Review
Medicine, General & Internal
Paolo Groff, Rodolfo Ferrari
Summary: The SARS-CoV-2 pandemic has caused disruptions worldwide in health, social, and economic aspects for the past 11 months. More information is being learned about the epidemiological and clinical features of CoViD-19, particularly in terms of using non-invasive respiratory support techniques for acute hypoxemic respiratory failure. Decision-making and operational support for healthcare workers are increasingly based on a growing series of mainly monocentric and retrospective studies.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2021)
Review
Medicine, General & Internal
Manel Lujan, Javier Sayas, Olga Mediano, Carlos Egea
Summary: Acute respiratory failure caused by COVID-19 pneumonia may require non-pharmacological strategies in addition to oxygen therapy. The response to these strategies varies depending on the predominant phenotypic involvement. Deciding when to use non-invasive respiratory support instead of conventional oxygen therapy, choosing the right method, and considering combined approaches are important for the daily care of critically ill COVID-19 patients.
FRONTIERS IN MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Jose Gregorio Gonzalez-Garcia, Sergi Pascual-Guardia, Ricardo J. Aguilar Colindres, Pilar Ausin Herrero, Mariela Alvarado Miranda, Mariela Arita Guevara, Diana Badenes Bonet, Salome Bellido Calduch, Oswaldo A. Caguana Velez, Cinta Cumpli Gargallo, Marisol Dominguez-Alvarez, Joaquim Gea, Nuria Grau, Karys Khilzi, Juana Martinez-Llorens, Monica Sanchez Ortiz, Albert Sanchez-Font, Antonio Sancho-Munoz, Francisco Jose Parrilla-Gomez, Judith Marin Corral, Purificacion Perez Teran, Juan Jose Rodriguez-Sevilla, Roberto Chalela, Diego Rodriguez-Chiaradia
Summary: The incidence of pulmonary embolism is remarkably higher in critically ill patients, especially those who require mechanical ventilation after non-invasive respiratory support. There is currently no clear strategy for thromboprophylaxis in patients under NIS. Patients who need intubation and mechanical ventilation are at significantly higher risk for PE.
RESPIRATORY MEDICINE
(2021)
Review
Critical Care Medicine
Ali Tabatabai, Samuel M. Galvagno, James O'Connor, Thomas M. Scalea, Kristopher B. Deatrick
Summary: Extracorporeal life support (ECLS) is utilized for severe cases caused by ARDS, trauma, cardiogenic shock, or cardiac arrest. This article discusses indications, predictors, procedural considerations, and post-cannulation management strategies of ECLS.
Editorial Material
Biochemistry & Molecular Biology
Nina S. Hsu, Saskia Hendriks, Khara M. Ramos, Christine Grady
Summary: Participating in clinical trials during COVID-19 may bring unexpected risks that investigators and institutional review boards are unsure how to investigate. The question of how to apply existing guidance and ethical frameworks in a pandemic setting has emerged as a key issue.
Article
Medicine, General & Internal
Harri Hemila, Angelique M. E. de Man
Summary: Vitamin C has shown to prevent and alleviate viral infections in numerous animal studies and placebo-controlled trials with humans, especially in respiratory virus infections. High doses of vitamin C are needed to increase plasma levels in critically ill patients, which has been shown to reduce ICU stay and mortality rates in sepsis patients. Vitamin C may have beneficial effects on acute respiratory distress syndrome (ARDS) complicating COVID-19 pneumonia.
FRONTIERS IN MEDICINE
(2021)
Article
Medicine, General & Internal
G. Pomponio, A. Ferrarini, M. Bonifazi, M. Moretti, A. Salvi, A. Giacometti, M. Tavio, G. Titolo, L. Morbidoni, G. Frausini, M. Onesta, D. Amico, M. L. B. Rocchi, S. Menzo, L. Zuccatosta, F. Mei, V. Menditto, S. Svegliati, A. Donati, M. M. D'Errico, M. Pavani, A. Gabrielli
Summary: This study utilized a structured design to identify predictive factors for response to tocilizumab in COVID-19 patients and aims to improve the design of future randomized trials. Lower levels of IL-6 and higher baseline values of PaO2/FiO(2) were found to predict a favorable response to tocilizumab.
JOURNAL OF INTERNAL MEDICINE
(2021)
Article
Medicine, General & Internal
Yaroslava Longhitano, Christian Zanza, Tatsiana Romenskaya, Angela Saviano, Tonia Persiano, Mirco Leo, Andrea Piccioni, Marta Betti, Antonio Maconi, Ivano Pindinello, Riccardo Boverio, Jordi Rello, Francesco Franceschi, Fabrizio Racca
Summary: The aim of this study was to determine whether a simple bedside test, the single-breath counting test (SBCT), can predict the need for non-invasive respiratory strategies (NIRS) in COVID-19 patients within 24 hours of accessing the Emergency Department (ED). The study found that SBCT was an accurate predictor of NIRS requirement, even in patients without respiratory symptoms.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Immunology
Mohadeseh Haji Abdolvahab, Shima Moradi-kalbolandi, Mohammad Zarei, Deepanwita Bose, Keivan Majidzadeh-A, Leila Farahmand
Summary: COVID-19, caused by SARS-CoV-2, is a public health crisis originating from bats and transmitted to humans. The disease is mainly spread through respiratory means with an incubation period of 2-14 days, with symptoms including fever, sore throat, and cough. Treatment focuses on supportive care and interferons, with combination therapy potentially being more effective.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2021)
Article
Respiratory System
Raul Mendez, Paula Gonzalez-Jimenez, Ana Latorre, Monica Piqueras, Leyre Bouzas, Katheryn Yepez, Ana Ferrando, Enrique Zaldivar-Olmeda, Antonio Moscardo, Ricardo Alonso, Soledad Reyes, Rosario Menendez
Summary: Endothelial damage in COVID-19 patients, assessed through surrogate systemic endothelial biomarkers, is associated with disease severity and prognosis. Higher baseline levels of proADM and/or proendothelin are linked to more severe episodes and ICU admissions, while elevated levels at admission are correlated with in-hospital mortality. High levels of these biomarkers after discharge are associated with reduced lung function.
Article
Immunology
Zachary M. Holliday, Alexander P. Earhart, Mohammed M. Alnijoumi, Armin Krvavac, Lee-Ann H. Allen, Adam G. Schrum
Summary: The study found that dornase alfa can improve oxygenation and decrease lung DNA : MPO complexes in patients with ARDS secondary to COVID-19, showing potential benefits. However, these effects were only effective during the period of drug delivery.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Medicine, General & Internal
Roberto Cosentini, Paolo Groff, Anna Maria Brambilla, Renzo Camajori Todeschini, Gianfilippo Gangitano, Stella Ingrassia, Roberta Marino, Francesca Nori, Fiammetta Pagnozzi, Francesco Panero, Rodolfo Ferrari
Summary: The rapid global spread of the COVID-19 crisis has overwhelmed healthcare systems, particularly in intensive care units. This paper emphasizes the importance of using non-invasive respiratory support techniques, such as standard oxygen therapy and continuous positive airway pressure, in managing respiratory failure caused by COVID-19-related pneumonia. The Emergency Department plays a crucial role in applying these techniques early on and assessing their effectiveness.
INTERNAL AND EMERGENCY MEDICINE
(2022)
Article
Medicine, General & Internal
Huolan Zhu, Yanfei Zhang, Zuowei Pei, Ying Guo, Chenguang Yang, Yan Song, Xiaomei Guo, Fang Wang
Summary: This study investigated the incidence and characteristics of myocardial injury in COVID-19 patients admitted in hospital. It found that cardiac injury is more common in older patients, patients with diabetes, and is associated with a significant decrease in lymphocytes.
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
(2021)
Article
Cell Biology
Philipp K. Buehler, Annelies S. Zinkernagel, Daniel A. Hofmaenner, Pedro David Wendel Garcia, Claudio T. Acevedo, Alejandro Gomez-Mejia, Srikanth Mairpady Shambat, Federica Andreoni, Martina A. Maibach, Jan Bartussek, Matthias P. Hilty, Pascal M. Frey, Reto A. Schuepbach, Silvio D. Brugger
Summary: Superinfections are common among COVID-19 patients with acute respiratory distress syndrome, leading to lower survival rates, longer intensive care treatment, and reduced ventilator-free days despite the use of empirical antibiotic therapy.
CELL REPORTS MEDICINE
(2021)
Review
Neurosciences
Maximillian N. J. Woodall, Tereza Masonou, Katie-Marie Case, Claire M. Smith
Summary: As therapeutics for COVID-19 remain limited, the use of physiologically relevant models to reproduce the pathology of infection and evaluate the efficacy of antiviral drugs has become increasingly important in research and drug development.
JOURNAL OF PHYSIOLOGY-LONDON
(2021)
Article
Health Care Sciences & Services
Rowan Howell, Matthew A. Clarke, Ann-Kathrin Reuschl, Tianyi Chen, Sean Abbott-Imboden, Mervyn Singer, David M. Lowe, Clare L. Bennett, Benjamin Chain, Clare Jolly, Jasmin Fisher
Summary: The COVID-19 pandemic has put healthcare systems under immense pressure globally. This study presents an executable disease-stage signalling network model to predict effective repurposed drug combinations for treating COVID-19 at different stages. Through in silico screening, the study identified nine new drug combinations, with Camostat and Apilimod showing potential in suppressing viral replication in the early stage of severe disease. The study highlights the use of mechanistic modelling in rapidly evaluating personalized treatment options and provides a novel resource and expandable model system to respond to pandemic needs.
NPJ DIGITAL MEDICINE
(2022)
Editorial Material
Critical Care Medicine
Mervyn Singer
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Review
Critical Care Medicine
Daniel A. Hofmaenner, Mervyn Singer
Summary: Medical practice is often guided by dogma without sufficient evidence. Clinicians rely on engrained treatment strategies, even though the supporting evidence may be distorted or overlooked. Critical reflection and prospective studies are necessary to improve current practices.
INTENSIVE CARE MEDICINE
(2022)
Review
Infectious Diseases
Muska Miller, Mervyn Singer
Summary: While antibiotics play a crucial role in treating infections, their modulation of the immune system can have harmful effects on pathogen clearance and immune functionality, increasing the risk of secondary infection. These adverse consequences may be mediated, in part, through effects on the compromised functioning of mitochondria, which is already affected by the underlying septic process.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2022)
Review
Infectious Diseases
Prashant Nasa, Elie Azoulay, Arunaloke Chakrabarti, Jigeeshu Divatia, Ravi Jain, Camilla Rodrigues, Victor Rosenthal, Waleed Alhazzani, Yaseen M. Arabi, Jan Bakker, Matteo Bassetti, Jan De Waele, George Dimopoulos, Bin Du, Sharon Einav, Laura Evans, Simon Finfer, Claude Guerin, Naomi E. Hammond, Samir Jaber, Ruth M. Kleinpell, Younsuck Koh, Marin Kollef, Mitchell M. Levy, Flavia R. Machado, Jordi Mancebo, Ignacio Martin-Loeches, Mervyn Mer, Michael S. Niederman, Paolo Pelosi, Anders Perner, John Peter, Jason Phua, Lise Piquilloud, Mathias W. Pletz, Andrew Rhodes, Marcus J. Schultz, Mervyn Singer, Jean-Francois Timsit, Balasubramanian Venkatesh, Jean-Louis Vincent, Tobias Welte, Sheila Myatra
Summary: There is a wide variation in the clinical practice of infection control and prevention for SARS-CoV-2 in ICU. International experts have developed consensus statements on infection control, including 25 clinical practice statements. However, consensus has not been reached on the optimal return to work criteria for healthcare workers infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Further research is needed to address these uncertainties.
LANCET INFECTIOUS DISEASES
(2022)
Article
Critical Care Medicine
Pietro Arina, Matteo Sorge, Andrea Gallo, Vittoria Di Mauro, Nicoletta Vitale, Paola Cappello, Luca Brazzi, Maria Barandalla-Sobrados, James Cimino, V. Marco Ranieri, Fiorella Altruda, Mervyn Singer, Daniele Catalucci, Mara Brancaccio, Vito Fanelli
Summary: This study identifies the AKT/Melusin pathway as a key player in preserving cardiac function in sepsis-induced cardiomyopathy. The cell-permeable mimetic peptide (R7W-MP) represents a potential therapeutic option for this condition.
Review
Immunology
Sang Ho Choi, Antoni Cesar, Timothy Arthur Chandos Snow, Naveed Saleem, Nishkantha Arulkumaran, Mervyn Singer
Summary: This study found that the efficacy of doxycycline is comparable to macrolides or fluoroquinolones in adult patients with mild-to-moderate community-acquired pneumonia (CAP), suggesting that it is a viable treatment option. However, larger trials are needed to confirm these findings due to the lack of recent studies.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Critical Care Medicine
Bruno A. M. P. Besen, Otavio T. Ranzani, Mervyn Singer
INTENSIVE CARE MEDICINE
(2023)
Review
Anesthesiology
W. Pisciotta, P. Arina, D. Hofmaenner, M. Singer
Summary: Dealing with uncertain or missed diagnoses in the intensive care unit is common. It can lead to a decrease in quality of care and increase the risk of poor outcomes for affected patients. The diagnostic process is complex, especially in critically ill patients where history may be unclear and clinical features may not be specific. This review aims to analyze common causes of diagnostic errors and suggest a diagnostic framework, emphasizing the importance of debiasing strategies and multidisciplinary teamwork to improve patient care and outcomes.
Review
Critical Care Medicine
Pedro Povoa, Luis Coelho, Felipe Dal-Pizzol, Ricard Ferrer, Angela Huttner, Andrew Conway Morris, Vandack Nobre, Paula Ramirez, Anahita Rouze, Jorge Salluh, Mervyn Singer, Daniel A. Sweeney, Antoni Torres, Grant Waterer, Andre C. Kalil
Summary: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Biomarkers can be used as indicators for infection, dysregulated host response, treatment response, and can aid in prognosticating patient risk. Over 250 biomarkers have been identified and evaluated, but none can accurately differentiate between sepsis and sepsis-like syndrome.
INTENSIVE CARE MEDICINE
(2023)
Editorial Material
Medicine, General & Internal
Michael Klompas, Chanu Rhee, Mervyn Singer
Summary: This viewpoint discusses the failure of SEP-1 sepsis outcome improvement initiative by Centers for Medicare & Medicaid Services in improving patients' sepsis outcomes, and suggests shifting the focus of sepsis quality metrics from processes to outcomes.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Biology
Vera B. M. Peters, Nishkantha Arulkumaran, Miranda J. Melis, Charlotte Gaupp, Thierry Roger, Manu Shankar-Hari, Mervyn Singer
Summary: Sepsis is a major clinical problem with high incidence and mortality. Current nutrition therapy for sepsis lacks consideration of the changing immunological, bioenergetic, and metabolic status. Butyrate, a fatty acid, has known anti-inflammatory effects and impact on immune function, mitochondrial function, and metabolism. This research explores the immunometabolic effects of butyrate in sepsis using in vitro and animal models.
Review
Medicine, Research & Experimental
Miranda J. Melis, Muska Miller, Vera B. M. Peters, Mervyn Singer
Summary: Sepsis is a life-threatening condition caused by an uncontrolled host response to infection, leading to organ dysfunction. It affects various body systems with fluctuations in gene transcription and downstream pathways. However, the complex nature of sepsis pathophysiology has hindered the development of new therapeutic approaches. This review highlights the impact of altered endocrine system on mitochondrial dysfunction and immune suppression, important aspects of sepsis pathophysiology.
Article
Multidisciplinary Sciences
Nishkantha Arulkumaran, Mervyn Singer, Stefan Howorka, Jonathan R. R. Burns
Summary: In this study, the authors assemble DNA subunits into structural frameworks to support the formation of membrane-based protocells and prototissues, harnessing simplicity to create complexity.
NATURE COMMUNICATIONS
(2023)