Association between thrombocytopenia and platelet profile with morbidity/mortality of severe and non-severe COVID-19 patients.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a novel infectious viral disease that can be associated with changes in platelet counts. Thrombocytopenia is a risk factor for increased mortality and morbidity among these patients. In this study, we aimed to measure the platelet count of COVID-19 patients and find the association with morbidity and mortality after following up. METHODS: This study was conducted on 1,320 confirmed COVID-19 patients who were admitted to the Ayatollah Taleghani and Shohada Tajrish Hospital in Tehran, Iran. The diagnosis of COVID-19 was confirmed by standard protocols. The data on the platelet profile were retrospectively extracted from patients' electronic medical records consisted of platelet counts on admission, the next 7 days during the hospital stay, and on discharge. Patients were categorized into two groups, namely, "non-severe presentation" and "severe presentation" based on clinical signs. RESULTS: There was no significant difference in platelet counts and thrombocytopenia between severe and non-severe, survivors and non-survivors, and severe survivors and severe non-survivors groups at the time of admission to the hospital. After 7 days, a trend toward an increase in platelet counts was seen in non-severe patients, survivors, and severe compared with severe patients, non-survivors, and severe non-survivors, respectively. CONCLUSIONS: Thrombocytopenia and thrombotic complications in COVID-19 patients are common and lead to a higher mortality rate.

Advanced glycation end products (AGEs) and its receptor, RAGE, modulate age-dependent COVID-19 morbidity and mortality. A review and hypothesis.

Coronavirus Disease 2019 (COVID-19), caused by the novel virus SARS-CoV-2, is often more severe in older adults. Besides age, other underlying conditions such as obesity, diabetes, high blood pressure, and malignancies, which are also associated with aging, have been considered risk factors for COVID-19 mortality. A rapidly expanding body of evidence has brought up various scenarios for these observations and hyperinflammatory reactions associated with COVID-19 pathogenesis. Advanced glycation end products (AGEs) generated upon glycation of proteins, DNA, or lipids play a crucial role in the pathogenesis of age-related diseases and all of the above-mentioned COVID-19 risk factors. Interestingly, the receptor for AGEs (RAGE) is mainly expressed by type 2 epithelial cells in the alveolar sac, which has a critical role in SARS-CoV-2-associated hyper inflammation and lung injury. Here we discuss our hypothesis that AGEs, through their interaction with RAGE amongst other molecules, modulates COVID-19 pathogenesis and related comorbidities, especially in the elderly.

Mesenchymal stromal/stem cells (MSCs) and MSC-derived extracellular vesicles in COVID-19-induced ARDS: Mechanisms of action, research progress, challenges, and opportunities.

In late 2019, a novel coronavirus (SARS-CoV-2) emerged in Wuhan city, Hubei province, China. Rapidly escalated into a worldwide pandemic, it has caused an unprecedented and devastating situation on the global public health and society economy. The severity of recent coronavirus disease, abbreviated to COVID-19, seems to be mostly associated with the patients' immune response. In this vein, mesenchymal stromal/stem cells (MSCs) have been suggested as a worth-considering option against COVID-19 as their therapeutic properties are mainly displayed in immunomodulation and anti-inflammatory effects. Indeed, administration of MSCs can attenuate cytokine storm and enhance alveolar fluid clearance, endothelial recovery, and anti-fibrotic regeneration. Despite advantages attributed to MSCs application in lung injuries, there are still several issues __foremost probability of malignant transformation and incidence of MSCs-related coagulopathy__ which should be resolved for the successful application of MSC therapy in COVID-19. In the present study, we review the historical evidence of successful use of MSCs and MSC-derived extracellular vesicles (EVs) in the treatment of acute respiratory distress syndrome (ARDS). We also take a look at MSCs mechanisms of action in the treatment of viral infections, and then through studying both the dark and bright sides of this approach, we provide a thorough discussion if MSC therapy might be a promising therapeutic approach in COVID-19 patients.