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2.
Acta Pharmacol Sin ; 2022 Apr 25.
Article in English | MEDLINE | ID: covidwho-1805599

ABSTRACT

Angiotensin-converting enzyme 2 (ACE2) is the receptor of COVID-19 pathogen SARS-CoV-2, but the transcription factors (TFs) that regulate the expression of the gene encoding ACE2 (ACE2) have not been systematically dissected. In this study we evaluated TFs that control ACE2 expression, and screened for small molecule compounds that could modulate ACE2 expression to block SARS-CoV-2 from entry into lung epithelial cells. By searching the online datasets we found that 24 TFs might be ACE2 regulators with signal transducer and activator of transcription 3 (Stat3) as the most significant one. In human normal lung tissues, the expression of ACE2 was positively correlated with phosphorylated Stat3 (p-Stat3). We demonstrated that Stat3 bound ACE2 promoter, and controlled its expression in 16HBE cells stimulated with interleukin 6 (IL-6). To screen for medicinal compounds that could modulate ACE2 expression, we conducted luciferase assay using HLF cells transfected with ACE2 promoter-luciferase constructs. Among the 64 compounds tested, 6-O-angeloylplenolin (6-OAP), a sesquiterpene lactone in Chinese medicinal herb Centipeda minima (CM), represented the most potent ACE2 repressor. 6-OAP (2.5 µM) inhibited the interaction between Stat3 protein and ACE2 promoter, thus suppressed ACE2 transcription. 6-OAP (1.25-5 µM) and its parental medicinal herb CM (0.125%-0.5%) dose-dependently downregulated ACE2 in 16HBE and Beas-2B cells; similar results were observed in the lung tissues of mice following administration of 6-OAP or CM for one month. In addition, 6-OAP/CM dose-dependently reduced IL-6 production and downregulated chemokines including CXCL13 and CX3CL1 in 16HBE cells. Moreover, we found that 6-OAP/CM inhibited the entry of SARS-CoV-2 S protein pseudovirus into target cells. These results suggest that 6-OAP/CM are ACE2 inhibitors that may potentially protect lung epithelial cells from SARS-CoV-2 infection.

3.
Int J Biol Sci ; 18(6): 2362-2371, 2022.
Article in English | MEDLINE | ID: covidwho-1753909

ABSTRACT

CTSL is expressed by cancerous tissues and encodes a lysosomal cysteine proteinase that regulates cancer progression and SARS-CoV-2 entry. Therefore, it is critical to predict the susceptibility of cancer patients for SARS-CoV-2 and evaluate the correlation between disease outcomes and the expression of CTSL in malignant cancer tissues. In the current study, we analyzed CTSL expression, mutation rate, survival and COVID-19 disease outcomes in cancer and normal tissues, using online databases. We also performed immunohistochemistry (IHC) to test CTSL expression and western blot to monitor its regulation by cordycepin (CD), and N6, N6-dimethyladenosine (m6 2A), respectively. We found that CTSL is conserved across different species, and highly expressed in both normal and cancer tissues from human, as compared to ACE2 or other proteinases/proteases. Additionally, the expression of CTSL protein was the highest in the lung tissue. We show that the mRNA expression of CTSL is 66.4-fold higher in normal lungs and 54.8-fold higher in cancer tissues, as compared to ACE2 mRNA expression in the respective tissues. Compared to other proteases/proteinases/convertases such as TMPRSS2 and FURIN, the expression of CTSL was higher in both normal lungs and lung cancer samples. All these data indicate that CTSL might play an important role in COVID-19 pathogenesis in normal and cancer tissues of the lungs. Additionally, the CTSL-002 isoform containing both the inhibitor_I29 and Peptidase_C1 domains was highly prevalent in all cancers, suggesting its potential role in tumor progression and SARS-CoV-2 entry in multiple types of cancers. Further analysis of the expression of CTSL mutant showed a correlation with FURIN and TMPRSS2, suggesting a potential role of CTSL mutations in modulating SARS-CoV-2 entry in cancers. Moreover, high expression of CTSL significantly correlated with a short overall survival (OS) in lung cancer and glioma. Thus, CTSL might play a major role in the susceptibility of lung cancer and glioma patients to SARS-CoV-2 uptake and COVID-19 severity. Furthermore, CD or m6 2A inhibited CTSL expression in the cancer cell lines A549, MDA-MB-231, and/or PC3 in a dose dependent manner. In conclusion, we show that CTSL is highly expressed in normal tissues and increased in most cancers, and CD or m6 2A could inhibit its expression, suggesting the therapeutic potential of targeting CTSL for cancer and COVID-19 treatment.


Subject(s)
COVID-19 , Glioma , Lung Neoplasms , Angiotensin-Converting Enzyme 2 , COVID-19/drug therapy , COVID-19/genetics , Cathepsin L , Furin/genetics , Furin/metabolism , Humans , RNA, Messenger , SARS-CoV-2
4.
Environ Pollut ; 301: 119027, 2022 May 15.
Article in English | MEDLINE | ID: covidwho-1700515

ABSTRACT

During the COVID-19 lockdown, atmospheric PM2.5 in the Pearl River Delta (PRD) showed the highest reduction in China, but the reasons, being a critical question for future air quality policy design, are not yet clear. In this study, we analyzed the relationships among gaseous precursors, secondary aerosols and atmospheric oxidation capacity in Shenzhen, a megacity in the PRD, during the lockdown period in 2020 and the same period in 2021. The comprehensive observational datasets showed large lockdown declines in all primary and secondary pollutants (including O3). We found that, however, the daytime concentrations of secondary aerosols during the lockdown period and normal period were rather similar when the corresponding odd oxygen (Ox≡O3+NO2, an indicator of photochemical processing avoiding the titration effect of O3 by freshly emitted NO) were at similar levels. Therefore, reduced Ox, rather than the large reduction in precursors, was a direct driver to achieve the decline in secondary aerosols. Moreover, Ox was also found to determine the spatial distribution of intercity PM2.5 levels in winter PRD. Thus, an effective strategy for winter PM2.5 mitigation should emphasize on control of winter O3 formation in the PRD and other regions with similar conditions.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Ozone , Air Pollutants/analysis , Air Pollution/analysis , China , Communicable Disease Control , Environmental Monitoring , Humans , Ozone/analysis , Particulate Matter/analysis
5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-318906

ABSTRACT

Background: Solid transplant patients are susceptible to Pneumocystis jirovecii pneumonia (PJP). While the vast majority of PJP cases occur within the first 6 months after transplantation, very few PJP cases are seen beyond 1 year post transplantation (late-onset PJP). PJP and coronavirus disease 2019 (COVID-19, caused by infection with SARS-CoV-2) share quite a few common clinical manifestations and imaging findings, making the diagnosis of PJP often underappreciated during the current COVID-19 pandemic. To date, only 1 case of kidney transplantation who developed COVID-19 and late-onset PJP has been reported, but this patient also suffered from many other infections and died from respiratory failure and multiple organ dysfunction syndrome. A successful treatment of kidney patients with COVID-19 and late-onset PJP has not been reported. Case presentation: We present a case of a 55-year-old male kidney transplant patient with COVID-19 who also developed late-onset PJP. He received a combined strategy, including specific anti-pneumocystis therapy, symptomatic supportive therapy, adjusted immunosuppressive therapy, and use of antiviral/antibiotics drugs, ending with a favorable outcome. Conclusions: This case highlights the importance of prompt and differential diagnosis of PJP in kidney transplant patients with SARS-CoV-2 infection. Further studies are required to clarify if kidney transplant patients with COVID-19 could be prone to develop late-onset PJP and how these patients should be treated.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315687

ABSTRACT

Coronavirus-infected diseases have posed great threats to human health. In past years, highly infectious coronavirus-induced diseases, including COVID-19, SARS, and MERS, have resulted in world-wide severe infections. Our literature annotations identified 72 chemical drugs and 27 antibodies effective against at least one human coronavirus infection in vitro or in vivo. Many of these drugs inhibit viral entry to cells and viral replication inside cells or modulate host immune responses. Many antimicrobial drugs, including antimalarial (e.g., chloroquine and mefloquine) and antifungal (e.g., terconazole and rapamycin) drugs as well as antibiotics (e.g., teicoplanin and azithromycin) were associated with anti-coronavirus activity. A few drugs, including remdesivir, chloroquine phosphate, favipiravir, and tocilizumab, have already been reported to be effective in treating COVID-19. After mapping our identified drugs to three ontologies ChEBI, NDF-RT, and DrON, many features such as roles and mechanisms of action (MoAs) of these drugs were identified and categorized. For example, out of 35 drugs with MoA annotations in NDF-RT, 34 have MoAs of different types of inhibitors and antagonists. Two clustering analyses, one based on ChEBI-based semantic similarity, the other based on drug chemical similarity, were performed to cluster over 60 drugs to new categories. Moreover, PCA analysis of anti-coronavirus drugs found differences in physicochemical properties between those inhibiting viral entry and viral replication. A total of 137 host genes were identified as the targets of 47 anti-coronavirus drugs, resulting in a network of 370 interactions among these drugs and targets. Chlorpromazine, dasatinib, and anisomycin are the hubs of the drug-target network with the highest number of connected target proteins. Many enriched pathways such as calcium signaling and neuroactive ligand-receptor interaction pathways were identified. These findings may be used to facilitate drug repurposing against COVID-19.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310890

ABSTRACT

Background: COVID-19 outbreak in Wuhan, China recently. It quickly spread throughout worldwide. In this study, we systematically reviewed the clinical features and outcomes of pregnant women with COVID-19. Methods: : PubMed、Web of Science、EMBASE、MEDLINE were searched from January 1, 2020 to April 16, 2020. Case review of pregnant women infected with COVID-19 were included. Two reviewers screened 366 literatures and 14 studies included, four reviewers independently extracted the features of the literatures. We used random-effects model to analyze incidence (P) and 95% confidence interval (95%CI). Heterogeneity was assessed using the I 2 statistic. Results: : The meta- analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%;95%CI, 0.49~0.93), cesarean section (65%;95%CI, 0.42~0.87), fever (51%;95%CI, 0.35~0.67), lymphopenia (49%;95%CI, 0.29~0.70), coexisting disorders (33%;95%CI, 0.21~0.44), cough (31%;95%CI, 0.23~0.39), fetal distress (29%;95%CI, 0.08~0.49), preterm labor (23%;95%CI, 0.14~0.32), severe case or death (12%;95%CI, 0.03~0.20). The subgroup analysis showed compared with nonpregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women group, 51%;nonpregnant patients group, 91%;P<0.00001) and cough (pregnant women group, 31%;nonpregnant patients group, 67%;P<0.0001). Conclusions: : The incidence of fever, cough and positive CT findings in pregnant women with COVID-19 is less than that in the general population, preterm labor is the opposite. There is no evidence that COVID-19 can propagate vertically for the time being.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308523

ABSTRACT

SARS-CoV-2 has affected over 9 million patients with more than 460,000 deaths in about 6 months. Understanding the factors that contribute to efficient SARS-CoV-2 infection of human cells, which are not previously reported, may provide insights on SARS-CoV-2 transmissibility and pathogenesis, and reveal targets of intervention. Here, we reported key host and viral determinants that were essential for efficient SARS-CoV-2 infection in the human lung. First, we identified heparan sulfate as an important attachment factor for SARS-CoV-2 infection. Second, we demonstrated that while cell surface sialic acids significantly restricted SARS-CoV infection, SARS-CoV-2 could largely overcome sialic acid-mediated restriction in both human lung epithelial cells and ex vivo human lung tissue explants. Third, we demonstrated that the inserted furin-like cleavage site in SARS-CoV-2 spike was required for efficient virus replication in human lung but not intestine tissues. Overall, these findings contributed to our understanding on efficient SARS-CoV-2 infection of human lungs.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325176

ABSTRACT

A reasonable prediction of infectious diseases transmission process under different disease control strategies is an important reference point for policy makers. Here we established a dynamic transmission model via Python and realized comprehensive regulation of disease control measures. We classified government interventions into three categories and introduced three parameters as descriptions for the key points in disease control, these being intraregional growth rate, interregional communication rate, and detection rate of infectors. Our simulation predicts the infection by COVID-19 in the UK would be out of control in 73 days without any interventions;at the same time, herd immunity acquisition will begin from the epicentre. After we introduced government interventions, single intervention is effective in disease control but at huge expense while combined interventions would be more efficient, among which, enhancing detection number is crucial in control strategy of COVID-19. In addition, we calculated requirements for the most effective vaccination strategy based on infection number in real situation. Our model was programmed with iterative algorithms, and visualized via cellular automata, it can be applied to similar epidemics in other regions if the basic parameters are inputted, and is able to synthetically mimick the effect of multiple factors in infectious disease control.

10.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325164

ABSTRACT

Background: The novel coronavirus pneumonia (COVID-19) is a highly contagious and highly pathogenic disease caused by a novel coronavirus(SARS-CoV-2)and has become pandemic within a short period of time. The epidemic has brought not only the risk of death from infection but also unbearable psychological pressure. College students as a special group, their mental health status need to be studied during the outbreak of COVID-19.MethodsWe used the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and the compulsive behavior part of the Yale-Brown Obsessive-Compulsive Scale (YBOCS), combined with demographic information, using online questionnaires to research, and the study was conducted between February 21 and 24, 2020. A total of 2270 valid questionnaires were collected, the respondents of these questionnaires included 563 medical students and 1707 non-medical students. We separately analyzed the mental health status of medical and non-medical students during the outbreak of COVID-19.ResultsOf the 563 medical students, 20 (3.55%) students had anxiety symptoms, and 57 (10.12%) students had depressive symptoms. Gender, PMH, compulsive behavior, and regularity of daily life during the epidemic outbreak were correlated with their anxiety symptoms and age, PMH, compulsive behavior, and regularity of daily life during the epidemic outbreak were associated with their depressive symptoms. Of the 1707 non-medical students, 66 (3.87%) students had anxiety symptoms, and 180 (10.54%) students had depressive symptoms. Gender, contact history of similar infectious disease, PMH, compulsive behavior, regularity of daily life and exercise during the epidemic outbreak and concern on COVID-19 were correlated with their anxiety symptoms and contact history of similar infectious disease, PMH, compulsive behavior, regularity of daily life and exercise during the epidemic outbreak and concern on COVID-19 were associated with their depressive symptoms.ConclusionsResults indicated that gender, age, contact history of similar infectious disease, past medical history (PMH), compulsive behavior, regularity of daily life, and exercise during the epidemic outbreak are the key factors making college students anxious or depressed. The results provided a theoretical basis for relevant interventions;it is also essential for medical education and public health epidemic prevention.

11.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324770

ABSTRACT

Given the existing COVID-19 pandemic worldwide, it is critical to systematically study the interactions between hosts and coronaviruses including SARS-Cov, MERS-Cov, and SARS-CoV-2 (cause of COVID-19). We first created four host-pathogen interaction (HPI)-Outcome postulates, and generated a HPI-Outcome model as the basis for understanding host-coronavirus interactions (HCI) and their relations with the disease outcomes. We hypothesized that ontology can be used as an integrative platform to classify and analyze HCI and disease outcomes. Accordingly, we annotated and categorized different coronaviruses, hosts, and phenotypes using ontologies and identified their relations. Various COVID-19 phenotypes are hypothesized to be caused by the backend HCI mechanisms. To further identify the causal HCI-outcome relations, we collected 35 experimentally-verified HCI protein-protein interactions (PPIs), and applied literature mining to identify additional host PPIs in response to coronavirus infections. The results were formulated in a logical ontology representation for integrative HCI-outcome understanding. Using known PPIs as baits, we also developed and applied a domain-inferred prediction method to predict new PPIs and identified their pathological targets on multiple organs. Overall, our proposed ontology-based integrative framework combined with computational predictions can be used to support fundamental understanding of the intricate interactions between human patients and coronaviruses (including SARS-CoV-2) and their association with various disease outcomes.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323772

ABSTRACT

The epidemic of COVID-19 has caused an unpredictable and devastated disaster to the public health in different territories around the world. Common phenotypes include fever, cough, shortness of breath, and chills. With more cases investigated, other clinical phenotypes are gradually recognized, for example, loss of smell, and loss of tastes. Compared with discharged or cured patients, severe or died patients often have one or more comorbidities, such as hypertension, diabetes, and cardiovascular disease. In this study, we systematically collected and analyzed COVID-19-related clinical phenotypes from 70 articles. The commonly occurring 17 phenotypes were classified into different groups based on the Human Phenotype Ontology (HPO). Based on the HP classification, we systematically analyze three nervous phenotypes (loss of smell, loss of taste, and headache) and four abdominal phenotypes (nausea, vomiting, abdominal pain, and diarrhea) identified in patients, and found that patients from Europe and USA turned to have higher nervous phenotypes and abdominal phenotypes than patients from Asia. A total of 23 comorbidities were found to commonly exist among COVID-19 patients. Patients with these comorbidities such as diabetes and kidney failure had worse outcomes compared with those without these comorbidities.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323571

ABSTRACT

An unexpected observation among the COVID-19 pandemic is that smokers constituted only 1.4-18.5% of hospitalized adults, calling for an urgent investigation to determine the role of smoking in SARS-CoV-2 infection. Here, we show that cigarette smoke extract (CSE) and carcinogen benzo(a)pyrene (BaP) increase ACE2 mRNA but trigger ACE2 protein catabolism. BaP induces an aryl hydrocarbon receptor (AhR)-dependent upregulation of the ubiquitin E3 ligase Skp2 for ACE2 ubiquitination. ACE2 in lung tissues of non-smokers is higher than in smokers, consistent with the findings that tobacco carcinogens downregulate ACE2 in mice. Tobacco carcinogens inhibit SARS-CoV-2 Spike protein pseudovirions infection of the cells. These data indicate that recommendation of cessation of tobacco smoking remains valid because it is the carcinogens that are responsible for ACE2 degradation.

14.
Front Med (Lausanne) ; 9: 770031, 2022.
Article in English | MEDLINE | ID: covidwho-1686499

ABSTRACT

BACKGROUND: COVID-19 pandemic is disaster to public health worldwide. Better perspective on COVID's features early in its course-prior to the development of vaccines and widespread variants-may prove useful in the understanding of future pandemics. Ontology provides a standardized integrative method for knowledge modeling and computer-assisted reasoning. In this study, we systematically extracted and analyzed clinical phenotypes and comorbidities in COVID-19 patients found at different countries and regions during the early pandemic using an ontology-based bioinformatics approach, with the aim to identify new insights and hidden patterns of the COVID-19 symptoms. RESULTS: A total of 48 research articles reporting analysis of first-hand clinical data from over 40,000 COVID-19 patients were surveyed. The patients studied therein were diagnosed with COVID-19 before May 2020. A total of 18 commonly-occurring phenotypes in these COVID-19 patients were first identified and then classified into different hierarchical groups based on the Human Phenotype Ontology (HPO). This meta-analytic approach revealed that fever, cough, and the loss of smell and taste were ranked as the most commonly-occurring phenotype in China, the US, and Italy, respectively. We also found that the patients from Europe and the US appeared to have more frequent occurrence of many nervous and abdominal symptom phenotypes (e.g., loss of smell, loss of taste, and diarrhea) than patients from China during the early pandemic. A total of 22 comorbidities, such as diabetes and kidney failure, were found to commonly exist in COVID-19 patients and positively correlated with the severity of the disease. The knowledge learned from the study was further modeled and represented in the Coronavirus Infectious Disease Ontology (CIDO), supporting semantic queries and analysis. Furthermore, also considering the symptoms caused by new viral variants at the later stages, a spiral model hypothesis was proposed to address the changes of specific symptoms during different stages of the pandemic. CONCLUSIONS: Differential patterns of symptoms in COVID-19 patients were found given different locations, time, and comorbidity types during the early pandemic. The ontology-based informatics provides a unique approach to systematically model, represent, and analyze COVID-19 symptoms, comorbidities, and the factors that influence the disease outcomes.

15.
Front Pediatr ; 9: 813034, 2021.
Article in English | MEDLINE | ID: covidwho-1590598
16.
J Ethnopharmacol ; 287: 114965, 2022 Apr 06.
Article in English | MEDLINE | ID: covidwho-1587284

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: Coronavirus and influenza virus infection seriously threaten human health. Cangma Huadu Granules (CMHD) is an in-hospital preparation composed of eight traditional Chinese medicines (TCM), which has been clinically used against COVID-19 in China and may be a promising candidate for the treatment of influenza. However, the role of its treatment urgently needs to be studied. AIM OF THE STUDY: To evaluate the therapeutic effects of CMHD on pneumonia induced by coronavirus (HCoV-229E) and influenza A virus (H1N1/FM1) in mice and explore its mechanism of anti-infection. MATERIALS AND METHODS: Mice were infected with HCoV-229E or H1N1/FM1 virus through the nasal cavity. CMHD (12.1, 6.05 and 3.03 g/kg/d) or the positive control drugs were administered intragastrically. The lung index and histopathological changes were used to evaluate the therapeutic effect of CMHD. The expression of TNF-α, IL-1ß, IL-6 and IL-4 in Serum and the proportion of CD4+ and CD8+ T lymphocytes in peripheral blood were detected to evaluate the anti-inflammatory and immune regulation effects of CMHD, respectively. Furthermore, the levels of p-NF-κBp65/ NF-κB p65, which was the key targets of the NF-κB pathway was analyzed. RESULTS: In HCoV-229E-induced pneumonia, the lung index was markedly reduced, and lung pathology was improved in mice that treated with CMHD (12.1, 6.05 g/kg/d). Meanwhile, the expression of TNF-α, IL-6 were obviously inhibited, but the expression of IL-4 was significantly increased in CMHD groups. Compared with the model group, CMHD could also markedly upregulate the level of CD4+ and CD8+. Furthermore, CMHD has a markedly effect on inhibit the expression of p-NF-κB p65/NF-κB p65 in the lung. In H1N1-induced pneumonia, the lung index of mice in the CMHD (12.1 g/kg/d) treatment group was lower than that in the model group, and less inflammatory infiltration could be seen in the lung pathological. Moreover, CMHD could also obviously decrease the expression of TNF-α, IL-1ß, IL-6, but significantly increase the expression of IL-4. Except for that, CMHD could also markedly downregulate the level of CD4+ and upregulate the level of CD8+ compared with the model group. In addition, CMHD has a markedly effect on inhibit the expression of p-NF-κB p65/NF-κB p65 in the lung. CONCLUSION: CMHD can significantly combats viral infections caused by HCoV-229E and H1N1, and the mechanism may be related to its multiple functions of anti-inflammatory, immunity regulating and inhibiting NF-κB signal transduction pathway.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Coronavirus Infections/drug therapy , Drugs, Chinese Herbal/pharmacology , Influenza A Virus, H1N1 Subtype/drug effects , Medicine, Chinese Traditional/methods , Orthomyxoviridae Infections/drug therapy , Animals , Anti-Inflammatory Agents/therapeutic use , Coronavirus 229E, Human/drug effects , Cytokines/metabolism , Disease Models, Animal , Drugs, Chinese Herbal/therapeutic use , Female , Immunity/drug effects , Male , Mice, Inbred BALB C , Mice, Inbred ICR , Pneumonia/drug therapy , Pneumonia/pathology , T-Lymphocytes/metabolism , Transcription Factor RelA/metabolism
17.
Ann Clin Microbiol Antimicrob ; 20(1): 83, 2021 Dec 15.
Article in English | MEDLINE | ID: covidwho-1582061

ABSTRACT

BACKGROUND: Solid transplant patients are susceptible to Pneumocystis jirovecii pneumonia (PJP). While the vast majority of PJP cases occur within the first 6 months after transplantation, very few PJP cases are seen beyond 1 year post-transplantation (late-onset PJP). PJP and coronavirus disease 2019 (COVID-19, caused by infection with SARS-CoV-2) share quite a few common clinical manifestations and imaging findings, making the diagnosis of PJP often underappreciated during the current COVID-19 pandemic. To date, only 1 case of kidney transplantation who developed COVID-19 and late-onset PJP has been reported, but this patient also suffered from many other infections and died from respiratory failure and multiple organ dysfunction syndrome. A successful treatment of kidney patients with COVID-19 and late-onset PJP has not been reported. CASE PRESENTATION: We present a case of a 55-year-old male kidney transplant patient with COVID-19 who also developed late-onset PJP. He received a combined treatment strategy, including specific anti-pneumocystis therapy, symptomatic supportive therapy, adjusted immunosuppressive therapy, and use of antiviral drugs/antibiotics, ending with a favorable outcome. CONCLUSIONS: This case highlights the importance of prompt and differential diagnosis of PJP in kidney transplant patients with SARS-CoV-2 infection. Further studies are required to clarify if kidney transplant patients with COVID-19 could be prone to develop late-onset PJP and how these patients should be treated.


Subject(s)
COVID-19 , Kidney Transplantation , Pneumonia, Pneumocystis , COVID-19/complications , COVID-19/drug therapy , Humans , Kidney Transplantation/adverse effects , Male , Middle Aged , Pneumonia, Pneumocystis/diagnosis , Pneumonia, Pneumocystis/drug therapy
18.
Respirol Case Rep ; 9(12): e0877, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1525484

ABSTRACT

Pulmonary mucormycosis (PM) is a rare, life-threatening fungal infection usually affecting immunocompromised patients. Its incidence is rising, with a recent outbreak associated with COVID-19 co-infection. Amphotericin B along with early surgery are considered the standard treatment. Recurrence has been reported in patients without adequate treatment and without permanent reversal of predisposing factors. We report a case of late recurrence of PM in a renal transplant recipient. In 2012, he was diagnosed with PM. Imaging at the time showed a lingular mass. He was treated with antifungal for 1 year until complete radiological resolution. Surgical intervention was considered but no further follow-up action was taken. In 2020, he presented with fever and haemoptysis. Imaging again showed a lingular mass, which was confirmed to be PM by bronchoscopic lung biopsy. This case highlights the importance of secondary antifungal prophylaxis for PM if permanent reversal of immunosuppression is not possible.

19.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-291635

ABSTRACT

Background: Educational interventions were necessary to clarify COVID-19 related misconceptions among Hong Kong older adults. Yet, face-to-face interventions were infeasible under the pandemic. The primary objective of the present study was to evaluate the efficacy of a healthcare student-led, telephone-delivered intervention in educating older adults on COVID-19 related health topics. Feasibility, satisfaction level in subjects and impacts on volunteer students of the intervention were also explored. Methods: Subjects aged 65 or above were recruited from a community center in Yuen Long, Hong Kong. The telephone-delivered intervention consisted of 5 phone call sessions conducted by student volunteers. The first four sessions included pre-tests covering three COVID-19 related health topics. Standardized explanations were offered to all subjects during phone call. In the last session, post-tests on all themes were conducted. Paired t-test and McNemar’s test were used to measure the efficacy of intervention based on the differences in pre-tests and post-tests scores. The level of significance was 0.05. Subject satisfaction surveys and student feedback surveys were analyzed. This was a longitudinal study with no control group. Results: Twenty-five subjects were recruited. Paired t-test results showed statistically significant improvement in test scores for all themes: from 76.0% to 95.3% (p<0.01) on Medication Safety, from 64.0% to 88.9% (p<0.01) on Healthcare Voucher, and from 78.0% to 93.0% (p<0.01) on COVID-19 Myth busting. McNemar’s test results showed an increase in correct rate for all questions. However, the improvement was not statistically significant in 65% of the questions due to small sample size and ceiling effect. Most subjects were satisfied with the program and improvement in mood after the program were reported. Student feedback survey suggested that the intervention enhanced students’ communication skills and understanding about older adults in Hong Kong. Conclusion: Our pilot study offered initial evidence to suggest the efficacy and feasibility of telephone-delivered educational intervention in educating Hong Kong older adults and its benefits on student volunteers. Future studies should include a larger sample size and evaluate the ability of phone calls in improving subjects’ mental well-being.

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