The “Invisible Enemy” SARS-CoV-2: Viral Spread and Drug Treatment

The Impact of Therapeutic Plasma Exchange on Inflammatory Markers and Acute Phase Reactants in Patients with Severe SARS-CoV-2 Infection

Background and Objectives: Due to the poor prognosis and the very high mortality rate associated with severe SARS-CoV-2 infections, various regimens have been tried to stop the evolution of the inflammatory cascade, such as immunomodulatory therapy and plasma clearance of the acute phase reactants involved. Therefore, the objective of this review was to analyze the effects of using therapeutic plasma exchange (TPE), also known as plasmapheresis, on the inflammatory markers of critically ill COVID-19 patients admitted to the intensive care unit (ICU). Materials and Methods: A thorough scientific database search was performed, and it included a review of articles published on PubMed, Cochrane Database, Scopus, and Web of Science from the beginning of the COVID-19 pandemic in March 2020 until September 2022 that focused on the treatment of SARS-CoV-2 infections using plasma exchange for patients admitted to the ICU. The current study included original articles, reviews, editorials, and short or special communications regarding the topic of interest. Results: A total of 13 articles were selected after satisfying the inclusion criterion of three or more patients enrolled with clinically severe COVID-19 that were eligible for TPE. From the included articles, it was observed that TPE was used as a last-resort salvage therapy that can be regarded as an alternative treatment method when the standard management for these patients fails. TPE significantly decreased the inflammatory status as measured by Interleukin-6 (IL-6), C-reactive protein (CRP), lymphocyte count, and D-dimers, as well as improving the clinical status measured with PaO₂/FiO₂ and duration of hospitalization. The pooled mortality risk reduction after TPE was 20%. Conclusions: There are sufficient studies and evidence to show that TPE reduces inflammatory mediators and improves coagulation function and the clinical/paraclinical status. Nevertheless, although it was shown that TPE decreases the severe inflammatory status without significant complications, the improvement of survival rate remains unclear.

Construction of network pharmacology-based approach and potential mechanism from major components of Coriander sativum L. against COVID-19

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Despite the fact that various therapeutic compounds have shown potential prevention or treatment, no specific medicine has been developed for the COVID-19 pandemic. Natural products have recently been suggested as a possible treatment option for COVID-19 prevention and treatment. This study focused on the potential of Coriander sativum L. (CSL) against COVID-19 based on network pharmacology approach. Interested candidates of CSL were identified by searching accessible databases for protein–protein interactions with the COVID-19. An additional GO and KEGG pathway analysis was carried out in order to identify the related mechanism of action. In the end, 51 targets were obtained through network pharmacology analysis with EGFR, AR, JAK2, PARP1, and CTSB become the core target. CSL may have favorable effects on COVID-19 through a number of important pathways, according to GO and KEGG pathway analyses. These findings suggest that CSL may prevent and inhibit the several processes related to COVID-19.

Histopathological examination of the placenta after delivery in pregnant women with COVID-19

Introduction: COVID-19 is a viral disease generated by a new coronavirus named SARS-CoV-2. The consequences of this virus on the human placenta and the newborn are still unclear. IL-6 can disturb the placenta's immunological homeostasis and be employed as an inflammatory marker for the poor prognosis of COVID-19 infection. Bax has some features like being a key protein regulating apoptotic mechanisms and plays an important role in both maintaining dynamic balance and integrity in the placenta as in many tissues. This study aims to indicate the impact of COVID-19 on inflammation and apoptotic pathways in the placenta by using IL-6 and Bax antibodies. Material and Method: COVID-19 positive (n:10) and COVID-19 negative (n:10) normotensive placentas were included. Haematoxylin-eosin staining and immunohistochemical staining (IL-6 and Bax antibodies) were applied. Statistical data of immunohistochemical (IL-6 and Bax expression) staining results were assessed by analyzing the H-score. Biochemical parameters were recorded. Group means were analyzed with a nonparametric Kruskal Wallis Test. Results: In the COVID-19 group, increased syncytial knots, fibrin deposition, inflammation, fibrinoid necrosis, neutrophil accumulation were observed. The COVID-19 group had considerably higher levels of IL-6 and Bax expression than the control group. Furthermore, COVID-19 patients had statistically lower WBC and higher CRP values than normotensive patients. Conclusion: COVID-19 has been linked to placental inflammation and trophoblast cell damage, both of which can result in major maternal and fetal problems during pregnancy. We found intense IL-6 expression in the placentas of pregnant women with COVID-19 infection. A rise in IL-6 levels triggers CRP production, and this increase is linked to the severity of COVID-19 as a risk factor. Also, we suggested that COVID-19 infection triggers the apoptotic process in placental tissue by increasing the expression of the proapoptotic Bax protein. It is clinically very significant to follow up COVID-19 positive pregnancies for maternal and fetal health. During this follow-up, IL-6 and Bax expression levels in the placenta, together with histopathological findings and serum CRP levels, can guide the evaluation of the prognosis, severity and response to treatment of the disease.