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1.
Molecules ; 26(16)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34443414

RESUMO

Natural antioxidants, especially those of plant origins, have shown a plethora of biological activities with substantial economic value, as they can be extracted from agro-wastes and/or under exploited plant species. The perennial hydrophyte, Potamogeton perfoliatus, has been used traditionally to treat several health disorders; however, little is known about its biological and its medicinal effects. Here, we used an integrated in vitro and in vivo framework to examine the potential effect of P. perfoliatus on oxidative stress, nociception, inflammatory models, and brewer's yeast-induced pyrexia in mice. Our results suggested a consistent in vitro inhibition of three enzymes, namely 5-lipoxygenase, cyclooxygenases 1 and 2 (COX-1 and COX-2), as well as a potent antioxidant effect. These results were confirmed in vivo where the studied extract attenuated carrageenan-induced paw edema, carrageenan-induced leukocyte migration into the peritoneal cavity by 25, 44 and 64% at 200, 400 and 600 mg/kg, p.o., respectively. Moreover, the extract decreased acetic acid-induced vascular permeability by 45% at 600 mg/kg, p.o., and chemical hyperalgesia in mice by 86% by 400 mg/kg, p.o., in acetic acid-induced writhing assay. The extract (400 mg/kg) showed a longer response latency at the 3 h time point (2.5 fold of the control) similar to the nalbuphine, the standard opioid analgesic. Additionally, pronounced antipyretic effects were observed at 600 mg/kg, comparable to paracetamol. Using LC-MS/MS, we identified 15 secondary metabolites that most likely contributed to the obtained biological activities. Altogether, our findings indicate that P. perfoliatus has anti-inflammatory, antioxidant, analgesic and antipyretic effects, thus supporting its traditional use and promoting its valorization as a potential candidate in treating oxidative stress-associated diseases.


Assuntos
Analgésicos/farmacologia , Anti-Inflamatórios/farmacologia , Antipiréticos/farmacologia , Extratos Vegetais/farmacologia , Potamogetonaceae/química , Ácido Acético , Animais , Antioxidantes/farmacologia , Comportamento Animal/efeitos dos fármacos , Permeabilidade Capilar/efeitos dos fármacos , Carragenina , Movimento Celular/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Avaliação Pré-Clínica de Medicamentos , Edema/patologia , Febre/patologia , Glucosídeos Iridoides/farmacologia , Leucócitos/efeitos dos fármacos , Masculino , Camundongos , Cavidade Peritoneal/patologia , Fenilpropionatos/farmacologia , Compostos Fitoquímicos/análise , Ratos , Saccharomyces cerevisiae
2.
Int J Mol Sci ; 22(16)2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34445566

RESUMO

BACKGROUND: The communication between the brain and the immune system is a cornerstone in animal physiology. This interaction is mediated by immune factors acting in both health and pathogenesis, but it is unclear how these systems molecularly and mechanistically communicate under changing environmental conditions. Behavioural fever is a well-conserved immune response that promotes dramatic changes in gene expression patterns during ectotherms' thermoregulatory adaptation, including those orchestrating inflammation. However, the molecular regulators activating the inflammatory reflex in ectotherms remain unidentified. METHODS: We revisited behavioural fever by providing groups of fish a thermal gradient environment during infection. Our novel experimental setup created temperature ranges in which fish freely moved between different thermal gradients: (1) wide thermoregulatory range; T° = 6.4 °C; and (2) restricted thermoregulatory range; T° = 1.4 °C. The fish behaviour was investigated during 5-days post-viral infection. Blood, spleen, and brain samples were collected to determine plasmatic pro- and anti-inflammatory cytokine levels. To characterize genes' functioning during behavioural fever, we performed a transcriptomic profiling of the fish spleen. We also measured the activity of neurotransmitters such as norepinephrine and acetylcholine in brain and peripheral tissues. RESULTS: We describe the first set of the neural components that control inflammatory modulation during behavioural fever. We identified a neuro-immune crosstalk as a potential mechanism promoting the fine regulation of inflammation. The development of behavioural fever upon viral infection triggers a robust inflammatory response in vivo, establishing an activation threshold after infection in several organs, including the brain. Thus, temperature shifts strongly impact on neural tissue, specifically on the inflammatory reflex network activation. At the molecular level, behavioural fever causes a significant increase in cholinergic neurotransmitters and their receptors' activity and key anti-inflammatory factors such as cytokine Il10 and Tgfß in target tissues. CONCLUSION: These results reveal a cholinergic neuronal-based mechanism underlying anti-inflammatory responses under induced fever. We performed the first molecular characterization of the behavioural fever response and inflammatory reflex activation in mobile ectotherms, identifying the role of key regulators of these processes. These findings provide genetic entry points for functional studies of the neural-immune adaptation to infection and its protective relevance in ectotherm organisms.


Assuntos
Comportamento Animal , Infecções por Birnaviridae/complicações , Febre/patologia , Imunidade , Vírus da Necrose Pancreática Infecciosa/fisiologia , Inflamação/patologia , Reflexo , Animais , Infecções por Birnaviridae/virologia , Regulação da Temperatura Corporal , Citocinas/metabolismo , Febre/etiologia , Peixes , Inflamação/etiologia
3.
PLoS One ; 16(7): e0255141, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34297774

RESUMO

The natural history of COVID-19 and predictors of mortality in older adults need to be investigated to inform clinical operations and healthcare policy planning. A retrospective study took place in 80 long-term nursing homes in Catalonia, Spain collecting data from March 1st to May 31st, 2020. Demographic and clinical data from 2,092 RT-PCR confirmed cases of SARS-CoV-2 infection were registered, including structural characteristics of the facilities. Descriptive statistics to describe the demographic, clinical, and molecular characteristics of our sample were prepared, both overall and by their symptomatology was performed and an analysis of statistically significant bivariate differences and constructions of a logistic regression model were carried out to assess the relationship between variables. The incidence of the infection was 28%. 71% of the residents showed symptoms. Five major symptoms included: fever, dyspnea, dry cough, asthenia and diarrhea. Fever and dyspnea were by far the most frequent (50% and 28%, respectively). The presentation was predominantly acute and symptomatology persisted from days to weeks (mean 9.1 days, SD = 10,9). 16% of residents had confirmed pneumonia and 22% required hospitalization. The accumulated mortality rate was 21.75% (86% concentrated during the first 28 days at onset). A multivariate logistic regression analysis showed a positive predictive value for mortality for some variables such as age, pneumonia, fever, dyspnea, stupor refusal to oral intake and dementia (p<0.01 for all variables). Results suggest that density in the nursing homes did not account for differences in the incidence of the infection within the facilities. This study provides insights into the natural history of the disease in older adults with high dependency living in long-term nursing homes during the first pandemic wave of March-May 2020 in the region of Catalonia, and suggests that some comorbidities and symptoms have a strong predictive value for mortality.


Assuntos
COVID-19 , Dispneia , Febre , Casas de Saúde , SARS-CoV-2 , Idoso , Idoso de 80 Anos ou mais , COVID-19/mortalidade , COVID-19/patologia , COVID-19/fisiopatologia , Comorbidade , Dispneia/mortalidade , Dispneia/patologia , Dispneia/fisiopatologia , Feminino , Febre/mortalidade , Febre/patologia , Febre/fisiopatologia , Humanos , Incidência , Masculino , Estudos Retrospectivos , Espanha/epidemiologia
5.
J Enzyme Inhib Med Chem ; 36(1): 1230-1235, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34074197

RESUMO

The ongoing Covid-19 is a contagious disease, and it is characterised by different symptoms such as fever, cough, and shortness of breath. Rising concerns about Covid-19 have severely affected the healthcare system in all countries as the Covid-19 outbreak has developed at a rapid rate all around the globe. Intriguing, a clinically used drug, acetazolamide (a specific inhibitor of carbonic anhydrase, CA, EC 4.2.1.1), is used to treat high-altitude pulmonary oedema (HAPE), showing a high degree of clinical similarities with the pulmonary disease caused by Covid-19. In this context, this preliminary study aims to provide insights into some factors affecting the Covid-19 patients, such as hypoxaemia, hypoxia as well as the blood CA activity. We hypothesise that patients with Covid-19 problems could show a dysregulated acid-base status influenced by CA activity. These preliminary results suggest that the use of CA inhibitors as a pharmacological treatment for Covid-19 may be beneficial.


Assuntos
Acetazolamida/uso terapêutico , Antivirais/uso terapêutico , COVID-19/tratamento farmacológico , Inibidores da Anidrase Carbônica/uso terapêutico , Anidrases Carbônicas/sangue , Equilíbrio Ácido-Base/efeitos dos fármacos , Doença da Altitude/sangue , Doença da Altitude/tratamento farmacológico , Anticonvulsivantes/uso terapêutico , Bicarbonatos/sangue , COVID-19/sangue , COVID-19/diagnóstico por imagem , COVID-19/virologia , Dióxido de Carbono/sangue , Tosse/sangue , Tosse/tratamento farmacológico , Tosse/patologia , Tosse/virologia , Reposicionamento de Medicamentos , Dispneia/sangue , Dispneia/tratamento farmacológico , Dispneia/patologia , Dispneia/virologia , Febre/sangue , Febre/tratamento farmacológico , Febre/patologia , Febre/virologia , Humanos , Concentração de Íons de Hidrogênio , Hipertensão Pulmonar/sangue , Hipertensão Pulmonar/tratamento farmacológico , Hipóxia/sangue , Hipóxia/tratamento farmacológico , Hipóxia/patologia , Hipóxia/virologia , Oximetria , Projetos de Pesquisa , SARS-CoV-2/patogenicidade , SARS-CoV-2/fisiologia , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
6.
Lancet Haematol ; 8(6): e433-e445, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34048682

RESUMO

BACKGROUND: Novel approaches are required to improve outcomes in relapsed or refractory classical Hodgkin lymphoma and non-Hodgkin lymphoma. We aimed to evaluate camidanlumab tesirine, an anti-CD25 antibody-drug conjugate, in this patient population. METHODS: This was a phase 1, dose-escalation (part 1), dose-expansion (part 2), multicentre trial done in 12 hospital sites (seven in the USA and five in the UK). Adults (≥18 years old) with pathologically confirmed relapsed or refractory classical Hodgkin lymphoma or non-Hodgkin lymphoma, an Eastern Cooperative Oncology Group performance status 0-2, who had no therapies available to them with established clinical benefit for their disease stage were enrolled. Camidanlumab tesirine was administered intravenously (3-150 µg/kg) once every 3 weeks. Primary objectives were to assess dose-limiting toxicity, determine maximum tolerated dose and recommended expansion dose(s), and assess safety of camidanlumab tesirine. Safety was assessed in all treated patients; antitumour activity was assessed in patients with one or more valid baseline and post-baseline disease assessment and in those who had disease progression or died after first study-drug dose. This trial was registered with ClinicalTrials.gov, NCT02432235. FINDINGS: Between Oct 5, 2015, and Jun 30, 2019, 133 patients were enrolled (77 [58%] had classical Hodgkin lymphoma and 56 (42%) had non-Hodgkin lymphoma). Median follow-up was 9·2 months (IQR 4·2-14·3). Eight dose-limiting toxicities were reported in five (6%) of 86 patients who were evaluable; the maximum tolerated dose was not reached. The recommended doses for expansion were 30 µg/kg and 45 µg/kg for patients with classical Hodgkin lymphoma and 80 µg/kg for patients with T-cell non-Hodgkin lymphomas. No recommended doses for expansion were defined for B-cell non-Hodgkin lymphomas. Grade 3 or worse treatment-emergent adverse events (reported by ≥10% of the 133 patients) included increased γ-glutamyltransferase (20 [15%] patients), maculopapular rash (16 [12%]), and anaemia (15 [11%]); 74 (56%) patients had serious treatment-emergent adverse events, most commonly pyrexia (16 [12%]). One (1%) fatal treatment-emergent adverse event and two (2%) deaths outside the reporting period were considered at least possibly study-drug related. Antitumoural activity was seen in classical Hodgkin and non-Hodgkin lymphomas; notably in all patients with classical Hodgkin lymphoma, the overall response was 71% (95% CI 60-81). INTERPRETATION: These results warrant evaluation of camidanlumab tesirine as a potential treatment option for relapsed or refractory lymphoma, particularly in patients with classical Hodgkin lymphoma. FUNDING: ADC Therapeutics.


Assuntos
Imunoconjugados/uso terapêutico , Linfoma/tratamento farmacológico , Administração Intravenosa , Adulto , Idoso , Esquema de Medicação , Exantema/etiologia , Exantema/patologia , Feminino , Febre/etiologia , Febre/patologia , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/patologia , Humanos , Imunoconjugados/efeitos adversos , Subunidade alfa de Receptor de Interleucina-2/imunologia , Estimativa de Kaplan-Meier , Linfoma/mortalidade , Linfoma/patologia , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva , Índice de Gravidade de Doença , Resultado do Tratamento
7.
J Med Virol ; 93(9): 5452-5457, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33969515

RESUMO

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is generally detected in nasopharyngeal swabs, viral RNA can be found in other samples including blood. Recently, associations between SARS-CoV-2 RNAaemia and disease severity and mortality have been reported in adults, while no reports are available in pediatric patients with coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the mortality, severity, clinical, and laboratory findings of SARS-CoV-2 RNA detection in blood in 96 pediatric patients with confirmed COVID-19. Among all patients, 6 (6%) had SARS-CoV-2 RNAaemia. Out of the six patients with SARS-CoV-2 RNAaemia, four (67%) had a severe form of the disease, and two out of the 6 patients with SARS-CoV-2 RNAaemia passed away (33%). Our results show that the symptoms more commonly found in the cases of COVID-19 in the study (fever, cough, tachypnea, and vomiting), were found at a higher percentage in the patients with SARS-CoV-2 RNAaemia. Creatine phosphokinase and magnesium tests showed significant differences between the positive and negative SARS-CoV-2 RNAaemia groups. Among all laboratory tests, magnesium and creatine phosphokinase could better predict SARS-CoV-2 RNAemia with area under the curve  levels of 0.808 and 0.748, respectively. In conclusion, 67% of individuals with SARS-CoV-2 RNAaemia showed a severe COVID-19 and one-third of the patients with SARS-CoV-2 RNAaemia passed away. Our findings suggest that magnesium and creatine phosphokinase might be considered as markers to estimate the SARS-CoV-2 RNAaemia.


Assuntos
COVID-19/patologia , Creatina Quinase/sangue , Magnésio/sangue , RNA Viral/sangue , SARS-CoV-2/patogenicidade , Viremia/patologia , Adolescente , Biomarcadores/sangue , COVID-19/diagnóstico , COVID-19/mortalidade , COVID-19/virologia , Teste de Ácido Nucleico para COVID-19 , Criança , Pré-Escolar , Tosse/diagnóstico , Tosse/mortalidade , Tosse/patologia , Tosse/virologia , Feminino , Febre/diagnóstico , Febre/mortalidade , Febre/patologia , Febre/virologia , Hospitais , Humanos , Lactente , Recém-Nascido , Irã (Geográfico) , Masculino , RNA Viral/genética , SARS-CoV-2/genética , Índice de Gravidade de Doença , Análise de Sobrevida , Taquipneia/diagnóstico , Taquipneia/mortalidade , Taquipneia/patologia , Taquipneia/virologia , Viremia/diagnóstico , Viremia/mortalidade , Viremia/virologia
8.
Eur J Med Genet ; 64(5): 104191, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33753323

RESUMO

Familial periodic fever (FPF) is an uncommonly diagnosed autosomal dominant disorder caused by a genetic alteration in the TNFRSF1A gene. These patients usually present with fever which is usually under-investigated and under-diagnosed. In untreated cases, amyloidosis is a frequent complication. We present a 24 years male who had a history of fever from childhood, however, remained undiagnosed short of genetic testing. He has recurrent episodes of fever. During the episodes of fever, he was found to have leukocytosis (total leukocyte count- 25.7 x10^9/L) and neutrophilia (absolute neutrophil count- 22.7 x10^9/L) both of which came back to normal limits as the fever subsided. On further evaluation for neutrophilia, the exclusion of common causes of neutrophilia was done. Next-generation sequencing detected a missense variant in TNFRSF1A: c.215G > A (p.Cys72Tyr) which was confirmed by Sanger sequencing. This variant has been described in the literature in anecdotal cases of FPF. This is a first case report from the Indian subcontinent reporting TNFRSF1A: c.215G > A (p.Cys72Tyr) variant in a patient of FPF. Short of genetic testing, the fever would remain a diagnostic dilemma in this patient. This report highlights the importance of targeted resequencing in clinching diagnosis in such patients.


Assuntos
Febre/genética , Doenças Hereditárias Autoinflamatórias/genética , Transtornos Leucocíticos/congênito , Receptores Tipo I de Fatores de Necrose Tumoral/genética , Febre/patologia , Doenças Hereditárias Autoinflamatórias/patologia , Humanos , Transtornos Leucocíticos/genética , Transtornos Leucocíticos/patologia , Masculino , Mutação de Sentido Incorreto , Adulto Jovem
9.
PLoS Pathog ; 17(2): e1009308, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33534855

RESUMO

Aerosol exposure to eastern equine encephalitis virus (EEEV) can trigger a lethal viral encephalitis in cynomolgus macaques which resembles severe human disease. Biomarkers indicative of central nervous system (CNS) infection by the virus and lethal outcome of disease would be useful in evaluating potential medical countermeasures, especially for therapeutic compounds. To meet requirements of the Animal Rule, a better understanding of the pathophysiology of EEEV-mediated disease in cynomolgus macaques is needed. In this study, macaques given a lethal dose of clone-derived EEEV strain V105 developed a fever between 2-3 days post infection (dpi) and succumbed to the disease by 6 dpi. At the peak of the febrile phase, there was a significant increase in the delta electroencephalography (EEG) power band associated with deep sleep as well as a sharp rise in intracranial pressure (ICP). Viremia peaked early after infection and was largely absent by the onset of fever. Granulocytosis and elevated plasma levels of IP-10 were found early after infection. At necropsy, there was a one hundred- to one thousand-fold increase in expression of traumatic brain injury genes (LIF, MMP-9) as well as inflammatory cytokines and chemokines (IFN-γ, IP-10, MCP-1, IL-8, IL-6) in the brain tissues. Phenotypic analysis of leukocytes entering the brain identified cells as primarily lymphoid (T, B, NK cells) with lower levels of infiltrating macrophages and activated microglia. Massive amounts of infectious virus were found in the brains of lethally-infected macaques. While no infectious virus was found in surviving macaques, quantitative PCR did find evidence of viral genomes in the brains of several survivors. These data are consistent with an overwhelming viral infection in the CNS coupled with a tremendous inflammatory response to the infection that may contribute to the disease outcome. Physiological monitoring of EEG and ICP represent novel methods for assessing efficacy of vaccines or therapeutics in the cynomolgus macaque model of EEEV encephalitis.


Assuntos
Aerossóis/efeitos adversos , Biomarcadores/análise , Encéfalo/imunologia , Encéfalo/patologia , Vírus da Encefalite Equina do Leste/patogenicidade , Encefalite Viral/imunologia , Febre/imunologia , Animais , Encéfalo/virologia , Citocinas/metabolismo , Modelos Animais de Doenças , Encefalite Viral/patologia , Encefalite Viral/virologia , Feminino , Febre/patologia , Febre/virologia , Macaca fascicularis , Masculino
11.
BMC Infect Dis ; 21(1): 110, 2021 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-33485297

RESUMO

BACKGROUND: Compelling evidence indicates that status epilepticus is a prevalent cause of rhabdomyolysis. However, cases of rhabdomyolysis induced by a single seizure accompanied by viral encephalitis are rarely reported. Herein, we present a case of adult Herpes Simplex Encephalitis complicated with rhabdomyolysis. CASE PRESENTATION: A 32-year-old male was patient presented with fever accompanied by episodes of convulsions, myalgia, and oliguria, which exacerbated the delirium. Routine blood examination showed impaired kidney function and elevated myoglobin (Mb) and creatine phosphokinase (CK) levels. MRI scanning revealed a damaged frontotemporal lobe and limbic system. In addition, herpes simplex virus (HSV) pathogen was identified in the cerebrospinal fluid thus indicating HSV infection. Therefore, a diagnosis of rhabdomyolysis triggered by HSV infection accompanied by epilepsy was made. Notably, the patient recovered well after early intervention and treatment. CONCLUSION: The case presented here calls for careful analysis of rhabdomyolysis cases with unknown causes, minor seizures, and without status epilepticus. This case also indicates that HSV virus infection might contribute to the rhabdomyolysis.


Assuntos
Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/diagnóstico , Rabdomiólise/diagnóstico , Rabdomiólise/etiologia , Adulto , Febre/diagnóstico , Febre/etiologia , Febre/patologia , Febre/fisiopatologia , Humanos , Masculino , Rabdomiólise/patologia , Rabdomiólise/fisiopatologia , Convulsões/diagnóstico , Convulsões/etiologia , Convulsões/patologia , Convulsões/fisiopatologia , Simplexvirus/isolamento & purificação
12.
Infection ; 49(1): 57-61, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32725596

RESUMO

BACKGROUND: The viral persistence in patients with Coronavirus Disease 2019 (COVID-19) remains to be investigated. METHODS: We investigated the viral loads, therapies, clinical features, and immune responses in a 70-year patient tested positive for SARS-CoV-2 for 3 months. FINDINGS: The patient exhibited the highest prevalence of abnormal indices of clinical features and immune responses at the first admission, including fever (38.3 â„ƒ), decreased lymphocytes (0.83 × 109/L) and serum potassium (3.1 mmol/L), as well as elevated serum creatinine (115 µmol/L), urea (8.6 mmol/L), and C-reactive protein (80 mg/L). By contrast, at the second and the third admission, these indices were all normal. Through three admissions, IL-2 increased from 0.14 pg/mL, 0.69 pg/mL, to 0.91 pg/mL, while IL-6 decreased from 11.78 pg/mL, 1.52 pg/mL, to 0.69 pg/mL, so did IL-10 from 5.13 pg/mL, 1.85 pg/mL, to 1.75 pg/mL. The steady declining trend was also found in TNF-α (1.49, 1.15, and 0.85 pg/mL) and IFN-γ (0.64, 0.42, and 0.27 pg/mL). The threshold cycle values of RT-PCR were 26.1, 30.5, and 23.5 for ORFlab gene, and 26.2, 30.6, and 22.7 for N gene, showing the patient had higher viral loads at the first and the third admission than during the middle term of the disease. The patient also showed substantially improved acute exudative lesions on the chest CT scanning images. CONCLUSIONS: The patient displayed declining immune responses in spite of the viral shedding for 3 months. We inferred the declining immune responses might result from the segregation of the virus from the immune system.


Assuntos
COVID-19/imunologia , Febre/imunologia , Linfopenia/imunologia , SARS-CoV-2/patogenicidade , Eliminação de Partículas Virais/imunologia , Idoso , Antivirais/uso terapêutico , Biomarcadores/sangue , Proteína C-Reativa/imunologia , Proteína C-Reativa/metabolismo , COVID-19/diagnóstico por imagem , COVID-19/patologia , COVID-19/virologia , Teste para COVID-19/métodos , Creatinina/sangue , Creatinina/imunologia , Febre/diagnóstico por imagem , Febre/patologia , Febre/virologia , Hospitalização , Humanos , Imunidade , Interferon gama/sangue , Interferon gama/imunologia , Interleucina-10/sangue , Interleucina-10/imunologia , Interleucina-2/sangue , Interleucina-2/imunologia , Interleucina-6/sangue , Interleucina-6/imunologia , Linfopenia/diagnóstico por imagem , Linfopenia/patologia , Linfopenia/virologia , Masculino , Recidiva , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2/genética , SARS-CoV-2/imunologia , Tomografia Computadorizada por Raios X , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/imunologia , Carga Viral/efeitos dos fármacos
13.
Infection ; 49(1): 153-157, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32725597

RESUMO

PURPOSE: The aim of our study was to assess respiratory function at the time of clinical recovery and 6 weeks after discharge in patients surviving to COVID-19 pneumonia. METHODS: Our case series consisted of 13 patients with COVID-19 pneumonia. RESULTS: At the time of clinical recovery, FEV1 (2.07 ± 0.72 L) and FVC (2.25 ± 0.86 L) were lower compared to lower limit of normality (LLN) values (2.56 ± 0.53 L, p = 0.004, and 3.31 ± 0.65 L, p < 0.001, respectively), while FEV1/FVC (0.94 ± 0.07) was higher compared to upper limit of normality (ULN) values (0.89 ± 0.01, p = 0.029). After 6 weeks pulmonary function improved but FVC was still lower than ULN (2.87 ± 0.81, p = 0.014). CONCLUSION: These findings suggest that COVID-19 pneumonia may result in clinically relevant alterations in pulmonary function tests, with a mainly restrictive pattern.


Assuntos
COVID-19/fisiopatologia , Tosse/fisiopatologia , Dispneia/fisiopatologia , Febre/fisiopatologia , Pulmão/fisiopatologia , SARS-CoV-2/patogenicidade , Adulto , Idoso , COVID-19/diagnóstico , COVID-19/patologia , COVID-19/virologia , Tosse/diagnóstico , Tosse/patologia , Tosse/virologia , Dispneia/diagnóstico , Dispneia/patologia , Dispneia/virologia , Feminino , Febre/diagnóstico , Febre/patologia , Febre/virologia , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pulmão/virologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Espirometria , Tomografia Computadorizada por Raios X
14.
J Med Virol ; 93(3): 1631-1638, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32926439

RESUMO

Many healthcare workers (HCWs) have been confirmed to be infected with SARS-CoV-2 in China. A retrospective, single-center study was conducted. The median age of the 132 HCWs with COVID-19 was 32 years, with 92 (69.7%) being females. There were 47 (35.6%) doctors, 72 (54.6%) nurses, and 13 (9.9%) other HCWs. Ten of the 132 patients (7.6%) had underlying diseases. The most common symptoms of illness onset were fever (70, 53.0%), cough (66, 50.0%), and fatigue (58, 43.9%). All patients were categorized into mild or moderate COVID-19 type on admission to hospital, and five (3.8%) progressed to the severe COVID-19 type. Sixty-six HCWs patients were included in both the early and later discharged group. In the logistic analysis, the later discharged patients had a longer time for illness onset to hospital admission (per 1 day; OR, 1.10; 95% CI, 1.03-1.18; p = .006), a higher proportion of >3 onset symptoms clustering (OR, 3.11; 95% CI, 1.27-7.62; p = .01), and a higher percentage of other HCWs (OR, 6.20; 95% CI, 1.49-25.80; p = .01). HCW patients were young female nurses with fewer comorbidities, and most were mild or moderate COVID-19 type. The later discharged patients exhibited characteristics of longer time for illness onset to hospitalization and clustering of onset symptoms.


Assuntos
COVID-19/epidemiologia , COVID-19/patologia , Pessoal de Saúde/estatística & dados numéricos , Adulto , COVID-19/virologia , China/epidemiologia , Comorbidade , Tosse/epidemiologia , Tosse/patologia , Tosse/virologia , Feminino , Febre/epidemiologia , Febre/patologia , Febre/virologia , Hospitalização/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Masculino , Alta do Paciente/estatística & dados numéricos , Estudos Retrospectivos , SARS-CoV-2/patogenicidade
15.
Trop Doct ; 51(2): 233-235, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33283680

RESUMO

Kawasaki disease is a common childhood vasculitis. Fever and lymphadenopathy, at times, are the only clinical presentation of Kawasaki disease, which mimics infectious lymphadenitis, especially, when other features are yet to evolve. In such a scenario, ultrasonography of cervical lymph nodes can help to differentiate Kawasaki disease lymphadenitis from infectious lymphadenitis. We present one such patient who was initially diagnosed as having bacterial lymphadenitis; however, ultrasonography of the neck lymph nodes showed typical imaging features described with Kawasaki disease lymphadenitis.


Assuntos
Febre/diagnóstico por imagem , Linfadenite/diagnóstico por imagem , Síndrome de Linfonodos Mucocutâneos/diagnóstico por imagem , Pré-Escolar , Diagnóstico Diferencial , Febre/patologia , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Linfadenite/patologia , Masculino , Síndrome de Linfonodos Mucocutâneos/patologia , Pescoço , Ultrassonografia
16.
Virulence ; 11(1): 1443-1452, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33108255

RESUMO

The diagnosed COVID-19 cases revealed that the incubation periods (IP) varied a lot among patients. However, few studies had emphasized on the different clinical features and prognosis of patients with different IP. A total of 330 patients with laboratory-confirmed COVID-19 were enrolled and classified into immediate onset group(IP<3 days, I group, 57 cases) and late onset group(IP>10 days, L group, 75 cases) based on IP. The difference of clinical characteristics and prognosis of the two groups were compared. There were more patients with fever in I group than in L group(P = 0.003), and counts of all the total lymphocytes, total T lymphocytes, CD4 + and CD8 + T lymphocytes were significantly different between the two groups(all P < 0.01). Besides, patients in L group had more GGOs in CT scan than I group and there were more patients in I group receiving antibiotic treatment than in L group(P < 0.001). For disease aggravation, the median CT scores were comparable between the two groups, but individually, there were more patients with increased CT score during hospitalization in I group than in L group. The aggravation incidence of CT presentation was 21.1% in I group, significantly higher than L group(8.0%, P = 0.042). Multivariable COX models suggested that IP was the only independent factors for CT aggravation. Conclusively, patients with different IP were different in clinical symptoms, laboratory tests, and CT presentations. Shorter IP was associated with the aggravation of lung involvement in CT scan.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Período de Incubação de Doenças Infecciosas , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Adulto , Betacoronavirus/patogenicidade , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/diagnóstico por imagem , Progressão da Doença , Feminino , Febre/epidemiologia , Febre/patologia , Hospitalização , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/diagnóstico por imagem , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , SARS-CoV-2 , Tomografia Computadorizada por Raios X
17.
BMC Med ; 18(1): 294, 2020 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-32951589

RESUMO

BACKGROUND: In malaria-endemic countries, febrile episodes caused by diseases other than malaria are a growing concern. However, limited knowledge of the prevalent etiologic agents and their geographic distributions restrict the ability of health services to address non-malarial morbidity and mortality through effective case management. Here, we review the etiology of fever in Latin America (LA) between 1980 and 2015 and map significant pathogens commonly implicated in febrile infectious diseases. METHODS: A literature search was conducted, without language restrictions, in three distinct databases in order to identify fever etiology studies that report laboratory-confirmed fever-causing pathogens that were isolated from usually sterile body sites. Data analyses and mapping was conducted with Tableau Desktop (version 2018.2.3). RESULTS: Inclusion criteria were met by 625 publications corresponding to data relative to 34 countries. Studies using serology (n = 339) predominated for viral infections, culture (n = 131) for bacteria, and microscopy (n = 62) for fungi and parasites. The pathogen groups most frequently reported were viral infections (n = 277), bacterial infections (n = 265), parasitic infections (n = 59), fungal infections (n = 47), and more than one pathogen group (n = 24). The most frequently reported virus was dengue virus (n = 171), followed by other arboviruses (n = 55), and hantavirus (n = 18). For bacteria, Staphylococcus spp. (n = 82), Rickettsia spp. (n = 70), and Leptospira spp. (n = 55) were frequently reported. Areas with biggest gaps on etiology of fever were apparent. CONCLUSIONS: This review provides a landscape of pathogens causing febrile illness other than malaria in LA for over 30 years. Our findings highlight the need to standardize protocols and report guidelines for fever etiology studies for better comparability of results and improved interpretation. Lastly, we should improve existing national laboratory surveillance systems, especially from low- to middle-income countries, to inform global fever policy priorities and timely identify emerging infections threats. STUDY REGISTRATION: PROSPERO systematic review registration number: CRD42016049281.


Assuntos
Febre/etiologia , Feminino , Febre/patologia , Humanos , América Latina , Masculino
18.
Am J Trop Med Hyg ; 103(4): 1350-1351, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32783797
19.
Clin Immunol ; 220: 108545, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32710937

RESUMO

COVID-19 rapidly turned to a global pandemic posing lethal threats to overwhelming health care capabilities, despite its relatively low mortality rate. The clinical respiratory symptoms include dry cough, fever, anosmia, breathing difficulties, and subsequent respiratory failure. No known cure is available for COVID-19. Apart from the anti-viral strategy, the supports of immune effectors and modulation of immunosuppressive mechanisms is the rationale immunomodulation approach in COVID-19 management. Diet and nutrition are essential for healthy immunity. However, a group of micronutrients plays a dominant role in immunomodulation. The deficiency of most nutrients increases the individual susceptibility to virus infection with a tendency for severe clinical presentation. Despite a shred of evidence, the supplementation of a single nutrient is not promising in the general population. Individuals at high-risk for specific nutrient deficiencies likely benefit from supplementation. The individual dietary and nutritional status assessments are critical for determining the comprehensive actions in COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/dietoterapia , Tosse/dietoterapia , Fatores Imunológicos/uso terapêutico , Micronutrientes/uso terapêutico , Pandemias , Pneumonia Viral/dietoterapia , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/imunologia , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/patologia , Tosse/diagnóstico , Tosse/imunologia , Tosse/patologia , Gerenciamento Clínico , Febre/diagnóstico , Febre/dietoterapia , Febre/imunologia , Febre/patologia , Humanos , Imunidade Celular/efeitos dos fármacos , Imunidade Inata/efeitos dos fármacos , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/dietoterapia , Transtornos do Olfato/imunologia , Transtornos do Olfato/patologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Pneumonia Viral/patologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/dietoterapia , Insuficiência Respiratória/imunologia , Insuficiência Respiratória/patologia , SARS-CoV-2 , Índice de Gravidade de Doença , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico
20.
Mol Med Rep ; 22(3): 2583-2587, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32705222

RESUMO

Since December 2019, an increasing number of cases associated with the 2019 novel coronavirus (2019­nCoV) have emerged in Wuhan, China, which has resulted in a rapid outbreak in China and worldwide. The present study aimed to describe the clinical, laboratory and radiological characteristics of 2019­nCoV pneumonia (NCP) in Zhejiang province, outside of Wuhan. A total of 74 patients with 2019­nCoV were continuously enrolled between January 22 and March 2, 2020 at Zhejiang Hospital. Diagnosis was confirmed at Zhejiang Hospital by reverse transcription­PCR (RT­PCR), which was approved by the Chinese government. Subsequently, the clinical features between positive­ and negative­NCP patients in Zhejiang were compared. Among the 74 hospitalized patients with suspected 2019­NCP, six patients (one male and five female patients) were confirmed to be infected with 2019­nCoV by RT­PCR. The average age of the confirmed patients was 40±13 years. There were three family clusters among the confirmed cases, one patient from each of these families had travel history or contact with patients from Wuhan within 2 weeks. Compared with non­NCP patients, the most common symptoms at onset for patients with NCP were fever (5/6; 83.3%) and cough (5/6; 83.3%), followed by dyspnea/pharyngalgia (2/6; 33.3%), whereas myalgia (1/6; 16.7%) and fatigue (1/6; 16.7%) were less common. All 74 patients with suspected NCP exhibited abnormal computerized tomography (CT) images. In total, 2/6 (33.3%) patients with confirmed NCP presented with bilateral pneumonia, and 21/68 (30.9%) non­NCP patients exhibited bilateral pneumonia, with bilateral distribution of patchy shadows or ground glass opacity. The present study revealed that epidemiological history was critical to the diagnosis of 2019­nCoV in low epidemic regions outside Hubei province. It was also identified that chest CT could not replace nucleic acid testing due to similar radiological manifestations.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Tosse/etiologia , Fadiga/etiologia , Febre/etiologia , Pneumonia Viral/complicações , Adulto , COVID-19 , China/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Tosse/patologia , Fadiga/patologia , Feminino , Febre/patologia , Humanos , Incidência , Masculino , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , SARS-CoV-2
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