scholarly journals The Contrasting Role of Nasopharyngeal Angiotensin Converting Enzyme 2 (ACE2) Expression in SARS-CoV-2 Infection: A Cross-Sectional Study of People Tested for COVID-19 in British Columbia

2020 ◽  
Author(s):  
Aidan M. Nikiforuk ◽  
Kevin S. Kuchinski ◽  
David D.W. Twa ◽  
Christine D. Lukac ◽  
Hind Sbihi ◽  
...  
Keyword(s):  
British Columbia ◽  
Cross Sectional Study ◽  
Viral Rna ◽  
Bivariate Analysis ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Angiotensin Converting Enzyme 2 ◽  
Biological Sex ◽  
Upper Respiratory

SummaryBackgroundAngiotensin converting enzyme 2 (ACE2) serves as the host receptor for SARS-CoV-2, with a critical role in viral infection. We aim to understand population level variation of nasopharyngeal ACE2 expression in people tested for COVID-19 and the relationship between ACE2 expression and SARS-CoV-2 viral RNA load, while adjusting for expression of the complementary protease, Transmembrane serine protease 2 (TMPRSS2), soluble ACE2, age, and biological sex.MethodsA cross-sectional study of n=424 participants aged 1-104 years referred for COVID-19 testing was performed in British Columbia, Canada. Participants who tested negative or positive for COVID-19 were matched by age and biological sex. Viral and host gene expression was measured by quantitative reverse-transcriptase polymerase chain reaction. Bivariate analysis and multiple linear regression were performed to understand the role of nasopharyngeal ACE2 expression in SARS-CoV-2 infection. The ACE2 gene was targeted to measure expression of transmembrane and soluble transcripts.FindingsAnalysis shows no association between age and nasopharyngeal ACE2 expression in those who tested negative for COVID-19 (P=0·092). Mean expression of transmembrane (P=1·2e-4), soluble ACE2 (P<0·0001) and TMPRSS2 (P<0·0001) differed between COVID-19-negative and -positive groups. In bivariate analysis of COVID-19-positive participants, expression of transmembrane ACE2 positively correlated with SARS-CoV-2 RNA viral load (P<0·0001), expression of soluble ACE2 negatively correlated (P<0·0001), and no correlation was found with TMPRSS2 (P=0·694). Multivariable analysis showed that the greatest viral RNA loads were observed in participants with high transmembrane ACE2 expression (B=0·886, 95%CI:[0·596 to 1·18]), while expression of soluble ACE2 may protect against high viral RNA load in the upper respiratory tract (B= −0·0990, 95%CI:[−0·176 to −0·0224]).InterpretationNasopharyngeal ACE2 expression plays a dual, contrasting role in SARS-CoV-2 infection of the upper respiratory tract. Transmembrane ACE2 positively correlates, while soluble ACE2 negatively correlates with viral RNA load after adjusting for age, biological sex and expression of TMPRSS2.FundingThis project (COV-55) was funded by Genome British Columbia as part of their COVID-19 rapid response initiative.

scholarly journals Evidence for a role of angiotensin converting enzyme 2 in proteinuria of idiopathic nephrotic syndrome

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Roberta da Silva Filha ◽  
Sérgio Veloso Brant Pinheiro ◽  
Thiago Macedo e Cordeiro ◽  
Victor Feracin ◽  
Érica Leandro Marciano Vieira ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Idiopathic Nephrotic Syndrome ◽  
Renin Angiotensin System ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Ang Ii ◽  
Cross Sectional ◽  
Angiotensin Converting Enzyme 2 ◽  
Inflammatory Molecules

AbstractIntroduction: Renin angiotensin system (RAS) plays a role in idiopathic nephrotic syndrome (INS). Most studies investigated only the classical RAS axis. Therefore, the aims of the present study were to evaluate urinary levels of RAS molecules related to classical and to counter-regulatory axes in pediatric patients with INS, to compare the measurements with levels in healthy controls and to search for associations with inflammatory molecules, proteinuria and disease treatment. Subjects and methods: This cross-sectional study included 31 patients with INS and 19 healthy controls, matched for age and sex. Patients and controls were submitted to urine collection for measurement of RAS molecules [Ang II, Ang-(1-7), ACE and ACE2] by enzyme immunoassay and cytokines by Cytometric Bead Array. Findings in INS patients were compared according to proteinuria: absent (<150 mg/dl, n = 15) and present (≥150 mg/dl, n = 16). Results: In comparison to controls, INS patients had increased Ang II, Ang-(1-7) and ACE, levels while ACE2 was reduced. INS patients with proteinuria had lower levels of ACE2 than those without proteinuria. ACE2 levels were negatively correlated with 24-h-proteinuria. Urinary concentrations of MCP-1/CCL2 were significantly higher in INS patients, positively correlated with Ang II and negatively with Ang-(1-7). ACE2 concentrations were negatively correlated with IP-10/CXCL-10 levels, which, in turn, were positively correlated with 24-h-proteinuria. Conclusion: INS patients exhibited changes in RAS molecules and in chemokines. Proteinuria was associated with low levels of ACE2 and high levels of inflammatory molecules.

scholarly journals A cross sectional study on prescription pattern of drugs in upper respiratory tract infections in a tertiary care hospital

2020 ◽  
Vol 9 (2) ◽  
pp. 271
Author(s):  
Divya Bade ◽  
Shivashankaramurthy K. G. ◽  
Kiran L. J. ◽  
Raghuprasada M. S. ◽  
Harishkumar V. S. ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Cross Sectional Study ◽  
Prescribing Patterns ◽  
Essential Medicines ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Upper Respiratory ◽  
Tract Infections

Background: Upper respiratory tract infections are one of the leading causes of hospital visits worldwide. Judicious use of antibiotics is challenging for upper respiratory tract infections (URTIs) in developing countries like India. This leads to inappropriate use of antibiotics causing many dreaded conditions like antibacterial resistance among other things. Hence rational use of drugs, mainly antibacterial, is a priority to reduce the burden of treatment failure. The objective of this study is to study the prescribing patterns and rationality of drugs prescribed in the management of URTIs.Methods: This was a cross-sectional study. Data was collected from records of 300 outpatients clinically diagnosed as URTIs from SSIMS and RC Hospital, Davangere between January 2015 and June 2016. The prescribing patterns, approval status and listing of drugs in World Health Organization (WHO) essential medicines list/ National List of Essential Medicines (NLEM) were analysed. The data was presented as percentages, mean and standard deviations.Results: A total of 300 cases were studied. Among these, acute pharyngitis (29%) and acute sinusitis (26%) are the most common infections. Of the 300 cases studied, 283 (94.3%) were prescribed antimicrobials. Of the total 740 medications prescribed, 393 (53.1%) were fixed-dose combinations (FDCs). A total of 724 medications (97.8%) were approved by Drugs Controller General of India and 248 (33.5%) by Food and Drug Administration. Only 5.8% of the prescribed drugs have been listed in WHO’s and NLEM. The most common class of antibacterials prescribed was Beta-lactams.Conclusions: Oral formulations were preferred over parenteral formulations and FDCs were preferred over single drug formulations. Beta-lactams comprised the major class of antibacterial prescribed.

scholarly journals Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shan Wang ◽  
Lihua Liu ◽  
Jianchao Liu ◽  
Likun Miao ◽  
Qian Zhuang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Pediatric Patients ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Short Supply ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Clinical Records

Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

scholarly journals Inflammatory Cell Infiltration of Adrenals in COVID-19

2020 ◽  
Vol 52 (09) ◽  
pp. 639-641 ◽  
Author(s):  
Vsevolod A. Zinserling ◽  
Natalya Yu. Semenova ◽  
Alexander G. Markov ◽  
Oksana V. Rybalchenko ◽  
Jun Wang ◽  
...  
Keyword(s):  
Inflammatory Cell ◽  
Adrenal Glands ◽  
Virus Entry ◽  
Upper Respiratory Tract ◽  
Angiotensin Converting Enzyme 2 ◽  
Cd8 T Lymphocytes ◽  
The World ◽  
Upper Respiratory ◽  
Perivascular Infiltration

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was originated in November–December 2019 in Wuhan, China, and has rapidly spread around the world causing severe health and socioeconomical damage to the entire civilization. The key feature of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is upper respiratory tract infection, which may be complicated by bilateral pneumonia. Angiotensin converting enzyme 2 (ACE2) has been identified as a key host factor, required for virus entry into cells. Interestingly, ACE2 is expressed not only in the respiratory system, but also in the other organs and systems including adrenal glands. Here we provide the first description of the pathomorphological changes in adrenal glands in patients with severe COVID-19 characterized by perivascular infiltration of CD3+ and CD8+ T-lymphocytes. Due to the central role of the adrenals in the stress response of the organism, this finding is of potential clinical relevance, because infection with the SARS-CoV-2 virus might critically impair adrenal function under pathophysiological conditions.

scholarly journals Stigma terhadap pasien pasca COVID-19 dan faktor yang mempengaruhinya

2021 ◽  
Vol 3 (2) ◽  
pp. 70
Author(s):  
Intan Okrima Putri
Keyword(s):  
Public Attitudes ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Community Leaders ◽  
Bivariate Analysis ◽  
Religious Leaders ◽  
Cross Sectional ◽  
Self Confidence ◽  
The People

Stigma is a negative action that can reduce a person’s self-confidence. During the COVID-19 pandemic, the stigma can be in the form of refusal of bodies, expulsion of medical staff or ex-communication of patients with confirmed COVID-19 and post-COVID-19 patients. There are 2 Post-COVID-19 patients in Papringan Hamlet. This study aims to find out the influence of knowledge, attitudes, and role of community leaders on the stigma against Post-COVID-19 patients in Papringan Helmet Sidomukti Magetan Regency. This was a cross-sectional study. The population were the people who live in Papringan Hamlet, the sample amount was 97 respondents who used the Slovin formula. The sample criteria were aged 26-45 years, chosen by purposive sampling technique. Data were collected by questionnaires and checklist observations. Data analysis used the logistic regression test. Results: The results of the bivariate analysis test showed that there was an influence a relationship between knowledge (Sig. 0,000), attitude (Sig. 0,000), and roles of community leaders (Sig. 0,000) on the stigma against post-COVID-19 patients and multivariate analysis using Binary logistic test indicated there is an influence of knowledge (OR=16,955) to stigma Post-COVID-19 patients in Papringan Hamlet Sidomukti Magetan Regency. The Health Service and community health centres can eliminate the stigma of Post-COVID-19 patients in the community by increasing public knowledge through health education, as well as encouraging the role of religious leaders and community leaders to influence public attitudes so as not to carry out negative stigma against Post-COVID patients.

scholarly journals The Role of Leadership and its Relationship with the Performance of Community Health Volunteer: A Survey in Rural Indonesia

2021 ◽  
Vol 15 (2) ◽  
pp. 103
Author(s):  
Ngatoiatu Rohmani ◽  
Dewi Utari
Keyword(s):  
Community Health ◽  
Rank Correlation ◽  
Cross Sectional Study ◽  
Community Health Services ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Spearman’S Rank Correlation ◽  
Community Health Volunteer ◽  
And Performance

Background: Community Health Volunteers (CHVs) are the manifestation of community participation to solve health issues of the community, which is reflected through Integrated Services Post or known as Posyandu activities. Therefore, CHVs selection criteria need to be upgraded to support their performance in delivering community health services. This research aimed at identifying the relationship between the role of leadership and their performance in Posyandu activities. Method: This was a cross-sectional study conducted in Purwomartani village, Sleman, with a total of 68 respondents. Data were collected using validated questionnaires to evaluate the leadership and performance of healthy volunteers. The data were analyzed using Spearman's rank correlation. Results: The respondents comprised 100% females, 71.3% were aged above 41, and 82.4% were housewives, and 83.3% completed their education up to senior high school. The study revealed that 57.4% of respondents showed excellent performance before, during, and after the Posyandu activities. Bivariate analysis revealed that the role of leadership has a significant relationship with the performance of health volunteers (p<0.05). Conclusion: Training on leadership and effective communication is needed to support the role of CHVs to motivate the community to use the facilities for better health status.

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