scholarly journals Long COVID-19 Pulmonary Sequelae and Management Considerations

2021 ◽  
Vol 11 (9) ◽  
pp. 838
Author(s):  
Afroditi K. Boutou ◽  
Andreas Asimakos ◽  
Eleni Kortianou ◽  
Ioannis Vogiatzis ◽  
Argyris Tzouvelekis
Keyword(s):  
Clinical Symptoms ◽  
Therapeutic Potential ◽  
Acute Infection ◽  
Rehabilitation Program ◽  
Therapeutic Interventions ◽  
Health Crisis ◽  
Multiple Organs ◽  
Current State ◽  
Pulmonary Manifestations

The human coronavirus 2019 disease (COVID-19) and the associated acute respiratory distress syndrome (ARDS) are responsible for the worst global health crisis of the last century. Similarly, to previous coronaviruses leading to past pandemics, including severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS), a growing body of evidence support that a substantial minority of patients surviving the acute phase of the disease present with long-term sequelae lasting for up to 6 months following acute infection. The clinical spectrum of these manifestations is widespread across multiple organs and consists of the long-COVID-19 syndrome. The aim of the current review is to summarize the current state of knowledge on the pulmonary manifestations of the long COVID-19 syndrome including clinical symptoms, parenchymal, and functional abnormalities, as well as highlight epidemiology, risk factors, and follow-up strategies for early identification and timely therapeutic interventions. The literature data on management considerations including the role of corticosteroids and antifibrotic treatment, as well as the therapeutic potential of a structured and personalized pulmonary rehabilitation program are detailed and discussed.

scholarly journals Neutralizing antibodies against SARS-CoV-2: current understanding, challenge and perspective

2020 ◽  
Vol 3 (4) ◽  
pp. 285-299
Author(s):  
Yang Huang ◽  
Hui Sun ◽  
Hai Yu ◽  
Shaowei Li ◽  
Qingbing Zheng ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Therapeutic Potential ◽  
Therapeutic Interventions ◽  
Viral Escape ◽  
Global Burden ◽  
Health Crisis ◽  
The Us ◽  
Preclinical And Clinical Studies ◽  
Insight Into ◽  
Rapid Emergence

Abstract The rapid emergence of Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome 2 coronavirus (SARS-CoV-2) as a pandemic that presents an urgent human health crisis. Many SARS-CoV-2 neutralizing antibodies (NAbs) were developed with efficient therapeutic potential. NAbs-based therapeutics against SARS-CoV-2 are being expedited to preclinical and clinical studies with two antibody drugs, LY3819253 (LY-CoV555) and REGN-COV2 (REGN10933 and REGN10987), approved by the US Food and Drug Administration for emergency use authorization for treating COVID-19. In this review, we provide a systemic overview of SARS-CoV-2 specific or cross-reactive NAbs and discuss their structures, functions and neutralization mechanisms. We provide insight into how these NAbs specific recognize the spike protein of SARS-CoV-2 or cross-react to other CoVs. We also summarize the challenges of NAbs therapeutics such as antibody-dependent enhancement and viral escape mutations. Such evidence is urgently needed to the development of antibody therapeutic interventions that are likely required to reduce the global burden of COVID-19.

scholarly journals Long-term health sequelae and quality of life at least 6 months after infection with SARS-CoV-2: design and rationale of the COVIDOM-study as part of the NAPKON population-based cohort platform (POP)

Infection ◽  
2021 ◽  
Author(s):  
A. Horn ◽  
L. Krist ◽  
W. Lieb ◽  
F. A. Montellano ◽  
M. Kohls ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Acute Infection ◽  
Population Based ◽  
Local Public Health ◽  
National Network ◽  
Multiple Organs ◽  
Patient Reported ◽  
The Impact

Abstract Purpose Over the course of COVID-19 pandemic, evidence has accumulated that SARS-CoV-2 infections may affect multiple organs and have serious clinical sequelae, but on-site clinical examinations with non-hospitalized samples are rare. We, therefore, aimed to systematically assess the long-term health status of samples of hospitalized and non-hospitalized SARS-CoV-2 infected individuals from three regions in Germany. Methods The present paper describes the COVIDOM-study within the population-based cohort platform (POP) which has been established under the auspices of the NAPKON infrastructure (German National Pandemic Cohort Network) of the national Network University Medicine (NUM). Comprehensive health assessments among SARS-CoV-2 infected individuals are conducted at least 6 months after the acute infection at the study sites Kiel, Würzburg and Berlin. Potential participants were identified and contacted via the local public health authorities, irrespective of the severity of the initial infection. A harmonized examination protocol has been implemented, consisting of detailed assessments of medical history, physical examinations, and the collection of multiple biosamples (e.g., serum, plasma, saliva, urine) for future analyses. In addition, patient-reported perception of the impact of local pandemic-related measures and infection on quality-of-life are obtained. Results As of July 2021, in total 6813 individuals infected in 2020 have been invited into the COVIDOM-study. Of these, about 36% wished to participate and 1295 have already been examined at least once. Conclusion NAPKON-POP COVIDOM-study complements other Long COVID studies assessing the long-term consequences of an infection with SARS-CoV-2 by providing detailed health data of population-based samples, including individuals with various degrees of disease severity. Trial registration Registered at the German registry for clinical studies (DRKS00023742).

scholarly journals Encapsulating Peritoneal Sclerosis: Pathophysiology and Current Treatment Options

2019 ◽  
Vol 20 (22) ◽  
pp. 5765 ◽  
Author(s):  
Rajesh M. Jagirdar ◽  
Andreas Bozikas ◽  
Sotirios G. Zarogiannis ◽  
Maria Bartosova ◽  
Claus Peter Schmitt ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Animal Studies ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Renin Angiotensin System ◽  
Mtor Inhibitors ◽  
Current Treatment ◽  
Therapeutic Interventions ◽  
Ultrafiltration Failure

Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of long-term peritoneal dialysis (PD), which may even occur after patients have switched to hemodialysis (HD) or undergone kidney transplantation. The incidence of EPS varies across the globe and increases with PD vintage. Causative factors are the chronic exposure to bioincompatible PD solutions, which cause long-term modifications of the peritoneum, a high peritoneal transporter status involving high glucose concentrations, peritonitis episodes, and smoldering peritoneal inflammation. Additional potential causes are predisposing genetic factors and some medications. Clinical symptoms comprise signs of intestinal obstruction and a high peritoneal transporter status with incipient ultrafiltration failure. In radiological, macro-, and microscopic studies, a massively fibrotic and calcified peritoneum enclosed the intestine and parietal wall in such cases. Empirical treatments commonly used are corticosteroids and tamoxifen, which has fibrinolytic properties. Immunosuppressants like azathioprine, mycophenolate mofetil, or mTOR inhibitors may also help with reducing inflammation, fibrin deposition, and collagen synthesis and maturation. In animal studies, N-acetylcysteine, colchicine, rosiglitazone, thalidomide, and renin-angiotensin system (RAS) inhibitors yielded promising results. Surgical treatment has mainly been performed in severe cases of intestinal obstruction, with varying results. Mortality rates are still 25–55% in adults and about 14% in children. To reduce the incidence of EPS and improve the outcome of this devastating complication of chronic PD, vigorous consideration of the risk factors, early diagnosis, and timely discontinuation of PD and therapeutic interventions are mandatory, even though these are merely based on empirical evidence.

scholarly journals The Long-Term Clinical Course of Canine Degenerative Myelopathy and Therapeutic Potential of Curcumin

2021 ◽  
Vol 8 (9) ◽  
pp. 192
Author(s):  
Yui Kobatake ◽  
Kohei Nakata ◽  
Hiroki Sakai ◽  
Jun Sasaki ◽  
Osamu Yamato ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Clinical Course ◽  
Therapeutic Potential ◽  
Late Onset ◽  
Respiratory Disorder ◽  
Limited Information ◽  
Respiratory Impairment ◽  
Degenerative Myelopathy ◽  
End Stage

Canine degenerative myelopathy (DM), recognized as a spontaneous model of amyotrophic lateral sclerosis, is known as a late-onset progressive degenerative disease of the spinal cord. Because of the progressive nature of DM, many dogs are elected to be euthanized, resulting in limited information on the end-stage clinical presentation. We investigated the long-term clinical course from diagnosis to natural death to further deepen our understanding of the entire clinical picture of this disease. Because curcumin was administered in some cases, the therapeutic effect of curcumin on DM was also examined. Forty dogs included in this study were client-owned Pembroke Welsh Corgis with a definitive diagnosis of DM by necropsy and histopathology. Dogs were excluded from this study if they died from another disease or were elected to be euthanized. Information on the long-term clinical symptoms of DM was investigated based on a questionnaire, which was collected from the dog owners. Urinary incontinence and respiratory disorder were observed in most dogs, as was respiratory impairment-correlated death. In contrast, signs consistent with brainstem dysfunction were noticed at the terminal stage in a small portion of dogs. Although further studies with more cases are needed, the results of this study suggest that administration of curcumin is effective in slowing the progression of DM.

scholarly journals Persistent symptoms and association with inflammatory cytokine signatures in recovered COVID-19 patients

2021 ◽  
Author(s):  
Sean Wei Xiang Ong ◽  
Siew-Wai Fong ◽  
Barnaby Edward Young ◽  
Yi-Hao Chan ◽  
Bernett Lee ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Acute Infection ◽  
Public Hospitals ◽  
Multivariable Model ◽  
Persistent Symptoms ◽  
Immune Mediators ◽  
Prospective Longitudinal ◽  
The Relationship

Abstract Background The complications and sequelae of coronavirus disease 2019 (COVID-19) and their effect on long-term health are unclear, and the trajectory of associated immune dysregulation poorly understood. Methods We conducted a prospective longitudinal multi-center cohort study at four public hospitals in Singapore. COVID-19 patients were monitored for a median of six months after recovery from acute infection. Clinical symptoms and radiologic data were collected, along with plasma samples for quantification of immune mediators. The relationship between clinical symptoms and immune cytokine profiles was investigated. Results 288 participants were recruited, and follow-up data were available for 183, 175, and 120 participants at days 30, 90 and 180 post-symptom onset respectively. Symptoms related to COVID-19 were present in 31 (16.9%), 13 (7.4%), and 14 (11.7%) at days 30, 90 and 180. In a multivariable model, age >65 years, non-Chinese ethnicity, and the severity of acute infection were associated with increased likelihood of persistent symptoms. Recovered COVID-19 patients had elevated levels of pro-inflammatory IL-17A, SCF, IL-12p70, IL-1βand pro-angiogenic MIP-1β, BDNF, VEGF at day 180 compared to healthy controls. Higher levels of MCP-1 and PDGF-BB were detected in patients with persistent symptoms, versus symptom-free patients. Conclusions About 10% of recovered patients had persistent symptoms six months after initial infection. Immune cytokine signatures of the recovered patients reflected ongoing chronic inflammation and angiogenesis. COVID-19 patients should be monitored closely for emerging long-term health consequences.

scholarly journals Ablation of STAT3 in the B Cell Compartment Restricts Gammaherpesvirus LatencyIn Vivo

mBio ◽  
2016 ◽  
Vol 7 (4) ◽  
Author(s):  
Sandeep Steven Reddy ◽  
Hui-Chen Chang Foreman ◽  
Thubten Ozula Sioux ◽  
Gee Ho Park ◽  
Valeria Poli ◽  
...  
Keyword(s):  
B Cells ◽  
B Cell ◽  
Cell Function ◽  
Acute Infection ◽  
Therapeutic Benefit ◽  
Therapeutic Interventions ◽  
Murine Gammaherpesvirus ◽  
Gammaherpesvirus 68 ◽  
Murine Gammaherpesvirus 68

ABSTRACTA challenging property of gammaherpesviruses is their ability to establish lifelong persistence. The establishment of latency in B cells is thought to involve active virus engagement of host signaling pathways. Pathogenic effects of these viruses during latency or following reactivation can be devastating to the host. Many cancers, including those associated with members of the gammaherpesvirus family, Kaposi’s sarcoma-associated herpesvirus and Epstein-Barr virus, express elevated levels of active host signal transducer and activator of transcription-3 (STAT3). STAT3 is activated by tyrosine phosphorylation in response to many cytokines and can orchestrate effector responses that include proliferation, inflammation, metastasis, and developmental programming. However, the contribution of STAT3 to gammaherpesvirus pathogenesis remains to be completely understood. This is the first study to have identified STAT3 as a critical host determinant of the ability of gammaherpesvirus to establish long-term latency in an animal model of disease. Following an acute infection, murine gammaherpesvirus 68 (MHV68) established latency in resident B cells, but establishment of latency was dramatically reduced in animals with a B cell-specific STAT3 deletion. The lack of STAT3 in B cells did not impair germinal center responses for immunoglobulin (Ig) class switching in the spleen and did not reduce either total or virus-specific IgG titers. Although ablation of STAT3 in B cells did not have a global effect on these assays of B cell function, it had long-term consequences for the viral load of the host, since virus latency was reduced at 6 to 8 weeks postinfection. Our findings establish host STAT3 as a mediator of gammaherpesvirus persistence.IMPORTANCEThe insidious ability of gammaherpesviruses to establish latent infections can have detrimental consequences for the host. Identification of host factors that promote viral latency is essential for understanding latency mechanisms and for therapeutic interventions. We provide the first evidence that STAT3 expression is needed for murine gammaherpesvirus 68 to establish latency in primary B cells during an active immune response to infection. STAT3 deletion in B cells does not impair adaptive immune control of the virus, but loss of STAT3 in B cells has a long-lasting impact on viral persistence. These results indicate a potential therapeutic benefit of STAT3 inhibitors for combating gammaherpesvirus latency and, thereby, associated pathologies.

scholarly journals MSC Based Therapies—New Perspectives for the Injured Lung

2020 ◽  
Vol 9 (3) ◽  
pp. 682 ◽  
Author(s):  
Judith Behnke ◽  
Sarah Kremer ◽  
Tayyab Shahzad ◽  
Cho-Ming Chao ◽  
Eva Böttcher-Friebertshäuser ◽  
...  
Keyword(s):  
Lung Injury ◽  
Clinical Symptoms ◽  
Therapeutic Potential ◽  
Convincing Evidence ◽  
Therapeutic Interventions ◽  
Chronic Lung Diseases ◽  
Chronic Pulmonary Diseases ◽  
Injured Lung ◽  
Lung Injuries ◽  
Disease Entities

Chronic lung diseases pose a tremendous global burden. At least one in four people suffer from severe pulmonary sequelae over the course of a lifetime. Despite substantial improvements in therapeutic interventions, persistent alleviation of clinical symptoms cannot be offered to most patients affected to date. Despite broad discrepancies in origins and pathomechanisms, the important disease entities all have in common the pulmonary inflammatory response which is central to lung injury and structural abnormalities. Mesenchymal stem cells (MSC) attract particular attention due to their broadly acting anti-inflammatory and regenerative properties. Plenty of preclinical studies provided congruent and convincing evidence that MSC have the therapeutic potential to alleviate lung injuries across ages. These include the disease entities bronchopulmonary dysplasia, asthma and the different forms of acute lung injury and chronic pulmonary diseases in adulthood. While clinical trials are so far restricted to pioneering trials on safety and feasibility, preclinical results point out possibilities to boost the therapeutic efficacy of MSC application and to take advantage of the MSC secretome. The presented review summarizes the most recent advances and highlights joint mechanisms of MSC action across disease entities which provide the basis to timely tackle this global disease burden.

scholarly journals Examining the Potential Synergistic Effects Between Mindfulness Training and Psychedelic-Assisted Therapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Maria Eleni Eleftheriou ◽  
Emily Thomas
Keyword(s):  
Clinical Symptoms ◽  
Synergistic Effects ◽  
Well Being ◽  
Preliminary Evidence ◽  
Therapeutic Benefit ◽  
Therapeutic Interventions ◽  
Great Promise ◽  
Present Moment ◽  
Great Success

Mindfulness-based interventions and psychedelic-assisted therapy have been experimentally utilised in recent years as alternative treatments for various psychopathologies with moderate to great success. Both have also demonstrated significant post-acute and long-term decreases in clinical symptoms and enhancements in well-being in healthy participants. These two therapeutic interventions share various postulated salutogenic mechanisms, such as the ability to alter present-moment awareness and anti-depressive action, via corresponding neuromodulatory effects. Recent preliminary evidence has also demonstrated that psychedelic administration can enhance mindfulness capacities which has already been demonstrated robustly as a result of mindfulness-based interventions. These shared mechanisms between mindfulness-based interventions and psychedelic therapy have led to scientists theorising, and recently demonstrating, synergistic effects when both are used in combination, in the form of potentiated therapeutic benefit. These synergistic results hold great promise but require replication in bigger sample groups and better controlled methodologies, to fully delineate the effect of set and setting, before they can be extended onto clinical populations.

CURRENT STATE AND DEVELOPMENT PERSPECTIVES OF THE CASPIAN SPRAT FISHERIES

2018 ◽  
pp. 69-75
Author(s):  
Tatiana Vasilievna Pomogaeva ◽  
Aliya Ahmetovna Aseinova ◽  
Yuriy Aleksandrovich Paritskiy ◽  
Vjacheslav Petrovich Razinkov
Keyword(s):  
Food Item ◽  
Growth Potential ◽  
North West ◽  
Marine Fishery ◽  
The North ◽  
Current State ◽  
West Part ◽  
Eggs And Larvae ◽  
Intensive Growth

The article presents annual statistical data of the Caspian Research Institute of Fishery. There has been kept track of the long term dynamics of the stocks of three species of Caspian sprat (anchovy, big-eyed kilka, sprat) and investigated a process of substituting a food item of sprats Eurytemora grimmi to a small-celled copepod species Acartia tonsa Dana. According to the research results, there has been determined growth potential of stocks of each species. Ctenophoran-Mnemiopsis has an adverse effect on sprat population by eating fish eggs and larvae. Ctenophoram - Mnemiopsis is a nutritional competitor to the full-grown fishes. The article gives recommendations on reclamation of stocks of the most perspective species - common sprat, whose biological characteristics helped not to suffer during Ctenophoram outburst and to increase its population during change of the main food item. Hydroacoustic survey data prove the intensive growth of common sprat biomass in the north-west part of the Middle Caspian. According to the results of the research it may be concluded that to realize the volumes of recommended sprat catch it is necessary to organize the marine fishery of common sprat at the Russian Middle Caspian shelf.

Integrating Focusing and Differentiation: A Therapeutic Path for Couples in Intimate Relationships

2018 ◽  
Vol 3 ◽  
Author(s):  
Evi Zohar
Keyword(s):  
Couples Therapy ◽  
Therapeutic Potential ◽  
Well Being ◽  
Point Of View ◽  
The Body ◽  
Self Awareness ◽  
Emotional Healing ◽  
Felt Sense ◽  
Inner World

Continuing the workshop I've given in the WPC Paris (2017), this article elaborates my discussion of the way I interlace Focusing with Differentiation Based Couples Therapy (Megged, 2017) under the systemic view, in order to facilitate processes of change and healing in working with intimate couples. This article presents the theory and rationale of integrating Differentiation (Bowen, 1978; Schnarch, 2009; Megged, 2017) and Focusing (Gendlin, 1981) approaches, and its therapeutic potential in couple's therapy. It is written from the point of view of a practicing professional in order to illustrate the experiential nature and dynamics of the suggested therapeutic path. Differentiation is a key to mutuality. It offers a solution to the central struggle of any long term intimate relationship: balancing two basic life forces - the drive for individuality and the drive for togetherness (Schnarch, 2009). Focusing is a body-oriented process of self-awareness and emotional healing, in which one learns to pay attention to the body and the ‘Felt Sense’, in order to unfold the implicit, keep it in motion at the precise pace it needs for carrying the next step forward (Gendlin, 1996). Combining Focusing and Differentiation perspectives can cultivate the kind of relationship where a conflict can be constructively and successfully held in the inner world of each partner, while taking into consideration the others' well-being. This creates the possibility for two people to build a mutual emotional field, open to changes, permeable and resilient.

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