Research

Jump to: Review

14 pages, 622 KiB

Open AccessArticle

Clinical Characteristics and Management of Patients with a Suspected COVID-19 Infection in Emergency Departments: A European Retrospective Multicenter Study

by Anthony Chauvin, Anna Slagman, Effie Polyzogopoulou, Lars Petter Bjørnsen, Visnja Nesek Adam, Ari Palomäki, Andrea Fabbri, Said Laribi and on behalf of the EUSEM Research Network Study Group

J. Pers. Med. 2022, 12(12), 2085; https://doi.org/10.3390/jpm12122085 - 19 Dec 2022

Cited by 1 | Viewed by 1242

Abstract

Background: Our aim is to describe and compare the profile and outcome of patients attending the ED with a confirmed COVID-19 infection with patients with a suspected COVID-19 infection. Methods: We conducted a multicentric retrospective study including adults who were seen in 21 [...] Read more.

Background: Our aim is to describe and compare the profile and outcome of patients attending the ED with a confirmed COVID-19 infection with patients with a suspected COVID-19 infection. Methods: We conducted a multicentric retrospective study including adults who were seen in 21 European emergency departments (ED) with suspected COVID-19 between 9 March and 8 April 2020. Patients with either a clinical suspicion of COVID-19 or confirmed COVID-19, detected using either a RT-PCR or a chest CT scan, formed the C+ group. Patients with non-confirmed COVID-19 (C− group) were defined as patients with a clinical presentation in the ED suggestive of COVID-19, but if tests were performed, they showed a negative RT-PCR and/or a negative chest CT scan. Results: A total of 7432 patients were included in the analysis: 1764 (23.7%) in the C+ group and 5668 (76.3%) in the C− group. The population was older (63.8 y.o. ±17.5 vs. 51.8 y.o. +/− 21.1, p < 0.01), with more males (54.6% vs. 46.1%, p < 0.01) in the C+ group. Patients in the C+ group had more chronic diseases. Half of the patients (n = 998, 56.6%) in the C+ group needed oxygen, compared to only 15% in the C− group (n = 877). Two-thirds of patients from the C+ group were hospitalized in ward (n = 1128, 63.9%), whereas two-thirds of patients in the C− group were discharged after their ED visit (n = 3883, 68.5%). Conclusion: Our study was the first in Europe to examine the emergency department’s perspective on the management of patients with a suspected COVID-19 infection. We showed an overall more critical clinical situation group of patients with a confirmed COVID-19 infection. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

8 pages, 804 KiB

Open AccessArticle

Diagnostic Performance of the Rapid Antigen Test as a Screening Tool for SARS-CoV-2 Infection in the Emergency Department

by Heekyung Lee, Hyunggoo Kang, Yongil Cho, Jaehoon Oh, Tae-Ho Lim, Byuk-Sung Ko and Juncheol Lee

J. Pers. Med. 2022, 12(7), 1172; https://doi.org/10.3390/jpm12071172 - 19 Jul 2022

Cited by 4 | Viewed by 1993

Abstract

The rapid antigen test (RAT) has been adopted as a screening tool for SARS-CoV-2 infection in many emergency departments (EDs). We aimed to investigate the diagnostic value of the accuracy of the SARS-CoV-2 RAT as a screening tool in the ED. This retrospective [...] Read more.

The rapid antigen test (RAT) has been adopted as a screening tool for SARS-CoV-2 infection in many emergency departments (EDs). We aimed to investigate the diagnostic value of the accuracy of the SARS-CoV-2 RAT as a screening tool in the ED. This retrospective observational study included patients who underwent both RAT and RT–PCR and visited the ED from 1 December 2021 to 15 March 2022. RAT and RT–PCR were performed by appropriately trained physicians. We performed detailed analyses using the E gene cyclic threshold (Ct) values of RT–PCR. Out of a total of 1875 patients, 348 (18.6%) had positive and 1527 (81.4%) had negative RT–PCR results. The overall sensitivity, specificity, positive predictive value, and negative predictive value of the RAT were 67.8%, 99.9%, 99.6%, and 93.2%, respectively. The E gene Ct value was significantly lower in the RAT-positive patients than in the RAT-negative patients (18.5 vs. 25.3, p < 0.001). When the E gene Ct cutoff was 30.0, 25.0, 20.0, and 15.0, the sensitivity of the RAT was 71.9%, 80.3%, 93.0%, and 97.8%, respectively. The sensitivity of the RAT could be considered high in patients with a high viral load, and the RAT could be used as a screening tool in the ED. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

8 pages, 504 KiB

Open AccessFeature PaperArticle

Predictive Value of SOFA and qSOFA for In-Hospital Mortality in COVID-19 Patients: A Single-Center Study in Romania

by Cosmin Citu, Ioana Mihaela Citu, Andrei Motoc, Marius Forga, Oana Maria Gorun and Florin Gorun

J. Pers. Med. 2022, 12(6), 878; https://doi.org/10.3390/jpm12060878 - 26 May 2022

Cited by 6 | Viewed by 1761

Abstract

Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease’s severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to assess the prognostic value of [...] Read more.

Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease’s severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to assess the prognostic value of SOFA and qSOFA scoring systems for in-hospital mortality among patients with COVID-19. The study included 133 patients with COVID-19 proven by reverse transcriptase polymerase chain reaction (RT-PCR) admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania between 1 October 2020 and 15 March 2021. Data on clinical features and laboratory findings on admission were collected from electronic medical records and used to compute SOFA and qSOFA. Mean SOFA and qSOFA values were higher in the non-survivor group compared to survivors (3.5 vs. 1 for SOFA and 2 vs. 1 for qSOFA, respectively). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy, both risk scores being excellent predictors of in-hospital mortality, with ROC–AUC values of 0.800 for SOFA and 0.794 for qSOFA. The regression analysis showed that for every one-point increase in SOFA score, mortality risk increased by 1.82 and for every one-point increase in qSOFA score, mortality risk increased by 5.23. In addition, patients with SOFA and qSOFA above the cut-off values have an increased risk of mortality with ORs of 7.46 and 11.3, respectively. In conclusion, SOFA and qSOFA are excellent predictors of in-hospital mortality among COVID-19 patients. These scores determined at admission could help physicians identify those patients at high risk of severe COVID-19. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

12 pages, 634 KiB

Open AccessArticle

The Genomic Profile Associated with Risk of Severe Forms of COVID-19 in Amazonian Native American Populations

by Lucas Favacho Pastana, Thays Amâncio Silva, Laura Patrícia Albarello Gellen, Giovana Miranda Vieira, Letícia Almeida de Assunção, Luciana Pereira Colares Leitão, Natasha Monte da Silva, Rita de Cássia Calderaro Coelho, Angélica Leite de Alcântara, Lui Wallacy Morikawa Souza Vinagre, Juliana Carla Gomes Rodrigues, Diana Feio da Veiga Borges Leal, Marianne Rodrigues Fernandes, Sandro José de Souza, José Eduardo Kroll, André Mauricio Ribeiro-dos-Santos, Rommel Mario Rodríguez Burbano, João Farias Guerreiro, Paulo Pimentel de Assumpção, Ândrea Campos Ribeiro-dos-Santos, Sidney Emanuel Batista dos Santos and Ney Pereira Carneiro dos Santos Show full author list Hide full author list

J. Pers. Med. 2022, 12(4), 554; https://doi.org/10.3390/jpm12040554 - 01 Apr 2022

Cited by 8 | Viewed by 2318

Abstract

Genetic factors associated with COVID-19 disease outcomes are poorly understood. This study aimed to associate genetic variants in the SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6, XCR1, and ABO genes with the risk of severe forms of COVID-19 in [...] Read more.

Genetic factors associated with COVID-19 disease outcomes are poorly understood. This study aimed to associate genetic variants in the SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6, XCR1, and ABO genes with the risk of severe forms of COVID-19 in Amazonian Native Americans, and to compare the frequencies with continental populations. The study population was composed of 64 Amerindians from the Amazon region of northern Brazil. The difference in frequencies between the populations was analyzed using Fisher’s exact test, and the results were significant when p ≤ 0.05. We investigated 64 polymorphisms in 7 genes; we studied 47 genetic variants that were new or had impact predictions of high, moderate, or modifier. We identified 15 polymorphisms with moderate impact prediction in 4 genes (ABO, CXCR6, FYCO1, and SLC6A20). Among the variants analyzed, 18 showed significant differences in allele frequency in the NAM population when compared to others. We reported two new genetic variants with modifier impact in the Amazonian population that could be studied to validate the possible associations with COVID-19 outcomes. The genomic profile of Amazonian Native Americans may be associated with protection from severe forms of COVID-19. This work provides genomic data that may help forthcoming studies to improve COVID-19 outcomes. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Graphical abstract

17 pages, 3259 KiB

Open AccessArticle

COVID-19 Detection in CT/X-ray Imagery Using Vision Transformers

by Mohamad Mahmoud Al Rahhal, Yakoub Bazi, Rami M. Jomaa, Ahmad AlShibli, Naif Alajlan, Mohamed Lamine Mekhalfi and Farid Melgani

J. Pers. Med. 2022, 12(2), 310; https://doi.org/10.3390/jpm12020310 - 18 Feb 2022

Cited by 24 | Viewed by 3807

Abstract

The steady spread of the 2019 Coronavirus disease has brought about human and economic losses, imposing a new lifestyle across the world. On this point, medical imaging tests such as computed tomography (CT) and X-ray have demonstrated a sound screening potential. Deep learning [...] Read more.

The steady spread of the 2019 Coronavirus disease has brought about human and economic losses, imposing a new lifestyle across the world. On this point, medical imaging tests such as computed tomography (CT) and X-ray have demonstrated a sound screening potential. Deep learning methodologies have evidenced superior image analysis capabilities with respect to prior handcrafted counterparts. In this paper, we propose a novel deep learning framework for Coronavirus detection using CT and X-ray images. In particular, a Vision Transformer architecture is adopted as a backbone in the proposed network, in which a Siamese encoder is utilized. The latter is composed of two branches: one for processing the original image and another for processing an augmented view of the original image. The input images are divided into patches and fed through the encoder. The proposed framework is evaluated on public CT and X-ray datasets. The proposed system confirms its superiority over state-of-the-art methods on CT and X-ray data in terms of accuracy, precision, recall, specificity, and F1 score. Furthermore, the proposed system also exhibits good robustness when a small portion of training data is allocated. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

12 pages, 976 KiB

Open AccessArticle

Outcome of Critically Ill COVID-19 Patients According to the Setting of Corticosteroid Initiation—A Retrospective Observational Cohort Study

by Sebastian Voicu, Thomas Lacoste-Palasset, Isabelle Malissin, Shana Bekhit, Eléonore Cauchois, Sirine Dahmani, Melkir Saib, Caroline Grant, Giulia Naim, Aymen M’Rad, Adrien Pepin-Lehaleur, Jean-Michel Ekhérian, Nicolas Deye and Bruno Mégarbane

J. Pers. Med. 2021, 11(12), 1359; https://doi.org/10.3390/jpm11121359 - 13 Dec 2021

Cited by 1 | Viewed by 1814

Abstract

(1) Background: Corticosteroids lower 28-day all-cause mortality in critically ill COVID-19 patients. However, the outcome of COVID-19 patients referred to the intensive care unit (ICU) for respiratory deterioration despite corticosteroids initiated during hospitalization before ICU admission has been poorly investigated. Our objective was [...] Read more.

(1) Background: Corticosteroids lower 28-day all-cause mortality in critically ill COVID-19 patients. However, the outcome of COVID-19 patients referred to the intensive care unit (ICU) for respiratory deterioration despite corticosteroids initiated during hospitalization before ICU admission has been poorly investigated. Our objective was to determine survival according to corticosteroid initiation setting. (2) Methods: We conducted a cohort study including all successive critically ill COVID-19 patients treated with corticosteroids and managed in our ICU. We compared survival, whether corticosteroids were initiated before (Cb-group) or after ICU admission (Ca-group), using a propensity score matching. (3) Results: Overall, 228 patients (67 years (56–74); 168M/60F; invasive mechanical ventilation on admission, 17%) were included with 63 patients in the Cb-group and 165 patients in the Ca-group. Survival to hospital discharge was 43% versus 69%, respectively (p = 0.001). In a multivariable analysis, factors associated with death were age (odds ratio, 1.07; 95%-confidence interval, (1.04–1.11); p < 0.0001), the sequential organ failure assessment (SOFA) score on ICU admission (1.30 (1.14–1.50); p = 0.0001) and corticosteroid initiation before ICU admission (2.64 (1.30–5.43); p = 0.007). No significant differences in outcome related to corticosteroid regimen were found. (4) Conclusions: Critically ill COVID-19 patients transferred to the ICU with deterioration despite corticosteroids initiated before admission have a less favorable outcome than patients receiving corticosteroids initiated after ICU admission. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

10 pages, 1413 KiB

Open AccessArticle

Prognostic Value of C-Reactive Protein to Lymphocyte Ratio (CLR) in Emergency Department Patients with SARS-CoV-2 Infection

by Ndenga Tonduangu, Pierrick Le Borgne, François Lefebvre, Karine Alame, Lise Bérard, Yannick Gottwalles, Lauriane Cipolat, Stéphane Gennai, Pascal Bilbault, Charles-Eric Lavoignet, Laure Abensur Vuillaume and on behalf of CREMS Network (Clinical Research in Emergency Medicine and Sepsis) (CLR)

J. Pers. Med. 2021, 11(12), 1274; https://doi.org/10.3390/jpm11121274 - 02 Dec 2021

Cited by 12 | Viewed by 1927

Abstract

(1) Introduction: According to recent studies, the ratio of C-reactive-protein to lymphocyte is more sensitive and specific than other biomarkers associated to systemic inflammatory processes. This study aimed to determine the prognostic value of CLR on COVID-19 severity and mortality at emergency department [...] Read more.

(1) Introduction: According to recent studies, the ratio of C-reactive-protein to lymphocyte is more sensitive and specific than other biomarkers associated to systemic inflammatory processes. This study aimed to determine the prognostic value of CLR on COVID-19 severity and mortality at emergency department (ED) admission. (2) Methods: Between 1 March and 30 April 2020, we carried out a multicenter and retrospective study in six major hospitals of northeast France. The cohort was composed of patients hospitalized for a confirmed diagnosis of moderate to severe COVID-19. (3) Results: A total of 1,035 patients were included in this study. Factors associated with infection severity were the CLR (OR: 1.001, CI 95%: (1.000–1.002), p = 0.012), and the lymphocyte level (OR: 1.951, CI 95%: (1.024–3.717), p = 0.042). In multivariate analysis, the only biochemical factor significantly associated with mortality was lymphocyte rate (OR: 2.308, CI 95%: (1.286–4.141), p = 0.005). The best threshold of CLR to predict the severity of infection was 78.3 (sensitivity 79%; specificity 47%), and to predict mortality, was 159.5 (sensitivity 48%; specificity 70%). (4) Conclusion: The CLR at admission to the ED could be a helpful prognostic biomarker in the early screening and prediction of the severity and mortality associated with SARS-CoV-2 infection. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

12 pages, 1465 KiB

Open AccessArticle

Dismal Survival in COVID-19 Patients Requiring ECMO as Rescue Therapy after Corticosteroid Failure

by Sebastian Voicu, Antoine Goury, Thomas Lacoste-Palasset, Isabelle Malissin, Lucie Fanet, Samar Souissi, Julia Busto, Vincent Legros, Laetitia Sutterlin, Giulia Naim, Aymen M’Rad, Adrien Pepin-Lehaleur, Nicolas Deye, Bruno Mourvillier and Bruno Mégarbane

J. Pers. Med. 2021, 11(11), 1238; https://doi.org/10.3390/jpm11111238 - 22 Nov 2021

Cited by 2 | Viewed by 1849

Abstract

(1) Background: COVID-19 may lead to refractory hypoxemia requiring venovenous extracorporeal membrane oxygenation (ECMO). Survival rate if ECMO is implemented as rescue therapy after corticosteroid failure is unknown. We aimed to investigate if ECMO implemented after failure of the full-recommended 10-day corticosteroid course [...] Read more.

(1) Background: COVID-19 may lead to refractory hypoxemia requiring venovenous extracorporeal membrane oxygenation (ECMO). Survival rate if ECMO is implemented as rescue therapy after corticosteroid failure is unknown. We aimed to investigate if ECMO implemented after failure of the full-recommended 10-day corticosteroid course can improve outcome. (2) Methods: We conducted a three-center cohort study including consecutive dexamethasone-treated COVID-19 patients requiring ECMO between 03/2020 and 05/2021. We compared survival at hospital discharge between patients implemented after (ECMO-after group) and before the end of the 10-day dexamethasone course (ECMO-before group). (3) Results: Forty patients (28M/12F; age, 57 years (51–62) (median (25th–75th percentiles)) were included, 28 (70%) in the ECMO-before and 12 (30%) in the ECMO-after group. In the ECMO-before group, 9/28 patients (32%) received the 6 mg/day dexamethasone regimen versus 12/12 (100%) in the ECMO-after group (p < 0.0001). The rest of the patients received an alternative dexamethasone regimen consisting of 20 mg/day during 5 days followed by 10 mg/day during 5 days. Patients in the ECMO-before group tended to be younger (57 years (51–59) versus 62 years (57–67), p = 0.053). In the ECMO-after group, no patient (0%) survived while 12 patients (43%) survived in the ECMO-before group (p = 0.007). (4) Conclusions: Survival is poor in COVID-19 patients requiring ECMO implemented after the full-recommended 10-day dexamethasone course. Since these patients may have developed a particularly severe presentation, new therapeutic strategies are urgently required. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Graphical abstract

8 pages, 526 KiB

Open AccessArticle

Intensive Care Patients from the First COVID-19 Wave: One-Year Survival after Tocilizumab Treatment

by Gabriele Melegari, Enrico Giuliani, Chiara Dallai, Lucia Veronesi, Elisabetta Bertellini, Suela Osmenaj and Alberto Barbieri

J. Pers. Med. 2021, 11(11), 1234; https://doi.org/10.3390/jpm11111234 - 21 Nov 2021

Cited by 2 | Viewed by 2141

Abstract

Introduction: An infection by COVID-19 triggers a dangerous cytokine storm, so tocilizumab has been introduced in Italy as an agent blocking the cytokine storm. This paper aims to describe the one-year survival of ICU patients treated with tocilizumab. Methods: This observational study enrolled [...] Read more.

Introduction: An infection by COVID-19 triggers a dangerous cytokine storm, so tocilizumab has been introduced in Italy as an agent blocking the cytokine storm. This paper aims to describe the one-year survival of ICU patients treated with tocilizumab. Methods: This observational study enrolled all patients confirmed to be infected by COVID-19 who were admitted to the ICU in our center. We offered tocilizumab to all non-septic patients if they did not present any contraindications. Results: We enrolled 68 ICU patients in our center on 72 occasions during the enrollment period; we excluded four patients due to study criteria. The one-year mortality hazard ratio of treated patients was 0.64, with a confidence interval of 0.31 to 1.19, with p = 0.169. Among the survivors, 32 of 35 patients answered the phone interview (14 patients in the treated group and 18 in the untreated group); overall, the effect of COVID-19 on quality of life was 58.14%. These effects were lower in the tocilizumab group, with p = 0.016 *. Conclusions: Our observational data follow the most relevant largest trial. Patients treated with tocilizumab had lower rates of new-onset symptoms later COVID-19 ICU hospitalizations. As reported by recent medical literature, the presence of these symptoms suggests that a follow-up program for these types of patients could be useful. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Graphical abstract

11 pages, 1393 KiB

Open AccessArticle

Biomarkers Associated with Failure of Liberation from Oxygen Therapy in Severe COVID-19: A Pilot Study

by Oh Joo Kweon, Min Jae Cha, Moon Seong Baek, Seong-Ho Choi and Won-Young Kim

J. Pers. Med. 2021, 11(10), 974; https://doi.org/10.3390/jpm11100974 - 29 Sep 2021

Cited by 4 | Viewed by 1893

Abstract

This study aimed to investigate whether clinical and laboratory biomarkers can identify patients with COVID-19 who are less likely to be liberated from oxygen therapy. This was a retrospective study comparing 18 patients in the weaning failure group with 38 patients in the [...] Read more.

This study aimed to investigate whether clinical and laboratory biomarkers can identify patients with COVID-19 who are less likely to be liberated from oxygen therapy. This was a retrospective study comparing 18 patients in the weaning failure group with 38 patients in the weaning success group. Weaning failure was defined as death or discharge with an oxygen device before day 28 after hospital admission or requiring oxygen support as of day 28. The median quick Sequential Organ Failure Assessment (qSOFA) score was significantly higher and the median SpO₂/FiO₂ was significantly lower in the weaning failure group. The laboratory biomarkers, procalcitonin (PCT) and D-dimer, were significantly higher in the weaning failure group, as were the biomarkers of endothelial injury, such as angiopoietin-2 (Ang-2) and Ang-2/Ang-1, and tumor necrosis factor-α (TNF-α). Patients’ qSOFA scores, SpO₂/FiO₂, and PCT, D-dimer, Ang-2, Ang-2/Ang-1, endocan (4-day and 7-day increases), and TNF-α levels predicted weaning failure; 7-day endocan levels were the best predictor of weaning failure with an AUC of 0.81 (95% CI, 0.67–0.94). We identified clinical and laboratory parameters, including plasma biomarkers of endothelial injury, that may be considered as biomarkers for predicting failure of liberation from oxygen therapy in patients with severe COVID-19. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

Review

Jump to: Research

11 pages, 626 KiB

Open AccessReview

Molecular Bases of Serotonin Reuptake Inhibitor Antidepressant-Attributed Effects in COVID-19: A New Insight on the Role of Bradykinins

by Ahmed S. Gouda and Bruno Mégarbane

J. Pers. Med. 2022, 12(9), 1487; https://doi.org/10.3390/jpm12091487 - 11 Sep 2022

Cited by 3 | Viewed by 2104

Abstract

Widely available effective drugs to treat coronavirus disease-2019 (COVID-19) are still limited. Various studies suggested the potential contribution of selective serotonin-reuptake inhibitor (SSRI) antidepressants to alleviate the clinical course of COVID-19. Initially, SSRI antidepressant-attributed anti-COVID-19 activity was attributed to their direct agonistic or [...] Read more.

Widely available effective drugs to treat coronavirus disease-2019 (COVID-19) are still limited. Various studies suggested the potential contribution of selective serotonin-reuptake inhibitor (SSRI) antidepressants to alleviate the clinical course of COVID-19. Initially, SSRI antidepressant-attributed anti-COVID-19 activity was attributed to their direct agonistic or indirect serotonin-mediated stimulation of sigma-1 receptors (Sig1-R). Thereafter, attention was drawn to the property of SSRI antidepressants to decrease ceramide production, as functional inhibitors of acid sphingomyelinase. Ceramides are cell membrane waxy lipids formed by sphingosine and a fatty acid, playing a major role in receptor signaling and infection. In COVID-19 patients, ceramide production is increased due to acid sphingomyelinase activation. Here, we aimed to review the relationships between bradykinins and the proposed pathways supporting SSRI antidepressant-attributed effectiveness in COVID-19. In COVID-19 patients, bradykinin receptor-B1 stimulation is enhanced following the downregulation of angiotensin-converting enzyme-2, which is responsible for the inactivation of des-Arg9-bradykinin, a bradykinin metabolite, contrasting with the decrease in bradykinin receptor-B2 (BDKRB2) stimulation, which results from the inhibition of cathepsin L, a kininogenase involved in bradykinin production and present at the infection site. Sig1-R stimulation modulates the inflammatory response by regulating cytokine production and counterbalances COVID-19-attributed BDKRB2 inhibition by potentiating its effects on the cytosolic calcium concentration. Moreover, the beneficial effects obtained with acid sphingomyelinase inhibition are parallel to those expected with BDKRB2 stimulation in COVID-19. Altogether, these findings suggest that one ultimate pathway of SSRI antidepressant-attributed anti-COVID-19 activity is the potentiation of BDKRB2 effects shown to be inhibited in COVID-19. In conclusion, SSRI antidepressants are able to interact positively with the pathophysiological mechanisms involved in COVID-19. However, their exact benefits in preventing morbidities or improving the outcome in COVID-19 patients remain unknown. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Graphical abstract

17 pages, 1348 KiB

Open AccessReview

Application of Artificial Intelligence in COVID-19 Diagnosis and Therapeutics

by Ken Asada, Masaaki Komatsu, Ryo Shimoyama, Ken Takasawa, Norio Shinkai, Akira Sakai, Amina Bolatkan, Masayoshi Yamada, Satoshi Takahashi, Hidenori Machino, Kazuma Kobayashi, Syuzo Kaneko and Ryuji Hamamoto

J. Pers. Med. 2021, 11(9), 886; https://doi.org/10.3390/jpm11090886 - 04 Sep 2021

Cited by 17 | Viewed by 4459

Abstract

The coronavirus disease 2019 (COVID-19) pandemic began at the end of December 2019, giving rise to a high rate of infections and causing COVID-19-associated deaths worldwide. It was first reported in Wuhan, China, and since then, not only global leaders, organizations, and pharmaceutical/biotech [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic began at the end of December 2019, giving rise to a high rate of infections and causing COVID-19-associated deaths worldwide. It was first reported in Wuhan, China, and since then, not only global leaders, organizations, and pharmaceutical/biotech companies, but also researchers, have directed their efforts toward overcoming this threat. The use of artificial intelligence (AI) has recently surged internationally and has been applied to diverse aspects of many problems. The benefits of using AI are now widely accepted, and many studies have shown great success in medical research on tasks, such as the classification, detection, and prediction of disease, or even patient outcome. In fact, AI technology has been actively employed in various ways in COVID-19 research, and several clinical applications of AI-equipped medical devices for the diagnosis of COVID-19 have already been reported. Hence, in this review, we summarize the latest studies that focus on medical imaging analysis, drug discovery, and therapeutics such as vaccine development and public health decision-making using AI. This survey clarifies the advantages of using AI in the fight against COVID-19 and provides future directions for tackling the COVID-19 pandemic using AI techniques. Full article

(This article belongs to the Special Issue Recent Advances on Coronavirus Disease 2019 (COVID-19))

► Show Figures

Figure 1

Journal Menu

Journal Browser

Recent Advances on Coronavirus Disease 2019 (COVID-19)

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Published Papers (12 papers)

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI