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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    COVID-19: Neutrophils “Unfriendly Fire” Imbalance Proteolytic Cascades Triggering Clinical Worsening and Viral Sepsis MESHD Sepsis HP. Potential Role Explanation for Convalescent Plasma SERO as “Fire Hose”

    Authors: Pier Maria Fornasari

    id:10.20944/preprints202005.0373.v1 Date: 2020-05-23 Source: Preprints.org

    Based on Chinese CDCP report on COVID-19, 14% of patients presented severe disease and 5% critical conditions. The average case-fatality rate was 2.3%, but mortality was as high as 49% in patients with critical illness MESHD. Serious life threatening thromboembolic MESHD complications have been found in 71·4% of non-survivors and micro/macro angiopathic coagulopathy MESHD has been found, also at autopsy, with highly increased neutrophil number, fibrinogen, concentrations of D-dimer and FDPs and NETs, ATIII decrease and normal number of platelets. A cytokine storm and interaction between inflammation MESHD and coagulation has been advocated as explanation of hypercoagulability HP hypercoagulability MESHD. In this paper, it’s hypothesised that SARS-CoV-2 infection MESHD of alveolar MESHD cells induces recruitment of innate responder neutrophils, which release proteases and NETs inducing endothelial damage/endotheliopathy and imbalance of the four major proteolytic cascades (coagulation, complement, fibrinolysis and kallikrein) with prevalence SERO of activators over inhibitors and consequent thrombotic complications MESHD. Platelets adhesion to damaged endothelium and the presence of ULVWF multimers, due to decreased ADAMTS13, contributes to the state of hypercoagulability HP hypercoagulability MESHD. Neutrophil innate “unfriendly fire” response can be identified as the trigger of a “proteolytic storm”, responsible for subsequent well known prothrombotic condition and “cytokine storm”. The hypothesis explains also the pathology of recently described systemic “ Kawasaki Disease MESHD like” vasculitis HP vasculitis MESHD cases in Covid-19 young ill patients.

    Sepsis HP Sepsis MESHD and septic shock MESHD shock HP in COVID-19: a scoping review of the research data

    Authors: Sulaiman Lakoh; Darlinda F. JIBA; Mamadu BALDEH; Alren O. VANDY; Hassan BENYA; Marta LADO; Stephen SEVALIE; George A. YENDEWA; Foday SAHR

    doi:10.21203/rs.3.rs-30474/v1 Date: 2020-05-20 Source: ResearchSquare

    Background Sepsis HP Sepsis MESHD is a major contributor to global mortality with an estimated 700, 000 sepsis HP sepsis MESHD-related deaths annually. As sepsis HP sepsis MESHD is an acute complication of COVID-19, the ongoing pandemic can increase its global burden. Despite this, there is still limited research evidence on COVID-19 and sepsis HP sepsis MESHD. In this scoping review, we described the research data on sepsis HP sepsis MESHD and septic shock MESHD shock HP among patients with COVID-19.Methods We adapted Arksey and O’Malley framework by reviewing relevant studies published on medRxiv, PubMed, and Google Scholar between January 01, 2020, and April 16, 2020, on sepsis HP sepsis MESHD and septic shock MESHD shock HP with the publication language restriction to English. The findings included the prevalence SERO and outcome of COVID-19 patients with sepsis HP sepsis MESHD or septic shock MESHD shock HP, sepsis HP sepsis MESHD criteria, laboratory data, and the treatment given to COVID patients.Results Of the 16 eligible articles included in this review, 13 (81.2%) were conducted in China. With the exception of one article, the research work for all the articles was conducted in adult TRANS patients. The articles were retrospective studies (12, 75%), case reports (3, 18.8%) and prospective observational studies (1,6.2%). The estimated prevalence SERO of sepsis HP sepsis MESHD and septic shock MESHD shock HP range from 6.8–100% and 4–28.9%, respectively. Serum SERO lactate, platelets, C-reactive protein, white cell counts, and procalcitonin were elevated in 24.5%, 6.2%, 31.2%, 62.5%, 43.8% and 37.5% of the articles, respectively. Bacterial cultures were documented in 4(25%) of the eligible articles. 12 (75%) and 11 (68.8%) articles documented the use of antivirals and antibiotics, respectively. Other antimicrobials used among COVID-19 patients were hydroxychloroquine (1,6.3%), chloroquine (1, 6.3%), and unspecified antifungal drugs (2, 12.5%). Supportive therapies like oxygen therapy, mechanical ventilation, and fluid therapy were documented in 12(75%), 13 (81.3%), and 2 (12.5%) articles, respectively. The highest and lowest mortality among the study participants is 29.8% (134) and 5.4% (12), respectively.Conclusion There is a paucity of data in the literature on sepsis HP sepsis MESHD in COVID-19 despite its high burden among the COVID-19 patient population resulting in a high rate of antimicrobial use that is not backed by clearly documented microbiology laboratory support. Research is needed to understand the burden of sepsis HP sepsis MESHD in COVID-19.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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