Several biomarkers have been evaluated as predictors of severity or in
directing the treatment of COVID-19, however there are no conclusive
results with prediction of the pathobiology of the infection. In this
study, we evaluated serum levels of cytokines, chemokines, and cell
growth factors in association with the pathobiology of mild to moderate
SARS-CoV-2 infection. Those markers may act as immuno-inflammatory
biomarkers in adults with mild to moderate flu syndrome who sought care
at health units. Serum levels of SARS-CoV-2 infected patients (n=113)
and flu symptoms individuals negative for SARS-CoV-2 (n=58), tested by
the RT-qPCR test - nasal swab were compared to healthy controls (n=53).
Participants who were symptomatic but negative for SARS-CoV-2 were
tested for Influenza A/B and Respiratory Syncytial Virus (RSV). Results
showed that the pro-inflammatory cytokines IL-1β, MCP-3, TNF-α and G-CSF
were increased in symptomatic patients and the cytokines IL-6 and IL-10
were associated with patients positive for SARS-CoV-2 when compared to
healthy controls. Symptoms associated with COVID-19 were fever, anosmia,
ageusia and myalgia. For patients without SARS-CoV-2 infection their
major symptom was sore throat. Five percent (4/83) of SARS-CoV-2
negative patients were positive for RSV. The pathobiology of mild to
moderate SARS-CoV-2 infection was associated with increasing
pro-inflammatory cytokines and also a pleiotropic IL-6 and
anti-inflammatory IL-10 cytokines compared to healthy controls.
Treatment options for mild to moderate COVID-19 is limited.
N-acetylcysteine and bromhexine have antiviral activity and show
potential as treatment options against SARS-CoV-2 infections. This study
evaluates the in vitro antiviral effect of bromhexine (BMX) for
SARS-CoV-2 and determines the efficacy of treatment with BMX in
combination with N-acetylcysteine (NAC) to reduce clinical scores in
patients with mild to moderate COVID-19. Upon evidence from pre-clinical
studies, a single center randomized trial of BMX + NAC
(ClinicalTrials.gov Identifier: NCT04928495) with 420 participants in
total took place in Fortaleza, CE, Brazil. Out of the 420 participants
140 received placebo, 140 received NAC alone, and 140 received NAC +
BMX. Patients were monitored for 10-14 days, where physicians recorded
all signs and symptoms reported. Nasopharyngeal swabs and blood samples
were collected for SARS-CoV-2 RNA testing during the first visit, as
well as 3 and 10 days after. Blood samples were collected at first visit
and 10 days after for immuno-inflammatory biomarkers measurements.
Treatment with NAC+BMX reduced clinical scores and symptoms when
compared to placebo group (2/26; 8% vs 7/18; 39%; p < 0.05).
Fever (≥37.8°C) was reduced by NAC + BMX treatment when compared to
treatment with NAC alone and placebo. This study was limited by a
largely vaccinated population. Our analysis showed that BMX reduces
SARS-CoV-2 infection in vitro. Clinical trial results suggested
that combinatory treatment with NAC + BMX is beneficial in mild to
moderate COVID-19.
We adopted the reverse transcriptase - loop mediated isothermal amplification (RT-LAMP) to detect SARS-Cov-2 in patient samples. Two primer sets for genes N and Orf1ab were designed to detect SARS-CoV-2, and one primer set was designed to detect the human gene Actin. We collected prospective 138 nasopharyngeal swabs, 70 oropharyngeal swabs, 69 saliva, and 68 mouth saline wash samples from patients suspected to have severe acute respiratory syndrome (SARS) caused by SARS-CoV-2 to test the RT-LAMP in comparison with the golden standard technique RT-qPCR. Accuracy of diagnosis using both primers, N5 and Orf9, was evaluated. Sensitivity and specificity for diagnosis was 96% (95% CI 87-99) and 85% (95% CI 76-91) in 138 samples, respectively. Accurate diagnosis results were obtained only in nasopharyngeal swab processed via extraction kit. Accurate and rapid diagnosis could aid COVID-19 pandemic management by identifying, isolating, and treating patients rapidly.
We report a case of COVID-19-associated meningoencephalitis with a fatal outcome in a male patient with concomitant influenza A, who had been hospitalized at the beginning of 2022, in the Northeastern region of Brazil. He died due to cardiopulmonary arrest after developing
status epilepticus
on the third day of hospitalization. The SARS-CoV-2 RNA was detected in cerebrospinal fluid and Influenza A was detected in the nasopharyngeal swab. Meningoencephalitis due to COVID-19 is a rare manifestation and physicians must be aware of this complication, mainly during the pandemic. In viral co-circulation situations, the possibility of respiratory coinfections should be remembered.
Com base em dados da China, onde a pandemia se deu origem, a lesão cardíaca se tornou uma característica proeminente da doença, acometendo até 30% dos pacientes e auxiliando para 40% das mortes. Foram descritas diversas complicações cardiovasculares, como lesão miocárdica (20% dos casos), arritmias (16%), miocardite (10%), além de insuficiência cardíaca (IC) e choque (até 5% dos casos). O objetivo desse trabalho é informar e descrever sobre a nova miocardite ocasionada pelo novo vírus. E demonstrar a importância para novos estudos relacionados com a nova doença. Foram utilizadas todas as publicações que possuírem dados sobre a nova miocardite em pacientes com o novo SARS-CoV-2, publicações científicas, oficiais da Organização Mundial da Saúde e governamentais, dentre a determinada data (2019-2021). Foram encontrados aproximadamente 500 artigos, foram verificados os idiomas, e se realmente se tratava sobre o tema da nova miocardite relacionada ao novo vírus, então foram obtidos 39 artigos para a realização da discussão. A lesão do miocárdio, sinalizada por marcadores foi evidenciada já nos primeiros casos da doença. O Conselho Nacional de Saúde da China demonstrou em um relatório, 12% dos pacientes sem problemas cardiovasculares. Sendo assim, já que o SARS-CoV-1 e SARS-CoV-2 atinge as células através da enzima conversora de angiotensina 2, onde isso possivelmente acontece também em pacientes infectados com o novo vírus. Porém ainda são necessárias mais pesquisas para comprovação dessas possíveis teorias.
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