scholarly journals A Case Report of a Patient on Therapeutic Warfarin Who Died of COVID-19 Infection with a Sudden Rise in D-Dimer

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1382
Author(s):  
Reita N. Agarwal ◽  
Hersheth Aggarwal ◽  
Ashmit Verma ◽  
Manish K. Tripathi
Keyword(s):  
Virus Disease ◽  
Clinical Manifestations ◽  
Economic Life ◽  
Host Cells ◽  
World Health ◽  
Coagulation System ◽  
African American Patient ◽  
American Patient ◽  
Sudden Rise ◽  
D Dimer

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has disrupted social and economic life globally. The global pandemic COVID-19 caused by this novel SARS-CoV-2 shows variable clinical manifestations, complicated further by cytokine storm, co-infections, and coagulopathy, leading to severe cases and death. Thrombotic complications arise due to complex and unique interplay between coronaviruses and host cells, inflammatory response, and the coagulation system. Heparin and derivatives are World Health Organization (WHO) recommended anticoagulants for moderate and severe Corona Virus Disease 19 (COVID-19), that can also inhibit viral adhesion to the cell membrane by interfering with heparan sulfate-dependent binding to angiotensin-converting enzyme 2 (ACE2) receptor. Heparin also possesses anti-inflammatory, immunomodulatory, antiviral, and anti-complement activity, which offers a benefit in limiting viral and microbial infectivity and anticoagulation from the immune-thrombosis system. Here we present a case study of the pathophysiology of unexpected COVID-19 coagulopathy of an obese African American patient. While being on therapeutic warfarin since admission, he had a dismal outcome due to cardio-pulmonary arrest after the sudden rise in D-dimer value from 1.1 to >20. This indicates that for such patients on chronic warfarin anticoagulation with “moderate COVID 19 syndromes”, warfarin anticoagulation may not be suitable compared to heparin and its derivatives. Further research should be done to understand the beneficial role of heparin and its derivatives compared to warfarin for COVID-19 inflicted patients.

scholarly journals A Review on Acute Respiratory Syndrome Corona Virus 2 (SARS-Cov-2) & Its Preventive Management

2020 ◽  
Vol 8 (3) ◽  
pp. 142-151
Author(s):  
Vijay Singh
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Virus Disease ◽  
Clinical Manifestations ◽  
Health Impact ◽  
Host Cells ◽  
World Health ◽  
Future Perspective ◽  
Family Welfare ◽  
Corona Virus ◽  
Health Organization

At the end of 2019 a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing severe acute respiratory syndrome expanded globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus a global pandemic. Severe Acute Respiratory Syndrome Coronavirus 2 can attack lung cells because there are many conserved receptor entries, namely Angiotensin Converting Enzyme-2. The presence of this virus in host cells will initiate various protective responses leading to pneumonia and Acute Respiratory Distress Syndrome. This review aimed to provide an overview related to this Corona Virus Disease 2019 (COVID-19) epidemiology, pathophysiology, diagnosis, management and future perspective.  We searched PubMed, Medline, Embase and Scopus databases for Severe Acute Respiratory Syndrome Coronavirus-2, Middle East respiratory syndrome-related coronavirus and Severe Acute Respiratory Syndrome Coronavirus. Full texts were retrieved, analyzed and developed into an easy-to-understand review. Although only when the pandemic ends it will be possible to assess the full health, social and economic impact of this global disaster, this review represents a picture of the current state of the art. In particular, we focus on public health impact, pathophysiology and clinical manifestations, diagnosis, case management, emergency response and preparedness. The Ministry of Health and Family Welfare, Government of India and ICMR (Indian Council of Medical Research) has formulated guidelines, advisories for social distancing protocol, diagnosis, management, do’s and don’ts and other reliable material.  

COVID 19: REALS AND CHALLENGES AGAINST DOCTORS

2020 ◽  
Vol 2 (1) ◽  
pp. 65-87
Author(s):  
Zen Ahmad
Keyword(s):  
Virus Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Unknown Etiology ◽  
Wuhan City ◽  
Traditional Markets ◽  
Pneumonia Case ◽  
The World ◽  
New Type ◽  
Health Organization

Corona Virus Disease (Covid-19) is a contagious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which was discovered in December 2019 in China. This disease can cause clinical manifestations in the airway, lung and systemic. The World Health Organization (WHO) representative of China reported a pneumonia case with unknown etiology in Wuhan City, Hubei Province, China on December 31, 2019. The cause was identified as a new type of coronavirus on January 7, 2020 with an estimated source of the virus from traditional markets (seafood market). ) Wuhan city

scholarly journals The expression of hACE2 receptor protein and its involvement in SARS-CoV-2 entry, pathogenesis, and its application as potential therapeutic target

Tumor Biology ◽  
2021 ◽  
Vol 43 (1) ◽  
pp. 177-196
Author(s):  
Lobna Al-Zaidan ◽  
Sarra Mestiri ◽  
Afsheen Raza ◽  
Maysaloun Merhi ◽  
Varghese Philipose Inchakalody ◽  
...  
Keyword(s):  
Binding Affinity ◽  
Receptor Binding ◽  
Virus Disease ◽  
Respiratory Illness ◽  
Host Cells ◽  
World Health ◽  
Receptor Protein ◽  
Unknown Etiology ◽  
Spike Glycoprotein ◽  
Binding Interface

Pneumonia cases of unknown etiology in Wuhan, Hubei province, China were reported to the World Health Organization on 31st of December 2019. Later the pathogen was reported to be a novel coronavirus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes Corona virus disease 2019 (COVID-19). The disease outspread was followed by WHO declaration of COVID-19 pandemic as a “Public Health Emergency of International Concern”. SARS-CoV-2 is a novel pathogenic beta coronavirus that infects humans causing severe respiratory illness. However, multifarious factors can contribute to the susceptibility to COVID-19 related morbidity and mortality such as age, gender, and underlying comorbidities. Infection initiates when viral particles bind to the host cell surface receptors where SARS-CoV-2 spike glycoprotein subunit 1 binds to the Angiotensin Converting Enzyme 2 (ACE2). It is of importance to mention that SARS-CoV and SARS-CoV-2 viruses’ mediate entry into the host cells via ACE2 receptor which might be correlated with the structural similarity of spike glycoprotein subunit 1 of both SARS viruses. However, the structural binding differs, whereas ACE2 receptor binding affinity with SARS-CoV-2 is 4 folds higher than that with SARS-CoV. Moreover, amino acids sequence divergence between the two S glycoproteins might be responsible for differential modulations of the specific immune response to both viruses. Identification of different aspects such as binding affinity, differential antigenic profiles of S-glycoproteins, and ACE2 mutations might influence the investigation of potential therapeutic strategies targeting SARS-CoV-2/ACE2 binding interface. In this review, we aim to elaborate on the expression of hACE2 receptor protein and its binding with SARS-CoV-2 S1 subunit, the possible immunogenic sequences of spike protein, effect of ACE 2 polymorphism on viral binding, and infectivity/susceptibility to disease. Furthermore, targeting of hACE2 receptor binding with SARS-CoV-2 S1 subunit via various mechanisms will be discussed to understand its role in therapeutics.

scholarly journals COVID-19 AND THE HUMAN EYE – CONJUNCTIVITIS A LONE COVID-19 FINDING - A case-control study

2022 ◽  
Author(s):  
Valeria Mocanu ◽  
Dharmesh Bhagwani ◽  
Abhinav Sharma ◽  
Claudia Borza ◽  
Ciprian Ilie Rosca ◽  
...  
Keyword(s):  
Virus Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Viral Reservoir ◽  
Initial Symptom ◽  
Drastic Increase ◽  
Confirmatory Tests ◽  
Sudden Appearance ◽  
Health Organization ◽  
Acute Conjunctivitis

Background: The worldwide sudden appearance and drastic increase in the number of infected cases with the severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) determined the World Health Organization to declare it as a pandemic situation. The ‘Corona Virus Disease 2019’ (COVID-19) has varied clinical manifestations, from asymptomatic to severe cases, and conjunctivitis, seems not only to be one of them, but sometimes found to be lone initial symptom present. Aim and method: The aim was to identify the prevalence of conjunctivitis as the first symptom in COVID-19 patients, in a primary healthcare unit. A retrospective study was conducted analyzing the presenting complains/symptoms and results of COVID-19 confirmatory tests. Results: Out of the 672 cases that were sent for RT-PCR testing only 121 (18%) were found to be positive. Among this 2.67% of patients who had both conjunctivitis and COVID-19, 77.77% of patients had unilateral eye affected while 22.22% had bilateral conjunctivitis of varying degrees. 15 patients diagnosed to have both acute conjunctivitis and COVID-19, presented other symptoms associated with COVID-19 infection. While 3 patients had only acute conjunctivitis during their entire course of COVID-19. Conclusions: Conjunctivitis is a symptom of COVID-19 and maybe the first sign of the infection, until the onset of the classical manifestations, the patient serves to be a viral reservoir. The physicians should not miss unilateral conjunctivitis, as it can be the only presenting complain of the COVID-19 disease at the initial phase, which might worsen if underwent undetected and can aid in the spread of the contagion.

ANALYSIS OF CASES OF THROMBOSIS OF THE GREAT SACRET VEIN HIPS IDENTIFIED SPONTANEOUSLY IN THE CONDITIONS OF THE RECEPTION DEPARTMENT OF A MULTI-PROFILE HOSPITAL

2020 ◽  
pp. 24-33
Author(s):  
Дмитрий Валериевич Судаков ◽  
Евгений Владимирович Белов ◽  
Артём Николаевич Шевцов ◽  
Елена Васильевна Богачева ◽  
Данаил Красимирович Назлиев
Keyword(s):  
Surgical Treatment ◽  
Primary Care Physicians ◽  
Clinical Manifestations ◽  
Venous System ◽  
Coagulation System ◽  
Minimally Invasive Surgical ◽  
The World ◽  
Life Threatening ◽  
D Dimer ◽  
Group 1

В статье проводится анализ случаев тромбоза большой подкожной вены (БПВ) при случайном их выявлении в условиях приемного отделения многопрофильного стационара. Данная тематика является весьма актуальной, так как в России и в мире наблюдается ежегодный рост заболеваний венозной системы и тромбозов в частности. Также во всем мире отмечается определенная тенденция - омоложение патологии сердечно-сосудистой системы. Это в полной мере касается и тромбозов. Малоподвижный образ жизни, вредные привычки, ожирение и многие другие факторы приводят к тому, что венозные тромбозы встречаются уже в молодом возрасте. Целью работы стала попытка проанализировать различные варианты случаев тромбоза БПВ, включая спонтанно выявленные на уровне приемного отделения областного стационара. Объектами исследования послужили 90 пациентов, мужчин и женщин, с диагнозом «тромбоз БПВ». Все пациенты были разделены на 3 группы по 30 пациентов. В первую группу вошли пациенты, у которых «тромбоз БПВ» выявлялся случайно. Вторую группу составили пациенты с уже выявленным тромбозом, не угрожающим жизни, направленные на плановое оперативное лечение. В третью группу вошли пациентки, уже имеющие в анамнезе опыт малоинвазивного хирургического лечения венозной системы. В исследовании проводился подробный сравнительный анализ показателей общего анализа крови, включая свертывающую систему и уровень Д-Димера. Было установлено, что для пациентов 1 группы был характерен более выраженный воспалительный процесс с более высоким показателем Д-Димера. Также в работе изучались основные клинические проявления и определялось наличие факторов риска развития тромбоза БПВ. Было замечено, что среди пациентов 1 группы, в отличии от 2 и 3, большинство симптомов были слабее выражены и встречались реже. Были определены и некоторые закономерности в уровне поражения, в зависимости от исследуемой группы. Данная работа представляет определенный интерес для врачей практического звена - хирургов и сосудистых хирургов, а также для врачей первичного звена - участковых терапевтов The article analyzes the cases of thrombosis of the great saphenous vein (BPV) in case of their accidental detection in the emergency department of a multidisciplinary hospital. This topic is very relevant, since in Russia and in the world there is an annual increase in diseases of the venous system and thrombosis in particular. Also, around the world there is a certain trend-rejuvenation of the pathology of the cardiovascular system. This fully applies to thrombosis. A sedentary lifestyle, bad habits, obesity and many other factors lead to the fact that venous thrombosis occurs even at a young age. The aim of the work was an attempt to analyze various variants of cases of BPV thrombosis, including spontaneously detected at the level of the admission department of the regional hospital. The objects of the study were 90 patients, men and women, with a diagnosis of “thrombosis of BPV”. All patients were divided into 3 groups of 30 patients. The first group included patients in whom "BPV thrombosis" was detected by chance. The second group consisted of patients with already identified life-threatening thrombosis, aimed at planned surgical treatment. The third group included patients who already had a history of minimally invasive surgical treatment of the venous system. The study conducted a detailed comparative analysis of the parameters of a general blood test, including the coagulation system and the level of D-dimer. It was found that patients of group 1 were characterized by a more pronounced inflammatory process with a higher D-Dimer score. Also, the main clinical manifestations were studied and the presence of risk factors for the development of thrombosis of BPV was determined. It was noted that among patients of group 1, in contrast to 2 and 3, most of the symptoms were weaker and less common. Some patterns were also determined in the level of damage, depending on the study group. This work is of particular interest for practitioners - surgeons and vascular surgeons, as well as for primary care physicians - district physicians

scholarly journals ACE2 Shedding and Furin Abundance in Target Organs may Influence the Efficiency of SARS-CoV-2 Entry

2021 ◽  
Vol 14 (1) ◽  
pp. 1-12
Author(s):  
Yuanchen Ma ◽  
Yinong Huang ◽  
Tao Wang ◽  
Andy Peng Xiang ◽  
Weijun Huang
Keyword(s):  
Virus Disease ◽  
Target Organ Damage ◽  
Clinical Manifestations ◽  
Virus Transmission ◽  
Organ Damage ◽  
Receptor Expression ◽  
Host Cells ◽  
Early Screening ◽  
Furin Cleavage ◽  
Furin Cleavage Site

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a lineage B coronavirus, causing the worldwide outbreak of Corona Virus Disease 2019 (COVID-19). Despite genetically closed to SARS-CoV, SARS-CoV-2 seems to possess enhanced infectivity and subtle different clinical features, which may hamper the early screening of suspected patients as well as the control of virus transmission. Unfortunately, there are few tools to predict the potential target organ damage and possible clinical manifestations caused by such novel coronavirus. Methods: To solve this problem, we use the online single-cell sequence datasets to analyze the expression of the major receptor in host cells that mediates the virus entry, including angiotensin converting enzyme 2 (ACE2), and its co-expressed membrane endopeptidases. Results: The results indicated the differential expression of ADAM10 and ADAM17 might contribute to the ACE2 shedding and affect the membrane ACE2 abundance. We further confirm a putative furin-cleavage site reported recently in the spike protein of SARS-CoV-2, which may facilitate the virus-cell fusion. Based on these findings, we develop an approach that comprehensively analyzed the virus receptor expression, ACE2 shedding, membrane fusion activity, virus uptake and virus replication to evaluate the infectivity of SARS-CoV-2 to different human organs. Conclusion: Our results indicate that, in addition to airway epithelia, cardiac tissue and enteric canals are susceptible to SARS-CoV-2 as well.

scholarly journals Variable Clinical Manifestations of COVID-19; Viral and Human Genomes Talk

2020 ◽  
Author(s):  
Zeinab Imani-Saber ◽  
Hajar Vaseghi ◽  
Mojdeh Mahdian ◽  
Fatemeh Safari ◽  
Mohsen Ghadami
Keyword(s):  
Viral Entry ◽  
Drug Transport ◽  
Phylogenetic Analyses ◽  
Clinical Manifestations ◽  
Host Cells ◽  
World Health ◽  
Ongoing Research ◽  
Transmission Mechanisms ◽  
Human Genomes ◽  
Health Organization

The new coronavirus, known as “SARS-CoV-2”; is the cause of one of the most prevalent infectious viral diseases that was recently announced pandemic by the world health organization. Ongoing research in the fields of prevention, management, and therapy establishes a functional scaffold for clinics during the time of crisis. To obtain this goal, it is necessary that all pathophysiologic aspects of COVID-19 from infection to predisposing backgrounds of infection be identified, so that all the ambiguities of researchers regarding transmission mechanisms, variable clinical manifestation, and therapeutic response can be solved. Here, we firstly discuss about the homology screening between nCoV-2019 and beta-coronavirus family using phylogenetic analyses. Secondly, we analyzed the viral motifs to show that viral entry into the host cells requires a primary activation step performed by FURIN and FURIN-like-mediated enzymatic cleavage on the structural glycoprotein. The cleavage increases viral performance by 1000 folds. We then present a comprehensive view on host cells and the significance of gene variants affecting activation enzymes, supportive entry, and spread mechanisms in humans including renin-angiotensin-aldosterone system (RAAS) a pathway results in certain phenotypes or exacerbate infection-related phenotypes in different organs, hence causes variable clinical manifestations. This is followed by discussing about the importance of personalized medicine in nCoV-2019 exposure. Moreover, chemical drugs prescribed for individuals affected with COVID-19, as well as genes involved in drug transport and metabolisms are reviewed as a prelude to drug response. Finally, we suggest some therapeutic approaches developed based on new methods and technology such as anti-sense therapy and antibodies.

scholarly journals Co-existence of multisystem inflammatory syndrome in children associated with COVID-19 and scrub typhus infection: a case series

2021 ◽  
Author(s):  
Sarbani M. Roy ◽  
Sushama Sahoo
Keyword(s):  
Clinical Features ◽  
Scrub Typhus ◽  
Virus Disease ◽  
Clinical Manifestations ◽  
Case Series ◽  
World Health ◽  
Laboratory Findings ◽  
Term Outcome ◽  
Corona Virus ◽  
Inflammatory Syndrome

We are in the midst of pandemic of corona virus disease (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). A clinical entity with hyperinflammatory syndrome, defined by World Health Organization (WHO) as multisystem inflammatory syndrome in children (MIS-C) and adolescents, temporarily related to COVID-19, is being reported in this pandemic from several countries. MIS-C has overlapping clinical features of Kawasaki disease (KD). KD has been described in association with various organisms including dengue, scrub typhus. MIS-C with concomitant infection has rarely been reported in literature till date. We report on ten sick pediatric patients presented with clinical features of MIS-C, in whom diagnosis of concomitant scrub typhus were also made. This retrospective study was conducted in the department of pediatric medicine of a medical college, in a district town of West Bengal, India. SARS-CoV-2 immunoglobulin G level was elevated in all of them and they were also positive with Scrub typhus serology. We reviewed and analysed their basic informations, clinical manifestations, epidemiological history, laboratory findings, treatment and short term outcome. Median age was 24 months (range 4 months-8 years), male: female was 1:1. All the patients survived. Concomitant tropical infection in a patient with MIS-C may play an important role in determining the prognosis of such patients. Early detection and intervention will result in better management and intact survival of them.

scholarly journals Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review

2020 ◽  
Vol 17 (8) ◽  
pp. 2690 ◽  
Author(s):  
Francesco Di Gennaro ◽  
Damiano Pizzol ◽  
Claudia Marotta ◽  
Mario Antunes ◽  
Vincenzo Racalbuto ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Virus Disease ◽  
Clinical Manifestations ◽  
Health Impact ◽  
Narrative Review ◽  
World Health ◽  
Current Status ◽  
Future Perspective ◽  
Global Pandemic ◽  
Health Organization

At the end of 2019 a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing severe acute respiratory syndrome expanded globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus a global pandemic. We performed a narrative review to describe existing literature with regard to Corona Virus Disease 2019 (COVID-19) epidemiology, pathophysiology, diagnosis, management and future perspective. MEDLINE, EMBASE and Scopus databases were searched for relevant articles. Although only when the pandemic ends it will be possible to assess the full health, social and economic impact of this global disaster, this review represents a picture of the current state of the art. In particular, we focus on public health impact, pathophysiology and clinical manifestations, diagnosis, case management, emergency response and preparedness.

scholarly journals ACE2 Homo-dimerization, Human Genomic variants and Interaction of Host Proteins Explain High Population Specific Differences in Outcomes of COVID19

2020 ◽  
Author(s):  
Swarkar Sharma ◽  
Inderpal Singh ◽  
Shazia Haider ◽  
Md. Zubbair Malik ◽  
Kalaiarasan Ponnusamy ◽  
...  
Keyword(s):  
Host Cell ◽  
Virus Disease ◽  
Rna Virus ◽  
Critical Role ◽  
Host Cells ◽  
Therapeutic Interventions ◽  
World Health ◽  
Structural Variations ◽  
S Protein ◽  
Differential Outcomes

ABSTRACTSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive single-stranded RNA virus that causes a highly contagious Corona Virus Disease (COVID19). Entry of SARS-CoV-2 in human cells depends on binding of the viral spike (S) proteins to cellular receptor Angiotensin-converting enzyme 2 (ACE2) and on S-protein priming by host cell serine protease TMPRSS2. Recently, COVID19 has been declared pandemic by World Health Organization (WHO) yet high differences in disease outcomes across countries have been seen. We provide evidences to explain these population-level differences. One of the key factors of entry of the virus in host cells presumably is because of differential interaction of viral proteins with host cell proteins due to different genetic backgrounds. Based on our findings, we conclude that a higher expression of ACE2 is facilitated by natural variations, acting as Expression quantitative trait loci (eQTLs), with different frequencies in different populations. We suggest that high expression of ACE2 results in homo-dimerization, proving disadvantageous for TMPRSS2 mediated cleavage of ACE2; whereas, the monomeric ACE2 has higher preferential binding with SARS-CoV-2 S-Protein vis-a-vis its dimerized counterpart. Further, eQTLs in TMPRSS2 and natural structural variations in the gene may also result in differential outcomes towards priming of viral S-protein, a critical step for entry of the Virus in host cells. In addition, we suggest that several key host genes, like SLC6A19, ADAM17, RPS6, HNRNPA1, SUMO1, NACA, BTF3 and some other proteases as Cathepsins, might have a critical role. To conclude, understanding population specific differences in these genes may help in developing appropriate management strategies for COVID19 with better therapeutic interventions.

Sign in / Sign up

Export Citation Format

Share Document