scholarly journals Immunothrombotic Dysregulation in COVID-19 Pneumonia Is Associated With Respiratory Failure and Coagulopathy

Circulation ◽  
2020 ◽  
Vol 142 (12) ◽  
pp. 1176-1189 ◽  
Author(s):  
Leo Nicolai ◽  
Alexander Leunig ◽  
Sophia Brambs ◽  
Rainer Kaiser ◽  
Tobias Weinberger ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Severe Acute Respiratory Syndrome ◽  
Disease Severity ◽  
Severe Pneumonia ◽  
Corona Virus ◽  
Coagulation Tests ◽  
Myocardial Involvement ◽  
Platelet Aggregates ◽  
Polymerase Chain

Background: Severe acute respiratory syndrome corona virus 2 infection causes severe pneumonia (coronavirus disease 2019 [COVID-19]), but the mechanisms of subsequent respiratory failure and complicating renal and myocardial involvement are poorly understood. In addition, a systemic prothrombotic phenotype has been reported in patients with COVID-19. Methods: A total of 62 subjects were included in our study (n=38 patients with reverse transcriptase polymerase chain reaction–confirmed COVID-19 and n=24 non–COVID-19 controls). We performed histopathologic assessment of autopsy cases, surface marker–based phenotyping of neutrophils and platelets, and functional assays for platelet, neutrophil functions, and coagulation tests, as well. Results: We provide evidence that organ involvement and prothrombotic features in COVID-19 are linked by immunothrombosis. We show that, in COVID-19, inflammatory microvascular thrombi are present in the lung, kidney, and heart, containing neutrophil extracellular traps associated with platelets and fibrin. Patients with COVID-19 also present with neutrophil-platelet aggregates and a distinct neutrophil and platelet activation pattern in blood, which changes with disease severity. Whereas cases of intermediate severity show an exhausted platelet and hyporeactive neutrophil phenotype, patients severely affected with COVID-19 are characterized by excessive platelet and neutrophil activation in comparison with healthy controls and non–COVID-19 pneumonia. Dysregulated immunothrombosis in severe acute respiratory syndrome corona virus 2 pneumonia is linked to both acute respiratory distress syndrome and systemic hypercoagulability. Conclusions: Taken together, our data point to immunothrombotic dysregulation as a key marker of disease severity in COVID-19. Further work is necessary to determine the role of immunothrombosis in COVID-19.

scholarly journals Spontaneous Retroperitoneal Hematoma in COVID-19 Severe Pneumonia–Dual-phase Multidetector Computed Tomography (MDCT) Angiogram and Role of Radiologist

2021 ◽  
Author(s):  
Vikash Kumar Gupta ◽  
Buthaina Mohammad Alkandari ◽  
Wasif Mohammed ◽  
Mohsen Ahmed Abdelmohsen ◽  
Mohammad Gaber Abdullah Mohammad
Keyword(s):  
Significant Risk ◽  
Severe Pneumonia ◽  
Retroperitoneal Hematoma ◽  
Low Molecular Weight ◽  
Rt Pcr ◽  
Prophylactic Dose ◽  
Therapeutic Anticoagulation ◽  
Coagulation Tests ◽  
Polymerase Chain

AbstractStudies available in the literature have shown alterations in blood coagulation tests in severe cases of COVID-19 pneumonia, with a significant risk of venous thromboembolism (VTE). Since microvascular thrombosis is a well-known fact in COVID-19 disease, requiring therapeutic anticoagulation, low-molecular weight heparin (LMWH) in prophylactic dose is a part of the clinical management of hospitalized COVID-19 patients. In this scenario, we describe three cases of abdominal spontaneous retroperitoneal hematoma (SRH) in hospitalized reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients.

scholarly journals Prolonged severe acute respiratory syndrome of Corona Virus-2 positive with polymerase chain reaction: A case report

2020 ◽  
Vol 11 (3) ◽  
pp. 295-301
Author(s):  
Linda Rosita ◽  
Rahma Yuantari ◽  
Budi Mulyono ◽  
Umi Solekhah Intansari ◽  
Ingesti Bilkis Zulfatina
Keyword(s):  
Polymerase Chain Reaction ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Chain Reaction ◽  
Corona Virus ◽  
Polymerase Chain

scholarly journals Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in Patients With Coronavirus Disease 2019

2020 ◽  
Vol 222 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Qing-Lei Zeng ◽  
Zu-Jiang Yu ◽  
Jian-Jun Gou ◽  
Guang-Ming Li ◽  
Shu-Huan Ma ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Mortality Rate ◽  
Severe Acute Respiratory Syndrome ◽  
Plasma Treatment ◽  
Critically Ill Patients ◽  
Plasma Therapy ◽  
Viral Shedding ◽  
Almost All ◽  
End Stage

Abstract Currently, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been reported in almost all countries globally. No effective therapy has been documented for COVID-19, and the role of convalescent plasma therapy is unknown. In the current study, 6 patients with COVID-19 and respiratory failure received convalescent plasma a median of 21.5 days after viral shedding was first detected, all tested negative for SARS-CoV-2 RNA within 3 days after infusion, and 5 eventually died. In conclusion, convalescent plasma treatment can end SARS-CoV-2 shedding but cannot reduce the mortality rate in critically ill patients with end-stage COVID-19, and treatment should be initiated earlier.

scholarly journals Effects of Severe Acute Respiratory Syndrome Coronavirus 2 Infection on Pregnant Women and Their Infants

2020 ◽  
Vol 144 (10) ◽  
pp. 1217-1222 ◽  
Author(s):  
Hui Yang ◽  
Bin Hu ◽  
Sudong Zhan ◽  
Li-ye Yang ◽  
Guoping Xiong
Keyword(s):  
Computed Tomography ◽  
Severe Acute Respiratory Syndrome ◽  
Pregnant Women ◽  
Perinatal Death ◽  
Severe Pneumonia ◽  
Neonatal Morbidity ◽  
Late Pregnancy ◽  
Chest Computed Tomography ◽  
Polymerase Chain ◽  
Novel Coronavirus

Context.— The pandemic of a novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented global health burden. Objective.— To investigate the effect of the SARS-CoV-2 infection on maternal, fetal, and neonatal morbidity and other poor obstetrical outcomes. Design.— All suspected cases of pregnant women with coronavirus disease 2019 (COVID-19) admitted into one center in Wuhan from January 20 to March 19, 2020, were included. Detailed clinical data of those pregnancies with COVID-19 were retrospectively collected and analyzed. Results.— Twenty-seven pregnant women (4 early pregnancies included) with laboratory or clinically confirmed SARS-CoV-2 infection and 24 neonates born to the 23 women in late pregnancy were analyzed. On admission, 46.2% (13 of 27) of the patients had symptoms, including fever (11 of 27), cough (9 of 27), and vomiting (1 of 27). Decreased total lymphocytes count was observed in 81.5% (22 of 27) of patients. Twenty-six patients showed typical viral pneumonia by chest computed tomography scan, whereas 1 patient confirmed with COVID-19 infection showed no abnormality on chest computed tomography. One mother developed severe pneumonia 3 days after her delivery. No maternal or perinatal death occurred. Moreover, 1 early preterm newborn born to a mother with the complication of premature rupture of fetal membranes, highly suspected to have SARS-CoV-2 infection, was SARS-CoV-2 negative after repeated real-time reverse transcriptase polymerase chain reaction testing. Statistical differences were observed between the groups of women in early and late pregnancy with COVID-19 in the occurrence of lymphopenia and thrombocytopenia. Conclusions.— No major complications were reported among the studied cohort, though 1 serious case and 1 perinatal infection were observed. Much effort should be made to reduce the pathogenic effect of COVID-19 infection in pregnancies.

scholarly journals Autoimmune Disorders & COVID-19

Medicines ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 55
Author(s):  
Leonardo Freire-de-Lima ◽  
Aline Miranda Scovino ◽  
Camilla Cristie Barreto Menezes ◽  
Leonardo Marques da Fonseca ◽  
Jhenifer Santos dos Reis ◽  
...  
Keyword(s):  
Immune System ◽  
Respiratory Failure ◽  
Autoimmune Disease ◽  
Severe Pneumonia ◽  
Type I ◽  
Cytokine Storm ◽  
Immunological Mechanisms ◽  
The World ◽  
Inflammatory Syndrome

Coronavirus disease 2019 (COVID-19) can progress to severe pneumonia with respiratory failure and is aggravated by the deregulation of the immune system causing an excessive inflammation including the cytokine storm. Since 2019, several studies regarding the interplay between autoimmune diseases and COVID-19 infections is increasing all over the world. In addition, thanks to new scientific findings, we actually know better why certain conditions are considered a higher risk in both situations. There are instances when having an autoimmune disease increases susceptibility to COVID-19 complications, such as when autoantibodies capable of neutralizing type I IFN are present, and other situations in which having COVID-19 infection precedes the appearance of various autoimmune and autoinflammatory diseases, including multisystem inflammatory syndrome in children (MIS-C), Guillain-Barré syndrome, and Autoimmune haemolytic anaemia (AIHA), thus, adding to the growing mystery surrounding the SARS-CoV-2 virus and raising questions about the nature of its link with autoimmune and autoinflammatory sequelae. Herein, we discuss the role of host and virus genetics and some possible immunological mechanisms that might lead to the disease aggravation.

scholarly journals Cerebrovascular complications in patients with SARS-CoV-2 infection: Case series

2020 ◽  
Author(s):  
Mauro Morassi ◽  
Daniele Bagatto ◽  
Milena Cobelli ◽  
Serena D’Agostini ◽  
Gian Luigi Gigli ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Case Series ◽  
Severe Pneumonia ◽  
Asymptomatic Infection ◽  
Retrospective Case ◽  
Cerebrovascular Complications ◽  
Behavioral Abnormalities ◽  
Coagulation Tests ◽  
Polymerase Chain ◽  
Responsible Pathogen

Abstract Background: Italy is one of the most affected countries by the Coronavirus disease 2019 (COVID-19). The responsible pathogen is named Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). The clinical spectrum ranges from asymptomatic infection to severe pneumonia leading to intensive care unit admission. Evidence of cerebrovascular complications associated with SARS-CoV-2 is limited. We herein report 6 patients who developed acute stroke during COVID-19 infection. Methods: Retrospective case series of patients diagnosed with COVID-19 using reverse-transcriptase–polymerase-chain-reaction (RT-PCR) on nasopharyngeal swabs, who developed clinical and neuroimaging evidence of acute stroke during SARS-CoV-2 infection.Results: Six patients were identified (5 men); median age was 69 years (range: 57-82). Stroke subtypes were ischemic (4, 67%) and hemorrhagic (2, 33%). All patients but 1 had pre-existing vascular risk factors. One patient developed encephalopathy prior to stroke, characterized by focal seizures and behavioral abnormalities. COVID-19-related pneumonia was severe (i.e. requiring critical care support) in 5/6 cases (83%). Liver enzyme alteration and lactate dehydrogenase (LDH) elevation was registered in all cases. Four patients (67%) manifested acute kidney failure prior to stroke. Four patients (67%) had abnormal coagulation tests. Outcome was poor in the majority of the patients: 4 died (67%), 1 is still in coma (20%) and the remaining 1 remains severely neurologically affected (mRS: 4).Conclusions: Acute stroke can complicate the course of COVI-19 infection. In our series, stroke developed mostly in patients with severe pneumonia and multi organ failure, liver enzymes and LDH were markedly increased in all cases, and the outcome was poor.

scholarly journals Detection of severe acute respiratory syndrome corona virus 2 in cervico-vaginal secretion of COVID-19-affected female: A prospective observational study from India

2021 ◽  
Vol 9 ◽  
pp. 205031212110229
Author(s):  
Mukta Agarwal ◽  
Swmkwr Basumatary ◽  
Divendu Bhusan ◽  
Binod Kumar Pati
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Prospective Observational Study ◽  
Sexual Transmission ◽  
Male Partner ◽  
Chain Reaction ◽  
Corona Virus ◽  
Vaginal Secretions ◽  
Female Genital System ◽  
Polymerase Chain ◽  
Female Genital

Background: The novel severe acute respiratory syndrome corona virus 2 (also known as 2019-nCoV) is a highly infectious agent and is declared as a global public health emergency by the World Health Organisation. The main known transmission route of severe acute respiratory syndrome corona virus 2 is through respiratory air droplets. Although recent studies have revealed that the virus is detectable in the throat, blood, urine, anal swabs, tears and even faeces; however, modes of transmission other than respiratory droplets has not been studied much. Knowledge on the presence of the virus in the female genital tract may help determine the risk of sexual transmission as well as the risk of mother-to-child transmission. However, not much data are available yet regarding the presence of the virus in the female genital system. Hence, to explore the presence of the virus in the female genital system and possibility of sexual transmission, a study was conducted where in we tried to detect severe acute respiratory syndrome corona virus 2 in cervico-vaginal secretions. Methods: From July 2020 to September 2020, 35 COVID-19-positive female patients admitted to tertiary care teaching institute of Eastern India, which is now declared dedicated Corona Hospital and Centre of Excellence for COVID-19 care, who consented for the research were enrolled in this prospective observational study. Proper gynaecological history, clinical records along with laboratory findings of the patient was recorded. The possibility of the sexual transmission of the virus from female to her male partner was to be ascertained by testing the presence of severe acute respiratory syndrome corona virus 2 in the vaginal, cervical secretions by reverse transcriptase polymerase chain reaction. Results: All 35 COVID-19-positive female patients were tested for severe acute respiratory syndrome corona virus 2 in their vaginal and cervical secretions by reverse transcriptase polymerase chain reaction. All the samples were tested negative for the virus. Conclusion: Findings from this study reveals that severe acute respiratory syndrome corona virus 2 is not present in the cervical and vaginal secretions, and the possibility of transmission from female to her male partner by vaginal sexual intercourse is unlikely.

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