Endothelial Immunity Trained by Coronavirus Infections, DAMP Stimulations and Regulated by Anti-Oxidant NRF2 May Contribute to Inflammations, Myelopoiesis, COVID-19 Cytokine Storms and Thromboembolism

To characterize transcriptomic changes in endothelial cells (ECs) infected by coronaviruses, and stimulated by DAMPs, the expressions of 1311 innate immune regulatomic genes (IGs) were examined in 28 EC microarray datasets with 7 monocyte datasets as controls. We made the following findings: The majority of IGs are upregulated in the first 12 hours post-infection (PI), and maintained until 48 hours PI in human microvascular EC infected by middle east respiratory syndrome-coronavirus (MERS-CoV) (an EC model for COVID-19). The expressions of IGs are modulated in 21 human EC transcriptomic datasets by various PAMPs/DAMPs, including LPS, LPC, shear stress, hyperlipidemia and oxLDL. Upregulation of many IGs such as nucleic acid sensors are shared between ECs infected by MERS-CoV and those stimulated by PAMPs and DAMPs. Human heart EC and mouse aortic EC express all four types of coronavirus receptors such as ANPEP, CEACAM1, ACE2, DPP4 and virus entry facilitator TMPRSS2 (heart EC); most of coronavirus replication-transcription protein complexes are expressed in HMEC, which contribute to viremia, thromboembolism, and cardiovascular comorbidities of COVID-19. ECs have novel trained immunity (TI), in which subsequent inflammation is enhanced. Upregulated proinflammatory cytokines such as TNFα, IL6, CSF1 and CSF3 and TI marker IL-32 as well as TI metabolic enzymes and epigenetic enzymes indicate TI function in HMEC infected by MERS-CoV, which may drive cytokine storms. Upregulat...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research

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Conclusions Although patients with a history of COVID-19 had worse function at time of admission to acute rehabilitation, inpatient rehabilitation significantly improved their function to comparable levels as patients who did not have COVID-19. To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives Upon completion of this article, the reader should be able to: (1) Identify how characteristics of patients with COVID-19 admitted to acute rehabilitation differ from those with similar admission codes but without COVID-19; (2) Desc...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: CME Article . 2021 Series . Number 12 Source Type: research
Conclusions The COVID-19 pandemic acutely affected patient care and overall institutional operations. The research consortium of New York and New Jersey rehabilitation institutions responded dynamically to bed expansions/contractions, staff deployment, and innovations that facilitated safe and effective patient care.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: SPECIAL SECTION on COVID-19 and PM&R Source Type: research
Objectives The aims of the study were to describe an interdisciplinary inpatient rehabilitation program for patients recovering from COVID-19 and to evaluate functional outcomes. Design This is an analysis of retrospective data captured from the electronic health record of COVID-19 patients admitted to the rehabilitation unit (N = 106). Rehabilitation approaches are described narratively. Functional gain was evaluated using the Activity Measure for Postacute Care 6 Clicks, basic mobility and daily activities. Results Interdisciplinary approaches were implemented to address the medical, physical, communica...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: SPECIAL SECTION on COVID-19 and PM&R Source Type: research
We present five models of care in varying degrees of development and compare processes and adaptations to address the unique needs of each center and their unique patient populations. Forging a path to recovery will necessitate a multidisciplinary team with physiatry involvement to meet the distinctive needs of patients with postacute sequelae of SARS-CoV-2. Furthermore, it is imperative that there be equitable access to this care and commitment from healthcare institutions to provide resources for these programs.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: SPECIAL SECTION on COVID-19 and PM&R Source Type: research
The long-term sequelae after SARS-CoV-2 infections in children is unknown. Guidance is needed on helpful models of care for an emerging subset of pediatric patients with postacute/long COVID who continue to experience persistent symptoms after initial COVID-19 diagnosis. Here, we describe a pediatric multidisciplinary post–COVID-19 rehabilitation clinic model as well as a case series of the initial cohort of patients who presented to this clinic. A consecutive sample of nine patients (pediatric patients
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: SPECIAL SECTION on COVID-19 and PM&R Source Type: research
The purpose of this observational study was to report the experience of a 1-yr home training with functional electrical stimulation cycling of a person with T4 American Impairment Scale A paraplegia for 9 yrs, homebound due to the COVID-19 health crisis. The 40-yr-old participant had a three-phase training: V1, isometric stimulation; V2, functional electrical stimulation cycling for 3 sessions/wk; and V3, functional electrical stimulation cycling for 2–4 sessions/wk. Data on general and physical tolerance, health impact, and performance were collected. Borg Scale score relating to fatigue was 10.1 before training and...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: SPECIAL SECTION on COVID-19 and PM&R Source Type: research
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Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: RFS – Teaching Images Source Type: research
Link to case here: Liver Failure [Medication-Induced] This case has an expert witness opinion from a GI doc. Patient was started on Depakote, LFTs were initially fine. Within 5 weeks she had a liver transplant. The expert notes that she had positive ASMA and ANA titers and homozygous positive for H63D hemochromatosis. Do these results suggest that there may be an alternative cause for her liver failure?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Gastroenterology Source Type: forums
The World Health Organization (WHO) will meet tomorrow to determine if the B.1.1.529 SARS-CoV-2 variant should be considered a variant of interest or concern.
Source: Forbes.com Healthcare News - Category: Pharmaceuticals Authors: Tags: Healthcare /healthcare Innovation /innovation Science /science business pharma Source Type: news
This qualitative study describes the psychological experience of patients hospitalized with COVID-19. These patients went through 3 psychological stages: extremely uncertainties during the initial diagnostic stage, complicated feelings of negativity during the treatment stage, and positive growth in the recovery stage. It is important for nurses to provide holistic care.
Source: Holistic Nursing Practice - Category: Nursing Tags: FEATURES Source Type: research
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