ABSTRACT
Background: Many observations denote that we should deal with COVID-19 as a systemic disease. Method(s): In the following report, we briefly discuss observations denoting "the systemic" nature of COVID-19. Result(s): COVID-19 virology, the roles of ACE-2 receptor in COVID-19 pathogenesis, immunolog-ical aspects of the disease, endothelial dysfunction and coagulopathy, and autopsy studies denote the systemic nature of COVID-19. Conclusion(s): Thinking of COVID-19 as a systemic disease, we will implement our ways of understanding and hence dealing with that disease. The most important public health solution is an effective vaccine for the broad population remaining at risk. As patients with COVID-19 present a broad spectrum of clinical presentation and distinct phenotypes, different strategies of management should be customized to the specific individual phenotypes. Further researches are highly needed to clarify the concept of "Is COVID-19 a systemic disease?". Until that time, we think that clinicians should deal with COVID-19 as a systemic disease.Copyright © 2021 Bentham Science Publishers.
ABSTRACT
Background: This pandemic has impacted health and the economy worldwide on an unprecedented scale. It has important systemic effects including the cardiovascular and immune systems. Aim(s): Discuss the links between COVID-19 clinical features and complications and its hematological findings and coagulopathy. This link may shed light on our prognostic view to patients with COVID-19 and will have significant therapeutic implications. One of these important implications is the use of mesenchymal stem cells (MSCs) to treat COVID-19 patients. Method(s): Review done to Autopsy findings support the concept that the pathogenesis of severe COVID-19 involves direct viral-induced injury of multiple organs, including heart and lungs, coupled with the consequences of a procoagulant state with coagulopathy. Mesenchymal stem cells as a potential therapy for COVID-19 INFECTION. Result(s): Mesenchymal stem cells (MSCs) can be isolated from different adult tissues, and neonatal birth-associated tissues, including placenta (PL), umbilical cord (UC), Warton jelly (WJ), amniotic fluid (AF), and cord blood (CB), and then stored for future possible applications. Differentiation potential, powerful immunoregulation, and endogenous repair mechanisms. Support to potential use of MSCs in treating patients came from observations that MSCs have been identified to efficiently cure ALI/ARDS from both infectious and noninfectious causes, mediated primarily by paracrine mechanisms based on the released extracellular vesicles (EVs). The immune-regulation of MSCs depends mainly on modulating activation and effector function of immune cells, suppressing lung-infiltrated cells, and enhancing the resolution of pulmonary edema [35]. Conclusion(s): COVID-19 is associated with distinct hematological changes, rise in serum inflammatory markers, and coagulopathy. Most of these changes were related to the patients' prognosis and mortality, particularly in those with severe disease. There are links between COVID-19 clinical features and complications and its hematological findings and coagulopathy. COVID-19 patients seems to be a promising approach. Further studies are needed to clarify more clinic-pathologic links in COVID-19 that might improve outcomes.
ABSTRACT
Objective: Various cancer societies worldwide have released guidelines to care for cancer patients suffering from COVID-19. Given the findings from our meta-analysis, in the absence of prospective data, we recommend diligent preventive care measures, full supportive care for immunosuppressed patients to minimize the risk of infection, limiting patient's visits to the hospital when possible and using telecommunication technology. Future studies should focus on collecting all the baseline characteristics of cancer patients suffering from COVID-19, all cancer and chemotherapy or radiation-related variables as well as the detailed COVID-19 care protocol followed in these patients and the dynamic biochemical and inflammatory profile of these patients during the infection. Case report: Our meta-analysis, suffers from several limitations. All the included studies are retrospective, the number of cancer patients is small, and many important data were not reported in these studies (cancer types, stages, and treatments). Methodology: Several groups have published on outcomes of cancer patients infected with of the SARS-CoV-2 virus causing the COVID-19 infection. However, most of these reports are single-center studies with a limited number of patients. We performed a systematic review and meta-analysis to evaluate the impact of COVID-19 infection on cancer patients. We searched PubMed, Web of Science, and Scopus for studies that reported the risk of infection and complications of COVID-19 in cancer patients. The literature search retrieved 22 studies (1018 cancer patients). Results: The analysis showed that the frequency of cancer among COVID-19 confirmed patients was 2.1% (95% CI: 1.3%, 3%) in the overall cohort. These patients had a mortality of 21.1% (95% CI: 14.7%, 27.6%), severe/critical disease rate of 45.4% (95% CI: 37.4%, 53.3%), ICU admission rate of 14.5% (95% CI: 8.5%, 20.4%), and mechanical ventilation rate of 11.7% (95% CI: 5.5%, 18%). The double-arm analysis showed that cancer patients had higher risk of mortality (OR = 3.23, 95% CI: 1.71, 6.13), severe/critical disease (OR = 3.91, 95% CI: 2.70, 5.67), ICU admission (OR = 3.10, 95% CI: 1.85, 5.17), and mechanical ventilation (OR = 4.86, 95% CI: 1.27, 18.65), compared to non-cancer patients. Further, cancer patients had significantly lower platelet levels and a significantly higher D-Dimer, C-reactive protein, and prothrombin time Conclusion: cancer patients are at a higher risk of COVID-19 infection-related complications. Therefore, cancer patients need diligent preventive care measures and aggressive surveillance for earlier detection of COVID-19 infection.