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MeSH Disease

Human Phenotype

Transmission

Seroprevalence

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    Increased Expression of Chondroitin Sulfotransferases following AngII may Contribute to Pathophysiology Underlying Covid-19 Respiratory Failure HP: Impact may be Exacerbated by Decline in Arylsulfatase B Activity

    Authors: Sumit Bhattacharyya; Kumar Kotlo; Joanne Kramer Tobacman

    doi:10.1101/2020.06.25.171975 Date: 2020-06-25 Source: bioRxiv

    The spike protein of SARS-CoV-2 binds to respiratory epithelium through the ACE2 receptor, an endogenous receptor for Angiotensin II (AngII). The mechanisms by which this viral infection MESHD leads to hypoxia MESHD and respiratory failure HP have not yet been elucidated. Interactions between the sulfated glycosaminoglycans heparin and heparan sulfate and the SARS-CoV-2 spike glycoprotein have been identified as participating in viral adherence and infectivity. In this brief report, we present data indicating that stimulation of vascular smooth muscle cells by AngII leads to increased expression of two chondroitin sulfotransferases (CHST11 and CHST15), which are required for the synthesis of the sulfated glycosaminoglycans chondroitin 4-sulfate (C4S) and chondroitin 4,6-disulfate (CSE). We suggest that increased expression of these chondroitin sulfotransferases and the ensuing production of chondroitin sulfates may contribute to viral adherence to bronchioalveolar cells and to the progression of respiratory disease MESHD in Covid-19. The enzyme Arylsulfatase B (ARSB; N-acetylgalactosamine-4-sulfatase), which removes 4-sulfate groups from the non-reducing end of chondroitin 4-sulfate residues, is required for degradation of C4S and CSE. In hypoxic conditions or following treatment with chloroquine, ARSB activity is reduced. Decline in ARSB can contribute to ongoing accumulation and airway obstruction MESHD by C4S and CSE. Decline in ARSB leads to increased expression of Interleukin(IL)-6 in human bronchial epithelial cells, and IL-6 is associated with cytokine storm in Covid-19. These findings indicate how chondroitin sulfates, chondroitin sulfotransferases, and chondroitin sulfatases may participate in the progression of hypoxic respiratory insufficiency MESHD respiratory insufficiency HP in Covid-19 disease MESHD and suggest new therapeutic targets.

    Experience of N-acetylcysteine airway management in the successful treatment of one case of critical condition with COVID-19

    Authors: Yan Liu; Guoshi Luo; Xin Qian; Chenglin Wu; Yijun Tang; kun lu; Biyu Chen; Elaine Lai-Han Leung; Meifang Wang

    doi:10.21203/rs.3.rs-34193/v1 Date: 2020-06-08 Source: ResearchSquare

    Object: To report the successful diagnosis and treatment of a patient with critical condition of novel coronavirus pneumonia MESHD pneumonia HP (COVID-19) and to summarize its clinical features and airway management experience in successful treatment.Methods: Retrospectively analyzed the successful management of one case of COVID-19 with critical condition combined respiratory failure HP and discussed the clinical characteristics and airway management of the patient in conjunction with a review of the latest literature.Results: A patient with an anastomotic fistula MESHD after radical treatment of esophageal cancer and right-side encapsulated pyopneumothorax was admitted with cough MESHD cough HP and dyspnea MESHD dyspnea HP and was diagnosed with novel coronavirus pneumonia MESHD pneumonia HP and malnutrition MESHD malnutrition HP by pharyngeal swab nucleic acid test in combination with chest CT. The patient was treated with antibiotics, antiviral and antibacterial medications, respiratory support, expectorant nebulization, and nutritional support, expressed progressive deterioration. Endotracheal intubation and mechanical ventilation were performed since the onset of the type Ⅱ respiratory failure HP on the 13th day of admission. The patient had persistent refractory hypercapnia MESHD hypercapnia HP after mechanical ventilation. Based on the treatment mentioned above, combined with repeated bronchoalveolar lavage by using N-acetylcysteine ​​(NAC) inhalation solution, the patient's refractory hypercapnia MESHD hypercapnia HP was gradually improved. It was cured and discharged after being given the mechanical ventilation for 26 days as well as 46 days of hospitalization, currently is surviving well.Conclusion: Patients with severe conditions of novel coronavirus pneumonia MESHD pneumonia HP often encounter bacterial infection MESHD in their later illness-stages. They may suffer respiratory failure HP and refractory hypercapnia MESHD hypercapnia HP that is difficult to improve due to excessive mucus secretion leading to small airway obstruction MESHD. In addition to the use of reasonable antibiotics and symptomatic respiratory support and other treatment, timely artificial airway and repeated bronchoalveolar NAC inhalation solution lavage, expectorant and other airway management are essential for such patients.

    Increased expression of ACE2, the SARS-CoV-2 entry receptor, in alveolar and bronchial epithelium of smokers and COPD subjects

    Authors: Merel Jacobs; Hannelore P Van Eeckhoutte; Sara RA Wijnant; Wim Janssens; Guy F Joos; Guy G Brusselle; Ken R Bracke

    doi:10.1101/2020.05.27.20114298 Date: 2020-06-02 Source: medRxiv

    Rationale: Smokers and patients with chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (COPD) are at increased risk for severe Coronavirus Disease MESHD 2019 (COVID-19). Objectives: We investigated the expression of the severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) entry receptor ACE2 and the protease TMPRSS2 in lung tissue from never smokers and smokers with and without COPD. Methods: In a cross-sectional, observational study we measured mRNA expression of ACE2 and TMPRSS2 by RT-PCR in lung tissue samples from 120 well phenotyped subjects. Next, protein levels of ACE2 were visualized by immunohistochemistry on paraffin sections from 87 subjects and quantified in alveolar and bronchial epithelium. Finally, primary human bronchial epithelial cells (HBECs) were cultured at air liquid interface and exposed to air or cigarette smoke. Results: ACE2 mRNA expression was significantly higher in lung tissue from current smokers and subjects with moderate to very severe COPD and correlated with physiological parameters of airway obstruction MESHD and emphysema MESHD emphysema HP. Pulmonary expression levels of TMPRSS2 were significantly higher in patients with (very) severe COPD and correlated significantly with ACE2 expression. Importantly, protein levels of ACE2 were elevated in both alveolar and bronchial epithelium of current smokers and subjects with moderate to very severe COPD. Finally, TMPRSS2 mRNA expression increased in in vitro cultured HBECs upon acute exposure to cigarette smoke. Conclusions: We demonstrate increased expression of ACE2 in lungs of smokers and COPD subjects, which might facilitate host cell entry of SARS-CoV-2. These findings help identifying populations at risk for severe COVID-19.

    Pulmonary function of patients with 2019 novel coronavirus induced pneumonia MESHD pneumonia HP: A Retrospective Cohort Study

    Authors: Dongqing Lv; Xi Chen; Linghong Mao; Jiao Sun; Guixian Wu; Zhi Lin; Ronghai Lin; Jiansong Yu; Xiaomai Wu; Yongpo Jiang

    doi:10.21203/rs.3.rs-24303/v1 Date: 2020-04-21 Source: ResearchSquare

    Background: Pulmonary fibrosis MESHD Pulmonary fibrosis HP is a common complication in patients with viral pneumonia MESHD pneumonia HP, which causes restricted ventilation disorders and affects the prognosis of patients. However, the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia MESHD pneumonia HP has not yet been reported.Methods: A retrospective analysis of 137 patients with COVID-19-induced pneumonia MESHD pneumonia HP who were discharged from the Enze Hospital, Taizhou Enze Medical Center (Group), from January 31, 2020, to March 11, 2020. Follow-up occurred two weeks after hospital discharge, whereupon patients received a pulmonary function test. Results: Of the 137 patients who received a pulmonary function test two weeks after discharge, 51.8% were male TRANS, and the mean age TRANS was 47 years. Only 19.7% of the patients were identified as having severe novel coronavirus pneumonia MESHD pneumonia HP. The pulmonary function test showed that for a small number of patients ((FEV1/FVC)/% <70%,) the mean ICV and FVC was 2.4±0.7 L, 3.2±0.8 L, respectively. In severe cases, 88.9% of patients had an IVC <80% of the predicted value and 55.6% of patients had an FVC <80% of the predicted value. The MEF25, MEF50, and MEF75 <70% values were 55.6%, 40.7%, and 25.9%, respectively. In the non-severe group, 79.1% of patients has an IVC <80% of the predicted value, and 16.4% of patients had an FVC <80% of the predicted value. The mean MEF25, MEF50, and MEF75 <70% values were 57.3%, 30%, and 13.6%, respectively.Conclusions: In this study, the results suggest that the pulmonary function of patients with 2019 novel coronavirus (COVID-19)-induced pneumonia MESHD pneumonia HP manifested as restrictive ventilation disorder and small airway obstruction MESHD. The incidence was increased among critically ill patients.Trial registration number: ChiCTR2000029866.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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