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1.
Biomed Pharmacother ; 147: 112614, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1682939

ABSTRACT

Post-Covid pulmonary fibrosis is evident following severe COVID-19. There is an urgent need to identify the cellular and pathophysiological characteristics of chronic lung squeals of Covid-19 for the development of future preventive and/or therapeutic interventions. Tissue-resident memory T (TRM) cells can mediate local immune protection against infections and cancer. Less beneficially, lung TRM cells cause chronic airway inflammation and fibrosis by stimulating pathologic inflammation. The effects of Janus kinase (JAK), an inducer pathway of cytokine storm, inhibition on acute Covid-19 cases have been previously evaluated. Here, we propose that Tofacitinib by targeting the CD8+ TRM cells could be a potential candidate for the treatment of chronic lung diseases induced by acute SARS-CoV-2 infection.


Subject(s)
CD8-Positive T-Lymphocytes/immunology , COVID-19/drug therapy , Janus Kinase Inhibitors/therapeutic use , Lung Injury/drug therapy , Piperidines/therapeutic use , Pyrimidines/therapeutic use , T-Lymphocyte Subsets/immunology , COVID-19/complications , COVID-19/immunology , Humans , Immunologic Memory/immunology , Lung/immunology , Lung Injury/etiology , Lung Injury/immunology , SARS-CoV-2 , T-Lymphocytes/immunology
2.
Eur Rev Med Pharmacol Sci ; 26(1): 270-277, 2022 01.
Article in English | MEDLINE | ID: covidwho-1631285

ABSTRACT

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare new syndrome occurring after the ChAdOx1 nCoV-19 vaccine immunization. Patients with VITT are characterized by a variable clinical presentation, likewise also the outcome of these patients is very variable. Here we report the lung ultrastructural findings in the course of VITT of a 58-year-old male patient. Alveoli were mainly dilated, irregular in shape, and occupied by a reticular network of fibrin, while interalveolar septa appeared thickened. The proliferation of small capillaries gave rise to plexiform structures and pulmonary capillary hemangiomatosis-like features. Near the alveoli occupied by a dense fibrin network, the medium-sized arteries showed a modified wall and an intraluminal thrombus. This scenario looks quite similar to that found during COVID-19, where the lungs suffer from the attack of the antigen-antibodies complexes and the virus respectively. In both diseases, the final outcome is a severe inflammation, activation of the haemostatic system and fibrinolysis.


Subject(s)
/adverse effects , Lung Injury/etiology , Lung Injury/pathology , Purpura, Thrombocytopenic, Idiopathic/chemically induced , Vaccination/adverse effects , COVID-19/prevention & control , Fibrin , Humans , Lung Injury/diagnostic imaging , Lung Injury/immunology , Male , Microscopy, Electron, Scanning , Middle Aged , Parenchymal Tissue/pathology , Purpura, Thrombocytopenic, Idiopathic/diagnosis , Purpura, Thrombocytopenic, Idiopathic/immunology
3.
Dis Markers ; 2021: 7686374, 2021.
Article in English | MEDLINE | ID: covidwho-1595046

ABSTRACT

Objective: S-Adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) are indicators of global transmethylation and may play an important role as markers of severity of COVID-19. Methods: The levels of plasma SAM and SAH were determined in patients admitted with COVID-19 (n = 56, mean age = 61). Lung injury was identified by computed tomography (CT) in accordance with the CT0-4 classification. Results: SAM was found to be a potential marker of lung damage risk in COVID-19 patients (SAM > 80 nM; CT3,4 vs. CT 0-2: relative ratio (RR) was 3.0; p = 0.0029). SAM/SAH > 6.0 was also found to be a marker of lung injury (CT2-4 vs. CT0,1: RR = 3.47, p = 0.0004). There was a negative association between SAM and glutathione level (ρ = -0.343, p = 0.011). Interleukin-6 (IL-6) levels were associated with SAM (ρ = 0.44, p = 0.01) and SAH (ρ = 0.534, p = 0.001) levels. Conclusions: A high SAM level and high methylation index are associated with the risk of lung injury in patients with COVID-19. The association of SAM with IL-6 and glutathione indicates an important role of transmethylation in the development of cytokine imbalance and oxidative stress in patients with COVID-19.


Subject(s)
COVID-19/complications , Lung Injury/blood , S-Adenosylhomocysteine/blood , S-Adenosylmethionine/blood , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , Atherosclerosis/epidemiology , Biomarkers , COVID-19/epidemiology , Comorbidity , Diabetes Mellitus/epidemiology , Female , Glutathione/blood , Humans , Hypertension/epidemiology , Interleukin-6/blood , Lung Injury/diagnostic imaging , Lung Injury/etiology , Male , Methylation , Middle Aged , Military Personnel , Risk , Tomography, X-Ray Computed , Young Adult
4.
Pediatr Pulmonol ; 57(3): 623-630, 2022 03.
Article in English | MEDLINE | ID: covidwho-1588892

ABSTRACT

AIM: To report on the clinical, laboratory, and radiological findings of adolescents who presented during the SARS-CoV-2 surge with symptoms of Coronavirus disease 2019 (COVID-19), did not test positive for the infection, and were diagnosed with E-cigarette and vaping product use associated lung injury (EVALI). METHODS: A retrospective review of 12 cases of EVALI admitted to the Bristol Meyers Squibb Children's Hospital between February 2020 and June 2020 was conducted. RESULTS: The ages of the patients ranged from 14 to 19 years. There were six males and six females. Three patients had a past history of anxiety, depression, or other psychiatric/mental health disorder, 9 had prolonged coagulation profile (prothrombin time, partial thromboplastin time, and/or International Normalized Ratio), and 11 had elevated inflammatory markers. Eight needed respiratory support. All 12 were negative for SARS-CoV-2 PCR. Four were tested for IgG antibodies and were negative. As these cases were admitted to rule out COVID infection, initial treatment included hydroxychloroquine. Steroids were started only after SARS-CoV-2 PCR was shown to be negative. Urine tetrahydrocannabinol was positive in all cases. Chest X-ray and computed tomography findings showed ground glass opacities. CONCLUSIONS: Clinical and radiological features are similar in both EVALI and SARS-CoV-2 infection. Inflammatory markers are elevated in both conditions. A detailed social and substance use history in patients presenting with "typical" COVID pneumonia like illness is important. EVALI should be ruled in early to start the appropriate treatment. Given the ongoing pandemic, pediatricians and other health-care providers need to be aware of other conditions that can masquerade as SARS-CoV-2.


Subject(s)
COVID-19 , Electronic Nicotine Delivery Systems , Lung Injury , Vaping , Adolescent , Adult , Child , Female , Humans , Lung Injury/diagnostic imaging , Lung Injury/etiology , Male , SARS-CoV-2 , Vaping/adverse effects , Young Adult
5.
South Med J ; 115(1): 8-12, 2022 01.
Article in English | MEDLINE | ID: covidwho-1579722

ABSTRACT

Before the coronavirus disease 2019 (COVID-19) pandemic, vaping-related illness was the prevailing public health concern. The incidence of vaping-related illnesses-mainly e-cigarette, or vaping, product use-associated lung injury (EVALI)-went from a peak in September 2019 to a low in February 2020, and the Centers for Disease Control and Prevention decided to discontinue the collection of EVALI case reports. Despite the decrease in EVALI with the arrival of COVID-19, EVALI should still be considered a differential diagnosis for people with COVID-19 for reasons outlined in this review. This narrative review describes vaping devices, summarizes the adverse health effects of vaping on the lungs and other systems, considers the potential interplay between vaping and COVID-19, and highlights gaps in knowledge about vaping that warrant further research.


Subject(s)
COVID-19/prevention & control , Vaping/adverse effects , COVID-19/psychology , Humans , Lung Injury/epidemiology , Lung Injury/etiology , Vaping/trends
6.
PLoS One ; 16(12): e0260290, 2021.
Article in English | MEDLINE | ID: covidwho-1560699

ABSTRACT

BACKGROUND: With the spread of COVID-19, significant concerns have been raised about the potential increased risk for electronic cigarette (e-cigarette) users for COVID-19 infection and related syndromes. Social media is an increasingly popular source for health information dissemination and discussion, and can affect health outcomes. OBJECTIVE: This study aims to identify the topics in the public vaping discussion in COVID-19-related Twitter posts in order to get insight into public vaping-related perceptions, attitudes and concerns, and to discern possible misinformation and misconceptions around vaping in the COVID-19 pandemic. METHODS: Using the tweets ID database maintained by Georgia State University's Panacea Lab, we downloaded the tweets related to COVID-19 from March 11, 2020, when the World Health Organization declared COVID-19 a pandemic, to February 12, 2021. We used R to analyze the tweets that contained a list of 79 keywords related to vaping. After removing duplicates and tweets created by faked accounts or bots, the final data set consisted of 11,337 unique tweets from 7,710 different users. We performed the latent Dirichlet allocation (LDA) algorithm for topic modeling and carried out a sentiment analysis. RESULTS: Despite fluctuations, the number of daily tweets was relatively stable (average number of daily tweets = 33.4) with a sole conspicuous spike happening on a few days after August 11, 2020 when a research team published findings that teenagers and young adults who vape face a much higher risk of COVID-19 infection than their peers who do not vape. Topic modeling generated 8 topics: linkage between vaping and risk of COVID-19 infection, vaping pneumonia and the origin of COVID-19, vaping and spread of COVID-19, vaping regulation, calling for quitting vaping, protecting youth, similarity between e-cigarette or vaping-associated lung injury (EVALI) and COVID-19, and sales information. Daily sentiment scores showed that the public sentiment was predominantly negative, but became slightly more positive over the course of the study time period. CONCLUSIONS: While some content in the public discourse on vaping before the COVID-19 pandemic continued in Twitter posts during the COVID-19 time period, new topics emerged. We found a substantial amount of anti-vaping discussion and dominantly negative sentiment around vaping during COVID-19, a sharp contrast to the predominantly pro-vaping voice on social media in the pre-COVID-19 period. Continued monitoring of social media conversations around vaping is needed, and the public health community may consider using social media platforms to actively convey scientific information around vaping and vaping cessation.


Subject(s)
COVID-19/diagnosis , Social Media , Vaping/adverse effects , COVID-19/epidemiology , COVID-19/etiology , COVID-19/virology , Databases, Factual , Humans , Lung Injury/etiology , Observational Studies as Topic , Pandemics , Risk Factors , SARS-CoV-2/isolation & purification
8.
Chem Res Toxicol ; 34(10): 2169-2179, 2021 10 18.
Article in English | MEDLINE | ID: covidwho-1461948

ABSTRACT

The outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) has been cause for concern to the medical community, particularly given that this novel illness has coincided with the COVID-19 pandemic, another cause of severe pulmonary illness. Though cannabis e-cigarettes tainted with vitamin E acetate were primarily associated with EVALI, acute lung injuries stemming from cannabis inhalation were reported in the literature prior to 2019, and it has been suggested that cannabis components or additives other than vitamin E acetate may be responsible. Despite these concerning issues, novel cannabis vaporizer ingredients continue to arise, such as Δ8-tetrahydrocannabinol, Δ10-tetrahydrocannabinol, hexahydrocannabinol, and cannabichromene. In order to address cannabis e-cigarette safety and vaping in an effective manner, we provide a comprehensive knowledge of the latest products, delivery modes, and ingredients. This perspective highlights the types of cannabis vaping modalities common to the United States cannabis market, with special attention to cartridge-type cannabis e-cigarette toxicology and their involvement in the EVALI outbreak, in particular, acute lung injurious responses. Novel ingredient chemistry, origins, and legal statuses are reviewed, as well as the toxicology of known cannabis e-cigarette aerosol components.


Subject(s)
Cannabis/chemistry , Lung Injury/etiology , Marijuana Smoking/adverse effects , Plant Extracts/chemistry , Aerosols/chemistry , Aerosols/toxicity , Cannabis/metabolism , Dronabinol/chemistry , Dronabinol/toxicity , Electronic Nicotine Delivery Systems , Humans , Plant Extracts/toxicity , Vitamin E/chemistry
9.
Crit Care Clin ; 37(4): 749-776, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1433017

ABSTRACT

The pathophysiology of acute respiratory distress syndrome (ARDS) is marked by inflammation-mediated disruptions in alveolar-capillary permeability, edema formation, reduced alveolar clearance and collapse/derecruitment, reduced compliance, increased pulmonary vascular resistance, and resulting gas exchange abnormalities due to shunting and ventilation-perfusion mismatch. Mechanical ventilation, especially in the setting of regional disease heterogeneity, can propagate ventilator-associated injury patterns including barotrauma/volutrauma and atelectrauma. Lung injury due to the novel coronavirus SARS-CoV-2 resembles other causes of ARDS, though its initial clinical characteristics may include more profound hypoxemia and loss of dyspnea perception with less radiologically-evident lung injury, a pattern not described previously in ARDS.


Subject(s)
COVID-19 , Lung Injury , Respiratory Distress Syndrome , Humans , Lung , Lung Injury/etiology , Respiration, Artificial/adverse effects , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , SARS-CoV-2
10.
Int J Biochem Cell Biol ; 137: 106039, 2021 08.
Article in English | MEDLINE | ID: covidwho-1318825

ABSTRACT

Following the emergence of electronic cigarette, or vaping product use associated lung injury (EVALI) in 2019 in the US, regulation of e-cigarettes has become globally tighter and the collective evidence of the detrimental effects of vaping has grown. The danger of cellular distress and altered homeostasis is heavily associated with the modifiable nature of electronic cigarette devices. An array of harmful chemicals and elevated concentrations of metals have been detected in e-cigarette aerosols which have been linked to various pathogeneses. Vaping is linked to increased inflammation, altered lipid homeostasis and mitochondrial dysfunction whilst also increasing microbial susceptibility whilst the long-term damage is yet to be observed. The scientific evidence is mounting and highlighting that, along with traditional tobacco cigarette smoking, electronic cigarette vaping is not a safe practice.


Subject(s)
Electronic Nicotine Delivery Systems/statistics & numerical data , Lung Injury/pathology , Vaping/adverse effects , Chronic Disease , Humans , Lung Injury/etiology
11.
PLoS One ; 16(7): e0254167, 2021.
Article in English | MEDLINE | ID: covidwho-1295525

ABSTRACT

Dexamethasone provides benefits in patients with coronavirus disease 2019 (COVID-19), although data regarding immunological profiles and viral clearance are limited. This study aimed to evaluate for differences in biomarkers among patients with severe COVID-19 who did and did not receive dexamethasone. We measured plasma biomarkers of lung epithelial/endothelial injury and inflammation in 31 patients with severe COVID-19 and in 13 controls. Changes in biomarkers and clinical parameters were compared during the 7-day period among COVID-19 patients, and also according to dexamethasone use. Thirty-two patients with severe COVID-19 who received mechanical ventilation (n = 6), high-flow nasal cannula (n = 11), and supplemental oxygen (n = 15) were analyzed. Relative to controls, patients with severe COVID-19 had significantly higher concentrations of biomarkers related to glycocalyx shedding (endocan and syndecan-1), endothelial injury (von Willebrand factor), and inflammation (soluble receptor for advanced glycation end-products [sRAGE] and interleukin-6). The 7-day decreases in biomarkers of endothelial injury (angiopoietin-2 [Ang-2] and intercellular adhesion molecule-1 [ICAM-1]) and sRAGE, but not in the biomarker of lung epithelial injury (surfactant protein D), were correlated with decreases in C-reactive protein and radiologic score at day 7. Twenty patients (63%) received dexamethasone, and the dexamethasone and non-dexamethasone groups differed in terms of disease severity. However, dexamethasone was associated marginally with increased SpO2/FiO2 and significantly with decreases in C-reactive protein and radiologic score after adjusting for baseline imbalances. Furthermore, the dexamethasone group exhibited a significant decrease in the concentrations of Ang-2, ICAM-1, soluble form of the Tie2 receptor (a biomarker of glycocalyx shedding), and sRAGE. Both groups exhibited a clinically insignificant increase in the cycle threshold value. Severe COVID-19 may be characterized by more severe endothelial injury and inflammation, and less severe lung epithelial injury. There is a possibility that dexamethasone improved severe COVID-19 and related endothelial injury without delaying viral clearance.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , COVID-19/drug therapy , Dexamethasone/therapeutic use , Endothelium, Vascular/drug effects , Inflammation/prevention & control , SARS-CoV-2 , Viremia/drug therapy , Adult , Aged , Anti-Inflammatory Agents/pharmacology , Biomarkers , COVID-19/blood , COVID-19/diagnostic imaging , Dexamethasone/pharmacology , Endothelium, Vascular/pathology , Female , Humans , Inflammation/blood , Inflammation/etiology , Lung Injury/blood , Lung Injury/diagnostic imaging , Lung Injury/etiology , Male , Oxygen/blood , Pilot Projects , Viral Load , Viremia/blood
12.
Pediatr Pulmonol ; 56(9): 2918-2924, 2021 09.
Article in English | MEDLINE | ID: covidwho-1293316

ABSTRACT

We describe six teenagers presenting with fever and severe abdominal symptoms admitted with concerns for multisystem inflammatory syndrome in children (MIS-C). Laboratory evaluation revealed elevated markers of inflammation, lymphopenia, and increased D-dimers. Imaging studies revealed multifocal airspace disease and ground-glass opacities. SARS-CoV-2 polymerase chain reaction and serologies were negative. All patients reported a history of vaping, prompting E-cigarette, or vaping, product use-associated lung injury (EVALI) diagnosis. MIS-C has overlapping clinical and laboratory features highlighting the added challenge of diagnosing EVALI during the COVID-19 pandemic. Keywords COVID-19 pandemic, EVALI, MIS-C.


Subject(s)
COVID-19/complications , Systemic Inflammatory Response Syndrome , Adolescent , Humans , Lung Injury/epidemiology , Lung Injury/etiology , Pandemics , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/complications
13.
Epidemiol Infect ; 149: e137, 2021 06 08.
Article in English | MEDLINE | ID: covidwho-1260912

ABSTRACT

The novel coronavirus identified as severe acute respiratory syndrome-coronavirus-2 causes acute respiratory distress syndrome (ARDS). Our aim in this study is to assess the incidence of life-threatening complications like pneumothorax, haemothorax, pneumomediastinum and subcutaneous emphysema, probable risk factors and effect on mortality in coronavirus disease-2019 (COVID-19) ARDS patients treated with mechanical ventilation (MV). Data from 96 adult patients admitted to the intensive care unit with COVID-19 ARDS diagnosis from 11 March to 31 July 2020 were retrospectively assessed. A total of 75 patients abiding by the study criteria were divided into two groups as the group developing ventilator-related barotrauma (BG) (N = 10) and the group not developing ventilator-related barotrauma (NBG) (N = 65). In 10 patients (13%), barotrauma findings occurred 22 ± 3.6 days after the onset of symptoms. The mortality rate was 40% in the BG-group, while it was 29% in the NBG-group with no statistical difference identified. The BG-group had longer intensive care admission duration, duration of time in prone position and total MV duration, with higher max positive end-expiratory pressure (PEEP) levels and lower min pO2/FiO2 levels. The peak lactate dehydrogenase levels in blood were higher by statistically significant level in the BG-group (P < 0.05). The contribution of MV to alveolar injury caused by infection in COVID-19 ARDS patients may cause more frequent barotrauma compared to classic ARDS and this situation significantly increases the MV and intensive care admission durations of patients. In terms of reducing mortality and morbidity in these patients, MV treatment should be carefully maintained within the framework of lung-protective strategies and the studies researching barotrauma pathophysiology should be increased.


Subject(s)
COVID-19/complications , Hemothorax/etiology , Mediastinal Emphysema/etiology , Pneumothorax/etiology , Respiratory Distress Syndrome/complications , Subcutaneous Emphysema/etiology , Adult , Aged , Barotrauma/epidemiology , Barotrauma/etiology , COVID-19/epidemiology , COVID-19/therapy , Female , Hemothorax/epidemiology , Hospital Mortality , Hospitalization , Humans , Intensive Care Units , Lung Injury/epidemiology , Lung Injury/etiology , Male , Mediastinal Emphysema/epidemiology , Middle Aged , Pneumothorax/epidemiology , Respiration, Artificial/adverse effects , Respiratory Distress Syndrome/epidemiology , Respiratory Distress Syndrome/therapy , Retrospective Studies , Risk Factors , SARS-CoV-2 , Subcutaneous Emphysema/epidemiology
14.
J Appl Physiol (1985) ; 130(4): 1143-1151, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1189943

ABSTRACT

Many patients who suffer from pulmonary diseases cannot inflate their lungs normally, as they need mechanical ventilation (MV) to assist them. The stress associated with MV can damage the delicate epithelium in small airways and alveoli, which can cause complications resulting in ventilation-induced lung injuries (VILIs) in many cases, especially in patients with acute respiratory distress syndrome (ARDS). Therefore, efforts were directed to develop safe modes for MV. In our work, we propose a different approach to decrease injuries of epithelial cells (EpCs) upon MV. We alter EpCs' cytoskeletal structure to increase their survival rate during airway reopening conditions associated with MV. We tested two anti-inflammatory drugs dexamethasone (DEX) and transdehydroandrosterone (DHEA) to alter the cytoskeleton. Cultured rat L2 alveolar EpCs were exposed to airway reopening conditions using a parallel-plate perfusion chamber. Cells were exposed to a single bubble propagation to simulate stresses associated with mechanical ventilation in both control and study groups. Cellular injury and cytoskeleton reorganization were assessed via fluorescence microscopy, whereas cell topography was studied via atomic force microscopy (AFM). Our results indicate that culturing cells in media, DEX solution, or DHEA solution did not lead to cell death (static cultures). Bubble flows caused significant cell injury. Preexposure to DEX or DHEA decreased cell death significantly. The AFM verified alteration of cell mechanics due to actin fiber depolymerization. These results suggest potential beneficial effects of DEX and DHEA for ARDS treatment for patients with COVID-19. They are also critical for VILIs and applicable to future clinical studies.NEW & NOTEWORTHY Preexposure of cultured cells to either dexamethasone or transdehydroandrosterone significantly decreases cellular injuries associated with mechanical ventilation due to their ability to alter the cell mechanics. This is an alternative protective method against VILIs instead of common methods that rely on modification of mechanical ventilator modes.


Subject(s)
Androsterone/therapeutic use , Dexamethasone/therapeutic use , Lung Injury/drug therapy , Respiration, Artificial/adverse effects , Animals , COVID-19/complications , COVID-19/drug therapy , COVID-19/therapy , Cell Death/drug effects , Cells, Cultured , Cytoskeleton/drug effects , Epithelial Cells/drug effects , Lung Injury/etiology , Rats
15.
Biomed Pharmacother ; 139: 111586, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1188337

ABSTRACT

It has become evident that the actions of pro-inflammatory cytokines and/or the development of a cytokine storm are responsible for the occurrence of severe COVID-19 during SARS-CoV-2 infection. Although immunomodulatory mechanisms vary among viruses, the activation of multiple TLRs that occurs primarily through the recruitment of adapter proteins such as MyD88 and TRIF contributes to the induction of a cytokine storm. Based on this, controlling the robust production of pro-inflammatory cytokines by macrophages may be applicable as a cellular approach to investigate potential cytokine-targeted therapies against COVID-19. In the current study, we utilized TLR2/MyD88 and TLR3/TRIF co-activated macrophages and evaluated the anti-cytokine storm effect of the traditional Chinese medicine (TCM) formula Babaodan (BBD). An RNA-seq-based transcriptomic approach was used to determine the molecular mode of action. Additionally, we evaluated the anti-inflammatory activity of BBD in vivo using a mouse model of post-viral bacterial infection-induced pneumonia and seven severely ill COVID-19 patients. Our study reveals the protective role of BBD against excessive immune responses in macrophages, where the underlying mechanisms involve the inhibition of the NF-κB and MAPK signaling pathways. In vivo, BBD significantly inhibited the release of IL-6, thus resulting in increased survival rates in mice. Based on limited data, we demonstrated that severely ill COVID-19 patients benefited from BBD treatment due to a reduction in the overproduction of IL-6. In conclusion, our study indicated that BBD controls excessive immune responses and may thus represent a cytokine-targeted agent that could be considered to treating COVID-19.


Subject(s)
Anti-Inflammatory Agents/administration & dosage , COVID-19/drug therapy , COVID-19/immunology , Cytokines/immunology , Medicine, Chinese Traditional/methods , Animals , COVID-19/complications , Female , Gene Expression Profiling , Humans , Lung Injury/etiology , Lung Injury/prevention & control , Mice , Mice, Inbred C57BL , Signal Transduction
16.
ASAIO J ; 67(4): 392-394, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1153287

ABSTRACT

A subset of patients with coronavirus disease 2019 (COVID-19) develop profound respiratory failure and are treated via invasive mechanical ventilation (IMV). Of these, a smaller subset has severe gas exchange abnormalities that are refractory to maximal levels of IMV support. Extracorporeal membrane oxygenation (ECMO) has been used successfully in these circumstances. However, using ECMO only after failure of IMV exposes patients to the risks of ventilator-induced lung injury. We report a successful outcome using ECMO in the setting of COVID-19 in the absence of IMV failure in an awake, nonintubated patient. This approach may be beneficial for selected patients with COVID-19.


Subject(s)
COVID-19/therapy , Extracorporeal Membrane Oxygenation , Lung Injury/etiology , Respiration, Artificial , Respiratory Insufficiency/therapy , Aortic Valve Stenosis/complications , Aortic Valve Stenosis/surgery , COVID-19/complications , Humans , Male , Middle Aged , Treatment Outcome
17.
BMJ Case Rep ; 14(3)2021 Mar 05.
Article in English | MEDLINE | ID: covidwho-1133187

ABSTRACT

The cardiovascular effects of electronic cigarette use are unknown. Here we present a case describing a young, previously healthy patient without prior cardiopulmonary comorbidities who developed severe, acute cardiac dysfunction in the setting of e-cigarette use, in addition to the more commonly encountered respiratory symptoms. While pulmonary manifestations are characteristic of e-cigarette or vaping product use-associated lung injury (EVALI), the acute and reversible cardiomyopathy seen here has not been previously described in association with either EVALI or e-cigarette use.


Subject(s)
Electronic Nicotine Delivery Systems , Lung Injury , Tobacco Products , Vaping , Humans , Lung , Lung Injury/etiology , Vaping/adverse effects
19.
Acta Biomed ; 91(4): e2020142, 2020 11 10.
Article in English | MEDLINE | ID: covidwho-1060458

ABSTRACT

The novel coronavirus disease (COVID-19) has affected people around the world both physically and psychologically. As result, developing coronavirus-specific vaccine and/or therapeutics is now a top priority for public health agencies. Since our findings about COVID-19 are relatively new, the current knowledge about the molecular mechanism involved in pathogenicity and virulence of the novel coronavirus is not advanced. Understanding angiotensin-converting enzyme 2 (ACE2), the receptor for the coronavirus, is significantly important. To better illustrate the role of ACE2 in the severity of COVID-19 and the impact of currently used drugs on this receptor, this paper briefly reviews newly published articles in this regard.


Subject(s)
Angiotensin-Converting Enzyme 2/physiology , COVID-19/complications , Lung Injury/etiology , Humans
20.
J Thorac Oncol ; 15(11): 1727-1737, 2020 11.
Article in English | MEDLINE | ID: covidwho-1056990

ABSTRACT

In the summer of 2019, there was a rise in clusters of adolescents and young adults in the United States reporting to emergency departments with acute respiratory distress related to use of e-cigarette (electronic cigarette) or vaping. The number of patients with e-cigarette or vaping-associated lung injury continued to rise through the summer before peaking in September 2019. Through the efforts of state and federal public health agencies, officials were able to define the condition, identify the relationship of the respiratory injury to tetrahydrocannabinol-containing products, and stem the rise in new cases. In this report, we present a comprehensive review of the clinical characteristics and features of patients with e-cigarette or vaping-associated lung injury and guidelines for patient care and management to inform and navigate clinicians who may encounter these patients in their clinical practice.


Subject(s)
COVID-19 , Electronic Nicotine Delivery Systems , Lung Injury , Lung Neoplasms , Vaping , Adolescent , Female , Humans , Lung Injury/epidemiology , Lung Injury/etiology , Lung Injury/therapy , Male , Pandemics , SARS-CoV-2 , United States/epidemiology , Vaping/adverse effects , Young Adult
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