Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019 DOI Open Access
Adeel Zubair, Lindsay McAlpine,

Tova Gardin

et al.

JAMA Neurology, Journal Year: 2020, Volume and Issue: 77(8), P. 1018 - 1018

Published: May 29, 2020

Importance

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019, causing human disease 2019 (COVID-19), which has now spread into a worldwide pandemic. The pulmonary manifestations of COVID-19 have been well described the literature. Two similar coronaviruses that cause Middle East (MERS-CoV) and severe (SARS-CoV-1) are known to central peripheral nervous systems. Emerging evidence suggests neurologic consequences as well.

Observations

This review serves summarize available information regarding system, identify potential tissue targets routes entry SARS-CoV-2 describe range clinical neurological complications reported thus far their pathogenesis. Viral neuroinvasion may be achieved by several routes, including transsynaptic transfer across infected neurons, via olfactory nerve, infection vascular endothelium, or leukocyte migration blood-brain barrier. most common complaints anosmia, ageusia, headache, but other diseases, such stroke, impairment consciousness, seizure, encephalopathy, also reported.

Conclusions Relevance

Recognition understanding disorders associated with lead improved outcomes better treatment algorithms. Further neuropathological studies will crucial pathogenesis longitudinal cognitive assessment individuals after recovery from understand natural history system monitor for any long-term sequelae.

Language: Английский

The trinity of COVID-19: immunity, inflammation and intervention DOI Creative Commons
Matthew Zirui Tay, Chek Meng Poh, Laurent Rénia

et al.

Nature reviews. Immunology, Journal Year: 2020, Volume and Issue: 20(6), P. 363 - 374

Published: April 28, 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of ongoing disease 2019 (COVID-19) pandemic. Alongside investigations into virology SARS-CoV-2, understanding fundamental physiological and immunological processes underlying clinical manifestations COVID-19 vital for identification rational design effective therapies. Here, we provide an overview pathophysiology SARS-CoV-2 infection. We describe interaction with immune system subsequent contribution dysfunctional responses to progression. From nascent reports describing make inferences on basis parallel pathophysiological features other human coronaviruses targeting lower tract - severe (SARS-CoV) Middle East (MERS-CoV). Finally, highlight implications these approaches potential therapeutic interventions that target viral infection and/or immunoregulation.

Language: Английский

Citations

4321
Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19) DOI Open Access
James M. Sanders, Marguerite L. Monogue,

Tomasz Z. Jodlowski

et al.

JAMA, Journal Year: 2020, Volume and Issue: unknown

Published: April 13, 2020

Importance

The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given rapid pace scientific discovery clinical data generated large number people rapidly infected SARS-CoV-2, clinicians need accurate evidence regarding medical treatments this infection.

Observations

No proven therapies virus currently exist. expanding knowledge SARS-CoV-2 virology provides a significant potential drug targets. most promising therapy is remdesivir. Remdesivir has potent in vitro activity against but it not US Food Drug Administration approved being tested ongoing randomized trials. Oseltamivir been shown have efficacy, corticosteroids are recommended. Current does support stopping angiotensin-converting enzyme inhibitors or angiotensin receptor blockers patients with COVID-19.

Conclusions Relevance

COVID-19 represents greatest global public health crisis generation and, potentially, since influenza outbreak 1918. speed volume trials launched investigate highlight both capability produce high-quality even middle pandemic. date.

Language: Английский

Citations

2399
COVID-19 pathophysiology: A review DOI Open Access
Koichi Yuki,

Miho Fujiogi,

Sophia Koutsogiannaki

et al.

Clinical Immunology, Journal Year: 2020, Volume and Issue: 215, P. 108427 - 108427

Published: April 20, 2020

Language: Английский

Citations

2149
Coronavirus Disease 2019–COVID-19 DOI
Kuldeep Dhama, Khan Sharun, Ruchi Tiwari

et al.

Clinical Microbiology Reviews, Journal Year: 2020, Volume and Issue: 33(4)

Published: June 23, 2020

In recent decades, several new diseases have emerged in different geographical areas, with pathogens including Ebola virus, Zika Nipah and coronaviruses (CoVs). Recently, a type of viral infection Wuhan City, China, initial genomic sequencing data this virus do not match previously sequenced CoVs, suggesting novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility other routes should be ruled out.

Language: Английский

Citations

1795
Potential Effects of Coronaviruses on the Cardiovascular System DOI Open Access
Mohammad Madjid,

Payam Safavi‐Naeini,

Scott D. Solomon

et al.

JAMA Cardiology, Journal Year: 2020, Volume and Issue: 5(7), P. 831 - 831

Published: March 27, 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes disease 2019 (COVID-19) has reached a pandemic level. Coronaviruses are known to affect the cardiovascular system. We review basics of coronaviruses, with focus on COVID-19, along their effects system.Coronavirus can cause viral pneumonia additional extrapulmonary manifestations and complications. A large proportion patients have underlying and/or cardiac risk factors. Factors associated mortality include male sex, advanced age, presence comorbidities including hypertension, diabetes mellitus, diseases, cerebrovascular diseases. Acute injury determined by elevated high-sensitivity troponin levels is commonly observed in severe cases strongly mortality. distress also mortality.Coronavirus high inflammatory burden that induce vascular inflammation, myocarditis, arrhythmias. Extensive efforts underway find specific vaccines antivirals against SARS-CoV-2. Meanwhile, factors conditions should be judiciously controlled per evidence-based guidelines.

Language: Английский

Citations

1724
Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study DOI Creative Commons
Nicole M. Kuderer, Toni K. Choueiri, Dimpy P. Shah

et al.

The Lancet, Journal Year: 2020, Volume and Issue: 395(10241), P. 1907 - 1918

Published: May 28, 2020

Language: Английский

Citations

1703
Immunology of COVID-19: Current State of the Science DOI Creative Commons
Nicolas Vabret, Graham J. Britton, Conor Gruber

et al.

Immunity, Journal Year: 2020, Volume and Issue: 52(6), P. 910 - 941

Published: May 6, 2020

Language: Английский

Citations

1662
Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19 DOI Open Access
Joshua D. Geleris, Yifei Sun, Jonathan Platt

et al.

New England Journal of Medicine, Journal Year: 2020, Volume and Issue: 382(25), P. 2411 - 2418

Published: May 7, 2020

Hydroxychloroquine has been widely administered to patients with Covid-19 without robust evidence supporting its use. We examined the association between hydroxychloroquine use and intubation or death at a large medical center in New York City. Data were obtained regarding consecutive hospitalized Covid-19, excluding those who intubated, died, discharged within 24 hours after presentation emergency department (study baseline). The primary end point was composite of time-to-event analysis. compared outcomes received did not, using multivariable Cox model inverse probability weighting according propensity score. Of 1446 patients, 70 excluded from remaining 1376 during median follow-up 22.5 days, 811 (58.9%) (600 mg twice on day 1, then 400 daily for 5 days); 45.8% treated department, 85.9% 48 hours. Hydroxychloroquine-treated more severely ill baseline than not receive (median ratio partial pressure arterial oxygen fraction inspired oxygen, 223 vs. 360). Overall, 346 (25.1%) had end-point event (180 whom 66 subsequently 166 died intubation). In main analysis, there no significant (hazard ratio, 1.04, 95% confidence interval, 0.82 1.32). Results similar multiple sensitivity analyses. this observational study involving admitted hospital, administration associated either greatly lowered an increased risk death. Randomized, controlled trials are needed. (Funded by National Institutes Health.).

Language: Английский

Citations

1662
Bacterial and Fungal Coinfection in Individuals With Coronavirus: A Rapid Review To Support COVID-19 Antimicrobial Prescribing DOI Creative Commons
Timothy M. Rawson, Luke Moore, Nina Zhu

et al.

Clinical Infectious Diseases, Journal Year: 2020, Volume and Issue: 71(9), P. 2459 - 2468

Published: April 30, 2020

Abstract Background To explore and describe the current literature surrounding bacterial/fungal coinfection in patients with coronavirus infection. Methods MEDLINE, EMBASE, Web of Science were searched using broad-based search criteria relating to bacterial coinfection. Articles presenting clinical data for infection (defined as SARS-1, MERS, SARS-CoV-2, other coronavirus) reported English, Mandarin, or Italian included. Data describing coinfections, treatments, outcomes extracted. Secondary analysis studies reporting antimicrobial prescribing SARS-CoV-2 even absence was performed. Results 1007 abstracts identified. Eighteen full texts Most did not identify report (85/140; 61%). Nine 18 (50%) on COVID-19, 5/18 (28%) 1/18 (6%) 3/18 (17%) coronaviruses. For 62/806 (8%) experiencing during hospital admission. demonstrated wide use broad-spectrum antibacterials, despite a paucity evidence On secondary analysis, 1450/2010 (72%) received therapy. No stewardship interventions described. non–COVID-19 cases, 89/815 (11%) patients. Broad-spectrum antibiotic reported. Conclusions Despite frequent prescription empirical antimicrobials coronavirus-associated respiratory infections, there is support association Generation prospective development policy appropriate specific COVID-19 pandemic urgently required.

Language: Английский

Citations

1555
Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations DOI Creative Commons
Jason Phua, Li Weng, Lowell Ling

et al.

The Lancet Respiratory Medicine, Journal Year: 2020, Volume and Issue: 8(5), P. 506 - 517

Published: April 6, 2020

As coronavirus disease 2019 (COVID-19) spreads across the world, intensive care unit (ICU) community must prepare for challenges associated with this pandemic. Streamlining of workflows rapid diagnosis and isolation, clinical management, infection prevention will matter not only to patients COVID-19, but also health-care workers other who are at risk from nosocomial transmission. Management acute respiratory failure haemodynamics is key. ICU practitioners, hospital administrators, governments, policy makers a substantial increase in critical bed capacity, focus just on infrastructure supplies, staff management. Critical triage allow rationing scarce resources might be needed. Researchers address unanswered questions, including role repurposed experimental therapies. Collaboration local, regional, national, international level offers best chance survival critically ill.

Language: Английский

Citations

1499