Cardiac damage and tropism of severe acute respiratory syndrome coronavirus 2
❗Again, an interesting European review study with very clear take-aways👇
➡️"An infection with SARS-CoV-2 has the potential to manifest a diverse set of cardiovascular health problems, including myocardial tissue damage, arrhythmia, myocarditis, and pericarditis."
➡️"The main underlying pathophysiological mechanisms of morbidity and mortality are ongoing inflammation, with TNF-α and ILs as key mediators, oxidative stress, altered immune response, and subsequent apoptosis within cardiac tissue, alongside genomic changes."
➡️"Evaluation of existing comorbidities showed an increased chance of adverse infection outcomes in elderly, male, unvaccinated individuals, and such characterized by pre-existing cardiovascular complications, diabetes, and obesity."
➡️"Taken together, evidence is pointing toward prolonged COVID symptoms with cardiac involvement in some individuals, independent of infection severity, making it difficult to ascertain risk factors and biomarkers able to predict long COVID."
Take-aways: 1. Myocardial damage is a typical cardiac manifestation following SARS-CoV-2 infection. 2. Mechanisms include inflammation, oxidative stress, innate immune response, apoptosis. 3. Age, gender, pre-existing heart problems, comorbidities predict in-hospital mortality.
🤔Review has some noted limitations and I don’t fully agree with some conclusion points, but its clear that “cardiology” is waking up! #AboutTime #GoodNews sciencedirect.com/science/articl…
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COVID-19: post infection implications in different age groups, mechanism, diagnosis, effective prevention, treatment, and recommendations
Again, Interesting review article, but now with an in-depth and detailed point analysis, worth your time and this 🧵👇
“This review offers a comprehensive understanding of the persistent effects of COVID-19 on individuals of varying ages, along with insights into diagnosis, treatment, vaccination, and future preventative measures against the spread of SARSCoV-2”
Highlights
• COVID-19 induces long-term effects in individuals of both genders of various ages.
• Artificial intelligence-based COVID-19 diagnostic tools are efficient.
• Pharmacological and non-pharmacological treatments reduced the long-term impacts of
COVID-19.
• All vaccines significantly reduced the persistent effects of COVID-19.
• No vaccine provides lifetime protection against COVID-19.
• Protective measures greatly limit SARS-CoV-2 transmission 1/n
Sarscov2 introduction 2/n
Long-term effects of COVID-19 on the human systems
Pulmonary system 3/n
❗️Excellent new CardioVascular Autonomic dysfunction(CVAD) overview:
For one: "As well as global circulatory disturbances, CVAD in post-COVID-19 syndrome(LongCovid) can manifest as microvascular and endothelial dysfunction, with local symptoms such as headache, brain fog, chest pain, dyspnoea and peripheral circulatory symptoms, including skin discolouration, oedema, Raynaud-like phenomena, and heat and cold intolerance"
➡️ Your N. Vagus at work!😰 nature.com/articles/s4156…
➡️ "CVAD arises from a malfunction of the autonomic control of the circulation, and can involve failure or inadequate or excessive activation of the sympathetic and parasympathetic components of the autonomic nervous system" 2/n
➡️"Cardiovascular autonomic dysfunction (CVAD), in particular postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia, are among the most frequent and distinct phenotypes of post-COVID-19 syndrome; one-third of highly symptomatic patients can be affected" 3/n
SARS-CoV-2 reservoir in post-acute sequelae of COVID-19 (PASC)
Lets dig into 1 of the 8 mechanisms that could cause LongCovid in this excellent study illustrating the importance of possible vagus involvement:
“SARS-CoV-2 reservoir may alter vagus nerve signaling”
🧵1/n
“A SARS-CoV-2 reservoir could also contribute to nonspecific PASC symptoms including fatigue, trouble concentrating, muscle and joint pain, sleep dysfunction, anxiety, depression, loss of appetite and autonomic dysfunction. These symptoms overlap with the sickness response (called ‘sickness behavior’ in animal models) that reflects the subjective and behavioral component of innate immunity and is largely mediated by signaling of the vagus nerve” 2/n
“Tens of thousands of afferent vagus nerve branches innervate all major trunk organs with chemoreceptor terminals, which collectively act as a sensitive and diffuse neuroimmune sensory organ for the CNS. These branches can detect highly localized paracrine immune signaling such as cytokine activation even in the absence of a systemic circulating immune response, triggering glial activation and neuroinflammation on the brain side of the blood–brain barrier and the sickness response. The persistence of a SARS-CoV-2 reservoir in body sites densely innervated by the vagus nerve (for example, gut, lung and bronchial tubes)—or direct infection of the vagus nerve as has been shown in autopsy studies—might activate localized paracrine signaling, leading to ongoing sickness response symptoms in infected individuals” 3/n
Why so little attention in #Belgium(=new red zone) for our well performing neighbor, Germany(Green zone)? They certainly seem to have their act together, surely they could be instrumental to learn from! #Thread#covid19 1/n @alexanderdecroo@JanJambon@eliodirupo
Testen:
FREE testing everywhere, with results in 15 minutes , to be stopped Oct 11, to further push unvaccinated to get their shot.
Mandatory tests in schools(2-3x/w) and all employers have to provide them for the employees at work. 2/n
3G rule:
For many places only admittance for vaccinated/post-covid starting 23 Aug
Only to be suspended when incidence reaches a 7D stable below 35! 3/n