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1.
J Med Virol ; 2022 Sep 03.
Article in English | MEDLINE | ID: covidwho-2013641

ABSTRACT

The clinical manifestation of coronavirus disease 2019 (COVID-19) mainly targets the lung as a primary affected organ, which is also a critical site of immune cell activation by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, recent reports also suggest the involvement of extrapulmonary tissues in COVID-19 pathology. The interplay of both innate and adaptive immune responses is key to COVID-19 management. As a result, a robust innate immune response provides the first line of defense, concomitantly, adaptive immunity neutralizes the infection and builds memory for long-term protection. However, dysregulated immunity, both innate and adaptive, can skew towards immunopathology both in acute and chronic cases. Here we have summarized some of the recent findings that provide critical insight into the immunopathology caused by SARS-CoV-2, in acute and post-acute cases. Finally, we further discuss some of the immunomodulatory drugs in preclinical and clinical trials for dampening the immunopathology caused by COVID-19.

2.
Sci Immunol ; 7(73): eabm7996, 2022 07 15.
Article in English | MEDLINE | ID: covidwho-1949936

ABSTRACT

The acute effects of various respiratory viral infections have been well studied, with extensive characterization of the clinical presentation as well as viral pathogenesis and host responses. However, over the course of the recent COVID-19 pandemic, the incidence and prevalence of chronic sequelae after acute viral infections have become increasingly appreciated as a serious health concern. Post-acute sequelae of COVID-19, alternatively described as "long COVID-19," are characterized by symptoms that persist for longer than 28 days after recovery from acute illness. Although there exists substantial heterogeneity in the nature of the observed sequelae, this phenomenon has also been observed in the context of other respiratory viral infections including influenza virus, respiratory syncytial virus, rhinovirus, severe acute respiratory syndrome coronavirus, and Middle Eastern respiratory syndrome coronavirus. In this Review, we discuss the various sequelae observed following important human respiratory viral pathogens and our current understanding of the immunological mechanisms underlying the failure of restoration of homeostasis in the lung.


Subject(s)
COVID-19 , Respiratory Tract Infections , Virus Diseases , COVID-19/complications , COVID-19/immunology , Coronavirus , Humans , Pandemics , Respiratory Tract Infections/immunology , Respiratory Tract Infections/virology , Virus Diseases/complications , Virus Diseases/immunology
4.
Hosp Pract (1995) ; 49(5): 307-324, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1528104

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 infections are associated with greater risk of both arterial and venous thromboembolic events.Pathophysiology and Clinical implications: This has been attributed to a florid proinflammatory state resulting in microvascular dysfunction, activation of platelets and procoagulant systems as well as possible direct endothelial injury. The associated morbidity and mortality of these events has prompted much speculation and varied anticoagulation and fibrinolytic strategies based on multiple criteria including disease severity and biomarkers. No clear definitive benefit has been established with these approaches, which have frequently led to greater bleeding complications without significant mortality benefit.Overview: In this review, we outline the burden of these thromboembolic events in coronavirus disease-2019 (COVID-19) as well as the hypothesized contributory biological mechanisms. Finally, we provide a brief overview of the major clinical studies on the topic, and end with a summary of major societal guideline recommendations on anticoagulation in COVID-19.


Subject(s)
Blood Coagulation Disorders/etiology , Blood Coagulation , COVID-19/complications , Anticoagulants/therapeutic use , Blood Platelets/virology , COVID-19/drug therapy , COVID-19/virology , Humans , Risk Factors , Venous Thromboembolism/etiology , Venous Thrombosis/etiology
5.
Eur Heart J Digit Health ; 1(1): 4-5, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-1287997
6.
J Virol ; 95(2)2020 12 22.
Article in English | MEDLINE | ID: covidwho-1041542

ABSTRACT

Viral infections during pregnancy lead to a spectrum of maternal and fetal outcomes, ranging from asymptomatic disease to more critical conditions presenting with severe maternal morbidity, stillbirth, preterm birth, intrauterine growth restriction, and fetal congenital anomalies, either apparent at birth or later in life. In this article, we review the pathogenesis of several viral infections that are particularly relevant in the context of pregnancy and intrauterine inflammation. Understanding the diverse mechanisms employed by viral pathogens as well as the repertoire of immune responses induced in the mother may help to establish novel therapeutic options to attenuate changes in the maternal-fetal interface and prevent adverse pregnancy outcomes.


Subject(s)
Inflammation/immunology , Pregnancy Complications, Infectious/virology , Virus Diseases/virology , Viruses/pathogenicity , Female , Humans , Infant, Newborn , Placenta/immunology , Placenta/virology , Pregnancy , Pregnancy Complications, Infectious/immunology , Pregnancy Complications, Infectious/pathology , Pregnancy Outcome , Virus Diseases/immunology , Virus Diseases/pathology , Viruses/classification , Viruses/immunology
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