scholarly journals The gut microbiome: an under-recognised contributor to the COVID-19 pandemic?

2020 ◽  
Vol 13 ◽  
pp. 175628482097491
Author(s):  
Jonathan P. Segal ◽  
Joyce W. Y. Mak ◽  
Benjamin H. Mullish ◽  
James L. Alexander ◽  
Siew C. Ng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gut Microbiome ◽  
Social Impact ◽  
Severe Disease ◽  
Receptor Expression ◽  
Attractive Potential ◽  
Future Research ◽  
Clinical Activity ◽  
Disease Course ◽  
Novel Coronavirus

The novel coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus has spread rapidly across the globe, culminating in major global morbidity and mortality. As such, there has been a rapid escalation in scientific and clinical activity aimed at increasing our comprehension of this virus. This volume of work has led to early insights into risk factors associated with severity of disease, and mechanisms that underpin the virulence and dynamics involved in viral transmission. These insights ultimately may help guide potential therapeutics to reduce the human, economic and social impact of this pandemic. Importantly, the gastrointestinal (GI) tract has emerged as an important organ influencing propensity to, and potentially severity of, COVID-19 infection. Furthermore, the gut microbiome has been linked to a variety of risk factors for COVID-19 infection, and manipulation of the gut microbiome is an attractive potential therapeutic target for a number of diseases. While data profiling the gut microbiome in COVID-19 infection to date are limited, they support the possibility of several routes of interaction between COVID-19, the gut microbiome, angiotensin converting enzyme 2 (ACE-2) expression in the small bowel and colon and gut inflammation. This article will explore the evidence that implicates the gut microbiome as a contributing factor to the pathogenesis, severity and disease course of COVID-19, and speculate about the gut microbiome’s capability as a therapeutic avenue against COVID-19. Lay summary It has been noted that certain baseline gut profiles of COVID-19 patients are associated with a more severe disease course, and the gut microbiome impacts the disease course of several contributory risk factors to the severity of COVID-19. A protein called ACE-2, which is found in the small intestine among other sites, is a key receptor for COVID-19 virus entry; there is evidence that the gut microbiome influences ACE-2 receptor expression, and hence may play a role in influencing COVID-19 infectivity and disease severity. Furthermore, the gut microbiome plays a significant role in immune regulation, and hence may be pivotal in influencing the immune response to COVID-19. In terms of understanding COVID-19 treatments, the gut microbiome is known to interact with several drug classes being used to target COVID-19 and should be factored into our understanding of how patients respond to treatment. Importantly, our understanding of the role of the gut microbiome in COVID-19 infection remains in its infancy, but future research may potentially aid our mechanistic understanding of viral infection, and new ways in which we might approach treating it.

Objawy oczne w przebiegu chorób tarczycy

2018 ◽  
Vol 21 (1A) ◽  
Author(s):  
Paweł Wójtowiec ◽  
Anna Wójtowiec ◽  
Tomasz Tomkalski
Keyword(s):  
Severe Disease ◽  
Surgical Decompression ◽  
Clinical Activity ◽  
Graves Disease ◽  
Disease Course ◽  
Clinical Activity Score ◽  
Ocular Manifestations ◽  
Ocular Lesions ◽  
Degree Of Severity

Thyroid-related ocular manifestations are typically associated with Graves’ disease. The cause of Graves’ ophthalmopathy is not fully understood but it is believed to be autoimmune in origin. The most important risk factors are smoking and age. Patient’s gender also plays a significant role: ophthalmopathy is more prevalent in women but men experience a more severe disease course. There are two forms of the disease: inflammatory with congestion and pain in the eyeballs and fibrotic stage with impaired eye movements and no signs of inflammation. The degree of severity of ocular lesions is determined by NO SPECS classification and activity coefficient of orbitopathy (Clinical Activity Score – CAS). Previous clinical trials have not produced satysfying answers to questions about effective treatment of orbitopathy. In order to obtain the desired results it is to first necessary to achieve euthyroidism. Treatment is usually continual and long-term. Regimens in various centers vary, depending on their experiences. Currently the most commonly used are steroid therapy, radiation therapy and surgical decompression of the eye sockets. Surgical treatment is, however, used infrequently.

scholarly journals COVID-19 vaccination of pregnant women: state-of-the-art

2021 ◽  
Vol 5 (11) ◽  
pp. 768-772
Author(s):  
A.A. Girina ◽  
◽  
A.L. Zaplatnikov ◽  
V.I. Svintsitskaya ◽  
S.D. Izhogina ◽  
...  
Keyword(s):  
Pregnant Women ◽  
State Of The Art ◽  
Severe Disease ◽  
Perinatal Outcomes ◽  
Professional Associations ◽  
Disease Course ◽  
Complete Control ◽  
Outcome Monitoring ◽  
Coronavirus Infection ◽  
Novel Coronavirus

Despite efforts made by the world community to battle the novel coronavirus infection, we are still unable to take complete control of virus spread. One of the causes of this issue is inadequate coverage of vaccination. Meanwhile, disease course in specific populations is associated with the risks of severe complications and lethal outcome. Infection of pregnant women is of particular concern. This paper addresses recent data on vaccination against the COVID-19 infection in pregnant women, including those with risk of severe disease course and unfavorable outcome. Monitoring the health of women infected with SARS-CoV-2 during gestation demonstrates unfavorable effects of the COVID-19 infection on the course and outcome of pregnancy. On the other hand, observational programs have demonstrated that vaccination has no effects on pregnancy course and perinatal outcomes. A view of the WHO and professional associations on the vaccination of pregnant women, particularly those from risk groups of severe COVID-19 course, is discussed. The importance of a personalized and balanced approach to COVID-19 vaccination of pregnant women involving the assessment of risks and benefits for the mother and child is emphasized. KEYWORDS: novel coronavirus infection, COVID-19, vaccination, immunization, pregnant women, risk group. FOR CITATION: Girina A.A., Zaplatnikov A.L., Svintsitskaya V.I., Izhogina S.D. COVID-19 vaccination of pregnant women: state-of-the-art. Russian Medical Inquiry. 2021;5(11):768–772 (in Russ.). DOI: 10.32364/2587-6821-2021-5-11-768-772.

scholarly journals Predictors for Severe COVID-19 Infection

2020 ◽  
Vol 71 (8) ◽  
pp. 1962-1968 ◽  
Author(s):  
Ashish Bhargava ◽  
Elisa Akagi Fukushima ◽  
Miriam Levine ◽  
Wei Zhao ◽  
Farah Tanveer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
Medical Center ◽  
Severe Disease ◽  
Academic Medical Center ◽  
Severe Infection ◽  
Supplemental Oxygen ◽  
Multivariable Logistic Regression Analysis ◽  
Cell Counts ◽  
Novel Coronavirus

Abstract Background COVID-19 is a pandemic disease caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Predictors for severe COVID-19 infection have not been well defined. Determination of risk factors for severe infection would enable identifying patients who may benefit from aggressive supportive care and early intervention. Methods We conducted a retrospective observational study of 197 patients with confirmed COVID-19 admitted to a tertiary academic medical center. Results Of 197 hospitalized patients, the mean (SD) age of the cohort was 60.6 (16.2) years, 103 (52.3%) were male, and 156 (82.1%) were black. Severe COVID-19 infection was noted in 74 (37.6%) patients, requiring intubation. Patients aged above 60 were significantly more likely to have severe infection. Patients with severe infection were significantly more likely to have diabetes, renal disease, and chronic pulmonary disease and had significantly higher white blood cell counts, lower lymphocyte counts, and increased C-reactive protein (CRP) than patients with nonsevere infection. In multivariable logistic regression analysis, risk factors for severe infection included pre-existing renal disease (odds ratio [OR], 7.4; 95% CI, 2.5–22.0), oxygen requirement at hospitalization (OR, 2.9; 95% CI, 1.3–6.7), acute renal injury (OR, 2.7; 95% CI, 1.3–5.6), and CRP on admission (OR, 1.006; 95% CI, 1.001–1.01). Race, age, and socioeconomic status were not independent predictors. Conclusions Acute or pre-existing renal disease, supplemental oxygen upon hospitalization, and admission CRP were independent predictors for the development of severe COVID-19. Every 1-unit increase in CRP increased the risk of severe disease by 0.06%.

scholarly journals The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned?

2020 ◽  
Vol 49 (3) ◽  
pp. 717-726 ◽  
Author(s):  
Noah C Peeri ◽  
Nistha Shrestha ◽  
Md Siddikur Rahman ◽  
Rafdzah Zaki ◽  
Zhengqi Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mainland China ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Lessons Learned ◽  
Future Research ◽  
The North ◽  
Control And Prevention ◽  
Clinical Signs And Symptoms ◽  
Novel Coronavirus

Abstract Objectives To provide an overview of the three major deadly coronaviruses and identify areas for improvement of future preparedness plans, as well as provide a critical assessment of the risk factors and actionable items for stopping their spread, utilizing lessons learned from the first two deadly coronavirus outbreaks, as well as initial reports from the current novel coronavirus (COVID-19) epidemic in Wuhan, China. Methods Utilizing the Centers for Disease Control and Prevention (CDC, USA) website, and a comprehensive review of PubMed literature, we obtained information regarding clinical signs and symptoms, treatment and diagnosis, transmission methods, protection methods and risk factors for Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and COVID-19. Comparisons between the viruses were made. Results Inadequate risk assessment regarding the urgency of the situation, and limited reporting on the virus within China has, in part, led to the rapid spread of COVID-19 throughout mainland China and into proximal and distant countries. Compared with SARS and MERS, COVID-19 has spread more rapidly, due in part to increased globalization and the focus of the epidemic. Wuhan, China is a large hub connecting the North, South, East and West of China via railways and a major international airport. The availability of connecting flights, the timing of the outbreak during the Chinese (Lunar) New Year, and the massive rail transit hub located in Wuhan has enabled the virus to perforate throughout China, and eventually, globally. Conclusions We conclude that we did not learn from the two prior epidemics of coronavirus and were ill-prepared to deal with the challenges the COVID-19 epidemic has posed. Future research should attempt to address the uses and implications of internet of things (IoT) technologies for mapping the spread of infection.

scholarly journals Involvement of Oxidative Stress and the Innate Immune System in SARS-CoV-2 Infection

Diseases ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 17
Author(s):  
Evgenii M. Kozlov ◽  
Ekaterina Ivanova ◽  
Andrey V. Grechko ◽  
Wei-Kai Wu ◽  
Antonina V. Starodubova ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Immune System ◽  
Severe Disease ◽  
Risk Groups ◽  
The Elderly ◽  
Economic Life ◽  
Potential Risk Factors ◽  
Rapid Transmission ◽  
Novel Coronavirus

The emergence of the novel coronavirus in December 2019 in China marked the beginning of a pandemic that impacted healthcare systems and economic life all over the world. The virus primarily targets the respiratory system causing severe acute respiratory syndrome (SARS) in some patients, and therefore received the name of SARS-CoV-2. The pathogen stands out among other coronaviruses by its rapid transmission from human to human, with the majority of infected individuals being asymptomatic or presenting with only minor illness, therefore facilitating the pathogen spread. At the same time, people from the risk groups, such as the elderly, patients suffering from chronic diseases, or obese individuals, have increased chances of developing a severe or even fatal disease. The search for risk factors explaining this phenomenon continues. In this review, we focus on the known mechanisms of SARS-CoV-2 infection affecting the functioning of the immune system and discuss potential risk factors responsible for the severe disease course. Oxidative stress is one of such factors, which plays a prominent role in innate immunity activity, and recent research has revealed its tight involvement in SARS-CoV-2 infection. We discuss these recent findings and the development of excessive inflammation and cytokine storm observed during SARS-CoV-2 infection. Finally, we consider potential use of antioxidant drugs for alleviating the severe symptoms in affected patients.

scholarly journals COVID-19 Disease Severity Correlates with Smoking Status

2020 ◽  
Author(s):  
Edouard Lansiaux ◽  
Pierre-Philippe Pébaÿ ◽  
Jean-Laurent Picard ◽  
Joachim Son-Forget
Keyword(s):  
Infectious Disease ◽  
Risk Factors ◽  
Disease Severity ◽  
Smoking Status ◽  
Severe Disease ◽  
Health Conditions ◽  
The Novel ◽  
Disease Course ◽  
P Values ◽  
The Us

The novel COVID-19 disease is a contagious acute respiratory infectious disease whose causative agent has been demonstrated to be a new virus of the coronavirus family, SARS-CoV-2. Multiple studies have already reported that risk factors for severe disease include older age and the presence of at least one of several underlying health conditions. However, a recent physiopathological report and the French COVID-19 scientifific council have postulated a protective effect of tobacco smoking. We have been able to demonstrate the statistical signifificance in this regard of recent series from both China and in the US, reporting smoking status as well as disease severity (p-values of 2.27 × 10 3 and 11.7 × 10 15, respectively). Subsequently and using a Bayesian approach we have established that disease severity is positively associated with smoking status. Finally, we refute claims linking general population smoking status (N in O(108) or O(109)) to much smaller disease course series (N in O(103)). The latter point in particular is presented to stimulate academic discussion, and must be further investigated by well-designed studies.

scholarly journals Complement C3 identified as a unique Risk Factor for Disease Severity among Young COVID-19 Patients in Wuhan

2020 ◽  
Author(s):  
Weiting Cheng ◽  
Roman Hornung ◽  
Kai Xu ◽  
Jian Li
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Disease Severity ◽  
Severe Disease ◽  
Multivariable Analysis ◽  
Laboratory Data ◽  
Young Patients ◽  
Complement C3 ◽  
Disease Course ◽  
Non Linear

Background Given that a substantial proportion of the subgroup of COVID-19 patients that face a severe disease course are younger than 60 years, it is critical to understand the disease-specific characteristics of young COVID-19 patients. Risk factors for a severe disease course for young COVID-19 patients and possibly non-linear influences remain unknown. Methods Data of COVID-19 patients with clinical outcome in a designated hospital in Wuhan, China, collected retrospectively from Jan 24th to Mar 27th, were analyzed. Clinical, demographic, treatment and laboratory data were collected from patients' medical records. Uni- and multivariable analysis using logistic regression and random forest, with the latter allowing the study of non-linear influences, were performed to investigate and exploit the clinical characteristics of a severe disease course. Results A total of 762 young patients (median age 47 years, interquartile ranges [IQR] 38 - 55, range 16 - 60; 55.9% female) were included, as well as 714 elderly patients as a comparison group. Among the young patients, 362 (47.5%) had a severe/critical disease course and the mean age was significantly higher in the severe subgroup than in the mild subgroup (59.3 vs. 56.0, Student's t-test: p < 0.001). The uni- and multivariable analysis suggested that several covariates such as elevated levels of ASS, CRP and LDH, and decreased lymphocyte counts are influential on disease severity independent of age. Elevated levels of complement C3 (odds ratio [OR] 15.6, 95% CI 2.41-122.3; p=0.039) are particularly associated with the risk for the development of severity specifically in young patients, where no such influence seems to exist for elderly patients. Additional analysis suggests that the influence of complement C3 in young patients is independent of age, gender, and comorbidities. Variable importance values and partial dependence plots obtained using random forests delivered additional insights, in particular indicating non-linear influences of risk factors on disease severity. Conclusion In young patients with COVID-19, the levels of complement C3 correlated with disease severity and tended to be a good predictor of adverse outcome.

scholarly journals Complement C3 identified as a unique risk factor for disease severity among young COVID-19 patients in Wuhan, China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Weiting Cheng ◽  
Roman Hornung ◽  
Kai Xu ◽  
Cai hong Yang ◽  
Jian Li
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Elderly Patients ◽  
Disease Severity ◽  
Severe Disease ◽  
Multivariable Analysis ◽  
Young Patients ◽  
Complement C3 ◽  
Disease Course ◽  
Non Linear

AbstractGiven that a substantial proportion of the subgroup of COVID-19 patients that face a severe disease course are younger than 60 years, it is critical to understand the disease-specific characteristics of young COVID-19 patients. Risk factors for a severe disease course for young COVID-19 patients and possible non-linear influences remain unknown. Data were analyzed from COVID-19 patients with clinical outcome in a single hospital in Wuhan, China, collected retrospectively from Jan 24th to Mar 27th. Clinical, demographic, treatment and laboratory data were collected from patients' medical records. Uni- and multivariable analysis using logistic regression and random forest, with the latter allowing the study of non-linear influences, were performed to investigate the clinical characteristics of a severe disease course. A total of 762 young patients (median age 47 years, interquartile range [IQR] 38–55, range 18–60; 55.9% female) were included, as well as 714 elderly patients as a comparison group. Among the young patients, 362 (47.5%) had a severe/critical disease course and the mean age was statistically significantly higher in the severe subgroup than in the mild subgroup (59.3 vs. 56.0, Student's t-test: p < 0.001). The uni- and multivariable analysis suggested that several covariates such as elevated levels of serum amyloid A (SAA), C-reactive protein (CRP) and lactate dehydrogenase (LDH), and decreased lymphocyte counts influence disease severity independently of age. Elevated levels of complement C3 (odds ratio [OR] 15.6, 95% CI 2.41–122.3; p = 0.039) are particularly associated with the risk of developing severe COVID-19 specifically in young patients, whereas no such influence seems to exist for elderly patients. Additional analysis suggests that the influence of complement C3 in young patients is independent of age, gender, and comorbidities. Variable importance values and partial dependence plots obtained using random forests delivered additional insights, in particular indicating non-linear influences of risk factors on disease severity. This study identified increased levels of complement C3 as a unique risk factor for adverse outcomes specific to young COVID-19 patients.

scholarly journals Does Thrombocytopenia Truly Correlate with COVID-19 Severity?

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 39-40
Author(s):  
Caroline Hana ◽  
Samar Aboulenain ◽  
Nakeya Dewaswala ◽  
Vijay Narendran
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Disease Severity ◽  
Retrospective Cohort ◽  
Severe Disease ◽  
Smoking History ◽  
Prognostic Impact ◽  
Disease Course ◽  
Platelet Counts ◽  
The Mean

Introduction: On March 11, 2020, the World Health Organization (WHO) declared SARS-CoV-19 a pandemic with about 114 countries affected. Many studies and metanalyses have investigated the risk factors associated with poor outcomes from COVID-19 infection. Different clinical as well as laboratory parameters have been shown to correlate with disease severity, including age, male gender, smoking history, presence of one or more co-morbidities, heart disease, hypertension, diabetes, obesity, and chronic lung disease. Among these risk factors, several studies suggest that a decreased platelet count is associated with more severe disease course. A lower platelets count was also observed to be associated with a poor prognosis. On the contrary, not all reports seem to show the same association. Objective: Our study is aimed at investigating the prognostic impact of the platelet count in patients admitted with COVID-19 infection and understanding its association with disease severity and mortality. Methodology: All patients admitted to JFK Medical center in Atlantis, Florida and diagnosed with COVID-19 from March 2020 to May 2020 were identified and included in this retrospective cohort. Certain demographic and clinical data were collected for each patient, including age, gender, comorbidities, complete blood count and blood chemistry values on admission. The following data was calculated: quick Sequential Organ Failure Assessment (qSOFA), the ratio of oxygen saturation to the fraction of inspired oxygen ratio (SpO2/FiO2) were calculated, presence or absence of adult respiratory distress syndrome (ARDS), and the outcome in terms of mortality. Data regarding the radiographic findings on chest X-ray (CXR) were determined to be normal, mild, moderate, or severe by a radiologist. Patients were identified as having severe disease if they met the following criteria: Admission to the intensive care unit (ICU) during hospitalization or met criteria for ARDS. Results: A total of 175 patients were identified. The mean age was 62.97 years(SD 17.9years), 97 patients (55.4%) were males, 36 (20.6%) had an ICU admission during their hospitalization, 18 (10.3%) met the criteria for ARDS, 131 (74.9%) had qSOFA of 0 with only 3 (1.7%) having qSOFA of 2. The majority of CXR findings were mild 66 out of valid 155 cases (37.7%) while 19.4% read as severe infiltrate. The mean platelets count on admission was 227.71 x 109/L (SD 104 x 109/L). 43 patients (24.6%) died in the hospital. Patients with severe disease versus non-severe disease did not differ significantly in the platelet count at admission. Platelet counts were also not associated with in-hospital mortality. No significant correlation was found between the platelets count and the qSOFA scale, the SpO2/FiO2 and the CXR findings (table 2). Conclusion: In our retrospective Cohort study, no significant association was found between the platelet count on admission and disease severity or mortality. Studies examining the risk factors for severe COVID-19 infection and mortality showed that thrombocytopenia is a significant risk factor.(13) Other studies showed that patients with significantly elevated platelets (&gt; 300 x 109/L) during treatment had longer average hospitalization days.(12). Finding practical and actionable indicators of disease severity can help clinicians guide patients with potentially worse outcomes to aggressive therapies that may lead to better outcomes when instituted earlier. More work should be done to clarify the role platelet counts can play in the prognostication of patients with COVID-19 infection. Our Study will be followed by further investigation of the correlation between day 3 platelet count and COVID-19 severity. We are also examining the validation of a scoring system involving the platelet count among other parameters to use as a predictor for disease course and outcome. Disclosures No relevant conflicts of interest to declare.

Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Critical Role ◽  
Self Report ◽  
Future Research ◽  
Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

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