The inflammatory response to SARS-coronavirus-2 (SARS-CoV-2) infection is thought to underpin COVID19 pathogenesis. We conducted daily transcriptomic profiling of three COVID19 cases and found that the early immune response in COVID19 patients is highly dynamic. Patient throat swabs were tested daily for SARS-CoV-2, with the virus persisting for 3 to 4 weeks in all three patients.

Cytokine analyses of whole blood revealed increased cytokine expression in the single most severe case. However, most inflammatory gene expression peaked after respiratory function nadir, except expression in the IL1 pathway.

Parallel analyses of CD4 and CD8 expression suggested that the pro-inflammatory response may be intertwined with T cell activation that could exacerbate disease or prolong the infection. Collectively, these findings hint at the possibility that IL1 and related pro-inflammatory pathways may be prognostic and serve as therapeutic targets for COVID19. This work may also guide future studies to illuminate COVID19 pathogenesis and develop host-directed therapies.

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Gastrointestinal and Liver Manifestations in Patients with COVID19.

As the outbreak of coronavirus disease 2019 (COVID19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread over the world, the World Health Organization has declared the outbreak of COVID19 an international public health emergency.

Besides typical respiratory symptoms and signs of COVID19, digestive symptoms and liver injury have been frequently reported during the course of the disease. In this review, we summarized the recent studies reporting of gastrointestinal and liver manifestations during the course of COVID19. Digestive symptoms, including anorexia, nausea, vomiting and diarrhea, are not uncommon in patients with COVID19, and in some cases digestive symptoms may occur in the absence of any respiratory symptoms.

Furthermore, SARS-CoV-2 could be detected in the stool of infected patients, implicating the possibility of fecal-oral transmission. Attention should also be paid to monitor liver function during the course of COVID19, especially in patients with higher disease severity.

A Dynamic Immune Response Shapes COVID-19 Progression.
A Dynamic Immune Response Shapes COVID-19 Progression.

Diabetes in COVID19: Prevalence, pathophysiology, prognosis and practical considerations.

High prevalence of diabetes makes it an important comorbidity in patients with COVID19. We sought to review and analyze the data regarding the association between diabetes and COVID19, pathophysiology of the disease in diabetes and management of patients with diabetes who develop COVID19 infection.PubMed database and Google Scholar were searched using the key terms ‘COVID-19’, ‘SARS-CoV-2’, ‘diabetes’, ‘antidiabetic therapy’ up to April 2, 2020. Full texts of the retrieved articles were accessed.

There is evidence of increased incidence and severity of COVID19 in patients with diabetes. COVID19 could have effect on the pathophysiology of diabetes. Blood glucose control is important not only for patients who are infected with COVID19, but also for those without the disease. Innovations like telemedicine are useful to treat patients with diabetes in today’s times.

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