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1.
Biochemistry ; 87(9):916-931, 2022.
Article in English | ProQuest Central | ID: covidwho-2038256

ABSTRACT

Endoplasmic reticulum (ER) is a multifunctional membrane-enclosed organelle. One of the major ER functions is cotranslational transport and processing of secretory, lysosomal, and transmembrane proteins. Impaired protein processing caused by disturbances in the ER homeostasis results in the ER stress. Restoration of normal ER functioning requires activation of an adaptive mechanism involving cell response to misfolded proteins, the so-called unfolded protein response (UPR). Besides controlling protein folding, UPR plays a key role in other physiological processes, in particular, differentiation of cells of connective, muscle, epithelial, and neural tissues. Cell differentiation is induced by the physiological levels of ER stress, while excessive ER stress suppresses differentiation and can result in cell death. So far, it remains unknown whether UPR activation induces cell differentiation or if UPR is initiated by the upregulated synthesis of secretory proteins during cell differentiation. Cell differentiation is an important stage in the development of multicellular organisms and is tightly controlled. Suppression or excessive activation of this process can lead to the development of various pathologies in an organism. In particular, impairments in the differentiation of connective tissue cells can result in the development of fibrosis, obesity, and osteoporosis. Recently, special attention has been paid to fibrosis as one of the major complications of COVID-19. Therefore, studying the role of UPR in the activation of cell differentiation is of both theoretical and practical interest, as it might result in the identification of molecular targets for selective regulation of cell differentiation stages and as well as the potential to modulate the mechanisms involved in the development of various pathological states.

2.
Proceedings of the Royal Society B. Biological Sciences ; 289(1981), 2022.
Article in English | CAB Abstracts | ID: covidwho-2037618

ABSTRACT

Transgenerational plasticity is a form of non-genetic inheritance that can reduce or enhance offspring fitness depending on parental stress. Yet, the adaptive value of such parental environmental effects and whether their expression varies among populations remain largely unknown. We used self-fertilized lines from climatically distinct populations of the crop wild relative Lupinus angustifolius. In the parental generation, full-siblings were grown in two contrasting watering environments. Then, to robustly separate the within-generation and transgenerational response to drought, we reciprocally assigned the offspring of parents to the same experimental treatments. We measured key functional traits and assessed lifetime reproductive fitness. Offspring of drought-stressed parents produced less reproductive biomass, but a similar number of lighter seeds, in dry soil compared to offspring of genetically identical, well-watered parents, an effect not mediated by differences in seed provisioning. Importantly, while the offspring of parents grown in the favourable environment responded to drought by slightly increasing individual seed mass, the pattern of plasticity of the offspring of drought-grown parents showed the opposite direction, and the negative effects of parental drought on seed mass were more pronounced in populations from cooler and moist habitats. Overall, our results show that parental effects may override immediate adaptive responses to drought and provide evidence of population-level variation in the expression of transgenerational plasticity.

3.
Plant Health Progress ; 22:4, 2021.
Article in English | CAB Abstracts | ID: covidwho-2037540

ABSTRACT

The I. E. Melhus Symposium is a prestigious event that takes place as part of the annual meeting of the American Phytopathology Society. The 19th symposium highlights some of the best and brightest graduate students in epidemiology on the theme Data Driven Plant Health. Because of the COVID-19 pandemic, the entire meeting was online. Despite the challenges, the awardees successfully presented their research to a live online audience of more than 150 attendees. The five research projects are collected in this issue of Plant Health Progress.

4.
Zhongguo Yufang Shouyi Xuebao / Chinese Journal of Preventive Veterinary Medicine ; 44(3):346-346, 2022.
Article in English, Chinese | CAB Abstracts | ID: covidwho-2034493

ABSTRACT

The new coronavirus (SARS-CoV-2) is raging around the world, infecting more than 460 million people and killing more than 6 million people, posing a serious threat to human health. Analyzing the pathogenic mechanism of the virus and discovering new drug targets are the keys to the development of antiviral drugs. Similar to the envelope proteins of many important viruses such as Ebola virus and Marburg virus, the spike (S) protein of SARS-CoV-2 relies on the cleavage and processing of cellular furin to mature during infection, and then make the virus infective, so furin is an important potential target for antiviral therapy. However, the regulation mechanism of furin enzyme activity in cells under physiological and infection conditions is not yet very clear.

5.
Slovensky Veterinarsky Casopis ; 45(2):72-74, 2020.
Article in Slovak | CAB Abstracts | ID: covidwho-2034129

ABSTRACT

This article describes the differences between the influenza pandemic and the Covid-19 pandemic and the immunological and virus-host cell characteristics of SARS-CoV-2.

6.
NeuroQuantology ; 20(8):8399-8406, 2022.
Article in English | EMBASE | ID: covidwho-2033473

ABSTRACT

Objectives: Dynamics of COVID-19 disease are changing with the emergence of the new variant of the COVID virus. Still, the severity of this disease is associated with comorbid conditions like diabetes mellitus (DM), hypertension, etc. and several biomarkers are studied. The objectives of the study were to estimate methemoglobin (Met-Hb), hemoglobin(Hb), lactate dehydrogenase (LDH) and C reactive protein(CRP) levels in COVID-19 patients with DM and without DM and then to compare between two groups. Materials and methods: This observational study was conducted in 40 COVID-19 patients with DM and 40 COVID-19 patients without DM from June 2021 to October 2021 in the biochemistry department of a tertiary care hospital. For all patients, estimation of Met-Hb, Hb, LDH and CRP levels were estimated on the 2nd-3rd day of hospital admission. Results: Met-Hb, LDH and CRP levels were significantly high and Hb levels were significantly low in elderly COVID-19 patients with DM than in those without DM (P<0.05). There was a significant positive correlation between Met-Hb with LDH and Met-Hb with CRP in both groups and a significant negative correlation was found between Met-Hb with Hb in the diabetic group. Conclusion: In elderly patients, diabetes is one of the important and independent risk factors for the severity of COVID-19 disease. Derangement of Met-Hb along with LDH and CRP shows the need for routine monitoring of Met-Hb. This may open new options in the treatment of COVID-19 disease with DM and improve outcomes in the future.

7.
Journal of Clinical and Diagnostic Research ; 16(8):BC19-BC23, 2022.
Article in English | EMBASE | ID: covidwho-2033410

ABSTRACT

Introduction: Lipids are fundamental biomolecules of the body. Infections like COVID-19 with intricate immune response in some patient’s leads to acute complications by affecting metabolic pathways at multiple levels. Metabolism of cholesterol, triglyceride and High Density Lipoprotein (HDL)-Cholesterol is deranged by cytokines and multiple inflammatory mediators. The sex differences in lipid metabolism may contribute in susceptibility, severity and outcome of Coronavirus Disease 2019 (COVID-19). Performing lipid profile in COVID-19 patient may help in assessing severity and prognosis of disease. Aim: To assess the relationship between lipid profile and inflammatory markers in COVID-19 patients and also to evaluate the gender wise differences in lipid parameters and their correlations with inflammatory markers. Materials and Methods: This retrospective study was conducted in Department of Biochemistry at SHKM, GMC, Mewat, Haryana, India (tertiary care health centre) on COVID-19 positive patients attending Outpatient Department (OPD) and Inpatient Department (IPD), from October 2020 to December 2020. The data of 85 patients with COVID-19 positive, confirmed by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and who were prescribed for lipid profile along with C-Reactive Protein (CRP) and serum ferritin were included in the study. Serum total cholesterol, triglyceride, HDL-Cholesterol, CRP and ferritin were measured in the subjects. Data was statistically analysed using Student’s t test and Pearson correlation coefficient. results: Total 85 (46 males and 39 females) COVID-19 patients were included in the study. Mean age in male and female patients were 43.02±15.52 years and 42.02±15.25 years, respectively with a range of 5-82 years. Mean value of Serum triglycerides, HDL-C and total cholesterol was 204.94±141.27 mg/dL, 42.97±13.38 mg/ dL and 187.058±45.75 mg/dL, respectively. Serum triglycerides were statistically significantly higher in males than females (p-value=0.0413). The HDL-C however was significantly higher in females than males (p-value=0.0006). In male patients, r-value between cholesterol and CRP was -0.3538, and p-value was 0.016. Ferritin had a significant negative correlation with HDL-C (r-value=-0.3578, p-value=0.00079). Weak Positive correlation was noted between triglyceride and ferritin (r-value= 0.2285, p-value=0.035). conclusion: High levels of serum triglycerides, low total cholesterol, and low HDL-cholesterol correlates with inflammatory markers like CRP and ferritin in COVID-19 patients. Lipid profile may be used as a potential marker in all COVID-19 patients in assessing prognosis of disease.

8.
Acta Veterinaria et Zootechnica Sinica ; 53(7):2260-2267, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-2025546

ABSTRACT

The C-terminal domain (CTD) of porcine deltacoronavirus S1 subunit is the main region which induces the neutralizing antibody. S1-CTD was expressed by HEK-293T eukaryotic expression system and purified, and porcine ileal epithelium cells membrane proteins were extracted to investigate porcine host proteins that interact with it. Thirty-two suspected interacting host proteins were obtained by co-inmunprecipitation (Co-IP) and mass spectrometry. Eukaryotic expression plasmid of KIF1 binding protein (KIFBP) was constructed, and the interaction between KIFBP and S1-CTD was identified by Co-IP and laser confocal microscopy. All results proved that KIFBP interacted with S1-CTD and co-located in cytoplasm. Further research indicated that overexpression of KIFBP could effectively reduce the viral mRNA level and the viral titer in which the mRNA level decreased by about 70%, and the viral titer decreased by 101.6TCID50. In conclusion, a host protein KIFBP interacting with PDCoV S1-CTD was screened and identified in this study which provides a theoretical basis for understanding the pathogenesis of PDCoV.

9.
Acta Veterinaria et Zootechnica Sinica ; 53(6):2024-2028, 2022.
Article in Chinese | CAB Abstracts | ID: covidwho-2025545

ABSTRACT

This study aimed to analyze the proliferation characteristics of porcine deltacoronavirus (PDCoV) in suspension cultured porcine kidney cells LLC-PK1, so as to provide Candidate cell for large-scale production of PDCoV inactivated vaccine. LLC-PK1 cells were suspended by gradually decreasing serum method. PDCoV adaptive monoclonal cell lines were screened by limited dilution method. Indirect immunofluorescence method was used to identify the infectivity of PDCoV. The initial cell density, MOI, time of receiving virus collection and TPCK pancreatin concentration were screened to determine the best suspension culture conditions. The suspension cell strain LLC-PK1Sa which can proliferate PDCoV efficiently was screened out;PDCoV can specifically infect LLC-PK1 cells;PDCoV inoculated LLC-PK1Sa cells with a density of 2 x 106 cells.mL-1 according to the MOI of 10-3, When the final concentration of TPCK pancreatin reached 7.5 g.mL-1, the titer of virus solution harvested 48 h after inoculation was the highest. In this study, the efficient proliferation of PDCoV in LLC-PK1Sa suspension cells was realized for the first time, and the suspension culture conditions were preliminarily optimized, which could provide theoretical reference for large-scale production of PDCoV inactivated vaccine.

10.
Viruses ; 14(8), 2022.
Article in English | CAB Abstracts | ID: covidwho-2024290

ABSTRACT

DNA damage response (DDR) is an evolutionarily conserved mechanism by which eukaryotic cells sense DNA lesions caused by intrinsic and extrinsic stimuli, including virus infection. Although interactions between DNA viruses and DDR have been extensively studied, how RNA viruses, especially coronaviruses, regulate DDR remains unknown. A previous study showed that the porcine epidemic diarrhea virus (PEDV), a member of the genus Alphacoronavirus in the Coronaviridae family, induces DDR in infected cells. However, the underlying mechanism was unclear. This study showed that PEDV activates the ATM-Chk2 signaling, while inhibition of ATM or Chk2 dampens the early stage of PEDV infection. Additionally, we found that PEDV-activated ATM signaling correlates with intracellular ROS production. Interestingly, we showed that, unlike the typical PH2AX foci, PEDV infection leads to a unique PH2AX staining pattern, including phase I (nuclear ring staining), II (pan-nuclear staining), and III (co-staining with apoptotic bodies), which highly resembles the apoptosis process. Furthermore, we demonstrated that PEDV-induced H2AX phosphorylation depends on the activation of caspase-7 and caspase-activated DNAse (CAD), but not ATM-Chk2. Finally, we showed that the knockdown of H2AX attenuates PEDV replication. Taken together, we conclude that PEDV induces DDR through the ROS-ATM and caspase7-CAD-PH2AX signaling pathways to foster its early replication.

11.
Non-Coding RNA ; 8(4):58, 2022.
Article in English | ProQuest Central | ID: covidwho-2023953

ABSTRACT

As research uncovers the underpinnings of cancer biology, new targeted therapies have been developed. Many of these therapies are small molecules, such as kinase inhibitors, that target specific proteins;however, only 1% of the genome encodes for proteins and only a subset of these proteins has ‘druggable’ active binding sites. In recent decades, RNA therapeutics have gained popularity due to their ability to affect targets that small molecules cannot. Additionally, they can be manufactured more rapidly and cost-effectively than small molecules or recombinant proteins. RNA therapeutics can be synthesised chemically and altered quickly, which can enable a more personalised approach to cancer treatment. Even though a wide range of RNA therapeutics are being developed for various indications in the oncology setting, none has reached the clinic to date. One of the main reasons for this is attributed to the lack of safe and effective delivery systems for this type of therapeutic. This review focuses on current strategies to overcome these challenges and enable the clinical utility of these novel therapeutic agents in the cancer clinic.

12.
Metabolites ; 12(8):770, 2022.
Article in English | ProQuest Central | ID: covidwho-2023910

ABSTRACT

The gut–brain axis plays a role in major depressive disorder (MDD). Gut-bacterial metabolites are suspected to reduce low-grade inflammation and influence brain function. Nevertheless, randomized, placebo-controlled probiotic intervention studies investigating metabolomic changes in patients with MDD are scarce. The PROVIT study (registered at clinicaltrials.com NCT03300440) aims to close this scientific gap. PROVIT was conducted as a randomized, single-center, double-blind, placebo-controlled multispecies probiotic intervention study in individuals with MDD (n = 57). In addition to clinical assessments, metabolomics analyses (1H Nuclear Magnetic Resonance Spectroscopy) of stool and serum, and microbiome analyses (16S rRNA sequencing) were performed. After 4 weeks of probiotic add-on therapy, no significant changes in serum samples were observed, whereas the probiotic groups’ (n = 28) stool metabolome shifted towards significantly higher concentrations of butyrate, alanine, valine, isoleucine, sarcosine, methylamine, and lysine. Gallic acid was significantly decreased in the probiotic group. In contrast, and as expected, no significant changes resulted in the stool metabolome of the placebo group. Strong correlations between bacterial species and significantly altered stool metabolites were obtained. In summary, the treatment with multispecies probiotics affects the stool metabolomic profile in patients with MDD, which sets the foundation for further elucidation of the mechanistic impact of probiotics on depression.

13.
Metabolites ; 12(8):765, 2022.
Article in English | ProQuest Central | ID: covidwho-2023909

ABSTRACT

LDL receptor gene expression is under negative feedback regulation by intracellular cholesterol levels via sterol regulatory element-binding protein (SREBP) [10]. Turning to the relationship between kidney disease and the high burden of co-morbidities, Vecka and colleagues present a study which compares 26 hemodialysis patients to 26 age- and sex-matched controls and found that the end-stage renal disease patients exhibited higher cholesterol absorption, increased levels of inflammatory markers and an abnormal lipid profile with lower HDL, elevated intermediate density lipoprotein (IDL) and higher numbers of chylomicron remnants [18]. Fecal short-chain fatty acids (SCFAs), commonly produced by the fermentation of indigestible fiber by gut bacteria, were found at concentrations that were lower in those classified as the high-fitness group compared to the low-fitness group [21]. Since each apoB-containing lipoprotein particle contains exactly one molecule of apoB, the number of apoB molecules in circulation reflects the atherogenicity in aggregate and may show superior accuracy, particularly in the setting of type 2 diabetes [28].

14.
Metabolites ; 12(8):712, 2022.
Article in English | ProQuest Central | ID: covidwho-2023907

ABSTRACT

In addition to metabolic disorders, which include impaired glucose tolerance, abdominal obesity, decreased high-density lipoprotein cholesterol (HDL-C) level and elevated triglycerides (TG), metabolic syndrome is characterized by a procoagulant, proinflammatory and prooxidant state [2], which further increases the likelihood of developing ischemic cardiovascular (CVD) and cerebrovascular diseases. [...]it was documented that moderate hyperglycemia per se is associated with increased risk of pregnancy complications [5]. [...]a mounting body of evidence point towards increased risk for cardiometabolic disorders of both mother and a child in the future [6]. [...]the implementation of metabolomics biomarkers in clinical practice is faced with several limitations, the most important being restricted availability to the clinicians, unmet need for validation and harmonization of the assays and uncertain cost-effectiveness, which require further evaluation. Data from large epidemiological studies and clinical trials have provided significant evidence that lowering fasting and post-prandial glycemia, as well as ameliorating other indices of glucose metabolism alterations, such as glycated hemoglobin (HbA1c), is an effective approach to reduce cardiometabolic risk [21].

15.
Journal of Clinical Medicine ; 11(17):5012, 2022.
Article in English | ProQuest Central | ID: covidwho-2023795

ABSTRACT

Glycosylated ferritin (GF) has been reported as a good diagnostic biomarker for adult-onset Still’s disease (AOSD), but only a few studies have validated its performance. We performed a retrospective study of all adult patients with at least one GF measurement over a 2-year period in one hospital laboratory. The diagnosis of AOSD was based on the expert opinion of the treating physician and validated by two independent investigators. Patients’ characteristics, disease activity, and outcome were recorded and compared. Twenty-eight AOSD and 203 controls were identified. Compared to controls, the mean GF was significantly lower (22.3% vs. 39.3, p < 0.001) in AOSD patients. GF had a high diagnostic accuracy for AOSD, independent of disease activity or total serum ferritin (AUC: 0.674 to 0.915). The GF optimal cut-off value for AOSD diagnosis was 16%, yielding a specificity of 89% and a sensitivity of 63%. We propose a modified diagnostic score for AOSD, based on Fautrel’s criteria but with a GF threshold of 16% that provides greater specificity and increases the positive predictive value by nearly 5 points. GF is useful for ruling out differential diagnoses and as an appropriate classification criterion for use in AOSD clinical trials.

16.
IOP Conference Series : Earth and Environmental Science ; 92, 2022.
Article in English | CAB Abstracts | ID: covidwho-2017614

ABSTRACT

Air pollution in the environment in which poultry is raised is one of the most serious problems facing the poultry sector across various aspects of production. Perhaps the most dangerous gas emitted from poultry houses is ammonia. The high concentrations of this gas in the air above the permissible limits (15 ppm) will have disastrous consequences. Ammonia directly affects the health and safety of birds, as it is a cause of ammonia blindness in birds accompanied by many respiratory diseases that destroy production and increase breeding costs. In addition, high concentrations of ammonia (above 20 ppm) contribute to enhancing the infection of birds with Newcastle and the bronchitis virus. In general, the greenhouse gases emitted from poultry houses included four main gases (carbon dioxide, nitrous oxide, methane and hydrogen sulphide). Studies regarding their direct effects on the health and productivity of birds have been insufficient. In the direct form, as the concentrations of greenhouse gases rise to very high limits, they cause suffocation and death., the behaviour of the greenhouse gases in the indirect effect is reflected being a source of nutritional stress and a group of diseases and parasites which lead to a decrease in productivity levels. The intensity and concentrations of gas emissions are directly related to many factors such as geographic location, the season of the year, ventilation technologies, humidity, litter quality, nutritional status and stocking density. The advances in ventilation technologies have played a key role in expelling all harmful gases, especially those that depend on negative pressure. However, greenhouse gases remain a real threat to the poultry industry in particular and to the planet's environment in general.

17.
Protein Science ; 31(9), 2022.
Article in English | ProQuest Central | ID: covidwho-2013731

ABSTRACT

SARS‐CoV‐2 may enter target cells through the process of membrane fusion at either the plasma (~pH 7.4–7.0) or endosomal (~pH 6.5–5.0) membrane in order to deliver its genetic information. The fusion domain (FD) of the spike glycoprotein is responsible for initiating fusion and is thus integral to the viral life cycle. The FD of SARS‐CoV‐2 is unique in that it consists of two structurally distinctive regions referred to as the fusion peptide (FP) and the fusion loop (FL);yet the molecular mechanisms behind how this FD perturbs the membrane to initiate fusion remains unclear. In this study via solution NMR, we witnessed only a slight conformational change in the FD between pH 7.4 and pH 5.0, resulting in a minor elongation of helix 1. However, we found that the FD's ability to mediate membrane fusion has a large and significant pH dependence, with fusion events being more readily induced at low pH. Interestingly, a biphasic relationship between the environmental pH and fusogenicity was discovered, suggesting a preference for the FD to initiate fusion at the late endosomal membrane. Furthermore, the conserved disulfide bond and hydrophobic motif “LLF” were found to be critical for the function of the complete FD, with minimal activity witnessed when either was perturbed. In conclusion, these findings indicate that the SARS‐CoV‐2 FD preferably initiates fusion at a pH similar to the late endosome through a mechanism that heavily relies on the internal disulfide bond of the FL and hydrophobic LLF motif within the FP.

18.
Salud i Ciencia ; 24(6):316-317, 2021.
Article in Portuguese | GIM | ID: covidwho-2012860

ABSTRACT

In patients with acute ischemic stroke and COVID-19, the highest ratio between neutrophils and lymphocytes and increased serum levels of C-reactive protein, ferritin, D-dimer and fibrinogen are associated with poor neurological prognosis;75% of these patients die or survive with significant disability. At the moment, however, they cannot be established firm conclusions about the long-term evolution of these patients. Thus, the objective of this systematic review was to identify and correlate clinical and biochemical findings in patients with infection confirmed by SARS-CoV-2 and acute ischemic stroke.

19.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009601

ABSTRACT

Background: Patients with comorbidities especially those with oncological diseases could have severe COVID-19 outcomes. OBJECTIVE: The aim of this study was to evaluate the role of prolonged positivity of SARS-Cov2 in evolution of patients with various neoplasia. Methods: We analysed clinical and laboratory (hematological parameters and inflammatory markers: interleukin-6 and ferritin) data of COVID-19 patients admitted in intensive care unit (ICU) Department of our hospital, during 2020-2021 and presented in medical history solid tumors or haematological neoplasia . The cohort of patients included 78 patients with severe and critical form of COVID-19, 31 patients with solid tumors and 47 patients with hematologic malignancies. We consider long COVID-19 all cases with SARS Cov2 positivity more than 14 days. Results: The frequency of long COVID-19 was quite equal between patients groups with solid tumors and hematologic malignancies, incidence rate 1:2, the incidence rate differences was 1:18, p = 0.75. Long COVID-19 was observed in 60% cases with favourable evolution, Chi-squared 5.35%, p = 0.02, these patients had moderate form and was admitted in hospital in 1 or more days after the onset, median value 3 (min 1, max 55) compared with patients with normal duration of positivity of SARS-Cov2 test-median value 2 (min 1, max 8), p = 0.01. The Kaplan Meyer survival analyses indicated long COVID-19 as predictive factor for unfavourable evolution, Chi-squared 17.97, p < 0.0001. Although we have not obtain significant differences, we observed more severe lymphopenia in patient without long COVID-19, probably because a part of these patients group died in the first 14 days of COVID-19 (0.765 (min 0.04, max 297.64) vs. 1.01 (min 0.09, max 254.35), p = 0.09). The rest of hematological and biochemistry parameters was not significant different between groups. Infectious and thrombotic complication was most frequent in patients with long COVID-19, Chi squared 8.6, p = 0.003. Conclusions: Long Covid-19 is predictable for unfavourable evolution and is associated with sepsis and thrombotic complication. This diagnosis is frequent in patients who was admitted in hospital after the onset of COVID-19 symptoms, early treatment of COVID-19 in oncological patients being very important for favourable evolution.

20.
Annals of the Rheumatic Diseases ; 81:1688, 2022.
Article in English | EMBASE | ID: covidwho-2009058

ABSTRACT

Background: According to the recent medical literature, COVID-19 disease can lead to a constellation of clinical syndromes lasting well beyond the frst 30 days of infection. The most common post COVID sequalae includes pulmonary, nervous system and neurocognitive, mental, metabolic, cardiovascular, gastrointestinal and several other clinical manifestations. Regarding joint involvement and particularly reactive arthritis (ReA), literature data is limited and describes case reports or series of cases of patients diagnosed with this condition following COVID-19 disease. Objectives: To describe the pattern and the management of post-COVID reactive arthritis. Methods: We have conducted a descriptive study of consecutive adult patients who presented to rheumatology outpatient clinic for joint or peri-articular pain/swelling/stiffness and received a diagnosis of post-COVID 19 reactive arthritis, by excluding other types of rheumatological conditions. The assessed clinical variables were: visual analogue scale (VAS) pain, swollen joint count (SJC), tender joint count (TJC), duration of morning stiffness, presence of enthesitis/tendinitis and axial involvement. Biochemistry and serology was performed: rheumatoid factor, ACPA, ANA, HLA B27, antiChlamydia Trachomatis, Ureaplasma Urealyticum and Mycoplasma Hominis Ab, anti HBs and HBc Ab, and anti HCV. COVID-19 disease prior to diagnosis of ReA was confrmed by PCR test. Results: In the study were included 16 patients with confrmed post COVID-19 ReA. The mean age of the study group was 43.5±10.8 (range 21-60), the female: male ratio was 4:1 and the duration of joint symptoms was 10.4±11.8 (range 1-42) weeks. The severity of COVID-19 disease was mild in 68.7% cases, moderate in 18.7% and severe in only 6.2% of the cases. The duration between COVID-19 diagnosis and ReA varied between cases, with a mean value of 4.3±4.2 (range 1-12) weeks. In 43.7% of the cases patients had peripheral joint involvement (synovitis), in 37.5%-periarticular involvement (enthesitis), 6.25%-isolate axial involvement (sacroiliac joints), 6.25% enthesitis and axial involvement (cervical spine) and 6.25% synovitis and enthesitis. In patients with peripheral joint pattern, the distribution of pain was symmetric (71.4%). The pattern of synovitis was determined by a TJC of 6.25±5.2 (range 1-16) joints and SJC 1.6±2.4 (range 0-7) joints. Both TJC and SJC correlated positively with the duration of morning stiffness (r=0.9 and r=0.6), but did not correlate with the VAS pain scale. In most of the cases synovitis affected the hand (wrist, MCP and PIP) 62.5% and the knee, feet and ankles-50%. Two patients presented with monoarthritis, 1 with oligoarthritis and 5 with polyarthritis, in the majority of cases, involvement being symmetric (75%). Periarticular pattern was determined by enthesi-tis, affecting the elbow and shoulder (50%), costo-sternal enthesitis (25%) and trochanteritis (25%). From the entire study group, 31.2% had elevated serum infammatory markers (ESR and/or CRP). Patients responded well to NSAIDs alone in 68.7% cases, local (intra-articular or peri-articular infltrations) or and systemic corticoids (5 mg Prednisolone equivalent) were administered in 5.3% and 12.5% cases respectively, in 12.5% cases (two patients) Methotrexate was administered. Conclusion: Reactive arthritis represents a post COVID-19 sequelae. The time of onset of ReA varied between 1 and 12 weeks after COVID-19 diagnosis. The clinical pattern of the disease was expressed by joint or periarticular involvement, mainly affecting the hand, feet and knee symmetrically. Cases of axial manifestations were less common. Most of the patients responded well to NSAIDs, only in a few particular cases, low doses of corticoids and/or Methotrexate were recommended.

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