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SARS-CoV-2 proteins

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    A Comprehensive Study on Prediction Reliability of The Severity of Computed Tomography Involvement in Patients with Covid-19 MESHD

    Authors: Semih Kalkan; Volkan Gurler; AHMET Guner; Macit Kalcik; Kamber Kasali; Mustafa Ferhat Keten; Gokhan Tonkaz; Emrah Bayam; Ahmet Karaduman; Mehmet Ozkan

    doi:10.21203/rs.3.rs-278630/v1 Date: 2021-02-26 Source: ResearchSquare

    Purpose: Computed tomography (CT) emerges as a high–sensitivity tool in diagnosing SARS-CoV-2 virus on admission, even with the cases of negative reverse transcription polymerase chain reaction (RT-PCR). Moreover, CT plays a significant role in the evaluation of disease severity. In this study, we aimed to identify several parameters that could aid in evaluating the initial chest CT severity score (CT-SS).Methods: A total of 348 RT-PCR positive patients were divided into three groups by evaluating the chest CT severity score (CT-SS) in detail. These three groups were defined as the CT-SS obtained 0-7, 8-15, 16-40 classified as mild, moderate and severe involvement, respectively. Patients with end-stage malignancy MESHD or immunodeficiency MESHD were excluded from the study. All CT images were evaluated by two chest radiologists, unaware of the clinical data.Results: The analysis of categorical variables show that the chest CT-SS tends to increase with higher CHA2DS2VASC risk score (RS) (p= 0.001), M-CHA2DS2VASC RS (p = 0.001), and CHADS2 RS (p = 0.003). Moreover, age, hypertension MESHD, cardiothoracic ratio, aortic diameter, white blood cell count, neutrophil counts, neutrophil-lymphocyte ratio, c-reactive protein HGNC, D-dimer, ferritin, fibrinogen HGNC, blood urea nitrogen, and lactate dehydrogenase were also found to be associated with higher chest CT-SS. A 5-variable multivariable linear regression model, consisting of more frequently used variables, suggests a higher CHA2DS2VASC RS as the only statistically significant variable predicting a higher severity scoreConclusion: The CHA2DS2VASC RS may assist clinicians in predicting the CT-SS in COVID-19 MESHD patients, even if they are asymptomatic.

    Compassionate use of rectal Ozone (O3) in severe COVID-19 MESHD pneumonia MESHD: a case-control study.

    Authors: Marcos Edgar Fernández-Cuadros; María Jesús Albaladejo-Florín; Sandra Alava-Rabasa; Juan Gallego-Galiana; Gerardo Fabiel Pérez-Cruz; Isabel Usandizaga-Elio; Enrique Pacios; David Torres-Garcia; Daiana Peña-Lora; Luz Casique-Bocanegra; María Jesús López-Muñoz; Javier Rodríguez-de-Cía; Olga Susana Pérez-Moro

    doi:10.21203/rs.3.rs-231696/v1 Date: 2021-02-11 Source: ResearchSquare

    Objectives: To evaluate effect of rectal Ozone in severe COVID-19 MESHD pneumonia MESHD and to compare to Standard-of-care (SOC). Material and Methods: In a case-control study, 14 patients with severe bilateral COVID-19 MESHD pneumonia MESHD (positive RT-PCR), treated with SOC and rectal Ozone, were evaluated before-and-after treatment and compared with SOC (14 patients) in a 10 day follow-up period. Ozone-protocol consisted of 8 sessions (1 session/day) of intra-rectal Ozone, (150mL volume, 35mg/ml concentration [5.25mg total dose]). The SOC-protocol included O 2- supply, antivirals (Remdesivir), corticosteroids (Dexamethasone/Metilprednisolone), monoclonal antibodies (Anakinra/Tocilizumab), antibiotics (Azytromicine), anticoagulants (Enoxaparine) and hyperimmune serum (if necessary). Primary outcome variables: a) clinical (O 2- saturation and O 2- supply); b) biochemical (Lymphocyte count, Fibrinogen HGNC, D-Dimer, Urea, Ferritin, LDH, IL-6 HGNC and CRP HGNC); c) radiological Taylor Scale. Secondary outcome variables: a) hospitalization length-of-stay, b) mortality-rate. Results: At baseline, Ozone/SOC-groups were not different on age, comorbidities, O 2 -saturation and O 2 -supply. Patients in Ozone-Group improved O 2- saturation and decrease O 2- supply. SOC maintained O 2- saturation and required more O 2- supply. Lymphocyte-count improved only in Ozone-group and with statistical difference (p<0.05). Biomarkers of inflammation MESHD ( Fibrinogen HGNC, D-Dimer, Urea, LDH, CRP HGNC and IL-6 HGNC) decreased in both groups, but only significantly in favor of Ozone-group (p<0.05). Ferritin showed a significant decrease in the Ozone-group but an increase on the SOC-Group. Radiological pneumonitis MESHD decreased on both groups but the decrease was only significant in the Ozone-Group (p<0.0001). Mortality and length-of-stay, although not significant, were inferior in Ozone-Group. Conclusion: Compassionate use of Rectal Ozone improved O 2 -saturation, reduced O 2 -supply, decreased inflammation MESHD biomarkers and improved Taylor’s radiological scale significantly when compared to SOC-Group. Mortality and length-of-stay was inferior in the Ozone-group, but this difference was not significant.

    Prognosis and hematological findings in patients with COVID-19 MESHD in an Amazonian population of Peru

    Authors: Sebastian Iglesias-Osores; Arturo Rafael-Heredia; Eric Ricardo Rojas-Tello; Washington A. Ortiz-Uribe; Walter Leveau-Bartra; Orison Armando Leveau-Bartra; Miguel Alcantara-Mimbela; Lizbeth M. Cordova-Rojas; Elmer Lopez-Lopez; Virgilio E. Failoc-Rojas

    doi:10.1101/2021.01.31.21250859 Date: 2021-02-01 Source: medRxiv

    Objective: This study examined the laboratory results of COVID-19 MESHD patients from a hospital in the Peruvian Amazon and their clinical prognosis. Methods: An analytical cross-sectional study was carried out whose purpose was to identify the laboratory tests of patients with COVID-19 MESHD and mortality in a hospital in Ucayali, Peru during the period from March 13 to May 9, 2020, selecting a total of 127 with Covid-19 MESHD. Mean and the standard deviation was described for age, leukocytes, neutrophils, platelets, RDW-SD; median and interquartile range for the variables lymphocyte, RN / L, fibrinogen HGNC, CRP HGNC, D-dimer, DHL, hematocrit, monocytes, eosinophils. Results: No differences were observed in this population regarding death MESHD and sex (OR: 1.31; 95% CI 0.92 to 1.87), however, it was observed that, for each one-year increase, the probability of death increased by 4% (PR: 1.04, 95% CI 1.03 to 1.05). The IRR HGNC (Incidence Risk Ratio) analysis for the numerical variables showed results strongly associated with hematological values such as Leukocytes (scaled by 2500 units) ( IRR HGNC: 1.08, 95% CI 1.03 to 1.13), neutrophils (scaled by 2500 units) ( IRR HGNC: 1.08; 95% CI 1.03 to 1.13), on the contrary, it is observed that the increase of 1000 units in lymphocytes, the probability of dying decreased by 48% ( IRR HGNC: 0.52; 95% CI 0.38 to 071). Conclusion: Parameters such as leukocytes and neutrophils were statistically much higher in patients who died.

    Cerebrospinal fluid in COVID-19 MESHD neurological complications: no cytokine storm or neuroinflammation.

    Authors: Maria A. Garcia; Paula V. Barreras; Allie Lewis; Gabriel Pinilla; Lori J. Sokoll; Thomas Kickler; Heba Mostafa; Mario Caturegli; Abhay Moghekar; Kathryn C. Fitzgerald; - Hopkins Neuro-COVID-19 Group; Carlos A Pardo

    doi:10.1101/2021.01.10.20249014 Date: 2021-01-12 Source: medRxiv

    BACKGROUND. Neurological complications MESHD occur in COVID-19 MESHD. We aimed to examine cerebrospinal fluid (CSF) of COVID-19 MESHD subjects with neurological complications MESHD and determine presence of neuroinflammatory changes implicated in pathogenesis. METHODS. Cross-sectional study of CSF neuroinflammatory profiles from 18 COVID-19 MESHD subjects with neurological complications categorized by diagnosis ( stroke MESHD, encephalopathy MESHD, headache MESHD) and illness severity (critical, severe, moderate, mild). COVID-19 MESHD CSF was compared with CSF from healthy, infectious and neuroinflammatory disorders MESHD and stroke MESHD controls (n=82). Cytokines ( IL-6 HGNC, TNF-alpha HGNC, IFN-gamma HGNC, IL-10 HGNC, IL-12p70, IL-17A HGNC), inflammation MESHD and coagulation markers (high-sensitivity- C Reactive Protein HGNC [hsCRP], ferritin, fibrinogen HGNC, D-dimer, Factor VIII) and neurofilament light chain ( NF-L HGNC), were quantified. SARS-CoV2 RNA and SARS-CoV2 IgG and IgA antibodies in CSF were tested with RT-PCR and ELISA. RESULTS. CSF from COVID-19 MESHD subjects showed a paucity of neuroinflammatory changes, absence of pleocytosis MESHD or specific increases in pro-inflammatory markers or cytokines ( IL-6 HGNC, ferritin, or D-dimer). Anti-SARS-CoV2 antibodies in CSF of COVID-19 MESHD subjects (77%) were observed despite no evidence of SARS-CoV2 viral RNA. A similar increase of pro-inflammatory cytokines ( IL-6 HGNC, TNF-alpha HGNC;, IL-12p70) and IL-10 HGNC in CSF of COVID-19 MESHD and non- COVID-19 MESHD stroke MESHD subjects was observed compared to controls. CSF-NF-L was elevated in subjects with stroke MESHD and critical COVID-19 MESHD. CSF-hsCRP was present almost exclusively in COVID-19 MESHD cases. CONCLUSION. The paucity of neuroinflammatory changes in CSF of COVID-19 MESHD subjects and lack of SARS-CoV2 RNA do not support the presumed neurovirulence of SARS-CoV2 or neuroinflammation MESHD in pathogenesis of neurological complications in COVID-19 MESHD. Elevated CSF-NF-L indicates neuroaxonal injury MESHD in COVID-19 MESHD cases. The role of CSF SARS-CoV2 IgG antibodies is still undetermined.

    The kidnapping of mitochondrial function associated to the SARS-CoV-2 infection MESHD

    Authors: Elizabeth Soria-Castro; María Elena Soto; Verónica; Gustavo Rojas; Mario Perezpeña-Diazconti; Sergio A Críales-Vera; Linaloe Manzano Pech; Israel Pérez-Torres

    doi:10.21203/rs.3.rs-137853/v1 Date: 2020-12-29 Source: ResearchSquare

    Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection leads to multiorganic failure MESHD associated with a cytokine storm and septic shock MESHD. The virus evades the mitochondrial production of interferons through its N protein PROTEIN. From that moment on, SARS-CoV-2 hijacks MESHD the functions of this organelle. The aim of this study was to show how the virus kidnaps the mitochondrial machinery for its benefit and survival, altering serum parameters and leading to nitrosative stress (NSS). In a prospective cohort of 15 postmortem patients who died from COVID-19 MESHD, six markers of mitochondrial function; COX II, COX IV HGNC, MnSOD HGNC, nitrotyrosine, Bcl-2 HGNC and caspase-9 HGNC were analyzed by the immune colloidal gold technique in samples from the lung, heart, kidney and liver. Biometric laboratory results from these patients showed alterations in hemoglobin, platelets, creatinine, urea nitrogen, glucose, C-reactive protein HGNC, albumin, D-dimer, ferritin, fibrinogen HGNC, Ca2+, K+, lactate and troponin. These changes were associated with alterations of the mitochondrial structure and function. The multiorganic dysfunction MESHD present in COVID-19 MESHD patients may be caused in part by damage to the mitochondria that results in an inflammatory state that contributes to the elevation of NSS. NSS activates the sepsis MESHD cascade and contributes to the increased mortality in COVID-19 MESHD patients.

    The Inflammatory Markers of Multisystem Inflammatory Syndrome MESHD in children ( MIS HGNC-C) and Adolescents During the COVID-19 Pandemic MESHD: A Meta-Analysis

    Authors: Yan Zhao; Li-juan Yin; Jenil Patel; Lei Tang; Ying Huang

    doi:10.21203/rs.3.rs-127768/v1 Date: 2020-12-13 Source: ResearchSquare

    As per the indicated need in literature, we conducted a systematic review and meta-analysis to characterize inflammatory markers of MIS HGNC-C patients with COVID-19 MESHD, Kawasaki disease MESHD ( KD MESHD), and coronary artery abnormalities MESHD. We searched nine databases for studies on inflammatory markers of MIS HGNC-C. After quality check, data were pooled using a fixed- or random-effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count ( ALC HGNC), absolute neutrophil count (ANC), platelet count (PLT), C-reactive protein HGNC ( CRP HGNC), procalcitonin (PCT), ferritin, D-dimer, lactate dehydrogenase (LDH), fibrinogen HGNC and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty studies with 2,990 participants yielded 684 MIS HGNC-C patients. Compared to non-severe COVID-19 MESHD patients, MIS-C MESHD MIS-C HGNC patients had lower ALC HGNC ALC MESHD and higher ANC, CRP HGNC and D-dimer levels. Compared to severe COVID-19 MESHD patients, MIS-C MESHD MIS-C HGNC patients had lower LDH MESHD and PLT counts and higher ESR levels. Compared to KD MESHD patients, MIS-C MESHD MIS-C HGNC patients had lower ALC MESHD ALC HGNC and PLT, and higher CRP HGNC and ferritin levels. Severe MIS HGNC-C patients had higher levels of WBC, CRP HGNC, D-dimer and ferritin. For MIS HGNC-C, younger children had lower CRP HGNC and ferritin levels than medium-aged/older children. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS HGNC-C and the associated disorders.

    Case Reports of Cerebral Sinus Venous Thrombosis in COVID-19 MESHD Patients

    Authors: Prysta Aderlia Sitanggang; Kumara Tini; Ni Made Susilawathi; Ida Ayu Sri Wijayanti; Putu Utami Dewi; Dewa Putu Gde Purwa Samatra

    doi:10.21203/rs.3.rs-100427/v1 Date: 2020-10-30 Source: ResearchSquare

    Background: The outbreak of Coronavirus disease 2019 MESHD ( COVID-19 MESHD) has started in China since December 2019 and expanding worldwide rapidly with cases of respiratory tract infection MESHD and multiple system involvement. Neurological manifestations are not exempted following the reports from various sources about Ischemic and haemorrhagic stroke MESHD related to COVID-19 MESHD, but the reports about cerebral sinus venous thrombosis MESHD ( CSVT MESHD) are still rare.Case presentation: We would like to report two cases of cerebral sinus venous thrombosis MESHD in COVID-19 MESHD patients following the respiratory manifestations with profound haematological and coagulation disarrangement triggered by COVID-19 MESHD and these are assumed as underlying mechanism. These two cases also have different course of disease and outcome which are interesting.Conclusions: CSVT MESHD is one of neurological complication and COVID -19 manifestation that can have grave prognosis, if this involves the brainstem venous drainage. Thrombogenesis and coagulation MESHD cascades are prolonged despite successful alteration to negative result of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV2) reverse transcription polymerase chain reaction (rt-PCR) test. Therefore, monitoring neutrophil to lymphocyte ration (NLR), D-dimer level, fibrinogen HGNC and C-reactive protein HGNC ( CRP HGNC) is paramount as well as indicators of poor prognosis.

    Extracorporeal Blood Purification in moderate and severe COVID-19 MESHD patients: a prospective cohort study

    Authors: Rodney Rosalia; Petar Ugurov; Dashurie Neziri; Simona Despotovska; Lidija Veljanovska-Kiridjievska; Emilija Kostoska; Dimche Kuzmanov; Aleksandar Trifunovski; Gianluca Villa; Dijana Popevski; Zan Mitrev

    doi:10.1101/2020.10.10.20210096 Date: 2020-10-13 Source: medRxiv

    Introduction: COVID-19 MESHD is characterised by hyperinflammation and coagulopathy MESHD. Severe cases often develop respiratory distress MESHD, requiring mechanical ventilation and critical cases progressing to ARDS. Control of hyperinflammation has been proposed as a possible therapeutic avenue for COVID-19 MESHD; extracorporeal blood purification ( EBP HGNC) modalities offer an attractive mean to ameliorate maladaptive inflammation MESHD. With this work, we describe the longitudinal variation of parameters of systemic inflammation MESHD in critically ill COVID-19 MESHD patients treated with blood purification using AN69ST (oXiris) hemodiafilter. Methods: We performed a time-series analysis of 44 consecutive COVID-19 MESHD cases treated with the AN69ST (oXiris) cytokine adsorbing hemodiafilter; we visualise longitudinal results of biochemical, inflammatory, blood gas- and vital sign parameters. Results: Blood purification was indicated for suspected hyperinflammation or hypercoagulation MESHD, (= CRP HGNC > 100 mg/L and/or IL-6 HGNC > 40 pg/mL and/or Ferritin > 500 ng/mL and/or Lactate Dehydrogenase > 365 U/L or D-dimers > 2000 ng/mL). All patients were treated with at least 1 cycle extracorporeal continuous venovenous hemofiltration (CVVHF) with cytokine adsorbing hemodiafilter (CAH); of these, 30 severe patients received CVVHF-CAH MESHD within 4 - 12 hours of hospitalisation. Another 14 patients admitted with mild-to-moderate symptoms progressed to severe disease and placed on EBP HGNC during the course of hospitalisation. The treatment was associated with a reduction of Ferritin, C-reactive protein HGNC, Fibrinogen HGNC, several inflammatory markers and a resolution of numerous cytopenias MESHD. The observed mortality across the cohort was 36.3% across the cohort. Conclusion: Extracorporeal blood purification with cytokine adsorbing hemofilter was associated with a decrease in the acute phase proteins CRP HGNC, Ferritin, and resolution of numerous cytopenias MESHD. Repetitive hemofiltration has been associated with lower levels of IL-6 HGNC in COVID-19 MESHD patients.

    More severe hypercoagulation status, cytokine storm, and disease progression in coronavirus disease 2019 MESHD with persistent RT-PCR negative results: a multicenter prospective study

    Authors: Wei Du; Guochao Shi; Min Zhou; Yahui Liu; Gelei Lan; Xueqing Du; Chunrong Huang; Ranran Dai; Wei Chen

    doi:10.21203/rs.3.rs-85866/v1 Date: 2020-09-30 Source: ResearchSquare

    Purpose: Persistent negative results (at least 3 times) of reverse transcription–polymerase chain reaction (RT-PCR) from pharyngeal swabs are not rare in coronavirus disease 2019 MESHD ( COVID-19 MESHD) patients, but their characteristics have not yet been well studied.Methods: PCR confirmed, serum antibody confirmed with persistent negative PCR results, and clinically diagnosed patients hospitalized in two medical centers during February and March 2020 were included. Differences in clinical, imaging and laboratory characteristics as well as factors affecting their prognosis were analyzed.Results: There were 114 PCR confirmed, 17 serology confirmed and 21 clinically diagnosed patients included. Time from onset of disease to the first PCR and admission were similar among the groups. Compared with PCR-confirmed patients, serology-confirmed patients were older and likely to have hypertension MESHD, vomiting MESHD, or symptoms of chest pain MESHD and dyspnea MESHD. Regarding imaging manifestations, serology-confirmed patients were more prone to pleural effusion MESHD. In addition, higher levels of C-reactive protein HGNC, neutrophil-to-lymphocyte ratio, total bilirubin, D-dimer, fibrinogen HGNC, troponin, interleukin-6 HGNC and IL-8 HGNC were also found. Although with similar mortality, serology confirmed patients were more likely to have disease progression. High levels of D-dimer and IL-6 HGNC were possibly the underlying factors leading to their worse prognosis. On the other hand, clinically diagnosed patients were more similar to PCR-confirmed patients.Conclusion: Serology confirmed COVID-19 MESHD patients with at least three negative PCR results had different clinical characteristics and were likely to have disease progression, possibly due to more severe hypercoagulation status MESHD and cytokine storm.

    Metabolic Consequences Of Obesity On The Hypercoagulable State Of Polycystic Ovary Syndrome: A Risk For Severe SARS-Cov-2 Infection MESHD?

    Authors: Abu Saleh Md Moin; Thozhukat Sathyapalan; Ilhame Diboun; Mohamed Elrayess; Alexandra E Butler; Stephen L Atkin

    doi:10.21203/rs.3.rs-76784/v1 Date: 2020-09-12 Source: ResearchSquare

    Introduction:  Polycystic ovary syndrome MESHD ( PCOS MESHD) women have a hypercoagulable state and are also at high risk for severe COVID-19 MESHD leading to thromboembolic complications MESHD and increased mortality; however, whether this is intrinsically due to PCOS MESHD or, alternatively, a consequence of its metabolic complications is unclear.  Methods: We determined plasma coagulation pathway protein levels in PCOS MESHD (n=146) and control (n=97) women recruited to a PCOS MESHD biobank. Circulating levels of a panel of 18 clotting pathway proteins were determined by Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement.Results: Cohorts were age matched, though PCOS MESHD had elevated body mass index (BMI)(p<0.001), insulin HGNC (p<0.001) and C-reactive protein HGNC ( CRP HGNC)(p<0.0001). Eight pro-coagulation proteins were elevated in PCOS MESHD: plasminogen activator inhibitor-1 HGNC ( PAI-1 HGNC)(p<0.0001), fibrinogen HGNC (p<0.01), fibrinogen gamma chain HGNC (p<0.0001), fibronectin HGNC (p<0.01), von Willebrand MESHD factor (p<0.05), D-dimer (p<0.0001), P-selectin HGNC (p<0.05), and plasma kallikrein (p<0.001). However, two anticoagulant proteins, vitamin K-dependent protein-S HGNC protein-S PROTEIN (p<0.0001) and heparin cofactor-II (p<0.001) were elevated and prothrombin was decreased (p<0.05). CRP HGNC, as a marker of inflammation MESHD, and insulin HGNC resistance (HOMA-IR) correlated with 11 and 6 of the clotting proteins, respectively (p<0.05). When matched for BMI<25 (16 PCOS MESHD, 53 controls) HOMA-IR remained elevated (p<0.05) and heparin cofactor-II was increased (p<0.05). In a multivariate analysis accounting for inflammation MESHD, insulin HGNC resistance and BMI, there was no correlation of PCOS MESHD with any of the coagulation proteins.Conclusion: The hypercoagulable State in PCOS MESHD can be fully accounted for by BMI, inflammation MESHD and insulin HGNC resistance suggesting that only obese PCOS MESHD women would be predisposed to an enhanced risk for severe COVID-19 MESHD-related disease.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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