scholarly journals Severe COVID-19 and Sepsis: Immune Pathogenesis and Laboratory Markers

2021 ◽  
Vol 9 (1) ◽  
pp. 159
Author(s):  
Mai M. Zafer ◽  
Hadir A. El-Mahallawy ◽  
Hossam M. Ashour
Keyword(s):  
Immune Responses ◽  
Multiorgan Failure ◽  
Serum Levels ◽  
Lung Damage ◽  
The Novel ◽  
Inflammatory Reactions ◽  
Dynamic Events ◽  
Cytokines And Chemokines ◽  
Plasma Leakage ◽  
Novel Coronavirus

The ongoing outbreak of the novel coronavirus disease 2019 (COVID-19), induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has taken a significant toll on people and countries all over the world. The pathogenesis of COVID-19 has not been completely elucidated yet. This includes the interplay between inflammation and coagulation which needs further investigation. The massive production of proinflammatory cytokines and chemokines results in the so-called cytokine storm, leading to plasma leakage, vascular hyperpermeability, and disseminated vascular coagulation. This is usually accompanied by multiorgan failure. The extensive changes in the serum levels of cytokines are thought to play a crucial role in the COVID-19 pathogenesis. Additionally, the viral load and host inflammation factors are believed to have a significant role in host damage, particularly lung damage, from SARS-CoV-2. Interestingly, patients exhibit quantitative and qualitative differences in their immune responses to the virus, which can impact the clinical manifestation and outcomes of COVID-19. There needs to be a better understanding of the dynamic events that involve immune responses, inflammatory reactions, and viral replication in the context of the COVID-19 infection. Here, we discuss the main aspects of COVID-19 pathogenesis while supporting the hypothesis that inflammatory immune responses are involved in the progression of the disease to a more critical and fatal phase. We also explore the similarities and differences between severe COVID-19 and sepsis. A deeper understanding of the COVID-19 clinical picture as it relates to better-known conditions such as sepsis can provide useful clues for the management, prevention, and therapy of the disease.

scholarly journals Hypercoagulation and Antithrombotic Treatment in Coronavirus 2019: A New Challenge

2020 ◽  
Vol 120 (06) ◽  
pp. 949-956 ◽  
Author(s):  
Francesco Violi ◽  
Daniele Pastori ◽  
Roberto Cangemi ◽  
Pasquale Pignatelli ◽  
Lorenzo Loffredo
Keyword(s):  
Multiorgan Failure ◽  
Laboratory Data ◽  
Clinical Severity ◽  
The Novel ◽  
Antithrombotic Treatment ◽  
Clotting System ◽  
Thrombotic Risk ◽  
Number Of Patients ◽  
Coronary Ischemia ◽  
Novel Coronavirus

AbstractThe novel coronavirus 2019 (COVID-19) is clinically characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for a high number of patients needing mechanical ventilation or intensive care units treatment and for the elevated mortality risk. A link between COVID-19 and multiorgan failure may be dependent on the fact that most COVID-19 patients are complicated by pneumonia, which is known to be associated with early changes of clotting and platelet activation and artery dysfunction; these changes may implicate in thrombotic-related events such as myocardial infarction and ischemic stroke. Recent data showed that myocardial injury compatible with coronary ischemia may be detectable in SARS-CoV-2 patients and laboratory data exploring clotting system suggest the presence of a hypercoagulation state. Thus, we performed a systematic review of COVID-19 literature reporting measures of clotting activation to assess if changes are detectable in this setting and their relationship with clinical severity. Furthermore, we discussed the biologic plausibility of the thrombotic risk in SARS-CoV-2 and the potential use of an antithrombotic treatment.

scholarly journals Laboratory abnormalities in children with novel Coronavirus Disease 2019

2020 ◽  
Vol 14 ◽  
pp. 117955652095517
Author(s):  
Laila Bourkhissi ◽  
Karima EL Fakiri ◽  
Houda Nassih ◽  
Rabiy EL Qadiry ◽  
Aicha Bourrahouat ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Prospective Study ◽  
Kidney Function ◽  
Serum Levels ◽  
The Novel ◽  
Laboratory Findings ◽  
Biological Features ◽  
Liver And Kidney ◽  
Novel Coronavirus

The novel Coronavirus disease 2019 continues to be a worldwide pandemic. Yet, little is still known about the biological features of this emergent infection in children. In this prospective study, we collected 68 children infected with SARS-COV-2 from March 2020 to May 2020, in Marrakesh, Morocco. No severe cases were observed in this cohort, and 66% of the patients were asymptomatic. The main laboratory abnormalities were hematological, as we found Leucopoenia in 4.4% of the cases, hyperleukocytosis in 1.6%. Neutropenia was found in 5 patients (7%) and only 2 cases (3%) had Lymphopenia. The inflammation and coagulation biomarkers were normal in the majority of the cases, as for liver and kidney function. Lactate dehydrogenase (LDH) serum levels were elevated in 8 cases (11.67%). The COVID-19 in children seems to have mild course and better outcome than in adults, which impacts the laboratory findings in this category. More studies must be conducted to learn more about the laboratory abnormalities in pediatric COVID-19.

scholarly journals Protective Immunity against COVID-19

2021 ◽  
Author(s):  
Anjali Priyadarshini ◽  
Archana Gupta ◽  
Manoj Kumar Yadav ◽  
Arpana Vibhuti ◽  
Ramendra Pati Pandey ◽  
...  
Keyword(s):  
United States ◽  
Immune Responses ◽  
Drug Administration ◽  
United States Of America ◽  
Protective Immunity ◽  
The United States ◽  
The Novel ◽  
Infectious Agents ◽  
Novel Coronavirus ◽  
Target Effects

Tuberculosis and Covid-19 infection measure two quite different diseases- TB is caused by a sort of bacterium whereas Covid-19 is caused by a virus. However, the BCG immunizing agent would possibly facilitate individuals build immune responses to things aside from TB, inflicting "off-target effects," In different words, in run format, individuals started learning positive in obtaining the immunizing agent that had nothing to try and do with TB, several studies showed however the BCG immunizing agent affects individuals with kind one although the precise mechanism for these off-target effects of the BCG immunizing agent is not clear, it's believed that the immunizing agent will cause a nonspecific boost of the reaction. There is presently no immunizing agent or treatments approved by the United States of America Food and Drug Administration for the novel coronavirus. BCG is usually innocuous with the most facet impact the event of inflammation at the positioning of injection. Supported by these observations BCG so emerges as a possible candidate for the development of innate and adjustive reactions which can be non-specifically taking care of mycobacterium and different infectious agents against that vaccine remains not on the market.

scholarly journals Cytokine Storm in the Novel Coronavirus Infection and Methods of its Correction

2021 ◽  
Vol 65 (11-12) ◽  
pp. 27-37
Author(s):  
A. V. Ershov ◽  
V. D. Surova ◽  
V. T. Dolgikh ◽  
T. I. Dolgikh
Keyword(s):  
Fatal Outcome ◽  
Lung Damage ◽  
The Novel ◽  
Cytokine Storm ◽  
Leading Role ◽  
Average Impact ◽  
Average Impact Factor ◽  
Coronavirus Infection ◽  
Novel Coronavirus

The aim of the study was to identify the role of cytokine storm in COVID-19, that emerged at the end of 2019, based on the analysis of 80 publications, including 17.4% Russian and 82.6% foreign publications for 2014–2020 with an average impact factor of 11.94 and a maximum of 74.699. This review includes an in-depth discussion of the possible causes and pathogenetic factors of cytokine storm syndrome development caused by COVID-19. The results of research on the use of various principles of cytokine storm correction are provided. It has been established that lung damage and the development of a fatal outcome are caused not by the virus itself, but by the hyperreaction of the body's immune system. The leading role in this process belongs to the cytokine storm, including the action of IL-6.

scholarly journals Anticoronavirus and Immunomodulatory Phenolic Compounds: Opportunities and Pharmacotherapeutic Perspectives

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1254
Author(s):  
Naiara Naiana Dejani ◽  
Hatem A. Elshabrawy ◽  
Carlos da Silva Maia Bezerra Filho ◽  
Damião Pergentino de Sousa
Keyword(s):  
Phenolic Compounds ◽  
Mortality Rate ◽  
Immune Responses ◽  
Therapeutic Strategy ◽  
Kidney Diseases ◽  
Pharmacological Properties ◽  
The Novel ◽  
Dual Action ◽  
Natural Phenolic Compounds ◽  
Novel Coronavirus

In 2019, COVID-19 emerged as a severe respiratory disease that is caused by the novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). The disease has been associated with high mortality rate, especially in patients with comorbidities such as diabetes, cardiovascular and kidney diseases. This could be attributed to dysregulated immune responses and severe systemic inflammation in COVID-19 patients. The use of effective antiviral drugs against SARS-CoV-2 and modulation of the immune responses could be a potential therapeutic strategy for COVID-19. Studies have shown that natural phenolic compounds have several pharmacological properties, including anticoronavirus and immunomodulatory activities. Therefore, this review discusses the dual action of these natural products from the perspective of applicability at COVID-19.

scholarly journals Treatment of invasive streptococcal infection with a peptide derived from human high-molecular weight kininogen

Blood ◽  
2009 ◽  
Vol 114 (2) ◽  
pp. 444-451 ◽  
Author(s):  
Sonja Oehmcke ◽  
Oonagh Shannon ◽  
Maren von Köckritz-Blickwede ◽  
Matthias Mörgelin ◽  
Adam Linder ◽  
...  
Keyword(s):  
Molecular Weight ◽  
High Molecular Weight ◽  
Multiorgan Failure ◽  
Medical Problem ◽  
Contact System ◽  
Lung Damage ◽  
High Molecular Weight Kininogen ◽  
Inflammatory Reactions ◽  
Disturbed Microcirculation ◽  
Sepsis And Septic Shock

Abstract Sepsis and septic shock remain an important medical problem, emphasizing the need to identify novel therapeutic opportunities. Hypovolemic hypotension, coagulation dysfunction, disturbed microcirculation, and multiorgan failure resulting from vascular leakage are often observed in these severe conditions. In the present study, we find that HKH20, a peptide derived from human high molecular weight kininogen (HK), down-regulates inflammatory reactions caused by Streptococcus pyogenes in a mouse model of sepsis. HK is a component of the pro-inflammatory and pro-coagulant contact system. Activation of the contact system in the bloodstream by S pyogenes leads to massive tissue damage in the lungs of the infected mice, which eventually results in the death of the animals. HKH20 inhibits activation of the contact system and protects mice with invasive S pyogenes infection from lung damage. In combination with clindamycin treatment, the peptide also significantly prolongs the survival of infected mice.

scholarly journals Abnormal Liver Function Test in Patients Infected with Coronavirus (SARS-CoV-2): A Retrospective Single-Center Study from Spain

2021 ◽  
Vol 10 (5) ◽  
pp. 1039
Author(s):  
Raquel Benedé-Ubieto ◽  
Olga Estévez-Vázquez ◽  
Vicente Flores-Perojo ◽  
Ricardo U. Macías-Rodríguez ◽  
Astrid Ruiz-Margáin ◽  
...  
Keyword(s):  
Liver Injury ◽  
Serum Levels ◽  
Serum Markers ◽  
Disease Outcome ◽  
Abnormal Liver Function Test ◽  
The Novel ◽  
Clinical Indicators ◽  
Single Center Study ◽  
Function Test ◽  
Novel Coronavirus

The outbreak of the novel coronavirus SARS-CoV-2 epidemic has rapidly spread and still poses a serious threat to healthcare systems worldwide. In the present study, electronic medical records containing clinical indicators related to liver injury in 799 COVID-19-confirmed patients admitted to a hospital in Madrid (Spain) were extracted and analyzed. Correlation between liver injury and disease outcome was also evaluated. Serum levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Gamma-glutamyltransferase (GGT), Alkaline phosphatase (ALP), Lactate dehydrogenase (LDH) and AST/ALT ratio were elevated above the Upper Limit of Normal (ULN) in 25.73%, 49.17%, 34.62%, 24.21%, 55.84% and 75% of patients, respectively. Interestingly, significant positive correlation between LDH levels and the AST/ALT ratio with disease outcome was found. Our data showed that SARS-CoV-2 virus infection leads to mild, but significant changes in serum markers of liver injury. The upregulated LDH levels as well as AST/ALT ratios upon admission may be used as additional diagnostic characteristic for COVID-19 patients.

scholarly journals Morphological characteristic of coronavirus infection of the first and second waves of the pandemic

2021 ◽  
pp. 53-66
Author(s):  
A.P. Nadeev ◽  
◽  
D.V. Morozov ◽  
M.A. Travin ◽  
K.A. Nizovtsev ◽  
...  
Keyword(s):  
Diffuse Alveolar Damage ◽  
Lower Lobe ◽  
Diagnostic Methods ◽  
Lung Damage ◽  
Endocrine Disorders ◽  
The Novel ◽  
Treatment Regimens ◽  
Coronavirus Infection ◽  
Productive Phase ◽  
Novel Coronavirus

Introduction. A peculiarity of the first two waves of the epidemic of a novel coronavirus infection was that during their development only diagnostic methods, treatment regimens and anti-epidemic measures were only being developed, there were no vaccines and no mass vaccination was carried out. In this regard, the pandemic of the novel coronavirus infection of the first two waves is characterized by spontaneous progression of the disease. Aim of the research. Comparative study of morphological and clinical features of the novel coronavirus infection in the 1st and 2nd waves of the pandemic in 2020. Materials and methods. The autopsy protocols of deceased patients at the City Clinical Hospital No. 1 (Novosibirsk) during the 1st (May — June 2020) (1st group) and 2nd (October — December 2020) (2nd group) waves of the epidemic were analyzed. The 1st group included 30 cases, that is 14 women (46.7%) and 16 men (53.3%), in the 2nd — 110 cases, of which 43 were women (39.1%) and 67 – men (60.9%). In all cases, the presence of SARS-CoV-2 RNA in nasopharyngeal swabs from the patients was confirmed by polymerase chain reaction. Results. The novel coronavirus infection (coronavirus disease 2019 (COVID-19), ICD-10 code: U07.1) as the principal diagnosis in both the 1st and 2nd waves was recorded in more than 66% of observations. Among the comorbidities, the circulatory and endocrine disorders (primarily diabetes mellitus and obesity), kidneys and urinary tract diseases, mainly chronic pyelonephritis, prevailed. The COVID-19 pneumonia was predominantly bilateral polysegmental serоhemorrhagic in nature, however, in the 1st wave of the pandemic, the frequency of subtotal and seropurulent pneumonias was higher than in patients hospitalized during the 2nd wave. Diffuse alveolar damage in the 1st wave of the epidemic was characterized by the predominance of the early (exudative) phase of inflammation, in contrast to the 2nd wave, which was characterized by the predominance of the late (productive) phase in patients. Histologically, in patients of the 1st wave, the signs of exudative inflammation and hemorrhagic phenomena (with neutrophils and hyaline membranes in the alveoli, infarctions caused by thrombosis and pulmonary thromboembolism) prevailed. In the 2nd wave, signs of productive inflammation were more common in the lungs (predominance of macrophages in the alveoli, organizing pneumonia (pneumofibrosis), squamous cell metaplasia). Conclusion. The differences in the course of the novel coronavirus infection in the 1st and 2nd waves of the 2020 epidemic concerned primarily the frequency and structure of comorbidities and the level of polymorbidity, which were higher in patients during the 2nd wave. The severity of lung damage in patients of the 2nd wave was less pronounced: subtotal bilateral pneumonias were less common, lower lobe seropurulent pneumonias were more common. Diffuse alveolar damage in the 1st wave of the epidemic was characterized by the predominance of the early (exudative) phase, in contrast to the 2nd wave, which was characterized by the predominance of the late, productive phase of inflammation.

scholarly journals Reduction of Experimental Cerebral Malaria and Its Related Proinflammatory Responses by the Novel Liposome-Basedβ-Methasone Nanodrug

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Jintao Guo ◽  
Judith H. Waknine-Grinberg ◽  
Andrew J. Mitchell ◽  
Yechezkel Barenholz ◽  
Jacob Golenser
Keyword(s):  
Immune Responses ◽  
Cerebral Malaria ◽  
Time Window ◽  
The Novel ◽  
Experimental Cerebral Malaria ◽  
Cytokines And Chemokines ◽  
Proinflammatory Responses ◽  
Th1 And Th2 Responses ◽  
Th1 Immune Responses

Cerebral malaria (CM) is a severe complication of and a leading cause of death due toPlasmodium falciparuminfection. CM is likely the result of interrelated events, including mechanical obstruction due to parasite sequestration in the microvasculature, and upregulation of Th1 immune responses. In parallel, blood-brain-barrier (BBB) breakdown and damage or death of microglia, astrocytes, and neurons occurs. We found that a novel formulation of a liposome-encapsulated glucocorticosteroid,β-methasone hemisuccinate (nSSL-BMS), prevents experimental cerebral malaria (ECM) in a murine model and creates a survival time-window, enabling administration of an antiplasmodial drug before severe anemia develops. nSSL-BMS treatment leads to lower levels of cerebral inflammation, expressed by altered levels of corresponding cytokines and chemokines. The results indicate the role of integrated immune responses in ECM induction and show that the new steroidal nanodrug nSSL-BMS reverses the balance between the Th1 and Th2 responses in malaria-infected mice so that the proinflammatory processes leading to ECM are prevented. Overall, because of the immunopathological nature of CM, combined immunomodulator/antiplasmodial treatment should be considered for prevention/treatment of human CM and long-term cognitive damage.

scholarly journals Delivery Routes for COVID-19 Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 524
Author(s):  
Jang Hyun Park ◽  
Heung Kyu Lee
Keyword(s):  
Immune Responses ◽  
Viral Vector ◽  
Future Research ◽  
The Novel ◽  
Subunit Vaccines ◽  
Mucosal Vaccination ◽  
The Status ◽  
Delivery Routes ◽  
History Of ◽  
Novel Coronavirus

The novel coronavirus, SARS-CoV-2, which causes COVID-19, has resulted in a pandemic with millions of deaths. To eradicate SARS-CoV-2 and prevent further infections, many vaccine candidates have been developed. These vaccines include not only traditional subunit vaccines and attenuated or inactivated viral vaccines but also nucleic acid and viral vector vaccines. In contrast to the diversity in the platform technology, the delivery of vaccines is limited to intramuscular vaccination. Although intramuscular vaccination is safe and effective, mucosal vaccination could improve the local immune responses that block the spread of pathogens. However, a lack of understanding of mucosal immunity combined with the urgent need for a COVID-19 vaccine has resulted in only intramuscular vaccinations. In this review, we summarize the history of vaccines, current progress in COVID-19 vaccine technology, and the status of intranasal COVID-19 vaccines. Future research should determine the most effective route for vaccine delivery based on the platform and determine the mechanisms that underlie the efficacy of different delivery routes.

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