Several studies have revealed that the hyper-inflammatory response induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major cause of disease severity and death. However, predictive biomarkers of pathogenic inflammation to help guide targetable immune pathways are critically lacking. We implemented a rapid multiplex cytokine assay to measure serum interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α and IL-1β in hospitalized patients with coronavirus disease 2019 (COVID-19) upon admission to the Mount Sinai Health System in New York. Patients (n = 1,484) were followed up to 41 d after admission (median, 8 d), and clinical information, laboratory test results and patient outcomes were collected. We found that high serum IL-6, IL-8 and TNF-α levels at the time of hospitalization were strong and independent predictors of patient survival (P < 0.0001, P = 0.0205 and P = 0.0140, respectively). Notably, when adjusting for disease severity, common laboratory inflammation markers, hypoxia and other vitals, demographics, and a range of comorbidities, IL-6 and TNF-α serum levels remained independent and significant predictors of disease severity and death. These findings were validated in a second cohort of patients (n = 231). We propose that serum IL-6 and TNF-α levels should be considered in the management and treatment of patients with COVID-19 to stratify prospective clinical trials, guide resource allocation and inform therapeutic options. Elevated levels of serum IL-6 and TNF-α at the time of hospitalization are independent and significant predictors of clinical outcome in two cohorts of patients with COVID-19.

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An inflammatory cytokine signature predicts COVID-19 severity and survival.

Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study.

SUMMARYIn recent decades, several new diseases have emerged in different geographical areas, with pathogens including Ebola virus, Zika virus, Nipah virus, and coronaviruses (CoVs). Recently, a new type of viral infection emerged in Wuhan City, China, and initial genomic sequencing data of this virus do not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility of other routes should not be ruled out. Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Compared to other emerging viruses, such as Ebola virus, avian H7N9, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 has shown relatively low pathogenicity and moderate transmissibility. Codon usage studies suggest that this novel virus has been transferred from an animal source, such as bats. Early diagnosis by real-time PCR and next-generation sequencing has facilitated the identification of the pathogen at an early stage. Since no antiviral drug or vaccine exists to treat or prevent SARS-CoV-2, potential therapeutic strategies that are currently being evaluated predominantly stem from previous experience with treating SARS-CoV, MERS-CoV, and other emerging viral diseases. In this review, we address epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended to counter this pandemic virus.

Coronavirus Disease 2019–COVID-19

https://www.scielo.br/pdf/rbp/2020nahead/1516-4446-rbp-1516444620200008.pdf

"Pandemic fear" and COVID-19: mental health burden and strategies.

The unprecedented outbreak of the 2019 novel coronavirus, termed as COVID-19 by the World Health Organization (WHO), has placed numerous governments around the world in a precarious position. The impact of the COVID-19 outbreak, earlier witnessed by the citizens of China alone, has now become a matter of grave concern for virtually every country in the world. The scarcity of resources to endure the COVID-19 outbreak combined with the fear of overburdened healthcare systems has forced a majority of these countries into a state of partial or complete lockdown. The number of laboratory-confirmed coronavirus cases has been increasing at an alarming rate throughout the world, with reportedly more than 3 million confirmed cases as of 30 April 2020. Adding to these woes, numerous false reports, misinformation, and unsolicited fears in regards to coronavirus, are being circulated regularly since the outbreak of the COVID-19. In response to such acts, we draw on various reliable sources to present a detailed review of all the major aspects associated with the COVID-19 pandemic. In addition to the direct health implications associated with the outbreak of COVID-19, this study highlights its impact on the global economy. In drawing things to a close, we explore the use of technologies such as the Internet of Things (IoT), Unmanned Aerial Vehicles (UAVs), blockchain, Artificial Intelligence (AI), and 5G, among others, to help mitigate the impact of COVID-19 outbreak.

/pdf/a-comprehensive-review-of-the-covid-19-pandemic-and-the-role-389ewrkgn8.pdf

A Comprehensive Review of the COVID-19 Pandemic and the Role of IoT, Drones, AI, Blockchain, and 5G in Managing its Impact

According to the World Health Organization (WHO), viral diseases continue to emerge and represent a serious issue to public health In the last twenty years, several viral epidemics such as the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 to 2003, and H1N1 influenza in 2009, have been recorded Most recently, the Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia in 2012 In a timeline that reaches the present day, an epidemic of cases with unexplained low respiratory infections detected in Wuhan, the largest metropolitan area in China's Hubei province, was first reported to the WHO Country Office in China, on December 31, 2019 Published literature can trace the beginning of symptomatic individuals back to the beginning of December 2019 As they were unable to identify the causative agent, these first cases were classified as "pneumonia of unknown etiology " The Chinese Center for Disease Control and Prevention (CDC) and local CDCs organized an intensive outbreak investigation program The etiology of this illness is now attributed to a novel virus belonging to the coronavirus (CoV) family, COVID-19 On February 11, 2020, the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, announced that the disease caused by this new CoV was a "COVID-19," which is the acronym of "coronavirus disease 2019" In the past twenty years, two additional coronavirus epidemics have occurred  SARS-CoV provoked a large-scale epidemic beginning in China and involving two dozen countries with approximately 8000 cases and 800 deaths, and the MERS-CoV that began in Saudi Arabia and has approximately 2,500 cases and 800 deaths and still causes as sporadic cases This new virus seems to be very contagious and has quickly spread globally In a meeting on January 30, 2020, per the International Health Regulations (IHR, 2005), the outbreak was declared by the WHO a Public Health Emergency of International Concern (PHEIC) as it had spread to 18 countries with four countries reporting human-to-human transmission An additional landmark occurred on February 26, 2020, as the first case of the disease, not imported from China, was recorded in the United States Initially, the new virus was called 2019-nCoV Subsequently, the task of experts of the International Committee on Taxonomy of Viruses (ICTV) termed it the SARS-CoV-2 virus as it is very similar to the one that caused the SARS outbreak (SARS-CoVs) The CoVs have become the major pathogens of emerging respiratory disease outbreaks They are a large family of single-stranded RNA viruses (+ssRNA) that can be isolated in different animal species  For reasons yet to be explained, these viruses can cross species barriers and can cause, in humans, illness ranging from the common cold to more severe diseases such as MERS and SARS  Interestingly, these latter viruses have probably originated from bats and then moving into other mammalian hosts — the Himalayan palm civet for SARS-CoV, and the dromedary camel for MERS-CoV — before jumping to humans The dynamics of SARS-Cov-2 are currently unknown, but there is speculation that it also has an animal origin The potential for these viruses to grow to become a pandemic worldwide seems to be a serious public health risk Concerning COVID-19, the WHO raised the threat to the CoV epidemic to the "very high" level, on February 28, 2020 Probably, the effects of the epidemic caused by the new CoV has yet to emerge as the situation is quickly evolving World governments are at work to establish countermeasures to stem possible devastating effects Health organizations coordinate information flows and issues directives and guidelines to best mitigate the impact of the threat At the same time, scientists around the world work tirelessly, and information about the transmission mechanisms, the clinical spectrum of disease, new diagnostics, and prevention and therapeutic strategies are rapidly developing Many uncertainties remain with regard to both the virus-host interac ion and the evolution of the epidemic, with specific reference to the times when the epidemic will reach its peak At the moment, the therapeutic strategies to deal with the infection are only supportive, and prevention aimed at reducing transmission in the community is our best weapon Aggressive isolation measures in China have led to a progressive reduction of cases in the last few days In Italy, in geographic regions of the north of the peninsula, political and health authorities are making incredible efforts to contain a shock wave that is severely testing the health system In the midst of the crisis, the authors have chosen to use the "Statpearls" platform because, within the PubMed scenario, it represents a unique tool that may allow them to make updates in real-time  The aim, therefore, is to collect information and scientific evidence and to provide an overview of the topic that will be continuously updated

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Features, Evaluation and Treatment Coronavirus (COVID-19)

While primary peritoneal mesothelioma rarely occurs, peritoneal carcinomatosis: PC (tumor infiltration of the peritoneum) is most commonly seen in abdominopelvic malignancies. It is a common manifestation in gastrointestinal and gynecological tumors during tumor disease because several gastrointestinal and gynecological malignancies have the potential to progress into the peritoneal cavity.Several risk factors can be cited: locally advanced carcinoma, mucosal tumors, tumor perforation, and tumor opening during resection.In colorectal cancer, the peritoneum is the second most common metastatic site and has a poor prognosis with a median survival of 6 to 9 months without treatment. According to population-based studies, colorectal peritoneal carcinomatosis prevalence varies between 5% to 10% in patients with colorectal cancer.Globally and each year, 240,000 women are diagnosed with ovarian cancer, and epithelial carcinomas account for about 90% of all cases. Due to its clinical presentation often and unfortunately in advanced stages, ovarian cancer is classified as a malignancy of the peritoneal surface.Primary forms, such as peritoneal mesothelioma and peritoneal carcinoma, must be differentiated from the peritoneal spread of malignant tumors, either gastrointestinal tract or ovarian; a median survival of 6 months for colorectal cancer and 3 months for gastric cancer shows a clearly limited prognosis. Results for peritoneal mesothelioma with systemic chemotherapy are similar. The probability of survival is better for advanced ovarian cancer, for which a median survival of up to 2 years is possible.Treatment should be multimodal and include preoperative systemic chemotherapy, complete cytoreductive surgery, intraabdominal hyperthermia combined with intraoperative chemotherapy.Thus the complete surgical cytoreduction possible is decisive for the prognosis, which requires multiple organ resections in addition to a partial to subtotal parietal peritonectomy.To quantify the extent of peritoneal metastases and determine the feasibility of tumor reduction, a surgical variable is used (index of peritoneal carcinomatosis: PCI). Indeed, depending on the pathologies, there is a threshold value beyond which the procedure does not improve survival.In addition to an excessively high PCI, the invasion of certain sites also contraindicates cytoreduction surgery. These are the root of the mesentery, the hepatic pedicle, the retroperitoneum, and the bladder. Major damage to the small bowel, which potentially could induce short bowel syndrome, is also a contraindication.Complete macroscopic cytoreduction is the basis for successful multimodal therapy.First described by Spratt in 1980 in animal experiments and known as a thermal transfusion infiltration system, hyperthermic intraperitoneal chemotherapy represents a concept of multimodal therapy increasingly used in the management of peritoneal carcinoma and more in the following decades and is now an integral part of the treatment of primary and secondary peritoneal tumors. This involves administering cytotoxic agents into the peritoneal cavity at an elevated temperature (41 to 43 degrees C) to promote their absorption by neoplastic nodules.Hyperthermic intraperitoneal chemotherapy (HIPEC) has become the treatment of choice for treating peritoneal metastases from ovarian, stomach, or colorectal cancers.Nowadays, surgical cytoreduction combined with hyperthermic intraperitoneal chemotherapy (CRS / HIPEC) has radically changed the approach of patients with malignant tumors of the peritoneum, which has improved the prognosis of appendicular, colorectal, and ovarian tumors, as well as peritoneal mesothelioma.This topic explains and describes the principles and importance of HIPEC in the concept of multimodal therapy of patients with malignant tumors of the peritoneum.

Raffaela Di Napoli

Papers

Features, Evaluation and Treatment Coronavirus (COVID-19)

Hyperthermic Intraperitoneal Chemotherapy