Despite the burden of disease of CVD and DM, there is a lack of experimentally validated literature exploring their association with exacerbation of COVID-19. Target receptors of medications commonly used to treat CVD and DM may be involved in the viral entry mechanism of SARS-CoV-2. We propose the potential protective effects of these medications in COVID-19 infections, highlighting the need for further research. Firstly, AMPK mediated phosphorylation of ACE-2 by metformin as well as the drug’s alkaline properties may interrupt the natural disease progression. Secondly, DPP4 receptor involvement in the putative viral entry of SARS-CoV-2 may be prevented by DPP4i. Finally, recent studies have shown that statins’ ability to inhibit the cytokine storm may outweigh concerns of statin mediated ACE-2 upregulation in COVID-19. The complex interplay of factors affecting CVD and DM in COVID-19 patients makes the direct effects of medications difficult to examine. Therefore, further research is needed, in the context of SARS-CoV-2 and the molecular pathways it exploits, to potentially repurpose such pre-existing drugs for their use in COVID-19.
Stroke is the second leading cause of death globally. Despite the decreasing trend in stroke mortality, its incidence and prevalence follow an upwards trajectory that is envisaged to continue for years to come. Previous literature has suggested a role for infectious disease in stroke aetiology; however, the pathophysiological basis for this has never fully been understood. Emerging infections, such as coronavirus disease (COVID-19), present new challenges that must be addressed, to prevent them from contributing to the predicted rise in stroke incidence. Almost one in 20 patients diagnosed with COVID-19 experience a stroke thereafter, hence achieving better understanding of the interactions between these disease entities is of major clinical significance.
A pericardial cyst is a rare and benign cause of a mediastinal mass. They are frequently asymptomatic and are usually incidental findings on imaging. Symptoms may include persistent cough, atypical chest pain, dysphagia, and dyspnea. Diagnosis is usually established with the aid of imaging, including a chest x-ray, a computed tomography (CT) scan, and magnetic resonance imaging (MRI). Therapeutic options include surgical resection or aspiration for large and/or symptomatic cysts, whereas conservative management with routine follow-up is advised for small or asymptomatic cysts. We herein describe the case of a 48-year-old lady, who presented with clinical features suggestive of acute cholecystitis, with an incidental finding of a pericardial cyst, measuring approximately 10.1 cm x 8.7 cm x 10.7 cm. The patient underwent video-assisted thoracoscopic surgery (VATS) for excision of the pericardial cyst. She had an uneventful recovery and was discharged on the second post-operative day. At six months, there was no evidence of disease recurrence.
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