Pathogenesis‐directed therapy of 2019 novel coronavirus disease

Journal of Medical Virology, Journal Year: 2020, Volume and Issue: 93(3), P. 1320 - 1342

Published: Oct. 19, 2020

The 2019 novel coronavirus disease (COVID-19) now is considered a global public health emergency. One of the unprecedented challenges defining optimal therapy for those patients with severe pneumonia and systemic manifestations COVID-19. should be largely based on pathogenesis infections caused by this acute respiratory syndrome 2 (SARS-CoV-2). Since onset COVID-19, there have been many prepublications publications reviewing COVID-19 as well SARS-CoV-2. However, no comprehensive reviews that link therapies to pathogenic mechanisms To SARS-CoV-2, we performed search through MEDLINE, PubMed, medRxiv, EMBASE, Scopus, Google Scholar, Web Science using following keywords: coronavirus, pathology, pathologic, pathogenesis, pathophysiology, pneumonia, infection, pulmonary cardiovascular gastroenteritis, autopsy findings, viral sepsis, endotheliitis, thrombosis, coagulation abnormalities, immunology, humeral immunity, cellular inflammation, cytokine storm, superantigen, therapy, treatment, therapeutics, immune-based antiviral agents, oxygen anticoagulation adjuvant preventative therapy. Opinions expressed in review also are personal experience clinicians, authors, peer reviewers, editors. This narrative linking SARS-CoV-2 has resulted six major therapeutic goals These listed below: 1. first goal identifying require both testing best accomplished molecular test from symptomatic determining saturation such pulse oximeter. Whether illness influenza, or another pathogen, an less than 90% means patient requires medical assistance. 2. second correct hypoxia. generally hospitalization therapy; other respiratory-directed prone positioning mechanical ventilation often used attempt hypoxemia due 3. third reduce load Ideally, would oral agent available seen use oseltamivir phosphate influenza. taken early course infection. Such not yet. Currently, two options reducing post-Covid-19 plasma high neutralizing antibody titer against intravenous remdesivir; hospitalization. 4. fourth identify address hyperinflammation phase hospitalized patients. fever elevated C-reactive protein useful diagnosing syndrome. Low-dose dexamethasone currently approach. 5. fifth hypercoagulability Patients who benefit can identified marked increase d-dimer prothrombin time decrease fibrinogen. disseminated intravascular coagulation-like phase, low weight heparin preferred. Anticoagulation unfractionated preferred kidney injuries. 6. last prophylaxis persons yet infected. Potential supplements include vitamin D zinc. Although data extremely strong, it argued almost 50% population worldwide deficiency. Correcting deficiency beneficial regardless any impact Similarly, zinc important supplement one's diet effect As emerging found more effective identified, they substituted presented review.

Language: Английский

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Cerebral venous thrombosis in COVID-19

Diabetes & Metabolic Syndrome Clinical Research & Reviews, Journal Year: 2021, Volume and Issue: 15(3), P. 1039 - 1045

Published: May 1, 2021

Language: Английский

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COVID‐19–related laboratory coagulation findings

International Journal of Laboratory Hematology, Journal Year: 2021, Volume and Issue: 43(S1), P. 36 - 42

Published: July 1, 2021

Abstract The alterations in the hemostatic balance COVID‐19 patients are strongly disturbed and contribute to a high prothrombotic status. rate of venous thromboembolism goes along with derangements coagulation laboratory parameters. Hemostasis testing has an important role diagnosed patients. Elevated D‐dimer levels were found be crucial marker risk assessment thrombosis diagnostic approach also includes prothrombin time platelet count. Fibrinogen might give indication for worsening coagulopathy. Other markers (activated partial thromboplastin (aPTT), fibrinolysis parameters, factors, natural anticoagulants, antiphospholipid antibodies parameters obtained by thromboelastography or thrombin generation assays) have been described as being deranged. These may help understand pathophysiology but currently no place diagnosis management For monitoring heparin anticoagulant therapy, anti‐Xa assay is suggested, because severe acute‐phase reaction (high fibrinogen factor VIII) shortens aPTT.

Language: Английский

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Role of pirfenidone in TGF-β pathways and other inflammatory pathways in acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a theoretical perspective

Pharmacological Reports, Journal Year: 2021, Volume and Issue: 73(3), P. 712 - 727

Published: April 21, 2021

Language: Английский

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Silibinin as potential tool against SARS‐Cov‐2: In silico spike receptor‐binding domain and main protease molecular docking analysis, and in vitro endothelial protective effects

Phytotherapy Research, Journal Year: 2021, Volume and Issue: 35(8), P. 4616 - 4625

Published: April 6, 2021

The spread of SARS‐CoV‐2, along with the lack targeted medicaments, encouraged research existing drugs for repurposing. rapid response to SARS‐CoV‐2 infection comprises a complex interaction cytokine storm, endothelial dysfunction, inflammation, and pathologic coagulation. Thus, active molecules targeting multiple steps in lifecycle are highly wanted. Herein we explored silico capability silibinin from Silybum marianum interact main target proteins, vitro effects against cytokine‐induced‐inflammation dysfunction human umbilical vein cells (HUVECs). Computational analysis revealed that forms stable spike protein RBD, has good negative binding affinity Mpro, interacts many residues on site thus supporting its potentiality inhibiting viral entry replication. Moreover, HUVECs pretreatment reduced TNF‐α‐induced gene expression proinflammatory genes IL‐6 MCP‐1, as well PAI‐1, critical factor coagulopathy thrombosis, ET‐1, peptide involved hemostatic vasoconstriction. Then, due endothelium antiinflammatory anticoagulant properties proteins demonstrated herein, could be strong candidate COVID‐19 management multitarget perspective.

Language: Английский

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