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The Role of Inflammation in COVID-19: From Pathophysiology to Treatment.
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The Role of Inflammation in COVID-19: From Pathophysiology to Treatment.

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (20 October 2021) | Viewed by 16338

Special Issue Editors

Dr. Dimitrios A. Vrachatis

E-Mail Website
Guest Editor
2nd Department of Cardiology, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
Interests: clinical cardiology; interventional cardiology; heart; imaging; electrophysiology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Spyridon G. Deftereos

E-Mail Website
Guest Editor
2nd Department of Cardiology, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece
Interests: interventional cardiology; atrial fibrillation; catheter ablation; pacemakers; clinical cardiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing coronavirus disease – 19 (COVID-19) has introduced a great pandemic in the 2020. A striking need for understanding of COVID-19 pathophysiology and development of efficient treatment strategies is more than evident. The role of inflammation in COVID-19 has soon been recognized. The so-called “cytokine-storm”, whilst a matter of debate, has driven a significant portion of research to strategies focusing on the potential of anti-inflammatory treatment.

The previous months have undoubtedly changed priorities in clinical practice and both bench and bedside research. A wide range of data became available, while a significant amount of studies is ongoing and will probably change the to-date comprehension of this disease. Indeed, in the context of this pandemic even approaches that just attenuate the physical course of the disease - without literally being a definite treatment - are of significant importance.

The present Special Issue aims to explore pathophysiological, diagnostic and treatment aspects of COVID-19 with special interest in the role of inflammation. We would be honored to have robust contributions from eminent experts on the field in order to update the scientific literature both with original research and review articles on this fascinating topic.

Dr. Dimitrios A. Vrachatis
Dr. Spyridon G. Deftereos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Colchicine
  • COVID-19
  • Anti-inflammatory
  • inflammation
  • pandemic
  • infectious disease
  • novel treatments
  • pathophysiology
  • epidemiology

Published Papers (4 papers)

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Research

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13 pages, 1499 KiB  
Article
Inflammatory and Hypercoagulable Biomarkers and Clinical Outcomes in COVID-19 Patients
by Hiroki Kitakata, Shun Kohsaka, Shunsuke Kuroda, Akihiro Nomura, Takeshi Kitai, Taishi Yonetsu, Sho Torii, Yuya Matsue and Shingo Matsumoto
J. Clin. Med. 2021, 10(14), 3086; https://doi.org/10.3390/jcm10143086 - 13 Jul 2021
Cited by 4 | Viewed by 2452
Abstract
Systemic inflammation and hypercoagulopathy are known pathophysiological processes of coronavirus disease 2019 (COVID-19), particularly in patients with known cardiovascular disease or its risk factors (CVD). However, whether a cumulative assessment of these biomarkers at admission could contribute to the prediction of in-hospital outcomes [...] Read more.
Systemic inflammation and hypercoagulopathy are known pathophysiological processes of coronavirus disease 2019 (COVID-19), particularly in patients with known cardiovascular disease or its risk factors (CVD). However, whether a cumulative assessment of these biomarkers at admission could contribute to the prediction of in-hospital outcomes remains unknown. The CLAVIS-COVID registry was a Japanese nationwide retrospective multicenter observational study, supported by the Japanese Circulation Society. Consecutive hospitalized patients with pre-existing CVD and COVID-19 were enrolled. Patients were stratified by the tertiles of CRP and D-dimer values at the time of admission. Multivariable Cox proportional hazard models were constructed. In 461 patients (65.5% male; median age, 70.0), the median baseline CRP and D-dimer was 58.3 (interquartile range, 18.2–116.0) mg/L and 1.5 (interquartile range, 0.8–3.0) mg/L, respectively. Overall, the in-hospital mortality rate was 16.5%, and the rates steadily increased in concordance with both CRP (5.0%, 15.0%, and 28.2%, respectively p < 0.001) and D-dimer values (6.8%, 19.6%, and 22.5%, respectively p = 0.001). Patients with the lowest tertiles of both biomarkers (CRP, 29.0 mg/L; D-dimer, 1.00 mg/L) were at extremely low risk of in-hospital mortality (0% until day 50, and 1.4% overall). Conversely, the elevation of both CRP and D-dimer levels was a significant predictor of in-hospital mortality (Hazard ratio, 2.97; 95% confidence interval, 1.57–5.60). A similar trend was observed when the biomarker threshold was set at a clinically relevant threshold. In conclusion, the combination of these abnormalities may provide a framework for rapid risk estimation for in-hospital COVID-19 patients with CVD. Full article
(This article belongs to the Special Issue The Role of Inflammation in COVID-19: From Pathophysiology to Treatment.)
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Review

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17 pages, 1663 KiB  
Review
Immunologic Dysregulation and Hypercoagulability as a Pathophysiologic Background in COVID-19 Infection and the Immunomodulating Role of Colchicine
by Dimitrios A. Vrachatis, Konstantinos A. Papathanasiou, Sotiria G. Giotaki, Konstantinos Raisakis, Charalampos Kossyvakis, Andreas Kaoukis, Fotis Kolokathis, Gerasimos Deftereos, Konstantinos E. Iliodromitis, Dimitrios Avramides, Harilaos Bogossian, Gerasimos Siasos, George Giannopoulos, Bernhard Reimers, Alexandra Lansky, Jean-Claude Tardif and Spyridon Deftereos
J. Clin. Med. 2021, 10(21), 5128; https://doi.org/10.3390/jcm10215128 - 31 Oct 2021
Cited by 2 | Viewed by 2160
Abstract
In 2020, SARS-COV-2 put health systems under unprecedented resource and manpower pressure leading to significant number of deaths. Expectedly, researchers sought to shed light on the pathophysiologic background of this novel disease (COVID-19) as well as to facilitate the design of effective therapeutic [...] Read more.
In 2020, SARS-COV-2 put health systems under unprecedented resource and manpower pressure leading to significant number of deaths. Expectedly, researchers sought to shed light on the pathophysiologic background of this novel disease (COVID-19) as well as to facilitate the design of effective therapeutic modalities. Indeed, early enough the pivotal role of inflammatory and thrombotic pathways in SARS-COV-2 infection has been illustrated. The purpose of this article is to briefly present the epidemiologic and clinical features of COVID-19, analyze the pathophysiologic importance of immunologic dysregulation and hypercoagulability in developing disease complications and finally to present an up-to-date systematic review of colchicine’s immunomodulating capacity in view of hindering coronavirus complications. Full article
(This article belongs to the Special Issue The Role of Inflammation in COVID-19: From Pathophysiology to Treatment.)
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19 pages, 17527 KiB  
Review
Infection of Human Cells by SARS-CoV-2 and Molecular Overview of Gastrointestinal, Neurological, and Hepatic Problems in COVID-19 Patients
by Mahdie Rahban, Agata Stanek, Amirreza Hooshmand, Yasaman Khamineh, Salma Ahi, Syed Naqui Kazim, Faizan Ahmad, Vladimir Muronetz, Mohamed Samy Abousenna, Samaneh Zolghadri and Ali A. Saboury
J. Clin. Med. 2021, 10(21), 4802; https://doi.org/10.3390/jcm10214802 - 20 Oct 2021
Cited by 15 | Viewed by 6979
Abstract
The gastrointestinal tract is the body’s largest interface between the host and the external environment. People infected with SARS-CoV-2 are at higher risk of microbiome alterations and severe diseases. Recent evidence has suggested that the pathophysiological and molecular mechanisms associated with gastrointestinal complicity [...] Read more.
The gastrointestinal tract is the body’s largest interface between the host and the external environment. People infected with SARS-CoV-2 are at higher risk of microbiome alterations and severe diseases. Recent evidence has suggested that the pathophysiological and molecular mechanisms associated with gastrointestinal complicity in SARS-CoV-2 infection could be explained by the role of angiotensin-converting enzyme-2 (ACE2) cell receptors. These receptors are overexpressed in the gut lining, leading to a high intestinal permeability to foreign pathogens. It is believed that SARS-CoV-2 has a lesser likelihood of causing liver infection because of the diminished expression of ACE2 in liver cells. Interestingly, an interconnection between the lungs, brain, and gastrointestinal tract during severe COVID-19 has been mentioned. We hope that this review on the molecular mechanisms related to the gastrointestinal disorders as well as neurological and hepatic manifestations experienced by COVID-19 patients will help scientists to find a convenient solution for this and other pandemic events. Full article
(This article belongs to the Special Issue The Role of Inflammation in COVID-19: From Pathophysiology to Treatment.)
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12 pages, 750 KiB  
Review
Correlation between α1-Antitrypsin Deficiency and SARS-CoV-2 Infection: Epidemiological Data and Pathogenetic Hypotheses
by Andrea Vianello, Gabriella Guarnieri, Fausto Braccioni, Beatrice Molena, Sara Lococo, Alessia Achille, Federico Lionello, Leonardo Salviati, Marco Caminati and Gianenrico Senna
J. Clin. Med. 2021, 10(19), 4493; https://doi.org/10.3390/jcm10194493 - 29 Sep 2021
Cited by 4 | Viewed by 3427
Abstract
The most common hereditary disorder in adults, α1-antitrypsin deficiency (AATD), is characterized by reduced plasma levels or the abnormal functioning of α1-antitrypsin (AAT), a major human blood serine protease inhibitor, which is encoded by the SERine Protein INhibitor-A1 (SERPINA1) gene and [...] Read more.
The most common hereditary disorder in adults, α1-antitrypsin deficiency (AATD), is characterized by reduced plasma levels or the abnormal functioning of α1-antitrypsin (AAT), a major human blood serine protease inhibitor, which is encoded by the SERine Protein INhibitor-A1 (SERPINA1) gene and produced in the liver. Recently, it has been hypothesized that the geographic differences in COVID-19 infection and fatality rates may be partially explained by ethnic differences in SERPINA1 allele frequencies. In our review, we examined epidemiological data on the correlation between the distribution of AATD, SARS-CoV-2 infection, and COVID-19 mortality rates. Moreover, we described shared pathogenetic pathways that may provide a theoretical basis for our epidemiological findings. We also considered the potential use of AAT augmentation therapy in patients with COVID-19. Full article
(This article belongs to the Special Issue The Role of Inflammation in COVID-19: From Pathophysiology to Treatment.)
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