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- Thread starter Michael Scally MD
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Aging Immunity May Exacerbate COVID-19
Aging is associated with increased morbidity arising from a range of tissue dysfunctions. A common denominator of age-associated frailty is increased baseline inflammation, called inflammaging, that is present in older individuals.
Recent studies have shown that the presence of excessive inflammation can inhibit immunity in both animals and humans and that this can be prevented by blocking inflammatory processes.
This finding has important implications for the immunity of older individuals who are infected with pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that induce overwhelming inflammation, which can be fatal, particularly in older people.
Reducing inflammation may be a therapeutic strategy for enhancing immunity in older people.
Akbar AN, Gilroy DW. Aging immunity may exacerbate COVID-19. Science 2020;369:256. Aging immunity may exacerbate COVID-19 | Science
Highly differentiated T cells in older individuals may induce damage in SARS-CoV-2–infected lungs, as hypothesized in the diagram.
Aging is associated with increased morbidity arising from a range of tissue dysfunctions. A common denominator of age-associated frailty is increased baseline inflammation, called inflammaging, that is present in older individuals.
Recent studies have shown that the presence of excessive inflammation can inhibit immunity in both animals and humans and that this can be prevented by blocking inflammatory processes.
This finding has important implications for the immunity of older individuals who are infected with pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that induce overwhelming inflammation, which can be fatal, particularly in older people.
Reducing inflammation may be a therapeutic strategy for enhancing immunity in older people.
Akbar AN, Gilroy DW. Aging immunity may exacerbate COVID-19. Science 2020;369:256. Aging immunity may exacerbate COVID-19 | Science
Highly differentiated T cells in older individuals may induce damage in SARS-CoV-2–infected lungs, as hypothesized in the diagram.
Addressing Male Sexual and Reproductive Health in The Wake of COVID-19 Outbreak
PURPOSE: The COVID-19 pandemic, caused by the SARS-CoV-2, represents an unprecedented challenge for healthcare. COVID-19 features a state of hyperinflammation resulting in a "cytokine storm", which leads to severe complications, such as the development of micro-thrombosis and disseminated intravascular coagulation (DIC).
Despite isolation measures, the number of affected patients is growing daily: as of June 12th, over 7.5 million cases have been confirmed worldwide, with more than 420,000 global deaths. Over 3.5 million patients have recovered from COVID-19; although this number is increasing by the day, great attention should be directed towards the possible long-term outcomes of the disease.
Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients.
METHODS: A literature research on the possible mechanisms involved in the development of ED in COVID-19 survivors was performed.
RESULTS: Endothelial dysfunction, subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics all contribute to the potential onset of ED. Additionally, COVID-19 might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED.
Testicular function in COVID-19 patients requires careful investigation for the unclear association with testosterone deficiency and the possible consequences for reproductive health. Treatment with phosphodiesterase-5 (PDE5) inhibitors might be beneficial for both COVID-19 and ED.
CONCLUSION: COVID-19 survivors might develop sexual and reproductive health issues. Andrological assessment and tailored treatments should be considered in the follow-up.
Sansone A, Mollaioli D, Ciocca G, et al. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak. Journal of endocrinological investigation 2020. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak
PURPOSE: The COVID-19 pandemic, caused by the SARS-CoV-2, represents an unprecedented challenge for healthcare. COVID-19 features a state of hyperinflammation resulting in a "cytokine storm", which leads to severe complications, such as the development of micro-thrombosis and disseminated intravascular coagulation (DIC).
Despite isolation measures, the number of affected patients is growing daily: as of June 12th, over 7.5 million cases have been confirmed worldwide, with more than 420,000 global deaths. Over 3.5 million patients have recovered from COVID-19; although this number is increasing by the day, great attention should be directed towards the possible long-term outcomes of the disease.
Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients.
METHODS: A literature research on the possible mechanisms involved in the development of ED in COVID-19 survivors was performed.
RESULTS: Endothelial dysfunction, subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics all contribute to the potential onset of ED. Additionally, COVID-19 might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED.
Testicular function in COVID-19 patients requires careful investigation for the unclear association with testosterone deficiency and the possible consequences for reproductive health. Treatment with phosphodiesterase-5 (PDE5) inhibitors might be beneficial for both COVID-19 and ED.
CONCLUSION: COVID-19 survivors might develop sexual and reproductive health issues. Andrological assessment and tailored treatments should be considered in the follow-up.
Sansone A, Mollaioli D, Ciocca G, et al. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak. Journal of endocrinological investigation 2020. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak
[OA] Are sex discordant outcomes in COVID-19 related to sex hormones?
COVID-19 has a clear sex disparity in clinical outcome. Globally, infection rates between men and women are similar; however, men are more likely to have more severe disease and are more likely to die.
The causes for this disparity are currently under investigation and are most likely multifactorial. Sex hormones play an important role in the immune response with estrogen seen as immune boosting and testosterone as immunosuppressing. Additionally, an important protease involved in viral entry, TMPRSS2, is regulated by androgens.
Many observational and prospective studies are ongoing or initiating to further examine the role of sex hormones in SARS-CoV-2 infection and if modulation of them is a realistic treatment option.
Strope JD, Chau CH, Figg WD. Are sex discordant outcomes in COVID-19 related to sex hormones? Seminars in oncology 2020. Are sex discordant outcomes in COVID-19 related to sex hormones? - ScienceDirect
COVID-19 has a clear sex disparity in clinical outcome. Globally, infection rates between men and women are similar; however, men are more likely to have more severe disease and are more likely to die.
The causes for this disparity are currently under investigation and are most likely multifactorial. Sex hormones play an important role in the immune response with estrogen seen as immune boosting and testosterone as immunosuppressing. Additionally, an important protease involved in viral entry, TMPRSS2, is regulated by androgens.
Many observational and prospective studies are ongoing or initiating to further examine the role of sex hormones in SARS-CoV-2 infection and if modulation of them is a realistic treatment option.
Strope JD, Chau CH, Figg WD. Are sex discordant outcomes in COVID-19 related to sex hormones? Seminars in oncology 2020. Are sex discordant outcomes in COVID-19 related to sex hormones? - ScienceDirect
[OA] Can dried blood spots (DBS) contribute to conducting comprehensive SARS-CoV-2 antibody tests?
Within months of the first report on its outbreak, the extent of the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has reached unexpected dimensions, and despite enormous global scientific efforts, several aspects characterizing the coronavirus disease 2019 (COVID‐19) and its transmission are not yet fully understood.1-3
A common credo amongst scientists appears to be the fact that analytical diagnostics are vital for understanding and, eventually, managing the pandemic. Here, complementary tests based on real‐time quantitative polymerase chain reaction (RT‐qPCR) analyses targeting the single‐stranded RNA‐composed virus and immunological approaches monitoring the development of immune responses of infected (and recovered) individuals have been established.4, 5
Advantages and limitations exist with both strategies, and various factors are suspected to affect the reliability of the analytical result1 yet, diagnostics are indispensable, and comprehensiveness and testing frequency is considered to be of particular importance in supporting the confinement of the pandemic.5, 6
An option to facilitate the testing of different anti‐SARS‐CoV‐2 antibodies could be the extension of existing analytical platforms from conventionally collected venous blood samples (including whole blood, serum, and plasma) to minimally invasive sampled capillary blood such as dried blood spots (DBS) or dried plasma spots (DPS), in line with recent initiatives, for example, by the US National Institutes of Health (NIH)7 or the Royal Institute of Technology Stockholm, Sweden,8 as well as earlier investigations into targeting anti‐influenza IgG antibodies.9
Thevis M, Knoop A, Schaefer MS, et al. Can dried blood spots (DBS) contribute to conducting comprehensive SARS-CoV-2 antibody tests?. Drug Test Anal. 2020;12(7):994-997. doi:10.1002/dta.2816 Error - Cookies Turned Off
Within months of the first report on its outbreak, the extent of the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has reached unexpected dimensions, and despite enormous global scientific efforts, several aspects characterizing the coronavirus disease 2019 (COVID‐19) and its transmission are not yet fully understood.1-3
A common credo amongst scientists appears to be the fact that analytical diagnostics are vital for understanding and, eventually, managing the pandemic. Here, complementary tests based on real‐time quantitative polymerase chain reaction (RT‐qPCR) analyses targeting the single‐stranded RNA‐composed virus and immunological approaches monitoring the development of immune responses of infected (and recovered) individuals have been established.4, 5
Advantages and limitations exist with both strategies, and various factors are suspected to affect the reliability of the analytical result1 yet, diagnostics are indispensable, and comprehensiveness and testing frequency is considered to be of particular importance in supporting the confinement of the pandemic.5, 6
An option to facilitate the testing of different anti‐SARS‐CoV‐2 antibodies could be the extension of existing analytical platforms from conventionally collected venous blood samples (including whole blood, serum, and plasma) to minimally invasive sampled capillary blood such as dried blood spots (DBS) or dried plasma spots (DPS), in line with recent initiatives, for example, by the US National Institutes of Health (NIH)7 or the Royal Institute of Technology Stockholm, Sweden,8 as well as earlier investigations into targeting anti‐influenza IgG antibodies.9
Thevis M, Knoop A, Schaefer MS, et al. Can dried blood spots (DBS) contribute to conducting comprehensive SARS-CoV-2 antibody tests?. Drug Test Anal. 2020;12(7):994-997. doi:10.1002/dta.2816 Error - Cookies Turned Off
Georgia unveils new logo to mark its early re-opening of the state during a global Coronavirus Pandemic. 
It's clear DeSantis has never been to a gym!!!
In this Covid-19 Medical Grand Rounds (July 16, 2020), three world experts discuss a variety of issues surrounding how the coronavirus moves from person to person, how best to block viral spread, and the potential that mask-wearing may not only prevent infection but also lead to a milder clinical course. The questions regarding aerosol vs. droplet transmission and the value of wearing masks and/or face shields are central to formulating public health strategies as well as to informing the personal decisions that each of us makes every day. The session is hosted by UCSF Department of Medicine chair Bob Wachter.
Twitter Thread -
See all UCSF Covid-19 grand rounds, which have been viewed more than 300,000 times, here: COVID-19 News Coverage | Department of Medicine
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