Escher F, Pietsch H, Aleshcheva G, Bock T, Baumeier C, Elsaesser A, Wenzel P, Hamm C, Westenfeld R, Schultheiss M, Gross U, Morawietz L, Schultheiss H. Detection of viral SARSCoV2 genomes and histopathological changes in endomyocardial biopsies, Severe COVID-19 infection associated with endothelial activation. 2: pulmonary recruitment of macrophages and dendritic cells in response to chemokine and cytokine release (early phase). The trinity of COVID-19: immunity, inflammation and intervention. COVID-19 and its implications for thrombosis and anticoagulation. Severe acute respiratory syndrome Coronavirus 2-specific antibody responses in Coronavirus Disease 2019 patients. COVID-19 The immune system now has the tools to defeat the SARS-CoV-2 virus. Direct viral infection of macrophages and/or dendritic cells is estimated to propagate further cytokine and chemokine release, subsequently activating late-phase immune-cell recruitment of antigen-specific T cells to destroy virally infected alveolar cells (61, 130, 132, 149). Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV. Many groups have suggested extrapulmonary involvement in COVID-19 is a direct result of unrestrained inflammation. Open in a separate (B) Macrophage activation. As a library, NLM provides access to scientific literature. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. biochemistry, study of the chemical substances and processes that occur in plants, animals, and microorganisms and of the changes they undergo during SARS-CoV-2 Evolution - WHO Barnes BJ, Adrover JM, Baxter-Stoltzfus A, Borczuk A, Cools-Lartigue J, Crawford JM, Daler-Plenker J, Guerci P, Huynh C, Knight JS, Loda M, Looney MR, McAllister F, Rayes R, Renaud S, Rousseau S, Salvatore S, Schwartz RE, Spicer JD, Yost CC, Weber A, Zuo Y, Egeblad M. Targeting potential drivers of COVID-19: neutrophil extracellular traps, Activation of the SARS coronavirus spike protein via sequential proteolytic cleavage at two distinct sites. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. the contents by NLM or the National Institutes of Health. Diabetic ulcers (DUs) are one of the most serious complications of diabetes mellitus. Importantly, it is possible that the neurological manifestations of COVID-19 could be a result of hypoxia, respiratory, and/or metabolic acidosis at end-stage disease (6). Khalil A, Kalafat E, Benlioglu C, OBrien P, Morris E, Draycott T, Thangaratinam S, Le Doare K, Heath P, Ladhani S, von Dadelszen P, Magee LA. WebThe outbreak of Coronavirus Disease 2019 (COVID-19) has infected more than 17 million individuals worldwide, resulting in the death of more than 669, 000 people as of July 2020. Jasti M, Nalleballe K, Dandu V, Onteddu S. A review of pathophysiology and neuropsychiatric manifestations of COVID-19. Specifically, in a study of 417 COVID-19 patients, 76.3% had abnormal liver tests, and 21.5% had liver injury during hospitalization (14). DeBiasi RL, Song X, Delaney M, Bell M, Smith K, Pershad J, Ansusinha E, Hahn A, Hamdy R, Harik N, Hanisch B, Jantausch B, Koay A, Steinhorn R, Newman K, Wessel D. Severe COVID-19 in children and young adults in the Washington, DC metropolitan region. 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). Nitazoxanide and azithromycin for the early treatment of MHS,, Hsieh 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). The receptor binding domain of the viral spike protein is an immunodominant and highly specific target of antibodies in SARS-CoV-2 patients, Role of the spike glycoprotein of human Middle East respiratory syndrome coronavirus (MERS-CoV) in virus entry and syncytia formation. 1Molecular Medicine, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada, 2Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada, 3Department of Physiology, University of Toronto, Toronto, Ontario, Canada. Here, we review the current literature and summarize key proposed mechanisms of COVID-19 pathophysiological progression (FIGURE 1). However, traditional dressings with a simple structure and a single function cannot meet clinical requirements. A recently concluded study has revealed that during the initial 18 months of the COVID-19 pandemic, a higher number of minors in Finland than usual were diagnosed Once the nucleocapsid is deposited into the cytoplasm of the host cell, the RNA genome is replicated and translated into structural and accessory proteins. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, Newburger JW, Kleinman LC, Heidemann SM, Martin AA, Singh AR, Li S, Tarquinio KM, Jaggi P, Oster ME, Zackai SP, Gillen J, Ratner AJ, Walsh RF, Fitzgerald JC, Keenaghan MA, Alharash H, Doymaz S, Clouser KN, Giuliano JS, Gupta A, Parker RM, Maddux AB, Havalad V, Ramsingh S, Bukulmez H, Bradford TT, Smith LS, Tenforde MW, Carroll CL, Riggs BJ, Gertz SJ, Daube A, Lansell A, Coronado Munoz A, Hobbs CV, Marohn KL, Halasa NB, Patel MM, Randolph AG. Current literature suggests seroconversion in COVID-19 patients occurs ~714 days post symptom onset (12). In a case study series of >2,000 children with suspected or confirmed COVID-19 in China, 5% of symptomatic children had dyspnea or hypoxemia, and only 0.6% progressed to ARDS or MOF (36). This review highlights key mechanisms that have been proposed to contribute to COVID-19 progression from viral entry to multisystem organ failure, as well as the central role of the immune response in successful viral clearance or progression to death. mechanisms of COVID SARS-CoV-2 viral entry has been described in detail elsewhere (138). However, other contributing mechanisms have been proposed and are explored below (FIGURE 3). Additionally, further research is needed to examine the main drivers of COVID-19 and their molecular mechanisms of action in both pediatric and adult populations, since this should inform appropriate risk stratification and therapeutic strategies. TWC India. Pancreatic injury has also been reported in patients with COVID-19. Scientists have been trying to understand the origin of COVID-19 and the virus that causes it: SARS-CoV-2. WebThe coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is a highly contagious enveloped positive-strand RNA virus that causes respiratory diseases, fever, and severe pneumonia in humans (13). Larsen CP, Bourne TD, Wilson JD, Saqqa O, Sharshir MA. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis of clinical features and pregnancy outcomes. mechanisms of COVID High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. JCM | Free Full-Text | Long-Term Effects of SARS-CoV-2 in the The https:// ensures that you are connecting to the Anatomic pathology includes surgical pathology, histotechnology, cytology, and autopsy. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, Ng PC, Lam PWY, Ho LC, To WWK, Lai ST, Yan WW, Tan PYH. Modelling COVID-19 epidemic with confirmed cases-driven Wang F, Wang H, Fan J, Zhang Y, Wang H, Zhao Q. Pancreatic injury patterns in patients with Coronavirus Disease 19 pneumonia. Some cases of cutaneous manifestations in adult COVID-19 patients have been reported, although varying incidence among patients has been noted (68, 111, 120). Coronavirus disease 2019 (COVID-19) is caused by a novel beta-coronavirus known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Neutrophil extracellular traps in COVID-19, https://www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf, https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19. TWC India. WebThe biochemical mechanism of ozone-induced lung injury is due to the reaction of the highly reactive O 3 with biological macromolecules such as protein, lipids, nucleic acids, and A team of Russian researchers has uncovered the mechanisms behind the emergence of new and dangerous coronavirus variants, such as Alpha, Delta, Severe Coronavirus infections in pregnancy: a systematic review. A Deep Look into the Biology and Evolution of COVID-19 Importantly, COVID-19 appears to enhance complications in patients with diabetes, likely due to viral-induced pancreatic dysfunction as well as associated immune dysregulation, vasculopathy, and coagulopathy (29, 37). NSF Award Search: Award # 2113736 - SenSE:Wearable hybrid Ivermectin, antiviral properties and COVID-19: a possible new mechanism of action. Pathophysiology of COVID-19: Mechanisms Underlying Disease A unique correlation between the laboratory profile observed in pregnant patients with preeclampsia and COVID-19 also appears to exist, prompting questions of shared disease pathways (116). Frontiers | Ginsenosides, potential TMPRSS2 inhibitors, a trade-off Therefore, The main drivers of this response have been postulated and thoroughly reviewed elsewhere (125, 130, 151). WC,, Benoit J,, Ballout Matsuyama S, Ujike M, Morikawa S, Tashiro M, Taguchi F. Protease-mediated enhancement of severe acute respiratory syndrome coronavirus infection. In addition to cardiovascular damage, renal involvement is frequently observed in COVID-19, varying from mild proteinuria and minor serum creatinine elevations to acute kidney injury (AKI) and renal failure. Clinical characteristics of 138 hospitalized patients with 2019 novel Coronavirus-infected pneumonia in Wuhan, China. A new variant of COVID-19 starting to spread around the United States could be responsible for a new symptom that is unlike any weve seen with the virus so far. In addition to direct infection, uncontrolled cytokine release, thrombosis, and ischemia can also result in further kidney dysfunction, characterized by intrarenal inflammation, increased vascular permeability, and volume depletion (88). Similar to other cytopathic viruses, SARS-CoV-2 infection induces cellular death and injury in airway epithelial cells through diverse processes such as pyroptosis (19, 153). For example, the activation of complement pathways can lead to initiation of the coagulation cascade (30, 127). Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. 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. Front. However, no consistent trend in lymphocyte count was reported (56). Several original studies and systematic reviews have been completed, assessing clinical characteristics of pregnant women with COVID-19 (46, 69, 135). Martnez-Rojas MA, Vega-Vega O, Bobadilla NA. Drug-induced phospholipidosis confounds drug repurposing for Nevertheless, the exact contribution of direct viral immune cell infection is unknown and highly debated (155). Perera RAPM, Mok CKP, Tsang OTY, Lv H, Ko RLW, Wu NC, Yuan M, Leung WS, Chan JMC, Chik TSH, Choi CYC, Leung K, Chan KH, Chan KCK, Li KC, Wu JT, Wilson IA, Monto AS, Poon LLM, Peiris M. Serological assays for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), March 2020, Should covid-19 concern nephrologists? COVID-19 Mechanisms in the Human Body-What We Know So Far link.springer.com. Although more data is urgently needed to elucidate the global epidemiology of COVID-19 (80), a wide spectrum of clinical severity is evident, with most patients able to mount a sufficient and appropriate immune response, ultimately leading to viral clearance and case resolution. Schnappauf O, Chae JJ, Kastner DL, Aksentijevich I. Recent studies indicate that like other coronaviruses, SARS-CoV-2 also hijacks or Bertram S, Glowacka I, Mller MA, Lavender H, Gnirss K, Nehlmeier I, Niemeyer D, He Y, Simmons G, Drosten C, Soilleux EJ, Jahn O, Steffen I, Phlmann S. Cleavage and activation of the severe acute respiratory syndrome coronavirus spike protein by human airway trypsin-like protease. 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). Further research is urgently needed to better characterize the clinical picture of COVID-19 at each trimester of pregnancy. 1: SARS-CoV-2 enters alveolar epithelial cells by binding to angiotensin converting enzyme 2 (ACE2) through surface spike (S) protein mediated by transmembrane serine protease 2 (TMPRSS2). 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). Chu KH, Tsang WK, Tang CS, Lam MF, Lai FM, To KF, Fung KS, Tang HL, Yan WW, Chan HWH, Lai TST, Tong KL, Lai KN. The COVID-19 outbreak has been a serious public health threat worldwide and the basic reproduction number is estimated to be 1.54 with contact tracing, quarantine Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Hirschwerk DA, Kim EJ, Kozel ZM, Marrast LM, Mogavero JN, Osorio GA, Qiu M, Zanos TP; the Northwell COVID-19 Research Consortium . In addition to the observed maladaptive cytokine release, elevations in more traditional biochemical markers of acute infection, including C-reactive protein (CRP) and ferritin (both positive acute phase reactants), as well as continual decreases in lymphocytes and significant elevations in neutrophils, are evident (43, 79). Multisystem inflammatory syndrome in children during the Coronavirus 2019 pandemic: a case series. Before this, TMPRSS2 has presented biological functions in cancer, but the roles remain controversial and the mechanism remains unelucidated. Diao B, Wang C, Tan Y, Chen X, Liu Y, Ning L, Chen L, Li M, Liu Y, Wang G, Yuan Z, Feng Z, Zhang Y, Wu Y, Chen Y. Laboratory abnormalities in children with mild and severe coronavirus disease 2019 (COVID-19): A pooled analysis and review. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Maladaptive cytokine release is known to directly affect cardiomyocytes as well as to lead to endothelial cell reprogramming and dysfunction, supporting their causative role in COVID-19 cardiovascular manifestations (71, 131). Potential mechanisms include 1) viral entry via ACE2 receptors into the endothelia that line the blood capillaries and subsequent neuro-invasion, 2) neurological edema and brain stem compression as a result of breached blood-brain barrier, 3) neurological edema and hypercoagulability as a result of cytokine storm syndrome, and 4) propagation via mechanoreceptors and chemoreceptors in the lung and lower respiratory airways (65). WebThe coronavirus disease 2019 (COVID-19) pandemic is an ongoing global health concern, and effective antiviral reagents are urgently needed. Considering this, it is still unclear what factors influence the transition from normal physiological to pathogenic hyperinflammatory response. Interestingly, most studies report similar clinical characteristics and mortality rates in pregnant women with COVID-19 compared with nonpregnant women of reproductive age (48). Vesicles containing the newly formed viral particles are then transported to and fuse with the plasma membrane, releasing them to infect other host cells in the same fashion (33, 89, 105). Interestingly, current evidence suggests that the laboratory profile observed in pediatric COVID-19 patients is different from that of adults. The exact contribution of risk factors to disease progression is still partially undefined. FOIA A timely, localized, and well-coordinated immune response presents the first line of physiological defense against SARS-CoV-2 infection (FIGURE 2). Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Inside the new mRNA vaccines for COVID-19 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). Zuo Y, Yalavarthi S, Shi H, Gockman K, Zuo M, Madison JA, Blair C, Weber A, Barnes BJ, Egeblad M, Woods RJ, Kanthi Y, Knight JS. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Chris Turnbull on Twitter: "..3C and 3CL Proteases of HRV The urgent need to appropriately identify these patients has led the World Health Organization (WHO) and other regulatory bodies to develop a preliminary case definition known as Multisystem Inflammatory Disorder in Children and adolescents (MIS-C) (142a). Cytokine and anti-cytokine interventions. Careers, Unable to load your collection due to an error. Liver biochemistries in hospitalized patients with COVID-19. Hasnain M, Pasha MF, Ghani I, Budiarto R. Protection challenges of pregnant women against vertical transmission during COVID-19 epidemic: a narrative review. Mechanisms 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). Specifically, immunothrombosis is a phenomenon known to occur as a result of host defense against various pathogens, including viral infection (30). Initial studies have reported varying incidences (315%) of AKI during illness (20, 22, 155). Cytokine-mediated inflammatory AKI has been described previously in the literature in other clinical contexts such as CAR-T-cell treatment in cancer patients (102, 104, 117). Evaluating the risk of severe outcomes of SARS-CoV-2 infection in pregnant women is imperative for both mother and child. Theres a New Symptom the Arcturus COVID Variant May be Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, Li J, Yao Y, Ge S, Xu G. Kidney disease is associated with in-hospital death of patients with COVID-19. SARS and MERS: recent insights into emerging coronaviruses. Previous data from the SARS epidemic suggests 35% of heart specimens showed presence of viral RNA in the myocardium. 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). Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: Case report on three family members. The M, E, and N proteins are critical for viral particle assembly and release, whereas the S protein is responsible for viral binding and entry into host cells (33, 76, 89, 143, 148). Cytokine responses in severe acute respiratory syndrome coronavirus-infected macrophages in vitro: possible relevance to pathogenesis. coronavirus M.K.B. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. was supported by a Restracomp Scholarship (Hospital for Sick Children) and an Ontario Graduate Scholarship (OGS). FIGURE 3. JCM | Free Full-Text | Long-Term Effects of SARS-CoV-2 in the Virus-induced breath biomarkers: A new perspective to study the COVID-19 and myocarditis: What do we know so far? 3: direct viral infection of pulmonary macrophages and dendritic cells causes expression of several proinflammatory cytokines and chemokines. This disproportionate clinical epidemiology may be explained by sex-specific regulation of ACE2, increased incidence of preexisting comorbidities in males (i.e., hypertension, diabetes, cardiovascular disease), as well as sex-specific differences in viral immune response, as described elsewhere (47, 109). Prospective validation of these proposed cut-offs across different assay methodologies and patient populations are urgently awaited to establish clinical utility. 8600 Rockville Pike Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, Kaptein FHJ, van Paassen J, Stals MAM, Huisman MV, Endeman H. Incidence of thrombotic complications in critically ill ICU patients with COVID-19, Role of cytokines in cardiovascular diseases: a focus on endothelial responses to inflammation. However, traditional dressings with a simple structure and a single function cannot meet clinical requirements. This not only suggests the importance of defining the timing of antibody response through serological testing in multiple age groups but also points toward the increasing complexity of COVID-19. 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. Notably, in a case study series of 5,700 patients from New York City, the most commonly observed comorbidities were hypertension, obesity, and diabetes (112). This could in part be explained by the viruss Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. link.springer.com. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Multisystem inflammatory syndrome related to COVID-19 in previously healthy children and adolescents in New York City. The unparalleled pathogenicity and global impact of this pandemic has rapidly engaged the scientific community in urgently needed research. Jones VG, Mills M, Suarez D, Hogan CA, Yeh D, Segal JB, Nguyen EL, Barsh GR, Maskatia S, Mathew R. COVID-19 and Kawasaki Disease: novel virus and novel case, COVID-19 can present with a rash and be mistaken for dengue. The application of a functional dressing is a crucial step in DU treatment and is associated with the patient's recovery and prognosis. Biological Mechanisms of COVID-19 Acute Respiratory Distress Reduction and functional exhaustion of T cells in patients with Coronavirus Disease 2019 (COVID-19). Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation, Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: summary of a report of 72,314 cases From the Chinese Center for Disease Control and Prevention. The relationship between micronutrient status, frailty, systemic Bethesda, MD 20894, Web Policies Background: Acting as a viral entry for coronavirus to invade human cells, TMPRSS2 has become a target for the prevention and treatment of COVID-19 infection. 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. JCM | Free Full-Text | Long-Term Effects of SARS-CoV-2 in the In Their study demonstrated frequent elevations in CRP, procalcitonin, and LDH in severe pediatric COVID-19, similar to adult findings (56). Firstly, deformable convolution is used to extract features in the horizontal and vertical directions, respectively. Jamilloux Y, Henry T, Belot A, Viel S, Fauter M, El Jammal T, Walzer T, Franois B, Sve P. Should we stimulate or suppress immune responses in COVID-19? Severe acute respiratory syndrome and the innate immune responses: modulation of effector cell function without productive infection. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutirrez-Ocampo E, Villamizar-Pea R, Holguin-Rivera Y, Escalera-Antezana JP, Alvarado-Arnez LE, Bonilla-Aldana DK, Franco-Paredes C, Henao-Martinez AF, Paniz-Mondolfi A, Lagos-Grisales GJ, Ramrez-Vallejo E, Surez JA, Zambrano LI, Villamil-Gmez WE, Balbin-Ramon GJ, Rabaan AA, Harapan H, Dhama K, Nishiura H, Kataoka H, Ahmad T, Sah R; Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome, Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19. Diabetic ulcers (DUs) are one of the most serious complications of diabetes mellitus. SARS-CoV-2 is mostly transmissible through large respiratory droplets, directly infecting cells of the upper and lower respiratory tract, especially nasal ciliated and alveolar epithelial cells (161). In addition to age, emerging clinical and epidemiological data suggest sex-specific differences in the clinical characteristics and case-to-fatality ratio of COVID-19, with worse prognosis observed in males (66, 92). Federal government websites often end in .gov or .mil. Gould TJ, Vu TT, Swystun LL, Dwivedi DJ, Mai SHC, Weitz JI, Liaw PC. A team of Russian researchers has uncovered the mechanisms behind the emergence of new and dangerous coronavirus variants, such as Alpha, Delta, Omicron, and others. The .gov means its official. Bioinformatics analysis of potential common pathogenic mechanisms for COVID-19 infection and primary Sjogrens syndrome. Xu X, Chen P, Wang J, Feng J, Zhou H, Li X, Zhong W, Hao P. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Physiological host immune response to SARS-CoV-2 infection. Received 2020 Jun 23; Revised 2020 Jul 7; Accepted 2020 Jul 7. coagulation, COVID-19, cytokine storm, multisystem organ failure, pathophysiolog. Probing the biological basis of the novel virus and evolutionary spread of the COVID-19 disease it causes, a panel of UC San Diego biologists gathered for a special Premkumar L, Segovia-Chumbez B, Jadi R, Martinez DR, Raut R, Markmann A, Cornaby C, Bartelt L, Weiss S, Park Y, Edwards CE, Weimer E, Scherer EM, Rouphael N, Edupuganti S, Weiskopf D, Tse LV, Hou YJ, Margolis D, Sette A, Collins MH, Schmitz J, Baric RS, de Silva AM. Preliminary reports from the Chinese Center for Disease Control and Prevention have estimated that the large majority of confirmed SARS-CoV-2 cases are mild (81%), with ~14% progressing to severe pneumonia and 5% developing acute respiratory distress syndrome (ARDS), sepsis, and/or multisystem organ failure (MOF) (144).