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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    The Impact of COVID-19 on Medical Practice: A Nationwide Survey of Dermatologists and Healthcare Providers

    Authors: Mohammed Shanshal; Hayder Saad Ahmed; Hayder Asfoor; Raad Ibrahim Salih; Shehab Ahmed Ali; Yusif k. Aldabouni

    doi:10.1101/2020.07.26.20156380 Date: 2020-08-04 Source: medRxiv

    Background: The COVID-19 pandemic has dramatically changed medical practice worldwide. It posed a significant impact on different health services, including dermatology. Methods and objectives: Two online surveys were conducted to determine the prevalence SERO of personal protective equipment-related skin complications (200 healthcare providers were included) and to demonstrate the outbreak s impact on dermatology practice (100 dermatologists were included). Results: In the first survey, the response rate was 72.46%. PPE- related dermatoses were reported by 147 (73%) participants, including frictional dermatitis MESHD (51.9%), mechanical acne HP (33.1%), contact dermatitis MESHD contact dermatitis HP (29.9%), nonspecific rash (17.5%), urticaria MESHD urticaria HP (9.1%) and skin infections MESHD (3.2%). The response rate of the second survey was 64%. COVID-19 emerging cutaneous manifestations were recognized by 20% of dermatologists, including maculopapular rash (41.67%), urticaria MESHD urticaria HP (37.50%), chilblain MESHD chilblain HP (25%) and vasculitis MESHD vasculitis HP (16.67). Telemedicine was provided by 73% of the dermatologists. The relapse rates of psoriasis MESHD, atopic dermatitis MESHD atopic dermatitis HP, rosacea MESHD, vitiligo MESHD vitiligo HP and alopecia areata MESHD alopecia areata HP were noticeably increased as observed by 62%, 50%, 20%, and 4% of dermatologists, respectively. Most dermatologists (89%) reported minimal use of immunosuppressive drugs amid the pandemic. Conclusions: This article highlights the pivotal role of dermatologists in the leading edge during the current health crisis and how they adapt to these unfamiliar circumstances to meet the challenges. It documents the emergence of PPE-related dermatoses among healthcare providers and the impact of COVID-19 on different aspects of dermatology practice.

    From SARS-CoV-2 hematogenous spreading to endothelial dysfunction: clinical-histopathological study of cutaneous signs of COVID-19

    Authors: Angela Patrì; Maria Vargas; Pasquale Buonanno; Maria Carmela Annunziata; Daniela Russo; Stefania Staibano; Giuseppe Servillo; Gabriella Fabbrocini

    doi:10.21203/rs.3.rs-50000/v1 Date: 2020-07-28 Source: ResearchSquare

    Background: To date, very few studies on clinical-histopathological correlations of cutaneous disorders associated with COVID-19 have been conducted. Case presentation: The Case 1 was a 90-year-old man, who tested positive for SARS-CoV-2 from a nasopharyngeal swab. Two days later,  he was hospitalized and after eleven days transferred to Intensive Care Unit. A chest CT showed bilateral ground-glass opacities. Just that day, an erythematous maculo-papular rash appeared on trunk, shoulders and neck, becoming purpuric after few days. Histological evaluations revealed a chronic superficial dermatitis MESHD with purpuric aspects. The superficial and papillary dermis appeared edematous, with a perivascular lympho-granulocytic infiltrate and erythrocytic extravasation. At intraepithelial level, spongiosis and a granulocyte infiltrate were detected. Arterioles, capillaries and post-capillary venules showed endothelial swelling and appeared ectasic. The patient was treated with hydroxychloroquine, azithromycin, lopinavir-ritonavir and tocilizumab. Regrettably, due to severe lung impairment, he died.The Case 2 was a 85-year-old man, admitted to Intensive Care Unit, where he was intubated. He had tested positive for SARS-CoV-2 from a nasopharyngeal swab two days before. A chest RX showed bilateral atypical pneumonia MESHD pneumonia HP. After seven days, a cutaneous reddening involving trunk, upper limbs, neck and face developed, configuring a sub- erythroderma HP. Histological evaluations displayed edema MESHD edema HP in the papillary and superficial reticular dermis, and a perivascular lymphocytic infiltrate in the superficial dermis. The patient was treated with hydroxychloroquine, azithromycin, lopinavir-ritonavir and tocilizumab. Sub- erythroderma HP as well as respiratory symptoms gradually improved until healing. Conclusions: The endothelial swelling detected in the Case 1 could be a morphological expression of SARS-CoV-2-induced endothelial dysfunction. We hypothesize that cutaneous damage could be initiated by endothelial dysfunction, caused by SARS-CoV-2 infection MESHD of endothelial cells or induced by immune system activation. The disruption of endothelial integrity could enhance microvascular permeability, extravasation of inflammatory cells and cytokines, with cutaneous injury. The Case 2 developed a sub- erythroderma HP associated with COVID-19, and a non-specific chronic dermatitis MESHD was detected at histological level. We speculate that a purpuric rash could represent the cutaneous sign of a more severe coagulopathy, as highlighted histologically by vascular abnormalities, while a sub- erythroderma HP could be expression of viral hematogenous spreading, inducing a non-specific chronic dermatitis MESHD.

    Inhibitory Effect of Phytochemicals from Azadirachta indica A Juss. and Tinospora cordifolia (Thunb.) Miers against SARS-CoV-2 Mpro and Spike Protease- An In Silico Analysis

    Authors: RAMAKRISHNAMACHARYA CH; VANITHA MURALIKUMAR; CHANDRASEKAR S

    doi:10.21203/rs.3.rs-40646/v1 Date: 2020-07-08 Source: ResearchSquare

    COVID 19 caused by SARS-CoV-2 is spreading worldwide and affected 10 million people with a mortality rate between 0.5 % to 5%. Medicinal plants from China, Morocco, Algeria, Africa and India were tested for antiviral efficacy in SARS-CoV-2. Ayurveda Medicine described many medicinal plants. The Nimba (Azadirachta indica A. Juss) is used in fever MESHD fever HP, bacterial and viral infections MESHD, and Amrita (Tinospora cordifolia (Thunb.) Miers) is used as antiviral, antipyretic, and anti-inflammatory purposes. The combination of both these plants is called Nimbamritam, and it is widely used in pyrexia, dermatitis MESHD, viral infections MESHD, etc. Spike protease (PDB ID 6VXX) and Mpro (PDB ID 6LU) were retrieved from RCSB and 16 ligands from A. indica and 6 ligands from T. cordifolia were obtained from IMPPAT and PubChem. AutoDock Vina embedded PyRx was used for docking. Remdesivir was taken as a reference drug. In silico study of Cordifolide A of T cordifolia showed the highest scores with -8.2 Kcal/mol and -10.3Kcal/mol with Mpro protease and Spike protease respectively. Cordifolide A had 4 H bonds and Kaempferol had 7 non-conventional bonds, including van der Waal with Mpro (6LU7) protease. The interactions with 6VXX had 5 H bonds in each ligand Cordifolide A and Azadirachtin B. The prevention of virus entry by targeting spike protease host receptor ACE2 and restricting replication of the viral genome by targeting Mpro residues were identified in our study. A. indica and T. cordifolia are promising therapeutic agents in COVID 19. 

    If the link missed:Could inflammatory skin disorders with barrier dysfunction increase the risk of COVID-19?

    Authors: Qiannan Xu; Lihong Chen; Li Zhang; Mengyan Hu; Xiaopan Wang; Qi Yang; Yunchen Le; Feng Xue; Xia Li; Jie Zheng

    doi:10.1101/2020.06.30.181297 Date: 2020-07-01 Source: bioRxiv

    Since the end of 2019, COVID-19 pandemic caused by the SARS-CoV-2 emerged globally. The angiotensin-converting enzyme 2 (ACE2) on the cell surface is crucial for SARS-COV-2 entering into the cells. The expression of ACE2 in skin suggested that skin might be a way of transmitting SARS-CoV-2. We found the elevated ACE2 level of patients with psoriasis MESHD but downregulated after IL-17 antibody SERO treatment. Further results showed that ACE2 expression increased either in psoriasis MESHD or in atopic dermatitis MESHD atopic dermatitis HP, which were typical inflammatory skin disorders with barrier dysfunction. And elevated ACE2 level was also detected in mouse models of dermatitis MESHD induced by imiquimod, calcipotriol, repeated tape-stripping or 1-Fluoro-2,4-dinitrobenzene (DNFB) respectively. Moreover, alleviation of cutaneous inflammation MESHD with skin recovery moisture also lowered expression of ACE2 in mouse models with barrier deteriorated inflammatory skin disorders. Furthermore, inflammatory skin disorders with barrier dysfunction increased the penetration of topical FITC conjugated spike protein into the skin. Conversely, improvement in skin permeability barrier could prevent this penetration. Thus, indicating the special link between inflammatory skin disorders with skin barrier dysfunction and increasing risk of COVID-19.

    A child TRANS confirmed COVID-19 with only symptoms of conjunctivitis MESHD conjunctivitis HP and eyelid dermatitis MESHD

    Authors: Ping Wu; liang liang; Jun Yang; ChunBao Chen; ShengQiong Nie

    doi:10.21203/rs.3.rs-22835/v1 Date: 2020-04-13 Source: ResearchSquare

    The outbreak of the 2019 novel coronavirus disease MESHD (COVID-19) infection in China had quickly spread worldwide. Recent reports showed that conjunctivitis MESHD conjunctivitis HP symptoms were found in a small number of adult TRANS patients diagnosed with COVID-19. But rare children TRANS diagnosed with COVID-19 were reported to have eye symptoms. Our case showed a 2 years and 10 months old child confirmed COVID-19 had no symptoms other than conjunctivitis and eyelid dermatitis MESHD, suggesting that doctors shouldn’t forget to conduct COVID-19 screening when children TRANS come to hospital for ocular surface symptoms during this epidemic period.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).

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MeSH Disease
Human Phenotype
Transmission
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