Prevalence of viral co-infection among COVID-19 cases in association disease severity and oral hygiene

Background: In December 2019, an episode of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV2) was reported in Wuhan, China and has spread around the world, increasing the number of contagions. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are common herpesviruses that can cause persistent latent infections and affect the developing immune system.The study was conducted to explore the prevalence and reactivation of CMV and EBV antibodies in COVID-19 patients group in comparison to healthy group and to investigate the association between the presence of these viruses with each of severity of disease and oral hygiene. Materials and Methods: Eighty Five subjects were participated in this case control study (50 patients with COVID-19 and 35 healthy controls), their age range from 18 to 77 years. Oral health status was established by oral hygiene index. Serum obtained from patients and controls was analyzed using ELISA to assess levels of anti- CMV and anti- EBV antibodies. Results: The study revealed that the mean of anti-EBV IgG in patients was significantly elevated (p<0.01) than that in controls. Otherwise, there was no significant difference (p>0.05) in levels of anti- EBV IgM, anti- CMV IgG and IgM between two groups (P>0.05). In addition there were no significant differences between patients and controls (p>0.05) in the number and percentage of anti-EBV and anti-CMV antibodies. Interestingly, there was a significant increase in the level of anti-CMV IgM in severe cases as compared to mild cases, (P<0.01). Furthermore, these results revealed that there were no significant differences (P>0.05) in levels of anti-viral antibodies in patients with good oral hygiene compared to patients with poor oral hygiene. Conclusions: Higher frequency of anti-EBV IgG among patients indicates that latent infection is more common in COVID-19 patients. While an increased percentage of anti-CMV IgM indicated reactivation of latent infection and is related to disease severity suggesting that COVID-19 can cause cellular immune impairment.

May the Force Be with You (Or Not): The Immune System under Microgravity

All terrestrial organisms have evolved and adapted to thrive under Earth’s gravitational force. Due to the increase of crewed space flights in recent years, it is vital to understand how the lack of gravitational forces affects organisms. It is known that astronauts who have been exposed to microgravity suffer from an array of pathological conditions including an impaired immune system, which is one of the most negatively affected by microgravity. However, at the cellular level a gap in knowledge exists, limiting our ability to understand immune impairment in space. This review highlights the most significant work done over the past 10 years detailing the effects of microgravity on cellular aspects of the immune system.

Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year

Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.

Stability and Hopf Bifurcation of a Delayed Viral Infection Dynamics Model with Immune Impairment

In this paper, we consider a viral infection dynamics model with immune impairment and time delay in immune expansion. By calculation, it is shown that the model has three equilibria: infection-free equilibrium, immunity-inactivated infection equilibrium, and immunity-activated infection equilibrium. By analyzing the distributions of roots of corresponding characteristic equations, the local stability of the infection-free equilibrium and the immunity-inactivated infection equilibrium is established. Furthermore, we discuss the existence of Hopf bifurcation at the immunity-activated infection equilibrium. Sufficient conditions are obtained for the global asymptotic stability of each feasible equilibria of the model by using LaSalle’s invariance principle and iteration technique, respectively. Numerical simulations are carried out to illustrate the main theoretical results.

Glyphosate inhibits melanization and increases susceptibility to infection in insects

Melanin, a black-brown pigment found throughout all kingdoms of life, has diverse biological functions including UV protection, thermoregulation, oxidant scavenging, arthropod immunity, and microbial virulence. Given melanin’s broad roles in the biosphere, particularly in insect immune defenses, it is important to understand how exposure to ubiquitous environmental contaminants affects melanization. Glyphosate—the most widely used herbicide globally—inhibits melanin production, which could have wide-ranging implications in the health of many organisms, including insects. Here, we demonstrate that glyphosate has deleterious effects on insect health in 2 evolutionary distant species, Galleria mellonella (Lepidoptera: Pyralidae) and Anopheles gambiae (Diptera: Culicidae), suggesting a broad effect in insects. Glyphosate reduced survival of G. mellonella caterpillars following infection with the fungus Cryptococcus neoformans and decreased the size of melanized nodules formed in hemolymph, which normally help eliminate infection. Glyphosate also increased the burden of the malaria-causing parasite Plasmodium falciparum in A. gambiae mosquitoes, altered uninfected mosquito survival, and perturbed the microbial composition of adult mosquito midguts. Our results show that glyphosate’s mechanism of melanin inhibition involves antioxidant synergy and disruption of the reaction oxidation–reduction balance. Overall, these findings suggest that glyphosate’s environmental accumulation could render insects more susceptible to microbial pathogens due to melanin inhibition, immune impairment, and perturbations in microbiota composition, potentially contributing to declines in insect populations.

Severe COVID-19 in pediatric age: an update on the role of the anti-rheumatic agents

Background SARS-CoV-2 can induce an immune impairment and dysregulation, finally resulting in the massive release of inflammatory mediators (cytokine storm), strongly contributing to the pulmonary and systemic manifestations in severe coronavirus disease 2019 (COVID-19). As a consequence, different drugs active on the immune system have been proposed for the treatment of the disease in adults. Role of the anti-rheumatic agents in children Children are more likely to develop a mild disease course, as the severe form of COVID-19 is identified in less than 5% of the pediatric patients. Moreover, in children a peculiar disease phenotype, defined as multisystem inflammatory syndrome in children (MIS-C) is observed, representing the most severe expression of the inflammatory dysregulation caused by SARS-CoV-2. The limited experience with the severe pediatric COVID-19 and MIS-C does not allow conclusions about the role of the immune pharmacological approach, and therefore the treatment of these conditions represents a considerable clinical challenge. The use of chloroquine, hydroxychloroquine, and colchicine in the early disease stages is not sufficiently supported by evidence, and there is an increasing interest in the role of biologic agents, including anti-IL-1 and anti-IL-6 agents, in the prevention and treatment of the severe manifestations of COVID-19. Conclusion The therapeutic approach to pediatric COVID-19 is multidisciplinary, and anti-rheumatic agents have a prominent role in severe disease. This paper reviews the rationale for the use of anti-rheumatic agents in pediatric COVID-19 and MIS-C and the clinical experience with the single drugs. Finally, the areas of potential improvement in the use of anti-rheumatic agents, including the optimization of the drug choice and the timing of administration, are discussed.

Absolute Counts of Peripheral Lymphocyte Subsets as Potential Immune Impairment Markers in Patients With Breast Cancer

Purpose This study was to evaluate clinic value of absolute counts of lymphocyte subsets (ACL) as potential blood biomarkers in progression and prognosis in breast cancer (BC) patients.Methods A total of 237 BC patients and 55 age-matched female normal healthy donors (normal cantrals, NCs) were enrolled in this study. The absolute counts (AC) and percentages of CD3+, CD3+CD4+, CD3+CD8+, B and NK cells were determined by flow cytometry. The clinicopathological parameters influencing disease progression were determined by binary logistic regression. The progression-free survival (PFS) was evaluated by Kaplan-Meier. Univariable and multivariable analyses were performed using log-rank test and proportional hazard regression models, respectively.Results Compared with NCs, the ACL in BC patients decreased significantly, while the percentages of lymphocytes showed no change. Of them, AC of CD3+CD4+ cells was closely related to clinical stages. The ACL, especially CD3+CD4+ cells, were affected by different treatments. Analysis of logistic regression showed that the cut-off value of CD3+CD4+ cells ≥ 451 cells/μL was the favorable prognostic factor. Multivariate analysis of prognostic factors of PFS showed CD3+CD4+ and CD3+CD8+ cells were independent factors for predicting PFS.Conclusions The AC of CD3+, CD3+CD4+, CD3+CD8+, B, and NK cells in BC patients were impaired obviously and can be as potential susceptive indications to evaluate the patient's immune states. The higher level of AC of CD3+CD4+ and CD3+CD8+ cells contributed to longer PFS and favorable outcome, and could help to adopt appropriate treatment strategies in clinic.

Gut microbiome dysbiosis and correlation with blood biomarkers in active-tuberculosis in endemic setting

Tuberculosis (TB) is the largest infectious disease with 10 million new active-TB patients and1.7 million deaths per year. Active-TB is an inflammatory disease and is increasingly viewed as an imbalance of immune responses to M. tb. infection. The mechanisms of a switch from latent infection to active disease is not well worked out but a shift in the immune responses is thought to be responsible. Increasingly, the role of gut microbiota has been described as a major influencer of the immune system. And because the gut is the largest immune organ, we aimed to analyze the gut microbiome in active-TB patients in a TB-endemic country, Pakistan. The study revealed that Ruminococcacea, Enetrobactericeae, Erysipelotrichaceae, Bifidobacterium, etc. were the major genera associated with active-TB, also associated with chronic inflammatory disease. Plasma antibody profiles against several M. tb. antigens, as specific biomarkers for active-TB, correlated closely with the patient gut microbial profiles. Besides, bcoA gene copy number, indicative of the level of butyrate production by the gut microbiome was five-fold lower in TB patients compared to healthy individuals. These findings suggest that gut health in TB patients is compromised, with implications for disease morbidity (e.g., severe weight loss) as well as immune impairment.