The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 is associated with excessive inflammation, as a main reason for severe condition and death. Increased inflammatory cytokines and humoral response to SARS-CoV-2 correlate with COVID-19 immunity and pathogenesis. Importantly, the levels of pro-inflammatory cytokines that increase profoundly in systemic circulation appear as part of the clinical pictures of two overlapping conditions, sepsis and the hemophagocytic syndromes. Both conditions can develop lethal inflammatory responses that lead to tissue damage, however, in many patients hemophagocytic lymphohistiocytosis (HLH) can be differentiated from sepsis. This is a key issue because the life-saving aggressive immunosuppressive treatment, required in the HLH therapy, is absent in sepsis guidelines. This paper aims to describe the pathophysiology and clinical relevance of these distinct entities in the course of COVID-19 that resemble sepsis and further highlights two effector arms of the humoral immune response (inflammatory cytokine and immunoglobulin production) during COVID-19 infection.
In the present study, the effect of Dracocephalum kotschyi essential oil (DKE) was investigated on growth, haematology, immune and antioxidant defence system and resistance of rainbow trout juveniles to bacterial infection (Aeromonas hydrophila). For this purpose, the fish were fed a diet containing different concentrations of DKE including 0 (control), 0.2, 0.25 and 0.3 mg/kg diet in three replicates for 60 days. After feeding trial, the fish were challenged with a pathogenic dose of A. hydrophila. Based on the results, immune components in plasma (alternative complement activity [ACH 50 ], IgM content, lysozyme activity, total protein and total albumin) and mucus (protease activity, IgM content and lysozyme activity) significantly elevated in fish fed diet containing 0.2 and 0.25 mg DKE/kg diet compared with other groups (p < 0.01). The plasma bactericidal activity increased in all DKE-supplemented fish. Supplementation of fish with 0.3 mg DKE/kg diet depressed the mucosal lysozyme activity and IgM content.
The HR crisis has affected the health system, but there is little research into how this HR disruption affects medical workers. Understanding the impact on the health of medical personnel is essential; the COVID-19 outbreak is still sweeping the world. With the empirical literature, we have succeeded in summarizing the impact of the HR crisis on the health of medical personnel. Exploratory systematic reviews have identified qualitative, theory-based empirical evidence against practitioners. We have searched a database of relevant HR crises and health issues. Then we analyzed it in depth with a phenomenological approach. A total of 40 peer-reviewed publications were reviewed, referring to the HR crisis and its impact on the health of medical personnel. Finally, this study confirms that the human resource crisis is transmitted to medical personnel through several models: (1) a decrease in the quality of health services; (2) the impact of inadequate service measures; and (3) increasing demands for health services from patients; (4) A wave of community protests for treatment; (5) service and budget inefficiency.
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