Elevated Plasmin (Ogen) As A Common Risk Factor For COVID-19 Susceptibility

Physiological reviews
Volume 100, Issue 3, July 2020, Pages 1065-1075

Ji, Hong-Long; Zhao, Runzhen; Matalon, Sadis; Matthay, Michael A.

Introduction

Patients with hypertension, diabetes, coronary heart disease, cerebrovascular illness, COPD, and kidney dysfunction have worse clinical outcomes when infected with SARS-CoV-2, for unknown reasons. The purpose of this review is to summarize the evidence for the existence of elevated plasmin(ogen) in COVID-19 patients with these comorbid conditions. Plasmin, and other proteases, may cleave a newly inserted furin site in the S protein of SARS-CoV-2, extracellularly, which increases its infectivity and virulence. Hyper-fibrinolysis associated with plasmin leads to elevated D-dimer in severe patients. The plasmin(ogen) system may prove a promising therapeutic target for combating COVID-19.

Keywords

Comorbidity, COVID-19, fibrinolysis, plasmin(ogen), SARS-CoV-2

COVID-19 in Endoscopy: Time to do more?

Gastrointestinal Endoscopy

Thompson, Christopher C.; Shen, Lin; Lee, Linda S.

Introduction

We have read with great interest the paired articles on SARS-CoV-2/Novel Coronavirus19 (COVID-19) in this issue of Gastrointestinal Endoscopy. The first is entitled “Coronavirus (COVID-19) outbreak: what the department of endoscopy should know” by Repici et al, 1 which describes the Italian experience, and the second is “Considerations in performing endoscopy during the COVID-19 pandemic” by Soetikno et al, 2 which is drawn largely from the Hong Kong experience. We would like to congratulate the authors for their development and rigorous account of the endoscopic practices they have successfully used to minimize infection of endoscopy staff while providing essential services in this high-risk environment. We would also like to share a U.S. hospital perspective gained from our experience contending with numerous COVID-19 cases following the Biogen conference in Boston, Massachusetts.

Keywords

Clinical aspects, diagnosis, treatment

Preventing bat-born viral outbreaks in future using ecological interventions

Environmental Research
Volume 185, June 2020, 109460

Nabi, Ghulam; Siddique, Rabeea; Ali, Ashaq; Khan, Suliman

Introduction

The Coronavirus Disease 2019 (COVID-19) outbreak caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was reported for the first time in December 2019, Wuhan, China (Khan et al., 2020). The COVID-19 then rapidly spread from the epicentre globally, and now characterized as a pandemic by the World Health Organization (World Health Organization, 2020). The high transmissibility of SARS-CoV-2, the lack of specific treatment and vaccines, and the unstoppable spread of infection have recently caused global health emergency, fear, and psychological stress among the public (Cohen and Kupferschmidt, 2020). Like SARS-CoV-2, other viruses including Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Marburg virus, and Ebola virus, have caused major outbreaks in history. These outbreaks caused large numbers of fatalities, morbidities, and cost billions of dollars, worldwide (Allocati et al., 2016; Fan et al., 2019). Bats are reported as a natural reservoir for these viruses, especially coronaviruses (CoVs) which constitute approximately, 31% of their virome (Allocati et al., 2016; Afelt et al., 2018). These viruses are transmitted to humans either directly or via intermediate hosts (Chan et al., 2013; Allocati et al., 2016). Furthermore, higher species diversity (over 1400), longer lifespan (over 30 years), resistance to viral infection, and migration make them a huge reservoir for pathogens and give them higher chances to transmit pathogens to other species in vast areas (Allocati et al., 2016; Frick et al., 2019; Banerjee et al., 2020). In 207 bat species, 5717 bat-associated animal viruses have been detected in 77 different countries (Allocati et al., 2016). However, the elusive and nocturnal habits make them difficult to be studied (Frick et al., 2019) therefore, there could be more deadly viruses with epidemic and pandemic potentials if other bats species are studied.

Keywords

Ethics, social science, economics

Learning From History: Coronavirus Outbreaks In The Past

Dermatologic Therapy

Abdelmaksoud, Ayman; Kroumpouzos, George; Jafferany, Mohammad; Lotti, Torello; Sadoughifar, Roxanna; Goldust, Mohamad

Introduction

“Those who cannot remember the past are condemned to repeat it." -George Santayana
Coronaviruses were considered relatively harmless pathogens until they caused three major outbreaks of severe respiratory disease in the last 20 years. The current pandemic has compelled us to scrutinize the break-outs that have occurred in the past and imposed global threat time and again. Coronavirus is a single stranded enveloped RNA virus that belongs to the subfamily Coronavirinae. Based on the genomic structure, 4 subtypes of this zoonotic virus have been recognized- alphacoronavirus, betacoronavirus, gammacoronavirus and delta coronavirus. Alphacoronavirus and beta coronaviruses infect only mammals whereas gammacoronavirus and delta coronavirus infect mainly birds. Out of the former group, seven viruses are known to cause human disease. Four of these viruses, HCoV 229E, HCoV OC43, HCoVNL63 and HCoVHKU1, cause mild infections whereas three, SARS-CoV, MERS-CoV and the recently identified SARS-CoV2 cause serious respiratory illnesses in humans (Marra et al., 2003).

Keywords

Epidemiology

Italy in a Time of Emergency and Scarce Resources: The Need for Embedding Ethical Reflection in Social and Clinical Settings

The Journal of Clinical Ethics
Volume 31, 2020, Issue 1, pp 92-94

Nicoli, F., Gasparetto, A.

Abstract

The COVID-19 virus is severely testing the Italian healthcare system, as the requests for intensive treatment are greater than the real capacity of the system to receive patients. Given this emergency situation, it follows that citizens are limited in their freedom of movement in order to limit infection, and that in hospitals a significant number of critical situations must be faced. This brief contribution aims to offer a reflection on the public and clinical role of the bioethicist: a figure able to promote dialogue between the world of medicine and the community, and to face ethical dilemmas even in emergent clinical settings.

Keywords

Epidemiology; Ethics, social science, economics

The Anesthesiologist and COVID-19

Brazilian Journal of Anesthesiology (English Edition)

Vinícius CaldeiraQuintão, Cláudia MarquezSimões, Laís Helena Navarro eLima, Guilherme Antônio Moreira deBarros, Marcello FonsecaSalgado-Filho, Gabriel Magalhães NunesGuimarãesfRodrigo LealAlves, Ana Maria MenezesCaetano, André PratoSchmidt, Maria José Carvalho Carmona 

Abstract

In December 2019, China reported clusters of pneumonia in the city of Wuhan, epidemiologically related to transmission from animals. On December, 31, 2019, the Center for Disease Control and Prevention of China described a new coronavirus and announced the first stage of an outbreak. In addition to coronavirus SARS-CoV and coronavirus MERS-CoV, the world would be facing a new virus that was named SARS-CoV-2, which could lead to a severe acute respiratory syndrome and was named by the World Health Organization Covid-19 (Coronavirus Disease 2019).

Keywords

Epidemiology

Separated pathways in the endoscopy unit for COVID-19 patients

Gastrointestinal Endoscopy

Valdivia, Pablo Cortegoso; le Grazie, Marco; Gaiani, Federica; Decembrino, Francesco; Luigi de’Angelis, Gian.

To the Editor:

Recently, Repici et al1 proposed a model for prevention of COVID-19 infection spread in endoscopic units. The topic is of utmost importance because of the potential for fecal–oral transmission of the SARS-CoV-2,2 its prolonged persistence on different surfaces,3 and the fact that, from now on, an increasing number of procedures in patients known to be COVID-19 positive will be performed.

Keywords

Clinical aspects, diagnosis, treatment

Mitigating the impact of conference and travel cancellations on researchers' futures

eLife
Volume 9, 2020

Weissgerber, T.; Bediako, Y.; de Winde, C. M.; Ebrahimi, H.; Fernandez-Chiappe, F.; Ilangovan, V.; Mehta, D.; Paz Quezada, C.; Riley, J. L.; Saladi, S. M.; Sarabipour, S.; Tay, A.

Abstract

The need to protect public health during the current COVID-19 pandemic has necessitated conference cancellations on an unprecedented scale. As the scientific community adapts to new working conditions, it is important to recognize that some of our actions may disproportionately affect early-career researchers and scientists from countries with limited research funding. We encourage all conference organizers, funders and institutions who are able to do so to consider how they can mitigate the unintended consequences of conference and travel cancellations and we provide seven recommendations for how this could be achieved. The proposed solutions may also offer long-term benefits for those who normally cannot attend conferences, and thus lead to a more equitable future for generations of researchers.

Keywords

Epidemiology; Ethics, social science, economics

Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China

Psychological Medicine
March 2020 , pp. 1-7

Bo, Hai-Xin; Li, Wen; Yang, Yuan; Wang, Yu; Zhang, Qinge; Cheung, Teris; Wu, Xinjuan; Xiang, Yu-Tao.

Body

The novel coronavirus disease (COVID-19) epidemic, which is believed to be originated from Wuhan, China at the end of 2019, has been rapidly transmitted globally. With the increasing number of infected cases and deaths, many patients experienced both physical sufferings and great psychological distress. In China, a range of guidelines and expert consensus have been developed by health authorities and academic associations. Crisis mental health interventions, such as online education and counseling services, have been widely adopted nationwide.(Liu et al., 2020) According to the treatment guidelines in China, COVID-19 patients need to be treated in isolated infectious hospitals. Due to social isolation, perceived danger, uncertainty, physical discomfort, medication side effects, fear of virus transmission to others, and overwhelming negative news portrayal in mass media coverage, patients with COVID-19 may experience loneliness, anger, anxiety, depression, and insomnia, and posttraumatic stress symptoms,(Wu, Chan, & Ma, 2005; Xiang et al., 2020) which could negatively affect individuals’ social and occupational functioning, and quality of life.(Monson, Caron, McCloskey, & Brunet, 2017; North et al., 2002) To date, no studies on the pattern of posttraumatic stress symptoms among COVID-19 patients have been reported.

Keywords

Ethics, social science, economics

The Impact of COVID-19 on Radiation Oncology Clinics and Cancer Patients in the U.S

Advances in Radiation Oncology

Rivera, Amanda; Ohri, Nitin; Thomas, Evan; Miller, Robert; Knoll, Miriam A.

Background

In December 2019, Wuhan, China witnessed the outbreak of the novel coronavirus (SARS-CoV-2) that would soon become an international public health emergency and world pandemic.1 In the U.S., we are at a time where preparation for healthcare systems is critical. Given the rapidity with which the novel coronavirus (SARS-CoV-2) is spreading, we can expect an increased burden of cancer patients diagnosed with COVID-19 at oncology treatment clinics and a need to address this diagnosis. As of the date of this writing, the U.S.

Keywords

COVID-19, SARS-CoV-2, Treatment

Perioperative Presentation of COVID-19 Disease in a Liver Transplant Recipient

Hepatology (Baltimore, Md.)

Qin, Juanjuan; Wang, Haitao; Qin, Xuan; Zhang, Peng; Zhu, Lihua; Cai, Jingjing; Yuan, Yufeng; Li, Hongliang.

Abstract

Coronavirus disease 2019 (COVID-19) is highly contagious. It may rapidly progress to acute respiratory distress syndrome (ARDS) and result in multiorgan dysfunction or death in some cases.((1,2)) Here, we report the case of a patient with hepatocellular carcinoma (HCC) who underwent liver transplantation and experienced COVID-19 infection during the perioperative period. This case may help clinicians by alerting them to potential COVID-19 infection in transplant recipients during the outbreak.

Keywords

Clinical aspects, diagnosis, treatment

CT morphology of COVID-19: Case report and review of literature

RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin

Hamer, Okka Wilkea; Salzberger, Bernd; Gebauer, Johannes; Stroszczynski, Christian; Pfeifer, Michael.

Introduction

In December 2019 a clustering of pneumonia was reported for the first time in Wuhan, Hubei, China. A coronavirus was identified as the pathogen, which has since been given the name Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 is called COVID-19 which has since spread worldwide. In Germany, the numbers continue to increase, and the level of COVID-19 lethality in Europe cannot yet be accurately estimated. However, lethality appears to be particularly higher in older patients compared to seasonal influenza. Based on experience in China, computed tomography (CT) is very helpful in COVID-19 in that it can produce an image that is suggestive for diagnosis, and the sensitivity of CT is in some cases higher than that of the current gold standard, real-time polymerase chain reaction (RT-PCR).

The aim of this article is to present a case with COVID-19 pneumonia and to provide an overview of the existing radiological literature on COVID-19.

Keywords

Clinical aspects, diagnosis, treatment

Identifying SARS-CoV-2 Related Coronaviruses in Malayan Pangolins

Nature

Lam, Tommy Tsan-Yuk; Shum, Marcus Ho-Hin; Zhu, Hua-Chen; Tong, Yi-Gang; Ni, Xue-Bing; Liao, Yun-Shi; Wei, Wei; Cheung, William Yiu-Man; Li, Wen-Juan; Li, Lian-Feng; Leung, Gabriel M.; Holmes, Edward C.; Hu, Yan-Ling; Guan, Yi.

Abstract

The ongoing outbreak of viral pneumonia in China and beyond is associated with a novel coronavirus, SARS-CoV-2(1). This outbreak has been tentatively associated with a seafood market in Wuhan, China, where the sale of wild animals may be the source of zoonotic infection(2). Although bats are likely reservoir hosts for SARS-CoV-2, the identity of any intermediate host that might have facilitated transfer to humans is unknown. Here, we report the identification of SARS-CoV-2-related coronaviruses in Malayan pangolins (Manis javanica) seized in anti-smuggling operations in southern China. Metagenomic sequencing identified pangolin-associated coronaviruses that belong to two sub-lineages of SARS-CoV-2-related coronaviruses, including one that exhibits strong similarity to SARS-CoV-2 in the receptor-binding domain. The discovery of multiple lineages of pangolin coronavirus and their similarity to SARS-CoV-2 suggests that pangolins should be considered as possible hosts in the emergence of novel coronaviruses and should be removed from wet markets to prevent zoonotic transmission.

Keywords

Epidemiology

Management of IBD during the COVID-19 outbreak: resetting clinical priorities

Nature reviews. Gastroenterology & hepatology

Danese, S.; Cecconi, M.; Spinelli, A.

Comment

Since December 2019 when the 2019 novel coronavirus (2019-nCoV as it was then termed, now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the WHO) outbreak had been described in Wuhan, Hubei, China, the situation has dramatically evolved. The pandemic, as declared by the WHO, has led to >300,000 cases worldwide reported as of March 2020, in all continents, excluding Antarctica, spreading on a logarithmic scale in Europe. Italy is currently the second most affected country after China and, as of 13 March 2020, Europe was declared the centre of the pandemic. Because of the very high transmission capacity, the WHO declared the outbreak of coronavirus disease (COVID-19) caused by SARS-CoV-2 infection a public health emergency of international concern.

Keywords

Clinical aspects, diagnosis, treatment

Multi-omics Evaluation of Gastrointestinal and Other Clinical Characteristics of SARS-CoV-2 and COVID-19

Gastroenterology

Du, Mulong; Cai, Guoshuai; Chen, Feng; Christiani, David C.; Zhang, Zhengdong; Wang, Meilin.

Introduction

Since December 2019, coronavirus disease 2019 (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has produced a worldwide panic. Except for a principal human to human transmission method by droplet and contact, there is still limited knowledge about possible alternate transmission methods to guide clinical care. Recent clinical studies have observed digestive symptoms in COVID-19 patients, possibly because of the enrichment and infection of SARS-CoV-2 in the gastrointestinal tract, mediated by virus receptor of angiotensin converting enzyme II (ACE2), which suggests the potential for a fecaloral route of SARS-CoV-2 transmission 3, 4. However, there is still a large gap in the biological knowledge of COVID-19. In this study, via a bulk-to-cell strategy focusing on ACE2, we performed an integrated omics analysis at the genome, transcriptome and proteome levels in bulk tissues and single cells across species to decipher the potential routes for SARS-CoV-2 infection in depth.

Keywords

COVID-19, SARS-CoV-2, Treatment

Molecular immune pathogenesis and diagnosis of COVID-19

Journal of Pharmaceutical Analysis
5 March 2020

Xiaowei Li, Manman Geng, Yizhao Peng, Liesu Meng, Shemin Lu

Abstract

Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia with an unusual outbreak in Wuhan, China, in December 2019, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the twenty-first century. In this minireview, we provide a brief introduction of the general features of SARS-CoV-2 and discuss current knowledge of molecular immune pathogenesis, diagnosis and treatment of COVID-19 on the base of the present understanding of SARS-CoV and MERS-CoV infections, which may be helpful in offering novel insights and potential therapeutic targets for combating the SARS-CoV-2 infection.

Keywords

Coronavirus, SARS-CoV-2, SARS-CoV, MERS-CoV, Pathogenesis

The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak

Journal of Autoimmunity
Available online 26 February 2020, 102433

Hussin A. Rothan, and Siddappa N. Byrareddy

Abstract

Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Based on the large number of infected people that were exposed to the wet animal market in Wuhan City, China, it is suggested that this is likely the zoonotic origin of COVID-19. Person-to-person transmission of COVID-19 infection led to the isolation of patients that were subsequently administered a variety of treatments. Extensive measures to reduce person-to-person transmission of COVID-19 have been implemented to control the current outbreak. Special attention and efforts to protect or reduce transmission should be applied in susceptible populations including children, health care providers, and elderly people. In this review, we highlights the symptoms, epidemiology, transmission, pathogenesis, phylogenetic analysis and future directions to control the spread of this fatal disease.

Keywords

Coronavirus, COVID-19, Wuhan city, Pneumonia, Pathogenesis

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges

International Journal of Antimicrobial Agents
Volume 55, Issue 3, March 2020, 105924

Chih-Cheng Lai, Tzu-Ping Shih, Wen-Chien Ko, Hung-Jen Tang, Po-Ren Hsueh

Abstract

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously provisionally named 2019 novel coronavirus or 2019-nCoV) disease (COVID-19) in China at the end of 2019 has caused a large global outbreak and is a major public health issue. As of 11 February 2020, data from the World Health Organization (WHO) have shown that more than 43 000 confirmed cases have been identified in 28 countries/regions, with >99% of cases being detected in China. On 30 January 2020, the WHO declared COVID-19 as the sixth public health emergency of international concern. SARS-CoV-2 is closely related to two bat-derived severe acute respiratory syndrome-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21. It is spread by human-to-human transmission via droplets or direct contact, and infection has been estimated to have mean incubation period of 6.4 days and a basic reproduction number of 2.24–3.58. Among patients with pneumonia caused by SARS-CoV-2 (novel coronavirus pneumonia or Wuhan pneumonia), fever was the most common symptom, followed by cough. Bilateral lung involvement with ground-glass opacity was the most common finding from computed tomography images of the chest. The one case of SARS-CoV-2 pneumonia in the USA is responding well to remdesivir, which is now undergoing a clinical trial in China. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary intervention being used. However, public health authorities should keep monitoring the situation closely, as the more we can learn about this novel virus and its associated outbreak, the better we can respond.

Keywords

2019-nCoV, SARS-CoV-2, COVID-19, China, Epidemic, Remdesivir

Some One Health based control strategies for the Middle East respiratory syndrome coronavirus

One Health
Volume 8, December 2019, 100102

Maged Gomaa Hemida, Abdelmohsen Alnaeem

Abstract

The Middle East respiratory syndrome coronavirus (MERS-CoV) presents an ideal example for developing One Health concepts. Dromedary camels are the principal reservoir for the virus. Infected camels shed the virus in body secretions, particularly nasal discharges. MERS-CoV has the potential to remain active in the environment for some time under optimum conditions of temperature and humidity. This shedding sustains the virus in endemic communities and thus contact with camels is considered a major risk factor for human infection. Reducing virus shedding from camels will have a great positive impact on reducing the human risk of infection. Our main objective is to highlight the potential aspects of reducing virus shedding from camels to the environment, thereby reducing the possibility of human infection. We will focus on the potential roles of camel markets, camel shows, importation, transportation and grazing in the amplification and shedding of the virus, providing some novel concepts for the control approaches for the MERS-CoV.

Keywords

MERS-CoV, One Health, Dromedary camel, Human, Transmission, Shedding

Current treatment options and the role of peptides as potential therapeutic components for Middle East Respiratory Syndrome (MERS): A review

Journal of Infection and Public Health
Volume 11, Issue 1, January–February 2018, Pages 9-17

Sabeena Mustafa, Hanan Balkhy, Musa N. Gabere

Abstract

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a highly pathogenic respiratory virus with mechanisms that may be driven by innate immune responses. Despite the effort of scientific studies related to this virus, Middle East Respiratory Syndrome (MERS) is still a public health concern. MERS-CoV infection has a high mortality rate, and to date, no therapeutic or vaccine has been discovered, that is effective in treating or preventing the disease. In this review, we summarize our understanding of the molecular and biological events of compounds acting as MERS-CoV inhibitors, the outcomes of existing therapeutic options and the various drugs undergoing clinical trials. Currently, several therapeutic options have been employed, such as convalescent plasma (CP), intravenous immunoglobulin (IVIG), monoclonal antibodies and repurposing of existing clinically approved drugs. However, these therapeutic options have drawbacks, thus the need for an alternative approach. The requirement for effective therapeutic treatment has brought the necessity for additional MERS treatments. We suggest that antimicrobial peptides (AMPs) may be used as alternative therapeutic agents against MERS-CoV infection. In addition, we propose the feasibility of developing effective agents by repurposing the existing and clinically approved anti-coronavirus and anti-viral peptide drugs.

Keywords

MERS-CoV, Ribavirin, Interferon, Peptide therapeutics, Convalescent plasma, Intravenous immunoglobin, Antimicrobial peptides