Cellular and molecular features of COVID-19 associated ARDS: therapeutic relevance

Scaramuzzo, Gaetano; Nucera, Francesco; Asmundo, Alessio; Messina, Roberto; Mari, Matilde; Montanaro, Federica; Johansen, Matt D.; Monaco, Francesco; Fadda, Guido; Tuccari, Giovanni; Hansbro, Nicole G.; Hansbro, Philip M.; Hansel, Trevor T.; Adcock, Ian M.; David, Antonio; Kirkham, Paul; Caramori, Gaetano; Volta, Carlo Alberto; Spadaro, Savino

doi:10.1186/s12950-023-00333-2

Cited by 5 publications

(4 citation statements)

References 237 publications

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“…Previous studies have shown that in COVID-19 related ARDS, there is a tendency toward a more severe phenotype related to extended pulmonary endothelial injury in the early phase of the disease [ 37 ]. Nevertheless, Ang-2 and ICAM-1 were the only markers observed to be elevated in non-survivors in contrast to survivors [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Endothelial dysfunction and persistent inflammation in severe post-COVID-19 patients: implications for gas exchange

Alfaro,

Díaz-García,

García-Tovar

et al. 2024

BMC Med

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Background Understanding the enduring respiratory consequences of severe COVID-19 is crucial for comprehensive patient care. This study aims to evaluate the impact of post-COVID conditions on respiratory sequelae of severe acute respiratory distress syndrome (ARDS). Methods We examined 88 survivors of COVID-19-associated severe ARDS six months post-intensive care unit (ICU) discharge. Assessments included clinical and functional evaluation as well as plasma biomarkers of endothelial dysfunction, inflammation, and viral response. Additionally, an in vitro model using human umbilical vein endothelial cells (HUVECs) explored the direct impact of post-COVID plasma on endothelial function. Results Post-COVID patients with impaired gas exchange demonstrated persistent endothelial inflammation marked by elevated ICAM-1, IL-8, CCL-2, and ET-1 plasma levels. Concurrently, systemic inflammation, evidenced by NLRP3 overexpression and elevated levels of IL-6, sCD40-L, and C-reactive protein, was associated with endothelial dysfunction biomarkers and increased in post-COVID patients with impaired gas exchange. T-cell activation, reflected in CD69 expression, and persistently elevated levels of interferon-β (IFN-β) further contributed to sustained inflammation. The in vitro model confirmed that patient plasma, with altered levels of sCD40-L and IFN-β proteins, has the capacity to alter endothelial function. Conclusions Six months post-ICU discharge, survivors of COVID-19-associated ARDS exhibited sustained elevation in endothelial dysfunction biomarkers, correlating with the severity of impaired gas exchange. NLRP3 inflammasome activity and persistent T-cell activation indicate on going inflammation contributing to persistent endothelial dysfunction, potentially intensified by sustained viral immune response.

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Section: Discussionmentioning

confidence: 99%

Endothelial dysfunction and persistent inflammation in severe post-COVID-19 patients: implications for gas exchange

Alfaro,

Díaz-García,

García-Tovar

et al. 2024

BMC Med

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“…A dysregulated inflammatory response is also a hallmark alteration in severe COVID-19 cases, especially when causing ARDS [71][72][73]. IL-6 elevation in plasma has been extensively studied in C-ARDS, showing a direct correlation with disease severity [71].…”

Section: Biomarkers In Covid Ards and Non-covid Ardsmentioning

confidence: 99%

Prone Positioning and Molecular Biomarkers in COVID and Non-COVID ARDS: A Narrative Review

Spadaro,

Jimenez-Santana,

La Rosa

et al. 2024

JCM

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Prone positioning (PP) represents a therapeutic intervention with the proven capacity of ameliorating gas exchanges and ventilatory mechanics indicated in acute respiratory distress syndrome (ARDS). When PP is selectively applied to moderate-severe cases of ARDS, it sensitively affects clinical outcomes, including mortality. After the COVID-19 outbreak, clinical application of PP peaked worldwide and was applied in 60% of treated cases, according to large reports. Research on this topic has revealed many physiological underpinnings of PP, focusing on regional ventilation redistribution and the reduction of parenchymal stress and strain. However, there is a lack of evidence on biomarkers behavior in different phases and phenotypes of ARDS. Patients response to PP are, to date, decided on PaO2/FiO2 ratio improvement, whereas scarce data exist on biomarker tracking during PP. The purpose of this review is to explore current evidence on the clinical relevance of biomarkers in the setting of moderate-severe ARDS of different etiologies (i.e., COVID and non-COVID-related ARDS). Moreover, this review focuses on how PP may modulate biomarkers and which biomarkers may have a role in outcome prediction in ARDS patients.

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“…Understanding the cellular and molecular mechanism that is the underlying cause of the development of ARDS in COVID-19 infected patients is important. This will give insights into the development of well-efficient therapies for this disease [22] .…”

Section: Introductionmentioning

confidence: 99%

Smoking and prevalence of COVID-19: Evidence from studies from January 2020 – May 2020

Butt

Sherwani

Aslam

et al. 2023

AIMSPH

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<abstract> <p>It is well-known that smoking tobacco harms the respiratory system and can lead to various health problems. Regarding COVID-19, a respiratory illness caused by the novel coronavirus SARS-CoV-2, smoking may have implications for both the risk of infection and the severity of the disease. Several studies have explored the association between smoking and COVID-19. However, findings have been somewhat inconsistent and vary from region to region for sample size. This article aims to study the prevalence of COVID-19 among those affected with their ongoing smoking history by computing pooled estimates of the published research. Fixed effect meta-analysis by following the guidelines of PRISMA has been carried out on 34 studies. The patients with confirmed RT-PCR and CT-scan were included, a total of 13,368; The studies' quality assessment was performed according to the Appraisal Checklist recommended by the Joanna Briggs Institute. The effect sizes of the published research are presented in the form of pooled estimates with their respective confidence intervals. Forest plots are used to represent the effect size graphically. Current smokers' effect sizes are 0.12 (CI = 0.11–0.12); for non-smokers, it is estimated to be 0.88 (CI = 0.88–0.89). The heterogeneity statistic <italic>I</italic><sup>2</sup> describes 0% of the total variation, meaning no heterogeneity among studies exists. A higher prevalence of COVID-19 among non-smokers is observed than the smokers.</p> </abstract>

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Cellular and molecular features of COVID-19 associated ARDS: therapeutic relevance

Cited by 5 publications

References 237 publications

Endothelial dysfunction and persistent inflammation in severe post-COVID-19 patients: implications for gas exchange

Endothelial dysfunction and persistent inflammation in severe post-COVID-19 patients: implications for gas exchange

Prone Positioning and Molecular Biomarkers in COVID and Non-COVID ARDS: A Narrative Review

Smoking and prevalence of COVID-19: Evidence from studies from January 2020 – May 2020

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