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Tabatabaei FS, Shafeghat M, Azimi A, Akrami A, Rezaei N. Endosomal Toll-Like Receptors intermediate negative impacts of viral diseases, autoimmune diseases, and inflammatory immune responses on the cardiovascular system. Expert Rev Clin Immunol 2025; 21:195-207. [PMID: 39137281 DOI: 10.1080/1744666x.2024.2392815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/17/2024] [Accepted: 08/12/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION Cardiovascular disease (CVD) is the leading cause of morbidity globally, with chronic inflammation as a key modifiable risk factor. Toll-like receptors (TLRs), pivotal components of the innate immune system, including TLR-3, -7, -8, and -9 within endosomes, trigger intracellular cascades, leading to inflammatory cytokine production by various cell types, contributing to systemic inflammation and atherosclerosis. Recent research highlights the role of endosomal TLRs in recognizing self-derived nucleic acids during sterile inflammation, implicated in autoimmune conditions like myocarditis. AREAS COVERED This review explores the impact of endosomal TLRs on viral infections, autoimmunity, and inflammatory responses, shedding light on their intricate involvement in cardiovascular health and disease by examining literature on TLR-mediated mechanisms and their roles in CVD pathophysiology. EXPERT OPINION Removal of endosomal TLRs mitigates myocardial damage and immune reactions, applicable in myocardial injury. Targeting TLRs with agonists enhances innate immunity against fatal viruses, lowering viral loads and mortality. Prophylactic TLR agonist administration upregulates TLRs, protecting against fatal viruses and improving survival. TLRs play a complex role in CVDs like atherosclerosis and myocarditis, with therapeutic potential in modulating TLR reactions for cardiovascular health.
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Affiliation(s)
- Fatemeh Sadat Tabatabaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Melika Shafeghat
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Research Center for Immunodeficiencies (RCID), Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Azimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashley Akrami
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL, USA
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies (RCID), Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Pathare N, MacPhail D. Physical therapy management of an individual with post-COVID fatigue considering emotional health in an outpatient setting: A case report. Physiother Theory Pract 2024; 40:2160-2170. [PMID: 37323003 DOI: 10.1080/09593985.2023.2225185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/12/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE The purpose of this case report is to provide a plan of care with an emphasis on patient education and consideration of emotional health for a patient with post-COVID fatigue in an outpatient setting. CASE DESCRIPTION A 50-year-old woman, ten-weeks post-COVID syndrome, participated in an examination that revealed deficits in exercise capacity, strength, breathing pattern, mild depression, emotional breakdown, and mild anxiety accompanied by "brain fog" with activity. Her primary complaint was fatigue with ordinary activities around her home that impeded her from returning to work. On examination, scores included six-minute walk test distance (6MWD): 79.5 m, UCSD Shortness of Breath Questionnaire (SOBQ): 72/120, and Patient Health Questionnaire (PHQ-9): 6/27. The patient participated in 20 biweekly sessions with a focus on patient education, supporting emotional health, aerobic training, strengthening exercises, breathing exercises, and home exercise program. OUTCOMES At discharge, the patient's exercise capacity, muscle strength, dyspnea, and depression improved, beyond the MCID/MID values, 6MWD: 335 m, SOBQ: 34/120; and PHQ-9 :1/27. The patient had no anxiety with activity and reported confidence to resume activities, allowing her to return to work safely. CONCLUSION Following an intervention that addressed emotional needs with physical symptoms, our patient with post-COVID fatigue showed substantial improvements in exercise capacity, muscle strength, dyspnea, and depression. This highlights the consideration of psychosocial well-being in our plan of care for this population.
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Affiliation(s)
- Neeti Pathare
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Boston, USA
| | - Dylan MacPhail
- Department of Physical Therapy, Sunnyview Rehabilitation Hospital, Schenectady, NY, USA
- Department of Physical Therapy, Russell Sage College, Troy, NY, USA
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Kinoshita H, Morita M, Maeda S, Kanegawa M, Sumimoto Y, Masada K, Shimonaga T, Sugino H. A curious Takotsubo cardiomyopathy after COVID-19. IDCases 2024; 36:e01958. [PMID: 38681073 PMCID: PMC11047175 DOI: 10.1016/j.idcr.2024.e01958] [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: 11/05/2023] [Revised: 03/28/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024] Open
Abstract
We present the case of a 66-year-old woman undergoing chronic dialysis who developed pneumonia and enteritis after being infected with COVID-19 and had severe wall motion reduction similar to a left ventricular aneurysm. There was concern that the condition might worsen due to left ventricular wall thinning and curious wall motion abnormalities, but echocardiography one month later showed normalization. After four months, simultaneous binuclear myocardial scintigraphy of thallium and BMIPP showed that the mismatch had disappeared. We considered that there may be other factors specific to COVID-19 infection in addition to the stress associated with infection and reviewed the literature.
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Affiliation(s)
- Haruyuki Kinoshita
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
| | - Masashi Morita
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
| | - Shiori Maeda
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
| | - Munehiro Kanegawa
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
| | - Yoji Sumimoto
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
| | - Kenji Masada
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
| | - Takashi Shimonaga
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
| | - Hiroshi Sugino
- Department of Cardiology National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Aoyamacho 3-1, Kure 737-0023, Japan
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Von Rekowski CP, Fonseca TAH, Araújo R, Brás-Geraldes C, Calado CRC, Bento L, Pinto I. The Characteristics and Laboratory Findings of SARS-CoV-2 Infected Patients during the First Three COVID-19 Waves in Portugal-A Retrospective Single-Center Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:59. [PMID: 38256320 PMCID: PMC10817678 DOI: 10.3390/medicina60010059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Given the wide spectrum of clinical and laboratory manifestations of the coronavirus disease 2019 (COVID-19), it is imperative to identify potential contributing factors to patients' outcomes. However, a limited number of studies have assessed how the different waves affected the progression of the disease, more so in Portugal. Therefore, our main purpose was to study the clinical and laboratory patterns of COVID-19 in an unvaccinated population admitted to the intensive care unit, identifying characteristics associated with death, in each of the first three waves of the pandemic. Materials and Methods: This study included 337 COVID-19 patients admitted to the intensive care unit of a single-center hospital in Lisbon, Portugal, between March 2020 and March 2021. Comparisons were made between three COVID-19 waves, in the second (n = 325) and seventh (n = 216) days after admission, and between discharged and deceased patients. Results: Deceased patients were considerably older (p = 0.021) and needed greater ventilatory assistance (p = 0.023), especially in the first wave. Differences between discharged and deceased patients' biomarkers were minimal in the first wave, on both analyzed days. In the second wave significant differences emerged in troponins, lactate dehydrogenase, procalcitonin, C-reactive protein, and white blood cell subpopulations, as well as platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios (all p < 0.05). Furthermore, in the third wave, platelets and D-dimers were also significantly different between patients' groups (all p < 0.05). From the second to the seventh days, troponins and lactate dehydrogenase showed significant decreases, mainly for discharged patients, while platelet counts increased (all p < 0.01). Lymphocytes significantly increased in discharged patients (all p < 0.05), while white blood cells rose in the second (all p < 0.001) and third (all p < 0.05) waves among deceased patients. Conclusions: This study yields insights into COVID-19 patients' characteristics and mortality-associated biomarkers during Portugal's first three COVID-19 waves, highlighting the importance of considering wave variations in future research due to potential significant outcome differences.
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Affiliation(s)
- Cristiana P. Von Rekowski
- ISEL—Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Rua Conselheiro Emídio Navarro 1, 1959-007 Lisbon, Portugal; (T.A.H.F.); (R.A.); (C.R.C.C.)
- NMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, Portugal;
- CHRC—Comprehensive Health Research Centre, Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal
| | - Tiago A. H. Fonseca
- ISEL—Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Rua Conselheiro Emídio Navarro 1, 1959-007 Lisbon, Portugal; (T.A.H.F.); (R.A.); (C.R.C.C.)
- NMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, Portugal;
- CHRC—Comprehensive Health Research Centre, Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal
| | - Rúben Araújo
- ISEL—Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Rua Conselheiro Emídio Navarro 1, 1959-007 Lisbon, Portugal; (T.A.H.F.); (R.A.); (C.R.C.C.)
- NMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, Portugal;
- CHRC—Comprehensive Health Research Centre, Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal
| | - Carlos Brás-Geraldes
- ISEL—Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Rua Conselheiro Emídio Navarro 1, 1959-007 Lisbon, Portugal; (T.A.H.F.); (R.A.); (C.R.C.C.)
- CEAUL—Centro de Estatística e Aplicações, Universidade de Lisboa, 1749-016 Lisbon, Portugal
| | - Cecília R. C. Calado
- ISEL—Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Rua Conselheiro Emídio Navarro 1, 1959-007 Lisbon, Portugal; (T.A.H.F.); (R.A.); (C.R.C.C.)
- CIMOSM—Centro de Investigação em Modelação e Optimização de Sistemas Multifuncionais, ISEL—Instituto Superior de Engenharia de Lisboa, 1959-007 Lisbon, Portugal
| | - Luís Bento
- NMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, Portugal;
- CHRC—Comprehensive Health Research Centre, Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal
- Intensive Care Department, CHULC—Centro Hospitalar Universitário de Lisboa Central, 1150-199 Lisbon, Portugal
- Integrated Pathophysiological Mechanisms, CHRC—Comprehensive Health Research Centre, NMS—NOVA Medical School, FCM—Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal
| | - Iola Pinto
- Department of Mathematics, ISEL—Instituto Superior de Engenharia de Lisboa, 1959-007 Lisbon, Portugal;
- NOVA Math—Center for Mathematics and Applications, NOVA SST—Nova School of Sciences and Tecnology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal
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Rodrigues F, Flores R, Vilela MJ, Nogueira C, Raposo AR, Vieira C. Stress Cardiomyopathy as a Complication of SARS-CoV-2 Infection. Cureus 2023; 15:e39264. [PMID: 37346211 PMCID: PMC10279927 DOI: 10.7759/cureus.39264] [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: 05/20/2023] [Indexed: 06/23/2023] Open
Abstract
The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in early 2020 led to the coronavirus disease 2019 (COVID-19) pandemic. Acute lung diseases, such as COVID-19 pneumonia, can trigger stress cardiomyopathy, raising concerns about potential cardiovascular complications related to these diseases. The current case involved a 72-year-old man with SARS-CoV-2 infection who was experiencing dyspnea, desaturation, and oppressive retrosternal chest pain. On his admission to the hospital, an electrocardiogram demonstrated sinus tachycardia, negative T waves in leads V4-V6, and slight ST-segment elevation in the same precordial leads. The patient also had an increased troponin I value and worsening of his baseline respiratory failure, which required starting noninvasive ventilation. The echocardiogram showed moderately depressed left ventricular systolic function and apical ballooning. The echocardiographic changes resolved during hospitalization without directed therapeutic intervention. We diagnosed Takotsubo syndrome associated with SARS-CoV-2 infection; however, the pathophysiological disruption remains to be clarified.
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Affiliation(s)
| | - Rui Flores
- Cardiology, Hospital de Braga, Braga, PRT
| | | | | | - Ana Rita Raposo
- Physical Medicine and Rehabilitation, Hospital de Braga, Braga, PRT
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Flores R, Pires O, Alves J, Pereira VH. An Echocardiographic Insight Into Post-COVID-19 Symptoms. Cureus 2023; 15:e38039. [PMID: 37228525 PMCID: PMC10207971 DOI: 10.7759/cureus.38039] [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: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has frequent acute cardiovascular manifestations, but long-term sequelae are yet to be described. Our main objective is to describe the echocardiographic findings of patients with a previous SARS-CoV-2 infection. METHODS A single-center prospective study was conducted. Patients who tested positive for SARS-CoV-2 were selected and submitted to a transthoracic echocardiogram six months after infection. A complete echocardiographic assessment was performed, including tissue Doppler, E/E' ratio, and ventricular longitudinal strain. Patients were divided into two subgroups according to their need for admission to the ICU. RESULTS A total of 88 patients were enrolled. The mean values and respective standard deviations of the echocardiographic parameters were as follows: left ventricular ejection fraction 60.8 ± 5.9%; left ventricular longitudinal strain 17.9 ± 3.6%; tricuspid annular plane systolic excursion 22.1 ± 3.6 mm; a longitudinal strain of the free wall of the right ventricle 19.0 ± 6.0%. We found no statistically significant differences between subgroups. CONCLUSIONS At the six-month follow-up, we found no significant impact of past SARS-CoV-2 infection on the heart using echocardiography parameters.
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Affiliation(s)
- Rui Flores
- Cardiology, Hospital de Braga, Braga, PRT
| | - Olga Pires
- Internal Medicine, Hospital de Braga, Braga, PRT
| | - Joana Alves
- Infectious Disease, Hospital of Braga, Braga, PRT
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Makarova YA, Ryabkova VA, Salukhov VV, Sagun BV, Korovin AE, Churilov LP. Atherosclerosis, Cardiovascular Disorders and COVID-19: Comorbid Pathogenesis. Diagnostics (Basel) 2023; 13:478. [PMID: 36766583 PMCID: PMC9914751 DOI: 10.3390/diagnostics13030478] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
The article describes how atherosclerosis and coronavirus disease 19 (COVID-19) may affect each other. The features of this comorbid pathogenesis at various levels (vascular, cellular and molecular) are considered. A bidirectional influence of these conditions is described: the presence of cardiovascular diseases affects different individuals' susceptibility to viral infection. In turn, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can have a negative effect on the endothelium and cardiomyocytes, causing blood clotting, secretion of pro-inflammatory cytokines, and thus exacerbating the development of atherosclerosis. In addition to the established entry into cells via angiotensin-converting enzyme 2 (ACE2), other mechanisms of SARS-CoV-2 entry are currently under investigation, for example, through CD147. Pathogenesis of comorbidity can be determined by the influence of the virus on various links which are meaningful for atherogenesis: generation of oxidized forms of low-density lipoproteins (LDL), launch of a cytokine storm, damage to the endothelial glycocalyx, and mitochondrial injury. The transformation of a stable plaque into an unstable one plays an important role in the pathogenesis of atherosclerosis complications and can be triggered by COVID-19. The impact of SARS-CoV-2 on large vessels such as the aorta is more complex than previously thought considering its impact on vasa vasorum. Current information on the mutual influence of the medicines used in the treatment of atherosclerosis and acute COVID-19 is briefly summarized.
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Affiliation(s)
- Yulia A. Makarova
- Laboratory of the Microangiopathic Mechanisms of Atherogenesis, Saint Petersburg State University, 199034 Saint-Petersburg, Russia
| | - Varvara A. Ryabkova
- Laboratory of the Microangiopathic Mechanisms of Atherogenesis, Saint Petersburg State University, 199034 Saint-Petersburg, Russia
- M.V. Chernorutsky Department of Internal Medicine (Hospital Course), Pavlov First Saint Petersburg State Medical University, 197022 Saint-Petersburg, Russia
| | - Vladimir V. Salukhov
- N.S. Molchanov 1st Clinic for the Improvement of Physicians, S.M. Kirov Military Medical Academy, 194044 Saint-Petersburg, Russia
| | - Boris V. Sagun
- N.S. Molchanov 1st Clinic for the Improvement of Physicians, S.M. Kirov Military Medical Academy, 194044 Saint-Petersburg, Russia
| | - Aleksandr E. Korovin
- Laboratory of the Microangiopathic Mechanisms of Atherogenesis, Saint Petersburg State University, 199034 Saint-Petersburg, Russia
- N.S. Molchanov 1st Clinic for the Improvement of Physicians, S.M. Kirov Military Medical Academy, 194044 Saint-Petersburg, Russia
| | - Leonid P. Churilov
- Laboratory of the Microangiopathic Mechanisms of Atherogenesis, Saint Petersburg State University, 199034 Saint-Petersburg, Russia
- Department of Experimental Tuberculosis, Saint Petersburg Research Institute of Phthisiopulmonology, 191036 Saint-Petersburg, Russia
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Priya SP, Sunil PM, Varma S, Brigi C, Isnadi MFAR, Jayalal JA, Shadamarshan RA, Kumar SS, Kumari NV, Kumar RPR. Direct, indirect, post-infection damages induced by coronavirus in the human body: an overview. Virusdisease 2022; 33:429-444. [PMID: 36311173 PMCID: PMC9593972 DOI: 10.1007/s13337-022-00793-9] [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: 08/19/2021] [Accepted: 09/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background Severe acute respiratory syndrome Coronavirus-2 invades the cells via ACE2 receptor and damages multiple organs of the human body. Understanding the pathological manifestation is mandatory to endure the rising post-infection sequel reported in patients with or without comorbidities. Materials and methods Our descriptive review emphasises the direct, indirect and post-infection damages due to COVID-19. We have performed an electronic database search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with selective inclusion and exclusion criteria. Results The included studies substantiated the extensive damages in the multiple organs due to direct and indirect consequences of COVID-19. After an apparent recovery, the prolonged presentation of the symptoms manifests as post-COVID that can be related with persisting viral antigens and dysregulated immune response. Conclusion A few of the symptoms of respiratory, cardiovascular, and neuropsychiatric systems that persist or reappear as post-COVID manifestations. Vaccination and preventive programs will effectively reduce the prevalence but, the post-COVID, a multisystem manifestation, will be a significant tribulation to the medical profession. However, the issue can be managed by implementing public health programs, rehabilitation services, and telemedicine virtual supports to raise awareness and reduce panic.
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Affiliation(s)
- Sivan Padma Priya
- Department of Basic Medical Sciences, RAK College of Dental Sciences, RAK Medical and Health Sciences, Ras Al Khaimah, UAE
| | - P. M. Sunil
- Department of Oral Pathology and Microbiology, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala India
- Centre for Stem Cells and Regenerate Medicine, Malabar Medical College, Calicut, Kerala India
| | - Sudhir Varma
- Department of Clinical Sciences, College of Dentistry, Center for Medical and Bio-Allied Health Science Research, Ajman University, Ajman, UAE
- Saveetha Dental College and Hospitals, Chennai, India
| | - Carel Brigi
- Molecular Medicine and Translational Research, University of Sharjah, Sharjah, UAE
| | - Mohammad Faruq Abd Rachman Isnadi
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - J. A. Jayalal
- Department of Surgery, Kanyakumari Medical College and Hospital, Asaripallam, India
| | - R. Arunkumar Shadamarshan
- Dental Officer and Graded Specialist (Oral and Maxillofacial Surgery), Indo Bhutan Friendship Hospital, IMTRAT, Thimpu Bhutan, 11001 Bhutan
| | - S. Suresh Kumar
- Centre for Materials Engineering and Regenerative Medicine,, Bharath Institute of Higher Eduction and Research, Chennai, 600073 Tamil Nadu India
| | - Neela Vasantha Kumari
- Department of Medical Microbiology and Parasitology, Universiti Putra Malaysia (UPM), Serdang, Selangor 43400 Malaysia
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Huang D, Yang H, Yu H, Wang T, Chen Z, Yao R, Liang Z. A prediction model for major adverse cardiovascular events (MACE) in patients with coronavirus disease 2019 (COVID-19). BMC Pulm Med 2022; 22:343. [PMID: 36096832 PMCID: PMC9466355 DOI: 10.1186/s12890-022-02143-3] [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: 05/31/2021] [Accepted: 09/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background Emerging evidence shows that cardiovascular injuries and events in coronavirus disease 2019 (COVID-19) should be considered. The current study was conducted to develop an early prediction model for major adverse cardiovascular events (MACE) during hospitalizations of COVID-19 patients. Methods This was a retrospective, multicenter, observational study. Hospitalized COVID-19 patients from Wuhan city, Hubei Province and Sichuan Province, China, between January 14 and March 9, 2020, were randomly divided into a training set (70% of patients) and a testing set (30%). All baseline data were recorded at admission or within 24 h after admission to hospitals. The primary outcome was MACE during hospitalization, including nonfatal myocardial infarction, nonfatal stroke and cardiovascular death. The risk factors were selected by LASSO regression and multivariate logistic regression analysis. The nomogram was assessed by calibration curve and decision curve analysis (DCA). Results Ultimately, 1206 adult COVID-19 patients were included. In the training set, 48 (5.7%) patients eventually developed MACE. Six factors associated with MACE were included in the nomogram: age, PaO2/FiO2 under 300, unconsciousness, lymphocyte counts, neutrophil counts and blood urea nitrogen. The C indices were 0.93 (95% CI 0.90, 0.97) in the training set and 0.81 (95% CI 0.70, 0.93) in the testing set. The calibration curve and DCA demonstrated the good performance of the nomogram. Conclusions We developed and validated a nomogram to predict the development of MACE in hospitalized COVID-19 patients. More prospective multicenter studies are needed to confirm our results. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-02143-3.
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Affiliation(s)
- Dong Huang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Huan Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - He Yu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Ting Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Zhu Chen
- Department of Infectional Inpatient Ward Two, Chengdu Public Health Clinical Medical Center, Chengdu, Sichuan, China
| | - Rong Yao
- Department of Emergency Medicine, Emergency Medical Laboratory, West China Hospital, Sichuan University, No 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. .,Disaster Medical Center, Sichuan University, Chengdu, Sichuan, China.
| | - Zongan Liang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
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Jusic A, Stellos K, Ferreira L, Baker AH, Devaux Y. (Epi)transcriptomics in cardiovascular and neurological complications of COVID-19. JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY PLUS 2022; 1:100013. [PMID: 36164464 PMCID: PMC9330360 DOI: 10.1016/j.jmccpl.2022.100013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 06/16/2023]
Abstract
Although systemic inflammation and pulmonary complications increase the mortality rate in COVID-19, a broad spectrum of cardiovascular and neurological complications can also contribute to significant morbidity and mortality. The molecular mechanisms underlying cardiovascular and neurological complications during and after SARS-CoV-2 infection are incompletely understood. Recently reported perturbations of the epitranscriptome of COVID-19 patients indicate that mechanisms including those derived from RNA modifications and non-coding RNAs may play a contributing role in the pathogenesis of COVID-19. In this review paper, we gathered recently published studies investigating (epi)transcriptomic fluctuations upon SARS-CoV-2 infection, focusing on the brain-heart axis since neurological and cardiovascular events and their sequelae are of utmost prevalence and importance in this disease.
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Affiliation(s)
- Amela Jusic
- Cardiovascular Research Unit, Department of Precision Health, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg
- Department of Biology, Faculty of Natural Sciences and Mathematics, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina
| | - Konstantinos Stellos
- Department of Cardiovascular Research, European Centre for Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- German Centre for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislauf-Forschung, DZHK), Heidelberg/Mannheim Partner Site, Mannheim, Germany
- Department of Cardiology, University Hospital Mannheim, Mannheim, Germany
- Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Lino Ferreira
- CNC-Center for Neurosciences and Cell Biology, CIBB-Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Portugal
- Faculty of Medicine, University Coimbra, 3000-548 Coimbra, Portugal
| | - Andrew H. Baker
- Centre for Cardiovascular Science, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
- CARIM Institute, University of Maastricht, Universiteitssingel 50, 6200 MD Maastricht, the Netherlands
| | - Yvan Devaux
- Cardiovascular Research Unit, Department of Precision Health, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg
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11
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Sualeh M, Uddin MR, Junaid N, Khan M, Pario A, Ain Q. Impact of COVID-19 Vaccination on Menstrual Cycle: A Cross-Sectional Study From Karachi, Pakistan. Cureus 2022; 14:e28630. [PMID: 36196308 PMCID: PMC9524410 DOI: 10.7759/cureus.28630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/05/2022] Open
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12
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Kovalevskaiia L, Pakhlevanzade A, Ivanchenko S, Kupriianova L, Volianska V, Plakida A, Panigrahi P. Cardiovascular Disorders as a Result of COVID-19. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Based on the literature data, we present current literature information about frequency, main spectrum, and prognostic value of cardiovascular complications of the SARS-CoV-2 infection. We have highlighted in detail the variants of cardiovascular disorders in the case of patients with SARS-CoV-2 infection caused by concomitant diseases of hypertension, acute coronary syndrome, myocardial infarction, arrhythmias, virus-associated myocarditis, and heart failure. We have described the adverse cardiovascular effects of medicines of different groups used to treat COVID-19 disease and possible medical interactions. We have summarized some current recommendations on cardiotonic and cardioprotective therapy in the case of patients with cardiovascular complications.
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13
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Pokorná A, Dolanová D, Benešová K, Búřilová P, Mužík J, Jarkovský J, Krupová L, Baťalík L, Klugarová J, Klugar M. How the COVID-19 pandemic influences the prevalence of pressure injuries in the Czech Republic: A nationwide analysis of a health registry in 2020. J Tissue Viability 2022; 31:424-430. [PMID: 35725785 PMCID: PMC9197563 DOI: 10.1016/j.jtv.2022.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/06/2022] [Accepted: 06/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND COVID-19 significantly influences the overall patient status and, in severe symptomatology, the ability to move and the low oxygenation of the tissue for the ventilated patient in Intensive Care Units (ICU). There is a higher risk for Pressure injuries (PIs) development. OBJECTIVES The nationwide analyses of the National health register aimed to compare the prevalence of PIs reported before the pandemic COVID-19 started and during the pandemic in 2020. METHOD A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist collected by the National Health Information System (NHIS), focusing on the PIs reporting based on the International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs in 2020. The data from the pandemic period of COVID-19 in 2020 were compared to the prevalence of PI cases in the period 2010-2019 in the Czech Republic in all hospitalized patients. RESULTS The total number of admissions for L89 in 2020 was 14,441, of which 1509 (10.4%) also had COVID-19. In the ICU were 4386 admissions, 12.1% of which also had COVID-19. A higher proportion of PIs is observed in patients hospitalized with COVID-19 than in patients without COVID-19 (2.62% vs 0.81%, respectively 1.05% vs 0.46% when standardized to the 2013 ESP = European Standard Population). In patients hospitalized in ICU, 3.68% with COVID-19 had PIs vs 1.42% without COVID-19 had PIs (1.97% vs 0.81% using the 2013 ESP). CONCLUSION The national health registers analyses have proven that the prevalence of PIs was higher among patients hospitalized with the SARS-CoV-2 infection.
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Affiliation(s)
- Andrea Pokorná
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic; Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic.
| | - Dana Dolanová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Klára Benešová
- Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Petra Búřilová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic; Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic; Department of Public Health, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic
| | - Jan Mužík
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Jiří Jarkovský
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic
| | - Lenka Krupová
- Department of Dermatology, University Hospital Ostrava, 17. Listopadu 1790/5, Ostrava, 708 00, Czech Republic
| | - Ladislav Baťalík
- Department of Public Health, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Department of Rehabilitation, University Hospital Brno, Jihlavska 20, Brno, 625 00, Czech Republic
| | - Jitka Klugarová
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic; Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic
| | - Miloslav Klugar
- Department of Health Sciences, Masaryk University, Faculty of Medicine, Kamenice 3, Brno, 625 00, Czech Republic; Institute of Health Information and Statistics, Palackého Náměstí 4, Prague, 128 01, Czech Republic; Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 3, Brno, 625 00, Brno, Czech Republic
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14
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Xu X, Wang Y, Li Y, Zhang B, Song Q. The future Landscape of macrophage research in cardiovascular disease: a bibliometric analysis. Curr Probl Cardiol 2022; 47:101311. [PMID: 35810847 DOI: 10.1016/j.cpcardiol.2022.101311] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/03/2022]
Abstract
Cardiovascular disease (CVD) refers to a group of diseases involving the heart or blood vessels and is currently the leading cause of morbidity and mortality in many countries around the world and poses a serious economic burden. Macrophages are key effectors of inflammatory and innate immune responses, and their aberrant expression contributes to the development of various types of CVD.This study retrieved articles published from 1990-2022 on macrophages in CVD from the Web of Science core collection, based on CiteSpace and VOSviewer on these literature The annual output, countries and regions, institutions, authors, core journals, keywords and co-cited literature were analyzed. A total of 7,197 articles and reviews were retrieved, with a general upward trend despite slight fluctuations in annual publications. Europe, the United States and Asia are the main countries and regions publishing articles, especially the United States, with the highest number of articles (2,581), citations (173,692) and H-index (197), which also has the world's largest number of elite institutions, professional The country also has the world's largest number of elite institutions, professional researchers and high-impact journals, and is the leading country in this field of research. Keywords "inflammation", "immunology", "autophagy", "lipid-peroxidation" are the main pathogenesis of CVD caused by macrophages. "NLRP3", "nf kappa b" and "TNF-α" are the most frequently studied signalling pathways. Atherosclerosis, myocarditis and myocardial injury are the most studied disease types in this field. In addition, the study of macrophage-related CVD induced by COVID-19 seems to be a recent hot topic, and the mechanisms involved are mainly macrophage polarization, inflammatory factor storm, ACE2 and so on. The present study reveals hot spots and new trends in research on macrophages in CVD, which can provide scholars with key information in this field of research and help further explore new research directions.
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Affiliation(s)
- Xia Xu
- Department of General Internal Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yajiao Wang
- Department of General Internal Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yumeng Li
- Department of General Internal Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Bingxuan Zhang
- Department of General Internal Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Qingqiao Song
- Department of General Internal Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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15
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Chen X, Qiao WH, Cao H, Shi JW, Du XL, Dong NG. Role of Neuroimmune Interactions in COVID-19-related Cardiovascular Damage. Curr Med Sci 2022; 42:555-560. [PMID: 35678914 PMCID: PMC9178934 DOI: 10.1007/s11596-022-2529-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 09/07/2021] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has caused a global pandemic impacting over 200 countries/regions and more than 200 million patients worldwide. Among the infected patients, there is a high prevalence of COVID-19-related cardiovascular injuries. However, the specific mechanisms linking cardiovascular damage and COVID-19 remain unclear. The COVID-19 pandemic also has exacerbated the mental health burden of humans. Considering the close association between neuroimmune interactions and cardiovascular disease, this review assessed the complex pathophysiological mechanisms connecting neuroimmune interactions and cardiovascular disease. It was revealed that the mental health burden might be a pivotal accomplice causing COVID-19-associated cardiovascular damage. Specifically, the proinflammatory status of patients with a terrible mood state is closely related to overdrive of the hypothalamus-pituitary-adrenal (HPA) axis, sympathovagal imbalance, and endothelial dysfunction, which lead to an increased risk of developing cardiovascular injury during COVID-19. Therefore, during the prevention and treatment of cardiovascular complications in COVID-19 patients, particular attention should be given to relieve the mental health burden of these patients.
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Affiliation(s)
- Xing Chen
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Wei-hua Qiao
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Hong Cao
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Jia-wei Shi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Xin-ling Du
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
| | - Nian-guo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
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16
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Alqahtani MS, Abbas M, Alsabaani A, Alqarni A, Almohiy HM, Alsawqaee E, Alshahrani R, Alshahrani S. The Potential Impact of COVID-19 Virus on the Heart and the Circulatory System. Infect Drug Resist 2022; 15:1175-1189. [PMID: 35345472 PMCID: PMC8957310 DOI: 10.2147/idr.s351318] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/08/2022] [Indexed: 12/13/2022] Open
Abstract
Heart attacks, arrhythmias, and cardiomyopathy are all linked to the 2019 coronavirus disease (COVID-19), which has been identified as a risk factor for cardiovascular disease. Nothing can be held accountable in the current state of affairs. Undiagnosed chronic systolic heart failure (CSHF) develops when the heart’s second half of the cardiac cycle does not function properly. As a result, the heart’s blood pumping function is interrupted. Stress-induced cardiomyopathy may be caused by a variety of factors inside the body (SICM). Cytokine storm and microvascular dysfunction are among the issues. There is inflammation in the heart muscle, which may lead to stress-induced cardiomyopathy. A major part of our study is going to be devoted to understanding the effects of coronavirus on the cardiovascular system and blood vessels. A lot of time and effort has been put into figuring out the health effects of radiation exposure. The heart and circulatory system are shown to be affected by the coronavirus in this research. COVID-19 is shown to influence persons with heart disease, heart failure, arrhythmias, microvascular angiopathy, and cardiac damage in this study.
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Affiliation(s)
- Mohammed S Alqahtani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.,BioImaging Unit, Space Research Centre, Michael Atiyah Building, University of Leicester, Leicester, LE1 7RH, U.K
| | - Mohamed Abbas
- Electrical Engineering Department, College of Engineering, King Khalid University, Abha, 61421, Saudi Arabia.,Computers and Communications Department, College of Engineering, Delta University for Science and Technology, Gamasa, 35712, Egypt
| | - Abdullah Alsabaani
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia
| | - Amjad Alqarni
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Hussain M Almohiy
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Entisar Alsawqaee
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Raghad Alshahrani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Shahd Alshahrani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
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17
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Li S, Wang J, Yan Y, Zhang Z, Gong W, Nie S. Clinical Characterization and Possible Pathological Mechanism of Acute Myocardial Injury in COVID-19. Front Cardiovasc Med 2022; 9:862571. [PMID: 35387441 PMCID: PMC8979292 DOI: 10.3389/fcvm.2022.862571] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/14/2022] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is a respiratory disease that can cause damage to multiple organs throughout the body. Cardiovascular complications related to COVID-19 mainly include acute myocardial injury, heart failure, acute coronary syndrome, arrhythmia, myocarditis. Among them, myocardial injury is the most common complication in COVID-19 hospitalized patients, and is associated with poor prognosis such as death and arrhythmias. There is a continuous relationship between myocardial injury and the severity of COVID-19. The incidence of myocardial injury is higher in critically ill patients and dead patients, and myocardial injury is more likely to occur in the elderly critically ill patients with comorbidities. Myocardial injury is usually accompanied by more electrocardiogram abnormalities, higher inflammation markers and more obvious echocardiographic abnormalities. According to reports, COVID-19 patients with a history of cardiovascular disease have a higher in-hospital mortality, especially in the elder patients. At present, the mechanism of myocardial injury in COVID-19 is still unclear. There may be direct injury of myocardial cells, systemic inflammatory response, hypoxia, prethrombotic and procoagulant state, myocardial interstitial fibrosis, interferon-mediated immune response and coronary artery plaque instability and other related factors, and angiotensin-converting enzyme-2 receptor may play a key role in the myocardial injury in COVID-19.
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Affiliation(s)
- Siyi Li
- Coronary Heart Disease Center, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Jinan Wang
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Yan
- Coronary Heart Disease Center, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Zekun Zhang
- Coronary Heart Disease Center, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Wei Gong
- Coronary Heart Disease Center, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
| | - Shaoping Nie
- Coronary Heart Disease Center, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
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18
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Malcangi G, Inchingolo AD, Inchingolo AM, Piras F, Settanni V, Garofoli G, Palmieri G, Ceci S, Patano A, Mancini A, Vimercati L, Nemore D, Scardapane A, Rapone B, Semjonova A, D’Oria MT, Macchia L, Bordea IR, Migliore G, Scarano A, Lorusso F, Tartaglia GM, Giovanniello D, Nucci L, Maggialetti N, Parisi A, Domenico MD, Brienza N, Tafuri S, Stefanizzi P, Curatoli L, Corriero A, Contaldo M, Inchingolo F, Dipalma G. COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines. CHILDREN (BASEL, SWITZERLAND) 2022; 9:249. [PMID: 35204969 PMCID: PMC8870718 DOI: 10.3390/children9020249] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/21/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023]
Abstract
Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children and infants this variation in epidemiology compared to the adult population and its impact on therapies and vaccines that are aimed towards them. A literature review, including in vitro studies, reviews, published guidelines and clinical trials was performed. Clinical trials concerned topics that allowed a descriptive synthesis to be produced. Four underlying mechanisms were found that may play a key role in providing COVID-19 protection in babies. No guidelines are available yet for therapy due to insufficient data; support therapy remains the most used. Only two vaccines are approved by the World Health Organization to be used in children from 12 years of age, and there are currently no efficacy or safety data for children below the age of 12 years. The COVID-19 clinical frame infection is milder in children and adolescents. This section of the population can act as vectors and reservoirs and play a key role in the transmission of the infection; therefore, vaccines are paramount. More evidence is required to guide safely the vaccination campaign.
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Affiliation(s)
- Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Grazia Garofoli
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Damiano Nemore
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Arnaldo Scardapane
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Alexandra Semjonova
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Maria Teresa D’Oria
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
- Department of Medical and Biological Sciences, University of Udine, Via delle Scienze, 206, 33100 Udine, Italy
| | - Luigi Macchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | | | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy;
| | - Delia Giovanniello
- Department of Toracic Surgery, Hospital “San Camillo Forlanini”, 00152 Rome, Italy;
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (M.C.)
| | - Nicola Maggialetti
- Department of Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy;
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Nicola Brienza
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70124 Bari, Italy; (N.B.); (A.C.)
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy; (S.T.); (P.S.)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy; (S.T.); (P.S.)
| | - Luigi Curatoli
- Department Neurosciences & Sensory Organs & Musculoskeletal System, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Alberto Corriero
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70124 Bari, Italy; (N.B.); (A.C.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (M.C.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
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19
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Arhontoulis DC, Kerr C, Richards D, Tjen K, Hyams N, Jones JA, Deleon-Pennell K, Menick D, Lindner D, Westermann D, Mei Y. Human Cardiac Organoids to Model COVID-19 Cytokine Storm Induced Cardiac Injuries. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2022.01.31.478497. [PMID: 35132419 PMCID: PMC8820666 DOI: 10.1101/2022.01.31.478497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Acute cardiac injuries occur in 20-25% of hospitalized COVID-19 patients. Despite urgent needs, there is a lack of 3D organotypic models of COVID-19 hearts for mechanistic studies and drug testing. Herein, we demonstrate that human cardiac organoids (hCOs) are a viable platform to model the cardiac injuries caused by COVID-19 hyperinflammation. As IL-1βis an upstream cytokine and a core COVID-19 signature cytokine, it was used to stimulate hCOs to induce the release of a milieu of proinflammatory cytokines that mirror the profile of COVID-19 cytokine storm. The IL-1 β treated hCOs recapitulated transcriptomic, structural, and functional signatures of COVID-19 hearts. The comparison of IL-1β treated hCOs with cardiac tissue from COVID-19 autopsies illustrated the critical roles of hyper-inflammation in COVID-19 cardiac insults and indicated the cardioprotective effects of endothelium. The IL-1β treated hCOs also provide a viable model to assess the efficacy and potential side effects of immunomodulatory drugs, as well as the reversibility of COVID-19 cardiac injuries at baseline and simulated exercise conditions.
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Affiliation(s)
- Dimitrios C Arhontoulis
- Molecular and Cellular Biology and Pathobiology Program, Medical University of South Carolina, Charleston, SC, USA
| | - Charles Kerr
- Molecular and Cellular Biology and Pathobiology Program, Medical University of South Carolina, Charleston, SC, USA
| | - Dylan Richards
- Bioengineering Department, Clemson University, Clemson, SC, USA
| | - Kelsey Tjen
- Molecular and Cellular Biology and Pathobiology Program, Medical University of South Carolina, Charleston, SC, USA
| | - Nathaniel Hyams
- Bioengineering Department, Clemson University, Clemson, SC, USA
| | - Jefferey A. Jones
- Molecular and Cellular Biology and Pathobiology Program, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Research Service, Charleston, SC, USA
- Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kristine Deleon-Pennell
- Molecular and Cellular Biology and Pathobiology Program, Medical University of South Carolina, Charleston, SC, USA
- Division of Cardiology, Department of Medicine, Gazes Cardiac Research Institute, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Research Service, Charleston, SC, USA
| | - Donald Menick
- Molecular and Cellular Biology and Pathobiology Program, Medical University of South Carolina, Charleston, SC, USA
- Division of Cardiology, Department of Medicine, Gazes Cardiac Research Institute, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Research Service, Charleston, SC, USA
| | - Diana Lindner
- Department of Cardiology, University Heart and Vascular Center Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg / Kiel / Lübeck, Germany
| | - Dirk Westermann
- Department of Cardiology, University Heart and Vascular Center Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg / Kiel / Lübeck, Germany
| | - Ying Mei
- Molecular and Cellular Biology and Pathobiology Program, Medical University of South Carolina, Charleston, SC, USA
- Bioengineering Department, Clemson University, Clemson, SC, USA
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20
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Wang H, Sun B, Li X, Wang Y, Yang Z. Clinical analysis of severe COVID-19 patients. Technol Health Care 2022; 30:225-234. [PMID: 35124599 PMCID: PMC9028659 DOI: 10.3233/thc-228021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND: Patients with unexplained pneumonia appeared in Wuhan, Hubei Province at the end of 2019. OBJECTIVE: To analyze the clinical data of patients with severe COVID-19. METHODS: Medical records of 28 severe patients admitted to the intensive care unit of Wuhan Xinzhou District People’s Hospital were collected from January 31 to March 17. RESULTS: The mortality rate of severe patients in our study was 39.3%. There were statistically significant differences in age, admission systolic blood pressure, lymphocyte count, albumin, total bilirubin, and lactate dehydrogenase between the death group and the survival group (P< 0.05). There were statistically significant differences in APACHE II, CURB-65, SOFA, respiratory frequency, systolic pressure, platelet, procalcitonin, albumin, creatinine, creatine kinase isoenzyme, lactate dehydrogenase, chloride ion, prothrombin time, international normalized ratio, arterial partial pressure of oxygen, and FiO2 at ICU between the death group and the survival group (P< 0.05). CONCLUSIONS: Fever and cough are the main symptoms, which is useful for predicting the prognosis to dynamically measure the APACHE II, CURB-65, SOFA, respiratory frequency, lymphocyte count, platelet, lactate dehydrogenase, and coagulation tests. The drugs that protect the liver and heart may improve the survival rate of patients with severe COVID-19.
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Affiliation(s)
- Hao Wang
- Intensive Care Unit, Qinghai Provincial People’s Hospital, Xining, Qinghai, China
| | - Bin Sun
- Intensive Care Unit, Qinghai Provincial People’s Hospital, Xining, Qinghai, China
| | - Xiayuan Li
- Intensive Care Unit, Qinghai Provincial People’s Hospital, Xining, Qinghai, China
| | - Yun Wang
- Digestive System Department, Qinghai University Affiliated Hospital, Xining, Qinghai, China
| | - Zhengping Yang
- Intensive Care Unit, Qinghai Provincial People’s Hospital, Xining, Qinghai, China
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21
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Augustine R, S A, Nayeem A, Salam SA, Augustine P, Dan P, Maureira P, Mraiche F, Gentile C, Hansbro PM, McClements L, Hasan A. Increased complications of COVID-19 in people with cardiovascular disease: Role of the renin-angiotensin-aldosterone system (RAAS) dysregulation. Chem Biol Interact 2022; 351:109738. [PMID: 34740598 PMCID: PMC8563522 DOI: 10.1016/j.cbi.2021.109738] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/19/2021] [Accepted: 11/01/2021] [Indexed: 01/28/2023]
Abstract
The rapid spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19), has had a dramatic negative impact on public health and economies worldwide. Recent studies on COVID-19 complications and mortality rates suggest that there is a higher prevalence in cardiovascular diseases (CVD) patients. Past investigations on the associations between pre-existing CVDs and susceptibility to coronavirus infections including SARS-CoV and the Middle East Respiratory Syndrome coronavirus (MERS-CoV), have demonstrated similar results. However, the underlying mechanisms are poorly understood. This has impeded adequate risk stratification and treatment strategies for CVD patients with SARS-CoV-2 infections. Generally, dysregulation of the expression of angiotensin-converting enzyme (ACE) and the counter regulator, angiotensin-converting enzyme 2 (ACE2) is a hallmark of cardiovascular risk and CVD. ACE2 is the main host receptor for SARS-CoV-2. Although further studies are required, dysfunction of ACE2 after virus binding and dysregulation of the renin-angiotensin-aldosterone system (RAAS) signaling may worsen the outcomes of people affected by COVID-19 and with preexisting CVD. Here, we review the current knowledge and outline the gaps related to the relationship between CVD and COVID-19 with a focus on the RAAS. Improved understanding of the mechanisms regulating viral entry and the role of RAAS may direct future research with the potential to improve the prevention and management of COVID-19.
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Affiliation(s)
- Robin Augustine
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar.
| | - Abhilash S
- Department of Microbiology, Majlis Arts and Science College, Puramannur, Malappuram, Kerala, 676552, India
| | - Ajisha Nayeem
- Department of Biotechnology, St. Mary's College, Thrissur, 680020, Kerala, India
| | - Shaheen Abdul Salam
- Department of Biosciences, MES College Marampally, Aluva, Ernakulam, 683107, Kerala, India
| | - Priya Augustine
- Department of Zoology, Kongunadu Arts and Science College, Coimbatore, Tamil Nadu, 641029, India
| | - Pan Dan
- Department of Cardiovascular and Transplantation Surgery, Regional Central Hospital of Nancy, Lorraine University, France; Department of Thoracic and Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Pablo Maureira
- Department of Cardiovascular and Transplantation Surgery, Regional Central Hospital of Nancy, Lorraine University, France
| | - Fatima Mraiche
- College of Pharmacy, QU-Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Carmine Gentile
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, NSW, Australia; School of Medicine, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Philip M Hansbro
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, NSW, Australia; School of Life Sciences, Faculty of Science, University of Technology Sydney, NSW, Australia
| | - Lana McClements
- School of Life Sciences, Faculty of Science, University of Technology Sydney, NSW, Australia
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar.
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22
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Egbuche O, Abe T, Nwokike SI, Jegede O, Mezue K, Olanipekun T, Onuorah I, Echols MR. Racial differences in cardiopulmonary outcomes of hospitalized COVID-19 patients with acute kidney injury. Rev Cardiovasc Med 2021; 22:1667-1675. [PMID: 34957809 PMCID: PMC9054458 DOI: 10.31083/j.rcm2204174] [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: 08/08/2021] [Revised: 10/12/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023] Open
Abstract
In-hospital acute kidney injury (IH-AKI) has been reported in a significant proportion of patients with COVID-19 and is associated with increased disease burden and poor outcomes. However, the mechanisms of injury are not fully understood. We sought to determine the significance of race on cardiopulmonary outcomes and in-hospital mortality of hospitalized COVID-19 patients with AKI. We conducted a retrospective cohort study of consecutive patients hospitalized in Grady Health System in Atlanta, Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. We evaluated the primary composite outcome of in-hospital cardiac events, and mortality in blacks with AKI versus non-blacks with AKI. In a subgroup analysis, we evaluated the impact of AKI in all blacks and in all non-blacks. Of 293 patients, effective sample size was 267 after all exclusion criteria were applied. The mean age was 61.4 ± 16.7, 39% were female, and 75 (28.1%) had IH-AKI. In multivariable analyses, blacks with IH-AKI were not more likely to have in-hospital cardiac events (aOR 0.3, 95% Confidence interval (CI) 0.04-1.86, p = 0.18), require ICU stay (aOR 0.80, 95% CI 0.20-3.25, p = 0.75), acute respiratory distress syndrome (aOR 0.77, 95% CI 0.16-3.65, p = 0.74), require mechanical ventilation (aOR 0.51, 95% CI 0.12-2.10, p = 0.35), and in-hospital mortality (aOR 1.40, 95% CI 0.26-7.50, p = 0.70) when compared to non-blacks with IH-AKI. Regardless of race, the presence of AKI was associated with worse outcomes. Black race is not associated with higher risk of in-hospital cardiac events and mortality in hospitalized COVID-19 patients who develop AKI. However, blacks with IH-AKI are more likely to have ARDS or die from any cause when compared to blacks without IH-AKI.
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Affiliation(s)
- Obiora Egbuche
- Division of Cardiovascular Medicine, Ohio State University, Columbus, OH 43210, USA,Correspondence: (Obiora Egbuche)
| | - Temidayo Abe
- Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Shirley I. Nwokike
- Department of Internal Medicine, Medical College of Georgia, Augusta, GA 30912, USA
| | - Opeyemi Jegede
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort-Worth, TX 76107, USA
| | - Kenechukwu Mezue
- Division of Nuclear Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Titilope Olanipekun
- Department of Hospital Medicine, Covenant Health System, Knoxville, TN 37902, USA
| | - Ifeoma Onuorah
- Division of Cardiovascular Disease, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Melvin R. Echols
- Division of Cardiovascular Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
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23
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PrabhuDas M, Fuldner R, Farber D, Kuchel GA, Mannick J, Nikolich-Zugich J, Sen R, Turner J. Research and resource needs for understanding host immune responses to SARS-CoV-2 and COVID-19 vaccines during aging. NATURE AGING 2021; 1:1073-1077. [PMID: 36908301 PMCID: PMC9997058 DOI: 10.1038/s43587-021-00156-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
On 16 and 17 March 2021, the National Institute of Allergy and Infectious Diseases and the National Institute of Aging convened a virtual workshop to discuss developments in SARS-CoV-2 research pertaining to immune responses in older adults, COVID-19 vaccines in both aged animals and older individuals, and to gain some perspective on the critical knowledge gaps that need addressing to establish scientific priorities for future research studies.
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Affiliation(s)
- Mercy PrabhuDas
- Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Rebecca Fuldner
- Division of Aging Biology, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Donna Farber
- Department of Microbiology and Immmunology, Columbia University, New York, NY, USA
- Department of Surgery, Columbia University, New York, NY, USA
| | - George A. Kuchel
- University of Connecticut Center on Aging, UConn Health, Farmington, CT, USA
| | | | - Janko Nikolich-Zugich
- Department of Immunobiology, Arizona Center on Aging, University of Arizona, Tucson, AZ, USA
| | - Ranjan Sen
- Laboratory of Molecular Biology and Immunology, National Institute on Aging, Baltimore, MD, USA
| | - Joanne Turner
- Texas Biomedical Research Institute, San Antonio, TX, USA
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24
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Hu C, Zeng JP, Peng K, Xia H, Zhang HM, Zhong Z, Jiang MY. Clinical Features and Temporal Lung Radiographic Changes in 25 Patients Recovering from COVID-19 Pneumonia: A Retrospective Case-Control Study. Med Sci Monit 2021; 27:e933381. [PMID: 34775462 PMCID: PMC8600820 DOI: 10.12659/msm.933381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Little is known of the changes in lung radiographic characteristics over time in patients recovering from COVID-19. This study analyzed the clinical features and temporal lung radiographic changes in patients with moderate and severe COVID-19 pneumonia who did not require invasive mechanical ventilation during the acute and convalescent periods. Material/Methods The data of 25 patients with COVID-19 pneumonia from January 29, 2020, to November 24, 2020, who did not require invasive mechanical ventilation and who were followed up were retrospectively collected. The 25 patients were divided into severe and moderate groups. Clinical characteristics and computed tomography (CT) manifestations were compared. A total of 121 consecutive thin-slice CT scans were collected at 4 weeks, 2 months, and 5 months after admission to evaluate lung abnormalities in the patients. The CT score was used to assess disease severity. Results The severe group had a lower rate of nucleic acid conversion within 10 days of admission and higher D-dimer, creatine kinase, and lactate dehydrogenase values. In the severe group, hospital stay was longer and hospitalization costs were higher. The average CT score of the severe group peaked in the second week, while the moderate group peaked in the first week and then decreased over time. There were no statistically significant differences in the average CT score between the 2 groups at the 5-month follow-up. Conclusions The pulmonary lesions of patients recovering from COVID-19 and who do not require invasive mechanical ventilation were gradually absorbed and resolved over time.
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Affiliation(s)
- Chao Hu
- Department of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Jian Ping Zeng
- Department of Cardiology, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Ke Peng
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Hong Xia
- Department of Orthopedics, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Huan Ming Zhang
- Department of Radiology, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Zhi Zhong
- Department of Radiology, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
| | - Ming Yan Jiang
- Department of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, Xiangtan, Hunan, China (mainland)
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25
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Sianes-Gallén M, Pujol-García AM, Rus García M, Partera Luque C, López Postigo M, Call Mañosa S, Camposo Montesino MC, Ibáñez Touriño B, Ribas Obon E, Segura Rodríguez T, Cores Fuentes P, Tamame Sanantonio M, Jornet-Gibert M. Pressure injuries during the SARS-CoV-2 pandemic: A retrospective, case-control study. J Tissue Viability 2021; 30:478-483. [PMID: 34389188 PMCID: PMC8328527 DOI: 10.1016/j.jtv.2021.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/22/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023]
Abstract
AIM OF STUDY The main objective of this study was to ascertain whether severe alterations in hypoxemic, inflammatory, and nutritional parameters in patients diagnosed with SARS-CoV-2 infection were associated with the occurrence and severity of developed dependency-related injuries. The secondary objective was to determine whether there were prognostic factors associated with the occurrence and severity of developed dependency-related injuries during the SARS-CoV-2 pandemic. MATERIAL AND METHODS A retrospective, single-centre, case-control study was conducted to compare SARS-CoV-2 patients who developed dependency-related injuries after the first 48 h after admission with a control group made up of SARS-CoV-2 patients without dependency-related injuries. The cases of the 1987 patients diagnosed with SARS-CoV-2 infection during the study period were reviewed. Data from 94 patients who developed dependency-related injuries and from 190 patients who did not develop them during hospital admission were analysed. RESULTS High baseline dependency levels, prolonged hospital stays, and low oxygen saturation levels on arrival in emergency department triage were associated with the occurrence of dependency-related injuries among patients diagnosed with SARS-CoV-2 infection. CONCLUSIONS SARS-CoV-2 infection can lead to complications such as dependency-related injuries. Although there are several non-modifiable variables associated with the occurrence of dependency-related injuries in these patients, it is essential to conduct further research and introduce consensus guidelines to reduce their incidence and prevalence.
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Affiliation(s)
- Mònica Sianes-Gallén
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Anna María Pujol-García
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montserrat Rus García
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Carmen Partera Luque
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montserrat López Postigo
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Silvia Call Mañosa
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - María Carmen Camposo Montesino
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Belén Ibáñez Touriño
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Eulalia Ribas Obon
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Tania Segura Rodríguez
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Pilar Cores Fuentes
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Marta Tamame Sanantonio
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montsant Jornet-Gibert
- Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
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26
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Rodriguez T, Dobrovolny HM. Estimation of viral kinetics model parameters in young and aged SARS-CoV-2 infected macaques. ROYAL SOCIETY OPEN SCIENCE 2021; 8:202345. [PMID: 34804559 PMCID: PMC8595996 DOI: 10.1098/rsos.202345] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
The SARS-CoV-2 virus disproportionately causes serious illness and death in older individuals. In order to have the greatest impact in decreasing the human toll caused by the virus, antiviral treatment should be targeted to older patients. For this, we need a better understanding of the differences in viral dynamics between SARS-CoV-2 infection in younger and older adults. In this study, we use previously published averaged viral titre measurements from the nose and throat of SARS-CoV-2 infection in young and aged cynomolgus macaques to parametrize a viral kinetics model. We find that all viral kinetics parameters differ between young and aged macaques in the nasal passages, but that there are fewer differences in parameter estimates from the throat. We further use our parametrized model to study the antiviral treatment of young and aged animals, finding that early antiviral treatment is more likely to lead to a lengthening of the infection in aged animals, but not in young animals.
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Affiliation(s)
- Thalia Rodriguez
- Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX, USA
| | - Hana M. Dobrovolny
- Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX, USA
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27
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Acherjee T, Behara A, Saad M, Vittorio TJ. Mechanisms and management of prothrombotic state in COVID-19 disease. Ther Adv Cardiovasc Dis 2021; 15:17539447211053470. [PMID: 34693818 PMCID: PMC8785300 DOI: 10.1177/17539447211053470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The novel severe acute respiratory syndrome viral disease outbreak due to SARS-CoV-2 is a rapidly evolving disease and represents one of the greatest medical challenges in recent times. It is believed that SARS-CoV-2 has migrated from bats to an intermediate host and then to humans. This article aims at the mechanism and management of prothrombotic state in COVID-19 positive patients. We tried to present how the SARS-CoV-2 virus can induce thromboembolic events and the incidence of these thromboembolic events. We also tried to depict anticoagulation management in these patients as well as postdischarge plan and follow-up. Invasion of type 2 pneumocytes by the SARS-CoV-2 virus is critical in the course of illness because it results in activation of immune cells leading to elevation of cytokines. The subsequent activation of T cells and macrophages infiltrates the infected myocardial cells causing direct myocardiocyte toxicity and development of arrhythmia. Hypoxia or hypotension during the clinical course causes a mismatch between myocyte oxygen supply and workload demand resulting in cardiac distress. SARS-CoV-2 affects endothelial cells and pericytes that lead to severe micro and macrovascular dysfunction, and together with oxygen supply-demand mismatch, immune hyperresponsivity can potentially cause destabilization and plaque rupture causing acute coronary syndromes. Other mechanisms of injury include myocarditis, pericarditis, stress cardiomyopathy, vasculitis, and DIC (Disseminated intravascular coagulation)/microthrombi. SARS-CoV-2 enters the cells by the Spike protein S whose surface unit, S1, binds to the ACE2 receptor on the host cell. The type II transmembrane serine proteases TMPRSS2 and histone acetyltransferases (HAT) are host cell proteases that are recruited by the virus to cleave ACE2 surface protein S which facilitates the viral entry. Therefore, TMPRSS2 and HAT could be targeted for potential drugs against SARS-CoV-2. SARS-CoV-2 uses an RNA-dependent RNA polymerase for proliferation, which is targeted by remdesivir that is currently approved for emergency use by Food and Drug Administration (FDA). We need to adopt a multifaceted approach when combating SARS-CoV-2 because it presents several challenges including medical, psychological, socioeconomic, and ethical. COVID-19 is the biggest calamity during the 21st century, we need to have a keen understanding of its pathophysiology and clinical implications for the development of preventive measures and therapeutic modalities.
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Affiliation(s)
- Trishna Acherjee
- Internal Medicine, BronxCare Health System, Bronx, NY-10457, USA
| | - Aparna Behara
- Internal Medicine, BronxCare Health System, Bronx, NY, USA
| | - Muhammad Saad
- Internal Medicine, BronxCare Health System, Bronx, NY, USA
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Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19. ACTA ACUST UNITED AC 2021; 2021:5942366. [PMID: 34557260 PMCID: PMC8455223 DOI: 10.1155/2021/5942366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/27/2022]
Abstract
Hydroxychloroquine (HCQ), also known by its trade name Plaquenil®, has been used for over 50 years as a treatment for malaria, systemic lupus erythematosus, and rheumatoid arthritis. As the COVID-19 pandemic emerged in the United States and globally in early 2020, HCQ began to garner attention as a potential treatment and as prophylaxis against COVID-19. Preliminary data indicated that HCQ as well as chloroquine (CQ) possessed in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early clinical data from China and France reported that HCQ and CQ were associated with viral load reduction and clinical improvement in patients with COVID-19 compared to control groups; however, an overwhelming number of randomized controlled trials, meta-analyses, and systematic reviews have since concluded that HCQ used alone, or in combination with azithromycin (AZ), provides no mortality or time-to-recovery benefit in hospitalized patients with COVID-19. Additionally, these same trials reported adverse events including cardiac, neuropsychiatric, hematologic, and hepatobiliary manifestations in patients with COVID-19 whom had been treated with HCQ. This review article summarizes the available data pertaining to the adverse events associated with HCQ use, alone or in combination with azithromycin, in patients with COVID-19 in order to fully assess the risk versus benefit of treating COVID-19 patients with these agents. The results of this review lead us to conclude that the risks of adverse events associated with HCQ use (with or without AZ) outweigh the potential clinical benefits and thus recommend against its use in the treatment or prevention of COVID-19.
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Tumor Necrosis Factor-Alpha Exacerbates Viral Entry in SARS-CoV2-Infected iPSC-Derived Cardiomyocytes. Int J Mol Sci 2021; 22:ijms22189869. [PMID: 34576032 PMCID: PMC8470197 DOI: 10.3390/ijms22189869] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/28/2021] [Accepted: 09/07/2021] [Indexed: 12/27/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic with high infectivity and mortality has caused severe social and economic impacts worldwide. Growing reports of COVID-19 patients with multi-organ damage indicated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) may also disturb the cardiovascular system. Herein, we used human induced pluripotent stem cell (iPSC)-derived cardiomyocytes (iCMs) as the in vitro platform to examine the consequence of SARS-CoV2 infection on iCMs. Differentiated iCMs expressed the primary SARS-CoV2 receptor angiotensin-converting enzyme-II (ACE2) and the transmembrane protease serine type 2 (TMPRSS2) receptor suggesting the susceptibility of iCMs to SARS-CoV2. Following the infection of iCMs with SARS-CoV2, the viral nucleocapsid (N) protein was detected in the host cells, demonstrating the successful infection. Bioinformatics analysis revealed that the SARS-CoV2 infection upregulates several inflammation-related genes, including the proinflammatory cytokine tumor necrosis factor-α (TNF-α). The pretreatment of iCMs with TNF-α for 24 h, significantly increased the expression of ACE2 and TMPRSS2, SASR-CoV2 entry receptors. The TNF-α pretreatment enhanced the entry of GFP-expressing SARS-CoV2 pseudovirus into iCMs, and the neutralization of TNF-α ameliorated the TNF-α-enhanced viral entry. Collectively, SARS-CoV2 elevated TNF-α expression, which in turn enhanced the SARS-CoV2 viral entry. Our findings suggest that, TNF-α may participate in the cytokine storm and aggravate the myocardial damage in COVID-19 patients.
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Rasmi Y, Babaei G, Nisar MF, Noreen H, Gholizadeh-Ghaleh Aziz S. Revealed pathophysiological mechanisms of crosslinking interaction of affected vital organs in COVID-19. COMPARATIVE CLINICAL PATHOLOGY 2021; 30:1005-1021. [PMID: 34539310 PMCID: PMC8432959 DOI: 10.1007/s00580-021-03269-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023]
Abstract
SARS-CoV-2 is one of the main serious challenges of human societies, which emerged in December 2019 from China and quickly extends to all parts of the world. The virus was previously believed to only affect the lungs and respiratory system, but subsequent research has revealed that it affects a variety of organs. For this reason, this disease is known as a multiorgan disease. Current article aimed to highlight latest information and updates about molecular studies regarding pathogenesis of SARS-CoV-2 in kidney, liver, and cardiovascular and respiratory systems, as well as the mechanisms of interaction of these organs with each other to cause clinical manifestations in patients.
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Affiliation(s)
- Yousef Rasmi
- Department of Clinical Biochemistry, Faculty of Medicine, Urmia Medical Sciences University (UMSU), Urmia, Iran
| | - Ghader Babaei
- Department of Clinical Biochemistry, Faculty of Medicine, Urmia Medical Sciences University (UMSU), Urmia, Iran
| | - Muhammad Farrukh Nisar
- Department of Physiology and Biochemistry, Cholistan University of Veterinary and Animal Sciences (CUVAS), Bahawalpur, 63100 Pakistan
| | - Hina Noreen
- Department of Physiology and Biochemistry, Cholistan University of Veterinary and Animal Sciences (CUVAS), Bahawalpur, 63100 Pakistan
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Bellia A, Andreadi A, Giudice L, De Taddeo S, Maiorino A, D'Ippolito I, Giorgino FM, Ruotolo V, Romano M, Magrini A, Di Daniele N, Rogliani P, Lauro D. Atherogenic Dyslipidemia on Admission Is Associated With Poorer Outcome in People With and Without Diabetes Hospitalized for COVID-19. Diabetes Care 2021; 44:2149-2157. [PMID: 34253561 DOI: 10.2337/dc20-2838] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/27/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Identifying metabolic factors associated with critical disease can help to improve management of patients hospitalized for coronavirus disease 2019 (COVID-19). High triglycerides and low HDL levels characterize the atherogenic dyslipidemia closely related to insulin resistance and diabetes. We examined associations of atherogenic dyslipidemia detected on admission with outcome of COVID-19 during hospitalization. RESEARCH DESIGN AND METHODS We retrospectively analyzed clinical reports of 118 consecutive patients hospitalized for COVID-19 in Rome, Italy, between March and May 2020. Clinical characteristics, inflammation markers, and glucose and lipid metabolism parameters at admission were collected. Critical disease was defined as in-hospital death or need for endotracheal intubation. Associations were tested using logistic regression analysis. RESULTS Patients with critical COVID-19 (n = 43) were significantly older than those with noncritical disease (n = 75) and presented higher levels of fasting glucose, triglycerides, C-reactive protein, interleukin-6, procalcitonin, and d-dimer (P < 0.01 for all), whereas HDL levels were lower (P = 0.003). Atherogenic dyslipidemia was more frequent in patients with critical COVID-19 (46 vs. 24%, P = 0.011), as well as diabetes (37 vs. 19%, P = 0.026), and significantly associated with death or intubation (odds ratio 2.53 [95% CI 1.16-6.32], P = 0.018). Triglycerides were significantly associated with selected inflammatory biomarkers (P < 0.05 for all) and poorer outcome of COVID-19 during hospitalization in both the overall population and the subgroup with atherogenic dyslipidemia. CONCLUSIONS Atherogenic dyslipidemia detected on admission can be associated with critical in-hospital course of COVID-19. Further investigations are needed to elucidate the hypothetical role of insulin resistance and related lipid abnormalities in severe acute respiratory syndrome coronavirus 2 pathogenesis. Assessment of lipid profile should be encouraged in patients hospitalized for COVID-19.
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Affiliation(s)
- Alfonso Bellia
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Aikaterini Andreadi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Luca Giudice
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Sofia De Taddeo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Alessio Maiorino
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Ilenia D'Ippolito
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Valeria Ruotolo
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Maria Romano
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Di Daniele
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Paola Rogliani
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Davide Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Division of Endocrinology and Diabetes, Fondazione Policlinico Tor Vergata, Rome, Italy
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Hessami A, Shamshirian A, Heydari K, Pourali F, Alizadeh-Navaei R, Moosazadeh M, Abrotan S, Shojaie L, Sedighi S, Shamshirian D, Rezaei N. Cardiovascular diseases burden in COVID-19: Systematic review and meta-analysis. Am J Emerg Med 2021; 46:382-391. [PMID: 33268238 PMCID: PMC7561581 DOI: 10.1016/j.ajem.2020.10.022] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/20/2020] [Accepted: 10/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND High rate of cardiovascular disease (CVD) have been reported among patients with novel coronavirus disease (COVID-19). Meanwhile there were controversies among different studies about CVD burden in COVID-19 patients. Hence, we aimed to study CVD burden among COVID-19 patients, using a systematic review and meta-analysis. METHODS We have systematically searched databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science as well as medRxiv pre-print database. Hand searched was also conducted in journal websites and Google Scholar. Meta-analyses were carried out for Odds Ratio (OR) of mortality and Intensive Care Unit (ICU) admission for different CVDs. We have also performed a descriptive meta-analysis on different CVDs. RESULTS Fifty-six studies entered into meta-analysis for ICU admission and mortality outcome and 198 papers for descriptive outcomes, including 159,698 COVID-19 patients. Results of meta-analysis indicated that acute cardiac injury, (OR: 13.29, 95% CI 7.35-24.03), hypertension (OR: 2.60, 95% CI 2.11-3.19), heart Failure (OR: 6.72, 95% CI 3.34-13.52), arrhythmia (OR: 2.75, 95% CI 1.43-5.25), coronary artery disease (OR: 3.78, 95% CI 2.42-5.90), and cardiovascular disease (OR: 2.61, 95% CI 1.89-3.62) were significantly associated with mortality. Arrhythmia (OR: 7.03, 95% CI 2.79-17.69), acute cardiac injury (OR: 15.58, 95% CI 5.15-47.12), coronary heart disease (OR: 2.61, 95% CI 1.09-6.26), cardiovascular disease (OR: 3.11, 95% CI 1.59-6.09), and hypertension (OR: 1.95, 95% CI 1.41-2.68) were also significantly associated with ICU admission in COVID-19 patients. CONCLUSION Findings of this study revealed a high burden of CVDs among COVID-19 patients, which was significantly associated with mortality and ICU admission. Proper management of CVD patients with COVID-19 and monitoring COVID-19 patients for acute cardiac conditions is highly recommended to prevent mortality and critical situations.
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Affiliation(s)
- Amirhossein Hessami
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amir Shamshirian
- Gastrointestinal Cancer Research Center, Non-Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran; Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Science, Mazandaran University of Medical Sciences, Sari, Iran
| | - Keyvan Heydari
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Gastrointestinal Cancer Research Center, Non-Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Pourali
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran; Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Saeed Abrotan
- Department of Cardiology, Babol University of Medical Sciences, Babol, Iran
| | - Layla Shojaie
- Research Center for Liver Diseases, Keck School of Medicine, Departments of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sogol Sedighi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Danial Shamshirian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Abate SM, Mantefardo B, Nega S, Chekole YA, Basu B, Ali SA, Taddesse M. Global burden of acute myocardial injury associated with COVID-19: A systematic review, meta-analysis, and meta-regression. Ann Med Surg (Lond) 2021; 68:102594. [PMID: 34336202 PMCID: PMC8316689 DOI: 10.1016/j.amsu.2021.102594] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 12/12/2022] Open
Abstract
Background The body of evidence showed that there is a strong correlation between acute myocardial Injury and COVID-19 infection. However, the link between acute myocardial infection and COVID-19, the prevalence, reliability of diagnostic modalities, independent predictors, and clinical outcomes are still uncertain and a topic of debate. The current study was designed to determine the prevalence, determinants, and outcomes of acute myocardial injury based on a systematic review and meta-analysis the global published peer-reviewed works of literature. Methods A comprehensive search was conducted in PubMed/Medline; Science direct, CINHAL, and LILACS from December 2019 to May 2021. All observational studies reporting the prevalence of AMI were included while case reports and reviews were excluded. The data were extracted with two independent authors in a customized format. The methodological quality of included studies was evaluated using the Newcastle-Ottawa appraisal tool. Results A total of 397 articles were identified from different databases. Thirty-seven Articles with 21, 204 participants were included while seven studies were excluded. The meta-analysis revealed that the pooled prevalence of myocardial injury during the COVID-19 pandemic was 22.33 % (95 % CI: 17.86 to 26.81, 37). Conclusion Our meta-analysis showed that mortality among patients with an acute myocardial injury during COVID-19 was more than four times more likely as compared to those without AMI. This necessitates a mitigating strategy to prevent and manage before its clinical outcomes getting worse.
The meta-analysis revealed that more than one-fifth of patients with COVID-19 sustained AMI ∙The incidence of mortality among patients with AMI during COVID-19 pandemic was four times more likely as compared those without AMI ∙Prevalence of AMI was three times more likely in patients with history of Coronary artery disease ∙Smoking and hypertension were the independent predictors of acute myocardial Injury
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Affiliation(s)
- Semagn Mekonnen Abate
- Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Ethiopia
| | - Bahiru Mantefardo
- Departemnt of Internal Medicine, College of Health Sciences and Medicine, Dilla University, Ethiopia
| | - Solomon Nega
- Departemnt of Internal Medicine, College of Health Sciences and Medicine, Dilla University, Ethiopia
| | - Yigrem Ali Chekole
- Departemnt of Psychiatry, College of Health Sciences and Medicine, Dilla University, Ethiopia
| | - Bivash Basu
- Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Ethiopia
| | - Siraj Ahmed Ali
- Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Ethiopia
| | - Moges Taddesse
- Public Health, College of Health Sciences and Medicine, Dilla University, Ethiopia
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Rasheed A, Rayner KJ. Macrophage Responses to Environmental Stimuli During Homeostasis and Disease. Endocr Rev 2021; 42:407-435. [PMID: 33523133 PMCID: PMC8284619 DOI: 10.1210/endrev/bnab004] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Indexed: 12/20/2022]
Abstract
Work over the last 40 years has described macrophages as a heterogeneous population that serve as the frontline surveyors of tissue immunity. As a class, macrophages are found in almost every tissue in the body and as distinct populations within discrete microenvironments in any given tissue. During homeostasis, macrophages protect these tissues by clearing invading foreign bodies and/or mounting immune responses. In addition to varying identities regulated by transcriptional programs shaped by their respective environments, macrophage metabolism serves as an additional regulator to temper responses to extracellular stimuli. The area of research known as "immunometabolism" has been established within the last decade, owing to an increase in studies focusing on the crosstalk between altered metabolism and the regulation of cellular immune processes. From this research, macrophages have emerged as a prime focus of immunometabolic studies, although macrophage metabolism and their immune responses have been studied for centuries. During disease, the metabolic profile of the tissue and/or systemic regulators, such as endocrine factors, become increasingly dysregulated. Owing to these changes, macrophage responses can become skewed to promote further pathophysiologic changes. For instance, during diabetes, obesity, and atherosclerosis, macrophages favor a proinflammatory phenotype; whereas in the tumor microenvironment, macrophages elicit an anti-inflammatory response to enhance tumor growth. Herein we have described how macrophages respond to extracellular cues including inflammatory stimuli, nutrient availability, and endocrine factors that occur during and further promote disease progression.
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Affiliation(s)
- Adil Rasheed
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Katey J Rayner
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
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Salem AM, Al Khathlan N, Alharbi AF, Alghamdi T, AlDuilej S, Alghamdi M, Alfudhaili M, Alsunni A, Yar T, Latif R, Rafique N, Al Asoom L, Sabit H. The Long-Term Impact of COVID-19 Pneumonia on the Pulmonary Function of Survivors. Int J Gen Med 2021; 14:3271-3280. [PMID: 34267545 PMCID: PMC8276825 DOI: 10.2147/ijgm.s319436] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The sequelae of COVID-19 pneumonia on pulmonary function and airways inflammation are still an area of active research. OBJECTIVE This research aimed to explore the long-term impact of COVID-19 pneumonia on the lung function after three months from recovery. METHODS Fifty subjects (age 18-60 years) were recruited and classified into two groups: the control group (30 subjects) and the post-COVID-19 pneumonia group (20 patients). Pulmonary function tests, spirometry, body plethysmography [lung volumes and airway resistance (Raw)], diffusion capacity for carbon monoxide (DLCO), and fractional exhaled nitric oxide (FeNO), were measured after at least 3 months post-recovery. RESULTS Significant reduction in total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume (FEV1), FEV1/FEV, and diffusing capacity for carbon monoxide (DLCO) was observed in post-COVID-19 subjects compared to controls. Restrictive lung impairment was observed in 50% of post-COVID-19 cases (n = 10) compared to 20% in the control group (n = 6, P = 0.026). In addition, mild diffusion defect was detected in 35% (n = 7) of the post-COVID-19 group compared to 23.3% (n = 7) in the controls (P = 0.012). CONCLUSION COVID-19 pneumonia has an impact on the lung functions in terms of restrictive lung impairment and mild diffusion defect after three months from recovery. Therefore, a long-term follow-up of the lung function in post-COVID-19 survivors is recommended.
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Affiliation(s)
- Ayad Mohammed Salem
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Noor Al Khathlan
- Department of respiratory care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Turki Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saleh AlDuilej
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Majed Alfudhaili
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ahmed Alsunni
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Talay Yar
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rabia Latif
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nazish Rafique
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Lubna Al Asoom
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hussein Sabit
- Department of Genetics, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Cajanding RJM. Comprehensive Review of Cardiovascular Involvement in COVID-19. AACN Adv Crit Care 2021; 32:169-187. [PMID: 33836538 DOI: 10.4037/aacnacc2021302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
COVID-19 has emerged as one of the most devastating and clinically significant infectious diseases of the last decade. It has reached global pandemic status at an unprecedented pace and has placed significant demands on health care systems worldwide. Although COVID-19 primarily affects the lungs, epidemiologic reports have shown that the disease affects other vital organs of the body, including the heart, vasculature, kidneys, brain, and the hematopoietic system. Of importance is the emerging awareness of the effects of COVID-19 on the cardiovascular system. The current state of knowledge regarding cardiac involvement in COVID-19 is presented in this article, with particular focus on the cardiovascular manifestations and complications of COVID-19 infection. The mechanistic insights of disease causation and the relevant pathophysiology involved in COVID-19 as they affect the heart are explored and described. Relevant practice essentials and clinical management implications for patients with COVID-19 with a cardiac pathology are presented in light of recent evidence.
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Affiliation(s)
- Ruff Joseph Macale Cajanding
- Ruff Joseph Macale Cajanding is Charge Nurse, Adult Critical Care Unit, 6th Floor, King George V Building, St Bartholomew's Hospital, Barts Health NHS Trust, 2 King Edward Street, London EC1A 1HQ, United Kingdom
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Kirkup C, Pawlowski C, Puranik A, Conrad I, O'Horo JC, Gomaa D, Banner‐Goodspeed VM, Mosier JM, Zabolotskikh IB, Daugherty SK, Bernstein MA, Zaren HA, Bansal V, Pickering B, Badley AD, Kashyap R, Venkatakrishnan AJ, Soundararajan V. Healthcare disparities among anticoagulation therapies for severe COVID-19 patients in the multi-site VIRUS registry. J Med Virol 2021; 93:4303-4318. [PMID: 33666246 PMCID: PMC8013987 DOI: 10.1002/jmv.26918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 11/10/2022]
Abstract
Here we analyze hospitalized andintensive care unit coronavirus disease 2019 (COVID-19) patient outcomes from the international VIRUS registry (https://clinicaltrials.gov/ct2/show/NCT04323787). We find that COVID-19 patients administered unfractionated heparin but not enoxaparin have a higher mortality-rate (390 of 1012 = 39%) compared to patients administered enoxaparin but not unfractionated heparin (270 of 1939 = 14%), presenting a risk ratio of 2.79 (95% confidence interval [CI]: [2.42, 3.16]; p = 4.45e-52). This difference persists even after balancing on a number of covariates including demographics, comorbidities, admission diagnoses, and method of oxygenation, with an increased mortality rate on discharge from the hospital of 37% (268 of 733) for unfractionated heparin versus 22% (154 of 711) for enoxaparin, presenting a risk ratio of 1.69 (95% CI: [1.42, 2.00]; p = 1.5e-8). In these balanced cohorts, a number of complications occurred at an elevated rate for patients administered unfractionated heparin compared to patients administered enoxaparin, including acute kidney injury, acute cardiac injury, septic shock, and anemia. Furthermore, a higher percentage of Black/African American COVID patients (414 of 1294 [32%]) were noted to receive unfractionated heparin compared to White/Caucasian COVID patients (671 of 2644 [25%]), risk ratio 1.26 (95% CI: [1.14, 1.40]; p = 7.5e-5). After balancing upon available clinical covariates, this difference in anticoagulant use remained statistically significant (311 of 1047 [30%] for Black/African American vs. 263 of 1047 [25%] for White/Caucasian, p = .02, risk ratio 1.18; 95% CI: [1.03, 1.36]). While retrospective studies cannot suggest any causality, these findings motivate the need for follow-up prospective research into the observed racial disparity in anticoagulant use and outcomes for severe COVID-19 patients.
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Affiliation(s)
| | | | | | | | | | - Dina Gomaa
- University of CincinnatiCincinnatiOhioUSA
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Trapani S, Masiero L, Puoti F, Rota MC, Del Manso M, Lombardini L, Riccardo F, Amoroso A, Pezzotti P, Grossi PA, Brusaferro S, Cardillo M. Incidence and outcome of SARS-CoV-2 infection on solid organ transplantation recipients: A nationwide population-based study. Am J Transplant 2021; 21:2509-2521. [PMID: 33278850 PMCID: PMC9906464 DOI: 10.1111/ajt.16428] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/02/2020] [Accepted: 11/24/2020] [Indexed: 01/25/2023]
Abstract
Since February 21 2020, when the Italian National Institute of Health (Istituto Superiore di Sanità-ISS) reported the first autochthonous case of infection, a dedicated surveillance system for SARS-CoV-2-positive (COVID+) cases has been created in Italy. These data were cross-referenced with those inside the Information Transplant System in order to assess the cumulative incidence (CI) and the outcome of SARS-COV-2 infection in solid organ transplant recipients (SOTRs) who are assumed to be most at risk. We compared our results with those of COVID+ nontransplanted patients (Non-SOTRs) with follow-up through September 30, 2020. The CI of SARS-CoV-2 infection in SOTRs was 1.02%, higher than in COVID+ Non-SOTRs (0.4%, p < .05) with a greater risk in the Lombardy region (2.89%). The CI by type of organ transplant was higher for heart (CI 1.57%, incidence rate ratio [IRR] 1.36) and lower for liver (CI 0.63%, IRR 0.54). The 60-day CI of mortality was 30.6%, twice as much that of COVID+ Non-SOTRs (15.4%) with a 60-day gender and age adjusted odds ratio (adjusted-OR) of 3.83 for COVID+ SOTRs (95% confidence interval [3.03-4.85]). The lowest 60-day adjusted-OR was observed in liver SOTRs (OR 0.46, 95% confidence interval [0.25-0.86]). More detailed studies on disease management and evolution will be necessary in these patients at greater risk of COVID-19.
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Affiliation(s)
- Silvia Trapani
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy,Correspondence Silvia Trapani, Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy.
| | - Lucia Masiero
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Puoti
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Maria C. Rota
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Del Manso
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Letizia Lombardini
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Antonio Amoroso
- Department of Medical Sciences, University of Turin and University Hospital “Città della Salute e della Scienza” of Turin, Turin, Italy
| | - Patrizio Pezzotti
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Massimo Cardillo
- Italian National Transplant Center, Istituto Superiore di Sanità, Rome, Italy
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Johnsen S, Sattler SM, Miskowiak KW, Kunalan K, Victor A, Pedersen L, Andreassen HF, Jørgensen BJ, Heebøll H, Andersen MB, Marner L, Hædersdal C, Hansen H, Ditlev SB, Porsbjerg C, Lapperre TS. Descriptive analysis of long COVID sequelae identified in a multidisciplinary clinic serving hospitalised and non-hospitalised patients. ERJ Open Res 2021; 7:00205-2021. [PMID: 34345629 PMCID: PMC8091683 DOI: 10.1183/23120541.00205-2021] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/20/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There are emerging data of long-term effects of coronavirus disease 2019 (COVID-19) comprising a diversity of symptoms. The aim of this study was to systematically describe and measure pulmonary and extra-pulmonary post-COVID-19 complications in relation to acute COVID-19 severity. METHODS Patients attending a standard of care 3 months post-hospitalisation follow-up visit and those referred by their general practitioner because of persistent post-COVID-19 symptoms were included. Patients underwent symptomatic, quality of life, pulmonary (lung function and high-resolution computed tomography (HRCT)), cardiac (high-resolution ECG), physical (1-min sit and stand test (1-MSTST), handgrip strength, cardiopulmonary exercise testing (CPET)) and cognitive evaluations. RESULTS All 34 hospitalised and 22 out of 23 non-hospitalised patients had ≥1 complaint or abnormal finding at follow-up. Overall, 67% of patients were symptomatic (Medical Research Council (MRC) ≥2 or COPD assessment test (CAT) ≥10), with no difference between hospitalised versus non-hospitalised patients. Pulmonary function (forced expiratory volume in 1 s (FEV1) or diffusing capacity of the lung for carbon monoxide (D LCO)) <80% of predicted) was impaired in 68% of patients. D LCO was significantly lower in those hospitalised compared to non-hospitalised (70.1±18.0 versus 80.2±11.2% predicted, p=0.02). Overall, 53% had an abnormal HRCT (predominantly ground-glass opacities) with higher composite computed tomography (CT) scores in hospitalised versus non-hospitalised patients (2.3 (0.1-4.8) and 0.0 (0.0-0.3), p<0.001). 1-MSTST was below the 25th percentile in almost half of patients, but no signs of cardiac dysfunction were found. Cognitive impairments were present in 59-66% of hospitalised and 31-44% of non-hospitalised patients (p=0.08). CONCLUSION Three months after COVID-19 infection, patients were still symptomatic and demonstrated objective respiratory, functional, radiological and cognitive abnormalities, which were more prominent in hospitalised patients. Our study underlines the importance of multidimensional management strategies in these patients.
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Affiliation(s)
- Stine Johnsen
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
- These authors contributed equally
| | - Stefan M. Sattler
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
- Biomedical Institute, Copenhagen University, Copenhagen, Denmark
- These authors contributed equally
| | | | - Keerthana Kunalan
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
| | - Alan Victor
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
| | - Lars Pedersen
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
| | - Helle Frost Andreassen
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
| | | | - Hanne Heebøll
- Dept of Radiology, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
| | - Michael Brun Andersen
- Dept of Radiology, Copenhagen University Hospital at Herlev/Gentofte, Copenhagen, Denmark
| | - Lisbeth Marner
- Dept of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital at Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Carsten Hædersdal
- Dept of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital at Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Henrik Hansen
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital at Hvidovre, Copenhagen, Denmark
| | - Sisse Bolm Ditlev
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
| | - Celeste Porsbjerg
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
- Respiratory Research Unit, Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
| | - Thérèse S. Lapperre
- Dept of Respiratory Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
- Dept of Pulmonology, University Hospital Antwerp, Antwerp, Belgium
- Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Antwerp, Belgium
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Nuthalapati P, Ghanta MK, Natesh NS, L.V.K.S. B. Association of hypercoagulation with severe acute respiratory syndrome coronavirus 2 infection. Blood Res 2021; 56:61-64. [PMID: 34083499 PMCID: PMC8246040 DOI: 10.5045/br.2021.2021011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 01/12/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has emerged as a major threat to all healthcare systems across the globe, and it was declared a public health emergency of international concern by the World Health Organization (WHO). The novel coronavirus affects the respiratory system, producing symptoms such as fever, cough, dyspnea, and pneumonia. The association between COVID-19 and coagulation has been previously reported. Due to several inflammatory changes that occur in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections such as alterations in the levels of clotting factors, platelet activation leads to thrombus formation in coronary and cerebral vessels, leading to myocardial infarction and cerebrovascular accidents, respectively. Unfortunately, the progression of hypercoagulability in COVID-19 is rapid in patients with and without comorbidities. Hence, the proper monitoring of thrombotic complications in patients with COVID-19 is essential to avoid further complications. The implementation of guidelines for antithrombotic treatments based on the presentation of the disease is recommended. This review discusses the symptoms and mechanisms of upregulated coagulation in patients with COVID-19.
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Affiliation(s)
| | | | | | - Bhaskar L.V.K.S.
- Department of Zoology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
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Farrag MA, Amer HM, Bhat R, Hamed ME, Aziz IM, Mubarak A, Dawoud TM, Almalki SG, Alghofaili F, Alnemare AK, Al-Baradi RS, Alosaimi B, Alturaiki W. SARS-CoV-2: An Overview of Virus Genetics, Transmission, and Immunopathogenesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6312. [PMID: 34200934 PMCID: PMC8296125 DOI: 10.3390/ijerph18126312] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022]
Abstract
The human population is currently facing the third and possibly the worst pandemic caused by human coronaviruses (CoVs). The virus was first reported in Wuhan, China, on 31 December 2019 and spread within a short time to almost all countries of the world. Genome analysis of the early virus isolates has revealed high similarity with SARS-CoV and hence the new virus was officially named SARS-CoV-2. Since CoVs have the largest genome among all RNA viruses, they can adapt to many point mutation and recombination events; particularly in the spike gene, which enable these viruses to rapidly change and evolve in nature. CoVs are known to cross the species boundaries by using different cellular receptors. Both animal reservoir and intermediate host for SARS-CoV-2 are still unresolved and necessitate further investigation. In the current review, different aspects of SARS-CoV-2 biology and pathogenicity are discussed, including virus genetics and evolution, spike protein and its role in evolution and adaptation to novel hosts, and virus transmission and persistence in nature. In addition, the immune response developed during SARS-CoV-2 infection is demonstrated with special reference to the interplay between immune cells and their role in disease progression. We believe that the SARS-CoV-2 outbreak will not be the last and spillover of CoVs from bats will continue. Therefore, establishing intervention approaches to reduce the likelihood of future CoVs spillover from natural reservoirs is a priority.
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Affiliation(s)
- Mohamed A. Farrag
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.F.); (R.B.); (M.E.H.); (I.M.A.); (A.M.); (T.M.D.)
| | - Haitham M. Amer
- Department of Virology, Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt;
| | - Rauf Bhat
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.F.); (R.B.); (M.E.H.); (I.M.A.); (A.M.); (T.M.D.)
| | - Maaweya E. Hamed
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.F.); (R.B.); (M.E.H.); (I.M.A.); (A.M.); (T.M.D.)
| | - Ibrahim M. Aziz
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.F.); (R.B.); (M.E.H.); (I.M.A.); (A.M.); (T.M.D.)
| | - Ayman Mubarak
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.F.); (R.B.); (M.E.H.); (I.M.A.); (A.M.); (T.M.D.)
| | - Turki M Dawoud
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (M.A.F.); (R.B.); (M.E.H.); (I.M.A.); (A.M.); (T.M.D.)
| | - Sami G Almalki
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah 11952, Saudi Arabia; (S.G.A.); (F.A.); (R.S.A.-B.)
| | - Fayez Alghofaili
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah 11952, Saudi Arabia; (S.G.A.); (F.A.); (R.S.A.-B.)
| | - Ahmad K. Alnemare
- Otolaryngology Department, College of Medicine, Majmaah University, Majmaah 11952, Saudi Arabia;
| | - Raid Saleem Al-Baradi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah 11952, Saudi Arabia; (S.G.A.); (F.A.); (R.S.A.-B.)
| | - Bandar Alosaimi
- Research Center, King Fahad Medical City, Riyadh 11525, Saudi Arabia;
| | - Wael Alturaiki
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah 11952, Saudi Arabia; (S.G.A.); (F.A.); (R.S.A.-B.)
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An X, Duan L, Zhang YH, Jin D, Zhao S, Zhou RR, Duan Y, Lian F, Tong X. The three syndromes and six Chinese patent medicine study during the recovery phase of COVID-19. Chin Med 2021; 16:44. [PMID: 34099015 PMCID: PMC8182732 DOI: 10.1186/s13020-021-00454-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), first broke out in Wuhan, China, in 2019. SARS-CoV-2 develops many types of mutations (such as B.1.1.7), making diagnosis and treatment challenging. Although we now have a preliminary understanding of COVID-19, including pathological changes, clinical manifestations, and treatment measures, we also face new difficulties. The biggest problem is that most COVID-19 patients might face sequelae (e.g., fatigue, sleep disturbance, pulmonary fibrosis) during the recovery phase. We aimed to test six Chinese patent medicines to treat three major abnormal symptoms in COVID-19 patients during the recovery phase, including cardiopulmonary function, sleep disturbance, and digestive function. We launched the "three syndromes and six Chinese patent medicines" randomized, double-blind, placebo-controlled, multicenter clinical trial on April 10, 2020. The results showed that Jinshuibao tablets and Shengmaiyin oral liquid significantly improved the cardiopulmonary function of recovering COVID-19 patients. Shumian capsules, but not Xiaoyao capsules, significantly improved patients' sleep disorders. This might be because the indication of Xiaoyao capsules is liver qi stagnation rather than psychological or emotional problems. Xiangsha Liujun pills and Ludangshen oral liquid significantly improved digestive function. Our research provides a guideline for treating COVID-19 sequelae in patients during the recovery period based on high-quality evidence.
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Affiliation(s)
- Xuedong An
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Liyun Duan
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yue Hong Zhang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - De Jin
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Shenghui Zhao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Rong Rong Zhou
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yingying Duan
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Fengmei Lian
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Xiaolin Tong
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
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Lu J, Lin J, Yin L, Shi R, Li H, Ge Y, Luo J. Using remote consultation to enhance diagnostic accuracy of bedside transthoracic echocardiography during COVID-19 pandemic. Echocardiography 2021; 38:1245-1253. [PMID: 34056743 PMCID: PMC8239538 DOI: 10.1111/echo.15124] [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: 02/26/2021] [Revised: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this study was to evaluate the clinical significance of remote consultation over bedside transthoracic echocardiography (RC‐B‐TTE) for patients with coronavirus disease 2019 (COVID‐19). Methods Five frontline echocardiographers performed and interpreted B‐TTE for 30 patients with COVID‐19 in the isolation wards, and the on‐site B‐TTE reports (OSR) were generated. Then remote consultation over the 30 B‐TTE studies was conducted by two experienced echocardiographic consultants while blinded to the OSR, and the corresponding remote consultation reports (RCR) were generated. Subsequently, the five frontline echocardiographers were convened together to discuss the difference between the OSR and RCR, and to confirm the correct interpretation and the misdiagnosis using a “majority‐vote” consensus as the diagnostic “gold standard”. Afterwards the reasons for the misdiagnosis were given by the frontline echocardiographers themselves. The inter‐rater agreement between the OSR and the “gold standard” was assessed using Kappa coefficient and percent agreement. Results Complete correctness of the 30 copies of the RCR were determined by the 5 frontline echocardiographers. The reliability of the OSR in the findings of cardiac chamber dilation, left ventricular hypertrophy and pulmonary hypertension were weak (Kappa <0.6). The reliability of the OSR in the recognition of major cardiac abnormalities was very weak (Kappa =0.304, percent agreement =63.3%). Misdiagnosis of major abnormalities was found in 11 copies of OSR (11/30, 36.7%). Conclusions The protocol of RC‐B‐TTE has shown noticeable superiority in ameliorating diagnostic accuracy of echocardiography, which should be generalized to clinical practice during the COVID‐19 or similar pandemic.
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Affiliation(s)
- Jing Lu
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Lin
- Department of Ultrasonography, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Lixue Yin
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.,Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Chengdu, China
| | - Rui Shi
- Department of Ultrasonography, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Huanxing Li
- Department of Ultrasonography, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Yang Ge
- Department of Ultrasonography, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Jing Luo
- Department of Ultrasonography, Public Health Clinical Center of Chengdu, Chengdu, China
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Fakhri S, Nouri Z, Moradi SZ, Akkol EK, Piri S, Sobarzo-Sánchez E, Farzaei MH, Echeverría J. Targeting Multiple Signal Transduction Pathways of SARS-CoV-2: Approaches to COVID-19 Therapeutic Candidates. Molecules 2021; 26:2917. [PMID: 34068970 PMCID: PMC8156180 DOI: 10.3390/molecules26102917] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
Due to the complicated pathogenic pathways of coronavirus disease 2019 (COVID-19), related medicinal therapies have remained a clinical challenge. COVID-19 highlights the urgent need to develop mechanistic pathogenic pathways and effective agents for preventing/treating future epidemics. As a result, the destructive pathways of COVID-19 are in the line with clinical symptoms induced by severe acute coronary syndrome (SARS), including lung failure and pneumonia. Accordingly, revealing the exact signaling pathways, including inflammation, oxidative stress, apoptosis, and autophagy, as well as relative representative mediators such as tumor necrosis factor-α (TNF-α), nuclear factor erythroid 2-related factor 2 (Nrf2), Bax/caspases, and Beclin/LC3, respectively, will pave the road for combating COVID-19. Prevailing host factors and multiple steps of SARS-CoV-2 attachment/entry, replication, and assembly/release would be hopeful strategies against COVID-19. This is a comprehensive review of the destructive signaling pathways and host-pathogen interaction of SARS-CoV-2, as well as related therapeutic targets and treatment strategies, including potential natural products-based candidates.
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Affiliation(s)
- Sajad Fakhri
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran; (S.F.); (S.Z.M.); (S.P.)
| | - Zeinab Nouri
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah 6714415153, Iran;
| | - Seyed Zachariah Moradi
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran; (S.F.); (S.Z.M.); (S.P.)
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Esra Küpeli Akkol
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Etiler, Ankara 06330, Turkey;
| | - Sana Piri
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran; (S.F.); (S.Z.M.); (S.P.)
| | - Eduardo Sobarzo-Sánchez
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
- Department of Organic Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Mohammad Hosein Farzaei
- Medical Technology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Javier Echeverría
- Departamento de Ciencias del Ambiente, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago 9170022, Chile
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Ugur M, Adiyeke E, Recep E, Bakan N, Yiyit N. Aggressive Thromboprophylaxis Improves Clinical Process and Decreases the Need of Intensive Care Unit in Covid-19. Pak J Med Sci 2021; 37:668-674. [PMID: 34104145 PMCID: PMC8155448 DOI: 10.12669/pjms.37.3.3687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/15/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES COVID-19 might cause thrombosis in the arterial and venous system either directly or via indirect means such as cytokine storm or hypoxia. Enoxaparin might contribute to clinical recovery in COVID-19 patients, both by reducing the risk of thrombosis with anticoagulant effect and avoiding the cytokine storm with its anti-inflammatory effect. In this study, the clinical results of prophylactic enoxaparin usage in COVID-19 patients in our hospital were investigated. METHODS We retrospectively analyzed the patients who had hospitalized in our hospital with the diagnosis of COVID-19 between March 12 and April 17, 2020. Patients were divided into two groups according to their clinical status. Patients who were discharged to their home were in Group-I and were transferred to intensive care unit (ICU) were in Group-II. Patients' demographics and laboratory examinations were compared between the groups. Then the effect of LMWH treatment in the rate of ICU transfer was evaluated. RESULTS There were 1216 hospitalized patients with COVID-19 in the study period. Increased age, levels of D-Dimer and fibrinogen and decreased hemoglobin, platelet, lymphocyte values were found to be statistically significantly risk factor for the need of ICU. Transfer rates of ICU were two times more in the patients who did not used enoxaparin and readmission after the discharge was higher in the patients who did not received enoxaparin in the hospital. CONCLUSION Enoxaparin treatment in COVID-19 might be effective not only anticoagulant effect but also anti-inflammatory effect that decreased the risk cytokine storm. In the patients with COVID-19 disease, starting enoxaparin treatment in the earlier stage will decrease the risk of microthrombosis in vital organs and might improve the clinical outcomes.
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Affiliation(s)
- Murat Ugur
- Murat Ugur, Department of Cardiovascular Surgery, Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Esra Adiyeke
- Esra Adiyeke, Department of Anesthesiology and Reanimation, Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Eymen Recep
- Eymen Recep, Department of Cardiovascular Surgery, Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Nurten Bakan
- Nurten Bakan, Department of Anesthesiology and Reanimation, Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Nurettin Yiyit
- Nurettin Yiyit, Department of Thoracic Surgery, Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Istanbul, Turkey
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46
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Perez-Bermejo JA, Kang S, Rockwood SJ, Simoneau CR, Joy DA, Silva AC, Ramadoss GN, Flanigan WR, Fozouni P, Li H, Chen PY, Nakamura K, Whitman JD, Hanson PJ, McManus BM, Ott M, Conklin BR, McDevitt TC. SARS-CoV-2 infection of human iPSC-derived cardiac cells reflects cytopathic features in hearts of patients with COVID-19. Sci Transl Med 2021; 13:eabf7872. [PMID: 33723017 PMCID: PMC8128284 DOI: 10.1126/scitranslmed.abf7872] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/23/2021] [Accepted: 03/10/2021] [Indexed: 12/15/2022]
Abstract
Although coronavirus disease 2019 (COVID-19) causes cardiac dysfunction in up to 25% of patients, its pathogenesis remains unclear. Exposure of human induced pluripotent stem cell (iPSC)-derived heart cells to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) revealed productive infection and robust transcriptomic and morphological signatures of damage, particularly in cardiomyocytes. Transcriptomic disruption of structural genes corroborates adverse morphologic features, which included a distinct pattern of myofibrillar fragmentation and nuclear disruption. Human autopsy specimens from patients with COVID-19 reflected similar alterations, particularly sarcomeric fragmentation. These notable cytopathic features in cardiomyocytes provide insights into SARS-CoV-2-induced cardiac damage, offer a platform for discovery of potential therapeutics, and raise concerns about the long-term consequences of COVID-19 in asymptomatic and severe cases.
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Affiliation(s)
| | - Serah Kang
- Gladstone Institutes, San Francisco, CA 94158, USA
| | | | - Camille R Simoneau
- Gladstone Institutes, San Francisco, CA 94158, USA
- Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA 94158, USA
| | - David A Joy
- Gladstone Institutes, San Francisco, CA 94158, USA
- UC Berkeley-UCSF Joint Program in Bioengineering, Berkeley, CA 94720, USA
| | - Ana C Silva
- Gladstone Institutes, San Francisco, CA 94158, USA
| | - Gokul N Ramadoss
- Gladstone Institutes, San Francisco, CA 94158, USA
- Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Will R Flanigan
- Gladstone Institutes, San Francisco, CA 94158, USA
- UC Berkeley-UCSF Joint Program in Bioengineering, Berkeley, CA 94720, USA
| | - Parinaz Fozouni
- Gladstone Institutes, San Francisco, CA 94158, USA
- Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Huihui Li
- Gladstone Institutes, San Francisco, CA 94158, USA
| | - Pei-Yi Chen
- Gladstone Institutes, San Francisco, CA 94158, USA
| | - Ken Nakamura
- Gladstone Institutes, San Francisco, CA 94158, USA
- Department of Neurology, UCSF, San Francisco, CA 94143, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, UCSF, San Francisco, CA 94143, USA
| | - Paul J Hanson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada
| | - Bruce M McManus
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada
| | - Melanie Ott
- Gladstone Institutes, San Francisco, CA 94158, USA.
- Department of Medicine, UCSF, San Francisco, CA 94143, USA
| | - Bruce R Conklin
- Gladstone Institutes, San Francisco, CA 94158, USA.
- Department of Medicine, UCSF, San Francisco, CA 94143, USA
- Innovative Genomics Institute, Berkeley, CA 94704, USA
- Department of Ophthalmology, UCSF, San Francisco, CA 94158, USA
| | - Todd C McDevitt
- Gladstone Institutes, San Francisco, CA 94158, USA.
- Department of Bioengineering and Therapeutic Sciences, UCSF, San Francisco, CA 94158, USA
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47
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Egbuche O, Jegede O, Abe T, Wagle B, Huynh K, Hayes D, Campbell ML, Mezue K, Ram P, Nwokike SI, Desai R, Effoe V, Kpodonu J, Morgan J, Ofili E, Onwuanyi A, Echols MR. Pre-existing cardiovascular disease, acute kidney injury, and cardiovascular outcomes in hospitalized blacks with COVID-19 infection. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2021; 11:212-221. [PMID: 34084656 PMCID: PMC8166582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The Corona Virus 19 (COVID-19) infection is associated with worse outcomes in blacks, although the mechanisms are unclear. We sought to determine the significance of black race, pre-existing cardiovascular disease (pCVD), and acute kidney injury (AKI) on cardiopulmonary outcomes and in-hospital mortality of COVID-19 patients. METHODS We conducted a retrospective cohort study of blacks with/without pCVD and with/without in-hospital AKI, hospitalized within Grady Memorial Hospital in Georgia between February and July 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on qualitative polymerase-chain-reaction assay. The primary outcome was a composite of in-hospital cardiac events. RESULTS Of the 293 patients hospitalized with COVID-19 in this study, 71 were excluded from the primary analysis (for race/ethnicity other than black non-Hispanic). Of the 222 hospitalized COVID-19 patients included in our analyses, 41.4% were female, 78.8% had pCVD, and 30.6% developed AKI during the admission. In multivariable analyses, pCVD (OR 4.7, 95% CI 1.5-14.8, P=0.008) and AKI (OR 2.7, 95% CI 1.3-5.5, P=0.006) were associated with increased odds of in-hospital cardiac events. AKI was associated with increased odds of in-hospital mortality (OR 8.9, 95% CI 3.3-23.9, P<0.0001). The presence of AKI was associated with increased odds of ICU stay, mechanical ventilation, and acute respiratory distress syndrome (ARDS). CONCLUSION pCVD and AKI were associated with higher risk of in-hospital cardiac events, and AKI was associated with a higher risk of in-hospital mortality in blacks.
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Affiliation(s)
- Obiora Egbuche
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Opeyemi Jegede
- Department of Biostatistics and Epidemiology, University of North Texas Health Science CenterFort-Worth, TX 76107, USA
| | - Temidayo Abe
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Bivek Wagle
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Ky Huynh
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Dolphurs Hayes
- Department of Internal Medicine, Morehouse School of MedicineAtlanta, GA 30310, USA
| | | | - Kenechukwu Mezue
- Division of Nuclear Cardiology, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA 02114, USA
| | - Pradhum Ram
- Division of Cardiovascular Disease, Emory University School of MedicineAtlanta, GA 30322, USA
| | - Shirley I Nwokike
- Department of Internal Medicine, Medical College of GeorgiaAugusta, GA 30912, USA
| | - Rupak Desai
- Division of Cardiovascular Disease, Atlanta VA Medical CenterDecatur, GA 30033, USA
| | - Valery Effoe
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Jacques Kpodonu
- Division of Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical SchoolBoston, MA 02215, USA
| | - Jayne Morgan
- Division of Quality and Safety, Piedmont Healthcare, Inc.Atlanta, GA 30309, USA
| | - Elizabeth Ofili
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Anekwe Onwuanyi
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
| | - Melvin R Echols
- Division of Cardiovascular Disease, Morehouse School of MedicineAtlanta, GA 30310, USA
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48
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Troisi J, Venutolo G, Pujolassos Tanyà M, Delli Carri M, Landolfi A, Fasano A. COVID-19 and the gastrointestinal tract: Source of infection or merely a target of the inflammatory process following SARS-CoV-2 infection? World J Gastroenterol 2021; 27:1406-1418. [PMID: 33911464 PMCID: PMC8047540 DOI: 10.3748/wjg.v27.i14.1406] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal (GI) symptoms have been described in a conspicuous percentage of coronavirus disease 2019 (COVID-19) patients. This clinical evidence is supported by the detection of viral RNA in stool, which also supports the hypothesis of a possible fecal-oral transmission route. The involvement of GI tract in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is corroborated by the theoretical assumption that angiotensin converting enzyme 2, which is a SARS-CoV-2 target receptor, is present along the GI tract. Studies have pointed out that gut dysbiosis may occur in COVID-19 patients, with a possible correlation with disease severity and with complications such as multisystem inflammatory syndrome in children. However, the question to be addressed is whether dysbiosis is a consequence or a contributing cause of SARS-CoV-2 infection. In such a scenario, pharmacological therapies aimed at decreasing GI permeability may be beneficial for COVID-19 patients. Considering the possibility of a fecal-oral transmission route, water and environmental sanitation play a crucial role for COVID-19 containment, especially in developing countries.
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Affiliation(s)
- Jacopo Troisi
- Metabolomics Section, Theoreo srl - Spin-off Company of the University of Salerno, Montecorvino Pugliano 84090, SA, Italy
- Department of Chemistry and Biology “A. Zambelli”, University of Salerno, Fisciano 84084, SA, Italy
- European Biomedical Research Institute of Salerno, Salerno 84125, SA, Italy
| | - Giorgia Venutolo
- European Biomedical Research Institute of Salerno, Salerno 84125, SA, Italy
| | - Meritxell Pujolassos Tanyà
- Metabolomics Section, Theoreo srl - Spin-off Company of the University of Salerno, Montecorvino Pugliano 84090, SA, Italy
| | - Matteo Delli Carri
- Metabolomics Section, Theoreo srl - Spin-off Company of the University of Salerno, Montecorvino Pugliano 84090, SA, Italy
- Department of Chemistry and Biology “A. Zambelli”, University of Salerno, Fisciano 84084, SA, Italy
| | - Annamaria Landolfi
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi 84081, SA, Italy
| | - Alessio Fasano
- European Biomedical Research Institute of Salerno, Salerno 84125, SA, Italy
- Mucosal Immunology and Biology Research Center and Center for Celiac Research, Harvard Medical School, Massachusetts Gen Hosp Children, Mucosal Immunology and Biology Research Center, Boston, MA 02114, United States
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49
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Wang XT, Peng Z, An YY, Shang T, Xiao G, He S, Chen X, Zhang H, Wang Y, Wang T, Zhang JH, Gao X, Zhu Y, Feng Y. Paeoniflorin and Hydroxysafflor Yellow A in Xuebijing Injection Attenuate Sepsis-Induced Cardiac Dysfunction and Inhibit Proinflammatory Cytokine Production. Front Pharmacol 2021; 11:614024. [PMID: 33986658 PMCID: PMC8112230 DOI: 10.3389/fphar.2020.614024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022] Open
Abstract
Sepsis-induced myocardial dysfunction is a major contributor to the poor outcomes of septic shock. As an add-on with conventional sepsis management for over 15 years, the effect of Xuebijing injection (XBJ) on the sepsis-induced myocardial dysfunction was not well understood. The material basis of Xuebijing injection (XBJ) in managing infections and infection-related complications remains to be defined. A murine cecal ligation and puncture (CLP) model and cardiomyocytes in vitro culture were adopted to study the influence of XBJ on infection-induced cardiac dysfunction. XBJ significantly improved the survival of septic-mice and rescued cardiac dysfunction in vivo. RNA-seq revealed XBJ attenuated the expression of proinflammatory cytokines and related signalings in the heart which was further confirmed on the mRNA and protein levels. Xuebijing also protected cardiomyocytes from LPS-induced mitochondrial calcium ion overload and reduced the LPS-induced ROS production in cardiomyocytes. The therapeutic effect of XBJ was mediated by the combination of paeoniflorin and hydroxysafflor yellow A (HSYA) (C0127-2). C0127-2 improved the survival of septic mice, protected their cardiac function and cardiomyocytes while balancing gene expression in cytokine-storm-related signalings, such as TNF-α and NF-κB. In summary, Paeoniflorin and HSYA are key active compounds in XBJ for managing sepsis, protecting cardiac function, and controlling inflammation in the cardiac tissue partially by limiting the production of IL-6, IL-1β, and CXCL2.
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Affiliation(s)
- Xin-Tong Wang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
| | - Zhen Peng
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
| | - Ying-Ying An
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
| | - Ting Shang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
| | - Guangxu Xiao
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
| | - Shuang He
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
| | - Xi Chen
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Han Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuefei Wang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tao Wang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jun-Hua Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiumei Gao
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yan Zhu
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
| | - Yuxin Feng
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and Medicine, Tianjin, China
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50
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Cao Q, Lei H, Yang M, Wei L, Dong Y, Xu J, Nasser M, Liu M, Zhu P, Xu L, Zhao M. Impact of Cardiovascular Diseases on COVID-19: A Systematic Review. Med Sci Monit 2021; 27:e930032. [PMID: 33820904 PMCID: PMC8035813 DOI: 10.12659/msm.930032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In December 2019, pneumonia of unknown cause broke out, and currently more than 150 countries around the world have been affected. Globally, as of 5: 46 pm CET, 6 November 2020, the World Health Organization (WHO) had reported 48 534 508 confirmed cases of COVID-19, including 1 231 017 deaths. The novel coronavirus disease (COVID-19) outbreak, caused by the SARS-CoV-2 virus, is the most important medical challenge in decades. Previous research mainly focused on the exploration of lung changes. However, with development of the disease and deepening research, more and more patients showed cardiovascular diseases, even in those without respiratory symptoms, and some researchers have found that underlying cardiovascular diseases increase the risk of infection. Although the related mechanism is not thoroughly studied, based on existing research, we speculate that the interaction between the virus and its receptor, inflammatory factors, various forms of the stress response, hypoxic environment, and drug administration could all induce the development of cardiac adverse events. Interventions to control these pathogenic factors may effectively reduce the occurrence of cardiovascular complications. This review summarizes the latest research on the relationship between COVID-19 and its associated cardiovascular complications, and we also explore possible mechanisms and treatments.
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Affiliation(s)
- Qingtai Cao
- Hunan Normal University School of Medicine, Changsha, Hunan, China (mainland)
| | - HanYu Lei
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Xiangya School of Medicine, Central South University, Changsha, Hunan, China (mainland)
| | - MengLing Yang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Xiangya School of Medicine, Central South University, Changsha, Hunan, China (mainland)
| | - Le Wei
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Xiangya School of Medicine, Central South University, Changsha, Hunan, China (mainland)
| | - YinMiao Dong
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - JiaHao Xu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Xiangya School of Medicine, Central South University, Changsha, Hunan, China (mainland)
| | - Mi Nasser
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - MengQi Liu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland).,Xiangya School of Medicine, Central South University, Changsha, Hunan, China (mainland)
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China (mainland)
| | - LinYong Xu
- School of Life Science, Central South University, Changsha, Hunan, China (mainland)
| | - MingYi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
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