crucial role of pathologists in enhancing our understanding of SARS-CoV-2-related disease, from initial pneumonia manifestations to persistent long COVID lung symptoms, is the focus of this review. Pathological explorations have offered unprecedented insights into the early stages of severe COVID-19, shedding light on the interplay between the virus and subsequent complications, thereby shaping clinical approaches. Growing interest is directed to residual lung abnormalities of COVID-19 survivors. Although various radiological studies reported long-lasting pulmonary changes (e.g., ground glass opacities, reticulations, and bronchiectasis), the true incidence of pulmonary fibrosis and corresponding pathological findings in these patients remains largely unknown. There are a few high-impact and knowledgeable works on late complications in COVID-19 survivors, several coming from explant or autopsy cases, and rare cases from in vivo sampling. The study of biopsy samples has further deepened our knowledge of the aftermath of COVID-19 on lung tissue, uncovering alterations at the cellular level and shifts in vascular and epithelial dynamics. Despite the substantial progress made, future research is needed to devise a uniform strategy for interpreting lung biopsies, with a focus on leveraging advanced tools such as molecular and digital pathology techniques, along with artificial intelligence.
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Affiliation(s)
- Gheorghe-Emilian Olteanu
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Federica Pezzuto
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- University Hospital of Padova, Padova, Italy
| | - Francesca Lunardi
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- University Hospital of Padova, Padova, Italy
| | | | | | - Fiorella Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova Medical School, Padova, Italy
- University Hospital of Padova, Padova, Italy
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20
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Obleagă CV, Ahmet RAM, Florescu DN, Popescu DM, Meşină C, Streba L, Vere CC, Constantin C. Post-COVID-19 enterocolitis - a cause of rebellious diarrhea, acute abdomen and liver failure. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:527-533. [PMID: 38184833 PMCID: PMC10863687 DOI: 10.47162/rjme.64.4.09] [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: 09/25/2023] [Accepted: 12/09/2023] [Indexed: 01/09/2024]
Abstract
Currently, worldwide, the coronavirus disease 2019 (COVID-19) pandemic, which first appeared in Wuhan, China, in December 2019, is capsizing the medical system and turning the attention of the entire healthcare system through the many aspects it presents, both from a pathophysiological and from a semiological view, insufficiently studied aspects. With a high rate of morbidity and mortality, the COVID-19 pandemic was initially observed as a pathology leading to a severe acute respiratory syndrome, but over time gastrointestinal and hepatic manifestations have been reported. The study includes an analysis of 21 patients in the stage of the clinical disease of COVID-19 or in the stage of recovery, hospitalized in the Departments of General Surgery II or Gastroenterology, Emergency Clinical County Hospital of Craiova, Romania, with predominantly digestive symptoms, with the clinical expression of infectious enterocolitis, although stool culture was negative for pathogenic bacteria. The evolution of patients was influenced by the appearance of peritonitis through colonic necrosis or remission of clinical symptoms under empirical therapy.
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Affiliation(s)
| | | | - Dan Nicolae Florescu
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, Romania
| | - Dragoş Marian Popescu
- Department of Extreme Conditions Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Cristian Meşină
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Liliana Streba
- Department of Medical Oncology, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Cristian Constantin
- Department of Medical Imaging, University of Medicine and Pharmacy of Craiova, Romania
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21
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Mercier MR, Koucheki R, Lex JR, Khoshbin A, Park SS, Daniels TR, Halai MM. The association between preoperative COVID-19-positivity and acute postoperative complication risk among patients undergoing orthopedic surgery. Bone Jt Open 2023; 4:704-712. [PMID: 37704204 PMCID: PMC10499528 DOI: 10.1302/2633-1462.49.bjo-2023-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Aims This study aimed to investigate the risk of postoperative complications in COVID-19-positive patients undergoing common orthopaedic procedures. Methods Using the National Surgical Quality Improvement Programme (NSQIP) database, patients who underwent common orthopaedic surgery procedures from 1 January to 31 December 2021 were extracted. Patient preoperative COVID-19 status, demographics, comorbidities, type of surgery, and postoperative complications were analyzed. Propensity score matching was conducted between COVID-19-positive and -negative patients. Multivariable regression was then performed to identify both patient and provider risk factors independently associated with the occurrence of 30-day postoperative adverse events. Results Of 194,121 included patients, 740 (0.38%) were identified to be COVID-19-positive. Comparison of comorbidities demonstrated that COVID-19-positive patients had higher rates of diabetes, heart failure, and pulmonary disease. After propensity matching and controlling for all preoperative variables, multivariable analysis found that COVID-19-positive patients were at increased risk of several postoperative complications, including: any adverse event, major adverse event, minor adverse event, death, venous thromboembolism, and pneumonia. COVID-19-positive patients undergoing hip/knee arthroplasty and trauma surgery were at increased risk of 30-day adverse events. Conclusion COVID-19-positive patients undergoing orthopaedic surgery had increased odds of many 30-day postoperative complications, with hip/knee arthroplasty and trauma surgery being the most high-risk procedures. These data reinforce prior literature demonstrating increased risk of venous thromboembolic events in the acute postoperative period. Clinicians caring for patients undergoing orthopaedic procedures should be mindful of these increased risks, and attempt to improve patient care during the ongoing global pandemic.
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Affiliation(s)
| | - Robert Koucheki
- University of Toronto Faculty of Medicine, Toronto, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Johnathan R. Lex
- University of Toronto Division of Orthopaedic Surgery, Toronto, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Amir Khoshbin
- University of Toronto Division of Orthopaedic Surgery, Toronto, Canada
- Department of Orthopaedic Surgery, St Michael's Hospital, Toronto, Canada
| | - Sam S. Park
- University of Toronto Division of Orthopaedic Surgery, Toronto, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Timothy R. Daniels
- University of Toronto Division of Orthopaedic Surgery, Toronto, Canada
- Department of Orthopaedic Surgery, St Michael's Hospital, Toronto, Canada
| | - Mansur M. Halai
- University of Toronto Division of Orthopaedic Surgery, Toronto, Canada
- Department of Orthopaedic Surgery, St Michael's Hospital, Toronto, Canada
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22
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Hu C. Emergency Protective Measures and Strategies of COVID-19: From Lifestyle to Traditional Chinese Medicine. CLINICAL COMPLEMENTARY MEDICINE AND PHARMACOLOGY 2023; 3:100089. [PMID: 37342312 PMCID: PMC10076251 DOI: 10.1016/j.ccmp.2023.100089] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/19/2023] [Accepted: 03/26/2023] [Indexed: 06/22/2023]
Abstract
This article reviews various aspects of COVID-19, including its current status, its side-effects, emergency protective measures and strategies from lifestyle to traditional Chinese medicine (TCM) for fighting against the SARS-CoV-2, and its major variants (Delta and Omicron), with the ongoing global COVID-19 pandemic, which include "Carassius auratus lifestyle" for high effective isolation, social and high-tech medical strategies, traditional Chinese herbs "Bark-Flower-Fruit-Grass-Leaf-Nucleolus(seed)-Root (BFFGLNR)", and the combination of Chinese and western medicine. As a choice, little is known whether the Chinese acupuncture is an effective method for confirming and suspecting COVID-19 patients, which include imported and asymptomatic cases. Definitely, acupuncture has been proven effective treatment for the recovery of COVID-19 cases. However, further animal experiments and clinical trials are required to confirm its effects and disclose underlying mechanisms. In conclusion, these emergency protective measures and strategies for COVID-19 will help to effectively combat the SARS-CoV-2 and its variants during the pandemic and post-COVID-19 era.
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Affiliation(s)
- Chunsong Hu
- Department of Cardiovascular Medicine, Hospital of Nanchang University (Jiangxi Academy of Medical Science), Nanchang University, Nanchang 330006, Jiangxi, China
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23
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Tuan NHN, Phuoc LV, Bao NVT, Khoa LV, Tu PD, Hanh DT, Duc NM. Endovascular management of massive hemoptysis due to pulmonary artery pseudoaneurysm in a COVID-19 patient in Vietnam: A case report. Radiol Case Rep 2023; 18:2880-2883. [PMID: 37333037 PMCID: PMC10267590 DOI: 10.1016/j.radcr.2023.05.065] [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: 02/13/2023] [Revised: 05/10/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023] Open
Abstract
Pulmonary artery pseudoaneurysm with massive hemoptysis is extremely rare in patients with coronavirus disease 2019 (COVID-19)-induced pneumonia, especially in its late stage. We report a case who presented with massive hemoptysis and pulmonary artery pseudoaneurysm without pulmonary thromboembolism in their ninth week of COVID-19 infection, which was treated by endovascular embolization. The endovascular intervention was technically and clinically successful, with complete hemoptysis cessation after the procedure. This is the first case reported in Vietnam.
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Affiliation(s)
| | - Le-Van Phuoc
- Department of Radiology, Cho Ray Hospital, Ho Chi Minh, Vietnam
| | | | - Le-Van Khoa
- Department of Radiology, Cho Ray Hospital, Ho Chi Minh, Vietnam
| | - Pham Dang Tu
- Department of Radiology, Cho Ray Hospital, Ho Chi Minh, Vietnam
| | - Dong-Thi Hanh
- Department of Radiology, Ha Dong General Hospital, Hanoi, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung Ward 12 Distric…, Ho Chi Minh City, 700000, Vietnam
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24
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Wang Y, Han Q, Zhang S, Xing X, Sun X. New perspective on the immunomodulatory activity of ginsenosides: Focus on effective therapies for post-COVID-19. Biomed Pharmacother 2023; 165:115154. [PMID: 37454595 DOI: 10.1016/j.biopha.2023.115154] [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: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023] Open
Abstract
More than 700 million confirmed cases of Coronavirus Disease-2019 (COVID-19) have been reported globally, and 10-60% of patients are expected to exhibit "post-COVID-19 symptoms," which will continue to affect human life and health. In the absence of safer, more specific drugs, current multiple immunotherapies have failed to achieve satisfactory efficacy. Ginseng, a traditional Chinese medicine, is often used as an immunomodulator and has been used in COVID-19 treatment as a tonic to increase blood oxygen saturation. Ginsenosides are the main active components of ginseng. In this review, we summarize the multiple ways in which ginsenosides affect post-COVID-19 symptoms, including inhibition of lipopolysaccharide, tumor necrosis factor signaling, modulation of chemokine receptors and inflammasome activation, induction of macrophage polarization, effects on Toll-like receptors, nuclear factor kappa-B, the mitogen-activated protein kinase pathway, lymphocytes, intestinal flora, and epigenetic regulation. Ginsenosides affect virus-mediated tissue damage, local or systemic inflammation, immune modulation, and other links, thus alleviating respiratory and pulmonary symptoms, reducing the cardiac burden, protecting the nervous system, and providing new ideas for the rehabilitation of patients with post-COVID-19 symptoms. Furthermore, we analyzed its role in strengthening body resistance to eliminate pathogenic factors from the perspective of ginseng-epidemic disease and highlighted the challenges in clinical applications. However, the benefit of ginsenosides in modulating organismal imbalance post-COVID-19 needs to be further evaluated to better validate the pharmacological mechanisms associated with their traditional efficacy and to determine their role in individualized therapy.
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Affiliation(s)
- Yixin Wang
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College, and Chinese Academy of Medical Sciences, China; Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China; Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders,State Administration of Traditional Chinese Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, China
| | - Qin Han
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College, and Chinese Academy of Medical Sciences, China; Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China; Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders,State Administration of Traditional Chinese Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, China
| | - Shuxia Zhang
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College, and Chinese Academy of Medical Sciences, China; Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China; Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders,State Administration of Traditional Chinese Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, China
| | - Xiaoyan Xing
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College, and Chinese Academy of Medical Sciences, China; Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China; Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders,State Administration of Traditional Chinese Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, China.
| | - Xiaobo Sun
- Beijing Key Laboratory of Innovative Drug Discovery of Traditional Chinese Medicine (Natural Medicine) and Translational Medicine, Institute of Medicinal Plant Development, Peking Union Medical College, and Chinese Academy of Medical Sciences, China; Key Laboratory of Bioactive Substances and Resources Utilization of Chinese Herbal Medicine, Ministry of Education, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100193, China; Key Laboratory of Efficacy Evaluation of Chinese Medicine against Glycolipid Metabolic Disorders,State Administration of Traditional Chinese Medicine, Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, China.
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25
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Xu J, Zhang W, Cai Y, Lin J, Yan C, Bai M, Cao Y, Ke S, Liu Y. Nomogram-based prediction model for survival of COVID-19 patients: A clinical study. Heliyon 2023; 9:e20137. [PMID: 37809383 PMCID: PMC10559916 DOI: 10.1016/j.heliyon.2023.e20137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
The study aim to construct an effective model for predicting the survival period of COVID-19 patients. METHODS Clinical data of 386 COVID-19 patients were collected from December 2022 to January 2023. The patients were randomly divided into training and validation cohorts in a 7:3 ratio. LASSO regression and multivariate Cox regression analyses were used to identify prognostic factors, and a nomogram was constructed. Nomogram was evaluated using decision curve analysis, receiver operating characteristic curve, consistency index (c-index), and calibration curve. RESULTS 86 patients (22.3%) died. A new nomogram for predicting the survival was established based on age, resting oxygen saturation, Blood urea nitrogen (BUN), c-reactive protein-to-albumin ratio (CAR), and pneumonia visual score. The decision curve indicated high clinical applicability. The nomogram c-indexes in the training and validation cohorts were 0.846 and 0.81, respectively. The area under the curves (AUCs) for the 15-day and 30-day survival probabilities were 0.906 and 0.869 in the training cohort, and 0.851 and 0.843 in the validation cohort. The calibration curves demonstrated consistency between predicted and actual survival probabilities. CONCLUSIONS Our nomogram has the capacity to assist clinical practitioners in estimating the survival rate of COVID-19 patients, thereby facilitating more optimal management strategies and therapeutic interventions with substantial clinical applicability.
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Affiliation(s)
- Jinxin Xu
- Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Wenshan Zhang
- Department of Thoracic Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Yingjie Cai
- Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Jingping Lin
- Zhongshan Hospital Xiamen University, Xiamen, China
| | - Chun Yan
- Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Meirong Bai
- Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Yunpeng Cao
- Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Sunkui Ke
- Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Yali Liu
- Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China
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Violaris IG, Lampros T, Kalafatakis K, Ntritsos G, Kostikas K, Giannakeas N, Tsipouras M, Glavas E, Tsalikakis D, Tzallas A. Modelling the COVID-19 pandemic: Focusing on the case of Greece. Epidemics 2023; 44:100706. [PMID: 37423142 DOI: 10.1016/j.epidem.2023.100706] [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: 05/07/2020] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/11/2023] Open
Abstract
The SARS-CoV-2 infection (COVID-19) pandemic created an unprecedented chain of events at a global scale, with European counties initially following individual pathways on the confrontation of the global healthcare crisis, before organizing coordinated public vaccination campaigns, when proper vaccines became available. In the meantime, the viral infection outbreaks were determined by the inability of the immune system to retain a long-lasting protection as well as the appearance of SARS-CoV-2 variants with differential transmissibility and virulence. How do these different parameters regulate the domestic impact of the viral epidemic outbreak? We developed two versions of a mathematical model, an original and a revised one, able to capture multiple factors affecting the epidemic dynamics. We tested the original one on five European countries with different characteristics, and the revised one in one of them, Greece. For the development of the model, we used a modified version of the classical SEIR model, introducing various parameters related to the estimated epidemiology of the pathogen, governmental and societal responses, and the concept of quarantine. We estimated the temporal trajectories of the identified and overall active cases for Cyprus, Germany, Greece, Italy and Sweden, for the first 250 days. Finally, using the revised model, we estimated the temporal trajectories of the identified and overall active cases for Greece, for the duration of the 1230 days (until June 2023). As shown by the model, small initial numbers of exposed individuals are enough to threaten a large percentage of the population. This created an important political dilemma in most countries. Force the virus to extinction with extremely long and restrictive measures or merely delay its spread and aim for herd immunity. Most countries chose the former, which enabled the healthcare systems to absorb the societal pressure, caused by the increased numbers of patients, requiring hospitalization and intensive care.
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Affiliation(s)
- Ioannis G Violaris
- Faculty of Informatics & Telecommunications, University of Ioannina, Arta, Greece
| | - Theodoros Lampros
- Faculty of Informatics & Telecommunications, University of Ioannina, Arta, Greece
| | - Konstantinos Kalafatakis
- Faculty of Informatics & Telecommunications, University of Ioannina, Arta, Greece; Institute of Health Sciences Education, Barts and the London School of Medicine & Dentistry (Malta campus), Queen Mary University of London, Victoria, Malta.
| | - Georgios Ntritsos
- Faculty of Informatics & Telecommunications, University of Ioannina, Arta, Greece
| | - Konstantinos Kostikas
- Department of Respiratory Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Nikolaos Giannakeas
- Faculty of Informatics & Telecommunications, University of Ioannina, Arta, Greece
| | - Markos Tsipouras
- Department of Electrical and Computer Engineering, University of Western Macedonia, Kozani, Greece
| | - Evripidis Glavas
- Faculty of Informatics & Telecommunications, University of Ioannina, Arta, Greece
| | - Dimitrios Tsalikakis
- Department of Electrical and Computer Engineering, University of Western Macedonia, Kozani, Greece
| | - Alexandros Tzallas
- Faculty of Informatics & Telecommunications, University of Ioannina, Arta, Greece
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27
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Allegra S, Chiara F, Zanatta M, Mengozzi G, Puccinelli MP, De Francia S. Age and Sex-Related Differences in Teicoplanine Isoform Concentrations in SARS-CoV-2 Patients. Life (Basel) 2023; 13:1792. [PMID: 37763195 PMCID: PMC10532956 DOI: 10.3390/life13091792] [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: 07/19/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023] Open
Abstract
Teicoplanin, a glycopeptide antibiotic commonly used to treat bacterial infections, was discovered to be active in vitro against SARS-CoV-2. The aim of this study was to assess the levels of teicoplanin and its components in a cohort of adult and pediatric SARS-CoV-2 patients, evaluating the effect of sex and age on analyte concentrations. The levels of AST, ALT and leukocytes were shown to be higher in females, while the C reactive protein was higher in males. Evaluating the absence/presence of teicoplanin isoforms, we observed that A2-2_3 is the only one consistently present in pediatrics and adults. In adult men and all pediatrics, A2-4_5 is always present. In pediatrics, except for A3-1, median isoform concentrations were higher in females; on the contrary, in adult patients, males showed higher levels. This is the first study to describe levels of teicoplanin isoforms in SARS-CoV-2 infected patients in males and females, and pediatrics and adults, despite the small sample size of our cohort. The observed results imply that additional testing, via therapeutic drug monitoring, may be helpful to more effectively manage infections, particularly those caused by the most recent viruses.
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Affiliation(s)
- Sarah Allegra
- Laboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10124 Orbassano, TO, Italy; (F.C.); (M.Z.); (S.D.F.)
| | - Francesco Chiara
- Laboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10124 Orbassano, TO, Italy; (F.C.); (M.Z.); (S.D.F.)
| | - Marina Zanatta
- Laboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10124 Orbassano, TO, Italy; (F.C.); (M.Z.); (S.D.F.)
| | - Giulio Mengozzi
- Laboratory of Clinical Biochemistry “Baldi e Riberi”, Metabolic Diseases Unit, AOU Città della Salute e della Scienza di Torino, 10126 Torino, TO, Italy; (G.M.); (M.P.P.)
| | - Maria Paola Puccinelli
- Laboratory of Clinical Biochemistry “Baldi e Riberi”, Metabolic Diseases Unit, AOU Città della Salute e della Scienza di Torino, 10126 Torino, TO, Italy; (G.M.); (M.P.P.)
| | - Silvia De Francia
- Laboratory of Clinical Pharmacology “Franco Ghezzo”, Department of Clinical and Biological Sciences, University of Turin, S. Luigi Gonzaga Hospital, 10124 Orbassano, TO, Italy; (F.C.); (M.Z.); (S.D.F.)
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28
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Yang Q, Jiang T, Ma S, Liu W, Wang B, Wang J, Chen S, Li M, Li F. Acupressure in the treatment of patients with mild infection of COVID-19 omicron variant: A prospectively observational study. Medicine (Baltimore) 2023; 102:e34610. [PMID: 37565844 PMCID: PMC10419346 DOI: 10.1097/md.0000000000034610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
During the coronavirus disease 2019 epidemic, acupressure has been widely used as a complementary treatment for coronavirus disease 2019 in China, but its safety and effectiveness have not been determined until now. This was a prospectively observational study containing 400 cases of mild infection of Omicron who were admitted to Chongming Flower Expo Makeshift Hospital from April 1, 2022 to May 1, 2022. Patients were assigned to receive basic treatment or a combination with acupressure treatment (5 minutes per acupoint, at least twice daily), from admission to discharge. The conversion time of viral RNA assay, the recovery time of symptoms and the clinical cure rate at day 7 were compared in 2 groups. All cases were included in the final analysis. The time to conversion of viral RNA assay (6 vs 7 days, P < .001) and time to symptom recovery (2 vs 4 days, P < .001) were markedly shortened in the acupressure treatment group compared to controls. The time to recovery from individual symptoms of coughing, a sore throat, a fever, fatigue, poor appetite, and insomnia were shorter in the treatment group compared to the control (all P < .05), but there was no statistical difference in reducing the recovery time from headache, muscle ache, anxiety, loss of taste between 2 groups (all P > .05). In addition, acupressure therapy also revealed a higher clinical cure rate at day 7 than basic treatment alone (91% vs 65%, P < .001) and reported no serious adverse events. This study provided evidence for acupressure therapy in treatment of Omicron infection concerning the viral load disappearance and the clinical symptoms improvements. Findings were expected to help guide efforts to position acupressure therapy as a therapeutic option for patients with Omicron variant.
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Affiliation(s)
- Qiqi Yang
- Graduate Faculty, Anhui University of Chinese Medicine, Hefei, China
| | - Tianxin Jiang
- Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Shouliang Ma
- Department of Encephalopathy, First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Wen Liu
- First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Baoguo Wang
- Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Jie Wang
- Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Shaofei Chen
- Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Meng Li
- Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Fei Li
- Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
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29
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Hazem M, Ali SI, AlAlwan QM, Al Jabr IK, Alshehri SAF, AlAlwan MQ, Alsaeed MI, Aldawood M, Turkistani JA, Amin YA. Diagnostic Performance of the Radiological Society of North America Consensus Statement for Reporting COVID-19 Chest CT Findings: A Revisit. J Clin Med 2023; 12:5180. [PMID: 37629222 PMCID: PMC10455816 DOI: 10.3390/jcm12165180] [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: 05/14/2023] [Revised: 07/24/2023] [Accepted: 08/05/2023] [Indexed: 08/27/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that leads to variable degrees of illness, and which may be fatal. We evaluated the diagnostic performance of each chest computed tomography (CT) reporting category recommended by the Expert Consensus of the Radiological Society of North America (RSNA) in comparison with that of reverse transcription polymerase chain reaction (RT-PCR). We aimed to add an analysis of this form of reporting in the Middle East, as few studies have been performed there. Between July 2021 and February 2022, 184 patients with a mean age of 55.56 ± 16.71 years and probable COVID-19 infections were included in this retrospective study. Approximately 64.67% (119 patients) were male, while 35.33% (65 patients) were female. Within 7 days, all patients underwent CT and RT-PCR examinations. According to a statement by the RSNA, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each CT reporting category were calculated, and the RT-PCR results were used as a standard reference. The RT-PCR results confirmed a final diagnosis of COVID-19 infection in 60.33% of the patients. For COVID-19 diagnoses, the typical category (n = 88) had a sensitivity, specificity, PPV, and accuracy of 74.8%, 93.2%, 94.3%, and 92.5%, respectively. For non-COVID-19 diagnoses, the PPVs for the atypical (n = 22) and negative (n = 46) categories were 81.8% and 89.1%, respectively. The PPV for the indeterminate (n = 28) category was 67.9%, with a low sensitivity of 17.1%. However, the RSNA's four chest CT reporting categories provide a strong diagnostic foundation and are highly correlated with the RT-PCR results for the typical, atypical, and negative categories, but they are weaker for the indeterminate category.
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Affiliation(s)
- Mohammed Hazem
- Department of Surgery, Collage of Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (I.K.A.J.); (S.A.F.A.)
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Sohag University, Sohag 82524, Egypt;
| | - Sayed Ibrahim Ali
- Department of Family and Community Medicine, Collage of Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (S.I.A.); (J.A.T.)
- Educational Psychology Department, College of Education, Helwan University, Cairo 11795, Egypt
| | - Qasem M. AlAlwan
- Department of Radiology, King Fahd Hospital Hofuf, Al-Ahsa 36441, Saudi Arabia; (Q.M.A.); (M.Q.A.)
| | - Ibrahim Khalid Al Jabr
- Department of Surgery, Collage of Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (I.K.A.J.); (S.A.F.A.)
| | - Sarah Abdulrahman F. Alshehri
- Department of Surgery, Collage of Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (I.K.A.J.); (S.A.F.A.)
| | - Mohammed Q. AlAlwan
- Department of Radiology, King Fahd Hospital Hofuf, Al-Ahsa 36441, Saudi Arabia; (Q.M.A.); (M.Q.A.)
| | | | - Mohammed Aldawood
- Collage of Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia;
| | - Jamela A. Turkistani
- Department of Family and Community Medicine, Collage of Medicine, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia; (S.I.A.); (J.A.T.)
| | - Yasser Abdelkarim Amin
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Sohag University, Sohag 82524, Egypt;
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Abha Mishra KM, Podili R, Pathlavath TS, Sethi KK. A critical review on brain and heart axis response in COVID-19 patients: Molecular mechanisms, mediators, biomarkers, and therapeutics. J Biochem Mol Toxicol 2023; 37:e23409. [PMID: 37341157 DOI: 10.1002/jbt.23409] [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: 07/26/2022] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023]
Abstract
Since the outbreak of highly virulent coronaviruses, significant interest was assessed to the brain and heart axis (BHA) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-affected patients. The majority of clinical reports accounted for unusual symptoms associated with SARS-CoV-2 infections which are of the neurological type, such as headache, nausea, dysgeusia, anosmia, and cerebral infarction. The SARS-CoV-2 enters the cells through the angiotensin-converting enzyme (ACE-2) receptor. Patients with prior cardiovascular disease (CVD) have a higher risk of COVID-19 infection and it has related to various cardiovascular (CV) complications. Infected patients with pre-existing CVDs are also particularly exposed to critical health outcomes. Overall, COVID-19 affected patients admitted to intensive care units (ICU) and exposed to stressful environmental constraints, featured with a cluster of neurological and CV complications. In this review, we summarized the main contributions in the literature on how SARS-CoV-2 could interfere with the BHA and its role in affecting multiorgan disorders. Specifically, the central nervous system involvement, mainly in relation to CV alterations in COVID-19-affected patients, is considered. This review also emphasizes the biomarkers and therapy options for COVID-19 patients presenting with CV problems.
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Affiliation(s)
- K M Abha Mishra
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Runesh Podili
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Teja S Pathlavath
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
| | - Kalyan K Sethi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India
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Hosseini M, Ahmed Hamad M, Mohseni G, Salamy S, Dehghan Tarzjani S, Taati Moghadam M. Prediction of tsunami of resistance to some antibiotics is not far-fetched which used during COVID-19 pandemic. J Clin Lab Anal 2023; 37:e24959. [PMID: 37650531 PMCID: PMC10561589 DOI: 10.1002/jcla.24959] [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: 01/17/2023] [Revised: 07/19/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023] Open
Abstract
One of the most tragic events in recent history was the COVID-19 outbreak, which has caused thousands of deaths. A variety of drugs were prescribed to improve the condition of patients, including antiparasitic, antiviral, antibiotics, and anti-inflammatory medicines. It must be understood, however, that COVID-19 is like a tip of an iceberg on the ocean, and the consequences of overuse of antibiotics are like the body of a mountain under water whose greatness has not yet been determined for humanity, and additional study is needed to understand them. History of the war between microbes and antimicrobial agents has shown that microbes are intelligent organisms that win over antimicrobial agents over time through many acquired or inherent mechanisms. The key terms containing "COVID-19," "Severe acute respiratory syndrome coronavirus-2," "SARS-CoV2," "Antibiotic Resistance," "Coronavirus," "Pandemic," "Antibiotics," and "Antimicrobial Resistance" were used for searching in PubMed, Scopus, and Google Scholar databases. The COVID-19 pandemic has resulted in an increased prescription of antibiotics. Infections caused by secondary or co-bacterial infections or beneficial bacteria in the body can be increased as a result of this amount of antibiotic prescription and exposure to antibiotics. Antibiotic resistance will likely pose a major problem in the future, especially for last resort antibiotics. In order to address the antibiotic resistance crisis, it is imperative that researchers, farmers, veterinarians, physicians, public and policymakers, pharmacists, other health and environmental professionals, and others collaborate during and beyond this pandemic.
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Affiliation(s)
- Mandana Hosseini
- Department of Microbiology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Mohammed Ahmed Hamad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Golazin Mohseni
- Department of Microbiology, Tonekabon Branch, Azad University, Tonekabon, Iran
| | - Shakiba Salamy
- Department of Microbiology, Faculty of Pharmacy, Islamic Azad University, Tehran, Iran
| | - Shabnam Dehghan Tarzjani
- Department of Cellular and Molecular Biology, Tehran Center Branch, Islamic Azad University, Tehran, Iran
| | - Majid Taati Moghadam
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Roham PH, Kamath JJ, Sharma S. Dissecting the Interrelationship between COVID-19 and Diabetes Mellitus. Adv Biol (Weinh) 2023; 7:e2300107. [PMID: 37246237 DOI: 10.1002/adbi.202300107] [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: 03/12/2023] [Revised: 04/20/2023] [Indexed: 05/30/2023]
Abstract
COVID-19 disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to enormous morbidity and mortality worldwide. After gaining entry into the human host, the virus initially infects the upper and lower respiratory tract, subsequently invading multiple organs, including the pancreas. While on one hand, diabetes mellitus (DM) is a significant risk factor for severe COVID-19 infection and associated death, recent reports have shown the onset of DM in COVID-19-recovered patients. SARS-CoV-2 infiltrates the pancreatic islets and activates stress response and inflammatory signaling pathways, impairs glucose metabolism, and consequently leads to their death. Indeed, the pancreatic autopsy samples of COVID-19 patients reveal the presence of SARS-CoV-2 particles in β-cells. The current review describes how the virus enters the host cells and activates an immunological response. Further, it takes a closer look into the interrelationship between COVID-19 and DM with the aim to provide mechanistic insights into the process by which SARS-CoV-2 infects the pancreas and mediates dysfunction and death of endocrine islets. The effects of known anti-diabetic interventions for COVID-19 management are also discussed. The application of mesenchymal stem cells (MSCs) as a future therapy for pancreatic β-cells damage to reverse COVID-19-induced DM is also emphasized.
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Affiliation(s)
- Pratiksha H Roham
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, 411007, India
| | - Jayesh J Kamath
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, 411007, India
| | - Shilpy Sharma
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, 411007, India
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Rădulescu PM, Căluianu EI, Traşcă ET, Mercuţ D, Georgescu I, Georgescu EF, Ciupeanu-Călugăru ED, Mercuţ MF, Mercuţ R, Padureanu V, Streba CT, Călăraşu C, Rădulescu D. The Impact of the COVID-19 Pandemic on Outcomes in Acute Pancreatitis: A Propensity Score Matched Study Comparing before and during the Pandemic. Diagnostics (Basel) 2023; 13:2446. [PMID: 37510190 PMCID: PMC10378087 DOI: 10.3390/diagnostics13142446] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
We aimed to evaluate the outcomes and survival of patients with acute pancreatitis who shared the same clinical form, age, and sex before the pandemic, during the pandemic, and among those with confirmed COVID-19 infection upon hospital admission. This consideration used the sparse data in the existing literature on the influence of the pandemic and COVID-19 infection on patients with acute pancreatitis. To accomplish this, we conducted a multicentric, retrospective case-control study using propensity score matching with a 2:1 match of 28 patients with SARS-CoV-2 infection and acute pancreatitis, with 56 patients with acute pancreatitis pre-pandemic, and 56 patients with acute pancreatitis during the pandemic. The study outcome demonstrated a six-fold relative risk of death in patients with acute pancreatitis and SARS-CoV-2 infection compared to those with acute pancreatitis before the pandemic. Furthermore, restrictive measures implemented during the pandemic period led to a partial delay in the care of patients with acute pancreatitis, which likely resulted in an impairment of their immune state. This, in certain circumstances, resulted in a restriction of surgical treatment indications, leading to a three-fold relative risk of death in patients with acute pancreatitis during the pandemic compared to those with acute pancreatitis before the pandemic.
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Affiliation(s)
| | - Elena Irina Căluianu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Emil Tiberius Traşcă
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dorin Mercuţ
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ion Georgescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Eugen Florin Georgescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Maria Filoftea Mercuţ
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Răzvan Mercuţ
- Department of Plastic and Reconstructive Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Vlad Padureanu
- Internal Medicine Department, Country Hospital of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Costin Teodor Streba
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
| | - Cristina Călăraşu
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
| | - Dumitru Rădulescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Li X, Fan C, Tang J, Zhang N. Meta-analysis of liver injury in patients with COVID-19. Medicine (Baltimore) 2023; 102:e34320. [PMID: 37478243 PMCID: PMC10662882 DOI: 10.1097/md.0000000000034320] [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: 04/24/2023] [Accepted: 06/22/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) is a major public health problem threatening human health. It can lead to multiple system complications, among which liver damage is also a common complication of COVID-19. The pathogenesis of liver injury is complex and involves the interaction of multiple factors. This study aims to investigate the incidence and risk factors of liver injury in COVID-19 patients and analyze the impact of liver injury on clinical prognosis of patients, so as to provide corresponding basis for clinical diagnosis and treatment. METHODS PubMed and Cochrane Library were searched in computer to collect original studies on liver injury cases, laboratory indicators and clinical outcomes in COVID-19 patients. Articles were screened according to inclusion and exclusion criteria, and data were meta-analyzed using Stata12.0 software. RESULTS A total of 49 studies, including 23,611 patients with COVID-19, had a prevalence of liver injury of 39.63%. Subgroup analysis found that patients in the Americas had the highest incidence of liver injury at 43.7% and lowest in Africa (25.99%). The vast majority of liver injury is manifested by aminotransferase or bilirubin levels greater than 1 times the upper limit of normal (49.16%). The older the age, the male, the associated chronic liver disease, and the higher the levels of white blood cells, neutrophils, and C-reactive protein, the higher the risk of liver injury. The use of hormones, hydroxychloroquine, and tocilizumab increases the risk of liver injury. Patients with concurrent liver injury have longer hospital stays, are more likely to progress to severe cases, and have a higher risk of death than patients without liver injury. CONCLUSION The incidence of liver injury in COVID-19 patients was high, affected by age, gender, chronic liver disease, inflammatory state and medication, and patients with liver injury were hospitalized longer and were more likely to have a poor prognosis. Therefore, clinical attention should be paid to early intervention.
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Affiliation(s)
- Xinghai Li
- Department of Minimally Invasive Intervention, Ganzhou People’s Hospital, Ganzhou, China
| | - Caiping Fan
- Department of Minimally Invasive Intervention, Ganzhou People’s Hospital, Ganzhou, China
| | - Jin Tang
- Department of Gastroenterology, Ganzhou People’s Hospital, Ganzhou, China
| | - Ning Zhang
- Department of Gastroenterology, Ganzhou People’s Hospital, Ganzhou, China
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Guo Y, Zeng X, Li L, Wang L. The impact of HBV infection on clinical outcomes of COVID-19 patients: a systematic review and meta-analysis. Epidemiol Infect 2023; 151:e135. [PMID: 37381822 PMCID: PMC10540167 DOI: 10.1017/s0950268823000705] [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: 06/30/2023] Open
Abstract
The impact of hepatitis B virus (HBV) infection on clinical outcomes of coronavirus disease 2019 (COVID-19) remains unclear. The aim of this study is to explore this impact. For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane library, China National Knowledge Infrastructure (CKNI), China Science and Technology Journal Database (VIP), and Wan Fang database for articles between 1 January 2020 and 1 February 2023. We used the Newcastle-Ottawa Quality Assessment to evaluate the study's quality. A random-effects meta-analysis was performed utilising the rates of severe/critical illness and death in COVID-19 patients with and without HBV infection. Eighteen studies with a total of 40,502 participants met the inclusion criteria. The meta-analysis showed that compared to those without HBV infection, COVID-19 patients with HBV were at increased risk of mortality (OR = 1.65, I2 = 58%, and 95% CI 1.08-2.53) and severity (OR = 1.90, I2 = 44%, and 95% CI 1.62-2.24). The region and gender may influence the outcomes of COVID-19 patients with HBV infection, but it requires more global data to confirm. In conclusion, HBV infection is significantly linked to an increased risk of severity and mortality in COVID-19.
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Affiliation(s)
- Yifan Guo
- Emergency Department of Infectious Diseases of Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xueling Zeng
- Emergency Department of Infectious Diseases of Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Li Li
- Emergency Department of Infectious Diseases of Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Linghang Wang
- Emergency Department of Infectious Diseases of Beijing Ditan Hospital, Capital Medical University, Beijing, China
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Paton B, Herrero P, Peraire J, del Pino A, Chafino S, Martinez-Picado J, Gómez-Bertomeu F, Rull A, Canela N, Suárez M. Fucosylated N-glycans as early biomarkers of COVID-19 severity. Front Immunol 2023; 14:1204661. [PMID: 37342334 PMCID: PMC10278543 DOI: 10.3389/fimmu.2023.1204661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/22/2023] [Indexed: 06/22/2023] Open
Abstract
Background The pathological mechanisms of SARS-CoV-2 in humans remain unclear and the unpredictability of COVID-19 progression may be attributed to the absence of biomarkers that contribute to the prognosis of this disease. Therefore, the discovery of biomarkers is needed for reliable risk stratification and to identify patients who are more likely to progress to a critical stage. Methods Aiming to identify new biomarkers we analysed N-glycan traits in plasma from 196 patients with COVID-19. Samples were classified into three groups according to their severity (mild, severe and critical) and obtained at diagnosis (baseline) and at 4 weeks of follow-up (postdiagnosis), to evaluate their behaviour through disease progression. N-glycans were released with PNGase F and labelled with Rapifluor-MS, followed by their analysis by LC-MS/MS. The Simglycan structural identification tool and Glycostore database were employed to predict the structure of glycans. Results We determined that plasma from SARS-CoV-2-infected patients display different N-glycosylation profiles depending on the disease severity. Specifically, levels of fucosylation and galactosylation decreased with increasing severity and Fuc1Hex5HexNAc5 was identified as the most suitable biomarker to stratify patients at diagnosis and distinguish mild from critical outcomes. Conclusion In this study we explored the global plasma glycosignature, reflecting the inflammatory state of the organs during the infectious disease. Our findings show the promising potential of glycans as biomarkers of COVID-19 severity.
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Affiliation(s)
- Beatrix Paton
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (Joint Unit Eurecat- Universitat Rovira i Virgili), Unique Scientific and Technical Infrastructure (ICTS), Reus, Spain
| | - Pol Herrero
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (Joint Unit Eurecat- Universitat Rovira i Virgili), Unique Scientific and Technical Infrastructure (ICTS), Reus, Spain
| | - Joaquim Peraire
- Hospital Universitari de Tarragona Joan XXIII (HJ23), Tarragona, Spain
- Institut Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Antoni del Pino
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (Joint Unit Eurecat- Universitat Rovira i Virgili), Unique Scientific and Technical Infrastructure (ICTS), Reus, Spain
| | - Silvia Chafino
- Hospital Universitari de Tarragona Joan XXIII (HJ23), Tarragona, Spain
- Institut Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Martinez-Picado
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Fréderic Gómez-Bertomeu
- Hospital Universitari de Tarragona Joan XXIII (HJ23), Tarragona, Spain
- Institut Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Anna Rull
- Hospital Universitari de Tarragona Joan XXIII (HJ23), Tarragona, Spain
- Institut Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Núria Canela
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (Joint Unit Eurecat- Universitat Rovira i Virgili), Unique Scientific and Technical Infrastructure (ICTS), Reus, Spain
| | - Manuel Suárez
- Institut Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Nutrigenomics Research Group, Tarragona, Spain
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Liu Z, Song L, Chen J, Zhou Y, Wang Y, Tang L, Li Y. Causal associations between chronic hepatitis B and COVID-19 in East Asian populations. Virol J 2023; 20:109. [PMID: 37264390 DOI: 10.1186/s12985-023-02081-4] [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: 03/03/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The relationship between chronic hepatitis B (CHB) and Coronavirus disease 2019 (COVID-19) has been inconsistent in traditional observational studies. METHODS We explored the total causal and direct causal associations between CHB and the three COVID-19 outcomes using univariate and multivariate Mendelian randomization (MR) analyses, respectively. Genome-wide association study datasets for CHB and COVID-19 were obtained from the Japan Biobank and the COVID-19 Host Genetics Initiative, respectively. RESULTS Univariate MR analysis showed that CHB increased the risk of SARS-CoV-2 infection (OR = 1.04, 95% CI 1.01-1.07, P = 3.39E-03), hospitalized COVID-19 (OR = 1.10, 95% CI 1.06-1.13, P = 7.31E-08), and severe COVID-19 (OR = 1.16, 95%CI 1.08-1.26, P = 1.43E-04). A series of subsequent sensitivity analyses ensured the stability and reliability of these results. In multivariable MR analyses adjusting for type 2 diabetes, body mass index, basophil count, and smoking, genetically related CHB is still positively associated with increased risk of SARS-CoV-2 infection (OR = 1.06, 95% CI 1.02-1.11, P = 1.44E-03) and hospitalized COVID-19 (OR = 1.12, 95% CI 1.07-1.16, P = 5.13E-07). However, the causal link between CHB and severe COVID-19 was attenuated after adjustment for the above variables. In addition, the MR analysis did not support the causal effect of COVID-19 on CHB. CONCLUSIONS This study provides evidence that CHB increases COVID-19 susceptibility and severity among individuals of East Asian ancestry.
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Affiliation(s)
- Zhenguo Liu
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Linnan Song
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Junling Chen
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Yongjun Zhou
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Yuhao Wang
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Libo Tang
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
| | - Yongyin Li
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
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Kandula UR, Wake AD. Effectiveness of RCTs Pooling Evidence on Mesenchymal Stem Cell (MSC) Therapeutic Applications During COVID-19 Epidemic: A Systematic Review. Biologics 2023; 17:85-112. [PMID: 37223116 PMCID: PMC10202141 DOI: 10.2147/btt.s404421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/09/2023] [Indexed: 05/25/2023]
Abstract
Background Global pandemic identified as coronavirus disease 2019 (COVID-19) has resulted in a variety of clinical symptoms, from asymptomatic carriers to those with severe acute respiratory distress syndrome (SARS) and moderate upper respiratory tract symptoms (URTS). This systematic review aimed to determine effectiveness of stem cell (SC) applications among COVID-19 patients. Methods Multiple databases of PubMed, EMBASE, Science Direct, Google Scholar, Scopus, Web of Science, and Cochrane Library were used. Studies were screened, chosen, and included in this systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist. Included studies' quality was assessed employing Critical Appraisal Skills Programme (CASP) quality evaluation criteria for 14 randomized controlled trials (RCTs). Results Fourteen RCTs were performed between the years of 2020 to 2022, respectively, with a sample size n = 574 (treatment group (n = 318); control group (n = 256)) in multiple countries of Indonesia, Iran, Brazil, Turkey, China, Florida, UK, and France. The greatest sample size reported from China among 100 COVID-19 patients, while the lowest sample of 9 COVID-19 patients from Jakarta, Indonesia, and the patient's age ranges from 18 to 69 years. Studies applied to the type of SC were "Umbilical cord MSCs, MSCs secretome, MSCs, Placenta-derived MSCs, Human immature dental pulp SC, DW-MSC infusion, Wharton Jelly-derived MSCs". The injected therapeutic dose was 1 × 106 cells/kg, 1 × 107 cells/kg, 1 × 105 cells/kg, and 1 million cells/kg as per the evidence from the different studies. Studies focused on demographic variables, clinical symptoms, laboratory tests, Comorbidities, respiratory measures, concomitant therapies, Sequential Organ Failure Assessment score, mechanical ventilation, body mass index, adverse events, inflammatory markers, and PaO2/FiO2 ratio were all recorded as study characteristics. Conclusion Clinical evidence on MSC's therapeutic applications during COVID-19 pandemic has proven to be a promising therapy for COVID-19 patient recovery with no consequences and applied as a routine treatment for challenging ailments.
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Affiliation(s)
- Usha Rani Kandula
- Department of Clinical Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Addisu Dabi Wake
- Department of Clinical Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
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Mardi A, Kamran A, Pourfarzi F, Zare M, Hajipour A, Doaei S, Abediasl N, Hackett D. Potential of macronutrients and probiotics to boost immunity in patients with SARS-COV-2: a narrative review. Front Nutr 2023; 10:1161894. [PMID: 37312883 PMCID: PMC10259402 DOI: 10.3389/fnut.2023.1161894] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/26/2023] [Indexed: 06/15/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) may cause inflammation and increased cytokine secretion. Dietary factors may play an important role in enhancing the immune responses against infectious diseases such as SARS-COV-2. This narrative review aims to determine the effectiveness of macronutrients and probiotics to improve immunity in SARS-COV-2 patients. Dietary proteins may boost pulmonary function in SARS-COV-2 patients through inhibitory effects on the Angiotensin-converting enzyme (ACE) and reduce Angiotensin (ANG-II). Moreover, omega-3 fatty acids may improve oxygenation, acidosis, and renal function. Dietary fiber may also produce anti-inflammatory effects by reducing the level of high-sensitivity C-Reactive Protein (hs-CRP), Interleukin (IL-6), and Tumor necrosis factor (TNF-α). In addition, some evidence indicates that probiotics significantly improve oxygen saturation which may enhance survival rate. In conclusion, the consumption of a healthy diet including adequate macronutrients and probiotic intake may decrease inflammation and oxidative stress. Following this dietary practice is likely to strengthen the immune system and have beneficial effects against SARS-COV-2.
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Affiliation(s)
- Afrouz Mardi
- Department of Public Health, School of Health, Ardabil University of Medical Science, Ardabil, Iran
| | - Aziz Kamran
- School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Maryam Zare
- Department of Nutrition, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Azadeh Hajipour
- School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saeid Doaei
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin Abediasl
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
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Liatsos GD. SARS-CoV-2 induced liver injury: Incidence, risk factors, impact on COVID-19 severity and prognosis in different population groups. World J Gastroenterol 2023; 29:2397-2432. [PMID: 37179584 PMCID: PMC10167898 DOI: 10.3748/wjg.v29.i16.2397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/17/2023] [Accepted: 04/07/2023] [Indexed: 04/24/2023] Open
Abstract
Liver is unlikely the key organ driving mortality in coronavirus disease 2019 (COVID-19) however, liver function tests (LFTs) abnormalities are widely observed mostly in moderate and severe cases. According to this review, the overall prevalence of abnormal LFTs in COVID-19 patients ranges from 2.5% to 96.8% worldwide. The geographical variability in the prevalence of underlying diseases is the determinant for the observed discrepancies between East and West. Multifactorial mechanisms are implicated in COVID-19-induced liver injury. Among them, hypercytokinemia with "bystander hepatitis", cytokine storm syndrome with subsequent oxidative stress and endotheliopathy, hypercoagulable state and immuno-thromboinflammation are the most determinant mechanisms leading to tissue injury. Liver hypoxia may also contribute under specific conditions, while direct hepatocyte injury is an emerging mechanism. Except for initially observed severe acute respiratory distress syndrome corona virus-2 (SARS-CoV-2) tropism for cholangiocytes, more recent cumulative data show SARS-CoV-2 virions within hepatocytes and sinusoidal endothelial cells using electron microscopy (EM). The best evidence for hepatocellular invasion by the virus is the identification of replicating SARS-CoV-2 RNA, S protein RNA and viral nucleocapsid protein within hepatocytes using in-situ hybridization and immunostaining with observed intrahepatic presence of SARS-CoV-2 by EM and by in-situ hybridization. New data mostly derived from imaging findings indicate possible long-term sequelae for the liver months after recovery, suggesting a post-COVID-19 persistent live injury.
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Affiliation(s)
- George D Liatsos
- Department of Internal Medicine, Hippokration General Hospital, Athens 11527, Attiki, Greece
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Kenny G, Townsend L, Savinelli S, Mallon PWG. Long COVID: Clinical characteristics, proposed pathogenesis and potential therapeutic targets. Front Mol Biosci 2023; 10:1157651. [PMID: 37179568 PMCID: PMC10171433 DOI: 10.3389/fmolb.2023.1157651] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/04/2023] [Indexed: 05/15/2023] Open
Abstract
The emergence of persistent ill-health in the aftermath of SARS-CoV-2 infection has presented significant challenges to patients, healthcare workers and researchers. Termed long COVID, or post-acute sequelae of COVID-19 (PASC), the symptoms of this condition are highly variable and span multiple body systems. The underlying pathophysiology remains poorly understood, with no therapeutic agents proven to be effective. This narrative review describes predominant clinical features and phenotypes of long COVID alongside the data supporting potential pathogenesis of these phenotypes including ongoing immune dysregulation, viral persistence, endotheliopathy, gastrointestinal microbiome disturbance, autoimmunity, and dysautonomia. Finally, we describe current potential therapies under investigation, as well as future potential therapeutic options based on the proposed pathogenesis research.
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Affiliation(s)
- Grace Kenny
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland
- Department of Infectious Diseases, St Vincent’s University Hospital, Dublin, Ireland
| | - Liam Townsend
- Department of Infectious Diseases, St Vincent’s University Hospital, Dublin, Ireland
| | - Stefano Savinelli
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland
- Department of Infectious Diseases, St Vincent’s University Hospital, Dublin, Ireland
| | - Patrick W. G. Mallon
- Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland
- Department of Infectious Diseases, St Vincent’s University Hospital, Dublin, Ireland
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Si X, Ma X, Wang Y, Li Y, Liu L, Yang Y, Guo Z, Liang Y, Pan G. Efficacy and safety of Jinhua Qinggan granules in the treatment of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33545. [PMID: 37058020 PMCID: PMC10100637 DOI: 10.1097/md.0000000000033545] [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: 01/26/2023] [Accepted: 03/27/2023] [Indexed: 04/15/2023] Open
Abstract
OBJECTIVE To evaluate, using meta-analysis, the efficacy and safety profile of Jinhua Qinggan granules (JHQG) in the treatment of novel coronavirus pneumonia. METHODS We screened multiple publication databases (PubMed, Embase, The Cochrane Library, Web of Science, CNKI, WanFang, and VIP), using parameters designed to identify articles detailing randomized controlled trials relating to the treatment of novel coronavirus pneumonia with JHQG. The inclusion period for each search was the point of database inception to November 2022. Each piece of literature identified in our initial screening was independently reviewed by 2 researchers, who extracted the relevant data and evaluated the bias risk associated with the study. The data was split in 2: the control group (containing patients who had received routine treatment or placebo) and the experimental group (containing patients treated with JHQG). The meta-analysis was performed using Revman 5.4 software. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS Four articles were selected for this study and combined included a total of 582 patients, which were subdivided into experimental (n = 347) and control (n = 235) groups. The results showed that treatment with JHQG could significantly: enhance the improvement rate of primary symptoms [relative ratio (RR) = 1.26,95% confidence interval (CI) (1.07, 1.49), P = .007] and fever [RR = 1.48, 95% CI (1.07, 2.04), P = .02]; decrease the viral nucleic acid in patients with coronavirus disease 2019 (COVID-19) [RR = 2.04, 95% CI (1.15, 3.62), P = .02] and reduce the progression of pneumonia [RR = 0.34, 95% CI (0.17, 0.67), P = .002]. However, there was no significant difference between the 2 groups with regards to: the improvement rate of cough, nausea and vomiting, fatigue, computed tomography, or frequency of adverse reactions. CONCLUSIONS Current evidence indicates that JHQG is effective in treating COVID-19, increasing the rate of improvement for fever, increasing the negative rate of viral nucleic acid in patients with COVID-19 and reducing the aggravation rate of pneumonia. These conclusions need to be verified by further rigorous studies, as the existing results were limited by the number and quality of the included studies.
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Affiliation(s)
- Xiuying Si
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaoxue Ma
- Jinan Zhangqiu District Hospital of Traditional Chinese Medicine, Jinan, China
| | - Youpeng Wang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yongjun Li
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Lujia Liu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yang Yang
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zheng Guo
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yuan Liang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Guangxia Pan
- Heilongjiang University of Chinese Medicine, Harbin, China
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Helou M, Nasr J, El Osta N, Jabbour E, Husni R. Liver manifestations in COVID-19 patients: A review article. World J Clin Cases 2023; 11:2189-2200. [PMID: 37122526 PMCID: PMC10131011 DOI: 10.12998/wjcc.v11.i10.2189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/09/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) initially presented as a disease that affected the lungs. Then, studies revealed that it intricately affected disparate organs in the human body, with the liver being one of the most affected organs. This review aimed to assess the association between COVID-19 and liver function, shedding light on its clinical implication. However, its exact pathophysiology remains unclear, involving many factors, such as active viral replication in the liver cells, direct cytotoxic effects of the virus on the liver or adverse reactions to viral antigens. Liver symptoms are mild-to-moderate transaminase elevation. In some patients, with underlying liver disease, more serious outcomes are observed. Thus, liver function should be meticulously considered in patients with COVID-19.
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Affiliation(s)
- Mariana Helou
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University Medical Center, Lebanese American University School of Medicine, Beirut 1102-2801, Lebanon
| | - Janane Nasr
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
| | - Nour El Osta
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
| | - Elsy Jabbour
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut 1102-2801, Lebanon
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Rivera J, Corchuelo S, Naizaque J, Parra É, Meek EA, Álvarez-Díaz D, Mercado M, Torres-Fernández O. Histopathology of COVID-19: An illustration of the findings from fatal cases. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:8-21. [PMID: 37167459 PMCID: PMC10481905 DOI: 10.7705/biomedica.6737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/04/2023] [Indexed: 05/13/2023]
Affiliation(s)
- Jorge Rivera
- Grupo de Morfología Celular, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
| | - Sheryll Corchuelo
- Grupo de Morfología Celular, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
| | - Julián Naizaque
- Grupo de Morfología Celular, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
| | - Édgar Parra
- Grupo de Patología, Dirección de Redes en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
| | - Eugenio Aladino Meek
- Grupo de Patología, Dirección de Redes en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
| | - Diego Álvarez-Díaz
- Genómica de Microorganismos Emergentes, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
| | - María Mercado
- Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
| | - Orlando Torres-Fernández
- Grupo de Morfología Celular, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
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AlGhawi FS, AlMudarra SS, Assiri AM. Mortality patterns among COVID‐19 patients in two Saudi hospitals: Demographics, etiology, and treatment. Influenza Other Respir Viruses 2023; 17:e13127. [PMID: 36970568 PMCID: PMC10030359 DOI: 10.1111/irv.13127] [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: 12/28/2022] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/24/2023] Open
Abstract
Background Saudi Arabia (SA) reported its first case of COVID‐19 on 2 March 2020. Mortality varied nationwide; by April 14, 2020, Medina had 16% of SA's total COVID‐19 cases and 40% of all COVID‐19 deaths. A team of epidemiologists investigated to identify factors impacting survival. Methods We reviewed medical records from two hospitals: Hospital A in Medina and Hospital B in Dammam. All patients with a registered COVID‐related death between March and May 1, 2020, were included. We collected data on demographics, chronic health conditions, clinical presentation, and treatment. We analyzed data using SPSS. Results We identified 76 cases: 38 cases from each hospital. More fatalities were among non‐Saudis at Hospital A (89%) versus Hospital B (82%, p < 0.001). Hypertension prevalence was higher among cases at Hospital B (42%) versus Hospital A (21%) (p < 0.05). We found statistically significant differences (p < 0.05) in symptoms at initial presentation among cases at Hospital B versus Hospital A, including body temperature (38°C vs. 37°C), heart rate (104 bpm vs. 89 bpm), and regular breathing rhythms (61% vs. 55%). Fewer cases (50%) at Hospital A received heparin versus Hospital B (97%, p‐value < 0.001). Conclusion Patients who died typically presented with more severe illnesses and were more likely to have underlying health conditions. Migrant workers may be at increased risk due to poorer baseline health and reluctance to seek care. This highlights the importance of cross‐cultural outreach to prevent deaths. Health education efforts should be multilingual and accommodate all literacy levels.
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Affiliation(s)
| | - Sami S. AlMudarra
- Field Epidemiology Training ProgramMinistry of HealthRiyadhSaudi Arabia
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46
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Jang WS, Jee H, Lee JM, Lim CS, Kim J. Performance Evaluation of a BZ COVID-19 NALF Assay for Rapid Diagnosis of SARS-CoV-2. Diagnostics (Basel) 2023; 13:diagnostics13061118. [PMID: 36980425 PMCID: PMC10047401 DOI: 10.3390/diagnostics13061118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Coronavirus disease (COVID-19) caused by SARS-CoV-2 infection has been a global pandemic for more than two years, and it is important to quickly and accurately diagnose and isolate patients with SARS-CoV-2 infection. The BZ COVID-19 NALF Assay could sensitively detect SARS-CoV-2 from a nasopharyngeal swab because it adopts both a loop-mediated isothermal amplification and lateral flow immunochromatography technology. In this study, a total of 389 nasopharyngeal swab samples, of which 182 were SARS-CoV-2 PCR positive and 207 were negative samples, were recruited. Compared to the Allplex™ SARS-CoV-2 Assay, the BZ COVID-19 NALF Assay showed 95.05% sensitivity and 99.03% specificity for detecting SARS-CoV-2. The concordance rate between the BZ COVID-19 NALF Assay and Allplex™ SARS-CoV-2 Assay was 97.69%. The turnaround time of the BZ COVID-19 NALF Assay is only about 40~55 min. The BZ COVID-19 NALF Assay is an accurate, easy, and quick molecular diagnostic test compared to the conventional PCR test for detection of SARS-CoV-2. In addition, the BZ COVID-19 NALF Assay is thought to be very useful in small size medical facilities or developing countries where it is difficult to operate a clinical laboratory.
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Affiliation(s)
- Woong Sik Jang
- Emergency Medicine, College of Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea
| | - Hyunseul Jee
- Departments of Laboratory Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Joon Min Lee
- Departments of Laboratory Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea
| | - Chae Seung Lim
- Departments of Laboratory Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Departments of Laboratory Medicine, Korea University Guro Hospital, Seoul 08308, Republic of Korea
| | - Jeeyong Kim
- Departments of Laboratory Medicine, College of Medicine, Korea University, Seoul 02841, Republic of Korea
- Correspondence: ; Tel.: +82-31-412-5304
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Karas BY, Sitnikova VE, Nosenko TN, Dedkov VG, Arsentieva NA, Gavrilenko NV, Moiseev IS, Totolian AA, Kajava AV, Uspenskaya MV. ATR-FTIR spectrum analysis of plasma samples for rapid identification of recovered COVID-19 individuals. JOURNAL OF BIOPHOTONICS 2023:e202200166. [PMID: 36869427 DOI: 10.1002/jbio.202200166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 01/08/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
The development of fast, cheap and reliable methods to determine seroconversion against infectious agents is of great practical importance. In the context of the COVID-19 pandemic, an important issue is to study the rate of formation of the immune layer in the population of different regions, as well as the study of the formation of post-vaccination immunity in individuals after vaccination. Currently, the main method for this kind of research is enzyme immunoassay (ELISA, enzyme-linked immunosorbent assay). This technique is sufficiently sensitive and specific, but it requires significant time and material costs. We investigated the applicability of attenuated total reflection (ATR) Fourier transform infrared (FTIR) spectroscopy associated with machine learning in blood plasma to detect seroconversion against SARS-CoV-2. The study included samples of 60 patients. Clear spectral differences in plasma samples from recovered COVID-19 patients and conditionally healthy donors were identified using multivariate and statistical analysis. The results showed that ATR-FTIR spectroscopy, combined with principal components analysis (PCA) and linear discriminant analysis (LDA) or artificial neural network (ANN), made it possible to efficiently identify specimens from recovered COVID-19 patients. We built classification models based on PCA associated with LDA and ANN. Our analysis led to 87% accuracy for PCA-LDA model and 91% accuracy for ANN, respectively. Based on this proof-of-concept study, we believe this method could offer a simple, label-free, cost-effective tool for detecting seroconversion against SARS-CoV-2. This approach could be used as an alternative to ELISA.
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Affiliation(s)
- Boris Y Karas
- Institute BioEngineering, ITMO University, St. Petersburg, Russia
| | - Vera E Sitnikova
- Institute BioEngineering, ITMO University, St. Petersburg, Russia
| | | | - Vladimir G Dedkov
- Saint-Petersburg Pasteur Institute, Federal Service on Consumers' Rights Protection and Human Well-Being Surveillance, St. Petersburg, Russia
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Natalia A Arsentieva
- Saint-Petersburg Pasteur Institute, Federal Service on Consumers' Rights Protection and Human Well-Being Surveillance, St. Petersburg, Russia
| | - Natalia V Gavrilenko
- Raisa Gorbacheva memorial Research Institute for Pediatric Oncology, Hematology and Transplantation, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
| | - Ivan S Moiseev
- Raisa Gorbacheva memorial Research Institute for Pediatric Oncology, Hematology and Transplantation, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
| | - Areg A Totolian
- Saint-Petersburg Pasteur Institute, Federal Service on Consumers' Rights Protection and Human Well-Being Surveillance, St. Petersburg, Russia
| | - Andrey V Kajava
- Centre de Recherche en Biologie cellulaire de Montpellier, Université Montpellier, Montpellier, France
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Abdul Rashid MR, Syed Mohamad SN, Tajjudin AIA, Roslan N, Jaffar A, Mohideen FBS, Addnan FH, Baharom N, Ithnin M. COVID-19 Pandemic Fatigue and Its Sociodemographic, Mental Health Status, and Perceived Causes: A Cross-Sectional Study Nearing the Transition to an Endemic Phase in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4476. [PMID: 36901486 PMCID: PMC10001764 DOI: 10.3390/ijerph20054476] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.
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Affiliation(s)
| | | | | | - Nuruliza Roslan
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
- Islamic Science Institute, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
| | - Aida Jaffar
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Sungai Besi, Kuala Lumpur 57000, Malaysia
| | | | - Faizul Helmi Addnan
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
| | - Nizam Baharom
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
| | - Muslimah Ithnin
- Corporate Communications Unit, Ministry of Health Malaysia, Putrajaya 62000, Malaysia
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Oliveira GBF, Neves PDMM, Oliveira HA, Catarino DGM, Alves LBO, Cavalcanti AB, Rosa RG, Veiga VC, Azevedo LC, Berwanger O, Lopes RD, Avezum Á. Rivaroxaban in Outpatients with Mild or Moderate COVID-19: Rationale and Design of the Study CARE (CARE - Coalition COVID-19 Brazil VIII). Arq Bras Cardiol 2023; 120:e20220431. [PMID: 37018790 PMCID: PMC10392853 DOI: 10.36660/abc.20220431] [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: 07/04/2022] [Revised: 10/28/2022] [Accepted: 11/23/2022] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Previous studies have demonstrated a high risk of arterial and venous thromboembolic events as a consequence of direct viral damage to endothelial cells by SARS-CoV-2 and a procoagulant milieu due to increased biomarkers, such as D-dimer, fibrinogen, and factor VIII. Although randomized controlled trials of antithrombotic therapies have been conducted in hospitalized patients, few have evaluated the role of thromboprophylaxis in an outpatient setting. OBJECTIVE To assess whether antithrombotic prophylaxis with rivaroxaban reduces the risk of venous or arterial thrombotic events, invasive ventilatory support, and death in COVID-19 outpatients. METHODS The COVID Antithrombotic Rivaroxaban Evaluation (CARE) study, a multicenter, randomized, open-label, controlled trial of rivaroxaban 10 mg once daily for 14 days or local standard treatment alone to prevent adverse outcomes, is registered in clinicaltrials.gov (NCT04757857). The inclusion criteria are adults with confirmed or suspected SARS-CoV-2 infection and mild or moderate symptoms without indication for hospitalization, within 7 days of symptom onset, and 1 risk factor for COVID-19 complication (> 65 years, hypertension, diabetes mellitus, asthma, chronic obstructive pulmonary disease or other chronic lung diseases, smoking, immunosuppression, or obesity). The primary composite endpoint, which includes venous thromboembolism, invasive mechanical ventilation, major acute cardiovascular events, and mortality within 30 days of randomization, will be assessed according to the intention-to-treat principle. All patients will provide informed consent. A significance level of 5% will be used for all statistical tests. RESULTS Major thrombotic and bleeding outcomes, hospitalizations, and deaths will be centrally adjudicated by an independent clinical events committee blinded to the assigned treatment groups. CONCLUSION The CARE study will provide relevant and contemporary information about the potential role of thromboprophylaxis in outpatients with COVID-19.
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Affiliation(s)
- Gustavo B. F. Oliveira
- Centro Internacional de PesquisaHospital Alemão Oswaldo CruzSão PauloSPBrasilCentro Internacional de Pesquisa, Hospital Alemão Oswaldo Cruz, São Paulo, SP – Brasil
| | - Precil Diego M. M. Neves
- Centro Internacional de PesquisaHospital Alemão Oswaldo CruzSão PauloSPBrasilCentro Internacional de Pesquisa, Hospital Alemão Oswaldo Cruz, São Paulo, SP – Brasil
| | - Haliton A. Oliveira
- Centro Internacional de PesquisaHospital Alemão Oswaldo CruzSão PauloSPBrasilCentro Internacional de Pesquisa, Hospital Alemão Oswaldo Cruz, São Paulo, SP – Brasil
| | - Daniela Ghidetti Mangas Catarino
- Centro Internacional de PesquisaHospital Alemão Oswaldo CruzSão PauloSPBrasilCentro Internacional de Pesquisa, Hospital Alemão Oswaldo Cruz, São Paulo, SP – Brasil
| | - Lucas B. O. Alves
- Centro Internacional de PesquisaHospital Alemão Oswaldo CruzSão PauloSPBrasilCentro Internacional de Pesquisa, Hospital Alemão Oswaldo Cruz, São Paulo, SP – Brasil
| | - Alexandre B. Cavalcanti
- Instituto de PesquisasHCORSão PauloSPBrasilInstituto de Pesquisas HCOR, São Paulo, SP – Brasil
| | - Regis G. Rosa
- Hospital Moinhos de VentoPorto AlegreRSBrasilHospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Viviane C. Veiga
- A Beneficência Portuguesa de São PauloSão PauloSPBrasilA Beneficência Portuguesa de São Paulo, São Paulo, SP – Brasil
| | - Luciano C.P. Azevedo
- Hospital Sírio LibanêsInstituto de Pesquisa e EnsinoSão PauloSPBrasilHospital Sírio Libanês – Instituto de Pesquisa e Ensino, São Paulo, SP – Brasil
| | - Otávio Berwanger
- Hospital Israelita Albert EinsteinSão PauloSPBrasilHospital Israelita Albert Einstein, São Paulo, SP – Brasil
| | - Renato D. Lopes
- Duke UniversityMedical CenterDurhamNCEUADuke University Medical Center, Durham, NC – EUA
- Instituto Brasileiro de Pesquisas ClínicasSão PauloSPBrasilInstituto Brasileiro de Pesquisas Clínicas, São Paulo, SP – Brasil
| | - Álvaro Avezum
- Centro Internacional de PesquisaHospital Alemão Oswaldo CruzSão PauloSPBrasilCentro Internacional de Pesquisa, Hospital Alemão Oswaldo Cruz, São Paulo, SP – Brasil
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Abstract
INTRODUCTION Since the end of 2019, a new disease outbreak has been spreading worldwide, after starting from Wuhan, China. The viral pathogen responsible for the disease was named as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), and for the illness the acronym COVID-19 was coined (COronaVIrus Disease 2019). Viral pathogenesis, epidemiology, and clinics are still somewhat obscure, when occurring during childhood the most. The aim of this study was to evaluate the features of liver involvement and damage in course of COVID-19. EVIDENCE ACQUISITION An insight into what is known as to COVID-19 and hepatic damage in adulthood as well as pediatric age was given. All the most relevant papers up to 15/10/2020 were identified and discussed. An extensive search strategy was carried out to identify all paper published from December 1st, 2019, to September 5, 2020, combining the key words "coronavirus," "coronavirus infection," "SARS-CoV-2," "COVID-19," "liver," "liver injury," "hepatic injury," "children," "pediatric" in key electronic bibliographic databases (PubMed, Google Scholar), following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. EVIDENCE SYNTHESIS Establishing whether liver damage is due to a direct viral action or host immune system inflammatory reaction or consequence of the administered drugs or secondary to another organ failure (for example the heart) is difficult. What is sure is the fact that liver function should be checked at the time of admission to hospital and during hospitalization. CONCLUSIONS In conclusion, liver involvement during COVID-19 is likely due to a multifactorial origin. An aberrant immune system reaction to SARS-CoV-2 is probably the most important underlying trigger, though more extended studies are needed for a definitive confirmation. The markers of liver injury should be carefully in each patient admitted for COVID-19: in fact, in case of altered hepatic markers, a specific therapy to protect liver is needed.
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Affiliation(s)
- Simone Mameli
- Graduate School in Pediatrics, University of Cagliari, Cagliari, Italy
| | - Maria A Marcialis
- Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
| | - Pier P Bassareo
- Mater Misericordiae University Hospital and Our Lady's Children's Hospital Crumlin, University College of Dublin, Dublin, Ireland -
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy
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