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Saeedifar AM, Ghorban K, Ganji A, Mosayebi G, Gholami M, Dadmanesh M, Rouzbahani NH. Evaluation of Tcell exhaustion based on the expression of EOMES, Tbet and co-inhibitory receptors in severe and non-severe covid-19 patients. Gene Rep 2023; 31:101747. [PMID: 36747893 PMCID: PMC9892327 DOI: 10.1016/j.genrep.2023.101747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
During viral infections, especially Covid-19, Tcell exhaustion plays a crucial role in reducing the activity of lymphocytes and the immune system's antiviral activities. This research aimed to investigate the co-inhibitory receptors and transcription factors involved in the Tcell exhaustion process in ICU-admitted (ICUA) compared to non-ICU admitted (non-ICUA) Covid-19 patients. A total of 60 Covid-19 patients (30 patients in the severe group who were admitted in the ICU (ICUA) and 30 patients in the mild group who were admitted in departments other than the ICU (non-ICUA)) and 10 healthy individuals were included in this study. Laboratory tests and the level of gene expressions related to 4 inhibitory co-receptors, including LAG-3, TIM-3, TIGIT, PD-1, and T-bet and Eomes transcription factors involved in the process of Tcell exhaustion in severe and mild patients of Covid-19 were investigated. The results showed lymphopenia and an increase in other hematologic laboratory factors such as NLR, PLR, CRP, ALT, and AST in people with a severe form of the disease (ICUA) compared to mild groups (non-ICUA) (P < 0.001). Furthermore, a significant increase in 3 co-inhibitory receptors, TIM-3, LAG-3, and PD-1, was observed in severe patients compared to mild and healthy people (P < 0.001). An increase in TIGIT gene expression was lesser than the other three mentioned receptors (P < 0.05). Concerning the transcription factors, we observed a significant increase in Eomes in ICUA patients compared to the non-ICUA group (P < 0.001), and this increment in T-bet gene expression was minor compared to Eomes (P < 0.05). In conclusion, Patients with a severe form of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represented a higher level of gene expressions in terms of co-inhibitory receptors and transcription factors involved in the T cell exhaustion process.
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Affiliation(s)
- Amir Mohammad Saeedifar
- Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Khodayar Ghorban
- Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran,Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Ali Ganji
- Department of Immunology, School of Medicine, Arak University of Medical Sciences, Arak, Iran,Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Ghasem Mosayebi
- Department of Immunology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Gholami
- Department of Medical Microbiology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran,Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Maryam Dadmanesh
- Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Negin Hosseini Rouzbahani
- Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran,Infectious Diseases Research Center, Aja University of Medical Sciences, Tehran, Iran,Corresponding author at: Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
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Okumura K, Nishida S, Sogawa H, Veillette G, Bodin R, Wolf DC, Dhand A. Inferior Liver Transplant Outcomes during early COVID-19 pandemic in United States. J Liver Transpl 2022; 7:100099. [PMID: 38013989 PMCID: PMC9110062 DOI: 10.1016/j.liver.2022.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background : Since its declaration as a global pandemic on March11th 2020, COVID-19 has had a significant effect on solid-organ transplantation. The aim of this study was to analyze the impact of COVID-19 on Liver transplantation (LT) in United States. Methods : We retrospectively analyzed the United Network for Organ Sharing database regarding characteristics of donors, adult-LT recipients, and transplant outcomes during early-COVID period (March 11- September 11, 2020) and compared them to pre-COVID period (March 11 - September 11, 2019). Results : Overall, 4% fewer LTs were performed during early-COVID period (4107 vs 4277). Compared to pre-COVID period, transplants performed in early-COVID period were associated with: increase in alcoholic liver disease as most common primary diagnosis (1315 vs 1187, P< 0.01), higher MELD score in the recipients (25 vs 23, P<0.01), lower time on wait-list (52 vs 84 days, P<0.01), higher need for hemodialysis at transplant (9.4 vs 11.1%, P=0.012), longer distance from recipient hospital (131 vs 64 miles, P<0.01) and higher donor risk index (1.65 vs 1.55, P<0.01). Early-COVID period saw increase in rejection episodes before discharge (4.6 vs 3.4%, P=0.023) and lower 90-day graft/patient survival (90.2 vs 95.1 %, P<0.01; 92.2 vs 96.5 %, P<0.01). In multivariable cox-regression analysis, early-COVID period was the independent risk factor for graft failure at 90-days post-transplant (Hazard Ratio 1.77, P<0.01). Conclusions : During early-COVID period in United States, overall LT decreased, alcoholic liver disease was primary diagnosis for LT, rate of rejection episodes before discharge was higher and 90-days post-transplant graft survival was lower.
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Key Words
- ALD, alcoholic related liver disease
- ALF, acute liver failure
- BMI, body mass index
- CI, confidence interval
- COD, causes of death
- COVID-19
- COVID-19 mortality
- COVID-19, Coronavirus disease 2019
- HBV, hepatitis B virus
- HCC, hepatocellular carcinoma
- HCV, hepatitis C virus
- HR, hazard ratio
- ICU, intensive care units
- IQR, interquartile range
- LT, liver transplant
- MELD, model for end-stage liver disease
- MV, mechanical ventilation
- SARS-CoV-2, severe acute respiratory syndrome coronavirus-2
- SE, standard error
- UNOS, United Network for Organ Sharing
- United Network for Organ Sharing
- United Network for Organ Sharing database
- alcohol related liver disease
- graft failure
- liver transplant
- liver transplant recipients
- outcomes
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Affiliation(s)
- Kenji Okumura
- Department of Surgery, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
| | - Seigo Nishida
- Department of Surgery, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
| | - Hiroshi Sogawa
- Department of Surgery, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
| | - Gregory Veillette
- Department of Surgery, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
| | - Roxana Bodin
- Department of Surgery, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
- Department of Medicine, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
| | - David C Wolf
- Department of Surgery, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
- Department of Medicine, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
| | - Abhay Dhand
- Department of Surgery, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
- Department of Medicine, Westchester Medical Center / New York Medical College, Valhalla, NY, USA
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Wang J, Zhu L, Liu L, Yan X, Xue L, Huang S, Zhang B, Xu T, Ji F, Li C, Ming F, Zhao Y, Cheng J, Chen K, Zhao XA, Sang D, Guan X, Chen X, Yan X, Zhang Z, Liu J, Huang R, Zhu C, Wu C. Clinical features and prognosis of COVID-19 patients with metabolic syndrome: A multicenter, retrospective study. Med Clin (Engl Ed) 2022; 158:458-465. [PMID: 35702719 PMCID: PMC9181760 DOI: 10.1016/j.medcle.2021.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/21/2021] [Indexed: 01/08/2023]
Abstract
Background Few studies have investigated the impacts of metabolic syndrome (MS) on coronavirus disease 2019 (COVID-19). We described the clinical features and prognosis of confirmed COVID-19 patients with MS during hospitalization and after discharge. Methods Two hundred and thirty-three COVID-19 patients from the hospitals in 8 cities of Jiangsu, China were retrospectively included. Clinical characteristics of COVID-19 patients were described and risk factors of severe illness were analyzed by logistic regression analysis. Results Forty-five (19.3%) of 233 COVID-19 patients had MS. The median age of COVID-19 patients with MS was significantly higher than non-MS patients (53.0 years vs. 46.0 years, P = 0.004). There were no significant differences of clinical symptoms, abnormal chest CT images, and treatment drugs between two groups. More patients with MS had severe illness (33.3% vs. 6.4%, P < 0.001) and critical illness (4.4% vs. 0.5%, P = 0.037) than non-MS patients. The proportions of respiratory failure and acute respiratory distress syndrome in MS patients were also higher than non-MS patients during hospitalization. Multivariate analysis showed that concurrent MS (odds ratio [OR] 7.668, 95% confidence interval [CI] 3.062–19.201, P < 0.001) and lymphopenia (OR 3.315, 95% CI 1.306–8.411, P = 0.012) were independent risk factors of severe illness of COVID-19. At a median follow-up of 28 days after discharge, bilateral pneumonia was found in 95.2% of MS patients, while only 54.7% of non-MS patients presented bilateral pneumonia. Conclusions 19.3% of COVID-19 patients had MS in our study. COVID-19 patients with MS are more likely to develop severe complications and have worse prognosis. More attention should be paid to COVID-19 patients with MS.
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Key Words
- ARDS, acute respiratory distress syndrome
- BMI, body mass index
- COVID-19, coronavirus disease 2019
- Coronavirus disease 2019
- FBG, fasting blood glucose
- ICU, intensive care units
- IQR, interquartile range
- MS, metabolic syndrome
- Metabolic syndrome
- Prognosis
- SARS, severe acute respiratory syndrome
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- TC, total cholesterol
- TG, triglycerides
- WHO, world Health Organization
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Affiliation(s)
- Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Li Zhu
- Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, China
| | - Longgen Liu
- Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Xuebing Yan
- Department of Infectious Diseases, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Leyang Xue
- Department of Critical Medicine, Huai'an No. 4 People's Hospital, Huai'an, China
| | - Songping Huang
- Department of Infectious Diseases, Nantong Third People's Hospital, Nantong University, Nantong, China
| | - Biao Zhang
- Department of Quality Control Office, Huai'an No. 4 People's Hospital, Huai'an, China
| | - Tianmin Xu
- Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Fang Ji
- Department of Infectious Diseases, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chunyang Li
- Department of Infectious Diseases, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Fang Ming
- Department of Infectious Diseases, Nantong Third People's Hospital, Nantong University, Nantong, China
| | - Yun Zhao
- Department of Infectious Diseases, The Third People's Hospital of Yangzhou, Yangzhou, China
| | - Juan Cheng
- Department of Infectious Diseases, Yancheng Second People's Hospital, Yancheng, China
| | - Kang Chen
- Department of Tuberculosis, The Third People's Hospital of Changzhou, Changzhou, China
| | - Xiang-An Zhao
- Department of Gastroenterology, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, China
| | - Dawen Sang
- Department of Infectious Diseases, Yancheng Second People's Hospital, Yancheng, China
| | - Xinying Guan
- Department of Neurology, The Affiliated Hospital of Kangda College of Nanjing Medical University, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Xiaobing Chen
- Department of Emergency, The Affiliated Hospital of Kangda College of Nanjing Medical University, The First People's Hospital of Lianyungang, Lianyungang, China
| | - Xiaomin Yan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhaoping Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiacheng Liu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Chuanwu Zhu
- Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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Abstract
Acute kidney injury (AKI) is a relatively common condition, encountered in everyday paediatric clinical practice. It is an important cause of morbidity and mortality in children both inside and outside intensive care units. It is associated with prolonged hospital stay and progression to chronic kidney disease. The burden of AKI is particularly high in low- and middle-income countries where rural areas and smaller cities in the countryside predominate. Most of these areas suffer from poverty, poor sanitation, water quality and hygiene, lack of education and poor access to health care. AKI is preventable if it is detected sufficiently early and managed promptly. Improved nephrology services and the availability of cost-effective dialysis facilities in resource-limited settings should reduce morbidity and save many children's lives.
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Affiliation(s)
- Mohamed B Abdelraheem
- a Al Jalila Children's Speciality Hospital , Dubai , United Arab Emirates.,b Department of Paediatrics , University of Khartoum , Khartoum , Sudan
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Piatti PM, Cioni M, Magistro A, Villa V, Crippa VG, Galluccio E, Fontana B, Spadoni S, Bosi E, Monti LD, Alfieri O. Basal insulin therapy is associated with beneficial effects on postoperative infective complications, independently from circulating glucose levels in patients admitted for cardiac surgery. J Clin Transl Endocrinol 2017; 7:47-53. [PMID: 29067250 PMCID: PMC5651296 DOI: 10.1016/j.jcte.2017.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 02/07/2023]
Abstract
The effect of insulin per se on infective complications during cardiac surgery was evaluated. Eight hundred twelve patients were included. Insulin therapy decreased infections independently from glycemic levels. Basal + premeal insulin therapy is well tolerated without severe hypoglycemia cases.
Background Although hyperglycemia is a strong predictor of postoperative infective complications (PIC), little is known about the effect of basal insulin therapy (BIT) per se on PIC. Aim To evaluate if there is an association between BIT, independent of glucose levels, and a possible improvement of PIC during the perioperative cardiosurgery period (PCP). Methods In 812 patients admitted for cardiac intervention and treated with a continuous intravenous insulin infusion (CIII) for hyperglycemic levels (>130 mg/dl), a retrospective analysis was performed during the PCP (January 2009–December 2011). Upon transfer to the cardiac surgery division, if fasting glucose was ≥130 mg/dl, a basal + premeal insulin therapy was initiated (121 patients, group 1); for <130 mg/dl, a premeal insulin alone was initiated (691 patients, group 2). Findings Compared with group 2, group 1 showed reductions in PIC (2.48% vs 7.96%, p < 0.049; odds ratio: 0.294; 95% CI: 0.110–0.780), C-Reactive Protein (p < 0.05) and white blood cell (p < 0.05) levels despite glucose levels and CIII that were higher during the first two days after surgery (179.8 ± 25.3 vs 169.5 ± 10.6 mg/dl, p < 0.01; 0.046 ± 0.008 vs 0.037 ± 0.015 U/kg/h, p < 0.05, respectively). Normal glucose levels were achieved in both groups from day 3 before the discharge. The mean length of hospital duration was 18% lower in group 1 than in group 2 (7.21 ± 05.08 vs 8.76 ± 9.08 days, p < 0.007), providing a significant impact on public health costs. Conclusions Basal + preprandial insulin therapy was associated with a lower frequency of PIC than preprandial insulin therapy alone, suggesting a beneficial effect of basal insulin therapy on post-surgery outcome.
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Affiliation(s)
- P M Piatti
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - M Cioni
- Cardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy
| | - A Magistro
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - V Villa
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - V G Crippa
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - E Galluccio
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - B Fontana
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - S Spadoni
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - E Bosi
- Cardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.,Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - L D Monti
- Cardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy
| | - O Alfieri
- Cardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy
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Abstract
UNLABELLED The changing pattern of hospital admissions during Hajj, the Muslims yearly pilgrimage attracting millions of pilgrims from all around the globe, has gradually seen infectious causes of hospital admission replaced by cardiovascular diseases as a leading cause of both intensive care unit admission and death. While this trend is partly associated with the high quality of medical services and awareness programs targeted at reducing the spread of infections, at the same time it underscores an urgent need to establish a pragmatic system to manage the challenge of cardiovascular morbidities and mortality during Hajj. SEARCH STRATEGY AND INCLUSION CRITERIA A PubMed Central (PMC) literature search without date restrictions was performed for articles reporting on the medical experience during Hajj. There were 109 articles were returned using "Hajj" and "mortality" as search terms. After determining relevance to the current theme based on both direct and indirect reference to the pattern hospital admission during Hajj, 20 articles reporting on conducted studies were obtained. Data from these studies reporting on the pattern and outcome of hospitalization during Hajj were examined and helped in arriving at the conclusions presented in this review.
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Affiliation(s)
- Abdullah Al Shimemeri
- Intensive Care Department, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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