SARS-CoV-2-associated cytokine storm during pregnancy as a possible risk factor for neuropsychiatric disorder development in post-pandemic infants

Emerging data suggest that obesity is a major risk factor for the progression of major complications such as acute respiratory distress syndrome (ARDS), cytokine storm and coagulopathy in COVID-19. Understanding the mechanisms underlying the link between obesity and disease severity as a result of SARS-CoV-2 infection is crucial for the development of new therapeutic interventions and preventive measures in this high-risk group. We propose that multiple features of obesity contribute to the prevalence of severe COVID-19 and complications. First, viral entry can be facilitated by the upregulation of viral entry receptors, like angiotensin-converting enzyme 2 (ACE2), among others. Second, obesity-induced chronic inflammation and disruptions of insulin and leptin signaling can result in impaired viral clearance and a disproportionate or hyper-inflammatory response, which together with elevated ferritin levels can be a direct cause for ARDS and cytokine storm. Third, the negative consequences of obesity on blood coagulation can contribute to the progression of thrombus formation and hemorrhage. In this review we first summarize clinical findings on the relationship between obesity and COVID-19 disease severity and then further discuss potential mechanisms that could explain the risk for major complications in patients suffering from obesity.

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COVID-19 and Children With Down Syndrome: is There Any Real Reason to Worry? Case Report

10.21203/rs.3.rs-44432/v1 ◽

2020 ◽

Author(s):

Ahmad Kantar ◽

Angelo Mazza ◽

Ezio Bonanomi ◽

Marta Odoni ◽

Manuela Seminara ◽

...

Keyword(s):

Down Syndrome ◽

Risk Factor ◽

Chromosome 21 ◽

Cytokine Storm ◽

Case Presentation ◽

Biological Condition ◽

Children With Down Syndrome ◽

Number Of Children ◽

Antiviral Responses ◽

Cardiovascular Anomalies

Abstract Background: Down syndrome (DS) is characterised by a series of immune dysregulations, of which interferon hyperreactivity is a key one as it is responsible for surging antiviral responses and probable initiation of an amplified cytokine storm. This biological condition is attributed to immune regulators encoded in chromosome 21. Moreover, DS is characterised by the coexistence of cardiovascular and respiratory anomalies as well as obesity, which constitutes a risk factor for SARS-CoV-2 respiratory disease (COVID-19).Case presentation: Of the total number of children 55 admitted to paediatric wards in Bergamo in the period between February to May 2020 for COVID-19 infection, we present 2 children with DS and confirmed COVID-19 diagnosis that had a severe course. In addition, both cases had one or more comorbidities, being cardiovascular anomalies, obesity, and/or OSA.Conclusions: Our observations indicate the need to consider children with DS a population at a risk of severe COVID-19.

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Obesity as a risk factor for severe COVID-19 and complications

10.31219/osf.io/vyd24 ◽

2020 ◽

Author(s):

Fien Demeulemeester ◽

Karin De Punder ◽

Marloes van Heijningen ◽

Femke van Doesburg

Keyword(s):

Risk Factor ◽

Disease Severity ◽

Viral Entry ◽

Thrombus Formation ◽

Clinical Findings ◽

High Risk Group ◽

Therapeutic Interventions ◽

Cytokine Storm ◽

Negative Consequences ◽

Major Complications

Emerging data suggest that obesity is a major risk factor for the progression of major complications such as, acute respiratory distress syndrome (ARDS), cytokine storm and coagulopathy in COVID-19. Understanding the mechanisms underlying the link between obesity and disease severity as a result of SARS-CoV-2 infection is crucial for the development of new therapeutic interventions and preventive measures in this high-risk group. We propose that multiple features of obesity contribute to the prevalence of severe COVID-19 and complications. First, viral entry can be facilitated by the upregulation of viral entry receptors, like angiotensin-converting enzyme 2 (ACE2), among others. Second, obesity-induced chronic inflammation and disruptions of leptin signaling can result in a disproportionate or hyper-inflammatory response, which together with elevated ferritin levels can be a direct cause for complications, such as ARDS and cytokine storm. Third, the negative consequences of obesity on blood coagulation can contribute to the progression of thrombus formation and hemorrhage. In this review we summarize clinical findings that provide insight into the relationship between obesity and COVID-19 disease severity and discusses potential mechanisms that could convey the risk for major complications in patients suffering from obesity.

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SARS-CoV-2 infection and overactivation of Nlrp3 inflammasome as a trigger of cytokine “storm” and risk factor for damage of hematopoietic stem cells

Leukemia ◽

10.1038/s41375-020-0887-9 ◽

2020 ◽

Vol 34 (7) ◽

pp. 1726-1729 ◽

Cited By ~ 33

Author(s):

Mariusz Z. Ratajczak ◽

Magda Kucia

Keyword(s):

Stem Cells ◽

Risk Factor ◽

Severe Acute Respiratory Syndrome ◽

Progenitor Cells ◽

Scientific Community ◽

Kidney Injury ◽

Fulminant Myocarditis ◽

Cytokine Storm ◽

Hematopoietic Stem

Abstract The scientific community faces an unexpected and urgent challenge related to the SARS-CoV-2 pandemic and is investigating the role of receptors involved in entry of this virus into cells as well as pathomechanisms leading to a cytokine “storm,” which in many cases ends in severe acute respiratory syndrome, fulminant myocarditis and kidney injury. An important question is if it may also damage hematopoietic stem progenitor cells?

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Clinical aspects of reactive oxygen and nitrogen species

Biochemical Society Symposium ◽

10.1042/bss0710121 ◽

2004 ◽

Vol 71 ◽

pp. 121-133 ◽

Cited By ~ 25

Author(s):

Ascan Warnholtz ◽

Maria Wendt ◽

Michael August ◽

Thomas Münzel

Keyword(s):

Oxidative Stress ◽

Reactive Oxygen Species ◽

Risk Factor ◽

Endothelial Dysfunction ◽

Vascular Tissue ◽

Rapid Development ◽

Reactive Oxygen ◽

Clinical Aspects ◽

No Production ◽

Oxygen Species

Endothelial dysfunction in the setting of cardiovascular risk factors, such as hypercholesterolaemia, hypertension, diabetes mellitus and chronic smoking, as well as in the setting of heart failure, has been shown to be at least partly dependent on the production of reactive oxygen species in endothelial and/or smooth muscle cells and the adventitia, and the subsequent decrease in vascular bioavailability of NO. Superoxide-producing enzymes involved in increased oxidative stress within vascular tissue include NAD(P)H-oxidase, xanthine oxidase and endothelial nitric oxide synthase in an uncoupled state. Recent studies indicate that endothelial dysfunction of peripheral and coronary resistance and conductance vessels represents a strong and independent risk factor for future cardiovascular events. Ways to reduce endothelial dysfunction include risk-factor modification and treatment with substances that have been shown to reduce oxidative stress and, simultaneously, to stimulate endothelial NO production, such as inhibitors of angiotensin-converting enzyme or the statins. In contrast, in conditions where increased production of reactive oxygen species, such as superoxide, in vascular tissue is established, treatment with NO, e.g. via administration of nitroglycerin, results in a rapid development of endothelial dysfunction, which may worsen the prognosis in patients with established coronary artery disease.

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