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Chen J, Gao X, Liang J, Wu Q, Shen L, Zheng Y, Ma Y, Peng Y, He Y, Yin J. Association between gut microbiota dysbiosis and poor functional outcomes in acute ischemic stroke patients with COVID-19 infection. mSystems 2024; 9:e0018524. [PMID: 38700338 PMCID: PMC11237522 DOI: 10.1128/msystems.00185-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/26/2024] [Indexed: 05/05/2024] Open
Abstract
Acute ischemic stroke (AIS) patients with active COVID-19 infection often have more severe symptoms and worse recovery. COVID-19 infection can cause gut microbiota dysbiosis, which is also a risk factor for poor outcomes in AIS patients. However, the association between gut microbiota and functional outcomes among AIS patients with COVID-19 infection has not been fully clarified yet. In this study, we performed 16S rRNA gene sequencing to characterize the gut microbial community among AIS patients with acute COVID-19 infection, AIS patients with post-acute COVID-19 infection, and AIS patients without COVID-19 infection. We found that AIS patients with acute COVID-19 experienced poorer recovery and significant gut dysbiosis, characterized by higher levels of Enterobacteriaceae and lower levels of Ruminococcaceae and Lachnospiraceae. Furthermore, a shorter time window (less than 28 days) between COVID-19 infection and stroke was identified as a risk factor for poor functional outcomes in AIS patients with COVID-19, and the enrichment of Enterobacteriaceae was indicated as a mediator in the relationship between infection time window and poor stroke outcomes. Our findings highlight the importance of early intervention after COVID-19 infection, especially by regulating the gut microbiota, which plays a role in the prognosis of AIS patients with COVID-19 infection.IMPORTANCEThe gut microbiota plays an important role in the association between respiratory system and cerebrovascular system through the gut-lung axis and gut-brain axis. However, the specific connection between gut bacteria and the functional outcomes of acute ischemic stroke (AIS) patients with COVID-19 is not fully understood yet. In our study, we observed a significant decrease in bacterial diversity and shifts in the abundance of key bacterial families in AIS patients with acute COVID-19 infection. Furthermore, we identified that the time window was a critical influence factor for stroke outcomes, and the enrichment of Enterobacteriaceae acted as a mediator in the relationship between the infection time window and poor stroke outcomes. Our research provides a new perspective on the complex interplay among AIS, COVID-19 infection, and gut microbiota dysbiosis. Moreover, recognizing Enterobacteriaceae as a potential mediator of poor stroke prognosis offers a novel avenue for future exploration and therapeutic interventions.
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Affiliation(s)
- Jiaying Chen
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Comprehensive Medical Treatment Ward, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuxuan Gao
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingru Liang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiheng Wu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Linlin Shen
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yifeng Zheng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu Ma
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuping Peng
- Department of Neurosurgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yan He
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for Laboratory Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Mental Health of the Ministry of Education, Guangzhou, Guangdong, China
| | - Jia Yin
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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2
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Li S, Liu H, Li D, Chen F. Female reproductive health during the COVID-19 pandemic: latest evidence and understanding. Arch Gynecol Obstet 2023; 308:1691-1696. [PMID: 36856820 PMCID: PMC9976669 DOI: 10.1007/s00404-023-06976-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/09/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has imposed a heavy burden on medical systems. In addition to the respiratory system, the virus also causes injuries to other organs and systems such as the gastroenteric system, kidneys, and reproductive system. Female reproductive health requires more attention in this context. METHODS We have performed a thorough review of the relevant literature that addresses the impacts of SARS-CoV-2 infection and COVID-19 vaccination on the female reproductive system. RESULTS Most evidence shows that SARS-CoV-2 does not infect the female reproductive system. However, the virus may indirectly influence sex hormone concentrations through inflammation associated with cytokine storms and nervous system damage. Menstrual disorders in women infected with SARS-CoV-2 may be caused by down-regulation of angiotensin-converting enzyme 2, abnormal hormone levels, medications, and stress. There is no significant difference in ovarian follicle quality and in vitro fertilization parameters between the pre- and post-COVID-19 vaccination groups. In addition, most symptoms due to side effects of vaccination could recover within a short period of time. CONCLUSION SARS-CoV-2 infection affects female reproductive system function through multiple mechanisms. It is recommended that women of childbearing age be vaccinated with COVID-19 vaccine.
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Affiliation(s)
- Shuhui Li
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China
| | - Hongxin Liu
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China
| | - Di Li
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, 133 Hehua Road, Jining, 272067, China.
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Garcia-Arellano G, Camacho-Ortiz A, Moreno-Arquieta IA, Cardenas-de la Garza JA, Rubio-Torres DC, Garza-Gonzalez E, Bocanegra-Ibarias P, Galarza-Delgado DA. Anticardiolipin and anti-beta-2 glycoprotein I antibodies in patients with moderate or severe COVID-19. Am J Med Sci 2023; 365:215-217. [PMID: 36335994 PMCID: PMC9632263 DOI: 10.1016/j.amjms.2022.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 08/22/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Gisela Garcia-Arellano
- Rheumatology Service, “Dr José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Adrian Camacho-Ortiz
- Infectiology Department, “Dr José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Ilse Andrea Moreno-Arquieta
- Rheumatology Service, “Dr José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - Diana Carolina Rubio-Torres
- Rheumatology Service, “Dr José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Elvira Garza-Gonzalez
- Infectiology Department, “Dr José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Paola Bocanegra-Ibarias
- Infectiology Department, “Dr José Eleuterio González” University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Dionicio Angel Galarza-Delgado
- Rheumatology Service, "Dr José Eleuterio González" University Hospital, Universidad Autónoma de Nuevo León, Monterrey, México.
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Lipták P, Banovcin P, Rosoľanka R, Prokopič M, Kocan I, Žiačiková I, Uhrik P, Grendar M, Hyrdel R. A machine learning approach for identification of gastrointestinal predictors for the risk of COVID-19 related hospitalization. PeerJ 2022; 10:e13124. [PMID: 35341062 PMCID: PMC8944335 DOI: 10.7717/peerj.13124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/24/2022] [Indexed: 01/12/2023] Open
Abstract
Background and aim COVID-19 can be presented with various gastrointestinal symptoms. Shortly after the pandemic outbreak, several machine learning algorithms were implemented to assess new diagnostic and therapeutic methods for this disease. The aim of this study is to assess gastrointestinal and liver-related predictive factors for SARS-CoV-2 associated risk of hospitalization. Methods Data collection was based on a questionnaire from the COVID-19 outpatient test center and from the emergency department at the University Hospital in combination with the data from internal hospital information system and from a mobile application used for telemedicine follow-up of patients. For statistical analysis SARS-CoV-2 negative patients were considered as controls in three different SARS-CoV-2 positive patient groups (divided based on severity of the disease). The data were visualized and analyzed in R version 4.0.5. The Chi-squared or Fisher test was applied to test the null hypothesis of independence between the factors followed, where appropriate, by the multiple comparisons with the Benjamini Hochberg adjustment. The null hypothesis of the equality of the population medians of a continuous variable was tested by the Kruskal Wallis test, followed by the Dunn multiple comparisons test. In order to assess predictive power of the gastrointestinal parameters and other measured variables for predicting an outcome of the patient group the Random Forest machine learning algorithm was trained on the data. The predictive ability was quantified by the ROC curve, constructed from the Out-of-Bag data. Matthews correlation coefficient was used as a one-number summary of the quality of binary classification. The importance of the predictors was measured using the Variable Importance. A 2D representation of the data was obtained by means of Principal Component Analysis for mixed type of data. Findings with the p-value below 0.05 were considered statistically significant. Results A total of 710 patients were enrolled in the study. The presence of diarrhea and nausea was significantly higher in the emergency department group than in the COVID-19 outpatient test center. Among liver enzymes only aspartate transaminase (AST) has been significantly elevated in the hospitalized group compared to patients discharged home. Based on the Random Forest algorithm, AST has been identified as the most important predictor followed by age or diabetes mellitus. Diarrhea and bloating have also predictive importance, although much lower than AST. Conclusion SARS-CoV-2 positivity is connected with isolated AST elevation and the level is linked with the severity of the disease. Furthermore, using the machine learning Random Forest algorithm, we have identified the elevated AST as the most important predictor for COVID-19 related hospitalizations.
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Affiliation(s)
- Peter Lipták
- Gastroenterology Clinic, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Peter Banovcin
- Gastroenterology Clinic, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Róbert Rosoľanka
- Clinic of Infectology and Travel Medicine, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Michal Prokopič
- Gastroenterology Clinic, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Ivan Kocan
- Clinic of Pneumology and Phthisiology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Ivana Žiačiková
- Clinic of Pneumology and Phthisiology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Peter Uhrik
- Gastroenterology Clinic, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Marian Grendar
- Laboratory of Bioinformatics and Biostatistics, Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovak Republic,Laboratory of Theoretical Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Rudolf Hyrdel
- Gastroenterology Clinic, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
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5
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COVID-19 in Latin America and the Caribbean Region: Symptoms and Morbidities in the Epidemiology of Infection. Curr Opin Pharmacol 2022; 63:102203. [PMID: 35255454 PMCID: PMC8896761 DOI: 10.1016/j.coph.2022.102203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/21/2022] [Accepted: 02/01/2022] [Indexed: 01/06/2023]
Abstract
The COVID-19 pandemic has widespread economic and social effects on Latin America (LA) and the Caribbean (CA). This region, which has a high prevalence of chronic diseases, has been one of the most affected during the pandemic. Multiple symptoms and comorbidities are related to distinct COVID-19 outcomes. However, there has been no explanation as to why different patients present with different arrays of clinical presentations. Studies report that similar to comorbidities, each country in LA and the CA has its own particular health issues. Moreover, economic and social features have yet to be studied in detail to obtain a complete perspective of the disease in the region. Herein, the impact of demographic and economic characteristics in LA and the CA on COVID-19 are presented in combination with symptoms and comorbidities related to the disease as important aspects that can influence management and treatment.
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Sun Z, Song ZG, Liu C, Tan S, Lin S, Zhu J, Dai FH, Gao J, She JL, Mei Z, Lou T, Zheng JJ, Liu Y, He J, Zheng Y, Ding C, Qian F, Zheng Y, Chen YM. Gut microbiome alterations and gut barrier dysfunction are associated with host immune homeostasis in COVID-19 patients. BMC Med 2022; 20:24. [PMID: 35045853 PMCID: PMC8769945 DOI: 10.1186/s12916-021-02212-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/09/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND COVID-19 is an infectious disease characterized by multiple respiratory and extrapulmonary manifestations, including gastrointestinal symptoms. Although recent studies have linked gut microbiota to infectious diseases such as influenza, little is known about the role of the gut microbiota in COVID-19 pathophysiology. METHODS To better understand the host-gut microbiota interactions in COVID-19, we characterized the gut microbial community and gut barrier function using metagenomic and metaproteomic approaches in 63 COVID-19 patients and 8 non-infected controls. Both immunohematological parameters and transcriptional profiles were measured to reflect the immune response in COVID-19 patients. RESULTS Altered gut microbial composition was observed in COVID-19 patients, which was characterized by decreased commensal species and increased opportunistic pathogenic species. Severe illness was associated with higher abundance of four microbial species (i.e., Burkholderia contaminans, Bacteroides nordii, Bifidobacterium longum, and Blautia sp. CAG 257), six microbial pathways (e.g., glycolysis and fermentation), and 10 virulence genes. These severity-related microbial features were further associated with host immune response. For example, the abundance of Bu. contaminans was associated with higher levels of inflammation biomarkers and lower levels of immune cells. Furthermore, human-origin proteins identified from both blood and fecal samples suggested gut barrier dysfunction in COVID-19 patients. The circulating levels of lipopolysaccharide-binding protein increased in patients with severe illness and were associated with circulating inflammation biomarkers and immune cells. Besides, proteins of disease-related bacteria (e.g., B. longum) were detectable in blood samples from patients. CONCLUSIONS Our results suggest that the dysbiosis of the gut microbiome and the dysfunction of the gut barrier might play a role in the pathophysiology of COVID-19 by affecting host immune homeostasis.
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Affiliation(s)
- Zhonghan Sun
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China.,Ministry of Education Key Laboratory of Contemporary Anthropology, Fudan University, Shanghai, China
| | - Zhi-Gang Song
- Shanghai Public Health Clinical Center, State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China.,Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Chenglin Liu
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Shishang Tan
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Shuchun Lin
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Jiajun Zhu
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Fa-Hui Dai
- Shanghai Public Health Clinical Center, State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Jian Gao
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Jia-Lei She
- Shanghai Public Health Clinical Center, State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Zhendong Mei
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Tao Lou
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Jiao-Jiao Zheng
- Shanghai Public Health Clinical Center, State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Yi Liu
- Shanghai Public Health Clinical Center, State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Jiang He
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Yuanting Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Chen Ding
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Feng Qian
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China. .,Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.
| | - Yan-Mei Chen
- Shanghai Public Health Clinical Center, State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China.
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7
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Doubeni CA, Corley DA, Peek RM. Advancing Diversity, Equity, and Inclusion in Scientific Publishing. Gastroenterology 2022; 162:59-62.e1. [PMID: 34740579 DOI: 10.1053/j.gastro.2021.10.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | - Douglas A Corley
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Richard M Peek
- Vanderbilt University Medical Center, Nashville, Tennessee
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8
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Pizuorno A, Brim H, Ashktorab H. Gastrointestinal manifestations and SARS-CoV-2 infection. Curr Opin Pharmacol 2021; 61:114-119. [PMID: 34688995 PMCID: PMC8463306 DOI: 10.1016/j.coph.2021.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/18/2021] [Accepted: 09/14/2021] [Indexed: 12/23/2022]
Abstract
Since COVID-19 occurrence in late 2019, intense research efforts on an unprecedented scale have focused on the study of named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry mechanisms and clinical presentations. As for other coronaviruses, SARS-CoV-2 presents with extrarespiratory clinical manifestations such as diarrhea, nausea, vomiting, and abdominal pain which highlight that the gastrointestinal (GI) system as another viral target along with the typical presentations of COVID-19 which is characterized primarily by respiratory symptoms. The digestive system is involved in many systemic functions through the gut-brain axis and systemic immunity modulation. Therefore, the GI system plays an important role in the presentation of the disease, pathogenesis, and possibly treatment outcomes. This minireview summarizes recent work to study SARS-CoV-2 infection as it relates to comorbidities, GI symptoms. This will help to strategize the priorities in understanding the impact of the virus on outcomes in various aspects.
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Affiliation(s)
- Antonio Pizuorno
- La Universidad del Zulia, Faculty of Medicine, School of Medicine, 4002, Maracaibo, Zulia state, Venezuela
| | - Hassan Brim
- Pathology and Cancer Center, Howard University College of Medicine, Washington, DC, USA
| | - Hassan Ashktorab
- Department of Medicine, Gastroenterology division, and Cancer Center, Howard University College of Medicine, Washington, DC, USA.
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9
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Figueroa-Pizano MD, Campa-Mada AC, Carvajal-Millan E, Martinez-Robinson KG, Chu AR. The underlying mechanisms for severe COVID-19 progression in people with diabetes mellitus: a critical review. AIMS Public Health 2021; 8:720-742. [PMID: 34786431 PMCID: PMC8568590 DOI: 10.3934/publichealth.2021057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/20/2021] [Indexed: 01/08/2023] Open
Abstract
Diabetes mellitus (DM) has a high incidence of comorbidities among patients with severe coronavirus disease 2019 (COVID-19). The elevated prevalence of DM in the world population makes it a significant risk factor because diabetic individuals appear to be prone to clinical complications and have increased mortality rates. Here, we review the possible underlying mechanisms involved in DM that led to worse outcomes in COVID-19. The impacts of hyperglycemia side effects, secondary comorbidities, weakened innate and adaptive immunity, chronic inflammation, and poor nutritional status, commonly present in DM, are discussed. The role of the SARS-CoV-2 receptor and its polymorphic variations on higher binding affinity to facilitate viral uptake in people with DM were also considered. Clinical differences between individuals with type 1 DM and type 2 DM affected by COVID-19 and the potential diabetogenic effect of SARS-CoV-2 infection were addressed.
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Affiliation(s)
- María D Figueroa-Pizano
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Alma C Campa-Mada
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Elizabeth Carvajal-Millan
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Karla G Martinez-Robinson
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
| | - Agustin Rascon Chu
- Research Center for Food and Development, CIAD, AC, Carretera Gustavo Enrique Astiazarán Rosas No. 46, C.P. 83304, Hermosillo, Sonora, México
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10
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Ashktorab H, Folake A, Pizuorno A, Oskrochi G, Oppong-Twene P, Tamanna N, Mehdipour Dalivand M, Umeh LN, Moon ES, Kone AM, Banson A, Federman C, Ramos E, Awoyemi EO, Wonni BJ, Otto E, Maskalo G, Velez AO, Rankine S, Thrift C, Ekwunazu C, Scholes D, Chirumamilla LG, Ibrahim ME, Mitchell B, Ross J, Curtis J, Kim R, Gilliard C, Mathew J, Laiyemo A, Kibreab A, Lee E, Sherif Z, Shokrani B, Aduli F, Brim H. COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome? World J Clin Cases 2021; 9:8374-8387. [PMID: 34754847 PMCID: PMC8554449 DOI: 10.12998/wjcc.v9.i28.8374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/19/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) disproportionately affected African Americans (AA) and Hispanics (HSP). AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal (GI) symptoms, laboratory values and comorbidities. METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020. We assessed the symptoms, including the GI manifestations, comorbidities, and mortality, using logistic regression analysis. RESULTS Of these 386 COVID-19 positive patients, 257 (63.7%) were AAs, 102 (25.3%) HSP, and 26 (6.45%) Whites. There were 257 (63.7%) AA, 102 (25.3%) HSP, 26 (6.45%) Whites. The mean age was 55.6 years (SD = 18.5). However, the mean age of HSP was the lowest (43.7 years vs 61.2 for Whites vs 60 for AAs). The mortality rate was highest among the AAs (20.6%) and lowest among HSP (6.9%). Patients with shortness of breath (SOB) (OR2 = 3.64, CI = 1.73-7.65) and elevated AST (OR2 = 8.01, CI = 3.79-16.9) elevated Procalcitonin (OR2 = 8.27, CI = 3.95-17.3), AST (OR2 = 8.01, CI = 3.79-16.9), ferritin (OR2 = 2.69, CI = 1.24-5.82), and Lymphopenia (OR2 = 2.77, CI = 1.41-5.45) had a high mortality rate. Cough and fever were common but unrelated to the outcome. Hypertension and diabetes mellitus were the most common comorbidities. Glucocorticoid treatment was associated with higher mortality (OR2 = 5.40, CI = 2.72-10.7). Diarrhea was prevalent (18.8%), and GI symptoms did not affect the outcome. CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities. Age is the most important factor along with SOB in determining the mortality rate. Overall, elevated liver enzymes, ferritin, procalcitonin and C-reactive protein were associated with poor prognosis. GI symptoms did not affect the outcome. Glucocorticoids should be used judiciously, considering the poor outcomes associated with it. Attention should also be paid to monitor liver function during COVID-19, especially in AA and HSP patients with higher disease severity.
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Affiliation(s)
- Hassan Ashktorab
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Adeleye Folake
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Antonio Pizuorno
- Faculty of Medicine, La Universidad del Zulia, Maracaibo 4002, Zulia, Venezuela
| | - Gholamreza Oskrochi
- College of Engineering and Technology, American University of Middle East Kuwait, Egaila 54200, Kuwait
| | - Philip Oppong-Twene
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Nuri Tamanna
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Maryam Mehdipour Dalivand
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Lisa N Umeh
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Esther S Moon
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Abdoul Madjid Kone
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Abigail Banson
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Cassandra Federman
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Edward Ramos
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Eyitope Ola Awoyemi
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Boubini Jones Wonni
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Eric Otto
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Guttu Maskalo
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Alexandra Ogando Velez
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Sheldon Rankine
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Camelita Thrift
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Chiamaka Ekwunazu
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Derek Scholes
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Lakshmi Gayathri Chirumamilla
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Mohd Elmugtaba Ibrahim
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Brianna Mitchell
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Jillian Ross
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Julencia Curtis
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Rachel Kim
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Chandler Gilliard
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Joseph Mathew
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Adeyinka Laiyemo
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Angesum Kibreab
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Edward Lee
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Zaki Sherif
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
- Department of Biochemistry and Molecular Biology, Howard University College of Medicine, Washington, DC 20060, United States
| | - Babak Shokrani
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Farshad Aduli
- Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
| | - Hassan Brim
- Pathology and Cancer Center, Department of Biochemistry and Molecular Biology, Howard University College of Medicine, Washington, DC 20060, United States
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11
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Russo T, Pizuorno A, Oskrochi G, Latella G, Massironi S, Schettino M, Aghemo A, Pugliese N, Brim H, Ashktorab H. Gastrointestinal Manifestations, Clinical Characteristics and Outcomes of COVID-19 in Adult and Pediatric Patients. SOJ MICROBIOLOGY & INFECTIOUS DISEASES 2021; 8:109. [PMID: 35611315 PMCID: PMC9126507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Italy was the first country in Europe to report a SARS-CoV-2 case. Since then, the country has suffered a large number of COVID-19 infections both in adults and children. This disease has been shown to lead to different outcomes in these two groups, which often present varying symptoms and comorbidities. AIM Therefore, we aimed to evaluate the symptoms, comorbidities and laboratory values in adults and children. METHODS We present the characteristics of 1,324 adults and 563 pediatric COVID-19 Italian patients. The data was retrieved from studies published in Italy and found via PubMed and Google Scholar. RESULTS The virus appeared to affect adults more than children and men more than women, and to result in more severe outcomes in patients with abnormal laboratory values and a higher number of comorbidities. Adults are at higher risk for complications and death, and they usually present with fever, respiratory symptoms, cough, fatigue, diarrhea, myalgia, and/or loss of taste, smell, or appetite. Children usually have a milder disease progression and usually present with fever, cough, rhinorrhea, pharyngitis, sore throat, pneumonia, GI symptoms (diarrhea, vomiting, abdominal pain), fatigue, and dyspnea. CONCLUSION Our findings support early reports that showed that SARS-CoV-2 is associated with more common asymptomatic cases and milder clinical outcome in children than in adults. Acute respiratory distress syndrome and Multisystem inflammatory syndrome in children (systemic vasculitis) are the most severe disease progressions for adults and children, respectively.
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Affiliation(s)
- Tiziano Russo
- Department of Medicine, Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC
| | - Antonio Pizuorno
- College of Engineering and Technology, American University of the Middle East, Kuwait
| | - Gholamreza Oskrochi
- College of Engineering and Technology, American University of the Middle East, Kuwait
| | - Giovanni Latella
- Gastroenterology Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - Sara Massironi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, and European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Mario Schettino
- Gastroenterology Unit, ASST Rhodense, Garbagnate Milanese, Lombardia, Italy
| | - Alessio Aghemo
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Nicola Pugliese
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Hassan Brim
- Department of Medicine, Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC
| | - Hassan Ashktorab
- Department of Medicine, Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC
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12
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El Boujnouni H, Rahouti M, El Boujnouni M. Identification of SARS-CoV-2 origin: Using Ngrams, principal component analysis and Random Forest algorithm. INFORMATICS IN MEDICINE UNLOCKED 2021; 24:100577. [PMID: 33898732 PMCID: PMC8056990 DOI: 10.1016/j.imu.2021.100577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 01/22/2023] Open
Abstract
COVID-19 is an infectious disease caused by the newly discovered SARS-CoV-2 virus. This virus causes a respiratory tract infection, symptoms include dry cough, fever, tiredness and in more severe cases, breathing difficulty. SARS-CoV-2 is an extremely contagious virus that is spreading rapidly all over the world and the scientific community is working tirelessly to find an effective treatment. This paper aims to determine the origin of this virus by comparing its nucleic acid sequence with all members of the coronaviridae family. This study uses a new approach based on the combination of three powerful techniques which are: Ngrams (For text categorization), Principal Component Analysis (For dimensionality reduction) and Random Forest algorithm (For supervised classification). The experimental results have shown that a large set of SARS-CoV-2 genomes, collected from different locations around the world, present significant similarities to those found in pangolins. This finding confirms some previous results obtained by other methods, which also suggest that pangolins should be considered as possible hosts in the emergence of the new coronavirus.
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Affiliation(s)
- Hamoucha El Boujnouni
- Research Center of Plant and Microbial Biotechnologies, Biodiversity, and Environment, Faculty of Sciences, Mohammed V University in Rabat, PO Box 1014, Morocco
| | - Mohamed Rahouti
- Research Center of Plant and Microbial Biotechnologies, Biodiversity, and Environment, Faculty of Sciences, Mohammed V University in Rabat, PO Box 1014, Morocco
| | - Mohamed El Boujnouni
- Laboratory of Information Technologies, National School of Applied Sciences, Chouaib Doukkali University in El Jadida, PO Box 1166, Morocco
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13
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Ashktorab Y, Brim A, Pizuorno A, Gayam V, Nikdel S, Brim H. COVID-19 Pediatric Patients: Gastrointestinal Symptoms, Presentations, and Disparities by Race/Ethnicity in a Large, Multicenter US Study. Gastroenterology 2021; 160:1842-1844. [PMID: 33421514 PMCID: PMC7787077 DOI: 10.1053/j.gastro.2020.12.078] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Yusuf Ashktorab
- Department of Medicine, Howard University College of Medicine, Washington DC
| | - Anas Brim
- Department of Medicine, Howard University College of Medicine, Washington DC
| | - Antonio Pizuorno
- Faculty of Medicine, School of Medicine, La Universidad del Zulia, Maracaibo, Zulia state, Venezuela
| | - Vijay Gayam
- Department of Medicine, SUNY Downstate University Hospital, New York
| | - Sahar Nikdel
- Department of Medicine, Howard University College of Medicine, Washington DC
| | - Hassan Brim
- Department of Medicine, Howard University College of Medicine, Washington DC.
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14
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Pizuorno A, Fierro NA. Latin America and chronic diseases: A perfect storm during the COVID-19 pandemic. Ann Hepatol 2021; 22:100332. [PMID: 33631378 PMCID: PMC7899031 DOI: 10.1016/j.aohep.2021.100332] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 02/04/2023]
Affiliation(s)
| | - Nora A. Fierro
- Department of Immunology, Biomedical Research Institute, National Autonomous University of Mexico, Mexico City, Mexico,Corresponding author at: Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, CP 045210, Ciudad de México, Mexico
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15
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Panduro A. Viruses and the Liver 2020: Before COVID-19 and the beginning of a new age in medicine. Ann Hepatol 2021; 20:100293. [PMID: 33388122 PMCID: PMC7834516 DOI: 10.1016/j.aohep.2020.100293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, "Fray Antonio Alcalde" and Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
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