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1.
BMC Pulm Med ; 21(1): 24, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33435949

RESUMO

BACKGROUND: Pulmonary radiological findings of the novel coronavirus disease 2019 (COVID-19) have been well documented and range from scattered ground-glass infiltrates in milder cases to confluent ground-glass change, dense consolidation, and crazy paving in the critically ill. However, lung cavitation has not been commonly described in these patients. The objective of this study was to assess the incidence of pulmonary cavitation in patients with COVID-19 and describe its characteristics and evolution. METHODS: We conducted a retrospective review of all patients admitted to our institution with COVID-19 and reviewed electronic medical records and imaging to identify patients who developed pulmonary cavitation. RESULTS: Twelve out of 689 (1.7%) patients admitted to our institution with COVID-19 developed pulmonary cavitation, comprising 3.3% (n = 12/359) of patients who developed COVID-19 pneumonia, and 11% (n = 12/110) of those admitted to the intensive care unit. We describe the imaging characteristics of the cavitation and present the clinical, pharmacological, laboratory, and microbiological parameters for these patients. In this cohort six patients have died, and six discharged home. CONCLUSION: Cavitary lung disease in patients with severe COVID-19 disease is not uncommon, and is associated with a high level of morbidity and mortality.


Assuntos
/complicações , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Pneumopatias/virologia , Tomografia Computadorizada por Raios X , Adulto , Idoso , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo
3.
J Med Imaging Radiat Oncol ; 64(5): 649-659, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33000560

RESUMO

To describe the chest CT features reported in children with confirmed COVID-19 infection, published in English literature. A systematic review was completed on PubMed, Embase and Scopus databases on the 1st of June 2020 using the PICO strategy. The NIH Quality Assessment Tool was used to assess the quality of the selected articles. The systematic review was evaluated by Case Series Studies and the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA). The extracted data were assessed and compared with those reported in the adult population. Seventy-two articles were retrieved from the database search and screened by the title, abstract and keywords. Eleven articles were deemed eligible for full-text assessment. Nine articles were included for the data extraction and in the final analysis. Chest CT features in children with COVID-19 differ from those in adults. 'Ground-grass opacities' (GGOs) are the most commonly described abnormalities, but closely followed by a combination of GGO and consolidation, not usual in adults. Children tend to have a more variable involvement than the subpleural and posterior and basal topography described in adults. Interlobular thickening and air bronchogram found in adults with COVID-19 are not frequent in children. Pulmonary embolism reported in up to 30% of adults has not been yet reported in children. Original articles describing chest CT features in children with COVID-19 in the English literature are limited to small populations of Chinese children. Chest CT imaging features are very diverse across the selected studies and globally different from those reported in adults. Data from children of different countries would provide a more comprehensive description of chest CT features in children with COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos , Betacoronavirus , Criança , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa
4.
J Med Imaging Radiat Oncol ; 64(5): 668-670, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33001577

RESUMO

This case report describes our early radiological experiences of middle-aged patients with COVID-19 at Westmead Hospital, Sydney. We found limited relationship between initial CT imaging appearances and progression to severe disease. The most effective use of imaging in COVID-19 is yet to be determined.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , Adulto , Austrália/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia
5.
BMJ Case Rep ; 13(9)2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32900753

RESUMO

Two 59-year-old male patients with COVID-19 pneumonia developed pulmonary cavitation with air-fluid level, accompanied by right-sided chest pain several weeks after first onset of symptoms. Considering a possible bacterial abscess formation, both patients were started on antibiotics. No microbiological pathogen was detected in further investigations (sputum analysis, bronchoscopy with bronchoalveolar lavage and CT-guided drainage of the cavitation). Histopathological analysis of the drained fluid was non-specific, and the aetiology remained not fully understood. We report pulmonary cavitation as a rare finding in late stage COVID-19 pneumonia. As both our patients presented with localised chest pain prior to detection of the lesions, new onset of this symptom should warrant further investigation.


Assuntos
Infecções por Coronavirus/complicações , Pneumopatias/virologia , Pneumonia Viral/complicações , Humanos , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias
6.
Kidney Blood Press Res ; 45(5): 661-670, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32957112

RESUMO

BACKGROUND: The outbreak of severe acute respiratory syndrome ß-coronavirus 2 (SARS-CoV-2) has the potential to become a long-lasting global health crisis. The number of people infected with the novel coronavirus has surpassed 22 million globally, resulting in over 700,000 deaths with more than 15 million people having recovered (https://covid19.who.int). Enormous efforts are underway for rapid vaccine and treatment developments. Amongst the many ways of tackling the novel coronavirus disease 2019 (COVID-19) pandemic, extracellular vesicles (EVs) are emerging. SUMMARY: EVs are lipid bilayer-enclosed structures secreted from all types of cells, including those lining the respiratory tract. They have established roles in lung immunity and are involved in the pathogenesis of various lung diseases, including viral infection. In this review, we point out the roles and possible contribution of EVs in viral infections, as well as ongoing EV-based approaches for the treatment of COVID-19, including clinical trials. Key Messages: EVs share structural similarities to viruses and recent findings demonstrate that viruses exploit EVs for cellular exit and EVs exploit viral entry mechanisms for cargo delivery. Moreover, EV-virus interplay could be exploited for future antiviral drug and vaccine development. EV-based therapies, especially the mesenchymal stem cell-derived EVs, are being intensively studied for the treatment of COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Vesículas Extracelulares/virologia , Pneumopatias/terapia , Pneumonia Viral/terapia , Antivirais/administração & dosagem , Infecções por Coronavirus/complicações , Infecções por Coronavirus/metabolismo , Vesículas Extracelulares/metabolismo , Terapia Genética/tendências , Humanos , Pneumopatias/metabolismo , Pneumopatias/virologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/metabolismo , Eliminação de Partículas Virais/efeitos dos fármacos , Eliminação de Partículas Virais/fisiologia
7.
J Med Imaging Radiat Oncol ; 64(5): 671-673, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32945110

RESUMO

We report the case of who has been hospitalized complaining about fever in the last 4 days. Laboratory data revealed lymphocytopenia and leucopenia with an elevation of C-reactive protein and positive real-time reverse transcription-polymerase chain reaction (RT-PCR). Six days before this hospitalization, when the patient was asymptomatic, 18 F-FDG PET/CT images were performed for the therapeutic control of liver metastases of colorectal cancer. Lung abnormality findings at 18 F-FDG PET/CT images, unrelated to cancer metastases, but suspicious for viral infection, may suggest the presence of COVID-19 disease in its early phase before symptoms onset. Since PET/CT is more sensitive than CT scan in detecting host's reaction, the added value of this technique could be monitoring disease progression and could be used as a biomarker of lung disease activity and therefore as an important tool for a better understanding of the factors that contribute to the progression of lung disease.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Betacoronavirus , Neoplasias Colorretais/patologia , Progressão da Doença , Fluordesoxiglucose F18 , Humanos , Achados Incidentais , Neoplasias Hepáticas/secundário , Pandemias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
8.
F1000Res ; 9: 609, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32934806

RESUMO

Background: Coronavirus disease (COVID-19) is an infectious disease discovered in 2019 and currently in outbreak across the world. Lung injury with severe respiratory failure is the leading cause of death in COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, there still lacks efficient treatment for COVID-19 induced lung injury and acute respiratory failure. Methods: Inhibition of angiotensin-converting enzyme 2 (ACE2) caused by the spike protein of SARS-CoV-2 is the most plausible mechanism of lung injury in COVID-19. We performed drug repositioning analysis to identify drug candidates that reverse gene expression pattern in L1000 lung cell line HCC515 treated with ACE2 inhibitor. We confirmed these drug candidates by similar bioinformatics analysis using lung tissues from patients deceased from COVID-19. We further investigated deregulated genes and pathways related to lung injury, as well as the gene-pathway-drug candidate relationships. Results: We propose two candidate drugs, COL-3 (a chemically modified tetracycline) and CGP-60474 (a cyclin-dependent kinase inhibitor), for treating lung injuries in COVID-19. Further bioinformatics analysis shows that 12 significantly enriched pathways (P-value <0.05) overlap between HCC515 cells treated with ACE2 inhibitor and human COVID-19 patient lung tissues. These include signaling pathways known to be associated with lung injury such as TNF signaling, MAPK signaling and chemokine signaling pathways. All 12 pathways are targeted in COL-3 treated HCC515 cells, in which genes such as RHOA, RAC2, FAS, CDC42 have reduced expression. CGP-60474 shares 11 of 12 pathways with COL-3 and common target genes such as RHOA. It also uniquely targets other genes related to lung injury, such as CALR and MMP14. Conclusions: This study shows that ACE2 inhibition is likely part of the mechanisms leading to lung injury in COVID-19, and that compounds such as COL-3 and CGP-60474 have potential as repurposed drugs for its treatment.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Reposicionamento de Medicamentos , Pneumopatias/tratamento farmacológico , Pneumopatias/virologia , Pneumonia Viral/tratamento farmacológico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Betacoronavirus , Humanos , Pandemias , Peptidil Dipeptidase A , Tetraciclinas/uso terapêutico
10.
Thorax ; 75(11): 1009-1016, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32839287

RESUMO

The COVID-19 pandemic has led to an unprecedented surge in hospitalised patients with viral pneumonia. The most severely affected patients are older men, individuals of black and Asian minority ethnicity and those with comorbidities. COVID-19 is also associated with an increased risk of hypercoagulability and venous thromboembolism. The overwhelming majority of patients admitted to hospital have respiratory failure and while most are managed on general wards, a sizeable proportion require intensive care support. The long-term complications of COVID-19 pneumonia are starting to emerge but data from previous coronavirus outbreaks such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) suggest that some patients will experience long-term respiratory complications of the infection. With the pattern of thoracic imaging abnormalities and growing clinical experience, it is envisaged that interstitial lung disease and pulmonary vascular disease are likely to be the most important respiratory complications. There is a need for a unified pathway for the respiratory follow-up of patients with COVID-19 balancing the delivery of high-quality clinical care with stretched National Health Service (NHS) resources. In this guidance document, we provide a suggested structure for the respiratory follow-up of patients with clinicoradiological confirmation of COVID-19 pneumonia. We define two separate algorithms integrating disease severity, likelihood of long-term respiratory complications and functional capacity on discharge. To mitigate NHS pressures, virtual solutions have been embedded within the pathway as has safety netting of patients whose clinical trajectory deviates from the pathway. For all patients, we suggest a holistic package of care to address breathlessness, anxiety, oxygen requirement, palliative care and rehabilitation.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Pneumopatias/terapia , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Transtornos Respiratórios/terapia , Algoritmos , Infecções por Coronavirus/diagnóstico , Humanos , Pneumopatias/diagnóstico , Pneumopatias/virologia , Pandemias , Pneumonia Viral/diagnóstico , Transtornos Respiratórios/diagnóstico , Transtornos Respiratórios/virologia
12.
Clin Immunol ; 218: 108524, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32659373

RESUMO

The outbreak of SARS-CoV-2-associated pneumonia, a disease called COVID-19, has caused a pandemic worldwide. To investigate the immune responses after infection of SARS-CoV-2 in non-critical patients may help to better understand the disease progression. We collected 334 confirmed COVID-19 cases including 212 still in hospital with nucleic acid test positive on halfway for SARS-CoV-2 and 122 discharged from hospital, compared specific antibodies, immune cells, and cytokine changes between the hospitalized and discharged patients. The hospitalized patients had a longer illness time compared with discharged patients. Analysis of viral loads explained long-term or persistent infection of SARS-CoV-2, which existed with the median time of 18.5 days of the positive nucleic acid test. Serum analysis showed that the specific anti-N IgG antibody was positive in all detected patients after infection of two weeks. Neutrophils, Monocytes, NK cells, and CD4+ T cells significantly increased, while total lymphocytes and CD8+ T cells decreased from non-critical hospitalized patients after longer-term infection. Further analysis of the cytokines showed that IL-6, TNF-α, IFN-γ, IL-2, IL-4, and IL-10 from the hospitalized patients were significantly higher, indicating a potential of the increased CD4+ T cell differentiation.


Assuntos
Betacoronavirus/patogenicidade , Doenças Cardiovasculares/imunologia , Infecções por Coronavirus/imunologia , Diabetes Mellitus/imunologia , Imunidade Inata , Pneumopatias/imunologia , Neoplasias/imunologia , Pneumonia Viral/imunologia , Idoso , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/virologia , China/epidemiologia , Comorbidade , Convalescença , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Citocinas/sangue , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/patologia , Diabetes Mellitus/virologia , Feminino , Hospitalização , Humanos , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/patologia , Células Matadoras Naturais/virologia , Pneumopatias/epidemiologia , Pneumopatias/patologia , Pneumopatias/virologia , Subpopulações de Linfócitos/imunologia , Subpopulações de Linfócitos/patologia , Subpopulações de Linfócitos/virologia , Masculino , Pessoa de Meia-Idade , Monócitos/imunologia , Monócitos/patologia , Monócitos/virologia , Neoplasias/epidemiologia , Neoplasias/patologia , Neoplasias/virologia , Neutrófilos/imunologia , Neutrófilos/patologia , Neutrófilos/virologia , Pandemias , Alta do Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Fatores de Tempo , Carga Viral/imunologia
13.
Virchows Arch ; 477(3): 359-372, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32642842

RESUMO

Since its initial recognition in December 2019, Coronavirus disease 19 (COVID-19) has quickly spread to a pandemic infectious disease. The causative agent has been recognized as a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), primarily affecting the respiratory tract. To date, no vaccines are available nor any specific treatment. To limit the number of infections, strict directives have been issued by governments that have been translated into equally rigorous guidelines notably for post-mortem examinations by international and national scientific societies. The recommendations for biosafety control required during specimen collection and handling have strongly limited the practice of autopsies of the COVID-19 patients to a few adequate laboratories. A full pathological examination has always been considered an important tool to better understand the pathophysiology of diseases, especially when the knowledge of an emerging disorder is limited and the impact on the healthcare system is significant. The first evidence of diffuse alveolar damage in the context of an acute respiratory distress syndrome has now been joined by the latest findings that report a more complex scenario in COVID-19, including a vascular involvement and a wide spectrum of associated pathologies. Ancillary tools such as electron microscopy and molecular biology used on autoptic tissue samples from autopsy are also significantly contributing to confirm and/or identify new aspects useful for a deeper knowledge of the pathogenetic mechanisms. This article will review and summarize the pathological findings described in COVID-19 until now, chiefly focusing on the respiratory tract, highlighting the importance of autopsy towards a better knowledge of this disease.


Assuntos
Infecções por Coronavirus/patologia , Pneumopatias/patologia , Pneumopatias/virologia , Pulmão/patologia , Pneumonia Viral/patologia , Autopsia , Betacoronavirus , Europa (Continente) , Humanos , Pandemias , Patologia Clínica
14.
Virchows Arch ; 477(3): 335-339, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32666230

RESUMO

Clinical characterization of COVID-19 (Corona Virus Disease 2019) is being performed worldwide to gain insights into the pathogenesis and course of the disease. Little is known regarding morphological findings, which are essential to understanding the unique features and pathomechanisms of the disease, from which one can identify possible new treatments. It has been shown that diffuse alveolar damage, signifying acute respiratory distress syndrome, is present together with atypical multinucleated cells in reported cases of the disease by Tian et al. (J Thorac Oncol 15:700-704, 2020). Macroscopic morphological findings in COVID-19 remain elusive to this day. Here, we report the case of the first German to die due to COVID-19. A detailed examination consisting of full-body computed tomography, autopsy, histology assessment, and viral assessment has been performed. The lungs of the deceased contained high concentrations of SARS-CoV-2 RNA and displayed the typical radiological signatures of COVID-19. Furthermore, a morphological pattern was found displaying hyperaemic areas interspersed by normally perfused areas affecting the whole lung. We also report a finding suggestive of micro-thrombotic events in the lung, which is compatible with the recently described coagulation changes and increased incidence of pulmonary artery embolisms seen in COVID-19 patients as reported by Wichmann et al. (Ann Intern Med, 2020). A broader study is needed to confirm these findings.


Assuntos
Infecções por Coronavirus/patologia , Pneumopatias/patologia , Pneumopatias/virologia , Pneumonia Viral/patologia , Alvéolos Pulmonares/patologia , Autopsia , Betacoronavirus , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Trombose/patologia , Trombose/virologia
15.
Aging (Albany NY) ; 12(14): 13860-13868, 2020 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-32688346

RESUMO

OBJECTIVE: To investigate the clinical, laboratory, and radiological characteristics of patients with coronavirus disease-2019 (COVID-19) in Heilongjiang Province. RESULTS: Patients in the ICU group were older and their incidence of cardiovascular disease was higher than those in the non-ICU group. Lymphocyte levels were lower and neutrophil and D-dimer levels were higher in the ICU than that in the non-ICU group. Compared to the non-ICU group, the incidence of pulmonary consolidation and ground-glass opacity with consolidation was significantly higher in the ICU group, all lung lobes were more likely to be involved, with higher number of lung lobes and areas surrounding the bronchi. Of the 59 patients with COVID-19 in this group, 15 received mechanical ventilation. All intubated patients involved lung lobes, and a large number of lesions were observed in the area around the bronchial vessels. CONCLUSION: Significant differences were observed in clinical symptoms, laboratory tests, and computed tomography features between the ICU and non-ICU groups. METHODS: A total of 59 patients with COVID-19, comprising 44 patients in the intensive care unit (ICU) and 15 in the non-ICU, were retrospectively analyzed. Characteristics of the two groups of patients were compared.


Assuntos
Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Pneumopatias/virologia , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Idoso , Betacoronavirus , China , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
16.
Virchows Arch ; 477(3): 349-357, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32607684

RESUMO

The pandemia of coronavirus disease 2019 (COVID-19) has caused more than 355,000 confirmed deaths worldwide. However, publications on postmortem findings are scarce. We present the pulmonary findings in four cases of fatal COVID-19 with a spectrum of lung pathology reflecting disease course and duration, invasive therapies, and laboratory features. Early disease is characterized by neutrophilic, exudative capillaritis with microthrombosis and high levels of IL-1beta and IL-6. Later stages are associated with diffuse alveolar damage and ongoing intravascular thrombosis in small to medium-sized pulmonary vessels, occasionally with areas of infarction equivalents, accompanied by laboratory features of disseminated intravascular coagulation. In late stages, organizing pneumonia with extensive intra-alveolar proliferation of fibroblasts and marked metaplasia of alveolar epithelium can be observed. Viral RNA is encountered in the lung, with virus particles in endothelial cells and pneumocytes. In many patients, multi-organ failure with severe liver damage sets in finally, possibly as consequence of an early-onset pro-inflammatory cytokine storm and/or thrombotic microangiopathy.


Assuntos
Infecções por Coronavirus/patologia , Pneumopatias/patologia , Pneumopatias/virologia , Pneumonia Viral/patologia , Idoso , Autopsia , Betacoronavirus , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Trombose/patologia , Trombose/virologia
17.
Cytokine Growth Factor Rev ; 53: 13-24, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32475759

RESUMO

COVID-19 mortality is strongly associated with the development of severe pneumonia and acute respiratory distress syndrome with the worst outcome resulting in cytokine release syndrome and multiorgan failure. It is becoming critically important to identify at the early stage of the infection those patients who are prone to develop the most adverse effects. Elevated systemic interleukin-6 levels in patients with COVID-19 are considered as a relevant parameter in predicting most severe course of disease and the need for intensive care. This review discusses the mechanisms by which IL-6 may possibly contribute to disease exacerbation and the potential of therapeutic approaches based on anti-IL-6 biologics.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Síndrome da Liberação de Citocina/tratamento farmacológico , Interleucina-6/antagonistas & inibidores , Pneumonia Viral/tratamento farmacológico , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/imunologia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Síndrome da Liberação de Citocina/patologia , Síndrome da Liberação de Citocina/virologia , Humanos , Interleucina-6/sangue , Interleucina-6/imunologia , Pneumopatias/imunologia , Pneumopatias/patologia , Pneumopatias/virologia , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia
18.
Am J Physiol Lung Cell Mol Physiol ; 319(2): L277-L288, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32551862

RESUMO

In the last few months, the number of cases of a new coronavirus-related disease (COVID-19) rose exponentially, reaching the status of a pandemic. Interestingly, early imaging studies documented that pulmonary vascular thickening was specifically associated with COVID-19 pneumonia, implying a potential tropism of the virus for the pulmonary vasculature. Moreover, SARS-CoV-2 infection is associated with inflammation, hypoxia, oxidative stress, mitochondrial dysfunction, DNA damage, and lung coagulopathy promoting endothelial dysfunction and microthrombosis. These features are strikingly similar to what is seen in pulmonary vascular diseases. Although the consequences of COVID-19 on the pulmonary circulation remain to be explored, several viruses have been previously thought to be involved in the development of pulmonary vascular diseases. Patients with preexisting pulmonary vascular diseases also appear at increased risk of morbidity and mortality. The present article reviews the molecular factors shared by coronavirus infection and pulmonary vasculature defects, and the clinical relevance of pulmonary vascular alterations in the context of COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumopatias/etiologia , Pulmão/irrigação sanguínea , Pulmão/fisiopatologia , Pneumonia Viral/complicações , Betacoronavirus/patogenicidade , Betacoronavirus/fisiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Citocinas/sangue , Dano ao DNA , Traumatismos Cardíacos/etiologia , Interações entre Hospedeiro e Microrganismos/fisiologia , Humanos , Hipóxia/etiologia , Mediadores da Inflamação/sangue , Pulmão/virologia , Pneumopatias/fisiopatologia , Pneumopatias/virologia , Mitocôndrias/fisiologia , Miocárdio , Estresse Oxidativo , Pandemias , Peptidil Dipeptidase A/fisiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Circulação Pulmonar , Embolia Pulmonar/etiologia , Receptores Virais/fisiologia , Fatores de Risco , Vasculite/etiologia
19.
J Exp Med ; 217(8)2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32556101

RESUMO

The renin-angiotensin system (RAS) has long been appreciated as a major regulator of blood pressure, but has more recently been recognized as a mechanism for modulating inflammation as well. While there has been concern in COVID-19 patients over the use of drugs that target this system, the RAS has not been explored fully as a druggable target. The abbreviated description of the RAS suggests that its dysregulation may be at the center of COVID-19.


Assuntos
Infecções por Coronavirus/fisiopatologia , Pneumopatias/fisiopatologia , Pulmão/virologia , Pneumonia Viral/fisiopatologia , Angiotensina I/metabolismo , Animais , Transtornos da Coagulação Sanguínea/virologia , Infecções por Coronavirus/etiologia , Infecções por Coronavirus/metabolismo , Citocinas/metabolismo , Humanos , Hipertensão/fisiopatologia , Pulmão/metabolismo , Pulmão/fisiopatologia , Pneumopatias/metabolismo , Pneumopatias/virologia , Obesidade/fisiopatologia , Pandemias , Fragmentos de Peptídeos/metabolismo , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/etiologia , Pneumonia Viral/metabolismo , Receptor Tipo 1 de Angiotensina/metabolismo , Índice de Gravidade de Doença
20.
J Zhejiang Univ Sci B ; 21(5): 411-415, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32425009

RESUMO

We present an unusual case of a patient with bilateral-lung transplantation due to severe coronavirus disease 2019 (COVID-19), who subsequently suffered complications with acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI).


Assuntos
Infecções por Coronavirus/complicações , Pneumopatias/virologia , Transplante de Pulmão , Intervenção Coronária Percutânea , Pneumonia Viral/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Idoso , Betacoronavirus , China , Humanos , Pneumopatias/cirurgia , Masculino , Pandemias , Infarto do Miocárdio com Supradesnível do Segmento ST/virologia
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