Chronic sequelae complicate convalescence from both dengue and acute viral respiratory illness

Kalimuddin, Shirin; Teh, Yii Ean; Wee, Liang En; Paintal, Shay; Sasisekharan, Ram; Low, Jenny Guek Hong; Sheth, Sujata; Ooi, Eng Eong

doi:10.1371/journal.pntd.0010724

Cited by 11 publications

(7 citation statements)

References 23 publications

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“…Several viral infections, like Dengue fever ( 28 ), WNV ( 29 ), SARS-CoV-2 ( 30 ), EVDs ( 31 ), and Marburg viruses ( 32 ), impact the neuropsychiatric systems upon complications present PVF, which may linger for months after infection. The PVF presents similar to chronic fatigue syndrome, characterized by fatigue/weakness, headache, dizziness, musculoskeletal pain, and cognitive and sleep disorders, and could be linked to dysregulated CCM ( 33 ) and microbial dysbiosis impacting the gut–brain axis ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Systems-level temporal immune-metabolic profile in Crimean-Congo hemorrhagic fever virus infection

Ambikan,

Elaldi,

Svensson-Akusjärvi

et al. 2023

Proc. Natl. Acad. Sci. U.S.A.

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Crimean-Congo hemorrhagic fever (CCHF) caused by CCHF virus (CCHFV) is one of the epidemic-prone diseases prioritized by the World Health Organisation as public health emergency with an urgent need for accelerated research. The trajectory of host response against CCHFV is multifarious and remains unknown. Here, we reported the temporal spectrum of pathogenesis following the CCHFV infection using genome-wide blood transcriptomics analysis followed by advanced systems biology analysis, temporal immune-pathogenic alterations, and context-specific progressive and postinfection genome-scale metabolic models (GSMM) on samples collected during the acute (T0), early convalescent (T1), and convalescent-phase (T2). The interplay between the retinoic acid-inducible gene-I-like/nucleotide-binding oligomerization domain-like receptor and tumor necrosis factor signaling governed the trajectory of antiviral immune responses. The rearrangement of intracellular metabolic fluxes toward the amino acid metabolism and metabolic shift toward oxidative phosphorylation and fatty acid oxidation during acute CCHFV infection determine the pathogenicity. The upregulation of the tricarboxylic acid cycle during CCHFV infection, compared to the noninfected healthy control and between the severity groups, indicated an increased energy demand and cellular stress. The upregulation of glycolysis and pyruvate metabolism potentiated energy generation through alternative pathways associated with the severity of the infection. The downregulation of metabolic processes at the convalescent phase identified by blood cell transcriptomics and single-cell type proteomics of five immune cells (CD4 + and CD8 + T cells, CD14 + monocytes, B cells, and NK cells) potentially leads to metabolic rewiring through the recovery due to hyperactivity during the acute phase leading to post-viral fatigue syndrome.

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Section: Discussionmentioning

confidence: 99%

Systems-level temporal immune-metabolic profile in Crimean-Congo hemorrhagic fever virus infection

Ambikan,

Elaldi,

Svensson-Akusjärvi

et al. 2023

Proc. Natl. Acad. Sci. U.S.A.

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“…La trombocitopenia estuvo presente en ambas patologías, pero fue más severa (<50.000/mm 3 ) en el dengue grave, lo que concuerda con un estudio realizado en pacientes con dengue e insuficiencia respiratoria, que reportó trombocitopenia grave en el 82,61% de los casos de pacientes con dengue grave (Kalimuddin et al, 2022) y similar a lo encontrado en otro estudio en Pakistán, donde los pacientes con dengue grave tenían trombocitopenia y plaquetas significativamente más bajas que los casos con dengue no grave (Arshad et al, 2022) hallazgo que también fue reportado en pacientes que además presentan linfohistiocitosis (Acharya et al, 2022). Esto contrasta con el estudio realizado en Puerto Maldonado, Perú, donde el recuento de plaquetas de los pacientes con dengue grave se encontraba dentro de los rangos normales, excepto en el grupo de 10 a 19 años que se encontraban por debajo de 150.000/mm 3 (Rojas et al, 2015).…”

Section: Discussionunclassified

Comparación clínica y laboratorial de la fiebre amarilla severa versus dengue grave en Perú

Montalvo

Díaz-Lazo²,

Montalvo³

et al. 2022

BMSA

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En los centros de Emergencia con poco apoyo de laboratorio, es difícil diferenciar a los pacientes con dengue grave y fiebre amarilla severa. El objetivo fue comparar el perfil clínico y de laboratorio de los pacientes con dengue grave y fiebre amarilla severa en Urgencias. Se realizó un estudio observacional retrospectivo de pacientes con diagnóstico confirmado de dengue y fiebre amarilla en el período 2018 a 2020 atendidos en la Unidad de Emergencia del Hospital Carrión, Huancayo-Perú. Se evaluaron un total de 35 pacientes, 11 pacientes (31,4%) fueron diagnosticados con fiebre amarilla severa y 24 pacientes (68,5%) con dengue grave. La media de los resultados de laboratorio con fiebre amarilla severa fueron bilirrubina indirecta 4,7 ml/dL, aspartato transaminasa 4463 UI/L, transaminasa aminotransferasa 4329 UI/L, creatinina 4,9 mg/dl. En pacientes con dengue grave el hematocrito promedio fue 51,8, hemoglobina 17,6 g/dl, plaquetas 24 × 103/mm. En pacientes con síndrome ictérico-febril la presencia de bradicardia, bilirrubina indirecta elevada y transaminasas muy elevadas debe hacer sospechar de fiebre amarilla; mientras que los pacientes que acuden por ascitis, derrame pleural, aumento de hematocrito y deficiencia de plaquetas, se debe tratar como dengue grave sobre todo en Unidades de Emergencia con poco apoyo de laboratorio.

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“…Although there is currently no evidence that COVID-19 requires treatment during the recovery phase, experts have called for research to identify appropriate therapies such as vaccines and antiviral drugs to prevent sequelae ( Kalimuddin et al, 2022 ). Studies have also analyzed pharmacological treatment in the recovery phase and found that it is mainly symptomatic supportive therapy, while the use of antibiotics and antivirals is ineffective ( Liu et al, 2020 ).…”

Section: Potential Advantages Of Traditional Chinese Medicine In the ...mentioning

confidence: 99%

The pathological mechanism of the COVID-19 convalescence and its treatment with traditional Chinese medicine

Duan

et al. 2023

Front. Pharmacol.

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The severe acute respiratory syndrome coronavirus - 2 (SARS - CoV - 2) was reported to cause the Wuhan outbreak of the corona virus disease 2019(COVID-19). To date, the COVID-19 has infected more than 600 million people gloabally. As a growing number of patients recover from acute infections and are discharged from hospitals, the proportion of patients in the recovery period is gradually increasing. Many of these individuals have been reported to experience multiple symptoms during the convalescence, such as fatigue, dyspnea and pain which are designated as “long-COVID”, “post-COVID syndrome” or “recovery sequelae. We searched for recent articles published in PubMed on COVID-19 convalescence and found that the pathogenesis of COVID-19 convalescence is not yet well recognized. It may be associated with incomplete recovery of immune system, parenchymal organ damage (liver or lung), coagulation abnormalities, “second hit” caused by viral infection, and Phenomenon of Cell Senescence-Associated Secretory Phenotype (SASP). Some drugs and psychological factors of patients also play a non-negligible role in it. We also found that the effect of traditional Chinese medicine (TCM) is effective in the treatment of the COVID-19 recovery phase, which can not only relieve the corresponding symptoms, but also improve the indicators and pulmonary fibrosis. Bufei Huoxue Capsule, as the only drug explicitly mentioned for COVID-19 recovery period, can exert strong rehabilitative effects on physiological activity in patients recovering from COVID-19. In addition, in previous studies, traditional Chinese medicine has been confirmed to have the ability to resist cytokine storms, as well as improve coagulation and myocardial damage, which makes it have potential therapeutic advantages in targeting the hyperimmune response, coagulation abnormalities and myocardial damage existing in the recovery period. In conclusion, the clinical symptoms of patients convalescing from COVID-19 are complex, and its pathogenesis has not been elucidated. traditional Chinese medicine, as a traditional treatment, its specific action and mechanism need to be confirmed by more studies, so that it can play a better role.

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Chronic sequelae complicate convalescence from both dengue and acute viral respiratory illness

Cited by 11 publications

References 23 publications

Systems-level temporal immune-metabolic profile in Crimean-Congo hemorrhagic fever virus infection

Systems-level temporal immune-metabolic profile in Crimean-Congo hemorrhagic fever virus infection

Comparación clínica y laboratorial de la fiebre amarilla severa versus dengue grave en Perú

The pathological mechanism of the COVID-19 convalescence and its treatment with traditional Chinese medicine

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