Sleep as a likely immunomodulation agent: novel approach in the treatment of COVID-19

The potential advantages of sleep concerning suppressing cytokine storms and inflammation in coronavirus disease 2019 (COVID-19) based on its immunopathogenesis are summarized in the current study. COVID-19 as a global pandemic in the past months has afflicted many people. Clinical properties, pathology, and the pathogenesis of acute respiratory disorder caused by coronaviruses or other pathogens are evidence implying the probable contribution of oxidation, excessive inflammation, and excessive immune response, particularly cytokine storm, to the pathology of COVID-19. According to findings by experimental and clinical research on animals and in humans, sleep loss impairs immune function. Sleep loss strongly influences peripheral levels of the immune response's inflammatory mediators, which is accomplished by the generation of various hormones and mediators during sleep. There are a large number of studies supporting the presence of reciprocal regulation between low-intensity inflammatory response and sleep. By improving sleep quality and at the same time adjusting the circadian rhythm, it may be possible to prevent infections and boost immunity. As a result, sufficient (or even more) sleep duration may lower susceptibility to COVID-19 infection as well as increase antibody levels. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Comparison of Clinical Characteristics, Laboratory Findings and Imag-ing Manifestations of COVID-19 in Sulfur Mustard-exposed Survivors and Others: a Case-control Study

Objective: The objective of this study is to determine if previous exposure to sulfur mustard (SM) gas increases the pathogenesis of COVID-19 by comparing clinical characteristics, laboratory findings, and imaging data between SM-exposed survivors and other patients with COVID-19. Methods: This case-control study was conducted in Baqiyatallah hospital, Tehran, Iran, from 26th Feb - 26th March 2020. The case group composed of 60 SM-exposed survivors infected with COVID-19, and the control group was composed of 60 patients with COVID-19. Groups were matched for demographic (including age and gender) and comorbidity variables except for lung disease which was higher in the case group. The clinical characteristics, laboratory findings, and imaging manifestations, as well as outcomes, were compared between the two groups. Results: While the majority of patients in the case and control groups had at least one comorbidity like diabetes, hypertension, or heart disease, only lung disease was significantly higher in the case than in the control group (P=0.001). Patients in both groups displayed a variety of symptoms on arrival. Only chest pain was significantly more frequent in case patients than those in the control group. The levels of Neutrophils, ESR, BS, AST, LDH, and CRP in both groups were higher, and Na levels were lower than the normal range. Neutrophils were significantly higher in the case than in the control group (p=0.02). The BUN level was significantly lower in the control than in the case group (p=0.04). Other laboratory findings were within their normal ranges and similar in both groups. Significantly more patients in the case group showed early-stage opacities than those in the control group (p=.03). There were no significant differences in treatment or outcomes between the two groups. Conclusion: Most clinical characteristics, outcomes, and laboratory findings of COVID-19 in SMexposed survivors, were similar to those in the non-exposed. While these findings suggest that sulfur mustard gas exposure does not significantly affect the prognosis of the disease, the limitations and sample size of the current study may warrant additional investigations.

Are Iranian sulfur mustard gas-exposed survivors more vulnerable to SARS-CoV-2? Some similarity in their pathogenesis. (Special Section: COVID-19.)

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged as a health problem worldwide. It seems that COVID-19 is more lethal for Iranian veterans with a history of exposure to mustard gas. There are some similarities in the pathogenesis of SARS-CoV-2 and mustard gas in immune system disruption and pulmonary infection. SARS-CoV-2 and mustard gas inducing oxidative stress, immune system dysregulation, cytokine storm, and overexpression of angiotensin-converting enzyme II (ACE2) receptor in lungs that act as functional entry receptors for SARS-CoV-2. Moreover, Iranian survivors of mustard gas exposure are more susceptible and vulnerable to COVID-19. It is suggested that the principles of COVID-19 infection prevention and control be adhered to more stringently in Iranian survivors of mustard gas exposure than others who have not been exposed to mustard gas. Therefore, in this review, we discuss the different pathologic aspects of lung injury caused by mustard gas and also the relationship between this damage and the increased susceptibility of Iranian mustard gas exposed survivors to COVID-19.

Understanding the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19) based on available evidence - A narrative review

Since December 2019, a new coronavirus, called the severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2), triggers pneumonia outbreak from Wuhan (Huanan seafood market) across China, which now poses major health threats to public health. The Coronavirus Disease-2019 (COVID-19) epidemic by SARS-CoV-2 is spreading worldwide, and by March 1, 2020, 67 countries, including Iran, have been affected. According to worldwide statistics, the mortality rate is 3.4%. Early symptoms of COVID-19 include pneumonia, fever, myalgia and fatigue. To date, no successful vaccine or antiviral agents has been clinically approved for COVID-19. Therefore, prevention and control of infection is a top priority for the general public. Extensive research into the SARS-CoV-2 is needed to fully elucidate its pathway and pathogenic mechanisms, and to identify potential therapeutic targets, which can be effective in developing common preventive and therapeutic measures. In this narrative review, based on evidences published until March 1, 2020, the epidemic and etiologic features of the SARS-CoV-2, its essential biological features, including its receptors and route of transmission, outline disease prevention and treatment approaches is provided. Given the origin of the Covid-19, it seems that the nutritional and health recommendations of Islam, especially Halal food and health observance, need to be addressed more throughout the world. Lack of inducing stress and anxiety among the people, besides advising and training people to abide by all the principles of health, is so important to fight against the disease. It is hoped that Covid-19 prevention, control and treatment will be achieved through vaccine and antiviral agents' production as well as health care measures in the near future. © 2020 Baqiyatallah University of Medical Sciences. All rights reserved.