Coronavirus 229E with Rhinovirus co-infection causing severe acute respiratory distress syndrome with thrombotic microangiopathy and death during Covid-19 pandemic: lessons to be learnt

Abstract

We report on a 3-month old infant male who had a seven-days history of fever and rhinorrhea associated with wheezing prior to his death, during the Covid-19 pandemic. Viral testing for Covid-19 (SARS-CoV-2) was negative but was positive for Coronavirus 229E and RP Human Rhinovirus. The pulmonary histological examination showed diffuse alveolar damage along with thrombotic microangiopathy affecting alveolar capillaries. Also, thrombotic microangiopathy was evident in the heart, lungs, brain, kidneys and liver. Thrombotic microangiopathy is a major pathologic finding in Acute Respiratory Distress Syndrome and in the multiorgan failure. This is the first report that illustrates thrombotic microangiopathy occurring in lung, heart, liver, kidney and brain in Acute Respiratory Distress Syndrome with Coronavirus 229E with Rhinovirus co-infection. The clinical presentation and pathological findings in our case share common features with Covid-19.

A Bibliometric Analysis of COVID-19 Scientific Literature From the English-Speaking Caribbean

“…Country-wise, frequent first authors are led by Trinidad and Tobago (50), most notably from the UWI, followed by UWI campuses in Barbados (19) and Jamaica (20), and St. George's University in Grenada (10). A numerical analysis of the last author's affiliation and countries shows the same trend as the first authors, with the UWI in Trinidad in the lead, followed by its campuses in Jamaica and Barbados.…”

“…Some of the notable articles include atrial arrhythmia findings and its treatment in Trinidad [47], cardiac findings in COVID-19 infections [48], usage of a short course of prednisone in COVID-19 patients, and how it helped in preventing worsening of shortness of breath in early COVID respiratory failure [49]. Prominent among literature with autopsy findings is the vivid description of pathologies of alveolar microcirculation at pericytes [50,51] with a high concentration of angiotensin-converting enzyme 2 (ACE2) receptors, which are believed to be the primary site of action of SARS-CoV-2.…”

IL‐33 prevents the enhancement of AP‐N, DPP4, and ACE2 expression induced by rhinovirus HRV16 in the human lung endothelium—potential implications for coronaviral airway infections

“…In such patients, the diffuse alveolar lung damage and thrombotic angiopathy in alveolar capillaries have been observed, which suggests an active involvement of the lung vascular endothelium. 4 The effect of HRV on the expression of HCoV entry receptors on the lung vascular endothelium and its modulation by IL‐33 widely distributed in asthmatic airways has not been elucidated.…”

“…In such patients, the diffuse alveolar lung damage and thrombotic angiopathy in alveolar capillaries have been observed, which suggests an active involvement of the lung vascular endothelium. 4 The effect of HRV on the expression of HCoV entry receptors on the lung vascular endothelium and its modulation by IL-33 widely distributed in asthmatic airways has not been elucidated. Firstly, we confirmed the HRV16 infection (MOI3) of human lung microvascular endothelial cells (HMVEC-L) (Figure 1A) and we observed the increase of IFNβ, RANTES (Figure 1B,C) IL-6, and TNFα protein release (Figure S1A,B,C).…”

Nearly Complete Genome Sequences of 12 Types of Human Rhinoviruses Isolated from Pediatric Inpatients in Fukushima, Japan

“…HRVs are a major cause of pediatric pneumonia following respiratory syncytial virus infection and sometimes cause severe acute respiratory infections in children ( 5 – 8 ). HRVs have also been detected in coinfections with acute respiratory pathogens ( 7 – 9 ), and coinfection with coronaviruses has recently been reported to affect the outcome of diseases by exacerbating or reducing virus infections ( 10 , 11 ).…”