Corpus overview


MeSH Disease

Human Phenotype


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    Pharmacological inhibition of the kinin-kallikrein system in severe COVID-19 A proof-of-concept study

    Authors: Eli Mansour; Andre C Palma; Raisa G Ulaf; Luciana C Ribeiro; Ana Flavia Bernardes; Thyago A Nunes; Marcus V Agrela; Bruna Bombassaro; Milena Monfort-Pires; Rafael L Camargo; Eliana P Araujo; Natalia S Brunetti; Alessandro S Farias; Antonio L Falcao; Thiago M Santos; Plinio Trabasso; Rachel P Dertkigil; Sergio S Dertkigil; Maria Luiza Moretti; Licio A Velloso

    doi:10.1101/2020.08.11.20167353 Date: 2020-08-14 Source: medRxiv

    Coronavirus disease-19 (COVID-19) can develop into a severe respiratory syndrome MESHD that results in up to 40% mortality. Acute lung inflammatory edema HP edema MESHD is a major pathological finding in autopsies explaining O2 diffusion failure and hypoxemia HP hypoxemia MESHD. Only dexamethasone has been shown to reduce mortality in severe cases, further supporting a role for inflammation MESHD in disease severity. SARS-CoV-2 enters cells employing angiotensin converting enzyme 2 (ACE2) as a receptor, which is highly expressed in lung alveolar MESHD cells. ACE2 is one of the components of the cellular machinery that inactivates the potent inflammatory agent bradykinin, and SARS-CoV-2 infection MESHD could interfere with the catalytic activity of ACE2, leading to accumulation of bradykinin. In this open-label, randomized clinical trial, we tested two pharmacological inhibitors of the kinin-kallikrein system that are currently approved for the treatment of hereditary angioedema MESHD angioedema HP, icatibant and inhibitor of C1 esterase/kallikrein, in a group of 30 patients with severe COVID-19. Neither icatibant nor inhibitor of C1 esterase/kallikrein resulted in significant changes in disease mortality and time to clinical improvement. However, both compounds promoted significant improvement of lung computed tomography scores and increased blood SERO eosinophils, which has been reported as an indicator of disease recovery. In this small cohort, we found evidence for a beneficial role of pharmacological inhibition of the kinin-kallikrein system in two markers that indicate improved disease recovery.

    Clinical and intestinal histopathological findings in SARS-CoV-2/COVID-19 patients with hematochezia HP hematochezia MESHD

    Authors: Margaret Cho; Weiguo Liu; Sophie Balzora; Yvelisse Suarez; Deepthi Hoskoppal; Neil D Theise; Wenqing Cao; Suparna A Sarkar

    doi:10.1101/2020.07.29.20164558 Date: 2020-08-07 Source: medRxiv

    Gastrointestinal ( GI MESHD) symptoms of SARS-CoV2/COVID-19 in the form of anorexia HP anorexia MESHD, nausea, vomiting HP nausea, vomiting MESHD vomiting MESHD, abdominal pain HP abdominal pain MESHD and diarrhea HP diarrhea MESHD are usually preceeded by respiratory manifestations and are associated with a poor prognosis. Hematochezia HP Hematochezia MESHD is an uncommon clinical presentation of COVID-19 disease and we hypothesize that older patients with significant comorbidites ( obesity HP obesity MESHD and cardiovascular) and prolonged hospitalization are suspectible to ischemic injury MESHD to the bowel. We reviewed the clinical course, key laboratory data including acute phase reactants, drug/medication history in two elderly TRANS male TRANS patients admitted for COVID-19 respiratory failure HP respiratory failure MESHD. Both patients had a complicated clinical course and suffered from hematochezia HP hematochezia MESHD and acute blood SERO blood MESHD loss anemia HP requiring blood SERO transfusion around day 40 of their hospitalization. Colonoscopic impressions were correlated with the histopathological findings in the colonic biopies and changes compatible with ischemia MESHD to nonspecific acute inflammation MESHD, edema HP edema MESHD and increased eosinophils in the lamina propria were noted.Both patients were on anticoagulants, multiple antibiotics and antifungal agents due to respiratory infections MESHD at the time of lower GI bleeding MESHD. Hematochezia HP Hematochezia MESHD resolved spontaneously with supportive care. Both patients eventually recovered and were discharged. Elderly TRANS patients with significant comorbid conditions are uniquely at risk for ischemic injury MESHD to the bowel. Hypoxic conditions MESHD due to COVID-19 pneumonia HP pneumonia MESHD and respiratory failure HP respiratory failure MESHD, compounded by preexisting cardiovascular complications, and/or cytokine storm orchestrated by the viral infection leading to alteration in coagulation profile and/or drug/medication injury can be difficult to distinguish in these critically ill patients. Presentation of hematochezia HP hematochezia MESHD may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.

    Multisystem inflammatory syndrome MESHD with features of Atypical Kawasaki disease MESHD during COVID-19 pandemic: Report of a case from India

    Authors: Abdul Rauf; Ajay Vijayan; Shaji Thomas John; Raghuram A Krishnan; Abdul Latheef

    doi:10.21203/ Date: 2020-05-15 Source: ResearchSquare

    There is a global concern of increasing number of children TRANS presenting with inflammatory syndrome MESHD with clinical features simulating Kawasaki disease, during ongoing COVID-19 pandemic. We report a very similar case of 5-year-old boy from a COVID-19 hotspot area in Kerala state of India who presented in late April 2020 with acute febrile illness MESHD with abdominal pain HP abdominal pain MESHD and loose stools followed by shock HP. On examination, child TRANS had bulbar conjunctivitis HP conjunctivitis MESHD and extremity edema HP edema MESHD. Initial investigations showed high inflammatory parameters, elevated serum creatinine HP serum SERO creatinine and liver enzymes. Echocardiography showed moderate LV dysfunction MESHD and normal coronaries. Cardiac enzymes were also elevated, suggesting myocarditis HP myocarditis MESHD. He was treated with inotropic support, respiratory support with High Flow Nasal Cannula, IV Immunoglobulins, aspirin, steroids and diuretics. RT PCR for SARS-CoV-2 was negative twice. His clinical condition improved rapidly, was afebrile from day 2, inflammatory parameters decreased, left ventricular function improved and was discharged after 6 days of hospital stay.

    Interference of SARS-CoV-2 with the Homeostasis of Ventilation and Perfusion in the Lung

    Authors: Clemente F. Arias; Francisco J. Acosta; Federica Bertocchini; Cristina Fernández-Arias

    id:10.20944/preprints202005.0177.v1 Date: 2020-05-10 Source:

    A growing number of studies suggest that SARS-CoV-2 could interfere with homeostatic mechanisms in the lung but the implications of this possible interference have not been fully explored in the literature. In this work, we examine the consequences that can be drawn from this hypothesis according to currently available knowledge. We suggest that one such consequence is the potential disruption of normal ventilation and perfusion of lung regions that may be distant from the infection sites. Loss of ventilation might result in local alveolar hypoxia MESHD and contribute to hypoxemia HP hypoxemia MESHD, which in turn could trigger homeostatic responses that enhance blood SERO oxygenation by redistributing pulmonary blood SERO circulation. Sudden changes in perfusion might then lead to the development of hydrostatic edema MESHD edema HP and eventually to vascular remodeling and inflammation MESHD. Therefore, the immune response might not be the only source of the substantial inflammation MESHD observed in lung tissues of patients with severe COVID-19, as is often assumed in the literature. The balance between the homeostatic and the immune reaction in each patient could account for the observed heterogeneity of the clinical manifestations of COVID-19.

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MeSH Disease
Human Phenotype

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