A metabolic handbook for the COVID-19 pandemic

Ayres, Janelle S.

doi:10.1038/s42255-020-0237-2

Cited by 254 publications

(263 citation statements)

References 112 publications

(190 reference statements)

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“…Além disso um pobre controle glicêmico atrapalha a resposta do sistema imune adaptativo a infecções virais e bacterianas predispondo o paciente à infecções pulmonares secundárias e quadro inflamatório crônico. Na prática, Ayres et al (2020) demonstraram que o novo coronavírus predispõe a evolução à quadros de fibrose pulmonar, doença pulmonar obstrutiva crônica, redução da função respiratória, pneumonia, síndrome do desconforto respiratório agudo e insuficiência respiratória.…”

Section: Discussionunclassified

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Influência do DM2 e do controle glicêmico no prognóstico de pacientes infectados por COVID-19

Aquino

Silva

Oliveira

et al. 2020

BJHR

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RESUMO Objetivo: Verificar, por meio de uma revisão narrativa de literatura, a influência do DM2 no prognóstico da infecção por COVID-19, assim como o impacto do controle glicêmico nos desfechos apresentados por esses pacientes. Revisão bibliográfica: A DM2 relaciona-se com a infecção e a gravidade da SARS-CoV-2. Os sintomas apresentados pelos pacientes diabéticos infectados por SARS-CoV-2 foram muito amplo, entretanto, percebeu-se maior comorbidade nas análises laboratoriais e de imagem, além de maior mortalidade entre os pacientes diabéticos infectados pelos novo coronavírus. A literatura divergiu ao comparar o quadro clínico do pacientes diabéticos e não diabéticos infectados por COVID-19, mas convergiu ao relatar aumento da morbimortalidade. Considerações finais: A adaptação metabólica promovida pelo indivíduo diabético se mostra prejudicial no contexto do COVID-19, predispondo o paciente à infecção e ao surgimento de outras complicações, além de determinar um pior controle glicêmico e prognóstico. Tais achados destacam a necessidade de uma abordagem multidisciplinar para o gerenciamento dessa população de pacientes visando à prevenção de complicações e de formas graves da infecção.

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Section: Discussionunclassified

“…O aumento de bilirrubina total, sem fluxo biliar nem lesão das vias biliares. Mas no contexto clínico, Ayres et al (2020) reporta um risco aumentado para esteatose hepática não alcoólica em pacientes com elevação de enzimas hepáticas séricas.…”

Section: Discussionunclassified

Influência do DM2 e do controle glicêmico no prognóstico de pacientes infectados por COVID-19

Aquino

Silva

Oliveira

et al. 2020

BJHR

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“…The immediate response to any infectious-disease outbreak is to approach it from the pathogen perspective because disease severity is assumed to be a direct function of pathogen burden [27]. However, the complexities of SARS-CoV-2 infection serve as an important reminder that this perspective is not su cient for understanding the survival of infectious diseases [28,29]. Disease and immune tolerance as opposed to hyperin ammatory (cytokine storm) state is proposed to be critical for limiting damage to the host and for improving patient survival in COVID-19 [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Temporal Landscape of Human Gut RNA and DNA Viromes in SARS-CoV-2 Infection and Severity

Zuo

Liu

Zhang

et al. 2020

Preprint

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Background: Coronavirus Disease 2019 (COVID-19) caused by the enveloped RNA virus SARS-CoV-2 primarily affects the respiratory and gastrointestinal tracts. SARS-CoV-2 was isolated from faecal samples and active viral replication was reported in human intestinal cells. The human gut also harbors an enormous amount of resident viruses (collectively known as virome) that play a role in regulating host immunity and pathophysiology. Understanding gut virome perturbation that underlies SARS-CoV-2 infection and severity is an unmet need.Methods:We enrolled 98 COVID-19 patients with varying disease severity (3 asymptomatic, 53 mild, 34 moderate, 5 severe, 3 critical) and 78 non-COVID-19 controls matched for gender and co-morbidities. All study subjects had faecal specimens sampled at inclusion. Blood specimens were sampled for COVID-19 patients at admission to test for inflammatory markers and white cell counts. Among COVID-19 cases, 37 (38%) patients had serially faecal samples collected 2 to 3 times per week from time of hospitalization until after discharge. Using shotgun metagenomics sequencing, we sequenced and profiled the faecal RNA and DNA virome respectively. We investigated alterations and longitudinal dynamics of the gut virome in association with disease severity and blood parameters.Results: Patients with COVID-19 showed underrepresentation of Pepper mild mottle virus (RNA virus) and multiple bacteriophage lineages (DNA viruses) and enrichment of environment-derived eukaryotic DNA viruses in faecal samples, compared to non-COVID-19 subjects. Such gut virome dysbiosis persisted up to 30 days after disease resolution. Faecal virome in SARS-CoV-2 infection harboured more stress-, inflammation- and virulence-associated gene encoding capacities including those pertaining to bacteriophage integration, DNA repair, and metabolism and virulence associated with their bacterial host. Human faecal baseline abundance of 10 virus species (1 RNA virus, Pepper chlorotic spot virus, and 9 DNA virus species) inversely correlated with disease severity of COVID-19. These viruses were also inversely associated with blood levels of pro-inflammatory proteins, white cells and neutrophils. Among the 10 COVID-19 severity-associated DNA virus species, 4 showed inverse correlation with age; 5 showed persistent lower abundance both during disease course and after disease resolution relative to non-COVID-19 subjects.Conclusions: Both enteric RNA and DNA viromes were perturbed in COVID-19, which prolonged even after disease resolution. Gut virome may calibrate host immunity and regulate severity to SARS-CoV-2 infection. Our observation that gut viruses inversely correlated with both severity of COVID-19 and host age partly explains that older subjects are prone to severe and unfavorable COVID-19 outcomes. Our data altogether highlight the significance of human gut virome in COVID-19 disease course and potentially therapeutics.

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“…While high viral burden may predict progression to severe cases of COVID-19, reduction of viral burden in itself may not lead to automatic recovery. 78 Therefore, aggressive measures to block viral entry or replication may seem futile once the disease has become progressive into severe symptoms. Clinical trials of hydroxychloroquine which aims to block viral entry by increasing pH of the endosome has been shown to be ineffective in severe COVID-19 patients.…”

Section: B Second Phase Of Viral Infectionmentioning

confidence: 99%

Knowing When and How to Fight: COVID-19 Between Viral Clearance and Immune Tolerance

Utomo¹

2020

J. Biomed. Transl. Res.

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COVID-19 is a complex disease involving immunological, vascular, and metabolic pathology caused by and consequences of beta-coronavirus SARS-CoV-2 infection. One may use Sun Tzu analogy of war to fight COVID-19 and to survive infection. When enemy has not reached the shore, gathering much intelligence is key to know how the enemy moves and who would be the most vulnerable targets of enemy attacks. Physical distancing, massive nucleic acid testing, and identification of comorbidity may prepare for the incoming enemies. Physical distancing has helped to limit transmission of the virus that mainly due to close contacts with droplets coughed off infected individuals. Moreover, aerosolized virus particles may also contribute to spreading. Nucleic acid testing using real time PCR platform has been a diagnostic gold standard to identify infected individuals during early stage of infection. On the other hand, serological test to capture antibody against SARS-CoV-2 may be useful for immunosurveillance. Discovery of human ACE2 (angiotensin converting enzyme) protein as an obligate partner of SARS-CoV-2 viral entry has provided insights to mechanisms of serious post-infection ramifications to individuals having comorbidities such as hypertension, diabetes or heart conditions. When the enemy reaches ashore, thorough profiling of biomarkers involved in inflammation and coagulation (IL-6, lymphopenia, ground glass opacity, d-dimers, thrombocytopenia) may help predict disease progression and guide treatment strategy. While estimated 80% of infected individuals may recover on their own, the remaining 20% may require hospitalization and serious therapeutic intervention. Several clinical trials are underway such as repurposing existing drugs and evaluating efficacy of convalescence plasma therapy. Finally, vaccine development using genetic engineering may also help control the global spread if it is proven effective.

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A metabolic handbook for the COVID-19 pandemic

Cited by 254 publications

References 112 publications

Influência do DM2 e do controle glicêmico no prognóstico de pacientes infectados por COVID-19

Influência do DM2 e do controle glicêmico no prognóstico de pacientes infectados por COVID-19

Temporal Landscape of Human Gut RNA and DNA Viromes in SARS-CoV-2 Infection and Severity

Knowing When and How to Fight: COVID-19 Between Viral Clearance and Immune Tolerance

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