SARS-Cov-2 pneumonia and concurrent myelodysplasia complicated by Pseudomonas aeruginosa over-infection

Pezzuto, Aldo; Tammaro, Antonella; Tonini, Giuseppe; Conforti, Giulia; Falangone, Francesca; Spuntarelli, Valerio; Teggi, Antonella; Pennica, Alfredo

doi:10.1016/j.jviromet.2021.114419

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…While other viral co-infections are known to provide cross-protection against SARS-CoV-2 [ 73 , 74 ], this type of co-protection is rare in cases of bacterial co-infection, implying a risk of subtle bacterial virulence initiated by SARS-CoV-2. Some rare cases of cross-reactive epitomes with SARS-CoV-2 have been reported for proteomes of BCG, Bordetella pertussis , Corynebacterium diphtheriae , Clostridium tetani , Hemophilus influenzae , Neisseria meningitidis , and Streptococcus pneumoniae [ 75 , 76 ], and this implies that similar cases for the Gram-negatives identified in this study are possible. Thus, the proper diagnosis and management of ARDS–COVID-19 patients with underlying causes have become imperative since they are prone to co-infections by respiratory pathogens such as Pseudomonas aeruginosa as reported by Pezzuto et al…”

Section: Discussionsupporting

confidence: 66%

“…These findings have significant clinical implications and require a specific differential diagnosis of ARDSs induced by COVID-19 and bacterial infection. Future vertical investigation for similar mechanisms of cytokine-induced ARDS by Gram-negative pathogens is warranted due to the growing outbreak of hypervirulent strains, which are rapidly circulating [ 76 ] n the region. This study has limitations in that it is a single-center study confined to Ha’il hospitals; a large-scale investigation conducted in major national hospitals would gain more insights.…”

Section: Discussionmentioning

confidence: 99%

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A Sequent of Gram-Negative Co-Infectome-Induced Acute Respiratory Distress Syndrome Are Potentially Subtle Aggravators Associated to the SARS-CoV-2 Evolution of Virulence

Said,

Alsolami,

Alshammari

et al. 2024

Diagnostics

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Acute respiratory distress syndrome (ARDS) is one of the major problems in COVID-19 that is not well understood. ARDS is usually complicated by co-infections in hospitals. Although ARDS is inherited by Europeans and Africans, this is not clear for those from the Middle East. There are severe limitations in correlations made between COVID-19, ARDS, co-infectome, and patient demographics. We investigated 298 patients for associations of ARDS, coinfections, and patient demographics on COVID-19 patients’ outcomes. Of the 149 patients examined for ARDS during COVID-19, 16 had an incidence with a higher case fatality rate (CFR) of 75.0% compared to those without ARDS (27.0%) (p value = 0.0001). The co-infectome association showed a CFR of 31.3% in co-infected patients; meanwhile, only 4.8% of those without co-infections (p value = 0.01) died. The major bacteria were Acinetobacter baumannii and Escherichia coli, either alone or in a mixed infection with Klebsiella pneumoniae. Kaplan–Meier survival analysis of COVID-19 patients with and without ARDS revealed a significant difference in the survival time of patients with ARDS (58.8 +/− 2.7 days) and without ARDS (41.9 +/− 1.8 days) (p value = 0.0002). These findings prove that increased hospital time was risky for co-infectome-induced SDRS later on. This also explained that while empiric therapy and lethal ventilations delayed the mortality in 75% of patients, they potentially did not help those without co-infection or ARDS who stayed for shorter times. In addition, the age of patients (n = 298) was significantly associated with ARDS (72.9 +/− 8.9) compared to those without it (56.2 +/− 15.1) and was irrespective of gender. However, there were no significant differences neither in the age of admitted patients before COVID-19 (58.5 +/− 15.3) and during COVID-19 (57.2 +/− 15.5) nor in the gender and COVID-19 fatality (p value 0.546). Thus, Gram-negative co-infectome potentially induced fatal ARDS, aggravating the COVID-19 outcome. These findings are important for the specific differential diagnosis of patients with and without ARDS and co-infections. Future vertical investigations on mechanisms of Gram-negative-induced ARDS are imperative since hypervirulent strains are rapidly circulating. This study was limited as it was a single-center study confined to Ha’il hospitals; a large-scale investigation in major national hospitals would gain more insights.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

A Sequent of Gram-Negative Co-Infectome-Induced Acute Respiratory Distress Syndrome Are Potentially Subtle Aggravators Associated to the SARS-CoV-2 Evolution of Virulence

Said,

Alsolami,

Alshammari

et al. 2024

Diagnostics

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“…Severe COVID-19 is not only associated with excessive inflammation, but also with immune dysfunction. Patients with immune dysfunction caused by COVID-19 or corticosteroid therapy are more likely to develop secondary pulmonary infection and increase the risk of death [ 32 , 35 ]. Therefore, for people at high risk of severe COVID-19, cheap, low-toxic and effective anti-inflammatory drugs are urgently needed.…”

Section: Discussionmentioning

confidence: 99%

Phase I/II clinical trial of efficacy and safety of EGCG oxygen nebulization inhalation in the treatment of COVID-19 pneumonia patients with cancer

Yin,

Zhu,

Tang

et al. 2024

BMC Cancer

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Background The antiviral drug Nirmatrelvir was found to be a key drug in controlling the progression of pneumonia during the infectious phase of COVID-19. However, there are very few options for effective treatment for cancer patients who have viral pneumonia. Glucocorticoids is one of the effective means to control pneumonia, but there are many adverse events. EGCG is a natural low toxic compound with anti-inflammatory function. Thus, this study was designed to investigate the safety and efficacy of epigallocatechin-3-gallate (EGCG) aerosol to control COVID-19 pneumonia in cancer populations. Methods The study was designed as a prospective, single-arm, open-label phase I/II trial at Shandong Cancer Hospital and Institute, between January 5, 2023 to March 31,2023 with viral pneumonia on radiographic signs after confirmed novel coronavirus infection. These patients were treated with EGCG nebulization 10 ml three times daily for at least seven days. EGCG concentrations were increased from 1760-8817umol/L to 4 levels with dose escalation following a standard Phase I design of 3–6 patients per level. Any grade adverse event caused by EGCG was considered a dose-limiting toxicity (DLT). The maximum tolerated dose (MTD) is defined as the highest dose with less than one-third of patients experiencing dose limiting toxicity (DLT) due to EGCG. The primary end points were the toxicity of EGCG and CT findings, and the former was graded by Common Terminology Criteria for Adverse Events (CTCAE) v. 5.0. The secondary end point was the laboratory parameters before and after treatment. Result A total of 60 patients with high risk factors for severe COVID-19 pneumonia (factors such as old age, smoking and combined complications)were included in this phase I-II study. The 54 patients in the final analysis were pathologically confirmed to have tumor burden and completed the whole course of treatment. A patient with bucking at a level of 1760 umol/L and no acute toxicity associated with EGCG has been reported at the second or third dose gradients. At dose escalation to 8817umol/L, Grade 1 adverse events of nausea and stomach discomfort occurred in two patients, which resolved spontaneously within 1 hour. After one week of treatment, CT showed that the incidence of non-progression of pneumonia was 82% (32/39), and the improvement rate of pneumonia was 56.4% (22/39). There was no significant difference in inflammation-related laboratory parameters (white blood cell count, lymphocyte count, IL-6, ferritin, C-reactive protein and lactate dehydrogenase) before and after treatment. Conclusion Aerosol inhalation of EGCG is well tolerated, and preliminary investigation in cancer population suggests that EGCG may be effective in COVID-19-induced pneumonia, which can promote the improvement of patients with moderate pneumonia or prevent them from developing into severe pneumonia. Trial registration ClinicalTrials.gov Identifier: NCT05758571. Date of registration: 8 February 2023.

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“…Understanding the genomics analysis of the virus can provide clues as to the treatment strategies [6]. From the pathophysiological view, we propose that treatment for COVID-19 should be based on improving the Tolerance to Hypoxia (Hemoglobin factor), decreasing inflammation and hyper-immune reaction, and the concomitant use of oxygen, antibiotics, rehydration, and anticoagulation drugs [7].…”

Section: Discussionmentioning

confidence: 99%

Pneumolysis in COVID-19: A Novel Concept Derived from High Altitude Physiology

Zubieta-Calleja¹,

Zubieta-DeUrioste²

2022

Glob. J. Respir. Care

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The COVID-19 pandemic surprised everyone with a severe lung compromise giving rise to gasping and death from respiratory insufficiency. The understanding of lung compromise is essential to advances in the field of pneumology. It is well known that the SARS-CoV-2 adheres through its spikes to the ACE-2 receptors of type II pneumocytes and introduces its RNAm material in search of its reproduction. Pneumolysis, defined as “lung destruction”, is the mechanism whereby the virus utilizes the alveolar cells to reproduce itself and destroys them in the process. The viral “attack” leads to dysfunction of the alveolar type II cells that work in conjunction with the type I alveolar cells, and a specialized thin oxygen and carbon dioxide permeable membrane. Once the virus is inside the cell, the organism’s immune system attempts to attack the virus, causing significant inflammatory reactions with remarkable ineffectiveness. The following destruction of the alveoli gives rise to a shunt, uneven ventilation-perfusion, and alteration of diffusion, generating a rapidly progressive hypoxemia that is often lethal.

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SARS-Cov-2 pneumonia and concurrent myelodysplasia complicated by Pseudomonas aeruginosa over-infection

Cited by 6 publications

References 14 publications

A Sequent of Gram-Negative Co-Infectome-Induced Acute Respiratory Distress Syndrome Are Potentially Subtle Aggravators Associated to the SARS-CoV-2 Evolution of Virulence

A Sequent of Gram-Negative Co-Infectome-Induced Acute Respiratory Distress Syndrome Are Potentially Subtle Aggravators Associated to the SARS-CoV-2 Evolution of Virulence

Phase I/II clinical trial of efficacy and safety of EGCG oxygen nebulization inhalation in the treatment of COVID-19 pneumonia patients with cancer

Pneumolysis in COVID-19: A Novel Concept Derived from High Altitude Physiology

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