30 de mayo de 2022

10 current research articles related

to our system.
Piticchio, T., Le Moli, R., Tumino, D. et al. Relationship between betacoronaviruses and
the endocrine system. A comprehensive review. J Endocrinol Invest 44, 1553–1570
(2021). https://doi.org/10.1007/s40618-020-01486-0

Coronavirus also damages endocrine system said the authors.

People with endocrine disorders may see their condition worsen as a result of
COVID-19, according to the authors. The virus that causes COVID-19--SARS-CoV-2--
binds to the ACE2 receptor, a protein that is expressed in many tissues. This allows the
virus to enter endocrine cells and cause the chaos associated with the disease. It can
cause loss of smell and enter the brain.

In previous coronavirus infections, such as the SARS epidemic in 2003, many patients
developed a post-viral syndrome with fatigue. This could be due in part to adrenal
insufficiency, a condition in which the adrenal glands do not produce enough cortisol, as
a result of damage to the pituitary system. During the SARS epidemic, patients who
developed adrenal insufficiency typically recovered within a year.

According to the authors, COVID-19 could also lead to new cases of diabetes and
worsening of existing diabetes. The SARS-CoV-2 virus binds to ACE2, the main entry
point into cells for the coronavirus, and disrupts insulin production, causing high blood
glucose levels in some patients. The authors highlight the need for tight glucose control
in patients with COVID-19 as a measure to maximize recovery.

"People with vitamin D deficiency may be more susceptible to coronavirus, and

supplementation may improve outcomes, although the evidence on the subject is
conflicting," the authors conclude.

La Perle, K.M.D. (2021). Endocrine System. In Pathology of Genetically Engineered and

Other Mutant Mice (eds J.P. Sundberg, P. Vogel and J.M. Ward). https://doi.org/
10.1002/9781119624608.ch17

The authors tell us that activity of the endocrine system affects each and every cell of
the organism, since it is responsible for maintaining the chemical balance and
controlling the functioning of the different organs, in such a way that it participates, they
give us a example in the regulation of body development and growth, the metabolization
of nutrients, sexual function, mood, sleep, brain activity, etc.

They explain us that all this is done through the production of hormones by a series of
glands located in different parts of the organism and which fulfill different functions of
control and stimulation in the functioning of organs and tissues. However, their functions
are basically threefold:

Homeostasis: stimulates or inhibits the chemical processes that develop in the cells,
maintaining the chemical balance of the organism.

Reproduction: it stimulates the maturation of eggs and the production of sperm, both
essential for human reproduction. In the case of women, it actively participates in
preparing the uterus to initiate gestation, maintain gestation and induce labor, in addition
to making breastfeeding possible.

Body development: it controls and induces the development of the human being from
the moment of conception, as well as the growth and development of the organism until
puberty and physical maturity are reached.

 Bouillon, R. and Quesada-Gomez, J.M. (2021), Vitamin D Endocrine System and

COVID-19. JBMR Plus, 5: e10576. https://doi.org/10.1002/jbm4.10576

The endocrine system is heavily involved in SARS-CoV-2 infection, so much so that

evidence of an 'endocrine phenotype' of Covid-19 has emerged, according to a
statement from the European Society of Endocrinology (ESE) published in the journal
Endocrine in April 2021.

Endocrine's leading researchers reviewed evidence that has accumulated over the past
year since the pandemic emerged and found evidence of links between a variety of
endocrine conditions. This statement is an update to a March 2020 statement that was
among the first and most widely read statements outlining the involvement of the
endocrine system in Covid-19.

The author tells us that the evidence is clear. The effect on hormones cannot be ignored
in the context of Covid-19 and that is why he decided to write his article.

He also says that we should be aware of the endocrine consequences of Covid-19 for
patients with a known endocrine condition such as diabetes, obesity or adrenal
insufficiency, but also for people without a known condition. Vitamin D insufficiency, for
example, is very common, and the knowledge that this condition has arisen frequently in
the hospitalized Covid-19 population and can adversely affect outcomes should not be
taken lightly.

the authors analyzed the available evidence regarding Covid-19 in a number of

endocrine conditions and related factors: diabetes, obesity, nutrition, hypocalcemia,
vitamin D insufficiency, vertebral fractures, adrenal insufficiency, as well as pituitary/
thyroid and sex hormone problems.

 The researchers identified vitamin D, calcium and bone as other areas that show a
growing body of evidence that better controls and solutions are needed for patients in
the context of coronavirus.

Daines, Lukea; Zheng, Banga; Pfeffer, Paulb; Hurst, John R.c; Sheikh, Aziza A clinical
review of long-COVID with a focus on the respiratory system, Current Opinion in
Pulmonary Medicine: May 2022 - Volume 28 - Issue 3 - p 174-179 doi: 10.1097/
MCP.0000000000000863

The author's purpose is to provide more information about the health effects of
COVID-19 as well as the needs it generates in medical devices.

He first discusses respiration and how it is compromised.

The main functions of the respiratory system, the author reminds us, are to provide
oxygen to the tissues and to remove carbon dioxide. These functions can be separated
into four components:

Pulmonary ventilation

Diffusion of gases between alveoli and blood.

Transport of oxygen and carbon dioxide

Regulation of ventilation

Respiratory processes are essential for life and depend largely on the small alveolar
sacs (200 micrometers in diameter). Disruption of this system can lead to death if not
properly treated.

Although about 80% of those infected with COVID-19 are asymptomatic or have minor
complications, the remaining percentage may suffer from fatal pneumonia.

Having reached the lungs, SARS-CoV2 causes the secretion of mucus, fluids and cells
to fight it. This accumulation of matter in the alveoli makes breathing difficult, especially
in vulnerable groups such as smokers, infants or older adults.

This damage to the alveolar tissue is called pneumonia. When the damage has been
considerable, and the alveoli are damaged, the lack of surfactant and fluid pressure
causes the definitive collapse of the sacs leading to death

David N Louis, Arie Perry, Pieter Wesseling, Daniel J Brat, Ian A Cree, Dominique
Figarella-Branger, Cynthia Hawkins, HK Ng, Stefan M Pfister, Guido Reifenberger,
Riccardo Soffietti, Andreas von Deimling, David W Ellison, La OMS de 2021
Clasificación de los tumores del sistema nervioso central: resumen, Neurooncología ,
volumen 23, número 8, agosto de 2021, páginas 1231–1251, https://doi.org/10.1093/
neuonc/noab106

Tumors of the central nervous system represent the seventh most frequent neoplasm in
the adult population. The most widely accepted and used classification is that of the
WHO, currently in its fourth edition. It classifies tumors according to their histological
(phenotypic) characteristics and, as a novel aspect in the latest edition, includes the
molecular (genotypic) characteristics of several tumors. This has implications
particularly for prognosis, as it has been shown that in some tumors it is better
correlated with molecular markers than with histologic grade.

The technique of choice for characterization of nervous system tumors is MRI, including
pT1 sequences without and with contrast, pT2 and FLAIR, diffusion, gradient echo and
magnetic susceptibility sequences, as well as others specific to particular regions such
as the cerebellar pontine angle or the selar region.

Diffuse infiltrative gliomas are a diverse and heterogeneous group that includes tumors
of glial lineage. These may be circumscribed with a tendency to benignity or diffusely
infiltrating with a tendency to malignancy.

 The author then goes on to cite all the tumors that fall into the classification he
proposes.

Ye, L., Yang, Z., Liu, J., Liao, L., and Wang, F. (2021) Digestive system manifestations
and clinical significance of coronavirus disease 2019: A systematic literature
review. Journal of Gastroenterology and Hepatology, 36: 1414– 1422. https://doi.org/
10.1111/jgh.15323.

The article discusses SARS-CoV-2, which is the seventh coronavirus identified as

capable of human infection. In 2019, it emerged as a new beta-coronavirus. It is a
single-stranded RNA virus whose intermediate transmitter has not yet been identified, is
highly contagious and stable in the environment, and is transmitted predominantly
between humans. Its genetic characteristics show that 89% of its nuclear sequence is
similar to Bat SARS-CoVZXC21 and 82% to SARS-CoV4. It can affect people of all
ages with a high infectivity rate, knowing that children may be less susceptible.

14% of the adult population have severe manifestations and 5% have critical
manifestations (respiratory failure, septic shock, multiple organ failure), with a mortality
rate of 2.3%7. In another cohort of patients, 6% of children developed severe disease
compared to 18.5% of adults.

The author talks about how although SARS-CoV-2 is primarily a respiratory pathogen, it
also affects the gastrointestinal tract. Approximately 10% of children with infection
develop diarrhea and vomiting. There are reports of isolated diarrhea preceding cough
and fever. Prolonged SARS-CoV-2 positivity in stool increases the likelihood of fecal-
oral transmission. Asymptomatic individuals, especially children, may behave as
transmitters of the disease given the lower index of suspicion and therefore lower
chance of detection. On the other hand, patients with severe SARS-CoV-2 disease have
elevated transaminases in up to 40-60% compared to those who are asymptomatic or

 those with mild disease where they are elevated in up to 18-25% of cases. In addition,
some cases of hepatic dysfunction have been described.

The aim of this publication was to alert about the gastrointestinal and hepatic
manifestations that have been described in COVID-19 (+) patients in order to increase
the index of suspicion, to make a timely diagnosis and to recognize possible
complications of the disease.

He, Y., Wang, J., Ren, J., Zhao, Y., Chen, J., & Chen, X. (2021). Effect of COVID-19 on
male reproductive system–a systematic review. Frontiers in endocrinology, 12, 677701.

The authors analyzed autopsy tissues from the testes of six men who died of the
infection.

The result: covid-19 virus appeared in the tissues of one of the men; in three there was
a decrease in the number of spermatozoa.

Another patient, who survived the covid-19 infection, underwent a testicular biopsy
about three months after his initial covid-19 infection disappeared. The biopsy showed
that the coronavirus was still in his testicles.

The team also discovered that covid-19 affects the penis. An analysis of penile tissue
from two men who received penile implants showed that the virus was present seven to
nine months after their covid-19 diagnosis. Both men had developed severe erectile
dysfunction, probably because the infection had reduced the blood supply to the penis.

Notably, one of the men had only mild symptoms of covid-19. The other had been
hospitalized. This suggests that even people with a relatively mild case of the virus can
experience severe erectile dysfunction after recovery.

These results are not entirely surprising. After all, the scientists explain that they have
seen how other viruses invade the testes and affect sperm production and fertility.

Martin-Almedina, S., Mortimer, P. S., & Ostergaard, P. (2021). Development and

physiological functions of the lymphatic system: insights from human genetic studies of
primary lymphedema. Physiological reviews, 101(4), 1809-1871.

What is the lymphatic system?

The lymphatic system is the second most important transport system in the body after
the blood circulatory system.

It owes its name to the fact that a fluid called lymph circulates through this pathway. This
fluid travels within the body in a unidirectional manner, from the feet to the neck, through
lymphatic ducts and vessels. This true transport network is located in the body at a very
superficial level, below the skin.

On its way, the lymph also passes through lymph nodes and organs, such as the
spleen, tonsils and thymus. Its contents finally flow into the circulatory system, through
which the waste is eliminated.

The human being can have about 15 liters of lymph.

Where are the lymph nodes?

Lymph nodes are oval structures, usually grouped in clusters near veins and lymphatic
vessels, such as neck, armpit, groin, abdomen, thorax, knee, elbow. Lymph nodes
produce and store lymphocytes. For this reason, when a person is confronted with an
infection the lymphocytes increase and the lymph nodes become enlarged or inflamed.

There are cervical, axillary and inguinal lymph nodes.

What is the function of the lymphatic system?

 The lymphatic system is in charge of collecting the elements that are transformed into
waste from the organism. Lymph is a means of transport for the elimination of various
elements, the most important of which are: toxins, waste, dead blood cells, pathogenic
organisms and other products collected in the interstitial spaces of the organism or
extracellular matrix (tissue surrounding the cells).

In addition, the lymphatic system has an important immune function, since the lymph is
made up of white blood cells, especially lymphocytes, acting as a barrier against
infections.

REN, Alexander Liang; DIGBY, R. J.; NEEDHAM, E. J. Neurological update:

COVID-19. Journal of neurology, 2021, vol. 268, no 11, p. 4379-4387

The author talks about how covid affects the nervous system and begins to give us a
synthesis of what covid is and how its contagion and effects work.

n terms of psychiatric symptoms, these included anxiety, mood disorders, psychosis and
insomnia. On the other hand, 28 studies reported seizures in 346 patients with
COVID-19. However, although these seizures may occur due to hypoxia, metabolic
disturbances or organ failure, coronavirus infection does not directly generate a risk of
seizures during acute illness.

Another striking finding of this research is that COVID-19 infection in children and
adolescents may modify long-term cognitive abilities and increase the risk of psychiatric
disorders.

In conclusion, the study points out that, although there are few publications on the
therapeutic approach to central and peripheral nervous system involvement in patients
with COVID-19, there seems to be consensus on the importance of early recognition
and timely treatment of these patients. However, future randomized clinical trials should
evaluate the effectiveness of treatments for neurological conditions, and prospective

cohort studies are needed to analyze the mid- and long-term complications of nervous
system involvement in COVID-19.

Given the impact of neurological involvement with a high probability of functional

sequelae, Dr. Ghotme emphasizes the importance of preventing SARS-CoV-2 infection
through vaccination and maintenance of protective measures, such as the use of masks
and hand washing.

Prateek Kumar Panda, MD, DM, Indar Kumar Sharawat, MD, DM, Pragnya Panda, MD,
Vivekanand Natarajan, MBBS, Rahul Bhakat, MD, Lesa Dawman, MD, Complicaciones
neurológicas de la infección por SARS-CoV-2 en niños: una sistemática Revisión y
metaanálisis, Journal of Tropical Pediatrics , volumen 67, número 3, junio de 2021,
fmaa070, https://doi.org/10.1093/tropej/fmaa070

This article discusses the neurologic and psychiatric complications of Severe Acute
Respiratory Syndrome (SARS)-CoV-2 coronavirus 2 infection and how they have been
well described in adult populations with coronavirus disease 2019 (COVID-19). But in
children and adolescents younger than 18 years, some case series reported neurologic
complications associated with paediatric inflammatory multisystem syndrome temporally
associated with SARS-CoV-2 (PIMS-TS), also known as multisystem inflammatory
syndrome in children (MIS-C), a rare entity that classically appears weeks after SARS-
CoV-2 infection. A previous single-institution study in the United Kingdom reported 9
children with neurological complications of PIMS-TS, and an international series
reported imaging findings in 38 children with SARS-CoV-2 infection. It also mentions
how a study of 1695 children and young adults (under 21 years of age) in the United
States reported transient neurological manifestations in 365 patients and life-threatening
neurological disorders in 43 patients. However, according to the author, the actual
prevalence of these complications is not yet known. The aim of the present study was to

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analyze the frequency of neurological complications of SARS-CoV-2 infection in

hospitalized children and adolescents.

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