NOPR Collection: Special issue on Covid-19: Disease Progression, Impact & Comorbidity (Guest Editor: Prof. Subir Kumar Das)

COVID-19 and Hyperinflammatory Syndrome

Tue, 01 Dec 2020 00:00:00 GMT

Title: COVID-19 and Hyperinflammatory Syndrome Authors: Ray, Partho Sarothi; Goswami, Binita Abstract: COVID-19, the multifactorial disease caused by the novel coronavirus SARS-CoV-2 is mediated by specific antiviral and inflammatory responses. It is now recognized that in most severe cases of COVID-19 an excessive and uncontrolled inflammatory response exacerbates lung damage caused by viral infection, and contributes to acute respiratory distress syndrome and respiratory failure. This hyperinflammatory syndrome is characterized by multiple cellular and molecular events, including aberrant neutrophil and lymphocyte function, amplification of the inflammatory response by release of damage associated molecular patterns, cytokine storm, lung damage and edema and a pro-fibrotic condition, ultimately leading to respiratory failure. This review discusses these molecular events in correlation with stages of viral infection and disease progression, underscoring the key points that characterize the clinical manifestations of the hyperinflammatory syndrome in COVID-19. Furthermore, it discusses the available or potential therapeutics that target various important mediators of this hyperinflammatory response that are being considered for treatment of COVID-19. Page(s): 662-669

HIF-1α contributing to COVID-19 infections and poor prognosis in cancer patients – A hypothesis

Tue, 01 Dec 2020 00:00:00 GMT

Title: HIF-1α contributing to COVID-19 infections and poor prognosis in cancer patients – A hypothesis Authors: Kaur, Rajandeep; Chauhan, Anshika; Pal, Arnab Abstract: In 2019, a new coronavirus (SARS-CoV-2) infecting Humans first identified in Wuhan, China, has caused the worst pandemic of the 21^st century. This virus infection leads to the clinical symptoms that may range from asymptomatic condition to life-threatening illness. The insights from the recent studies suggest that SARS-CoV-2 requires a host enzyme, Furin to activate receptor-binding domain (RBD) of its S protein. Upon binding of RBD to host cell membrane-bound Angiotensin Convertase Enzyme 2 (ACE2), it facilitates the entry of virus in the host cell. Evidence from the literature also suggests that HIF-1α (Hypoxia-inducible factor 1-α) is one of the factors regulating the expression of Furin. In addition, it is also well documented that the interior of solid tumours, which grow very fast, leads to the hypoxic tumour microenvironment, resulting in overexpression and release of HIF-1α. The SARS-CoV-2 infected patients with severe tissue damage and inflammatory injury also suffer from tissue hypoxia. So, we hypothesize that hypoxic condition due to tumour microenvironment in cancer patients upregulates the HIF-1α, leading to increased expression of Furin. Upon infection of cancer patients with SARS-CoV-2 having increased Furin expression in the cells due to upregulation of HIF-1α, leads to the entry of a greater number of SARS-CoV-2 virus in these cells resulting in severe infection. The vicious cycle of the virus infection in which virus is more easily invaded into surrounding tissue leads to the involvement of multiple organs and ultimately poor prognosis in the disease outcome. Therefore, we suggest evaluating the expression of HIF-1α in SARS-CoV-2 infections at an early phase of infection particularly in patients with comorbidities like solid malignancies as well as patients having signs and symptoms of hypoxia. It is also suggested that continuous monitoring of the SpO₂ level and early institution of preventive O₂ therapy at an early stage in these patients may lead to lesser morbidity as well as mortality in COVID-19 patients. Page(s): 670-675

Histopathological basis of COVID-19: A short review

Tue, 01 Dec 2020 00:00:00 GMT

Title: Histopathological basis of COVID-19: A short review Authors: Adhya, Shouvanik Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the global pandemic in 2020 resulting a massive morbidity & mortality. The lung is the predominant organ involved in symptomatic patients with Coronavirus disease-2019 (COVID-19) along with involvement of other organs. Understanding the histopathological changes of lung and other organs in COVID-19 become essential for not only formulating future management protocols but also for determing prognosis. The collection of potentially contaminated tissues during the autopsy and further processing of them in histopathology laboratory with proper maintenance of safety protocol is of immense importance. A review of the available scientific articles shows the diffuse alveolar damage and microvascular thrombi are common observation found in lung tissue in patients who died due to COVID-19. Page(s): 676-680

Evaluation of Gamma glutamyl-transferase (GGT) levels in COVID-19: A retrospective analysis in tertiary care centre

Tue, 01 Dec 2020 00:00:00 GMT

Title: Evaluation of Gamma glutamyl-transferase (GGT) levels in COVID-19: A retrospective analysis in tertiary care centre Authors: Saini, Neha; Saini, Ram Krishan; Kumari, Mohana; Kumar, Dev; Bhardwaj, Manish; Soni, Shiv; Suri, Vikas; Malhotra, Pankaj; Ram, Sant; Zohmangaihi, Deepy Abstract: Many recent studies have reported that patients infected with novel coronavirus 2019 or SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) might have a liver injury. However, few studies have focussed on the levels of Gamma glutamyl-transferase (GGT) alone and the variations associated with it. We retrospectively analysed the GGT levels of 476 admitted patients with conﬁrmed COVID-19 in a tertiary care centre, PGIMER (Post Graduate Institute of Medical Education and Research), Chandigarh. Out of the total 476 COVID-19 patients studied, 35% had elevated GGT levels. ICU care was required for 51.19% (P <0.0001) of these patients and their hospital stay was of longer duration as compared to the patients with normal GGT levels. The incidence of GGT elevation was found to be more pronounced in males and elderly patients. The male population displayed higher GGT levels with 52% having raised levels compared to females where only 21.6% had elevated GGT levels. Although the number of COVID-19 cases was majorly from young age groups, the elevation in GGT levels has been reported more in elderly patients. GGT levels can therefore serve as a predictor for the extent of liver injury and severity in COVID-19 patients. Page(s): 681-686