Pathogenesis of COVID-19; Acute Auto-inflammatory Disease (Endotheliopathica & Leukocytoclastica COVIDicus).

BACKGROUND: The pathogenesis of the COVID19 pandemic, that has killed one million nine hundred people and infected more the 90 million until end of 2020, has been studied by many researchers. Here, we try to explain its biological behavior based on our recent autopsy information and review of literature. METHODS: In this study, patients with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) result were considered eligible for enrollment. Histopathological examinations were done on 13 people who were hospitalized in Afzalipour hospital, Kerman, Iran. Clinical and laboratory data were reviewed. Tissue examination was done by light microscopy, immunohistochemistry and electron microscopy. RESULTS: The most frequent co-morbidity in the patients was cardiovascular disease. The common initial symptoms of COVID-19 infection were dyspnea and cough. In all cases, the number of white blood cells was higher than the normal range. Common histopathological findings were variable degrees of vasculitis as degenerative to necrotic changes of endothelium and trafficking of inflammatory cells in the vessel wall with fibrinoid necrosis. Tissue damage included interstitial acute inflammatory cells reaction with degenerative to necrotic changes of the parenchymal cells. CD34 and Factor VIII immunohistochemistry staining showed endothelial cell degeneration to necrosis at the vessel wall and infiltration by inflammatory cells. Electron microscopic features confirmed the degenerative damages in the endothelial cells. CONCLUSION: Our histopathological studies suggest that the main focus of the viral damage is the endothelial cells (endotheliopathica) in involved organs. Also, our findings suggest that degeneration of leukocytes occurs at the site of inflammation and release of cytokines (leukocytoclastica) resulting in a cytokine storm.

Effect of green tea on metabolic and hormonal aspect of polycystic ovarian syndrome in overweight and obese women suffering from polycystic ovarian syndrome: A clinical trial.

BACKGROUND AND OBJECTIVE: Polycystic ovarian syndrome (PCOS) is the common cause of Oligo-ovulation. This syndrome causes long-term metabolic issues as well as increase the risk of diabetes type 2, hypertension, dyslipidemia, and cardiovascular disease. The current research aimed to study the effect of green tea on weight and hormonal changes of women suffering from PCOS. METHODS: This two group, double-blind, randomized clinical trial was conducted in Isfahan city. Overweight women suffering from PCOS (n = 60) were randomly divided into two groups. Green tea was prescribed to the experimental group, and placebo was prescribed to the control group. Free testosterone hormones and fasting insulin were compared in both groups at the beginning and 12 weeks after the study commencement. The weight of participants of both groups was also measured before and after the study. The statistical data were analyzed by SPSS software and paired t-test. RESULTS: The paired t-test showed that there was no significant difference in the mean weight of both groups before the intervention (P = 0.812), but the difference was significant after the intervention (P = 0.031). There was no significant difference in the mean fasting insulin of both groups before the intervention (P = 0.352), but the difference was significant after the intervention (P < 0.0001). Moreover, there was no significant difference in the mean free testosterone level of both groups before the intervention (P = 0.638), but the difference was significant after the intervention (P < 0.0001). CONCLUSION: The consumption of green tea by overweight and obese women suffering from PCOS leads to weight loss, a decrease in fasting insulin, and a decrease in the level of free testosterone.