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HGNC Genes

SARS-CoV-2 proteins

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    A systematic review on Multisystem Inflammatory Syndrome in Children ( MIS HGNC-C) with COVID-19 MESHD: Development of a scoring system for clinical diagnosis

    Authors: Dr.Suchitra Vishwambhar Surve; Ms. Shaini Joseph; Dr. Rahul K Gajbhiye; Smita D Mahale; Dr. Deepak N Modi

    doi:10.1101/2021.04.23.21255879 Date: 2021-04-25 Source: medRxiv

    Background There is growing evidence of Multisystem Inflammatory Syndrome MESHD in Children ( MIS HGNC-C) resembling Kawasaki disease in children infected with SARS-CoV-2. The review was undertaken to evaluate the case definition, the spectrum of clinical presentations and current management practices in children with COVID-19 MESHD presenting with or without MIS HGNC-C. Methods The individual patient data from 119 studies accounting for 333 children were analyzed. We devised a scoring system as per WHO criteria to classify the patients as MIS HGNC-C or without MIS HGNC-C. A score of 3 was given for the presence of fever MESHD (>24h) and a score of 1 for lab-confirmed diagnosis of SARS-CoV-2. Additionally, a score of 1 was given for a) rash MESHD or conjunctivitis MESHD or muco-cutaneous inflammation MESHD signs, b) hypotension MESHD or shock, c) diarrhea MESHD, vomiting MESHD or abdominal pain MESHD, d) features of myocardial dysfunction MESHD as determined by abnormal eco-cardiography or elevated Troponin or N-terminal pro b-type natriuretic peptide (NT-proBNP), e) evidence of coagulopathy MESHD as evidenced by elevated levels of prothrombin time PT, partial thromboplastin time PTT or D-dimer, f) laboratory evidence of inflammation MESHD as determined by elevated erythrocyte sedimentation rate (ESR) or C-reactive protein HGNC ( CRP HGNC) or procalcitonin. A negative score of (-3) was given when there was a diagnosis of sepsis MESHD, staphylococcal or streptococcal shock syndrome MESHD. Based on these criteria, a minimum score of 6 was essential to classify the child as MIS HGNC-C. Results Based on this score, 18% (52/289) of cases were identified to be MIS HGNC-C. A greater proportion of children with MIS HGNC-C had cardiac involvement ( MIS HGNC-C 80% vs Non- MIS HGNC-C 20%) and gastrointestinal involvement MESHD ( MIS HGNC-C 71% vs Non- MIS HGNC-C 12%). Lymphopenia MESHD was commonly reported in MIS-C ( MIS HGNC-C 54.2% vs Non- MIS HGNC-C 29.7%). In addition to routine inflammatory markers, significamtly greater proportion of children with MIS-C had elevated Ferritin, LDH, Fibrinogen HGNC and IL-6 HGNC. Children with MIS HGNC-C were less likely to have respiratory symptoms like cough ( MIS HGNC-C 25% vs Non- MIS HGNC-C 75%) and rhinorrhea MESHD ( MIS HGNC-C 4% vs Non- MIS HGNC-C 22.8%). A greater proportion of children with MIS HGNC-C required intensive care and aggressive treatment; and mortality rates were also higher in MIS-C group ( MIS HGNC-C 10% vs Non- MIS HGNC-C 1%). Conclusion The children with COVID-19 MESHD having cardiac and/or gastrointestinal involvement MESHD are more likely to develop MIS HGNC-C. The children with MIS HGNC-C have higher mortality rates. The scoring system developed herein will aid clinicians in patient diagnosis and timely management.

    Clinico-laboratory profile, intensive care needs, treatment details, and outcome of Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS): A systematic review and Meta-analysis.

    Authors: Vijai Williams; Nabaneea Dash; Renu Suthar; Vichithra Mohandoss; Nishant Jaiswal; TK Kavitha; Karthi Nallasamy; Suresh Kumar Angurana

    doi:10.1101/2020.10.21.20217034 Date: 2020-10-25 Source: medRxiv

    Objectives: To synthesize the current data on clinico-laboratory features, intensive care needs, treatment, and outcome of Pediatric inflammatory multisystem syndrome MESHD temporally associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome MESHD in children (MIS-C). Data Sources: Articles published in PubMed, Web of Science, Scopus, Google Scholar, and WHO COVID-19 MESHD research database, CDC database, and Cochrane COVID-19 MESHD study register between 1st December 2019 to 10th July 2020. Study Selection: Observational studies involving patients [≤]21 years with PIMS-TS or MIS-C, that reported the clinico-laboratory features, intensive care needs, treatment, and outcome. Data Extraction: The search identified 422 citations and finally 18 studies with 833 participants were included and pooled estimate was calculated for parameters of interest utilising random effect model. Data Synthesis: The median age was 9 (8-11) years. Fever MESHD, gastrointestinal symptoms MESHD, rash MESHD, conjunctival injection, and respiratory symptoms MESHD were common clinical features. Majority had positive SARS-CoV-2 antibody test and only 1/3rd had RT-PCR positive. The commonest laboratory abnormalities were elevated CRP, D-dimer, procalcitonin, BNP HGNC, fibrinogen HGNC, ferritin, troponin, and IL-6 HGNC; and lymphopenia MESHD, hypoalbuminemia MESHD, and thrombocytopenia MESHD. The cardiovascular complications included shock (65%), myocardial dysfunction MESHD (61%), myocarditis MESHD (65%), and coronary artery abnormalities MESHD (39%). Three-fourth children required admission in PICU for mechanical ventilation (25%) and vasoactive drugs (61%). The common treatment provided was IVIG (82%), steroids (54%), antiplatelet drugs (64%), and anticoagulation (51%). The mortality was low (n=13). Conclusion: Fever MESHD, gastrointestinal MESHD and mucocutaneous symptoms, cardiac dysfunction MESHD, shock, and hyperinflammation are common manifestations of PIMS-TS or MIS-C. The short-term outcome is good with supportive intensive care and immunomodulatory treatment.

    Early Risk Factors for Extrapulmonary Organ Injury in Adult COVID-19 MESHD Patients

    Authors: Fang Huang; Wenxia Ma; Jun Jin; Hui Zheng; Yan Ye; Hui Chen; Nan Su; Xinyue Li; Xiaoping Li; Xiangqiong Lu; Yang He; Yuyu Wang; Yongsheng Li; Jun Wang

    doi:10.21203/rs.3.rs-70751/v1 Date: 2020-09-02 Source: ResearchSquare

    Objective COVID-19 MESHD is becoming a global pandemic and often develops extrapulmonary organ injury. However, the risk factors for extrapulmonary organ injury are still unclear. We aim to explore the risk factors for extrapulmonary organ injury for COVID-19 MESHD and the association between extrapulmonary organ injury and the prognosis of COVID-19 MESHD patients. Methods This is a single-center, retrospective, observational study and total 349 confirmed COVID-19 MESHD patients admitted to Tongji Hospital from January 25 to February 25, 2020 were enrolled. We collected demographic, clinical, laboratory and treatment data from electronic medical records. Potential risk factors for extrapulmonary organ injury of COVID-19 MESHD patients were analyzed by a multivariable binary logistic model, and multivariable COX proportional hazard regression model was used for survival analysis in the patients with extrapulmonary organ injury. Results Average age of the included patients was 61.73±14.64 years. In the final logistic model, variables including aged 60 or older (OR 1.826, 95% CI 1.060-3.142), ARDS (OR 2.748, 95% CI 1.051-7.185), lymphocytes count lower than 1.1 ×109/L (OR 0.478, 95% CI 0.240-0.949), level of IL-6 HGNC greater than 7 pg/ml (OR 1.664, 95% CI 1.005-2.751) and D-Dimer greater than 0.5 μg/ml (OR 2.190, 95% CI 1.176-4.084) were significantly associated with the extrapulmonary organ injury. Kaplan-Meier curve and log-rank test showed that the probabilities of survival for patients with extrapulmonary organ injury MESHD were significantly lower than those without extrapulmonary organ injury.between Multivariate COX proportional hazards model showed that only myocardial injury MESHD (P=0.000, HR: 5.068, 95% CI: 2.728-9.417) and circulatory system injury MESHD (P=0.000, HR: 4.076, 95% CI: 2.216-7.498) were the independent factors associated with COVID-19 MESHD patients’ poor prognosis. Conclusion Older age, lymphocytopenia MESHD, high level of D-Dimer and IL-6 HGNC and the severity of lung injury MESHD were the high-risk factors of extrapulmonary organ injury in COVID-19 MESHD patients. Myocardial and circulatory system injury MESHD were the most important risk factors related to poor outcomes of COVID-19 MESHD patients. It may help clinicians to identify extrapulmonary organ injury early and provide relevant management strategy.

    The Pathogenisis of COVID-19 MESHD Myocardial Injury: an Immunohistochemical Study of Postmortem Biopsies 

    Authors: Camila Hartmann; Anna Flavia dos Santos Miggiolaro; Jarbas da Silva Motta Junior; Lucas Baena Carstens; Caroline Busatta Vaz De Paula; Sarah Fagundes Grobe; Larissa Hermann de Souza Nunes; Gustavo Lenci Marques; Lidia Zytynski Moura; Lucia de Noronha; Cristina Pellegrino Baena

    doi:10.21203/rs.3.rs-45192/v2 Date: 2020-07-17 Source: ResearchSquare

    Rationale: M yocardial injury MESHDis significantly and independently associated with mortality in COVID-19 MESHD patients. However, the pathogenesis of m yocardial injury MESHDin COVID-19 MESHD is still not clear, and cardiac involvement by SARS-CoV-2 remains a major challenge worldwide. Objective: This histopathological and immunohistochemical study seeks to clarify the pathogenesis and propose a mechanism with pathways involved in COVID-19 MESHD m yocardial injury. MESHD Methods and Results: Postmortem minimally invasive autopsies were performed in six patients who died from COVID-19 MESHD, and the myocardium samples were compared to a control patient. Histopathological analysis was performed using hematoxylin-eosin and toluidine blue staining. Immunohistochemical (IHC) staining was performed using monoclonal antibodies against the following targets: c aspase-1, HGNC I CAM-1, HGNC T NF-α, HGNC I L-4, HGNC I L-6, HGNC C D163, HGNC T GF-β, HGNC M MP-9, HGNC type 1 and type 3 collagen. The samples were also subjected to a TUNEL assay to detect potential apoptosis. The histopathological analysis showed severe pericellular interstitial e dema MESHDsurrounding each of the cardiomyocytes and higher mast cells count by high-power field in all COVID-19 MESHD myocardium samples. The IHC analysis showed increased expression of c aspase-1, HGNC I CAM-1, HGNC I L-4, HGNC I L-6, HGNC C D163, HGNC M MP-9 HGNCand type 3 collagen in the COVID-19 MESHD patients compared to the control. No difference from the control was observed in expression of T NF-α, HGNC T GF-β HGNCand type 1 collagen. The TUNEL assay was positive in all the COVID-19 MESHD samples confirming the presence of endothelial apoptosis. Conclusions: The pathogenesis of COVID-19 MESHD m yocardial injury MESHDseems to be related with pyroptosis leading to endothelial cell injury and disfunction. The subsequent i nflammation MESHDwith associated interstitial e dema MESHDcould explain the myocardial disfunction and a rrythmias MESHDin these patients. Our findings also show that COVID-19 MESHD m yocardial injury MESHDmay cause m yocardial fibrosis MESHDin the long term. These patients should be monitored for m yocardial dysfunction MESHDand a rrythmias MESHDafter the acute phase of COVID-19 MESHD.

    Immunophenotyping of Circulating Leukocytes Reveal Non-specific Activation of Innate and Adaptive Immune Systems in Multi-System Inflammatory Syndrome of Childhood Temporally Associated with SARS-Cov-2 Infection MESHD: Descriptive Cohort Study

    Authors: Michael J. Carter; Matthew Fish; Aislinn Jennings; Katie J. Doores; Paul Wellman; Jeffrey Seow; Sam Acors; Emma Timms; Julia Kenny; Stuart Neil; Michael H. Malim; Shane M. Tibby; Manu Shankar-Hari

    id:10.20944/preprints202007.0252.v1 Date: 2020-07-12 Source: Preprints.org

    We describe the innate and adaptive immune system trajectory in Multi-system inflammatory syndrome MESHD of childhood (MIS-C), at acute(within 72 hours of hospitalization), resolution (at clinical improvement) and convalescent phase. In our cohort, in the acute phase, 68% of the children were SARS-CoV-2 seropositive, with hypercytokinenemia (high interleukin(IL)-1beta HGNC, IL-6 HGNC, IL-8 HGNC, IL-10 HGNC, IL-17 HGNC, interferon gamma HGNC), procoagulant state, myocardial dysfunction MESHD, activated neutrophils and monocytes; differential T and B cell subset lymphopenia MESHD; activated chemokine receptor type-7 positive and gamma-delta T cell subsets; antigen presenting cells had reduced HLA-DR expression; and B-cell class-switch responses occurred with illness resolution. MIS-C is an immunopathogenic illness associated with SARS-CoV-2 infections MESHD in children.

    Life-threatening cardiogenic shock in a pediatric patient with SARS-CoV-2-associated myocarditis treated with remdesivir: a case description and report of similar cases from the Literature

    Authors: Silvia Molinari; Lucia M.D. Colasanto; Maria L. Melzi; Alessandro Cattoni; Roberto Panceri; Michela Bombino; Giuseppe Lapadula; Andrea Biondi

    doi:10.21203/rs.3.rs-34802/v1 Date: 2020-06-12 Source: ResearchSquare

    BackgroundChildren are relatively spared from Coronavirus disease 2019 MESHD ( COVID-19 MESHD), but some severe cases have been reported. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD in children may affect the cardiovascular system. We hereby report about a case of myocarditis MESHD evolving to cardiogenic shock MESHD in a SARS-CoV-2 positive child.Case presentationAn otherwise healthy 12-year-old patient was admitted with fever MESHD, vomiting MESHD, diarrhoea and drowsiness MESHD, without any respiratory symptoms. He was diagnosed with COVID-19 MESHD on nasopharyngeal swab. He developed hypotension MESHD and cardiogenic shock MESHD. Bedside echocardiography revealed left ventricular impairment MESHD with an ejection fraction (LVEF) below 25%. Plasmatic markers of myocardial injury MESHD were remarkably raised, as well as inflammatory biomarkers, including procalcitonin (highest recorded value: 66 ng/mL) and interleukin-6 HGNC (8209 pg/mL). The child was transferred to Intensive Care Unit and he was treated with catecholamine support, mechanical ventilation and empiric anti-infectious therapy, including broad spectrum antibiotics and the antiviral agent remdesivir. All additional microbiological investigations yielded negative results. We observed a gradual improvement of LVEF within 5 days. A cardiac magnetic resonance confirmed the suspicion of myocarditis MESHD. After 21 days of hospitalisation, the child was discharged without sequelae.ConclusionsOur hypothesis is that the child suffered from SARS-CoV-2-induced fulminant myocarditis MESHD, probably in the setting of cytokine release syndrome (CRS). The peculiarity of this SARS-CoV-2 infection MESHD is the presence of cardiac failure MESHD in a previously healthy child without a respiratory illness MESHD. The positive outcome is in line with published Literature about the overall better prognosis of COVID-19 MESHD children compared to adults. Remdesivir, an investigational antiviral therapy, may have played a role on the clinical improvement of the child.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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