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Background: D-dimer and LDH are crucial biomarkers, particularly in view of the fact that they have been strongly linked to COVID-19 infection and have been linked to worse consequences in people who have severe viral infections. Objectives: To determine how D-dimer and LDH correlated with clinical effects in COVID-19 patients who were hospitalised and how they forecasted the severity of COVID-19 patients. Material and Methods: This was cross-sectional research conducted relatively early in the second wave of the pandemic. A total of 110 patients diagnosed with COVID-19 and admitted to the ICU from January 2021 to June 2021, were included in the study. The clinical outcome was evaluated in terms of discharge and death among patients requiring various forms of assisted ventilation. Results: The average age of patients was 53.16 years (+or- 18.47 years). 35.5% of the patients were with comorbidities of which diabetes, hypertension, and COPD were around 80%. D-dimer was deranged in 2.7% of the subjects and LDH was deranged in 60% of the study subjects at the time of admission. Coming on to the outcome, all patients were put on assisted ventilation with 71.8% on NIV, 20% on HFNO, 1% on CPAP, and 7.2% on MV. During their hospital stays, 6 (5.45%) patients died and the remaining patients were discharged. A higher D-dimer value (> 1.5 g/ml) during the hospital stay was found to be statistically significant with assisted ventilation and deaths of the admitted study subjects. Conclusion: In our investigation, the biomarker D-dimer value was more associated than LDH with mortality in patients with COVID-19 infection.
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Background: Coronavirus disease 2019, first reported in December 2019 mainly presented with the symptoms of Cough, Fever, Shortness of breath, Myalgia, Weakness and anosmia. C-reactive Protein (CRP) is an acute-phase reactant protein which is synthesized by the liver in response to raised levels of interleukin-6 (IL-6) which is a biomarker of inflammation. Methods: This was a prospective observational study, done on 110 COVID-19 patients after applying inclusion and exclusion criteria. Detailed history, vaccination status, presence of comorbidities and thorough clinical examination was performed. Serum CRP levels was assessed and Computed Tomographic scan (CT scan) of Thorax was done. CORADS scoring and CT severity grading as per CT scan was done. All the above parameters were recorded in the preformed proforma and data was entered in excel spreadsheet and was analysed using SPSS v26 software. Results: Majority were males (56.3%) and majority were from 61-80 years of age. Majority (57.3%) patients were non-smokers. Hypertension was the most common associated comorbidity (86.4%) (r=0.743, p=0.000). There is a strong positive correlation between CRP levels and CTSS in COVID 19 patients and a strong negative correlation between the CRP levels and outcome of COVID-19 patients (r=-0.449, p=0.000). Conclusion: Elevated serum CRP value is associated with disease progression and poorer outcome.
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Background and Objectives: Autism spectrum disorder (ASD) is a neuro-developmental disorder which is mostly caused by deficits in social interactions. Lack of physical activity and poor nutritional habits are common problems in these patients which may be exaggerated by the Covid-19 pandemic. The study aims to assess the effect of functional training along with online nutrition education on inflammatory biomarkers in children with ASD. Subjects and Methods: In this randomized controlled clinical trial, 80 children with ASD (age=9.73+or-1.29 years, weight=49.94+or-2.08 kg, height=146.08+or-40 cm, body mass index=24.71 +or-1.48 kg/m2) were randomly divided into four groups of training, education, training+ education, and control. The interventions lasted for 8 weeks. The inflammatory biomarkers including white blood cell (WBC) count, C-reactive protein (CRP) level, neutrophil count, eosinophil count, and basophil count were assessed (using blood samples collected from antecubital vein) before and after the interventions. Results: There was no significant difference between the groups before the interventions (P>0.05). After the intervention, the results showed a significant decrease in WBC (P<0.001), CRP (P=0.001), neutrophils (sig.=0.009), and eosinophil (P=0.003) in all groups. Basophil count decreased in all groups (P=0.01) except in the education group. Conclusion: Functional training and online nutrition education are beneficial interventions for management of inflammatory biomarkers in children with ASD which can be used during the Covid-19 pandemic.
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Background: COVID-19 (Corona Virus Disease-2019) pandemic has a high mortality rate especially in Medan, Indonesia. Serum albumin and liver function tests are believed to be predictive biomarkers for prognosis in patients with infectious diseases, including COVID-19. This study aimed to investigate the association between the mortality events and severely ill COVID-19 patients' serum albumin and liver enzymes. Method: This is a cross-sectional study using secondary data from the medical records of H. Adam Malik Hospital patients with COVID-19 who were confirmed by RT-PCR from August to December 2020. All patients were analyzed for age, sex, hypoalbuminemia, increased liver enzymes and outcome using Chi-square tests (P <0.05). Results: The average age of severe COVID-19 patients at H. Adam Malik Hospital ranged from 41 to 60 years, with more women prevalence than men. Most of the patients had hypoalbuminemia (84.2%), an increase in AST (59.4)% and ALT (45.5%). There was no significant association between hypoalbuminemia and the disease outcome (P =0.12). There was a significant association between elevated liver enzymes and mortality in severely ill COVID-19 patients (P <0.001). Conclusion: We found that hypoalbuminemia is common in patients with severe COVID-19. However, we found that albumin levels had no association with the patients' mortality rate. Liver enzymes levels appear to be a predictive biomarker for outcomes in COVID-19 patients of H. Adam Malik Hospital. We found that higher ALT and AST levels were associated with significantly higher mortality.
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Annotation: The causes of the development of cerebrovascular diseases in COVID-19 may be a significant deterioration in the rheological properties of blood, activation of hemostasis, changes in the atrombogenic properties of the vascular wall endothelium. Thrombocytopenia and elevated levels of fibrinogen, D-dimer and coagulation factor VIII are most often observed in COVID-19, Changes in the indicators of neurobiomarkers, namely antibodies to gliadin- fibrillar acid protein (GFAP), S-100 protein, to serotonin and dopamine receptors in CHEM indicate the severity of this disease. The aim of the study was to study the features of neurological and biochemical parameters in patients with CHEM who had a coronavirus infection, to assess the number and prognostic value of markers of brain damage: antibodies to GFAP, serotonin, dopamine receptors and S-100 protein.
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Objective: Postinfectious irritable bowel syndrome (IBS) is a known entity. We evaluated the incidence of post-COVID-19 IBS in patients discharged from the hospital and analyzed its correlation with the clinical and laboratory parameters, and treatment during the hospital stay. Methods: Three hundred three COVID-19 hospitalized patients without prior history of IBS were prospectively followed after their discharge and were evaluated as per Rome-IV criteria for IBS. Results: One hundred seventy-eight patients were males (58.7%). The age range was 17-95 years (mean +or- SD, 55.9 +or- 15.8). A total of 194 (64%) had mild COVID-19, 74 (24.4%) had moderate COVID-19, whereas 35 (11.6%) had severe COVID-19 infection. Sixteen (5.3%) patients had concomitant GI symptoms during COVID-19 infection. IBS symptoms were found to be present in 32 (10.6%) patients, out of which 17 (53.13%) had diarrhea-predominant, 10 (31.25%) had constipation-predominant, and five (15.62%) had mixed-type IBS. Post-COVID-19 IBS was more common in the female sex (P < 0.001), concomitant GI symptoms with COVID-19 (P < 0.001), oxygen requirement (P = 0.015), deranged liver function tests at the time of admission (P = 0.002), high procalcitonin (P = 0.013), high C-reactive protein levels (P = 0.035);whereas negative correlation was found with remdesivir treatment (P = 0.047). After performing regression analysis, female sex (P < 0.001), oxygen requirement during hospital stay (P = 0.016), GI symptoms during COVID-19 infection (P < 0.001), and high procalcitonin levels (P = 0.017) were independently associated with post-COVID-19 IBS. Conclusion: GI symptoms during active COVID-19 infection increase the chances of developing post-COVID-19 IBS. The risk of developing post-COVID-19 IBS increases in female patients, those requiring oxygen and having high procalcitonin levels during COVID-19 infection.
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Sepsis is a global health problem, annually over 45 million patients are diagnosed and over 11 million deaths are recorded. Activation of monocytes in sepsis by the pathogen agent or hypoxia brings about functional, morphological and phenotypic changes in these cells. Monocyte Distribution Width (MDW) is a new biomarker, defined as a measure of monocyte size heterogeneity and has been approved by the Food and Drug Administration for the early diagnosis of sepsis in the adult patient in the emergency department. In intensive care services, this biomarker can be used as a prognostic index in the follow-up of patients with sepsis. The indicator is a measure of the increased morphological variability of monocytes in response to infections, regardless of bacterial, viral or fungal etiology. This new marker also has increased values in the infection with COVID-19 and correlates positively with the severity of the disease.
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Silicon nanowires are next-generation high performance biosensor materials compatible with multiple types of biomolecules. Bioelectronic sensors, which output electrical signals for biological detection, have unique advantages in miniaturization, fast response, and portability. Despite that these nanomaterials have demonstrated high performance, complex fabrication methods that are not compatible with industrial production are usually implemented. This work deals with the development, fabrication, and testing of a rapid and cost-effective silicon nanowire biosensor that is less than one inch in width and suited for industrial mass production. The silicon nanowires are fabricated using a silver-assisted chemical etching which can be mass-producible and CMOS-compatible, tunable etch rate, and high consistency. The nanowire sensor is then fabricated using a series of nanofabrication instruments that are commonly used for semiconductor processing. The fabrication process is developed and modified to be suited for biosensing applications, and the scanning electron microscopy demonstrates that the fabricated sensor has etched vertical silicon nanowire arrays of around 350 nm in length and 1010 per 1 cm2 in density.The fabricated vertically-oriented silicon nanowire array-based sensor consists of a p-n diode. Since the diode type nanowire biosensors have not been thoroughly implemented and studied, in this work, in order to simulate and validate the operation mechanisms of the proposed biosensor, an operation protocol is proposed to characterize the sensor by measuring its current as a function of the applied voltage and calculating the derivative the current-voltage function. Then the mathematical and physical models of the device are studied, and a water-gate experiment is conducted to justify the models. In the case when the unexpected disturbance occurs, the model also provides with a method to eliminate the noise in the effective resistance of the sensor.The fabricated biosensors are then functionalized for the testing of three types of analytes including two cancer cell antibodies and the spike protein of the severe acute respiratory syndrome coronavirus 2. The results show that the developed sensors have high sensitivity and specificity against bovine serum albumin. Although still with a preliminary design, the proposed sensor has already been demonstrated to be able to detect clinically relevant concentrations of the target for the diagnosis of the disease. This technology offers the potential to complement conventional biosensor systems in applications of portable and rapid responding biosensing. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Recently, COVID-19 has been investigated for questions pertaining to eosinophils. Eosinopenia, often known as a decrease in eosinophil levels, was identified as a characteristic feature associated with SARSCoV- 2 infection. However, in the past researchers have found conflicting evidence on the connection between eosinopenia and the severity of the disease. It is not quite obvious if these changes occurred as a consequence of the immunomodulation that the medication provided or of the disease process itself. In addition, additional study is required to shed light on the possible connection that exists between the eosinophil count and the development and severity of COVID-19. The current analysis was to report changes in the eosinophil count in symptomatic COVID- 19 patients and to link such changes with severity and prognosis. The purpose of the investigation was also to record variations in the eosinophil count.
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COVID-19 is a rapidly growing pandemic with its first case identified during December 2019 in Wuhan, Hubei Province, China. Due to the rampant rise in the number of cases in China and globally, WHO declared COVID-19 as a pandemic on 11th March 2020. The disease is transmitted via respiratory droplets of infected patients during coughing or sneezing and affects primarily the lung parenchyma. The spectrum of clinical manifestations can be seen in COVID-19 patients ranging from asymptomatic infections to severe disease resulting in mortality. Although respiratory involvement is most common in COVID-19 patients, the virus can affect other organ systems as well. The systemic inflammation induced by the disease along with multisystem expression of Angiotensin Convertin Enzyme 2 (ACE2), a receptor which allows viral entry into cells, explains the manifestation of extra-pulmonary symptoms affecting the gastrointestinal, cardiovascular, hematological, renal, musculoskeletal, and endocrine system. To date, many biomarkers reflecting the main pathophysiological characteristics of the disease have been identified and associated with the risk of developing severe disease. Proteolytic enzymes, or proteases, are known to play important roles in the maintenance of pulmonary homeostasis. However, during disease, proteolytic activity can become dysregulated and cause damage to the lung, contributing to the pathology of conditions like cystic fibrosis, chronic obstructive pulmonary disease, asthma, pulmonary fibrosis and ARDS. we first evaluated the status of CTSS in the context of ARDS and models of ARDS. These investigations revealed that CTSS levels and activity were elevated in the lungs of patients with ARDS, and that elevated CTSS activity was also detectable in the plasma of these patients. Altogether, these findings support a role for CTSS in the pathogenesis of ARDS and the fact that Corona virus infects the respiratory system and the severity of the infection increases with the increase in the severity of the inflammation.
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Objective: To explore the value of liver function indexes on evaluation of the illness condition of coronavirus disease 2019 (COVID-19). Methods: 261 patients with confirmed COVID-19 which collected from Huangshi Hospital of Traditional Chinese Medicine from January to March 2020 were investigated and separated into:group of critical type, group of severe type and group of common type, and the data of the patients about age, gender, past medical history and the results of liver function test were collected. Chi-square test, analysis of variance, univariate and multivariate logistic regression analysis were adopted to explore the relationship between liver function indexes and illness condition of COVID-19. Results: 50.2% of COVID-19 patients had abnormal liver function. Compared with the group of severe type, the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP), P-glutamyl transferase (GGT) and total bilirubin (TBIL)in the group of critical type was significantly higher, while the level of albumin(ALB)was significantly lower, and the differences were statistically significant (all P < 0.05);compared with the group of common type, the levels of ALT, +AST, and GGT in the group of severe type were significantly higher, while the level of ALB was significantly lower, and the differences were statistically significant (all P < 0.05). The proportions of patients with abnormal liver function or liver damage in the group of critical type were significantly higher than those in the group of severe type (P < 0.05), and the proportions of patients with abnormal liver function or liver damage in the group of severe type was significantly higher than those in the group of common type (P < 0.05). The incidence ratio of abnormal liver function in patients with underlying disease was higher than that of without underlying disease (P < 0.05). ALT, AST, ALP, TBIL, and ALB were all risk factors for severe progress of COVID-19 disease (all P < 0.05);multivariate logistic regression analysis inidicating that TBIL (OR=10.862, P < 0.05) and ALB (OR=11.733, P < 0.05)were the independent risk factors. TBIL level was positively correlated with the severity of COVID-19 (r=0.367, P < 0.05), and ALB level was negatively correlated with the severity of COVID-19 (r=-0.613, P < 0.05). Conclusions: The abnormal liver function, especially the obvious abnormality of TBIL and ALB, could be used as the reference index of COVID-19 severity. The COVID-19 patients with underlying disease were easily suffered liver injury.
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A good proportion of patients complain of cardiopulmonary symptoms even after COVID recovery. Post-COVID symptoms were reported most often as mild and self-limiting. On the other hand, severe post COVID cardiopulmonary complications had also been reported. Therefore, the status of extent and severity of underlying cardiopulmonary disease in this group of patients is very mysterious. Evaluation of underlying disease in such patients is extremely essential. Whereas evaluation is a tough challenge during this COVID pandemic due to the high epidemiological burden of symptomatic post COVID patients. Therefore a systemic review was conducted, collecting and compiling all the literature related to post COVID cardiopulmonary symptoms to understand their pathophysiology and severity of underlying disease. At the same time, an attempt was initiated to derive an approach and strategy for evaluation. During analysis, we obtained useful information as described below. Post COVID cardiopulmonary symptoms can arise due to causes like cardiac, pulmonary, psychogenic, neurogenic, and endocrine, etc. COVID manifests a spectrum of post COVID cardiopulmonary sequelae like myocarditis (2/3rd cases), pericarditis (3% cases), pericardial effusion (5% cases), LV dysfunction (12% cases), pulmonary fibrosis (20% cases), pulmonary function abnormalities (40% cases) etc., which can manifest cardiopulmonary symptoms in post COVID patients. However, the extent and severity of cardiopulmonary involvement is very limited. Reported abnormalities during cardiopulmonary evaluation were found to be mild and self-limiting. However, there is higher chance of developing life threatening complications like pulmonary embolism, acute coronary syndrome, left ventricular failure and arrhythmia in a few rare post COVID cases due to the persistence of hyper inflammatory and hypercoagulable states. Stratification of cases based on past history, records during acute COVID period, clinical findings and biomarkers, can guide in identifying high risk cases. A selective, systemic, and step wise clinical and laboratory approach can help in proper evaluation of patients. However, exclusion of other non COVID related causes is extremely essential, before designating symptoms as post COVID symptoms.
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Background & Objective: Biological markers for the prediction of acquiring Covid-19 risk are deficient and there is a dire need of immediate research data. The objective of the study was to predict the link of ABO blood group types along with Rh factor distribution with the severity of Covid-19. Methods: This was an observational cross-sectional survey conducted in medicine department of Pakistan Ordnance Factory Hospital, Wah Cantt Pakistan, from August 2020 to December 2020 after approval of IRB. Participants tested positive for presence of Covid-19 infection by polymerase chain reaction (PCR) were included in the study. Covid-19 infection severity was measured through mild, moderate and severe disease categories and analyzed. ABO blood group and Rh subgroups data for all the Covid-19 infected patients were obtained from the laboratory section of the hospital and analyzed. Data was entered in SPSS v 26 and analyzed. Cox regression model was used to find out the severity of Covid-19. Results: Total 248 patients were included;75% patients were male and 25% were females. The mean age of the patients was 52.77+or-15.58 years. A very significant association was found between ABO blood group types, Rh factor antigen and severity of Covid-19 (p=0.001). When stratified ABO, Rh antigen blood group with health status of all patients there was a very significant association between them (p=0.013). An insignificant association between male and female odds ratio of ABO blood group types but blood group B, Rh positive antigen was more susceptible in Covid-19 positive patients. Conclusion: There is a link between ABO blood group types along with Rh factor antigen (B+ and O+) with the severity of Covid-19 positive patients. ABO blood group types and Rh factor can be used as a potential marker/tool to predict the susceptibility of acquiring Covid-19 infection as well as for severity of the infection.
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Coronavirus disease 2019 (COVID-19), an extremely infectious illness caused by a novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that has spread over the worldwide, has become one of the most difficult public health problems of our time. Age and gender are two major characteristics that influence the risks and outcomes of numerous diseases. Our study will investigate and compare the difference in hematological, biochemical, and serological biomarkers between sexes in order to evaluate severity and pathogenicity. Clinical records were taken from 150 SARS-CoV-2 positive patients were included in this study;the infection was confirmed by real time reverse transcriptase polymerase chain reaction. Blood samples subjected to measure changes in hematological parameters and serum subjected to measure biochemical test including ferritin, creatinine, CRP, D-dimer, and liver function enzyme either for ELISA test to measure serological biomarkers including IgM, IgG, TNF-α, IFN-γ, IL-6, and IL-10. 90 (60%) of whom were male and 60 (40%) of whom were female. Our study found a significant increase in CRP, IgM, IL-6, IL-10, TNF-α, IFN-γ, AST, ALP, and TBIL levels in males compared to females, and the age group most susceptible to SARS-CoV-2 infection was 41-60 years. Based on these findings, we concluded that males and those of older age had a high prevalence of severity and progression than females.
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Objectives: To reveal the importance of the laboratory routine determination of some hematological, coagulation and biochemical parameters in the prognosis of COVID-19. Materials and methods: The basic characteristic information such as age, gender, clinical symptoms and the clinical laboratory data of 300 COVID-19 patients that were admitted to the Respiratory Care Unit, Al-lmam Al-Hussein Medical City, Kerbala, Iraq were obtained from the patients' records. The patients were 146 males and 154 females, their ages were between 20 and 50 years (34.3±8.6). Results: According to their clinical status, patients were divided into moderate and severe groups. Among the 300 patients, 177 were considered as moderate cases and 123 were severe cases. Ferritin, D-Dimer, and C-reactive protein (CRP) levels were significantly higher in severe cases (P<0.05), as were lymphocytes and white blood cells (WBC) levels (P=0.0001). Hematocrit and hemoglobin were at almost the same levels in both groups (P>0.05). Platelet counts showed normal values in moderate and severe cases. In severe cases, lactate dehydrogenase (LDH) was significantly increased (P=0.0001). The receiver operating characteristic (ROC) curve exhibited that WBC, D-Dimer and LDH have fair values regarding the discriminative ability between the moderate and severe groups (AUC 0.788, 0.718 and 0.761, respectively, P-value of 0.0001). Conclusion: The laboratory routine determination is of a key importance in the prognosis and handling of the cases of COVID-19, especially those that could develop acute respiratory failure, so further deterioration can be avoided.
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Background: The severity of Coronavirus Disease-2019 (COVID-19) cases is associated with hyperinflammation. Patients with critical and severe COVID-19 have been observed to have high amounts of circulating cytokines. Neopterin, a crucial cytokine in the antiviral immune response that is released by macrophages upon stimulation with interferon-gamma, can be utilized to forecast the severity of illness in COVID-19 patients. Methods: The study included 185 patients with COVID-19. The patients with COVID-19 were divided into three groups according to disease severity as critical disease (n=51), severe disease (n=81), and moderate disease (n=53). All basic demographic and clinical data of the patients were recorded and blood samples were collected. Results: Neopterin levels were significantly higher in critical COVID-19 patients compared with severe and moderate COVID-19 patients (p < 0.0001). Further, neopterin showed significantly higher levels in the age group >50 years of patients with COVID-19 than in the age group <50 years. Neopterin levels were correlated with WBCs, Platelet, CRP, D-Dimer, Ferritin, Fibrinogen, IL-6, and Procalcitonin levels positively (ρ= 0.569, 0.474, 0.338, 0.696, 0.605, 0.77, 0.727, and 0.585;p < 0.01 respectively), and correlated with BMI, SpO2, and lymphocyte negatively (ρ= - 0.165;p < 0.05, p= - 0.754, - 0. 548;p < 0.01 respectively). A cutoff value of 23.62 nmol/L for neopterin predicted COVID-19 with a sensitivity of 95.7% and a specificity of 95.5% (AUC: 0.986;p < 0.0001). Conclusion: Neopterin may be a useful prognostic biomarker for assessing the severity of COVID-19.
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Rationale: Autopsy and biomarker studies suggest that endotheliopathy contributes to coronavirus disease (COVID-19)-associated acute respiratory distress syndrome. However, the effects of COVID-19 on the lung endothelium are not well defined. We hypothesized that the lung endotheliopathy of COVID-19 is caused by circulating host factors and direct endothelial infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objectives: We aimed to determine the effects of SARS-CoV-2 or sera from patients with COVID-19 on the permeability and inflammatory activation of lung microvascular endothelial cells. Methods: Human lung microvascular endothelial cells were treated with live SARS-CoV-2;inactivated viral particles;or sera from patients with COVID-19, patients without COVID-19, and healthy volunteers. Permeability was determined by measuring transendothelial resistance to electrical current flow, where decreased resistance signifies increased permeability. Inflammatory mediators were quantified in culture supernatants. Endothelial biomarkers were quantified in patient sera. Measurements and Main Results: Viral PCR confirmed that SARS-CoV-2 enters and replicates in endothelial cells. Live SARS-CoV-2, but not dead virus or spike protein, induces endothelial permeability and secretion of plasminogen activator inhibitor 1 and vascular endothelial growth factor. There was substantial variability in the effects of SARS-CoV-2 on endothelial cells from different donors. Sera from patients with COVID-19 induced endothelial permeability, which correlated with disease severity. Serum levels of endothelial activation and injury biomarkers were increased in patients with COVID-19 and correlated with severity of illness. Conclusions: SARS-CoV-2 infects and dysregulates endothelial cell functions. Circulating factors in patients with COVID-19 also induce endothelial cell dysfunction. Our data point to roles for both systemic factors acting on lung endothelial cells and viral infection of endothelial cells in COVID-19-associated endotheliopathy.
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To date, there is no consensus explaining the relationship between varying concentrations of IFNgamma and the severity of infection caused by SARS-CoV-2. The aim of this article was to analyze and formulate conclusions from the selected studies and publications, which, in sum, provide a potentially reasonable view on the role of IFNgamma in COVID-19 pathogenesis. This article highlights current data on the immunological role of IFNgamma which affects differentiation of naive T helper cells, acting as a polarizing factor. It activates the major histocompatibility complex (MHC) class I and II, by increasing the expression of MHC I/II subunits, inhibiting replication of the viral particles by initiating activation of interferon-stimulated genes followed by subsequent synthesis of antiviral proteins. Moreover, IFNgamma activates the production of cytokines by T cells, enhancing cytotoxic activity of the T killers. IFNgamma exerts immunostimulatory and immunomodulatory effects via STAT1, SOCS1 and PIAS genes, thus regulating activation of the JAK-STAT signaling pathway. A number of studies were considered where the patterns of changes in serum IFNgamma concentration were examined in viral infections and SARS-CoV-2. We performed a systemic analysis of the results of studies that showed a relationship between high concentrations of IFNgamma and COVID-19 severity. In a number of studies, the significantly high levels of IFNgamma in COVID-19 patients were often associated with a poor outcome of the disease. The median values of the IFNgamma concentration in severe COVID-19 were found to be significantly higher compared to the results obtained in the cases of moderate severity. It shows an increase, in parallel with viral load in the nasopharyngeal samples upon worsening of the clinical condition. Based on the data on the decreased IFNgamma concentrations in convalescent patients, the mechanism of antagonism between IFNgamma and IL-4 is considered, where the decreases serum concentrations of IFNgamma along with increasing level of IL-4 may be an indirect proof of normal adaptive immune response with subsequent development of antibodies to SARS-CoV-2 and gradual elimination of the virus from the body. Moreover, the evidence is discussed that the patients harboring some parasitic infections (Toxoplasma gondii, Cryptosporidium, Blastocystis hominis, Giardia duodenalis, Entamoeba histolytica) with persistently elevated level of IFNgamma are at reduced risk for severe course of COVID-19. Copyright © 2022, SPb RAACI.
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To date, there is no consensus explaining the relationship between varying concentrations of IFNgamma and the severity of infection caused by SARS-CoV-2. The aim of this article was to analyze and formulate conclusions from the selected studies and publications, which, in sum, provide a potentially reasonable view on the role of IFNgamma in COVID-19 pathogenesis. This article highlights current data on the immunological role of IFNgamma which affects differentiation of naive T helper cells, acting as a polarizing factor. It activates the major histocompatibility complex (MHC) class I and II, by increasing the expression of MHC I/II subunits, inhibiting replication of the viral particles by initiating activation of interferon-stimulated genes followed by subsequent synthesis of antiviral proteins. Moreover, IFNgamma activates the production of cytokines by T cells, enhancing cytotoxic activity of the T killers. IFNgamma exerts immunostimulatory and immunomodulatory effects via STAT1, SOCS1 and PIAS genes, thus regulating activation of the JAK-STAT signaling pathway. A number of studies were considered where the patterns of changes in serum IFNgamma concentration were examined in viral infections and SARS-CoV-2. We performed a systemic analysis of the results of studies that showed a relationship between high concentrations of IFNgamma and COVID-19 severity. In a number of studies, the significantly high levels of IFNgamma in COVID-19 patients were often associated with a poor outcome of the disease. The median values of the IFNgamma concentration in severe COVID-19 were found to be significantly higher compared to the results obtained in the cases of moderate severity. It shows an increase, in parallel with viral load in the nasopharyngeal samples upon worsening of the clinical condition. Based on the data on the decreased IFNgamma concentrations in convalescent patients, the mechanism of antagonism between IFNgamma and IL-4 is considered, where the decreases serum concentrations of IFNgamma along with increasing level of IL-4 may be an indirect proof of normal adaptive immune response with subsequent development of antibodies to SARS-CoV-2 and gradual elimination of the virus from the body. Moreover, the evidence is discussed that the patients harboring some parasitic infections (Toxoplasma gondii, Cryptosporidium, Blastocystis hominis, Giardia duodenalis, Entamoeba histolytica) with persistently elevated level of IFNgamma are at reduced risk for severe course of COVID-19. Copyright © 2022, SPb RAACI.