• Journal of Applied Biological Chemistry
• /
• 제64권3호
• /
• pp.277-284
• /
• 2021

The emergence and rapid spread of the potentially fatal coronavirus disease 2019, caused due to infection by severe acute respiratory syndrome coronavirus-2, has led to worldwide interest in developing functional bioactive ingredients that act as immunomodulatory agents. In this study, we aimed to characterize Carica papaya extract and explore its potential as an immunomodulator by performing in vitro cell screening. Papaya leaf water extract (PLW) was found to significantly increase the levels of nitric oxide (NO) and prostaglandin E₂ (PGE₂) by upregulating inducible nitric oxide synthase and cyclo-oxygenase-2 activity, respectively. Additionally, PLW increased the production of tumor necrosis factor-α and interleukin 1β in RAW 264.7 cells. Furthermore, PLW activated the expression of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK) but not that of p38 mitogen-activated protein kinase. These results indicate that PLW increased the production of NO, PGE₂, and pro-inflammatory cytokines by activating the JNK and ERK pathways in macrophages, thus demonstrating immunomodulatory properties. Finally, high-performance liquid chromatography fingerprint analysis indicated the presence of rutin, narirutin, and ρ-coumaric acid in PLW (6.30, 119.76, and 47.25 ppm, respectively). Treating cells with these compounds at non-toxic concentrations had no effect on NO production. Taken together, these results suggest that PLW may have potential as an immunity-enhancing supplement.

• Clinical and Experimental Pediatrics
• /
• 제64권5호
• /
• pp.239-246
• /
• 2021

Background: The consequences of severe acute respiratory syndrome corona virus 2 on mother and fetus remain unknown due to a lack of robust evidence from prospective studies. Purpose: This study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission. Methods: This ambispective observational study enrolled pregnant women with COVID-19 in North India from April 1 to August 31, 2020 to evaluate neonatal outcomes and the risk of vertical transmission. Results: A total of 44 neonates born to 41 COVID-19-positive mothers were evaluated. Among them, 28 patients (68.3%) (2 sets of twins) were delivered within 7 days of testing positive for COVID-19, 23 patients (56%) (2 sets of twins) were delivered by cesarean section; 13 newborns (29.5%) had low birth weight; 7 (15.9%) were preterm; and 6 (13.6%) required neonatal intensive care unit admission, reflecting an increased incidence of cesarean delivery and low birth weight but zero neonatal mortality. Samples of cord blood, placental membrane, vaginal fluid, amniotic fluid, peritoneal fluid (in case of cesarean section), and breast milk for COVID-19 reverse transcription-polymerase chain reaction tested negative in 22 prospective delivery cases. Nasopharyngeal swabs of 2 newborns tested positive for COVID-19: one at 24 hours and the other on day 4 of life. In the former case, biological samples were not collected as the mother was asymptomatic and her COVID-19 report was available postdelivery; hence, the source of infection remained inconclusive. In the latter case, all samples tested negative, ruling out the possibility of vertical transmission. All neonates remained asymptomatic on follow-up. Conclusion: COVID-19 does not have direct adverse effects on the fetus per se. The possibility of vertical transmission is almost negligible, although results from larger trials are required to confirm our findings.

• IMMUNE NETWORK
• /
• 제21권1호
• /
• pp.5.1-5.22
• /
• 2021

Coronavirus disease 2019 (COVID-19) has developed as a pandemic, and it created an outrageous effect on the current healthcare and economic system throughout the globe. To date, there is no appropriate therapeutics or vaccines against the disease. The entire human race is eagerly waiting for the development of new therapeutics or vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Efforts are being taken to develop vaccines at a rapid rate for fighting against the ongoing pandemic situation. Amongst the various vaccines under consideration, some are either in the preclinical stage or in the clinical stages of development (phase-I, -II, and -III). Even, phase-III trials are being conducted for some repurposed vaccines like Bacillus Calmette-Guérin, polio vaccine, and measles-mumps-rubella. We have highlighted the ongoing clinical trial landscape of the COVID-19 as well as repurposed vaccines. An insight into the current status of the available antigenic epitopes for SARS-CoV-2 and different types of vaccine platforms of COVID-19 vaccines has been discussed. These vaccines are highlighted throughout the world by different news agencies. Moreover, ongoing clinical trials for repurposed vaccines for COVID-19 and critical factors associated with the development of COVID-19 vaccines have also been described.

• Pediatric Infection and Vaccine
• /
• 제29권3호
• /
• pp.125-130
• /
• 2022

장기화된 코로나19의 유행으로 많은 임산부들이 분만에 임박하여 감염되는 사례들이 많아진 반면, 이런 상황에서 출생하는 신생아들을 처치 및 검사에 대한 국내 권고 사항은 코로나19 유행 초기에 만들어져 진료 현장에서 어려움이 많았다. 다행히 최근에 축적된 자료와 외국의 최신 지침을 반영한 국내 권고 사항이 개정 발표되어 이를 소개하게 되었다. 대표적인 변화로는 코로나19 확진 산모에게 출생한 신생아의 처치 및 검사가 반드시 음압 격리 시설 내에서 이루어질 필요 없이 적절한 보호장구를 착용한 상태에서 신생아실에서 이루어질 수 있도록 하였다. 또한 코로나19 검사도 생후 48-72시간에 1회 시행할 것을 권고하였으며, 모자 동실을 할 경우에는 증상 없는 건강한 신생아라면 검사 없이 경과 관찰할 수 있도록 하였다. 입원이 필요한 경우에는 기존 권고 사항과 같이 생후 24시간, 48시간 째에 각각 두 번 검사를 시행하도록 하였다. 개정된 권고 사항이 코로나19 확진 산모와 신생아의 진료에 유연성을 주면서 감염의 확산을 최소화할 수 있으리라 기대한다.

• Childhood Kidney Diseases
• /
• 제27권1호
• /
• pp.34-39
• /
• 2023

Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.

• 생명과학회지
• /
• 제30권8호
• /
• pp.731-741
• /
• 2020

코로나바이러스감염증-19(COVID-19)는 SARS-CoV-2에 의해 발병된다. 지금까지 인간에게 감염되는 7 가지 종류의 코로나 바이러스가 보고되었다. 그 중, HCoV-229E, HCoV-OC43, HCoV-NL63, 그리고 HCoV-HKU1 등 4종류의 코로나바이러스는 감기와 같은 단순 호흡기 질환을 유발한다고 보고되었다. 반면, SARS-CoV는 2002년에, MERS-CoV는 2012년에 각각 대유행을 일으킨 바 있다. 가장 최근에는 2019년 12월 중국 우한에서 처음 보고된 SARS-CoV-2가 전세계적인 대유행의 원인이 되고 있다. 이러한 SARS-CoV-2를 진단하고, 치료하고, 예방하기 위해서는 신속 정확한 진단키트, 치료제, 그리고 안전한 백신의 개발의 필수적으로 요구된다. 이러한 강력한 도구들을 개발하기 위해서는 SARS-CoV-2의 표현형, 유전자형, 그리고 생활주기 등의 연구가 선행되어야 한다. SARS-CoV-2의 진단기술은 현재 크게 두가지의 큰 분야인 분자진단과 면역혈청학적 진단으로 구분할 수 있다. 분자진단의 경우 SARS-CoV-2의 유전체를 대상으로 하며, 면역혈청학적 진단은 SARS-CoV-2의 항원 단백질 혹은 SARS-CoV-2에 대한 항체를 대상으로 한다. 본 총설에서는 SARS-CoV-2의 표현형, 유전체 구조, 그리고 유전자 발현에 대해서 정리하고, SARS-CoV-2에 대한 다양한 진단 기술 등에 대한 기초지식을 제공하고자 한다.

• Tuberculosis and Respiratory Diseases
• /
• 제86권2호
• /
• pp.142-149
• /
• 2023

Background: Coronavirus disease 2019 (COVID-19) is an ongoing global public health threat and different variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been identified. This study aimed to analyse the factors associated with negative conversion of polymerase chain reaction (PCR) and prognosis in critically ill patients according to the SARS-CoV-2 variant. Methods: This study retrospectively analysed 259 critically ill patients with COVID-19 who were admitted to the intensive care unit of a tertiary medical center between January 2020 and May 2022. The Charlson comorbidity index (CCI) was used to evaluate comorbidity, and a negative PCR test result within 2 weeks was used to define negative PCR conversion. The cases were divided into the following three variant groups, according to the documented variant of SARS-CoV-2 at the time of diagnosis: non-Delta (January 20, 2020-July 6, 2021), Delta (July 7, 2021- January 1, 2022), and Omicron (January 30, 2022-April 24, 2022). Results: The mean age of the 259 patients was 67.1 years and 93 (35.9%) patients were female. Fifty (19.3%) patients were smokers, and 50 (19.3%) patients were vaccinated. The CCI (hazard ratio [HR], 1.555; p<0.001), vaccination (HR, 0.492; p=0.033), and Delta variant (HR, 2.469; p=0.002) were significant factors for in-hospital mortality. The Delta variant (odds ratio, 0.288; p=0.003) was associated with fewer negative PCR conversion; however, vaccination (p=0.163) and remdesivir (p=0.124) treatments did not. Conclusion: The Delta variant of SARS-CoV-2 is associated with lower survival and negative PCR conversion. Contrary to expectations, vaccination and remdesivir may not affect negative PCR conversion in critically ill patients with COVID-19.

• Journal of Chest Surgery
• /
• 제56권1호
• /
• pp.6-13
• /
• 2023

Background: Coronavirus disease 2019 (COVID-19) has been found to cause life-threatening respiratory failure, which can progress to irreversible lung damage. Lung transplantation can be a life-saving treatment in patients with terminal lung disease (e.g., acute respiratory distress syndrome caused by infection). This study aimed to present the clinical course and results after initial lung transplantation in patients with severe COVID-19 who did not recover even with optimal medical care. Methods: From August 2019 to February 2022, this study enrolled 10 patients with COVID-19 (5 men; median age, 55.7 years) who underwent lung transplantation at a single center in Korea. All patients' characteristics, clinical pathway, overall survival, complications, and operative data were collected and analyzed. Results: Veno-venous extracorporeal membrane oxygenation or an oxygenator in a right ventricular assist device circuit was applied to 90% of the patients, and the median length of extracorporeal life support before operation was 48.5 days. There were no cases of mortality after a median follow-up of 372.8 days (interquartile range, 262.25-489 days). The major complications included the requirement for postoperative extracorporeal membrane oxygenation support in 2 cases (20%), re-transplantation in 1 case (10%), and re-exploration due to bleeding in 2 cases (20%). During the follow-up period, 3 out of 10 patients died. Conclusion: Excellent early outcomes were observed for patients who underwent lung transplantation. Thus, lung transplantation can be an effective and feasible treatment for patients with end-stage lung disease caused by COVID-19.

• Pediatric Infection and Vaccine
• /
• 제30권2호
• /
• pp.73-83
• /
• 2023

목적: 본 연구의 목적은 혈액종양 기저질환으로 치료 중 유증상 코로나바이러스감염증-19(COVID-19)으로 확진 된 소아청소년에서 바이러스 부하(viral load)의 변화를 확인하고자 하였다. 방법: 후향적 종단 코호트연구(retrospective longitudinal cohort study)로, 19세 미만 소아청소년 중 악성 빈혈, 혈액암, 또는 고형암으로 치료 중인 상태에서 2022년 3월 1일부터 8월 30일 사이에 SARS-CoV-2 PCR 양성으로 유증상 코로나바이러스감염증-19가 확진 된 환자를 대상으로 하였다. 환자들의 의무 기록과 전화 문진으로 임상 증상과 전파경로, 그리고 증상의 경과에 대한 자료를 얻었고, 서울성모병원에서 시행했던 SARS-CoV-2 PCR titer 값을 분석하였다. 확진 이후 E gene RT-PCR Ct value ≥25을 전파가능성이 낮은 상태로 정의하였다. 결과: 6개월의 연구 기간 동안 총 43명의 환자에서 44번의 COVID-19 확진 사례가 포함되었다. 환자의 평균 연령은 8세(interquartile range, 4.9-10.5)였으며, 가장 흔한 기저 질환은 급성 림프구성 백혈병(n=30, 68.2%)이었고, 다음으로 조혈모세포이식 후(n=8, 18.2%) 상태인 환자들이었다. 대부분 경증 COVID-19 (n=32, 72.7%)에 해당이 되었고, 3명의 환자(7.0%)는 중증/위중증 COVID-19에 해당되어 산소 치료를 받았다. 2.3% (n=1)는 COVID-19 관련 급성 호흡곤란 증후군으로 사망하였다. 확진 이후 E gene RT-PCR Ct값이 ≥25을 도달한 시점이 15-21일인 환자는 총 39.4%(n=13)이었고, 22-28일에 도달한 환자는 30.3% (n=10)이었다. 15.2% (n=5)의 환자에서는 확진 후 28일이 지난 시점에서도 Ct값 <25를 유지하였다. E gene Ct값이 <25 장기간 지속되는 위험인자로 난치성 악성 종양 상태(β, 67.0; 95% CI, 7.0-17.0; P=0.030)가 유의한 관련이 있었다. 한 환자는 확진 후 Ct 값이 <25으로 유지되던 중, 확진 후 86일 째 보호자로 상주하던 어머니에게 바이러스를 전파하였다. 결론: 난치성 악성 종양 상태에서 유증상 COVID-19에 확진 되는 경우 바이러스를 장기간 배출 할 수 있기 때문에, 이런 환자군에서는 PCR 기반 바이러스 전파 예방 조치가 도움이 될 수 있다.

• IMMUNE NETWORK
• /
• 제21권6호
• /
• pp.38.1-38.8
• /
• 2021

Recently, a new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (B.1.1.529) Omicron variant originated from South Africa in the middle of November 2021. SARS-CoV-2 is also called coronavirus disease 2019 (COVID-19) since SARS-CoV-2 is the causative agent of COVID-19. Several studies already suggested that the SARS-CoV-2 Omicron variant would be the fastest transmissible variant compared to the previous 10 SARS-CoV-2 variants of concern, interest, and alert. Few clinical studies reported the high transmissibility of the Omicron variant but there is insufficient time to perform actual experiments to prove it, since the spread is so fast. We analyzed the SARS-CoV-2 Omicron variant, which revealed a very high rate of mutation at amino acid residues that interact with angiostatin-converting enzyme 2. The mutation rate of COVID-19 is faster than what we prepared vaccine program, antibody therapy, lockdown, and quarantine against COVID-19 so far. Thus, it is necessary to find better strategies to overcome the current crisis of COVID-19 pandemic.