Extra-Pulmonary Complications in SARS-CoV-2 Infection: A Comprehensive Multi Organ-System Review

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is typically presented with acute symptoms affecting upper and lower respiratory systems. As the current pandemic progresses, COVID-19 patients are experiencing a series of nonspecific or atypical extra-pulmonary complications such as systemic inflammation, hypercoagulability state, and dysregulation of the renin–angiotensin–aldosterone system (RAAS). These manifestations often delay testing, diagnosis, and the urge to seek effective treatment. Although the pathophysiology of these complications is not clearly understood, the incidence of COVID-19 increases with age and the presence of pre-existing conditions. This review article outlines the pathophysiology and clinical impact of SARS-CoV-2 infection on extra-pulmonary systems. Understanding the broad spectrum of atypical extra-pulmonary manifestations of COVID-19 should increase disease surveillance, restrict transmission, and most importantly prevent multiple organ-system complications.

Differential Network Testing Reveals Diverging Dynamics of Organ System Interactions for Survivors and Non-survivors in Intensive Care Medicine

Statistical network analyses have become popular in many scientific disciplines, where an important task is to test for differences between two networks. We describe an overall framework for differential network testing procedures that vary regarding (1) the network estimation method, typically based on specific concepts of association, and (2) the network characteristic employed to measure the difference. Using permutation-based tests, our approach is general and applicable to various overall, node-specific or edge-specific network difference characteristics. The methods are implemented in our freely available R software package DNT, along with an R Shiny application. In a study in intensive care medicine, we compare networks based on parameters representing main organ systems to evaluate the prognosis of critically ill patients in the intensive care unit (ICU), using data from the surgical ICU of the University Medical Centre Mannheim, Germany. We specifically consider both cross-sectional comparisons between a non-survivor and a survivor group and longitudinal comparisons at two clinically relevant time points during the ICU stay: first, at admission, and second, at an event stage prior to death in non-survivors or a matching time point in survivors. The non-survivor and the survivor networks do not significantly differ at the admission stage. However, the organ system interactions of the survivors then stabilize at the event stage, revealing significantly more network edges, whereas those of the non-survivors do not. In particular, the liver appears to play a central role for the observed increased connectivity in the survivor network at the event stage.

Musculoskeletal complications of diabetes post COVID-19

Background: COVID-19 is an emerging disease caused by the severe respiratory syndrome. This affects the respiratory system but directly or indirectly affects the multiple organ system, including the musculoskeletal system. The patients with diabetes who get COVID are at risk of a severe disease course and mortality.Methods: The study design is Observational study. The study will be conducted on 30patients who have recovered from covid-19 with diabetes mellitus. The samples of the study are selected randomly. The data will be collected in a non-homogenous way, especially regarding lifestyle habits, and severity of the illness. Myalgia was calculated by numerical rating scale, Arthralgia was calculated by visual analog scale, and fatigue was calculated by Chalder fatigue scale to assess the severity of fatigue.Results: The severity of the complication was decreased in patients with second month COVID-19 recovery than in the first month.Conclusions: Background: COVID-19 is an emerging disease caused by the severe respiratory syndrome. This affects the respiratory system but directly or indirectly affects the multiple organ system, including the musculoskeletal system. The patients with diabetes who get COVID are at risk of a severe disease course and mortality.Methods: The study design is Observational study. The study will be conducted on 30patients who have recovered from covid-19 with diabetes mellitus. The samples of the study are selected randomly. The data will be collected in a non-homogenous way, especially regarding lifestyle habits, and severity of the illness. Myalgia was calculated by numerical rating scale, Arthralgia was calculated by visual analog scale, and fatigue was calculated by Chalder fatigue scale to assess the severity of fatigue.Results: The severity of the complication was decreased in patients with second month COVID-19 recovery than in the first month.Conclusions: This study concluded that there is decrease in the severity of musculoskeletal complications in diabetic patients from 1st month to 2nd month COVID-19 recoveries.

Regulatory Role of Non-Coding RNAs on Immune Responses During Sepsis

Sepsis is resulted from a systemic inflammatory response to bacterial, viral, or fungal agents. The induced inflammatory response by these microorganisms can lead to multiple organ system failure with devastating consequences. Recent studies have shown altered expressions of several non-coding RNAs such as long non-coding RNAs (lncRNAs), microRNAs (miRNAs) and circular RNAs (circRNAs) during sepsis. These transcripts have also been found to participate in the pathogenesis of multiple organ system failure through different mechanisms. NEAT1, MALAT1, THRIL, XIST, MIAT and TUG1 are among lncRNAs that participate in the pathoetiology of sepsis-related complications. miR-21, miR-155, miR-15a-5p, miR-494-3p, miR-218, miR-122, miR-208a-5p, miR-328 and miR-218 are examples of miRNAs participating in these complications. Finally, tens of circRNAs such as circC3P1, hsa_circRNA_104484, hsa_circRNA_104670 and circVMA21 and circ-PRKCI have been found to affect pathogenesis of sepsis. In the current review, we describe the role of these three classes of noncoding RNAs in the pathoetiology of sepsis-related complications.

Identification of Secondary Metabolite Compounds and Cytotoxic Activity Test of Papuan Grape (Sararanga Sinuosa Hemsley) Extract using Brine Shrimp Lethality Test (BSLT) Method

Papua has a diversity of flora species, one of which is the Papuan Grape (Sararanga sinuosa Hemsley). It is commonly used by the Depapre community, Jayapura, as a stamina booster. This research aims to identify the secondary metabolite compounds, to test the cytotoxic activity of Papuan Grape (Sararanga sinuosa Hemsley) extract, and to determine the best concentration that inhabits the growth of Artemia salina larvae using the BSLT method. This study was conducted with the extraction stage using the maceration method by making use of 96% ethanol solvent. Subsequently, the concentration series 0, 50, 100, 150, 200, 250, 300 ppm of Papuan Grape (Sararanga sinuosa Hemsley) extract were made to test the cytotoxic activity on the mortality of Artemia salina shrimp larvae. The results showed that Alkaloids, Flavonoids, Saponins, and Tannins were compounded as secondary metabolite. An antioxidant research that had been carried out previously had LC50 of green-white fruit (12,49 ± 0,35 mg/ml), orange-red fruit (17,62 ± 3,49 mg/ml) and red fruit (12,23 ± 0,46 mg/ml). The community process one stalk of it into juice and used or consumed it two times a day. An inappropriate dose of traditional medicine usage can affect the organ system and had adverse effects in the future The result of cytotoxic research obtained the value of LC50 in ethanol extract of Papuan Grape was 140,863 ppm, and concentration of 250 ppm was the best concentration to inhibit the growth of shrimp larvae (Artemia salina L). The conclusion of this study was the ethanol extract of Papuan Grape (Sararanga sinuosa Hemsley) showed the highest cytotoxic activity and potentially become an anti-cancer agent.

Graves’ Disease

Graves’ disease (GD) is an autoimmune disorder characterized by presence of TSH receptor autoantibody. It is most common cause of hyperthyroidism worldwide. Though GD can occur any age but peak incidence is seen during adulthood in between 20 to 50 years of age. GD is more commonly seen in female. GD is primarily disease of thyroid gland but affects multi organ system i.e. heart, liver, muscle, eye and skin. Symptoms and signs are result from hyperthyroidism or a consequence of underlying autoimmunity. Weight loss, fatigue, heat intolerance, tremor, and palpitations are the most common symptoms. Diffuse goiter presents in most of younger patients with thyrotoxicosis but less common in older patients. Graves’ ophthalmopathy and pretibial myxedema are extrathyroidal manifestations of GD which results from action of TSHR autoantibodies on TSHR present onfibroblast, adipocyte and T cells in extrathyroidal tissue. Treatment of GD remains in between antithyroid drugs, radioiodine or surgery. In this review we discuss the diagnosis and management of GD.

Perceived Physical Fatigability: A Prognostic Marker of Biological, Organ System, and Brain Aging

Characterizing perceived physical fatigability enables researchers to quantify an individual’s susceptibility to experiencing fatigue in the context of a standardized physical task. This approach eliminates self-pacing, and is a less-biased, more sensitive means to measure the degree to which fatigue may limit activity. Our previous work with two validated measures of perceived fatigability, the Pittsburgh Fatigability Scale (PFS) and Borg Rating of Perceived Exertion (RPE) at the end of a standardized 5-minute treadmill walk, are prognostic indicators of phenotypic aging. This symposium will present new directions related to greater fatigability as a marker of biological aging, organ system health and functioning, as well as brain pathology and structure. Specifically, Mr. Katz will explore the relationship between leukocyte telomere length, a marker of biological aging, with PFS fatigability in participants from the Long Life Family Study. The other four papers use data from the Baltimore Longitudinal Study of Aging (BLSA) and RPE fatigability (RPE). Drs. Simonsick and Karikkineth investigate fatigability as an early marker of aging and disease related impacts on key organ systems, specifically diminished renal function as reflected in estimated Glomerular Filtration Rate and cardiovascular health evaluated as vascular stiffness. Ms. Liu and Dr. Schrack will share whether there are associations of perceived fatigability with brain health, specifically Alzheimer’s disease-related pathology (PiB) and changes in brain structure. Lastly, our Discussant, Dr. Eldadah, will critically review the presentations in the context of new directions in fatigability research.

Core concepts in physiology: teaching homeostasis through pattern recognition

Homeostasis is a core concept in systems physiology that future clinicians and biomedical professionals will apply in their careers. Despite this, many students struggle to transfer the principles governing homeostasis to concrete examples. Precourse assessments conducted on 72 undergraduate biology students enrolled in an introductory systems physiology course at the University of Belgrade during the February–May semester of 2021 revealed that students had a vague, fragmentary understanding of homeostasis and its related concepts that was often conflated with topics touched on during their previous coursework. We formalized and implemented an approach to teaching homeostasis that focused heavily on consistent reinforcement of physiological reflex patterns throughout the course. To that end, we employed a variety of activities aimed at getting students to view organ system integration holistically. After the semester, postcourse assessment demonstrated that students were better able to provide concrete examples of organ system contributions to homeostasis and were more adept at applying basic principles to novel physiological scenarios. Comparison of final grades with previous semesters revealed that students outperformed their peers who had taken the course previously. In this article, we summarize the findings of pre- and postcourse assessments, describe the general approach we took to teaching homeostasis as well as the specific techniques used in the classroom, and compare student performance with previous semesters.

Multiscale Brain Aging in the Context of Neurodegeneration and Alzheimer's Disease

The brain, with a diverse array of specialized cells, regional substructures, and a relatively isolated microenvironment, represents a uniquely challenging organ system for aging research. The brain can experience physical trauma, interact with the periphery, and is responsible for cognitive and behavioral modifications that can feed back into the molecular processes of aging both within and external to the brain. Advances to our understanding and ability to intervene in the complexity that personifies brain aging and associated neurodegeneration will require integrated, multiscale approaches operating in tandem. Therefore, we have organized this symposium to highlight promising new approaches to study brain aging through the lens of multiple biological levels of organization. We will provide insight not only into normal brain aging, but will also suggest key spurious processes that may drive neurodegeneration and functional decline.