COVID-19 pathophysiology: A review

Yuki, Koichi; Fujiogi, Miho; Koutsogiannaki, Sophia

doi:10.1016/j.clim.2020.108427

Cited by 1,725 publications

(1,925 citation statements)

References 44 publications

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“…If this Virus (COVID-19) causes complex pathology, treatment strategies should also be complex. (Yuki et al, 2020) The in ammation of Interstitium, diffuse alveolar damage, and necrotizing bronchitisbronchiolitis are general histopathological ndings of lung in this respiratory viral infections. (Burke and Aubry, 2016) Diffuse alveolar damage is the most commonly observed nding with respiratory virus infections both in acute and late (organizing) stages.…”

Section: Discussionmentioning

confidence: 99%

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2020

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Background Current COVID-19 treatment methods are in the form of oral tablets or intravenous therapy. However, even if the efficacy of these agents is shown in in-vitro studies, the same effect cannot be seen in in-vivo. This is because these treatments are intended to reach the lungs through the blood. However, severe interstitial edema and blood alveolar barrier does not allow medications to reach the lungs effectively. Objective In the new inhaler treatment (NIT) given in this clinical study, the molecules that have antiviral, antioxidant and anti-inflammatory effects without any toxicity were brought together. This study aims to prevent rapid and effective clinical improvement in COVID-19 patients and prevent any complications related to COVID-19 infection. Methods This study approved by The Ministry of Health of Turkey. This clinical study was designed as a multi-center study and performed in Istanbul and Mersin, Turkey. The patients were divided into two groups. Patients were randomly assigned following simple randomization procedures. Eight patients received the normal treatment protocol, while eight patients received the new inhalation treatment protocol in addition to the normal treatment protocol. It was applied by connecting the T nebulizer device in intubated patients and with a nebulizer mask in non-intubated patients. Pulse oxygen saturation, respiratory rate, percentage of lung involvement, arterial blood gas, and duration of hospitalization were compared after the treatment. Results One of the most important points of this study is the duration of hospital stay between the two groups. The mean duration of hospitalization in group 1 was 6.5 ± 1.8; in group 2 it was 17.1 ± 2.4. The duration of stay in Group 1 was significantly lower than group 2. (P < 0.05) FOS (Finger oxygen saturation) values were 89.2 ± 4.8 and 96.1 ± 4.7 in group 1 at the end of the 3rd and 7th days, respectively. In group 2, it was 80.3 ± 5.9 and 84.6 ± 4.4. After treatment FOS levels were significantly higher in group 1 for days 3 and 7. (P < 0.05) Conclusion Methods of treatment with multiple molecules should be developed for complex diseases, not single molecule therapy. In this sense, this study is very important as it will bring a new perspective to the scientific world. With the treatment mentioned in the current study; It is important in terms of making a new prophylaxis and therapeutic plan for Covid-19. It is thought that it will be unique in terms of creating a treatment plan with low potential for natural and non-synthetic side effects instead of using toxic and side effects products.

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Section: Discussionmentioning

confidence: 99%

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2020

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“…There were additional 100 cases tested positive with COVID-19 by this date as the group of asymptomatic patients [9]. In the severe patients con rmed positive with COVID-19, the pathology of COVID-19 is the production of in ammatory cytokines such as IL-1, IL-6, IL-8, and TNF-α, which attract alveolar macrophages, neutrophils (IL-8), and induce alveolar and interstitial in ammation [14]. Severe COVID-19 infection is characterized by a massive pro-in ammatory response or cytokine storm that results in acute respiratory distress syndrome and multi-organ dysfunction [14].…”

Section: Inhaled Ozone Pollutants Cause Remarkably Reversible Acute Lmentioning

confidence: 99%

“…In the severe patients con rmed positive with COVID-19, the pathology of COVID-19 is the production of in ammatory cytokines such as IL-1, IL-6, IL-8, and TNF-α, which attract alveolar macrophages, neutrophils (IL-8), and induce alveolar and interstitial in ammation [14]. Severe COVID-19 infection is characterized by a massive pro-in ammatory response or cytokine storm that results in acute respiratory distress syndrome and multi-organ dysfunction [14]. A combination of ozone exposure and positive infection with COVID-19 might greatly increase an acute respiratory distress syndrome and induced severe acute respiratory syndrome in developing severe bilateral pneumonia, multiple mottling, and ground-glass opacity, and pneumothorax [15].…”

Section: Inhaled Ozone Pollutants Cause Remarkably Reversible Acute Lmentioning

confidence: 99%

Ozone Pollutants and the Onset of COVID-19 Symptoms in Chiba Prefecture, Japan

Dao

Fanjul

2020

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Abstract Background We examined the association between ozone pollutants in the breathing air and the onset of symptoms of COVID-19 infection. Methods We accessed online data of positive COVID-19 cases published by the Chiba Prefectural Government, including their ID, residence, age, sex, the dates of onset of symptoms, and tested positive with COVID-19. The daily data ozone concentrations were derived from an online database of 20 weather stations in the prefecture. The data of daily onset of symptoms of 735 patients were linked with the daily data of ozone concentrations. We estimated the number of daily person-years by dividing the number of the population by 365 (days). The incidence rate ratio and 95% confidence interval (IRR, 95% CI) were estimated by the levels of ozone concentrations. Results There was a significant positive association between the date of symptom onset and levels of ozone concentrations. Adjusted IRR, 95% CI, tertile_3 vs. tertile_1, was 1.69 (1.26, 2.26) for total participants, p for trend = 0.000. The positive association was observed in women but not in men, adjusted IRR, 95% CI, tertile_3 vs. tertile_1: 3.18 (1.94, 5.22), and 1.07 (0.73, 1.57), respectively. The positive association was seen for the sub-groups of ages under 60 but not 60+, adjusted IRR, 95% CI, tertile_3 vs. tertile_1: 1.90 (1.37, 2.65) and 1.10 (0.57, 2.17), respectively. Conclusions Ozone pollutants affect susceptibility to COVID-19 in the onset of symptoms. The findings warrant further studies on the mechanism of how ozone pollutants affect susceptibility to COVID-19.

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“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the COVID-19 pandemic, is a positive-sense single-stranded RNA coronavirus highly related to SARS-CoV, which caused the 2002 SARS pandemic [1,2]. Like SARS, COVID-19 primarily affects the respiratory system (although other organs can also be affected): symptoms are mild in some, but in others the infection can result in pneumonia, Acute Respiratory Distress Syndrome (ARDS) and death [3]. Risk factors associated with poor prognosis include age, diabetes and cardiovascular disease [4].…”

Section: Introductionmentioning

confidence: 99%

TMPRSS2, required for SARS-CoV-2 entry, is downregulated in lung cells by enzalutamide, a prostate cancer therapeutic

Leach¹,

Isac²,

Bevan³

et al. 2020

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The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, attacks various organs but most destructively the lung. It has been shown that SARS-CoV-2 entry into lung cells requires two host cell surface proteins: ACE2 and TMPRSS2. Downregulation of one or both of these is thus a potential therapeutic approach for COVID-19. TMPRSS2 is a known target of the androgen receptor, a ligand-activated transcription factor; activation of the androgen receptor increases TMPRSS2 levels in various tissues, most notably the prostate. We show here that treatment with the antiandrogen enzalutamide – a well-tolerated drug widely used in advanced prostate cancer – reduces TMPRSS2 levels in human lung cells. Further, enzalutamide treatment of mice dramatically decreased Tmprss2 levels in the lung. In support of this new experimental data, analysis of existing datasets shows striking co- expression of AR and TMPRSS2, including in specific lung cell types that are targeted by SARS- CoV-2. Together, the data presented provides strong evidence to support clinical trials to assess the efficacy of antiandrogens as a treatment option for COVID-19.

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COVID-19 pathophysiology: A review

Cited by 1,725 publications

References 44 publications

This preprint has been removed

This preprint has been removed

Ozone Pollutants and the Onset of COVID-19 Symptoms in Chiba Prefecture, Japan

TMPRSS2, required for SARS-CoV-2 entry, is downregulated in lung cells by enzalutamide, a prostate cancer therapeutic

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