Characteristic features and outcomes of severe acute respiratory syndrome found in severe acute respiratory syndrome intensive care unit patients

Lien, Te-Cheng; Sung, Chun-Sung; Lee, Chen‐Hsen; Kao, Hsin-Kuo; Huang, Ying-Che; Liu, Cheng-Yi; Perng, Reury-Perng; Wang, Jia-Horng

doi:10.1016/j.jcrc.2007.05.004

Cited by 20 publications

(23 citation statements)

References 17 publications

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“…These data indicate that in the absence of both T cells and Abs, innate defense mechanisms are able to control SARS-CoV infection. Consistent with our findings in mice, high neutrophil and low lymphocyte counts were reported in the peripheral blood of SARS patients (29). The cellular mechanisms underlying Ab-and T-cell-independent control of SARS-CoV infection in this model require further investigation.…”

Section: Clearance Of Sars-cov In the Absence Of Both T Cells And Abssupporting

confidence: 90%

Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4⁺T Cells Are Important in Control of SARS-CoV Infection

Chen

Lau

Lamirande

et al. 2010

J Virol

405

364

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The global outbreak of severe acute respiratory syndrome (SARS) in 2003 that infected more than 8,000 people in 29 countries across five continents, with 774 deaths reported by the World Health Organization (54), was caused by a highly contagious coronavirus designated SARS-CoV (33). The elderly were more likely to die from SARS-CoV infection than younger people (7), with a case-fatality rate of 50% in people older than 65 years (14, 53). Disease pathogenesis in SARS is complex, with multiple factors leading to severe pulmonary injury and dissemination of the virus to other organs. High viral load; systemic infection; a cytokine storm with high levels of CXCL10/IP-10, CCL3/MIP-1␣, and CCL2/MCP-1; massive lung infiltration by monocytes and macrophages; and rapid depletion of T cells are hallmarks of SARS (5,13,15,21,28,35). The role of neutralizing antibodies (Abs) in protection from SARS-CoV infection has been well documented. Virusspecific neutralizing Abs reduce viral load, protect against weight loss, and reduce histopathology in animal models (42,47,48). Although the role of type I interferons (IFNs) in the natural history of SARS is controversial (5, 9, 59), the innate defense system appears to be critical for controlling SARSCoV replication in mice (23, 41). Mice lacking normal innate signaling due to STAT1 or MyD88 deficiency are highly susceptible to SARS-CoV infection. Virus-specific T-cell responses are present in convalescent patients with SARS (27, 55). However, little is known about the role of T cells in the acute phase of SARS.Several mouse models have been developed for the in vivo study of SARS pathogenesis. However, no single model accurately reproduces all aspects of the human disease. SARS-CoV replicates in the upper and lower respiratory tracts of 4-to 8-week-old mice and is cleared rapidly; infection is associated with transient mild pneumonitis, and cytokines are not detectable in the lungs (20,42,49). A SARS-CoV isolate that was adapted by serial passage in mice (MA-15) replicates to a higher titer and for a longer duration in the lungs than the unadapted (Urbani) virus and is associated with viremia and mortality in young mice (36), but the histologic changes in the lungs are caused by high titers of virus and cell death without significant infiltrates of inflammatory cells. The heightened susceptibility of elderly patients to SARS led us to develop a pneumonia model in 12-to 14-month-old (mo) BALB/c mice using the Urbani virus. In this model, pulmonary replication of virus was associated with signs of clinical illness and histopathological evidence of disease characterized by bronchiolitis, interstitial pneumonitis, diffuse alveolar damage, and fibrotic scarring (3), thus resembling SARS in the elderly. We evaluated the host response to SARS-CoV infection by examining the gene expression profile in the senescent mouse model and found a robust response to virus infection, with an increased expression of several immune response and cell-to-cell

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Section: Clearance Of Sars-cov In the Absence Of Both T Cells And Abssupporting

confidence: 90%

Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4⁺T Cells Are Important in Control of SARS-CoV Infection

Chen

Lau

Lamirande

et al. 2010

J Virol

405

364

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“…Interestingly, barotrauma rates were elevated during the SARS and Middle East respiratory syndrome coronavirus outbreaks. In the 2002-2004 SARS epidemic, reports of barotrauma varied between 12% and 34% (8)(9)(10)(11). In the Middle East respiratory syndrome epidemic, a pneumothorax rate of 30% was reported in a small study of intensive care unit-intubated patients (12), higher than both our incident rate of 15% and the overall rate of 24%.…”

Section: Discussionmentioning

confidence: 51%

Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation

et al. 2020

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A t New York University Langone Health at the height of the coronavirus disease 2019 (COVID-19) pandemic, 22% of hospitalized patients diagnosed with COVID-19 infection required invasive mechanical ventilation (IMV) (1). We noted many patients with COVID-19 infection who developed pneumothorax, pneumomediastinum, and pneumopericardium, and in some cases, at multiple separate time points. Given this observation, we hypothesized that barotrauma related to IMV was elevated in patients with COVID-19 infection. The purpose of this study was to evaluate the rate of barotrauma in patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and who required IMV compared with other patients in the same institution during the same period who also required IMV, and to a temporally remote (pre-COVID-19) historical cohort of patients who required IMV support in the setting of acute respiratory distress syndrome (ARDS). Materials and Methods This retrospective study was performed with institutional review board waiver of authorization and consent (is20-00582) given the current urgent conditions created by the pandemic. Study Population The New York University Langone Health electronic medical record system (Epic Systems, Verona, Wis) was searched for patients age 18 years or older seen in our emergency department between March 1, 2020, and April 6, 2020, with chest imaging within 24 hours of nasopharyngeal or oropharyngeal swab testing for SARS-CoV-2. Test assay techniques are detailed in Appendix E1 (online). Patients with positive real-time reverse transcription polymerase chain reaction assays were deemed COVID-19 positive, and those with negative results were deemed COVID-19 negative. COVID-19 testing was performed in all patients who presented to the emergency

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“…Patients infected with SARS-CoV initially had features of atypical pneumonia. Cough was a common presenting symptom in up to 74% of patients [8][9][10] (Table 1). Other symptoms suggestive of an upper respiratory tract infection (e.g., rhinitis) were less frequent.…”

Section: Sars-covmentioning

confidence: 99%

“…13 Most patients received antibacterial antibiotics, with or without the use of ribavirin and corticosteroids. [9][10][11] Angiotensin-converting enzyme 2 (ACE2) serves as a functional receptor to SARS-CoV. 13,14 SARS-CoV also disrupts the urokinase pathway, which controls fibrin levels through extracellular remodeling, and is associated with pulmonary hemorrhage and fibrosis.…”

Section: Sars-covmentioning

confidence: 99%

A Comprehensive Review of Manifestations of Novel Coronaviruses in the Context of Deadly COVID-19 Global Pandemic

Gulati¹,

Pomeranz²,

Qamar³

et al. 2020

The American Journal of the Medical Sciences

116

129

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Since December 2019, the global pandemic caused by the highly infectious novel coronavirus 2019-nCoV (COVID-19) has been rapidly spreading. As of April 2020, the outbreak has spread to over 210 countries, with over 2,400,000 confirmed cases and over 170,000 deaths. 1 COVID-19 causes a severe pneumonia characterized by fever, cough and shortness of breath. Similar coronavirus outbreaks have occurred in the past causing severe pneumonia like COVID-19, most recently, severe acute respiratory syndrome coronavirus (SARS-CoV) and middle east respiratory syndrome coronavirus (MERS-CoV). However, over time, SARS-CoV and MERS-CoV were shown to cause extrapulmonary signs and symptoms including hepatitis, acute renal failure, encephalitis, myositis and gastroenteritis. Similarly, sporadic reports of COVID-19 related extrapulmonary manifestations emerge. Unfortunately, there is no comprehensive summary of the multiorgan manifestations of COVID-19, making it difficult for clinicians to quickly educate themselves about this highly contagious and deadly pathogen. What is more, is that SARS-CoV and MERS-CoV are the closest humanity has come to combating something similar to COVID-19, however, there exists no comparison between the manifestations of any of these novel coronaviruses. In this review, we summarize the current knowledge of the manifestations of the novel coronaviruses SARS-CoV, MERS-CoV and COVID-19, with a particular focus on the latter, and highlight their differences and similarities.

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Characteristic features and outcomes of severe acute respiratory syndrome found in severe acute respiratory syndrome intensive care unit patients

Abstract: In a SARS ICU, patients with a confirmed diagnosis of SARS had significantly different clinical features and timing of mortality from those of the control group.

Cited by 20 publications

References 17 publications

Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4⁺T Cells Are Important in Control of SARS-CoV Infection

Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4⁺T Cells Are Important in Control of SARS-CoV Infection

Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation

A Comprehensive Review of Manifestations of Novel Coronaviruses in the Context of Deadly COVID-19 Global Pandemic

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Characteristic features and outcomes of severe acute respiratory syndrome found in severe acute respiratory syndrome intensive care unit patients

Abstract: In a SARS ICU, patients with a confirmed diagnosis of SARS had significantly different clinical features and timing of mortality from those of the control group.

Cited by 20 publications

References 17 publications

Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4+T Cells Are Important in Control of SARS-CoV Infection

Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4+T Cells Are Important in Control of SARS-CoV Infection

Increased Incidence of Barotrauma in Patients with COVID-19 on Invasive Mechanical Ventilation

A Comprehensive Review of Manifestations of Novel Coronaviruses in the Context of Deadly COVID-19 Global Pandemic

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Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4⁺T Cells Are Important in Control of SARS-CoV Infection

Cellular Immune Responses to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection in Senescent BALB/c Mice: CD4⁺T Cells Are Important in Control of SARS-CoV Infection