Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Sep 2020
ReviewDysregulation of the immune system as a driver of the critical course of the novel coronavirus disease 2019.
Novel coronavirus disease 2019 (COVID‑19) is a highly contagious, respiratory disease caused by the newly emerged severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). Given that inflammatory immune cells may induce severe lung injury, the involvement of immunological factors in the pathogenesis of the disease cannot be overestimated. It has been demonstrated that coronaviruses have developed mechanisms of immune evasion, making themselves invisible to the immune system at an early stage of infection. ⋯ The occurrence of virus transmission even in asymptomatic individuals infected with SARS‑CoV‑2 clearly strengthens the evidence for the key role played by the sufficient immune control of viral replication in a subset of cases (eg, in children, a population with a highly effective innate immune response). Although administration of immunomodulatory drugs is recommended under certain conditions by the guidelines for COVID‑19 management, controversies regarding treatment protocols in immunocompromised patients infected with SARS‑CoV‑2 still exist. Extending clinicians' knowledge on the dysregulated immune response, which is a driver of the COVID‑19 outcome, may improve both therapeutic strategies and the prognosis of patients infected with SARS‑CoV‑2.
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Pol. Arch. Med. Wewn. · Sep 2020
Observational StudyUsefulness of GDF-15 concentrations in plasma in prognosing serious adverse events and bleeding in acute pulmonary embolism: a prospective observational study.
Growth differentiation factor 15 (GDF‑15), a cytokine induced in the myocardium by pressure overload and ischemia, has a well‑established prognostic role for diseases of the left ventricle. Plasma GDF‑15 concentrations were shown to predict bleeding events in patients with atrial fibrillation on anticoagulation. ⋯ Plasma GDF‑15 concentrations may be a promising biomarker for predicting hemodynamic destabilization and bleeding complications in PE.