Résumé
PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19) is a highly contagious and potentially lethal pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No specific antiviral treatment is currently available. The purpose of this review is to highlight the main repurposed drug treatments with in-vitro or in-vivo efficacy against the SARS-CoV-2. RECENT FINDINGS: Recent clinical trials suggested remdesivir, IFN-ß-1b and favipiravir have potential clinical and/or virological benefits on patients with COVID-19. Short course of stress dose of corticosteroids might be used as adjunctive treatment to patients who are late presenters with cytokine storm. Convalescent plasma from recovered COVID-19 patients with high neutralizing antibody might also be beneficial in the treatment of severe disease. SUMMARY: Early effective antiviral therapy in COVID-19 patients will suppress the SARS-CoV-2 viral load. Adjunctive therapy with corticosteroid and convalescent plasma might further ameliorate the cytokine response. Further randomized clinical trials of combination therapy are needed.
Sujets)
Betacoronavirus , Infections à coronavirus/traitement médicamenteux , Pneumopathie virale/traitement médicamenteux , Hormones corticosurrénaliennes/usage thérapeutique , Antiviraux/usage thérapeutique , COVID-19 , Infections à coronavirus/immunologie , Infections à coronavirus/thérapie , Humains , Immunisation passive , Interféron bêta/usage thérapeutique , Pandémies , Pneumopathie virale/immunologie , SARS-CoV-2 , ,Résumé
We reviewed the diagnostic accuracy of SARS-CoV-2 serological tests. Random-effects models yielded a summary sensitivity of 82% for IgM, and 85% for IgG and total antibodies. For specificity, the pooled estimate were 98% for IgM and 99% for IgG and total antibodies. In populations with ≤ 5% of seroconverted individuals, unless the assays have perfect (i.e. 100%) specificity, the positive predictive value would be ≤ 88%. Serological tests should be used for prevalence surveys only in hard-hit areas.
Sujets)
Anticorps antiviraux/sang , Techniques de laboratoire clinique/méthodes , Infections à Coronaviridae/diagnostic , Infections à coronavirus/diagnostic , Coronavirus/immunologie , Pneumopathie virale/diagnostic , Tests sérologiques/normes , Syndrome respiratoire aigu sévère/immunologie , Betacoronavirus , COVID-19 , Dépistage de la COVID-19 , Techniques de laboratoire clinique/normes , Coronavirus/isolement et purification , Infections à coronavirus/épidémiologie , Infections à coronavirus/immunologie , Humains , Immunoglobuline G/sang , Immunoglobuline M/sang , Pandémies , Pneumopathie virale/épidémiologie , Pneumopathie virale/immunologie , Valeur prédictive des tests , SARS-CoV-2 , Sensibilité et spécificité , Tests sérologiques/méthodes , Syndrome respiratoire aigu sévère/sangSujets)
Betacoronavirus/immunologie , Techniques de laboratoire clinique , Infections à coronavirus/diagnostic , Politique de santé , Pneumopathie virale/diagnostic , COVID-19 , Dépistage de la COVID-19 , Infections à coronavirus/immunologie , Erreurs de diagnostic , Angleterre , Humains , Pandémies , Pneumopathie virale/immunologie , SARS-CoV-2 , Médecine d'État , Facteurs tempsRésumé
OBJECTIVE: To investigate the characteristics and predictive roles of lymphocyte subsets in COVID-19 patients. METHOD: We evaluated lymphocyte subsets and other clinical features of COVID-19 patients, and analyzed their potential impacts on COVID-19 outcomes. RESULTS: 1. Lymphocyte subset counts in the peripheral blood of patients with COVID-19 were significantly reduced, especially in patients with severe disease. 2. In patients with non-severe disease, the time from symptom onset to hospital admission was positively correlated with total T cell counts. 3. Among COVID-19 patients who did not reach the composite endpoint, lymphocyte subset counts were higher than in patients who had reached the composite endpoint. 4. The Kaplan-Meier survival curves showed significant differences in COVID-19 patients, classified by the levels of total, CD8+, and CD4+ T cells at admission. CONCLUSION: Our study showed that total, CD8+, and CD4+ T cell counts in patients with COVID-19 were significantly reduced, especially in patients with severe disease. Lower T lymphocyte subsets were significantly associated with a higher occurrence of composite endpoint events. These subsets may help identify patients with a high risk of composite endpoint events.
Sujets)
Betacoronavirus , Infections à coronavirus/immunologie , Sous-populations de lymphocytes/physiologie , Pneumopathie virale/immunologie , Adulte , COVID-19 , Femelle , Humains , Numération des lymphocytes , Mâle , Adulte d'âge moyen , Pandémies , SARS-CoV-2Sujets)
Lymphocytes B/immunologie , Betacoronavirus/immunologie , Infections à coronavirus/immunologie , Syndrome de libération de cytokines/immunologie , Immunité cellulaire , Pneumopathie virale/immunologie , Lymphocytes T/immunologie , Anticorps neutralisants/immunologie , Anticorps neutralisants/métabolisme , Anticorps antiviraux/immunologie , Anticorps antiviraux/métabolisme , Lymphocytes B/métabolisme , Betacoronavirus/isolement et purification , COVID-19 , Infections à coronavirus/complications , Infections à coronavirus/épidémiologie , Infections à coronavirus/virologie , Humains , Mémoire immunologique , Pandémies , Pneumopathie virale/complications , Pneumopathie virale/épidémiologie , Pneumopathie virale/virologie , SARS-CoV-2 , Indice de gravité de la maladieRésumé
Copper (Cu) is an essential micronutrient for both pathogens and the hosts during viral infection. Cu is involved in the functions of critical immune cells such as T helper cells, B cells, neutrophils natural killer (NK) cells, and macrophages. These blood cells are involved in the killing of infectious microbes, in cell-mediated immunity and the production of specific antibodies against the pathogens. Cu-deficient humans show an exceptional susceptibility to infections due to the decreased number and function of these blood cells. Besides, Cu can kill several infectious viruses such as bronchitis virus, poliovirus, human immunodeficiency virus type 1(HIV-1), other enveloped or nonenveloped, single- or double-stranded DNA and RNA viruses. Moreover, Cu has the potent capacity of contact killing of several viruses, including SARS-CoV-2. Since the current outbreak of the COVID-19 continues to develop, and there is no vaccine or drugs are currently available, the critical option is now to make the immune system competent to fight against the SARS-CoV-2. Based on available data, we hypothesize that enrichment of plasma copper levels will boost both the innate and adaptive immunity in people. Moreover, owing to its potent antiviral activities, Cu may also act as a preventive and therapeutic regime against COVID-19.
Sujets)
Cuivre/usage thérapeutique , Infections à coronavirus/traitement médicamenteux , Pneumopathie virale/traitement médicamenteux , Immunité acquise , Antiviraux/usage thérapeutique , Betacoronavirus , COVID-19 , Infections à coronavirus/immunologie , Humains , Système immunitaire , Immunité innée , Pandémies , Pneumopathie virale/immunologie , Espèces réactives de l'oxygène/métabolisme , SARS-CoV-2 , Résultat thérapeutique ,Sujets)
Betacoronavirus/pathogénicité , Érythème pernio/anatomopathologie , Érythème pernio/virologie , Infections à coronavirus/anatomopathologie , Infections à coronavirus/virologie , Pneumopathie virale/anatomopathologie , Pneumopathie virale/virologie , Administration par voie topique , Adolescent , Hormones corticosurrénaliennes , COVID-19 , Infections à coronavirus/immunologie , Test ELISA , Femelle , Doigts/vascularisation , Doigts/virologie , Humains , Pandémies , Éducation du patient comme sujet , Pneumopathie virale/immunologie , Quarantaine , SARS-CoV-2 , Orteils/vascularisation , Orteils/virologieSujets)
Production d'anticorps , Facilitation dépendante des anticorps , Betacoronavirus/pathogénicité , Infections à coronavirus/immunologie , Pneumopathie virale/immunologie , Betacoronavirus/immunologie , COVID-19 , Vaccins contre la COVID-19 , Chine , Coronavirus/pathogénicité , Infections à coronavirus/prévention et contrôle , Virus de la dengue/pathogénicité , Humains , Immunisation passive , Pandémies , Récepteurs au complément/métabolisme , Virus du SRAS/pathogénicité , SARS-CoV-2 , Indice de gravité de la maladie , Vaccination , Vaccins antiviraux/immunologieRésumé
The coronavirus disease 2019 (COVID-19), the result of an infection with the new virus, SARS-CoV-2, is rapidly spreading worldwide. It is largely unknown whether the occurrence of COVID-19 in patients with rheumatic immune diseases has some specific manifestations, or makes them more prone to rapidly progress into severe COVID-19. In this case report, we describe the clinical features of 5 rheumatic immune disease patients with the concomitant presence of COVID-19. Amongst these patients, 4 had rheumatoid arthritis (RA) and 1 had systemic sclerosis (SSc). Two patients had a history of close contact with a COVID-19 patient. The age of the patients ranged between 51 and 79 years. Fever (80%), cough (80%), dyspnea (40%), and fatigue (20%) were the most common presenting symptoms. Laboratory investigations revealed leukopenia and lymphopenia in 2 patients. In all the patients, chest computerized tomography (CT) revealed patchy ground glass opacities in the lungs. During the hospital stay, the condition of two patients remained the same (i.e., mild COVID-19), two patients progressed to the severe COVID-19, and one patient worsened to the critically ill COVID-19. These patients were treated with antiviral agents for COVID-19, antibiotics for secondary bacterial infections, and immunomodulatory agents for rheumatic immune diseases. All the patients responded well, were cured of COVID-19, and subsequently discharged.
Sujets)
Antiviraux/usage thérapeutique , Polyarthrite rhumatoïde , Infections à coronavirus , Immunomodulation , Pandémies , Pneumopathie virale , Sclérodermie systémique , Sujet âgé , Polyarthrite rhumatoïde/diagnostic , Polyarthrite rhumatoïde/épidémiologie , Polyarthrite rhumatoïde/thérapie , Betacoronavirus/isolement et purification , Hémogramme/méthodes , COVID-19 , Infections à coronavirus/diagnostic , Infections à coronavirus/épidémiologie , Infections à coronavirus/immunologie , Infections à coronavirus/thérapie , Maladie grave/thérapie , Évolution de la maladie , Femelle , Humains , Poumon/imagerie diagnostique , Mâle , Adulte d'âge moyen , Pneumopathie virale/diagnostic , Pneumopathie virale/épidémiologie , Pneumopathie virale/immunologie , Pneumopathie virale/thérapie , SARS-CoV-2 , Sclérodermie systémique/diagnostic , Sclérodermie systémique/épidémiologie , Sclérodermie systémique/thérapie , Évaluation des symptômes/méthodes , Tomodensitométrie/méthodes , Résultat thérapeutiqueSujets)
Techniques de laboratoire clinique/méthodes , Techniques de laboratoire clinique/normes , Infections à coronavirus/diagnostic , Infections à coronavirus/prévention et contrôle , Pandémies/prévention et contrôle , Pneumopathie virale/diagnostic , Pneumopathie virale/prévention et contrôle , Antigènes viraux/analyse , COVID-19 , Dépistage de la COVID-19 , , Techniques de laboratoire clinique/économie , Techniques de laboratoire clinique/tendances , Infections à coronavirus/économie , Infections à coronavirus/immunologie , Infections à coronavirus/virologie , Désinfection des mains , Humains , Inde/épidémiologie , Masques , Pneumopathie virale/immunologie , Pneumopathie virale/virologie , Tests de grossesse , ARN viral/analyse , Sensibilité et spécificité , Isolement social , Facteurs temps , États-Unis/épidémiologie , Food and Drug Administration (USA) , Charge virale , Organisation mondiale de la santéRésumé
Two recent Lancet and Lancet Oncology papers report that cancer patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have higher mortality rates. Common independent factors associated with increased risk of death were older age, history of smoking status, number of comorbidities, more advanced performance status, and active cancer.
Sujets)
Betacoronavirus/pathogénicité , Infections à coronavirus/mortalité , Prévention des infections/normes , Transmission de maladie infectieuse du professionnel de santé au patient/prévention et contrôle , Tumeurs/mortalité , Pneumopathie virale/mortalité , Facteurs âges , Sujet âgé , Betacoronavirus/immunologie , COVID-19 , Infections à coronavirus/immunologie , Infections à coronavirus/transmission , Infections à coronavirus/virologie , Humains , Tumeurs/immunologie , Tumeurs/thérapie , Pandémies , Pneumopathie virale/immunologie , Pneumopathie virale/transmission , Pneumopathie virale/virologie , Appréciation des risques , Facteurs de risque , SARS-CoV-2Résumé
SOURCE CITATION: Ye Z, Rochwerg B, Wang Y, et al. Treatment of patients with nonsevere and severe coronavirus disease 2019: an evidence-based guideline. CMAJ. 2020;192:E536-45. 32350002.
Sujets)
Infections à coronavirus/thérapie , Pneumopathie virale/thérapie , Hormones corticosurrénaliennes/usage thérapeutique , Antiviraux/usage thérapeutique , Betacoronavirus , COVID-19 , Infections à coronavirus/immunologie , Humains , Immunisation passive/méthodes , Pandémies , Plasma sanguin , Pneumopathie virale/immunologie , SARS-CoV-2 , Indice de gravité de la maladie ,Sujets)
Immunité acquise , Betacoronavirus/immunologie , Infections à coronavirus/immunologie , Documentation/éthique , Pneumopathie virale/immunologie , Vaccins antiviraux , COVID-19 , Vaccins contre la COVID-19 , Infections à coronavirus/prévention et contrôle , Humains , Pandémies , SARS-CoV-2 , VaccinationRésumé
As severe acute respiratory syndrome coronavirus 2 continues to spread worldwide, there have been increasing reports from Europe, North America, Asia, and Latin America describing children and adolescents with COVID-19-associated multisystem inflammatory conditions. However, the association between multisystem inflammatory syndrome in children and COVID-19 is still unknown. We review the epidemiology, causes, clinical features, and current treatment protocols for multisystem inflammatory syndrome in children and adolescents associated with COVID-19. We also discuss the possible underlying pathophysiological mechanisms for COVID-19-induced inflammatory processes, which can lead to organ damage in paediatric patients who are severely ill. These insights provide evidence for the need to develop a clear case definition and treatment protocol for this new condition and also shed light on future therapeutic interventions and the potential for vaccine development. TRANSLATIONS: For the French, Chinese, Arabic, Spanish and Russian translations of the abstract see Supplementary Materials section.
Sujets)
Betacoronavirus , Infections à coronavirus/épidémiologie , Infections à coronavirus/immunologie , Pneumopathie virale/épidémiologie , Pneumopathie virale/immunologie , Syndrome de réponse inflammatoire généralisée/épidémiologie , Syndrome de réponse inflammatoire généralisée/immunologie , Adolescent , Anti-inflammatoires non stéroïdiens/usage thérapeutique , Antiviraux/usage thérapeutique , COVID-19 , Enfant , Enfant d'âge préscolaire , Infections à coronavirus/traitement médicamenteux , Infections à coronavirus/virologie , Femelle , Humains , Immunoglobulines par voie veineuse/usage thérapeutique , Nourrisson , Nouveau-né , Mâle , Maladie de Kawasaki/traitement médicamenteux , Maladie de Kawasaki/immunologie , Pandémies , Pneumopathie virale/traitement médicamenteux , Pneumopathie virale/virologie , Facteurs de risque , SARS-CoV-2 , Syndrome de réponse inflammatoire généralisée/traitement médicamenteux , Syndrome de réponse inflammatoire généralisée/virologie , Jeune adulte ,Résumé
The COVID-19 pandemic has spread to many countries around the world, but the infection and death rates vary widely. One country that appeared to have kept the infection under control despite limited societal restrictions is Japan. This commentary explores why Japan may have, up to now, been spared an escalation of the SARS-CoV-2 infections.
Sujets)
Betacoronavirus , Infections à coronavirus/épidémiologie , Pneumopathie virale/épidémiologie , Angiotensin-converting enzyme 2 , Vaccin BCG/immunologie , COVID-19 , Contrôle des maladies transmissibles , Infections à coronavirus/génétique , Infections à coronavirus/immunologie , Culture (sociologie) , Acides gras monoinsaturés , Variation génétique , Antigènes d'histocompatibilité de classe I/génétique , Antigènes d'histocompatibilité de classe I/immunologie , Humains , Japon/épidémiologie , Pandémies , Peptidyl-Dipeptidase A/génétique , Pneumopathie virale/génétique , Pneumopathie virale/immunologie , SARS-CoV-2Sujets)
Donneurs de sang/législation et jurisprudence , Infections à coronavirus/immunologie , Infections à coronavirus/thérapie , Plasma sanguin/immunologie , Pneumopathie virale/immunologie , Pneumopathie virale/thérapie , Syndrome d'immunodéficience acquise/épidémiologie , Syndrome d'immunodéficience acquise/transmission , Transfusion sanguine , COVID-19 , Hépatite B/épidémiologie , Hépatite B/transmission , Hépatite C/épidémiologie , Hépatite C/transmission , Humains , Immunisation passive , Mâle , Pandémies , Plasma sanguin/virologie , Minorités sexuelles , États-Unis , Food and Drug Administration (USA) ,Sujets)
Betacoronavirus/pathogénicité , Prise de décision clinique , Infections à coronavirus/traitement médicamenteux , Infections à coronavirus/immunologie , Interleukine-6/antagonistes et inhibiteurs , Pneumopathie virale/traitement médicamenteux , Pneumopathie virale/immunologie , Stéroïdes/effets indésirables , Stéroïdes/usage thérapeutique , Incertitude , Anticorps monoclonaux humanisés/pharmacologie , Anticorps monoclonaux humanisés/usage thérapeutique , Betacoronavirus/effets des médicaments et des substances chimiques , Betacoronavirus/immunologie , COVID-19 , Infections à coronavirus/mortalité , Infections à coronavirus/anatomopathologie , Humains , Immunosuppresseurs/pharmacologie , Immunosuppresseurs/usage thérapeutique , Interleukine-6/immunologie , Macrophages/effets des médicaments et des substances chimiques , Macrophages/immunologie , Pandémies , Médecins/psychologie , Pneumopathie virale/mortalité , Pneumopathie virale/anatomopathologie , Essais contrôlés randomisés comme sujet , SARS-CoV-2 , Stéroïdes/administration et posologie , Stéroïdes/pharmacologie , Lymphocytes T/effets des médicaments et des substances chimiques , Lymphocytes T/immunologieRésumé
Respiratory immune characteristics associated with Coronavirus Disease 2019 (COVID-19) severity are currently unclear. We characterized bronchoalveolar lavage fluid immune cells from patients with varying severity of COVID-19 and from healthy people by using single-cell RNA sequencing. Proinflammatory monocyte-derived macrophages were abundant in the bronchoalveolar lavage fluid from patients with severe COVID-9. Moderate cases were characterized by the presence of highly clonally expanded CD8+ T cells. This atlas of the bronchoalveolar immune microenvironment suggests potential mechanisms underlying pathogenesis and recovery in COVID-19.
Sujets)
Betacoronavirus/pathogénicité , Infections à coronavirus/immunologie , Infections à coronavirus/anatomopathologie , Pneumopathie virale/immunologie , Pneumopathie virale/anatomopathologie , Analyse sur cellule unique , Liquide de lavage bronchoalvéolaire/immunologie , Liquide de lavage bronchoalvéolaire/virologie , Lymphocytes T CD8+/immunologie , Lymphocytes T CD8+/virologie , COVID-19 , Infections à coronavirus/diagnostic , Infections à coronavirus/virologie , Humains , Pandémies , Pneumopathie virale/diagnostic , Pneumopathie virale/virologie , SARS-CoV-2Résumé
A male bias in mortality has emerged in the COVID-19 pandemic, which is consistent with the pathogenesis of other viral infections. Biological sex differences may manifest themselves in susceptibility to infection, early pathogenesis, innate viral control, adaptive immune responses or the balance of inflammation and tissue repair in the resolution of infection. We discuss available sex-disaggregated epidemiological data from the COVID-19 pandemic, introduce sex-differential features of immunity and highlight potential sex differences underlying COVID-19 severity. We propose that sex differences in immunopathogenesis will inform mechanisms of COVID-19, identify points for therapeutic intervention and improve vaccine design and increase vaccine efficacy.