The severity of COVID-19 is positively correlated to the level of inflammatory cytokines such as interleukins (IL-2, IL-6, IL-7, IL-10), granulocyte colony-stimulating factor (GCSF), interferon gamma-induced protein 10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein 1 alpha (MIP-1A) and tumor necrosis factor Conclusion Evidence on why persistent symptoms occur is still limited, and available studies are heterogeneous. conceived and designed research; M.K.B., A.H., L.S., and K.A. A Deep Look into the Biology and Evolution of COVID-19 Although hepatocytes have not been shown to exhibit high ACE2 expression, previous studies have demonstrated a high level of ACE2 expression in cholangiocytes, suggesting direct bile duct infection/damage as a potential cause of abnormal liver enzymes (17). Galang RR, Chang K, Strid P, Snead MC, Woodworth KR, House LD, Perez M, Barfield WD, Meaney-Delman D, Jamieson DJ, Shapiro-Mendoza CK, Ellington SR. It is unclear whether increased antibody prevalence in severe COVID-19 patients suggests potential antibody-dependent enhancement (ADE) or is simply a result of higher viral antigen exposure. Individuals with Alzheimers disease (AD) and related dementia, as well as persons with Down syndrome (DS), are especially vulnerable to COVID-19, but the Finally, several comorbidities have been associated with poor outcomes, likely due to the fact that organ and immune function may already be compromised and in a state of subclinical inflammation (53, 158). COVID Some chemicals have been This paper proposes a model algorithm based on convolutional neural network combined with attention mechanism to realize fast and accurate identification of biological image. Immune dysregulation, auto-immunity, endothelial dysfunction, occult viral persistence, as well as coagulation activation are the main underlying pathophysiological mechanisms so far. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from the Hong Kong cohort and systematic review and meta-analysis. The most common GI manifestations reported in both adult and especially pediatric COVID-19 patients include diarrhea, nausea, vomiting, and abdominal pain (16, 133, 157). As such, the neutrophil-to-lymphocyte ratio appears to be a useful indicator of disease prognostication and management (83). Several studies have demonstrated significantly elevated levels of classical markers of cardiac injury and failure [i.e., cardiac troponin and brain natriuretic peptides (BNP)] in patients with greater disease severity (53a, 78). The application of a functional dressing is a crucial step in DU treatment and is associated with the patient's recovery and prognosis. Henry BM, De Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): A meta-analysis. Zhang H, Zhou P, Wei Y, Yue H, Wang Y, Hu M, Zhang S, Cao T, Yang C, Li M, Guo G, Chen X, Chen Y, Lei M, Liu H, Zhao J, Peng P, Wang CY, Du R. Histopathologic changes and SARS-COV-2 immunostaining in the lung of a patient with COVID-19. The immune system now has the tools to defeat the SARS-CoV-2 virus. Qin L, Li X, Shi J, Yu M, Wang K, Tao Y, Zhou Y, Zhou M, Xu S, Wu B, Yang Z, Zhang C, Yue J, Cheng C, Liu X, Xie M. Gendered effects on inflammation reaction and outcome of COVID19 patients in Wuhan. Their study demonstrated frequent elevations in CRP, procalcitonin, and LDH in severe pediatric COVID-19, similar to adult findings (56). Autopsy findings in SARS-CoV infections have shown strong evidence of neuro-invasion, with demonstrated viral presence in the cerebrospinal fluid (6, 95). Nitazoxanide and Azithromycin are widely used for the early treatment of COVID-19. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome, Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19. This molecular mimicry has been identified as an efficient evolutionary adaptation that some viruses have acquired for exploiting the host cellular machinery. Some cases of cutaneous manifestations in adult COVID-19 patients have been reported, although varying incidence among patients has been noted (68, 111, 120). Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, Jain SS, Burkhoff D, Kumaraiah D, Rabbani L, Schwartz A, Uriel N. Cole SA, Laviada-Molina HA, Serres-Perales JM, Rodriguez-Ayala E, Bastarrachea RA. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, Nahabedian J, Anderson K, Gilboa SM. Molecular mechanism of interaction between SARS-CoV-2 and Similar to renal COVID-19 involvement, there is evidence of direct SARS-CoV-2 GI infection through isolation of viral RNA from GI epithelial cells (146). Patients with abnormal liver function tests, particularly elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST), also had significantly higher risk of developing severe pneumonia (14). Nevertheless, the exact contribution of direct viral immune cell infection is unknown and highly debated (155). This review presents various potential pathophysiological mechanisms behind SARS-CoV-2 infection. This work was supported by a Foundation Grant from the Canadian Institutes of Health Research (CIHR) (grant no. reported that 17% of COVID-19 patients in their cohort (n = 52) had serologic evidence of exocrine pancreatic injury, defined as elevated amylase or lipase (140). Further research is urgently needed to better characterize the clinical picture of COVID-19 at each trimester of pregnancy. Larsen CP, Bourne TD, Wilson JD, Saqqa O, Sharshir MA. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Inflammation and thrombosis: roles of neutrophils, platelets and endothelial cells and their interactions in thrombus formation during sepsis. Gtzinger F, Santiago-Garca B, Noguera-Julin A, Lanaspa M, Lancella L, Cal Carducci FI, Gabrovska N, Velizarova S, Prunk P, Osterman V, Krivec U, Lo Vecchio A, Shingadia D, Soriano-Arandes A, Melendo S, Lanari M, Pierantoni L, Wagner N, LHuillier AG, Heininger U, Ritz N, Bandi S, Krajcar N, Rogli S, Santos M, Christiaens C, Creuven M, Buonsenso D, Welch SB, Bogyi M, Brinkmann F, Tebruegge M, Pfefferle J, Zacharasiewicz A, Berger A, Berger R, Strenger V, Kohlfrst DS, Zschocke A, Bernar B, Simma B, Haberlandt E, Thir C, Biebl A, Vanden Driessche K, Boiy T, Van Brusselen D, Bael A, Debulpaep S, Schelstraete P, Pavic I, Nygaard U, Glenthoej JP, Heilmann Jensen L, Lind I, Tistsenko M, Uustalu , Buchtala L, Thee S, Kobbe R, Rau C, Schwerk N, Barker M, Tsolia M, Eleftheriou I, Gavin P, Kozdoba O, Zsigmond B, Valentini P, Ivakeviciene I, Ivakevicius R, Vilc V, Schlvinck E, Rojahn A, Smyrnaios A, Klingenberg C, Carvalho I, Ribeiro A, Starshinova A, Solovic I, Falcn L, Neth O, Minguell L, Bustillo M, Gutirrez-Snchez AM, Guarch Ibez B, Ripoll F, Soto B, Ktz K, Zimmermann P, Schmid H, Zucol F, Niederer A, Buettcher M, Cetin BS, Bilogortseva O, Chechenyeva V, Demirjian A, Shackley F, McFetridge L, Speirs L, Doherty C, Jones L, McMaster P, Murray C, Child F, Beuvink Y, Makwana N, Whittaker E, Williams A, Fidler K, Bernatoniene J, Song R, Oliver Z, Riordan A; ptbnet COVID-19 Study Group . Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Miao X, Li Y, Hu B. Neurologic manifestations of hospitalized patients with Coronavirus Disease 2019 in Wuhan, China, Possible link between anosmia and COVID-19: sniffing out the truth. The association of GI manifestations with disease severity is not well described, with many conflicting results reported (25, 139, 154). However, the validity of these mechanisms have been debated, since abnormal liver enzymes have been reported at hospital admission before any drug treatment as well as in patients without the need for mechanical ventilation (7). Recent autopsy data from Italy also observed fibrin thrombi in pulmonary small arterial vessels in 87% of fatal cases examined, suggesting the contribution of coagulation in diffuse alveolar and endothelial damage (15). The pyrin inflammasome in health and disease. Shapiro J, Sciaky N, Lee J, Bosshart H, Angeletti RH, Bonifacino JS. Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, Cani DS, Cerini M, Farina D, Gavazzi E, Maroldi R, Adamo M, Ammirati E, Sinagra G, Lombardi CM, Metra M. Cardiac involvement in a patient with Coronavirus disease 2019 (COVID-19). Cheung EW, Zachariah P, Gorelik M, Boneparth A, Kernie SG, Orange JS, Milner JD. It is important to note that the heterogeneous standards used to interpret laboratory tests in pediatrics could contribute to the variation observed in study findings. In terms of exocrine-related damage, a study by Wang et al. Although these reports indicate a milder COVID-19 profile in pediatric patients compared with adults (159), reports from China and the CDC indicate that the documented hospitalization and mortality rates in pediatric cases are concerning and emphasize the importance of comprehensive studies to examine the clinical picture of pediatric disease (15a, 36). Pathophysiology of COVID-19: Mechanisms Underlying Disease Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. That The reported neurological manifestations of COVID-19 include headache, dizziness, confusion, epilepsy, ataxia (lack of voluntary muscle movement), altered sense of smell (hyposmia/anosmia), loss of taste (ageusia), and Guillain-Barr syndrome, among others (97, 115, 134). A recent, large, multi-center U.S. study of 186 patients who met the broad CDC criteria for MIS-C reported 92% of patients had at least four laboratory results indicating inflammation, including but not limited to elevated CRP and ferritin, lymphocytopenia, neutrophilia, hypoalbuminemia, thrombocytopenia, anemia, as well as elevated D-dimer and fibrinogen (44). Anand P, Puranik A, Aravamudan M, Venkatakrishnan AJ, Soundararajan V. SARS-CoV-2 strategically mimics proteolytic activation of human ENaC, Elevated interleukin-6 and severe COVID-19: A meta-analysis, Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms, COVID-19 and the liver: little cause for concern. Previous data from the SARS epidemic suggests 35% of heart specimens showed presence of viral RNA in the myocardium. SARS and MERS: recent insights into emerging coronaviruses. Chai X, Hu L, Zhang Y, Han W, Lu Z, Ke A, Zhou J, Shi G, Fang N, Fan J, Cai J, Fan J, Lan F. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. Drug-induced phospholipidosis confounds drug repurposing for Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. The condition is typically treated with either an infusion of antibodies, known as immunoglobulin therapy, or plasma exchange, in which a patients blood plasma is removed and replaced.
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