SARS, MERS and COVID-19: clinical manifestations and organ-system complications: a mini review

Harb, Jad Gerges; Noureldine, Hussein A; Chedid, Georges; Eldine, Mariam Nour; Abdallah, Dany Abou; Chedid, Nancy Falco; Nour‐Eldine, Wared

doi:10.1093/femspd/ftaa033

Cited by 58 publications

(39 citation statements)

References 66 publications

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“…Several differences in clinical manifestations and complications of COVID-19 patients have been observed suggesting variability in the disease process [ 19 ]. Genetic variants in the host human genome, can in part explain the broad inter-individual variation of disease susceptibility and/or severity [ 6 , 19 , 20 , 21 ]. Moreover, the expression levels of human genes encoding the main proteins involved in this mechanism could be critical for the susceptibility, symptoms and outcome of SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

Expression profiles of the SARS-CoV-2 host invasion genes in nasopharyngeal and oropharyngeal swabs of COVID-19 patients

Amati¹,

Vancheri²,

Latini³

et al. 2020

Heliyon

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We collect the nasopharyngeal and oropharyngeal swabs of 63 subjects with severe symptoms or contacts with COVID-19 confirmed cases to perform a pilot-study aimed to verify the “in situ” expression of SARS-CoV-2 host invasion genes ( ACE2 , TMPRSS2 , PCSK3 , EMILIN1 , EMILIN2 , MMRN1 , MMRN2 , DPP4 ). ACE2 (FC = +1.88, p ≤ 0.05) and DPP4 (FC = +3, p < 0.01) genes showed a significant overexpression in COVID-19 patients. ACE2 and DPP4 expression levels had a good performance (AUC = 0.75; p < 0.001) in distinguishing COVID-19 patients from negative subjects. Interestingly, we found a significant positive association of ACE2 mRNA and PCSK3 , EMILIN1 , MMRN1 and MMRN2 expression and of DPP4 mRNA and EMILIN2 expression only in COVID-19 patients. Noteworthy, a subgroup of severe COVID-19 (n = 7) patients, showed significant high level of ACE2 mRNA and another subgroup of less severe COVID-19 patients (n = 6) significant raised DPP4 levels. These results indicate that a group of SARS-CoV-2 host invasion genes are functionally related in COVID-19 patients and suggests that ACE2 and DPP4 expression level could act as genomic biomarkers. Moreover, at the best of our knowledge, this is the first study that shows an elevated DPP4 expression in naso- and oropharyngeal swabs of COVID-19 patient thus suggesting a functional role of DPP4 in SARS-CoV-2 infections.

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Section: Discussionmentioning

confidence: 99%

Expression profiles of the SARS-CoV-2 host invasion genes in nasopharyngeal and oropharyngeal swabs of COVID-19 patients

Amati¹,

Vancheri²,

Latini³

et al. 2020

Heliyon

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“…In addition to severely affecting lungs, the clinical manifestations of COVID-19 including acute injuries to the liver, heart, intestine, and brain that may progresses to sepsis and multiorgan failure, resulting in death [ 139 , 140 ]. The probability of mortalities is significantly high in aged people with co-morbid conditions including diabetes, cancer, diseases of heart, and respiratory problems.…”

Section: Organprotective Effects Of Echinaceamentioning

confidence: 99%

Can Echinacea be a potential candidate to target immunity, inflammation, and infection - The trinity of coronavirus disease 2019

Meeran¹,

Javed²,

Sharma³

et al. 2021

Heliyon

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Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing public health emergency. The pathogenesis and complications advanced with infection mainly involve immune-inflammatory cascade. Therefore, the therapeutic strategy relies on immune modulation, reducing infectivity and inflammation. Given the interplay of infection and immune-inflammatory axis, the natural products received attention for preventive and therapeutic usage in COVID-19 due to their potent antiviral and anti-immunomodulatory activities. Recently, Echinacea preparations, particularly E. purpurea, have been suggested to be an important antiviral agent to be useful in COVID-19 by modulating virus entry, internalization and replication. In principle, the immune response and the resultant inflammatory process are important for the elimination of the infection, but may have a significant impact on SARS-CoV-2 pathogenesis and may play a role in the clinical spectrum of COVID-19. Considering the pharmacological effects, therapeutic potential, and molecular mechanisms of Echinacea , we hypothesize that it could be a reasonably possible candidate for targeting infection, immunity, and inflammation in COVID-19 with recent recognition of cannabinoid-2 (CB2) receptors and peroxisome proliferator-activated receptor gamma (PPARγ) mediated mechanisms of bioactive components that make them notable immunomodulatory, anti-inflammatory and antiviral agent. The plausible reason for our hypothesis is that the presence of numerous bioactive agents in different parts of plants that may synergistically exert polypharmacological actions in regulating immune-inflammatory axis in COVID-19. Our proposition is to scientifically contemplate the therapeutic perspective and prospect of Echinacea on infection, immunity, and inflammation with a potential in COVID-19 to limit the severity and progression of the disease. Based on the clinical usage for respiratory infections, and relative safety in humans, further studies for the evidence-based approach to COVID-19 are needed. We do hope that Echinacea could be a candidate agent for immunomodulation in the prevention and treatment of COVID-19.

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“…While SARS-CoV-2 primarily causes respiratory disease, the central and peripheral nervous system's involvement is not infrequent. Meningitis, encephalitis, seizures, ischemic and hemorrhagic stroke, and persistent disorders of consciousness are among frequently reported central nervous system manifestations of COVID-19 illness [ 5 - 8 , 11 - 18 ]. AHNE is a rare neurologic complication secondary to para-infectious and hyperimmune response to SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

“…Manifestations include headache, myalgia, olfactory disorders, meningoencephalitis, myelitis, necrotizing encephalopathy, impaired consciousness, stroke, seizures, Guillain-Barré syndrome, and acute demyelinating encephalomyelitis [ 5 - 7 ]. Many of the coronavirus disease 2019 (COVID-19) related post-infectious inflammatory neurological conditions, such as acute disseminated encephalomyelitis, acute inflammatory demyelinating neuropathy, and acute necrotizing hemorrhagic encephalopathy, mirror those seen with other viral respiratory diseases and coronaviruses [ 8 ]. Acute hemorrhagic necrotizing encephalitis (AHNE) due to COVID-19 is a rare but disabling post-infectious inflammatory condition of the central nervous system.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Related Acute Hemorrhagic Necrotizing Encephalitis: A Report of Two Cases and Literature Review

Mullaguri¹,

Sivakumar²,

Battineni³

et al. 2021

Cureus

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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, has proven neurotropism and causes a multitude of neurologic manifestations. Acute hemorrhagic necrotizing encephalitis (AHNE), though rare, can be seen in patients with severe infection and is associated with devastating neurologic outcomes. The true prevalence of this syndrome is unknown due to underrecognition, difficulty in timely acquisition of neuroimaging, and high mortality in this subset of patients escaping detection. It is a distinct clinicoradiological syndrome, with patients suffering from rapidly worsening encephalopathy and coma within the first two weeks of severe illness and hemorrhagic necrotizing parenchymal changes on neuroimaging. The pathophysiology of this syndrome is unclear but hypothesized to occur due to cytokine storm, blood-brain-barrier dysfunction, and direct viral-mediated endotheliopathy. Diagnosis requires a high index of suspicion in patients who have unexplained persistent severe encephalopathy associated with COVID-19 infection. Most patients have elevated systemic inflammatory markers and severe lung disease with hypoxic respiratory failure requiring mechanical ventilation. MRI is the imaging modality of choice, with a distinct neuroimaging pattern. CSF (cerebrospinal fluid) studies have a low yield for viral particle detection with currently available testing. While long-term outcomes are unclear, early immunomodulatory treatment with intravenous immunoglobulin, plasma exchange, and steroids may portend a favorable outcome. We discuss two cases of COVID-19 related AHNE and also include a pertinent literature search of similar cases in PubMed to consolidate the AHNE clinical syndrome, neuroimaging characteristics, management strategies, and reported short-term prognosis.

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SARS, MERS and COVID-19: clinical manifestations and organ-system complications: a mini review

Cited by 58 publications

References 66 publications

Expression profiles of the SARS-CoV-2 host invasion genes in nasopharyngeal and oropharyngeal swabs of COVID-19 patients

Expression profiles of the SARS-CoV-2 host invasion genes in nasopharyngeal and oropharyngeal swabs of COVID-19 patients

Can Echinacea be a potential candidate to target immunity, inflammation, and infection - The trinity of coronavirus disease 2019

COVID-19 Related Acute Hemorrhagic Necrotizing Encephalitis: A Report of Two Cases and Literature Review

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