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Rodrigues NCP, Andrade MKDN. Evaluation of post-COVID mortality risk in cases classified as severe acute respiratory syndrome in Brazil: a longitudinal study for medium and long term. Front Med (Lausanne) 2024; 11:1495428. [PMID: 39744527 PMCID: PMC11688282 DOI: 10.3389/fmed.2024.1495428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 12/05/2024] [Indexed: 01/31/2025] Open
Abstract
Background There are few studies in the literature evaluating post-COVID mortality in Brazil, along medium and long term, especially in those who presented severe clinical disease. Objective This study aims to investigate the factors associated with post-COVID mortality of severe acute respiratory syndrome (SARS) cases from 2020 to 2023 in Brazil, along medium and long term. Methods Retrospective cohort study using notification data of SARS classified as COVID-19 from the Brazilian National Information System, "Sistema de Vigilância Epidemiológica (SIVEP)," during the period 2020 to 2023. Data included demographics, comorbidities, vaccination status, number of COVID-19 vaccine doses, city of residence, and survival outcomes. Classic Cox, Cox mixed effects, and Cox fragility models were used to assess medium and long-term risks of dying post-COVID. Results In the medium and long-term periods studied, 5,157 deaths were recorded out of 15,147 reported SARS/COVID-19 cases. Of these deaths, 91.5% (N = 4,720) occurred within the first year, while 8,5% (N = 437) after the first year. People without formal education, the older adult, had higher percentages of deaths in both periods. In the medium-term post-COVID period, the risk of death was reduced by 8% for those who had been vaccinated while in the long-term post-COVID period, the risk of death almost doubled for those who had been vaccinated. While in the medium term, there was a reduction in mortality risk for those who took two or three doses, in the long term the risk of death was greater for those who took one or two doses. Conclusion The protective effect of COVID-19 immunization was observed up to one year after the first symptoms. After one year, the effect was reversed, showing an increased risk of death for those vaccinated. These results highlight the need for further research to elucidate the factors that contribute to these findings.
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Affiliation(s)
- Nádia Cristina Pinheiro Rodrigues
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde/Escola Nacional de Saúde Pública Sérgio Arouca/Fundação Oswaldo Cruz, Rio de Janeiro/Brasil and Departamento de Epidemiologia/Instituto de Medicina Social Hesio Cordeiro/Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Kramer de Noronha Andrade
- Programa Academico de Tuberculose/Faculdade de Medicina/Instituto de Doenças do Torax/Hospital Universitário Clementino Fraga Filho/ Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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2
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Wang Q, Wei J, He J, Ming S, Li X, Huang X, Hong Z, Wu Y. HSP70 contributes to pathogenesis of fulminant hepatitis induced by coronavirus. Int Immunopharmacol 2024; 141:112963. [PMID: 39159560 DOI: 10.1016/j.intimp.2024.112963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/07/2024] [Accepted: 08/15/2024] [Indexed: 08/21/2024]
Abstract
Fulminant viral hepatitis (FH) represents a significant clinical challenge, with its pathogenesis not yet fully elucidated. Heat shock protein (HSP)70, a molecular chaperone protein with a broad range of cytoprotective functions, is upregulated in response to stress. However, the role of HSP70 in FH remains to be investigated. Notably, HSP70 expression is upregulated in the livers of coronavirus-infected mice and patients. Therefore, we investigated the mechanistic role of HSP70 in coronavirus-associated FH pathogenesis. FH was induced in HSP70-deficient (HSP70 KO) mice or in WT mice treated with the HSP70 inhibitor VER155008 when infected with the mouse hepatitis virus strain A59 (MHV-A59). MHV-A59-infected HSP70 KO mice exhibited significantly reduced liver damage and mortality. This effect was attributed to decreased infiltration of monocyte-macrophages and neutrophils in the liver of HSP70 KO mice, resulting in lower levels of inflammatory cytokines such as IL-1β, TNFα, and IL-6, and a reduced viral load. Moreover, treatment with the HSP70 inhibitor VER155008 protected mice from MHV-A59-induced liver damage and FH mortality. In summary, HSP70 promotes coronavirus-induced FH pathogenesis by enhancing the infiltration of monocyte-macrophages and neutrophils and promoting the secretion of inflammatory cytokines. Therefore, HSP70 is a potential therapeutic target in viral FH intervention.
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Affiliation(s)
- Qiaohua Wang
- Center for Infection and Immunity, Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China
| | - Jiayou Wei
- Center for Infection and Immunity, Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China
| | - Jianzhong He
- Department of Pathology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China
| | - Siqi Ming
- Department of Laboratory Medicine, Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, Guangdong Province 519015, China
| | - Xingyu Li
- Center for Infection and Immunity, Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China
| | - Xi Huang
- Center for Infection and Immunity, Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China
| | - Zhongsi Hong
- Center of Infectious Disease, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China; Key Laboratory of Traditional Chinese Medicine for the Prevention and Treatment of Infectious Diseases, Traditional Chinese Medicine Bureau of Guangdong Province, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China.
| | - Yongjian Wu
- Center for Infection and Immunity, Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong Province 519000, China; Key Laboratory of Traditional Chinese Medicine for the Prevention and Treatment of Infectious Diseases, Traditional Chinese Medicine Bureau of Guangdong Province, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China.
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Lovero R, Charitos IA, Topi S, Castellaneta F, Cazzolla AP, Colella M. Current Views About the Link between SARS-CoV-2 and the Liver: Friends or Foe? Endocr Metab Immune Disord Drug Targets 2024; 24:642-650. [PMID: 37846575 DOI: 10.2174/0118715303251985231009050626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023]
Abstract
The emergence of the novel coronavirus and the pandemic resulting from its spread have led to significant negative impacts on health, economy, relationships, and others. Particularly in the field of hospital care, the need for a greater number of patients has led to a breakdown of the system. Gastrointestinal manifestations are common in SARS-COV 2 patients, while 10% of those who are sick exhibit symptoms only from gastrointestinal without any manifestation on the part of the respiratory tract. The main manifestations are nausea, vomiting, diarrhoea, and anorexia. It is also interesting to note that biochemical liver disorder is a frequent finding and is associated with a worse prognosis and higher probability admission to intensive care. It was also observed that RNA from the virus was found in the stool several days after the tests came back negative pulmonary secretions, while rectal swab virus detection methods were used with a lower but comparable sensitivity to that of nasal swabs. Gastrointestinal symptoms in SARS-COV 2 infection are common and their search should be part of the initial diagnosis approach and have a connection with the gut microbiota dysbiosis and this can lead to an alteration of the gut/liver axis.
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Affiliation(s)
- Roberto Lovero
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari - Ospedale Giovanni XXIII, Bari 70124, Italy
| | | | - Skender Topi
- Department of Clinical Disciplines, University of Elbasan, Elbasan, 3001, Albania
| | - Francesca Castellaneta
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari - Ospedale Giovanni XXIII, Bari 70124, Italy
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, Università degli Studi di Foggia, Foggia, 71122, Italy
| | - Marica Colella
- Interdisciplinary Department of Medicine, Section of Microbiology and Virology, Università degli Studi di Bari, 70124, Bari, Italy
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Khullar N, Bhatti JS, Singh S, Thukral B, Reddy PH, Bhatti GK. Insight into the liver dysfunction in COVID-19 patients: Molecular mechanisms and possible therapeutic strategies. World J Gastroenterol 2023; 29:2064-2077. [PMID: 37122601 PMCID: PMC10130970 DOI: 10.3748/wjg.v29.i14.2064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/23/2022] [Accepted: 03/21/2023] [Indexed: 04/13/2023] Open
Abstract
As of June 2022, more than 530 million people worldwide have become ill with coronavirus disease 2019 (COVID-19). Although COVID-19 is most commonly associated with respiratory distress (severe acute respiratory syndrome), meta-analysis have indicated that liver dysfunction also occurs in patients with severe symptoms. Current studies revealed distinctive patterning in the receptors on the hepatic cells that helps in viral invasion through the expression of angiotensin-converting enzyme receptors. It has also been reported that in some patients with COVID-19, therapeutic strategies, including repurposed drugs (mitifovir, lopinavir/ritonavir, tocilizumab, etc.) triggered liver injury and cholestatic toxicity. Several proven indicators support cytokine storm-induced hepatic damage. Because there are 1.5 billion patients with chronic liver disease worldwide, it becomes imperative to critically evaluate the molecular mechanisms concerning hepatotropism of COVID-19 and identify new potential therapeutics. This review also designated a comprehensive outlook of comorbidities and the impact of lifestyle and genetics in managing patients with COVID-19.
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Affiliation(s)
- Naina Khullar
- Department of Zoology, Mata Gujri College, Fatehgarh Sahib 140407, Punjab, India
| | - Jasvinder Singh Bhatti
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda 151401, Punjab, India
| | - Satwinder Singh
- Department of Computer Science and Technology, Central University of Punjab, Bathinda 151401, Punjab, India
| | - Bhawana Thukral
- Department of Nutrition and Dietetics, University Institute of Applied Health Sciences, Chandigarh University, Mohali 140413, Punjab, India
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
| | - Gurjit Kaur Bhatti
- Department of Medical Lab Technology, University Institute of Applied Health Sciences, Chandigarh University, Mohali 140413, Punjab, India
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Liu K, Stern S, Heil EL, Li L, Khairi R, Heyward S, Wang H. Dexamethasone mitigates remdesivir-induced liver toxicity in human primary hepatocytes and COVID-19 patients. Hepatol Commun 2023; 7:e0034. [PMID: 36809346 PMCID: PMC9949788 DOI: 10.1097/hc9.0000000000000034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a global pandemic that has caused more than 600 million cases and over six million deaths worldwide. Despite the availability of vaccination, COVID-19 cases continue to grow making pharmacological interventions essential. Remdesivir (RDV) is an FDA-approved antiviral drug for treatment of both hospitalized and non-hospitalized COVID-19 patients, albeit with potential for hepatotoxicity. This study characterizes the hepatotoxicity of RDV and its interaction with dexamethasone (DEX), a corticosteroid often co-administered with RDV for inpatient treatment of COVID-19. METHODS Human primary hepatocytes and HepG2 cells were used as in vitro models for toxicity and drug-drug interaction studies. Real-world data from hospitalized COVID-19 patients were analyzed for drug-induced elevation of serum ALT and AST. RESULTS In cultured hepatocytes, RDV markedly reduced the hepatocyte viability and albumin synthesis, while it increased the cleavage of caspase-8 and caspase-3, phosphorylation of histone H2AX, and release of ALT and AST in a concentration-dependent manner. Importantly, co-treatment with DEX partially reversed RDV-induced cytotoxic responses in human hepatocytes. Moreover, data from COVID-19 patients treated with RDV with and without DEX co-treatment suggested that among 1037 patients matched by propensity score, receiving the drug combination was less likely to result in elevation of serum AST and ALT levels (≥ 3 × ULN) compared to the RDV alone treated patients (OR = 0.44, 95% CI = 0.22-0.92, p = 0.03). CONCLUSION Our findings obtained from in vitro cell-based experiments and patient data analysis provide evidence suggesting combination of DEX and RDV holds the potential to reduce the likelihood of RDV-induced liver injury in hospitalized COVID-19 patients.
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Affiliation(s)
- Kaiyan Liu
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Sydney Stern
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Emily L. Heil
- Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Linhao Li
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Rula Khairi
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Scott Heyward
- BioIVT, 1450 S Rolling Rd, Halethorpe, Maryland, USA
| | - Hongbing Wang
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
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Sokouti B. A systems biology approach for investigating significantly expressed genes among COVID-19, hepatocellular carcinoma, and chronic hepatitis B. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022; 23:146. [PMID: 37521843 PMCID: PMC9584277 DOI: 10.1186/s43042-022-00360-3] [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: 05/02/2022] [Accepted: 10/12/2022] [Indexed: 01/08/2023] Open
Abstract
Background Worldwide, COVID-19's death rate is about 2%, considering the incidence and mortality. However, the information on its complications in other organs, specifically the liver and its disorders, is limited in mild or severe cases. In this study, we aimed to computationally investigate the typical relationships between liver-related diseases [i.e., hepatocellular carcinoma (HCC), and chronic hepatitis B (CHB)] and COVID-19, considering the involved significant genes and their molecular mechanisms. Methods We investigated two GEO microarray datasets (GSE164805 and GSE58208) to identify differentially expressed genes (DEGs) among the generated four datasets for mild/severe COVID-19, HCC, and CHB. Then, the overlapping genes among them were identified for GO and KEGG enrichment analyses, protein-protein interaction network construction, hub genes determination, and their associations with immune cell infiltration. Results A total of 22 significant genes (i.e., ACTB, ATM, CDC42, DHX15, EPRS, GAPDH, HIF1A, HNRNPA1, HRAS, HSP90AB1, HSPA8, IL1B, JUN, POLR2B, PTPRC, RPS27A, SFRS1, SMARCA4, SRC, TNF, UBE2I, and VEGFA) were found to play essential roles among mild/severe COVID-19 associated with HCC and CHB. Moreover, the analysis of immune cell infiltration revealed that these genes are mostly positively correlated with tumor immune and inflammatory responses. Conclusions In summary, the current study demonstrated that 22 identified DEGs might play an essential role in understanding the associations between the mild/severe COVID-19 patients with HCC and CHB. So, the HCC and CHB patients involved in different types of COVID-19 can benefit from immune-based targets for therapeutic interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s43042-022-00360-3.
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Affiliation(s)
- Babak Sokouti
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Aronova ES, Belov BS, Gridneva GI. Viral mixed infection complicated by acute hepatitis and allergic toxic dermatitis (clinical case). MODERN RHEUMATOLOGY JOURNAL 2022. [DOI: 10.14412/1996-7012-2022-5-71-74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Epstein-Barr virus (EBV) belongs to the family of herpesviruses (herpes type 4) and is one of the most common and highly contagious. During the pandemic of a new coronavirus disease, it was found that in patients previously infected with EBV, COVID-19 can cause its reactivation, which is often manifested by the clinic of acute hepatitis. The article presents a clinical case of the development of acute hepatitis in a patient with mixed infection with EBV and SARS-CoV-2 in combination with allergic toxic reaction while taking sulfasalazine prescribed for spondyloarthritis. A feature of this case was the development of severe hepatitis of mixed genesis with a favorable outcome. The importance of adherence to drug monitoring rules for newly prescribed drugs for COVID-19 was emphasized. In severe cases of the disease, the possibility of mixed infection should be taken into account.
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Affiliation(s)
| | - B. S. Belov
- V.A. Nasonova Research Institute of Rheumatology
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Mietus-Snyder M, Suslovic W, Delaney M, Playford MP, Ballout RA, Barber JR, Otvos JD, DeBiasi RL, Mehta NN, Remaley AT. Changes in HDL cholesterol, particles, and function associate with pediatric COVID-19 severity. Front Cardiovasc Med 2022; 9:1033660. [PMID: 36312284 PMCID: PMC9597312 DOI: 10.3389/fcvm.2022.1033660] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Myriad roles for high-density lipoprotein (HDL) beyond atheroprotection include immunologic functions implicated in the severity of coronavirus disease-2019 (COVID-19) in adults. We explored whether there is an association between HDL and COVID-19 severity in youth. Methods A pediatric cohort (N = 102), who tested positive for COVID-19 across a range of disease manifestations from mild or no symptoms, to acute severe symptoms, to the multisystem inflammatory syndrome of children (MIS-C) was identified. Clinical data were collected from the medical record and reserve plasma aliquots were assessed for lipoproteins by NMR spectroscopy and assayed for HDL functional cholesterol efflux capacity (CEC). Findings were compared by COVID-19 status and symptom severity. Lipoprotein, NMR spectroscopy and CEC data were compared with 30 outpatient COVID negative children. Results Decreasing HDL cholesterol (HDL-c), apolipoprotein AI (ApoA-I), total, large and small HDL particles and HDL CEC showed a strong and direct linear dose-response relationship with increasing severity of COVID-19 symptoms. Youth with mild or no symptoms closely resembled the uninfected. An atypical lipoprotein that arises in the presence of severe hepatic inflammation, lipoprotein Z (LP-Z), was absent in COVID-19 negative controls but identified more often in youth with the most severe infections and the lowest HDL parameters. The relationship between HDL CEC and symptom severity and ApoA-I remained significant in a multiply adjusted model that also incorporated age, race/ethnicity, the presence of LP-Z and of GlycA, a composite biomarker reflecting multiple acute phase proteins. Conclusion HDL parameters, especially HDL function, may help identify youth at risk of more severe consequences of COVID-19 and other novel infectious pathogens.
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Affiliation(s)
- Michele Mietus-Snyder
- Children's National Hospital, Washington, DC, United States
- The Children's National Clinical and Translational Science Institute, Washington, DC, United States
- Division of Cardiology, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | | | - Meghan Delaney
- Children's National Hospital, Washington, DC, United States
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Division of Clinical and Laboratory Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | - Martin P. Playford
- Cardiovascular and Pulmonary Branch, National Institutes of Health, Bethesda, MD, United States
| | - Rami A. Ballout
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - John R. Barber
- The Children's National Clinical and Translational Science Institute, Washington, DC, United States
| | - James D. Otvos
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Roberta L. DeBiasi
- Children's National Hospital, Washington, DC, United States
- The Children's National Clinical and Translational Science Institute, Washington, DC, United States
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Division of Infectious Diseases, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
- Department of Microbiology, Immunology and Tropical Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | - Nehal N. Mehta
- Cardiovascular and Pulmonary Branch, National Institutes of Health, Bethesda, MD, United States
| | - Alan T. Remaley
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
- Clinical Center, Department of Laboratory Medicine, National Institutes of Health, Bethesda, MD, United States
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Baroiu L, Anghel L, Tatu A, Iancu A, Dumitru C, Leșe AC, Drăgănescu M, Năstase F, Niculeț E, Fotea S, Nechita A, Voinescu D, Stefanopol A. Risk of hepatitis B reactivation: From biologic therapies for psoriasis to immunosuppressive therapies for COVID‑19 (Review). Exp Ther Med 2022; 23:385. [PMID: 35495599 PMCID: PMC9019722 DOI: 10.3892/etm.2022.11312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/28/2021] [Indexed: 12/15/2022] Open
Abstract
The cytokine storm from the evolution of severe cases of COVID-19, requiring strong immunosuppressive therapies, has raised the issue of reactivation of hepatitis B virus (HBV) infections in these patients. An analysis of the first observational studies in patients with COVID-19 and immunosuppressive therapy and HBV infection along with special clinical cases was presented, as well as personal experience on a series of cases (a group of 958 patients with COVID-19), compared with the analysis of studies performed on patients with HBV infection that underwent biological therapies for psoriasis and personal experience (a group of 81 psoriasis patients treated with biological therapies). Clinical studies have revealed that HBV reactivation in patients undergoing biological therapies for psoriasis, can be prevented with monitoring and treatment protocols and thus, these therapies have been demonstrated to be safe and effective. In COVID-19, immunosuppressive therapies are short-lived but in high doses, and the conclusions of clinical trials are contradictory, but there are published cases of HBV reactivation, which requires a unitary attitude in the prevention of HBV reactivation in these patients. An algorithm was presented for monitoring and treatment of HBV infection for patients with psoriasis treated with biological therapy and the conditions when this protocol can be used for patients with COVID-19 and immunosuppressive therapy.
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Affiliation(s)
- Liliana Baroiu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Lucreția Anghel
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Alin Tatu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Alina Iancu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Caterina Dumitru
- Department of Laboratory Medicine, ‘Sf. Cuv. Parascheva’ Clinical Infectious Diseases Hospital, 800179 Galati, Romania
| | - Ana-Cristina Leșe
- Faculty of Visual Arts and Design, ‘George Enescu’ National University of Arts, 700451 Iasi, Romania
| | - Miruna Drăgănescu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Florentina Năstase
- Department of Neuropsychomotor Rehabilitation, ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Elena Niculeț
- Multidisciplinary Integrated Center of Dermatological Interface Research, ‘Dunărea de Jos’ University, 800008 Galați, Romania
| | - Silvia Fotea
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Aurel Nechita
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Doina Voinescu
- Department of Clinical Medicine, Faculty of Medicine and Pharmacy, ‘Dunărea de Jos’ University, 800216 Galati, Romania
| | - Anca Stefanopol
- Multidisciplinary Integrated Center of Dermatological Interface Research, ‘Dunărea de Jos’ University, 800008 Galați, Romania
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Babajani A, Moeinabadi-Bidgoli K, Niknejad F, Rismanchi H, Shafiee S, Shariatzadeh S, Jamshidi E, Farjoo MH, Niknejad H. Human placenta-derived amniotic epithelial cells as a new therapeutic hope for COVID-19-associated acute respiratory distress syndrome (ARDS) and systemic inflammation. Stem Cell Res Ther 2022; 13:126. [PMID: 35337387 PMCID: PMC8949831 DOI: 10.1186/s13287-022-02794-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/25/2022] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has become in the spotlight regarding the serious early and late complications, including acute respiratory distress syndrome (ARDS), systemic inflammation, multi-organ failure and death. Although many preventive and therapeutic approaches have been suggested for ameliorating complications of COVID-19, emerging new resistant viral variants has called the efficacy of current therapeutic approaches into question. Besides, recent reports on the late and chronic complications of COVID-19, including organ fibrosis, emphasize a need for a multi-aspect therapeutic method that could control various COVID-19 consequences. Human amniotic epithelial cells (hAECs), a group of placenta-derived amniotic membrane resident stem cells, possess considerable therapeutic features that bring them up as a proposed therapeutic option for COVID-19. These cells display immunomodulatory effects in different organs that could reduce the adverse consequences of immune system hyper-reaction against SARS-CoV-2. Besides, hAECs would participate in alveolar fluid clearance, renin-angiotensin-aldosterone system regulation, and regeneration of damaged organs. hAECs could also prevent thrombotic events, which is a serious complication of COVID-19. This review focuses on the proposed early and late therapeutic mechanisms of hAECs and their exosomes to the injured organs. It also discusses the possible application of preconditioned and genetically modified hAECs as well as their promising role as a drug delivery system in COVID-19. Moreover, the recent advances in the pre-clinical and clinical application of hAECs and their exosomes as an optimistic therapeutic hope in COVID-19 have been reviewed.
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Affiliation(s)
- Amirhesam Babajani
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kasra Moeinabadi-Bidgoli
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Rismanchi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepehr Shafiee
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siavash Shariatzadeh
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Jamshidi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Farjoo
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Allisan‐Arrighi AE, Rapoport SK, Laitman BM, Bahethi R, Mori M, Woo P, Genden E, Courey M, Kirke DN. Long‐term upper aerodigestive sequelae as a result of infection with
COVID
‐19. Laryngoscope Investig Otolaryngol 2022; 7:476-485. [PMID: 35434347 PMCID: PMC9008172 DOI: 10.1002/lio2.763] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/06/2021] [Accepted: 01/31/2022] [Indexed: 01/14/2023] Open
Abstract
Objectives Respiratory, voice, and swallowing difficulties after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may result secondary to upper airway disease from prolonged intubation or mechanisms related to the virus itself. We examined a cohort who presented with new laryngeal complaints following documented SARS‐CoV‐2 infection. We characterized their voice, airway, and/or swallowing symptoms and reviewed the clinical course of their complaints to understand how the natural history of these symptoms relates to COVID‐19 infections. Methods Retrospective review of patients who presented to our department with upper aerodigestive complaints as sequelae of prior infection with, and management of, SARS‐CoV‐2. Results Eighty‐one patients met the inclusion criteria. Median age was 54.23 years (±17.36). Most common presenting symptoms were dysphonia (n = 58, 71.6%), dysphagia/odynophagia (n = 16, 19.75%), and sore throat (n = 9, 11.11%). Thirty‐one patients (38.27%) presented after intubation. Mean length of intubation was 16.85 days (range 1–35). Eighteen patients underwent tracheostomy and were decannulated after an average of 70.69 days (range 23–160). Patients with history of intubation were significantly more likely than nonintubated patients to be diagnosed with a granuloma (8 vs. 0, respectively, p < .01). Fifty patients (61.73%) were treated for SARS‐CoV‐2 without requiring intubation and were significantly more likely to be diagnosed with muscle tension dysphonia (19 vs. 1, p < .01) and laryngopharyngeal reflux (18 vs. 1, p < .01). Conclusion In patients with persistent dyspnea, dysphonia, or dysphagia after recovering from SARS‐CoV‐2, early otolaryngology consultation should be considered. Accurate diagnosis and prompt management of these common underlying etiologies may improve long‐term patient outcomes. Level of evidence 4
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Affiliation(s)
- Annie E. Allisan‐Arrighi
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Sarah K. Rapoport
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Benjamin M. Laitman
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Rohini Bahethi
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Matthew Mori
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Peak Woo
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Eric Genden
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Mark Courey
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Diana N. Kirke
- Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
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12
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Shirani K, Ashraf M, Sherafat A, Naderi Z, Sami R, Soltaninejad F, Khodadadi S, Mashayekhbakhsh S, Sharafi N, Ahmadi S, Shayganfar A, Zand I, Ajami A. Association of systemic complications with mortality in coronavirus disease of 2019: A cohort study on intensive care unit patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:34. [PMID: 35548176 PMCID: PMC9081519 DOI: 10.4103/jrms.jrms_1213_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/13/2021] [Accepted: 03/08/2022] [Indexed: 11/12/2022]
Abstract
Background: Since the beginning of the coronavirus disease of 2019 (COVID-19) pandemic, concerns raised by the growing number of deaths worldwide. Acute respiratory distress syndrome (ARDS) and extrapulmonary complications can correlate with prognosis in COVID-19 patients. This study evaluated the association of systemic complications with mortality in severely affected COVID-19 patients. Materials and Methods: This retrospective study was done on 51 intensive care unit (ICU)-admitted COVID-19 adult patients who were admitted to the ICU ward of Khorshid hospital, affiliated with Isfahan University of Medical Sciences. Only the patients who had a definite hospitalization outcome (dead vs. survivors) were included in the study. Daily clinical and paraclinical records were used to diagnose in-hospital complications in these patients. Results: The sample was comprised of 37 males (72.5%) and 14 females (27.4%). The median age of patients was 63 years (Min: 20, Max: 84), with the mortality rate of 47.1%. In total, 70.6% of patients had at least one coexisting disorder. Chronic kidney disease was associated with the worse outcome (29.16% of dead patients against 3.70 of survived ones). Mechanical ventilation was used in 58.8% of patients. Patients who had received invasive ventilation were more likely to die (87.50% of dead patients against 7.40 of survivors), Complications including sepsis and secondary infections (odds ratio: 8.05, confidence interval: 2.11–30.63) was the strongest predictors of mortality. Conclusion: Complications including sepsis and secondary infections can increase the risk of death in ICU-admitted COVID-19 patients. Therefore, it is substantial that the physicians consider preventing or controlling these complications.
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13
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Moreira JLDS, Barbosa SMB, Gonçalves Júnior J. Pathophysiology and molecular mechanisms of liver injury in severe forms of COVID-19: An integrative review. Clin Res Hepatol Gastroenterol 2021; 45:101752. [PMID: 34303828 PMCID: PMC8299216 DOI: 10.1016/j.clinre.2021.101752] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS SARS-CoV-2 has primary pulmonary impairment, but other organs such as the liver can also be affected. This implies a worsening of patient's prognosis and an increase in morbidity and mortality. The metabolic pathways and molecular factors involved in the genesis of this injury are still unknown. Therefore, we aimed to carry out an integrative review about the pathophysiology and possible molecular mechanisms of liver injury by COVID-19. METHODS We carried out an integrative literature review in the following databases: PubMed, Scopus, and Embase from December 2020 to March 2021 using the following descriptors: # 1 "COVID-19" (MeSH) AND / OR # 2 "Liver injury" (MeSH) AND / OR # 3 "Pathophysiology" (MesH). RESULTS The data were extracted and divided into two main themes, for heuristic purposes: "Hepatotropism and SARS-CoV-2", and "Pathophysiological hypotheses for liver injury associated with SARS-CoV-2". CONCLUSIONS The virus seems to promote liver damage through five mechanisms: direct injury, humoral and cellular inflammatory response, hypoxemia caused by a decrease in the effective circulating volume, reinfection through the portal system, and use of drugs in the treatment. The literature also points out that the expression of the angiotensin-converting enzyme II and transmembrane serine protease 2 receptors is expressive in cholangiocyte and is present in hepatocytes, which is a risk factor for the virus to enter these cells. Finally, patients with previous liver disease appear to be more susceptible to liver injury by COVID-19.
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Affiliation(s)
| | | | - Jucier Gonçalves Júnior
- Departament of Internal Medicine - Division of Rheumathology, Universidade de São Paulo (USP), São Paulo, Brazil.
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14
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Aiyegbusi OL, Hughes SE, Turner G, Rivera SC, McMullan C, Chandan JS, Haroon S, Price G, Davies EH, Nirantharakumar K, Sapey E, Calvert MJ, on behalf of the TLC Study Group. Symptoms, complications and management of long COVID: a review. J R Soc Med 2021; 114:428-442. [PMID: 34265229 PMCID: PMC8450986 DOI: 10.1177/01410768211032850] [Citation(s) in RCA: 516] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/29/2021] [Indexed: 12/13/2022] Open
Abstract
Globally, there are now over 160 million confirmed cases of COVID-19 and more than 3 million deaths. While the majority of infected individuals recover, a significant proportion continue to experience symptoms and complications after their acute illness. Patients with 'long COVID' experience a wide range of physical and mental/psychological symptoms. Pooled prevalence data showed the 10 most prevalent reported symptoms were fatigue, shortness of breath, muscle pain, joint pain, headache, cough, chest pain, altered smell, altered taste and diarrhoea. Other common symptoms were cognitive impairment, memory loss, anxiety and sleep disorders. Beyond symptoms and complications, people with long COVID often reported impaired quality of life, mental health and employment issues. These individuals may require multidisciplinary care involving the long-term monitoring of symptoms, to identify potential complications, physical rehabilitation, mental health and social services support. Resilient healthcare systems are needed to ensure efficient and effective responses to future health challenges.
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Affiliation(s)
- Olalekan Lee Aiyegbusi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
| | - Sarah E Hughes
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, Birmingham, UK
| | - Grace Turner
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Samantha Cruz Rivera
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Christel McMullan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Shamil Haroon
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Gary Price
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Midlands Health Data Research UK, Birmingham, UK
| | - Elizabeth Sapey
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Melanie J Calvert
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR) Applied Research Centre West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK
- Health Data Research UK, London, UK
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15
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Nadeem A, Suresh K, Awais H, Waseem S. Epstein-Barr Virus Coinfection in COVID-19. J Investig Med High Impact Case Rep 2021; 9:23247096211040626. [PMID: 34428954 PMCID: PMC8392798 DOI: 10.1177/23247096211040626] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Epstein-Barr virus (EBV), a member of the herpes virus family, is a causative agent for infectious mononucleosis in young adults. It has an asymptomatic and subclinical distribution in about 90% to 95% of the world population based on seropositivity. EBV is associated with various lymphomas, nasopharyngeal carcinoma, and in immunocompromised states can give rise to aggressive lymphoproliferative disorders. Symptomatic patients mostly present with mild hepatitis, rash, oral symptoms, lymphadenopathy, and generalized malaise. Recently with the COVID-19 (coronavirus disease-2019) pandemic, hepatitis has been found to be related to acute EBV and cytomegalovirus reactivation versus acute infection in the absence of other major causes. We describe a case of EBV coinfection in a patient with resolving mild COVID-19 infection.
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Affiliation(s)
- Asim Nadeem
- Conemaugh Memorial Medical Center, Johnstown, PA, USA
| | | | - Hassan Awais
- Conemaugh Memorial Medical Center, Johnstown, PA, USA
| | - Saba Waseem
- Conemaugh Memorial Medical Center, Johnstown, PA, USA
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16
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Seidu S, Kunutsor SK, Cos X, Khunti K. Indirect impact of the COVID-19 pandemic on hospitalisations for cardiometabolic conditions and their management: A systematic review. Prim Care Diabetes 2021; 15:653-681. [PMID: 34083122 PMCID: PMC8162904 DOI: 10.1016/j.pcd.2021.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic has led to a dramatic crisis in health care systems worldwide. These may have significant implications for the management of cardiometabolic diseases. We conducted a systematic review of published evidence to assess the indirect impact of the COVID-19 pandemic on hospitalisations for cardiovascular diseases and their management. METHODS Studies that evaluated volume of hospitalisations for cardiometabolic conditions and their management with comparisons between the COVID-19 and pre-COVID periods were identified from MEDLINE, Embase and the reference list of relevant studies from January 2020 to 25 February 2021. RESULTS We identified 103 observational studies, with most studies assessing hospitalisations for acute cardiovascular conditions such as acute coronary syndrome, ischemic strokes and heart failure. About 89% of studies reported a decline in hospitalisations during the pandemic compared to pre-pandemic times, with reductions ranging from 20.2 to 73%. Severe presentation, less utilization of cardiovascular procedures, and longer patient- and healthcare-related delays were common during the pandemic. Most studies reported shorter length of hospital stay during the pandemic than before the pandemic (1-8 vs 2-12 days) or no difference in length of stay. Most studies reported no change in in-hospital mortality among hospitalised patients. CONCLUSION Clinical care of patients for acute cardiovascular conditions, their management and outcomes have been adversely impacted by the COVID-19 pandemic. Patients should be educated via population-wide approaches on the need for timely medical contact and health systems should put strategies in place to provide timely care to patients at high risk. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2021: CRD42021236102.
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Affiliation(s)
- Samuel Seidu
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, UK.
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK
| | - Xavier Cos
- DAP_Cat Research Group, Gerencia Territorial Barcelona Ciutat, Institut Català de la Salut, Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, UK
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17
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Hoque MN, Akter S, Mishu ID, Islam MR, Rahman MS, Akhter M, Islam I, Hasan MM, Rahaman MM, Sultana M, Islam T, Hossain MA. Microbial co-infections in COVID-19: Associated microbiota and underlying mechanisms of pathogenesis. Microb Pathog 2021; 156:104941. [PMID: 33962007 PMCID: PMC8095020 DOI: 10.1016/j.micpath.2021.104941] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus infectious disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has traumatized the whole world with the ongoing devastating pandemic. A plethora of microbial domains including viruses (other than SARS-CoV-2), bacteria, archaea and fungi have evolved together, and interact in complex molecular pathogenesis along with SARS-CoV-2. However, the involvement of other microbial co-pathogens and underlying molecular mechanisms leading to extortionate ailment in critically ill COVID-19 patients has yet not been extensively reviewed. Although, the incidence of co-infections could be up to 94.2% in laboratory-confirmed COVID-19 cases, the fate of co-infections among SARS-CoV-2 infected hosts often depends on the balance between the host's protective immunity and immunopathology. Predominantly identified co-pathogens of SARS-CoV-2 are bacteria such as Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Acinetobacter baumannii, Legionella pneumophila and Clamydia pneumoniae followed by viruses including influenza, coronavirus, rhinovirus/enterovirus, parainfluenza, metapneumovirus, influenza B virus, and human immunodeficiency virus. The cross-talk between co-pathogens (especially lung microbiomes), SARS-CoV-2 and host is an important factor that ultimately increases the difficulty of diagnosis, treatment, and prognosis of COVID-19. Simultaneously, co-infecting microbiotas may use new strategies to escape host defense mechanisms by altering both innate and adaptive immune responses to further aggravate SARS-CoV-2 pathogenesis. Better understanding of co-infections in COVID-19 is critical for the effective patient management, treatment and containment of SARS-CoV-2. This review therefore necessitates the comprehensive investigation of commonly reported microbial co-pathogens amid COVID-19, their transmission pattern along with the possible mechanism of co-infections and outcomes. Thus, identifying the possible co-pathogens and their underlying molecular mechanisms during SARS-CoV-2 pathogenesis may shed light in developing diagnostics, appropriate curative and preventive interventions for suspected SARS-CoV-2 respiratory infections in the current pandemic.
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Affiliation(s)
- M Nazmul Hoque
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Gynecology, Obstetrics and Reproductive Health, Bangabandhu Sheikh Mujibur Rahman Agricultural University (BSMRAU), Gazipur, 1706, Bangladesh
| | - Salma Akter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | | | - M Rafiul Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - M Shaminur Rahman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Masuda Akhter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Israt Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mehedi Mahmudul Hasan
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Fisheries and Marine Science, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Md Mizanur Rahaman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Munawar Sultana
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Tofazzal Islam
- Institute of Biotechnology and Genetic Engineering (IBGE), BSMRAU, Gazipur, 1706, Bangladesh
| | - M Anwar Hossain
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Jashore University of Science and Technology, Jashore, 7408, Bangladesh.
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18
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Li J, Liu X, Zou Y, Deng Y, Zhang M, Yu M, Wu D, Zheng H, Zhao X. Factors Affecting COVID-19 Preventive Behaviors among University Students in Beijing, China: An Empirical Study Based on the Extended Theory of Planned Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7009. [PMID: 34209072 PMCID: PMC8297113 DOI: 10.3390/ijerph18137009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022]
Abstract
Higher education institutions (HEIs), among other social systems, have an irreplaceable role in combating COVID-19. However, we know little about institutional and individual factors that might facilitate university students' beliefs and behaviors toward preventive behaviors for COVID-19 within the higher education context. Our study applies an extended theory of planned behavior (TPB) model to investigate the structural relationships among the institutional climate, attitudes, subjective norms, perceived behavioral control and preventive behaviors of university students and to detect the moderating impacts of perceived risk on the structural model. Data were collected from 3693 university students at 18 universities in Beijing, China through an online survey. Structural equation modeling (SEM) and multigroup analysis were performed to examine the empirical model. The results reveal that (1) the institutional climate has a significant, direct effect on preventive behaviors for COVID-19 among university students, (2) the TPB components, namely attitudes, subjective norms and perceived behavioral control, partially mediate the relationship between the institutional climate and preventive behaviors for COVID-19, and (3) perceived risk moderates several paths in the model. Theoretical and practical implications are offered, and recommendations for future research are outlined.
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Affiliation(s)
- Jiabin Li
- Advising Center for Student Development, Beijing University of Technology, Beijing 100124, China;
| | - Xianwei Liu
- Institute of Higher Education, Research Centre for Capital Engineering Education Development, Beijing University of Technology, Beijing 100124, China
| | - Yang Zou
- College of Business Administration, Capital University of Economics and Business, Beijing 100070, China;
| | - Yichu Deng
- Publicity Department, Beijing University of Technology, Beijing 100124, China;
| | - Meng Zhang
- School of Civil and Transportation Engineering, Beijing University of Civil Engineering and Architecture, Beijing 102616, China;
| | - Miaomiao Yu
- Institute of Education Economics and Management, University of Science and Technology Beijing, Beijing 100083, China;
| | - Dongjiao Wu
- School of Marxism, Beihang University, Beijing 100191, China;
| | - Hao Zheng
- China Youth & Children Research Center, Beijing 100089, China;
| | - Xinliang Zhao
- Beijing Academy of Educational Sciences, Beijing 100045, China;
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19
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Attenuated Risk of Pneumonia Due to Inflammation by Frequent Sauna Baths: A PROSPECTIVE COHORT STUDY. J Cardiopulm Rehabil Prev 2021; 42:59-63. [PMID: 33797457 DOI: 10.1097/hcr.0000000000000598] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Inflammatory pathways are involved in the pathogenesis of pneumonia. Frequent sauna sessions may reduce the risk of respiratory tract infections including pneumonia independent of inflammation. We aimed to evaluate the independent and joint associations of high-sensitivity C-reactive protein (hsCRP) and frequency of sauna bathing (FSB) with risk of pneumonia in a prospective cohort study. METHODS Serum hsCRP as an inflammatory marker was measured using an immunometric assay and FSB was assessed by self-reported sauna bathing habits at baseline in 2264 men aged 42-61 yr. Serum hsCRP was categorized as normal and high (≤3 and >3 mg/L, respectively) and FSB as low and high (defined as ≤1 and 2-7 sessions/wk, respectively). Multivariable-adjusted HRs (CIs) were calculated for incident pneumonia. RESULTS A total of 528 cases of pneumonia occurred during a median follow-up of 26.6 yr. Comparing high versus normal hsCRP, the multivariable-adjusted risk for pneumonia was HR = 1.30 (95% CI, 1.04-1.62). The corresponding risk was HR = 0.79 (95% CI, 0.66-0.95) comparing high versus low FSB. Compared with men with normal hsCRP and low FSB, high hsCRP and low FSB was associated with an increased risk of pneumonia in multivariable analysis (HR = 1.67: 95% CI, 1.21-2.29), with no evidence of an association for high hsCRP and high FSB and pneumonia (HR = 0.94: 95% CI, 0.69-1.29). CONCLUSIONS In a general middle-aged to older male Caucasian population, frequent sauna baths attenuated the increased risk of pneumonia due to inflammation.
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20
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Kunutsor SK, Laukkanen JA. High fitness levels, frequent sauna bathing and risk of pneumonia in a cohort study: Are there potential implications for COVID-19? Eur J Clin Invest 2021; 51:e13490. [PMID: 33426640 PMCID: PMC7995101 DOI: 10.1111/eci.13490] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/31/2020] [Accepted: 01/03/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND There is an ongoing debate on a potential protective role of habitual physical activity and passive heat therapy on the risk of COVID-19, a respiratory infectious disease that can manifest as severe pneumonia. To explore these putative roles, we evaluated the independent and joint associations of cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) with pneumonia risk in a prospective cohort study of 2275 men aged 42-61 years at recruitment. MATERIAL AND METHODS Objectively measured CRF and self-reported sauna bathing habits were assessed at baseline. CRF was categorized as low and high (median cut-offs) and FSB as low and high (defined as ≤1 and 2-7 sessions/wk, respectively). Multivariable-adjusted hazard ratios (HRs) with confidence intervals (CIs) were calculated for incident pneumonia. RESULTS During a median follow-up of 26.6 years, 529 cases of pneumonia occurred. Comparing high vs low CRF, the multivariable-adjusted HR (95% CIs) for pneumonia was 0.75 (0.61-0.91). Comparing high vs low FSB, the corresponding HR was 0.81 (0.68-0.97). Compared to men with low CRF & low FSB, the multivariable-adjusted HRs of pneumonia for the following groups: high CRF & low FSB; low CRF & high FSB; and high CRF & high FSB were 0.88 (0.65-1.20), 0.89 (0.71-1.13), and 0.62 (0.48-0.80) respectively. CONCLUSIONS In a general male Caucasian population, a combination of high fitness levels and frequent sauna baths is associated with a substantially lowered future pneumonia risk compared with each modality alone. The implications of these findings in altering COVID-19 disease or its severity deserve study.
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Affiliation(s)
- Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.,Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Learning & Research Building (Level 1), Southmead Hospital, University of Bristol, Bristol, UK
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Central Finland Health Care District Hospital District, Jyväskylä, Finland
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21
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SeyedAlinaghi S, Afsahi AM, MohsseniPour M, Behnezhad F, Salehi MA, Barzegary A, Mirzapour P, Mehraeen E, Dadras O. Late Complications of COVID-19; a Systematic Review of Current Evidence. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021; 9:e14. [PMID: 33681819 PMCID: PMC7927752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto. Japan
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22
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SeyedAlinaghi S, Afsahi AM, MohsseniPour M, Behnezhad F, Salehi MA, Barzegary A, Mirzapour P, Mehraeen E, Dadras O. Late Complications of COVID-19; a Systematic Review of Current Evidence. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021. [PMID: 33681819 PMCID: PMC7927752 DOI: 10.22037/aaem.v9i1.1058] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto. Japan
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23
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COVID-19 Among Patients With Hepatitis B or Hepatitis C: A Systematic Review. HEPATITIS MONTHLY 2021. [DOI: 10.5812/hepatmon.111617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Context: Hepatic manifestations of Coronavirus Disease 2019 (COVID-19) are common among people living with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). Objectives: This systematic review aimed to summarize the evidence on COVID-19 patients living with HBV or HCV co-infections. Data Sources: We searched multiple electronic databases and preprint servers from December 1, 2019, to August 9, 2020. Study Selection: Studies were included if they reported quantitative empirical data on COVID-19 patients living with HBV or HCV co-infections. Data Extraction: Descriptive analyses were reported, and data were synthesized narratively. The quality assessment was completed using the Joanna Briggs Institute critical appraisal tools. Results: Out of the 941 uniquely identified records, 27 studies were included. Of the eligible studies, 232 COVID-19 patients were living with HBV and 22 were living with HCV. Most patients were male, and the mean age was 49.8 and 62.8 years in patients living with HBV and HCV, respectively. Among the reported cases of SARS-CoV-2-HBV co-infection, the proportions of death were 4.7% and 15% in cross-sectional and case series/report studies, respectively. The death proportion was 8.3% among the reported cases of SARS-CoV-2-HCV co-infection. Among COVID-19 patients, 34.1% and 76.2% reported at least one comorbidity besides HBV and HCV infections, mainly hypertension and type 2 diabetes mellitus. The most common COVID-19-related symptoms in both HBV and HCV groups were fever, cough, dyspnea, fatigue, and gastrointestinal symptoms. Conclusions: While understanding the pathogenesis of SARS-CoV-2 requires further investigations, the careful assessment of hepatic manifestations and chronic infections, such as HBV and HCV upon the admission of COVID-19 patients could help reduce multimorbidity among HBV or HCV patients and lead to more favorable health outcomes among them.
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24
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Picone M, Inoue S, DeFelice C, Naujokas MF, Sinrod J, Cruz VA, Stapleton J, Sinrod E, Diebel SE, Wassman ER. Social Listening as a Rapid Approach to Collecting and Analyzing COVID-19 Symptoms and Disease Natural Histories Reported by Large Numbers of Individuals. Popul Health Manag 2020; 23:350-360. [PMID: 32897820 DOI: 10.1089/pop.2020.0189] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Given the severe and rapid impact of COVID-19, the pace of information sharing has been accelerated. However, traditional methods of disseminating and digesting medical information can be time-consuming and cumbersome. In a pilot study, the authors used social listening to quickly extract information from social media channels to explore what people with COVID-19 are talking about regarding symptoms and disease progression. The goal was to determine whether, by amplifying patient voices, new information could be identified that might have been missed through other sources. Two data sets from social media groups of people with or presumed to have COVID-19 were analyzed: a Facebook group poll, and conversation data from a Reddit group including detailed disease natural history-like posts. Content analysis and a customized analytics engine that incorporates machine learning and natural language processing were used to quickly identify symptoms mentioned. Key findings include more than 20 symptoms in the data sets that were not listed in online lists of symptoms from 4 respected medical information sources. The disease natural history-like posts revealed that people can experience symptoms for many weeks and that some symptoms change over time. This study demonstrates that social media can offer novel insights into patient experiences as a source of real-world data. This inductive research approach can quickly generate descriptive information that can be used to develop hypotheses and new research questions. Also, the method allows rapid assessments of large numbers of social media conversations that could be applied to monitor public health for emerging and rapidly spreading diseases such as COVID-19.
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Affiliation(s)
- Maria Picone
- TREND Community, Philadelphia, Pennsylvania, USA
| | - Sarah Inoue
- TREND Community, Philadelphia, Pennsylvania, USA
| | | | | | - Jay Sinrod
- Documented.space, Brooklyn, New York, USA
| | | | | | - Emily Sinrod
- TREND Community, Philadelphia, Pennsylvania, USA
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25
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Bongiovanni M, Zago T. Acute hepatitis caused by asymptomatic COVID-19 infection. J Infect 2020; 82:e25-e26. [PMID: 32891635 PMCID: PMC7470895 DOI: 10.1016/j.jinf.2020.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Marco Bongiovanni
- Internal Medicine Unit, Department of Medicine, Ospedale di Circolo di Rho, ASST Rhodense, Milan, Italy.
| | - Tiziano Zago
- Urology Unit, Department of Surgery, Ospedale di Circolo di Rho, ASST Rhodense, Italy
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26
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Kunutsor SK, Laukkanen JA. Incidence of venous and arterial thromboembolic complications in COVID-19: A systematic review and meta-analysis. Thromb Res 2020; 196:27-30. [PMID: 32823173 PMCID: PMC7418701 DOI: 10.1016/j.thromres.2020.08.022] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK.
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland District, Jyväskylä, Finland
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