Shock and dyselectrolytemia in a neonate with late-onset COVID-19 infection

Most reports of COVID-19 in neonates suggest that they are infected postnatally and present with gastrointestinal or respiratory symptoms. We describe a neonate who had community-acquired COVID-19, and presented with late-onset sepsis and developed dyselectrolytemia. The 26-day-old male baby had fever, feed refusal and shock. Rapid antigen test for SARS-CoV-2 by nasopharyngeal swab was positive and levels of circulating inflammatory markers were high. The baby was supported with antibiotics, and inotropic and vasopressor drugs. He had seizures and bradycardia due to dyselectrolytemia on day 2 of admission. On day 3, he had respiratory distress, with non-specific chest radiographic findings, and was managed with non-invasive support for 24 hours. The baby was discharged after 8 days. On serial follow-up, he was breastfeeding well and gaining weight appropriately with no morbidity. Our report highlights a unique presentation of COVID-19, with late-onset infection and shock-like features along with dyselectrolytemia and seizures.

Effects of multicomponent interventions on biochemical markers in obese youth: a systematic review protocol

Physical exercise is effective in modulating circulating inflammatory markers of obesity. However, little is known about the effects of interventions with physical exercise programs accompanied by nutritional and/or psychological guidance, configuring themselves as multicomponent programs. Thus, the aim of this review is to systematically evaluate the evidence related to the effects of multicomponent weight-loss interventions in modulating circulating inflammatory markers in children and adolescents. Therefore, the following databases will be searched to identify all relevant articles: PubMed, SciELO, Lilacs, Web of Science, EMBASE, Scopus, SPORT Discus. Randomized controlled trials and quasi-experimental studies of children and adolescents (6 to 18 years old) will be included. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or combinations thereof). Two independent reviewers will select studies using Rayyan QCRI software and extract the data to a standard form. The main outcomes of the review will be the circulating values of leptin, interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF- α) in a quantitative way. To assess the methodological quality (or risk of bias) of individual studies, Effective Public Health Practice Project assessment tool will be used. The meta-analysis will be performed using the Review Manager software.

Persistent level of mental distress in PTSD patients is not reflected in cytokine levels one year after treatment

Objective Cross-sectional data show that Post-Traumatic Stress Disorder (PTSD) patients often have increased levels of circulating inflammatory markers. There is, however, still a paucity of longitudinal studies with long follow-up times on levels of cytokines in such patients. The current study assesses patients with and without PTSD diagnosis one year after discharge from inpatient treatment. Methods Patients in treatment for serious non-psychotic mental disorders were recruited at the beginning of their treatment stay at a psychiatric center in Norway. Ninety patients submitted serum samples and filled out the Hopkins Symptom Checklist-90 Revised Global Severity Index (HSCL-90R GSI) questionnaire during their main stay and at a follow-up stay one year after discharge. Of these patients, 33 were diagnosed with PTSD, 48 with anxiety, depression or eating disorder, while nine patients had missing data. The patients were diagnosed using the Mini-International Neuropsychiatric Interview (M.I.N.I.). Results At the follow-up stay (T3), PTSD patients had higher levels of GSI scores than non-PTSD patients (p = 0.048). These levels were unchanged from the year before (T2) in both groups. The levels of circulating cytokines/chemokine did not differ between the PTSD and non-PTSD patients at T3. At T2, however, the PTSD and non-PTSD groups exhibited different levels of IL-1β (p = 0.053), IL-1RA (p = 0.042) and TNF-α (p = 0.037), with the PTSD patients having the higher levels. Conclusion Despite exhibiting different mental distress scores, the PTSD and non-PTSD patients did not differ regarding levels of circulating inflammatory markers at one-year follow-up. Significant outcome PTSD and non-PTSD patients show persistently different scores of mental distress one year after psychiatric treatment. In contrast, their cytokine levels do not differ one year after discharge from a psychiatric treatment inpatient stay. Limitations The patients with higher scores of mental distress were those who attended the follow-up stay, introducing a selection bias to the study. Further, it was not assessed whether the patients were fasting or smoking cigarettes prior to blood collection, or their sleeping or physical exercise status.

Genome-wide association study identifies 16 genomic regions associated with circulating cytokines at birth

Circulating inflammatory markers are essential to human health and disease, and they are often dysregulated or malfunctioning in cancers as well as in cardiovascular, metabolic, immunologic and neuropsychiatric disorders. However, the genetic contribution to the physiological variation of levels of circulating inflammatory markers is largely unknown. Here we report the results of a genome-wide genetic study of blood concentration of ten cytokines, including the hitherto unexplored calcium-binding protein (S100B). The study leverages a unique sample of neonatal blood spots from 9,459 Danish subjects from the iPSYCH initiative. We estimate the SNP-heritability of marker levels as ranging from essentially zero for Erythropoietin (EPO) up to 73% for S100B. We identify and replicate 16 associated genomic regions (p < 5 x 10−9), of which four are novel. We show that the associated variants map to enhancer elements, suggesting a possible transcriptional effect of genomic variants on the cytokine levels. The identification of the genetic architecture underlying the basic levels of cytokines is likely to prompt studies investigating the relationship between cytokines and complex disease. Our results also suggest that the genetic architecture of cytokines is stable from neonatal to adult life.

Neopterin predicts disease severity in hospitalized patients with COVID-19

This study evaluates the predictive value of circulating inflammatory markers, especially neopterin, in patients with COVID-19. Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease severity, risk for ICU admission, need for mechanical ventilation and death. Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical management of patients.

Interactions of SARS-CoV-2 infection with chronic obesity inflammation: a complex network phenomenon

Obesity is one of the biggest public health problems in the world, and its pathophysiological characteristics include chronic inflammation with an increase in various circulating inflammatory markers, such as acute inflammatory cytokines. Complications in the respiratory tract are related to bodily problems, which lead to a restriction of lung function due to reduced volume, inducing an increase in respiratory work. SARS-CoV-2 has a high potential for contamination by respiratory secretions and, therefore, obesity is one of the main risk factors for complications due to the association established between obesity, chronic inflammation and respiratory infection. The objective was to analyze the complex relationships between obesity and COVID-19 in a meta-analysis study using complex network modeling and the theoretical knockouts technique. Here, we identify and justify through a mathematical analysis the relationships between all the immunological agents added to the proposed immunological networks, considered as a simple evident interaction, relationship, influence, response, activation, based on our quantifiers. They performed the knockouts of all 52 vertices in the COVID-19 network and obesity - regardless of the environment, which would result in nonsense - and the COVID-19 infection network without considering obesity. The stationary flow vector (flow profile), for some knockouts of immunological interest in COVID-19 infections, was chosen IFNα, IL-6, IL-10, IL-17 and TNFα. This initial study pointed out the importance of chronic inflammation in the obese individual as an important factor in potentiating the disease caused by covid-19 and, in particular, the importance on IL-17.