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SARS-CoV-2 proteins

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    Mast Cells and COVID-19 MESHD: a case report implicating a role of mast cell activation in the prevention and treatment of Covid-19 MESHD

    Authors: Isabelle Brock; Anne Maitland

    doi:10.21203/rs.3.rs-330667/v2 Date: 2021-03-15 Source: ResearchSquare

    Coronavirus disease MESHD ( COVID-19 MESHD) is a heterogeneous syndrome MESHD following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD of the upper respiratory tract. ln adults, the clinical condition can range from asymptomatic cases to severe acute respiratory syndrome MESHD and multi-organ dysfunction MESHD. Those at risk of developing COVID-19 MESHD related hyperinflammatory syndrome MESHD likely had an ineffective, innate immune response to this novel pathogen. Mast cells are associated with the epithelium, contributing to tissue homeostasis and epithelial barrier defense. Equipped with an array of pathogen receptors, mast cells exhibit distinct cytokine profiles, dependent on the tissue and the triggered pathogen receptors. Following viral infections, mast cells produce pro-inflammatory chemical mediators, such as interleukin-1 (IL-1) and IL-6 HGNC, and these cytokines has been shown to be elevated in severe COVID-19 MESHD cases. Here, we present a case of a patient with a longstanding history of signs and symptoms, worrisome for a mast cell activation syndrome MESHD ( MCAS MESHD), but never had laboratory confirmation of this non-clonal mast cell activation disorder, until she contracted COVID-19 MESHD. This case illustrates the need to recognize the rate of mast cell activation in SARS-CoV-2 infection MESHD, not only to optimize anti-SARS-CoV-2 therapy, including the development of vaccine, but to potentially curb the risk of SARS­ CoV-2 triggered hyperinflammatory syndrome MESHD.

    Plasma ACE2 HGNC levels predict outcome of COVID-19 MESHD in hospitalized patients

    Authors: Tue W Kragstrup; Helene S Singh; Ida Grundberg; Ane L L Nielsen; Felice Rivellese; Arnav Mehta; Marcia B Goldberg; Michael Filbin; Per Qvist; Bo Martin Bibby

    doi:10.1101/2021.03.08.21252819 Date: 2021-03-10 Source: medRxiv

    Background Severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) binds to angiotensin converting enzyme 2 ( ACE2 HGNC) enabling entrance of the virus into cells and causing the infection termed coronavirus disease of 2019 ( COVID-19 MESHD). COVID-19 MESHD is a disease with a very broad spectrum of clinical manifestations, ranging from asymptomatic and subclinical infection to severe hyperinflammatory syndrome MESHD and death MESHD. Methods This study used data from a large longitudinal study of 306 COVID-19 MESHD positive patients and 78 COVID-19 MESHD negative patients (MGH Emergency Department COVID-19 MESHD Cohort with Olink Proteomics). Comprehensive clinical data were collected on this cohort, including 28-day outcomes classified according to the World Health Organization (WHO) COVID-19 MESHD outcomes scale. The samples were run on the Olink Explore 1536 platform which includes measurement of the ACE2 HGNC protein. Findings High baseline levels of ACE2 HGNC in plasma from COVID-19 MESHD patients were associated with worse WHOmax category at 28 days with OR=0.56, 95%-CI: 0.44-0.71 (P < 0.0001). This association was significant in regression models with correction for baseline characteristics, pre-existing medical conditions, and laboratory test results. High levels of ACE2 HGNC in plasma from COVID-19 MESHD patients were also significantly associated with worse WHO category at the time of blood sampling at both day 0, day 3, and day 7 (P = 0.0004, P < 0.0001, and P < 0.0001, respectively). The levels of ACE2 HGNC in plasma from COVID-19 MESHD patients with hypertension MESHD were significantly higher compared to patients without hypertension MESHD (P = 0.0045). The plasma ACE2 HGNC levels were also significantly higher in COVID-19 MESHD patients with pre-existing heart conditions and kidney disease MESHD compared with patients without these pre-existing conditions (P = 0.0363 and P = 0.0303, respectively). There was no difference in plasma ACE2 HGNC levels comparing patients with or without pre-existing lung disease MESHD, diabetes MESHD, or immunosuppressive conditions (P = 0.953, P = 0.291, and P = 0.237, respectively). The associations between high plasma levels of ACE2 HGNC and worse WHOmax category during 28 days were more pronounced in COVID-19 MESHD positive patients compared with COVID-19 MESHD negative patients but the difference was not significant in the two-way ANOVA analysis. Interpretation This study suggests that measuring ACE2 HGNC is potentially valuable in predicting COVID-19 MESHD outcomes. Further, ACE2 HGNC levels could be a link between severe COVID-19 MESHD disease and its risk factors, namely hypertension MESHD, pre-existing heart disease MESHD and pre-existing kidney disease MESHD. The design of the data analysis using the Olink platform does not allow assessment of quantitative differences. However, previous studies have described a positive correlation between plasma ACE2 HGNC and ACE1 HGNC activity. This is interesting because ACE1 HGNC (serum ACE HGNC) analysis is a standardized test in most hospital laboratories. Therefore, our study encourages quantitative investigations of both plasma ACE 1 and 2 in COVID-19 MESHD.

    Elevated HScore is Associated with Poor Clinical Outcomes in COVID-19 MESHD, Even in the Absence of Secondary Hemophagocytic Lymphohistiocytosis MESHD.

    Authors: Rafael Benavente; Camila Peña M.D.; Allyson Cid M.D.; Nicolás Cabello M.D.; Pablo Bustamante M.D.; Marco Álvarez M.D.; Elizabeth Henríquez M.D.; Andrés Soto M.D.; Érika Rubilar M.D.

    doi:10.1101/2021.01.26.21249335 Date: 2021-01-26 Source: medRxiv

    Introduction: Patients with Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) frequently experience a hyperinflammatory syndrome MESHD, that leads to unfavorable outcomes. This condition resembles Secondary Hemophagocytic Lymphohistiocytosis MESHD (sHLH) described in neoplastic, rheumatic MESHD and other infectious diseases MESHD. However, it has not been prospectively studied on these patients. A scoring system (HScore) has been validated for sHLH, and recently proposed to evaluate hyperinflammation in COVID-19 MESHD. Methods: 143 patients aged [≥]18 years admitted because of COVID-19 MESHD were enrolled in a prospective, single-center, cohort study. HScore was calculated within the 72 hours since admission. The incidence of sHLH during hospitalization was evaluated. Additionally, the relationship between HScore [≥]130 points and either the requirement of mechanical ventilation or 60-days mortality was explored. Results: The median age of enrolled patients was 57 (21-100), and 63.6% were male. The median HScore was 96 (33-169). One patient was diagnosed with sHLH (incidence 0,7%), due to a HScore of 169. After adjusting for age, sex, comorbidities and obesity MESHD, HScore [≥]130 was independently associated with the composite clinical outcome (HR 2.13, p=0.022). Conclusion: sHLH is not frequent among COVID-19 MESHD patients. HScore can efficiently predict the risk for poor outcomes.

    Assessment of Anxiety, Depression and Sleep Disorder MESHD Among Cardiology Physicians During COVID-19 Pandemic MESHD

    Authors: ozlem arican ozluk; Berkay Ekici; mehdi zoghi; elif ilkay yüce; caglar ozmen; Mustafa Yenercag; bilgen kanat; oktay ergene

    doi:10.21203/rs.3.rs-126160/v1 Date: 2020-12-10 Source: ResearchSquare

    Background: In this study, the anxiety MESHD levels and sleep qualities of cardiologists who continue to treat cardiac emergency MESHD patients in addition to their epidemic duties during the period when the COVID 19 pandemic was the most intense and the unknown was the most in our country. Methods:  This cross-sectional study included 347 cardiologists throughout Turkey from April 17 to 20, 2020. The research was conducted by means of a confidential on-line survey. The research used the Turkish versions of the 7-item Generalized Anxiety Disorder MESHD Scale, 7-item Insomnia Severity Index and 9 –item Patient Health Questionnaire.Results : Of the total number of respondents, n= 193 (55.6 %) were aged 31 to 40 years and n= 84 ( 24.2%) were women. 79% of the participants were working in tertiary care centers where cardiac patients and covid patients were admitted and treated more. A considerable proportion of participants reported symptoms of anxiety MESHD (54.2 %), insomnia MESHD (44.1%), and depression MESHD (%71.1). Women cardiologist reported more severe degrees of all measurements of anxiety symptoms MESHD and depression MESHD symptoms than male cardiologists. Mean Generalized Anxiety Disorder MESHD scale scores among women vs male : 6.6 ± 3.5 vs 5.0 ± 4.3 ; p = 0.005 ; mean Insomnia Severity Index scores among women vs male doctors: 7.3±4.3 vs 6.9±4.6; P > 0.05; mean Impact of Event Scale–Revised scores among women vs male cardiologists : 8.0 ± 3.9 vs 6.8± 4.7; p = 0.02. Conclusions: In this survey, during this outbreak most of the cardiologists were found to be mentally challenged while continuing their profession. Especially the anxiety MESHD and depression MESHD symptoms of female doctor are higher than their male counterparts. The anxiety and stress disorder MESHD created by this pandemic may have serious consequences in the future, especially for physicians in intensive branches such as cardiology, who have to serve large patient groups in like low and middle-income countries. It should not be ignored that female doctors working in these branches are more sensitive to burnout syndrome MESHD.

    Identification of a unique TCR repertoire, consistent with a superantigen selection process in Children with Multi-system Inflammatory Syndrome

    Authors: Rebecca A Porritt; Lisa Paschold; Magali Noval Rivas; Mary Hongying Cheng; Lael M Yonker; Harsha Chandnani; Merrick Lopez; Donjete Simnica; Christoph Schultheiss; Chintda Santiskulvong; Jennifer Van Eyk; Alessio Fasano; Ivet Bahar; Mascha Binder; Moshe Arditi

    doi:10.1101/2020.11.09.372169 Date: 2020-11-09 Source: bioRxiv

    Multisystem Inflammatory Syndrome in Children ( MIS HGNC-C), a hyperinflammatory syndrome MESHD associated with SARS-CoV-2 infection MESHD, shares many clinical features with toxic shock syndrome MESHD, which is triggered by bacterial superantigens. The superantigen specificity for binding different Vbeta-chains results in Vbeta-skewing, whereby T cells with specific Vbeta-chains and diverse antigen specificity are overrepresented in the TCR repertoire. Here, we characterized the TCR repertoire of MIS HGNC-C patients and found a profound expansion of TCR Beta Variable gene (TRBV)11-2. Furthermore, TRBV11-2 skewing was remarkably correlated with MIS HGNC-C severity and serum cytokine levels. Further analysis of TRBJ gene usage and CDR3 length distribution of MIS HGNC-C expanding TRBV11-2 clones revealed extensive junctional diversity, indicating a superantigen-mediated selection process for TRBV expansion. In silico modelling indicates that polyacidic residues in TCR Vbeta11-2 engage in strong interactions with the superantigen-like motif of SARS-CoV-2 spike PROTEIN glycoprotein. Overall, our data indicate that the immune response in MIS HGNC-C is consistent with superantigenic activation.

    Extremely wicked, shockingly evil and undoubtedly COVID-19 MESHD: the silent serial killer

    Authors: Anasuya Guha; Jan Plzak; Petr Schalek; Martin Chovanec

    doi:10.21203/rs.3.rs-95644/v1 Date: 2020-10-20 Source: ResearchSquare

    Background:The SARS-COV-2 virus has more than just an infectious role to play in the society. The rapid spread has also led to significant personal, professional, financial and economic recession globally. Health care professionals are getting seriously compromised due to these issues.  No published data is available on the indirect effects of COVID-19 MESHD on high risk medical specialties. Otorhinolaryngology is considered as one such specialty. Hence we designed a national survey to address these issues.Materials and Methods: A google questionnaire was sent to all the otorhinolaryngologists in Czech Republic with the help of the Czech Society of Otorhinolaryngology and Head and Neck Surgery to evaluate the problems they encountered during the first wave of COVID-19 MESHD.  Personal, professional and financial losses were also addressed. Online access to the survey was from 15thApril 2020 to 26th April 2020.Results: The psychosomatic MESHD indirect impact of the disease affected female doctors than males. Burnout syndrome MESHD was the most commonly reported problem. Around 44.75% of all doctors had a combination of health, financial and economic as well as professional development and educational issues. Doctors from private practices faced higher financial losses.Conclusions: Our study showed that personal, professional and financial disturbances MESHD amongst doctors can lead to more serious consequences. With the lack of drastic measures in improving the support system for healthcare workers, the healthcare systems will fail quickly. Adequate support should be made mandatory by health authorities.

    Participatory syndromic surveillance as a tool for tracking COVID-19 MESHD in Bangladesh

    Authors: Ayesha S Mahmud; Shayan Chowdhury; Kawsar Hossain Sojib; Anir Chowdhury; Md. Tanvir Quader; Sangita Paul; Md. Sheikh Saidy; Ramiz Uddin; Kenth Engo-Monsen; Caroline O Buckee

    doi:10.1101/2020.08.28.20183905 Date: 2020-09-01 Source: medRxiv

    Limitations in laboratory diagnostic capacity and reporting delays have hampered efforts to mitigate and control the ongoing coronavirus disease MESHD coronavirus disease 2019 MESHD ( COVID-19 MESHD) pandemic globally. To augment traditional lab and hospital-based surveillance, Bangladesh established a participatory surveillance system for the public to self-report symptoms consistent with COVID-19 MESHD through multiple channels. Here, we report on the use of this system, which received over 3 million responses within two months, for tracking the COVID-19 MESHD outbreak in Bangladesh. Although we observe considerable noise in the data and initial volatility in the use of the different reporting mechanisms, the self-reported syndromic data exhibits a strong association with lab-confirmed cases at a local scale. Moreover, the syndromic data also suggests an earlier spread of the outbreak across Bangladesh than is evident from the confirmed case counts, consistent with predicted spread of the outbreak based on population mobility data. Our results highlight the usefulness of participatory syndromic MESHD surveillance for mapping disease burden generally, and particularly during the initial phases of an emerging outbreak.

    Severe Paediatric Multisystem Inflammatory Syndrome (PIMS) in a 23 months old baby post COVID-19 MESHD effectively managed with IVIG and pulse Steroid: Case report 

    Authors: Dr Yogesh Kumar Gupta; Dr Sowmya Shenoy; Dr Kuldip G Paike; Dr Mrigendra Nath Tudu

    doi:10.21203/rs.3.rs-68719/v1 Date: 2020-08-30 Source: ResearchSquare

    C oronavirus disease MESHD( COVID-19 MESHD) in children largely causes mild disease. Some of these recovered children may present with delayed manifestations described as H yperinflammatory syndrome MESHDresembling closely with K awasaki disease MESHD(K D) MESHD or T oxic Shock Syndrome MESHD(T SS) MESHD. Timely identification, supportive treatment and treatment with immunomodulatory drugs make a significant difference in the outcome.

    Burnout in the Clinical Personnel of Puerto Rico during the COVID-19 MESHD COVID-19 MESHD Pandemic

    Authors: Gustavo Cortina-Rodríguez; Yelianne Afanador

    id:10.20944/preprints202007.0451.v1 Date: 2020-07-19 Source: Preprints.org

    Objective: To examine the burnout syndrome among the healthcare personnel in Puerto Rico during the COVID-19 MESHD COVID-19 MESHD pandemic. Methods: Descriptive study that pursues to understand burnout syndrome in the clinical personnel in Puerto Rico. The Maslach Burnout Inventory (MBI) was sent via email to healthcare professionals around the island. Furthermore, open questions were asked to the participants. Results: The overall burnout level on the clinical personnel was found to be moderate. Nonetheless, in physicians, 12.1% had severe burnout levels compared to a 13.1% score in nurses. Additionally, 92.4% of physicians and 100% of nurses had moderate to severe burnout. In the three subscales, nurses scored high levels in all of them, and physicians were high in Emotional Exhaustion and moderate level in Depersonalization and Personal Accomplishment at Work. There were high levels of burnout syndrome of the clinical personnel in Puerto Rico. Conclusion: Since the beginning of the COVID-19 pandemic MESHD, over 90% of healthcare professionals in Puerto Rico have been working with moderate to severe burnout syndrome MESHD, being the nurses the most affected. Key Words: Burnout syndrome, MBI, Clinical personnel, COVID-19 MESHD, SARS-CoV-2

    Neurological manifestations associated with COVID-19 MESHD: a nationwide registry

    Authors: Elodie Meppiel; Nathan Peiffer-Smadja; Alexandra Maury; Imen Bekri; Cecile Delorme; Virginie Desestret; Lucas Gorza; Geoffroy Hautecloque-Raysz; Sophie Landre; Annie Lannuzel; Solene Moulin; Peggy Perrin; Paul Petitgas; Francois Sellal; Adrien Wang; Pierre Tattevin; Thomas de Broucker; - contributors to the NeuroCOVID registry

    doi:10.1101/2020.07.15.20154260 Date: 2020-07-16 Source: medRxiv

    Background: The clinical description of the neurological manifestations in COVID-19 MESHD patients is still underway. This study aims to provide an overview of the spectrum, characteristics and outcomes of neurological manifestations associated with SARS-CoV-2 infection MESHD. Methods: We conducted a nationwide, multicentric, retrospective study during the French COVID-19 MESHD epidemic in March-April 2020. All COVID-19 MESHD patients with de novo neurological manifestations were eligible. Results: We included 222 COVID-19 MESHD patients with neurological manifestations from 46 centers throughout the country. Median age was 65 years (IQR 53-72), and 136 patients (61.3%) were male. COVID-19 MESHD was severe or critical in almost half of the patients (102, 45.2%). The most common neurological diseases MESHD were COVID-19 MESHD associated encephalopathy MESHD (67/222, 30.2%), acute ischemic cerebrovascular syndrome MESHD (57/222, 25.7%), encephalitis MESHD (21/222, 9.5%), and Guillain-Barre Syndrome MESHD (15/222, 6.8%). Neurological manifestations appeared after first COVID-19 MESHD symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19 MESHD associated encephalopathy MESHD, 7 (5-10) days in encephalitis MESHD, 12 (7-18) days in acute ischemic cerebrovascular syndrome MESHD and 18 (15-28) days in Guillain-Barre Syndrome MESHD. Brain imaging was performed in 192 patients (86.5%), including 157 MRI (70.7%). Brain MRI of encephalitis MESHD patients showed heterogeneous acute non vascular lesion in 14/21 patients (66.7%) with associated small ischemic lesion or microhemorrhages MESHD in 4 patients. Among patients with acute ischemic cerebrovascular syndrome MESHD, 13/57 (22.8%) had multi territory ischemic strokes MESHD, with large vessel thrombosis MESHD in 16/57 (28.1%). Cerebrospinal fluid was analyzed in 97 patients (43.7%), with pleocytosis MESHD in 18 patients (18.6%). A SARS-CoV-2 PCR was performed in 75 patients and was positive only in 2 encephalitis MESHD patients. Among patients with encephalitis MESHD, ten out of 21 (47.6%) fully recovered, 3 of whom received corticosteroids (CS). Less common neurological manifestations included isolated seizure MESHD (8/222, 3.6%), critical illness neuropathy MESHD (8/222, 3.6%), transient alteration of consciousness (5/222, 2.3%), intracranial hemorrhage MESHD (5/222, 2.3%), acute benign lymphocytic meningitis MESHD (3/222, 1.4%), cranial neuropathy MESHD (3/222, 1.4%), single acute demyelinating lesion MESHD (2/222, 0.9%), Tapia syndrome MESHD (2/222, 0.9%), cerebral venous thrombosis MESHD (1/222, 0.5%), sudden paraparesis MESHD (1/222, 0.5%), generalized myoclonus MESHD and cerebellar ataxia MESHD (1/222, 0.5%), bilateral fibular palsy (1/222, 0.5%) and isolated neurological symptoms ( headache MESHD, anosmia MESHD, dizziness MESHD, sensitive or auditive symptoms MESHD, hiccups MESHD, 15/222, 6.8%). The median (IQR) follow-up of the 222 patients was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). Conclusion: Neurological manifestations associated with COVID-19 MESHD mainly included CAE, AICS, encephalitis MESHD and GBS MESHD. Clinical spectrum and outcomes were broad and heterogeneous, suggesting different underlying pathogenic processes.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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