Cytokine Storm in COVID-19: Immunopathogenesis and Therapy

Medicina, Journal Year: 2022, Volume and Issue: 58(2), P. 144 - 144

Published: Jan. 18, 2022

A cytokine storm is a hyperinflammatory state secondary to the excessive production of cytokines by deregulated immune system. It manifests clinically as an influenza-like syndrome, which can be complicated multi-organ failure and coagulopathy, leading, in most severe cases, even death. The term was first used 1993 describe graft-versus-host disease following allogeneic hematopoietic stem cell transplantation. then reused define adverse syndromes administration immunostimulating agents, such anti-CD28 antibodies or bioengineered cells, i.e., CAR T-cell therapy. Currently, concept has been better elucidated extended pathogenesis many other conditions, sepsis, autoinflammatory disease, primary hemophagocytic lymphohistiocytosis, multicentric Castleman disease. Moreover, recently emerged key aspect novel Coronavirus 2019, affected patients show high levels several pro-inflammatory cytokines, IL-1, IL-2, IL-6, TNF-α, IFN-γ, IP-10, GM-CSF, MCP-1, IL-10, some also correlate with severity. Therefore, since onset pandemic, numerous agents have tested effort mitigate COVID-19 patients, are effective reducing mortality, especially critically ill now becoming standards care, glucocorticoids inhibitors. However, challenge still far from being met, therapeutic strategies hope that we eventually overcome

Language: Английский

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Myocarditis after COVID-19 mRNA vaccination: clinical observations and potential mechanisms

Nature Reviews Cardiology, Journal Year: 2021, Volume and Issue: 19(2), P. 75 - 77

Published: Dec. 9, 2021

Language: Английский

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Cardiovascular Manifestation of the BNT162b2 mRNA COVID-19 Vaccine in Adolescents

Tropical Medicine and Infectious Disease, Journal Year: 2022, Volume and Issue: 7(8), P. 196 - 196

Published: Aug. 19, 2022

This study focuses on cardiovascular manifestation, particularly myocarditis and pericarditis events, after BNT162b2 mRNA COVID-19 vaccine injection in Thai adolescents. prospective cohort enrolled students aged 13-18 years from two schools, who received the second dose of vaccine. Data including demographics, symptoms, vital signs, ECG, echocardiography, cardiac enzymes were collected at baseline, Day 3, 7, 14 (optional) using case record forms. We 314 participants; these, 13 participants lost to follow-up, leaving 301 for analysis. The most common signs symptoms tachycardia (7.64%), shortness breath (6.64%), palpitation (4.32%), chest pain hypertension (3.99%). One participant could have more than one sign and/or symptom. Seven (2.33%) exhibited least elevated biomarker or positive lab assessments. Cardiovascular manifestations found 29.24% patients, ranging myopericarditis. Myopericarditis was confirmed patient vaccination. Two patients had suspected four subclinical myocarditis. In conclusion, manifestation adolescents vaccination included tachycardia, palpitation, clinical presentation myopericarditis usually mild temporary, with all cases fully recovering within days. Hence, receiving vaccines should be monitored side effects. Clinical Trial Registration: NCT05288231.

Language: Английский

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The Importance of Vaccination in the Context of the COVID-19 Pandemic: A Brief Update Regarding the Use of Vaccines

Vaccines, Journal Year: 2022, Volume and Issue: 10(4), P. 591 - 591

Published: April 12, 2022

The COVID-19 pandemic has led the world to undertake largest vaccination campaign in human history. In record time, unprecedented scientific and governmental efforts have resulted acquisition of immunizers utilizing different technologies (nucleotide acids, viral vectors, inactivated protein-based vaccines). Currently, 33 vaccines already been approved by regulatory agencies countries, more than 10 billion doses administered worldwide. Despite undeniable impact on control pandemic, recurrent emergence new variants interest raised challenges. recent mutations precede outbreaks that rapidly spread at global proportions. addition, reducing protective efficacy rates observed among main authorized vaccines. Besides these issues, several other crucial issues for appropriate combatting remain uncertain or under investigation. Particularly noteworthy include use vaccine-boosting strategies increase protection; concerns related long-term safety vaccines, child immunization reliability uncommon adverse events; persistence virus society; transition from a an endemic state. this review, we describe updated scenario regarding SARS-CoV-2 outline current discussions covering vaccine efficacy, future perspectives.

Language: Английский

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Viral Myocarditis: Classification, Diagnosis, and Clinical Implications

Frontiers in Cardiovascular Medicine, Journal Year: 2022, Volume and Issue: 9

Published: June 20, 2022

Myocarditis is an inflammatory disease of the myocardium with focal or diffuse involvement. Viral infections are most common cause myocarditis, especially in Western countries. A recent viral illness gastroenteric upper respiratory symptoms often precedes myocarditis. The absence specific pathognomonic features conjunction wide spectrum clinical manifestations that range from subclinical cases to sudden cardiac death (SCD) makes myocarditis diagnosis particularly challenging. Moreover, might represent a initially unexplained dilated cardiomyopathy (DCM) and heart failure (HF), among children young adults. Cardiac magnetic resonance imaging (CMR) crucial for diagnosis, because its ability detect interstitial edema during acute inflammation. Assessment subepicardial mid-myocardial fibrosis by late gadolinium enhancement (LGE) typical arrhythmias frequent events may arise more severe cases. form arrhythmia atrial fibrillation, followed ventricular tachycardia. Documented have been reported commonly HIV than other such as Adenovirus, Parvovirus B19, human Herpes virus 6, Enterovirus. mechanisms arrhythmogenesis myocardial inflammation not fully understood; phase, ranges direct effect on cardiomyocytes leads electrical instability ion channel impairment ischemia coronary macro- microvascular disease. In chronic instead, replacement promotes scar-mediated re-entrant arrhythmias. Observational data suggested important role CMR, LGE being strongest independent predictor SCD, cardiac, all-cause mortality. localization dwells lateral wall. Patients develop HF usually show larger distribution involving several segments. mid-layer interventricular septum syndromes risk SCD patients areas significant, shared decision-making approach warranted. Nevertheless, there no formal consensus about extension justify implantable cardioverter defibrillator (ICD) implantation primary prevention.

Language: Английский

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Histopathological Features of SARS-CoV-2 in Extrapulmonary Organ Infection: A Systematic Review of Literature

Pathogens, Journal Year: 2022, Volume and Issue: 11(8), P. 867 - 867

Published: July 31, 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health concern responsible for the ongoing pandemic. Histopathological pieces of evidence on COVID-19 are not fully investigated. This review aims to provide, through microscopy investigations, histopathological overview structural and ultrastructural alterations in different organs tissues, excluding system. The authors systematically reviewed literature over period February 2020–July 2022. Selected databases were PubMed, Scopus, Google Scholar. search strategy included following terms: “COVID-19” or SARS-CoV-2 “histopathology” “pathology”; “microscopy” “liver”, “myocardium”,” spleen”, “testis”, “placenta”. Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) guidelines used. Thirty-one articles this systematic demonstrated, at level, that exerts detrimental effects often promoting degenerative processes. Even if shows tropism system, other from cardiovascular reproductive, affected by COVID-19. Therefore, paper provides an up-to-date view observations associated with may contribute better knowledge physiopathological bases disease.

Language: Английский

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Cardiovascular magnetic resonance for evaluation of cardiac involvement in COVID-19: recommendations by the Society for Cardiovascular Magnetic Resonance

Journal of Cardiovascular Magnetic Resonance, Journal Year: 2023, Volume and Issue: 25(1), P. 21 - 21

Published: Feb. 1, 2023

Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic that has affected nearly 600 million people to date across the world. While COVID-19 primarily a respiratory illness, cardiac injury also known occur. Cardiovascular magnetic resonance (CMR) imaging uniquely capable of characterizing myocardial tissue properties in-vivo, enabling insights into pattern and degree injury. The reported prevalence involvement identified by CMR in context infection among previously hospitalized patients ranges from 26 60%. Variations may result differing patient populations (e.g. differences severity illness) varying intervals between acute evaluation. Standardized methodologies image acquisition, analysis, interpretation, reporting abnormalities would likely improve concordance studies. This consensus document Society for Magnetic Resonance (SCMR) provides recommendations on metrics towards goal improved standardization uniform data acquisition analytic approaches when performing with infection.

Language: Английский

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Oxidative Stress in Sepsis: A Focus on Cardiac Pathology

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(5), P. 2912 - 2912

Published: March 2, 2024

This study aims to analyze post-mortem human cardiac specimens, verify and evaluate the existence or extent of oxidative stress in subjects whose cause death has been traced sepsis, through immunohistological oxidative/nitrosative markers. Indeed, present study, i-NOS, NOX2, nitrotyrosine markers were higher expressed septic group when compared control group, associated with also a significant increase 8-OHdG, highlighting pivotal role etiopathogenesis. In particular, 70% cardiomyocyte nuclei from specimens showed positivity for 8-OHdG. Furthermore, intense massive NOX2-positive myocyte immunoreaction was noticed as immunostaining reaction found cells. These results demonstrated correlation between nitrosative imbalance pathophysiology dysfunction documented cases sepsis. Therefore, subsequent studies will focus on expression other organs tissues, well involvement intracellular pattern apoptosis, better clarify complex pathogenesis multi-organ failure, leading support rationale including therapies targeting redox abnormalities management patients.

Language: Английский

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Myocarditis in Athletes Recovering from COVID-19: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health, Journal Year: 2022, Volume and Issue: 19(7), P. 4279 - 4279

Published: April 2, 2022

Background: To assess the event rates of myocarditis detected by Cardiac Magnetic Resonance (CMR) in athletes who recovered from COVID-19. Methods: A systematic literature search was performed to identify studies reporting abnormal CMR findings Secondary analyses were considering increased serum high sensitivity troponin (hs-Tn) levels and electrocardiographic (ECG) echocardiographic (ECHO) abnormalities. Results: In total, 7988 15 included analysis. The pooled rate 1% (CI 1–2%), reaching 4% sub-group addition, heterogeneity observed (I2 43.8%). elevated hs-Tn levels, ECG ECHO 2% 1–5%), 3% 1–10%) 1–6%), respectively. ECG, level abnormalities did not show any correlation with myocarditis. Conclusions: prevalence COVID-19-related athletic population ranges 1 4%. Even if is quite low, current screening protocols are helpful tools for a safe return play properly address studies. Trial registration: study protocol registered PROSPERO database (registration number: CRD42022300819).

Language: Английский

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Death after the Administration of COVID-19 Vaccines Approved by EMA: Has a Causal Relationship Been Demonstrated?

Vaccines, Journal Year: 2022, Volume and Issue: 10(2), P. 308 - 308

Published: Feb. 16, 2022

More than eight billion doses of COVID-19 vaccines have been administered globally so far and 44.29% people are fully vaccinated. Pre-authorization clinical trials were carried out the safety is still continuously monitored through post-commercialization surveillance. However, some afraid vaccine side effects, claiming they could lead to death, hesitate get Herein, a literature review COVID-19-vaccine-related deaths has according PRISMA standards understand if there causal relationship between vaccination death highlight real extent such events. There 55 cases after reported excluded in 17 cases. In remaining cases, link was not specified (8) or considered possible (15), probable (1), very probable/demonstrated (14). The causes among these were: vaccine-induced immune thrombotic thrombocytopenia (VITT) (32), myocarditis (3), ADEM myocardial infarction rhabdomyolysis (1). demonstration obvious, more studies, especially with post-mortem investigations, needed deepen understanding pathophysiological mechanisms fatal effects. any event, given scarcity benefits outweigh risks scientific community needs be cohesive asserting that fundamental containing spread SARS-CoV-2.

Language: Английский

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