Características y especialización de la respuesta inmunitaria en la COVID-19 y posibles tratamientos profilácticos

2020 ◽  
Vol 63 (4) ◽  
pp. 7-18 ◽  
Author(s):  
Anamary Súarez Reyes ◽  
Carlos Agustín Villegas Valverde

Characteristics and Specialization of the Immune Response in COVID-19 Abstract The outbreak of coronavirus pneumonia in Wuhan, China, became a pandemic on March 11, 2020. It has caused almost 4 million confirmed cases worldwide, with more than 270,000 deaths. Coronavirus is an enveloped RNA virus of the β-coronavirus genus distributed in birds, humans, and other mammals. The World Health Organization has named the new disease COVID-19. The scientific community is look http://doi.org/10.22201/fm.24484865e.2020.63.4.02 8 8 Revista de la Facultad de Medicina de la UNAM | ing for evidence that can lead to a better understanding of the infection and the immune response (IR), prognostic and therapeutic predictors, effective treatments and vaccines. The objective of this review was to compile updated scientific evidence of the IR to COVID-19, in order to guide professionals with solutions that have a clinical impact. The most important elements involve innate immunity with failures in the interferon system in the early stages of the infection and a sustained increase in proinflammatory interleukins. This can end in a potentially fatal cytokine storm. The infiltration of neutrophils and macrophages at the alveolar level, accompanied by neutrophilia, is very characteristic. Lymphopenia is evident at the adaptive immunity level, that, depending on the degree, can indicate the severity of the disease. Understanding the temporal sequence of the IR is crucial for choosing the appropriate and effective therapies, especially when selecting which type of anti-inflammatory drugs can be used and the frequency of the dosage. Due to the fact that it is difficult to determine when they will be clearly beneficial, not harmful to the IR and not too late, due to the irreversibility of the process. Key words: COVID-19; coronavirus; immune response

2014 ◽  
Vol 27 (3) ◽  
pp. 511-529 ◽  
Author(s):  
Sudeepa Abeysinghe

ArgumentScientific uncertainty is fundamental to the management of contemporary global risks. In 2009, the World Health Organization (WHO) declared the start of the H1N1 Influenza Pandemic. This declaration signified the risk posed by the spread of the H1N1 virus, and in turn precipitated a range of actions by global public health actors. This article analyzes the WHO's public representation of risk and examines the centrality of scientific uncertainty in the case of H1N1. It argues that the WHO's risk narrative reflected the context of scientific uncertainty in which it was working. The WHO argued that it was attempting to remain faithful to the scientific evidence, and the uncertain nature of the threat. However, as a result, the WHO's public risk narrative was neither consistent nor socially robust, leading to the eventual contestation of the WHO's position by other global public health actors, most notably the Council of Europe. This illustrates both the significance of scientific uncertainty in the investigation of risk, and the difficulty for risk managing institutions in effectively acting in the face of this uncertainty.


Author(s):  
Nicholas Spence ◽  
Jerry P. White

On June 11, 2009, the Director General of the World Health Organization, Dr. Margaret Chan, announced that the scientific evidence indicated that the criteria for an influenza pandemic had been met: pandemic H1N1/09 virus, the first in nearly 40 years, was officially upon us. The World Health Organization has estimated that as many as 2 billion or between 15 and 45 percent of the population globally will be infected by the H1N1/09 virus. Scientists and governments have been careful to walk a line between causing mass public fear and ensuring people take the risks seriously. The latest information indicates that the majority of individuals infected with the H1N1/09 virus thus far have suffered mild illness, although very severe and fatal illness have been observed in a small number of cases, even in young and healthy people (World Health Organization 2009c). There is no evidence to date that the virus has mutated to a more virulent or lethal form; however, as we enter the second wave of the pandemic, a significant number of people in countries across the world are susceptible to infection. Most importantly, certain subgroups have been categorized as high risk given the clinical evidence to date. One of these subgroups is Indigenous populations (World Health Organization 2009c).


The outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China has been brought to global attention and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. In a recent study of Nanshan Chen et al., on patients of Wuhan Jinyintan Hospital, Wuhan, China, from the 99 patients with SARSCoV-2 infection, 51% had chronic diseases and they had symptoms of fever (83%), cough (82%) shortness of breath (31%), muscle ache (11%), fatigue (9%), headache (8%), sore throat (5%), rhinorrhea (4%), chest pain (2%), diarrhea (2%), and nausea and vomiting (1%) [1, 2]. The majority of patients can recover, however, about 25% of patients will progress into severe complications including acute respiratory distress syndrome (ARDS), which may worsen rapidly into respiratory failure, need an intensive care unit (ICU) and even cause multiple organ failure [3]. Depending on the pathophysiological mechanisms supposed to be involved in the development of the various clinical forms of the disease, various types of treatment have been tested with varying degrees of success. We have developed a nanotherapy to block the entry of the virus into the host cell, to reduce its potential for replication and to regulate the immune response against the microbial aggressor [4].


Author(s):  
Rawaz Tawfeeq ◽  
Tarin Tahssen Obied ◽  
Aram Ommar

Background: Errors in drug prescriptions are the most common preventable medication errors encountered in clinical practices worldwide. The purpose of this study is to examine the pattern of prescriptions and drug use in the Kurdistan region and to determine whether prescription patterns are based on rational therapeutic considerations. Methods: A cross sectional-observational study was conducted in the Kurdistan region of Iraq over a period of five months. A total of 1000 prescriptions were selected randomly from different pharmacies and data obtained from each prescription. In these prescriptions a total of 2878 medications were prescribed. After collection, excel software was then used to perform calculations. Results: The average number of drugs per prescription was calculated to be 2.8. Drugs prescribed by generic name were 27% and more than 98 percent of prescriptions were handwritten. The duration of therapy was mentioned in 56.5% of prescriptions. However, the dose and dosage form of medications were recorded 62% and 87.3% respectively. The percentage of prescriptions containing a signature was 88.1%. Furthermore, the percentage of antibiotics, supplements, non-steroidal anti-inflammatory drugs and other painkillers were prescribed at a rate of 51.8%, 44.2%, 31.8%, and 21.8% per prescription. Conclusion: Whilst observing the data we can conclude that the rate of drugs written per prescription is much higher than the suggested World Health Organization (WHO0 average. Prescribing errors are one of the most common preventable causes of medication errors and the use of electronic prescriptions may play a huge role in ameliorating this fact.


2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Áurea Gabriel ◽  
Ana Valério-Bolas ◽  
Joana Palma-Marques ◽  
Patrícia Mourata-Gonçalves ◽  
Pedro Ruas ◽  
...  

This review is aimed at providing a comprehensive outline of the immune response displayed against cutaneous leishmaniasis (CL), the more common zoonotic infection caused by protozoan parasites of the genus Leishmania. Although of polymorphic clinical presentation, classically CL is characterized by leishmaniotic lesions on the face and extremities of the patients, which can be ulcerative, and even after healing can lead to permanent injuries and disfigurement, affecting significantly their psychological, social, and economic well-being. According a report released by the World Health Organization, the disability-adjusted life years (DALYs) lost due to leishmaniasis are close to 2.4 million, annually there are 1.0–1.5 million new cases of CL, and a numerous population is at risk in the endemic areas. Despite its increasing worldwide incidence, it is one of the so-called neglected tropical diseases. Furthermore, this review provides an overview of the existing knowledge of the host innate and acquired immune response to cutaneous species of Leishmania. The use of animal models and of in vitro studies has improved the understanding of parasite-host interplay and the complexity of immune mechanisms involved. The importance of diagnosis accuracy associated with effective patient management in CL reduction is highlighted. However, the multiple factors involved in CL epizoology associated with the unavailability of vaccines or drugs to prevent infection make difficult to formulate an effective strategy for CL control.


2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Iben Axén ◽  
Cecilia Bergström ◽  
Marc Bronson ◽  
Pierre Côté ◽  
Casper Glissmann Nim ◽  
...  

Abstract Background In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known. Main text During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements. We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies. Conclusions Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.


2020 ◽  
Vol 11 ◽  
Author(s):  
Concetta Di Natale ◽  
Sara La Manna ◽  
Ilaria De Benedictis ◽  
Paola Brandi ◽  
Daniela Marasco

At the end of December 2019, an epidemic form of respiratory tract infection now named COVID-19 emerged in Wuhan, China. It is caused by a newly identified viral pathogen, the severe acute respiratory syndrome coronavirus (SARS-CoV-2), which can cause severe pneumonia and acute respiratory distress syndrome. On January 30, 2020, due to the rapid spread of infection, COVID-19 was declared as a global health emergency by the World Health Organization. Coronaviruses are enveloped RNA viruses belonging to the family of Coronaviridae, which are able to infect birds, humans and other mammals. The majority of human coronavirus infections are mild although already in 2003 and in 2012, the epidemics of SARS-CoV and Middle East Respiratory Syndrome coronavirus (MERS-CoV), respectively, were characterized by a high mortality rate. In this regard, many efforts have been made to develop therapeutic strategies against human CoV infections but, unfortunately, drug candidates have shown efficacy only into in vitro studies, limiting their use against COVID-19 infection. Actually, no treatment has been approved in humans against SARS-CoV-2, and therefore there is an urgent need of a suitable vaccine to tackle this health issue. However, the puzzled scenario of biological features of the virus and its interaction with human immune response, represent a challenge for vaccine development. As expected, in hundreds of research laboratories there is a running out of breath to explore different strategies to obtain a safe and quickly spreadable vaccine; and among others, the peptide-based approach represents a turning point as peptides have demonstrated unique features of selectivity and specificity toward specific targets. Peptide-based vaccines imply the identification of different epitopes both on human cells and virus capsid and the design of peptide/peptidomimetics able to counteract the primary host-pathogen interaction, in order to induce a specific host immune response. SARS-CoV-2 immunogenic regions are mainly distributed, as well as for other coronaviruses, across structural areas such as spike, envelope, membrane or nucleocapsid proteins. Herein, we aim to highlight the molecular basis of the infection and recent peptide-based vaccines strategies to fight the COVID-19 pandemic including their delivery systems.


2020 ◽  
Vol 9 ◽  
Author(s):  
Rafaella Do Carmo Ribeiro ◽  
Milena Nunes Alves de Sousa

Objetivo: correlacionar as estratégias de enfrentamento, dimensões de Burnout e qualidade de vida em estudantes de Medicina. Metodologia: pesquisa transversal, descritiva e correlacional. Amostra não probabilística intencional, representada por 76,66% do universo. Aplicaram-se três instrumentos validados: Inventário de1 Estratégias de Coping, Maslach Burnout Inventory - Students Survey e World Health Organization of Life-Bref. Os dados foram analisados a partir de estatística descritiva, Correlações de Pearson e regressão linear múltipla com método Stepwise. Resultados: a estratégia fuga e esquiva teve correlação negativa com os aspectos psicológico e social de qualidade de vida, ao contrário da resolução de problemas e reavaliação positiva que demonstraram correlação positiva. Quanto às dimensões de Burnout, confronto e afastamento mostraram relação positiva com exaustão emocional e descrença. Fuga e esquiva correlacionou-se positivamente apenas com descrença, enquanto resolução de problemas correlacionou-se de forma negativa. Reavaliação positiva associou-se à eficácia profissional positivamente. Conclusão: todas as dimensões da síndrome de Burnout foram afetadas pela utilização das estratégias de enfrentamento e os aspectos da qualidade de vida mais comprometidos por essas estratégias envolveram o psicológico e social dos alunos.Descritores: Adaptação Psicológica. Qualidade de Vida. Burnout. Estudantes de Medicina.


2021 ◽  
Vol 10 (1) ◽  
pp. 65-74
Author(s):  
Germán Enrique Arenas ◽  
Jesús De León Martínez ◽  
Marcela Negrete Vasquez ◽  
Mario Lora ◽  
Martín Carvajal ◽  
...  

Introduction: the Coronavirus disease 2019 (COVID-19) was declared as a global pandemic by the World Health Organization on March 11, 2020. The clinical presentation and severity of the disease has been described from its most typical symptoms, the common cold, pneumonia and respiratory distress syndrome, to the involvement of other organs and systems such such as the gastrointestinal, renal and cardiovascular. Case report: we describe the first case of COVID-19 diagnosed in Cartagena, Colombia, on March 11, 2020, and its uncommon clinic presentation, which was almost unknown at the time. An 85-year-old woman with week-long initial symptoms of nausea and occasional vomiting, with progression to diarrhea and a 38.5 oC fever during the last three days. The patient came from Oxford, UK, and she had been on a Caribbean cruise excursion since the end of February, 2020. Chest computed tomography showed ground glass opacities in both peripheral and central lung fields, multilobar and predominantly subpleural; without evidence of consolidation or pleural effusion. COVID-19 was confirmed three days after admission, when a RT-PCR molecular test performed on a nasopharyngeal swab sample tested positive for SARS-Cov-2 Conclusion: this first case of COVID-19 diagnosed in Cartagena occurred at a time when our health system was not prepared to face the pandemic. However, despite having manifested with a clinical that had not been described at the time, and thanks to the epidemiological, clinical and imaging data, the case could be adequately approached, diagnosed and treated according to the necessary and recommended measures at the time.


2021 ◽  
Author(s):  
Pinar Kiymet Karataban

Coronavirus (COVID-19) is an enveloped RNA virus with a size of ~350 kilobase-pair and COVID-19 is commonly transmitted via aerosols, saliva, nasal droplets, and surface contact which causes severe acute respiratory tract infection among infected humans, and recently many cases declared with severe blood clotting. The average incubation period ranges from 4 to 14 days. The infected person usually presents fever accompanying an upper respiratory tract infection (RTI) and complaints of dry cough, and dyspnea. It is highly recommended to keep any suspected individuals in quarantine (isolation). After its first emergence in Wuhan, China in 2019 and then intercontinental spread it was declared as a pandemic by the World Health Organization in March 2020. The pandemic of COVID-19 deeply affected the whole world and healthcare workers as front liners are most at risk among professional groups. Dentistry is among the riskiest occupational groups that include all direct and indirect ways of COVID-19 spread. In this process, the dentists who experienced the effects of COVID-19 in the working conditions, economy, and social fields were psychologically negatively affected, and their anxiety, fear, and stress levels increased. In this review, we discuss the increased risk of the spread of coronavirus during dental operative procedures and the effects of the COVID-19 pandemic on the anxiety level, depression, and mental health of dental professionals.


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