Understanding the Pandemic

Pathophysiology, Transmission, and Treatment of COVID-19

1st Edition - November 7, 2024
Editors: Shampa Chatterjee, Amaro Nunes Duarte Neto, Marco Cascella, Sonia Villapol, Anand Viswanathan, Aravind Ganesh, Ching Lung Lai, Giuseppe Remuzzi
Language: English
Paperback ISBN:
9 7 8 - 0 - 4 4 3 - 1 9 1 7 0 - 1
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 2 9 0 0 4 - 6

Understanding the Pandemic: Pathophysiology, Transmission, and Treatment of COVID-19 aims to cover all aspects of COVID-19 infection from the virus, transmission, pathogene… Read more

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Understanding the Pandemic: Pathophysiology, Transmission, and Treatment of COVID-19 aims to cover all aspects of COVID-19 infection from the virus, transmission, pathogenesis, immune-inflammation response, systemic injury, organ damage, associated factors, and comorbidities that drive mortality. Organized into ten sections, the book aims to provide a comprehensive examination of the impact of COVID-19. The book begins a review of coronaviruses, their structure and mechanism of action. The book goes on to discuss the immune response to the virus and its effect on various organs. It examines clinical cases based on an observations and postmortem studies.

Other topics include the long-term effects of COVD-19, vaccines, and public health response.

Understanding the Pandemic
Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Introduction to editors
Preface
Section 1: Coronaviruses (SARS-CoV-1, SARS-CoV-2, and MERS-CoV), structure (sequence), and mechanism of action
Introduction
Chapter 1 Origin, evolution, and spread of SARS-CoV-2
Abstract
Keywords
Introduction
Structure and genomic features of SARS-CoV-2
Structure
Genomic features
Genomic variability
SARS-CoV-2 variants in the world
Transmission and spread of SARS-CoV-2
Phylodynamic aspects of SARS-CoV-2
Phylogeography: Profile of dissemination of SARS-CoV-2 in the world
Immunological aspects of SARS-CoV-2 infection
Innate immune response
Adaptive immune response
Antibody response
Immunopathology
Vaccination
Conclusion
Take-home message
References
Chapter 2 SARS-CoV-2 spike protein in infectivity
Abstract
Keywords
Introduction
S protein structure and pathogenicity
S protein subunits’ structure and organization
S protein binding to ACE-2 receptor
S protein conformational switch
S protein cleavage
The role of S protein in SARS-CoV-2 entry and transmission
The effect of SARS-CoV-2 S protein on the immune system
Immune response to SARS-CoV-2 S protein
The role of S protein in immune escape
S protein mutations and evolved SARS-CoV-2 variants
Effect of SARS-CoV-2 S protein mutation on conformational change
Effect of SARS-CoV-2 S protein mutation on viral entry and transmission
Effect of SARS-CoV-2 S protein mutation in immune evasion
S protein as a diagnostic marker for SARS-CoV-2 infection
Nucleic acid amplification testing (NAATs) of S protein
Antigen–antibody detection
Therapeutics and vaccine development against SARS-CoV-2 S protein
SARS-CoV-2 S protein-based vaccines
Messenger RNA (mRNA) vaccines
DNA vaccines (DNAVs)
Adenovirus-based vaccine
Protein subunit-based vaccine
SARS-CoV-2 S protein-based therapies
Antiviral natural products
Small molecule inhibitors
Antiviral peptides
Antiviral lectins
Antiviral recombinant proteins
Monoclonal neutralizing antibodies
Concluding remarks and future prospective
Take-home message
References
Chapter 3 Structural and functional properties of the SARS-CoV-2 spike protein: Potential vaccine and drug development for COVID-19
Abstract
Keywords
Acknowledgments
Structure of the SARS-CoV-2 spike protein
General structure
Functional properties of the SARS-CoV-2 spike protein
Attachment and entry
Immune response
Structural and functional consequences of mutations in variants of concern
Receptor-binding domain mutations
N-terminal domain mutations
Furin cleavage site mutations
Intermolecular interaction mutations
Aggregation
Syncytia
Coagulation
Vaccine and drug development targeting the spike protein
Mechanisms and efficacy of available vaccines
Future directions for vaccine development
Mechanisms and efficacy of available drugs targeting the spike protein
Future directions for drugs targeting the spike protein
Take-home message
References
Chapter 4 Population-specific polymorphisms and SARS-CoV-2 infectivity
Abstract
Keywords
Introduction
ACE2 and its variants
Single nucleotide polymorphisms in ACE2 and its association with SARS-CoV-2 infection and severity of COVID-19
Gender differences in SARS-CoV-2 infection
Age disparity in COVID-19 infection
Racial and ethnicity differences in COVID-19 infections
Targeting ACE2 and SARS-CoV-2 RBD in COVID-19 treatment
Conclusion
Take-home message
References
Chapter 5 Insights into SARS-CoV-2 structure: Approaches and action of SARS-CoV-2 main protease inhibitor
Abstract
Keywords
Declaration of competing interest
Data availability statement
Introduction
The structure SARS-CoV-2
The structural proteins
The nonstructural proteins
Structure of Mpro
Functions of the main protease
The main protease as a drug target
Therapeutic strategies to target Mpro
Repurposed drugs and designed drug-like compounds
Natural product-based compounds
In silico strategies to target SARS-CoV-2 Mpro
Drugs in a clinical trial
PF-07321332 (Paxlovid)
S-217622
PF-07304814
FB2001/11a (DC402234)
EDP-235
SIM0417 (SSD8432)
PBI-0451
ALG-097111
MPI8
EDDC-2214
Conclusion and future perspectives
Take-home message
References
Chapter 6 SARS-CoV-1, SARS-CoV-2, and MERS-CoV: Similarities and differences in origin and transmission
Abstract
Keywords
Introduction
Animal hosts of coronaviruses
Structure and properties
Viral structure and origins
Structure of the spike protein
Spike protein and cellular entry: A comparison between SARS, MERS, and COVID-19
Binding to host cells
Transmission
Demographic characteristics of SARS, MERS, and COVID-19
Infection and immune response
Clinical manifestations of SARS, MERS, and COVID-19
Conclusion
Take-home message
References
Section 2: Inflammation and immune response to SARS-CoV-2
Introduction
Chapter 7 Characterization of the immune response with viral attack
Abstract
Keywords
Introduction
Response of the immune system to a viral infection
Innate immune response
Adaptive immune response
Immunopathology and regulation
Evasion strategies employed by viruses
Molecular mechanism of immune cells during viral infection
Onset of immune signaling
The roles of PRRs and their functional significance
Characteristics of the immune response during viral invasion: The case of coronaviruses
SARS-CoV, MERS-CoV, and SARS-CoV-2
Key aspects of immune response progression and aberrations in COVID-19
Potential triggers of the autoimmune and antiinflammatory response in COVID-19
Conclusion
Take-home message
References
Chapter 8 Inflammation, cytokines, and COVID-19 severity
Abstract
Keywords
Introduction to COVID-19 and its severity
Perspective of cytokine storm in COVID-19
Death rate of COVID-19 due to cytokine storm
Cytokine storm
The cytokines associated with COVID-19
Interleukin 1β
Interleukin-6
Tumor necrosis factor-α
Interferon-gamma
GM-CSF and VEGF
Molecular relations of cytokines with inflammation
IL-6 signaling
Classic signaling and the trans signaling
IL-6/JAK/STAT cascade
IFN-γ-related signaling pathway
GM-CSF and IL-17/IL-23 axis
Toll-like receptor signaling pathway
Inflammatory markers associated with COVID-19 prognosis
Neutrophil to lymphocyte ratio
Platelet to lymphocyte ratio
Lymphocyte-to-monocyte ratio
Lymphocyte to C-reactive protein ratio
C-reactive protein to albumin ratio (CAR) and C-reactive protein to prealbumin ratio (CPAR)
Glasgow prognostic score, modified GPS, and high-sensitivity mGPS
Prognostic index
Prognostic nutritional index
Systemic immune-inflammation index
Interferon-α-inducible protein 27
Clinical manifestation of cytokine storm in COVID-19 patient
Treatment options for management of CS in COVID-19
Therapeutic interventions involving different cytokines
Antibodies against TNF-α and IFN-γ
Blocking the IL-1 family
Anti-IL-6 receptor antagonists
JAK-STAT inhibitors and other therapies
Interventions involving GM-CSF
Conclusions
Take-home message
References
Chapter 9 Immunological considerations for COVID-19: Vaccines and other protective strategies
Abstract
Keywords
Introduction
Vaccination-elicited immune response
Whole-virus vaccines
Viral vector vaccines
Protein-based vaccines
Nucleic acid vaccines
Mucosal vaccines
Immunomodulation
Bacterial mucosal immunotherapy MV130
Immunomodulatory drugs
Pre- and postexposure prophylaxis
MABs (only PrEP)
Postexposure prophylaxis
Antiviral therapy
Genetic testing-based protection
Role of the MSC's in the COVID-19 pandemic
Pregnancy and COVID-19 immunological response
Translation of the COVID-19 immunological findings into protective strategies
What has been tried thus far?
Future considerations
Take-home message
References
Chapter 10 Virus-specific T cell response in SARS-CoV-2 infection and vaccinations
Abstract
Keywords
Introduction
T cells in antiviral immunity
Virus-specific T cells after SARS-CoV-2 infection
Virus-specific T cells after vaccination
T cells location at the site of SARS-CoV-2 infection
T cells and pathology
Strategies employed by SARS-CoV-2 to escape T cell recognition
Concluding remarks
Take-home message
References
Chapter 11 Inflammation and the oral and gut microbiota with COVID-19
Abstract
Keywords
Introduction
SARS-CoV-2 infection and inflammation in general
The oral cavity and SARS-CoV-2 replication
Bidirectional relationship between SARS-COV-2 and oral disease
SARS-CoV2, microbiome and oral-gut-brain-lung axis
Effects of altered microbiota on COVID-19 outcomes
Impact of medication on oral health and COVID-19
The decreased rate of dental care
Long COVID on oral health
Conclusion
Take-home message
References
Chapter 12 Implications of inflammation: Bone and joint health with COVID-19
Abstract
Keywords
Introduction
The musculoskeletal system
Inflammation, COVID-19, and the MSK
Impact of coronaviruses (SARS-COV and MERS-COV) on bone and muscle
Impact of SARS-CoV-2 on bone and muscle
Clinical findings
COVID-19 and osteoporosis
Steroidal therapies and bone health
Animal model of SARS-COV-2
Long COVID-19
Conclusion
Take-home message
References
Chapter 13 COVID-19 and immune dysfunction: Consequences and natural remedies for management
Abstract
Keywords
Introduction
Long COVID pathophysiology
Natural remedies in the management of post-COVID complications
Phytochemical mechanisms to prevent and fight long COVID-19
Conclusion
Take-home message
References
Section 3: Pathological findings with clinical correlation
Introduction
Chapter 14 Postmortem examination of COVID-19 lungs
Abstract
Keywords
Introduction
The SARS-CoV-2 virus
Clinical features
Pathological patterns of COVID-19 pneumonia
Diffuse alveolar damage—Exudative phase
Diffuse alveolar damage—Intermediary phase
Diffuse alveolar damage—Fibroproliferative phase
Immunothrombosis and endothelial dysfunction in severe COVID-19
Long COVID-19 and pulmonary pathology
Pathology of pulmonary explants
Secondary pneumonia in COVID-19
COVID-19 diagnosis and in situ diagnosis in lung tissue
Differential diagnosis on anatomical pathology
Perspectives
Take-home message
References
Chapter 15 Histopathological analysis of the cardiovascular system in severe COVID-19
Abstract
Keywords
Introduction
Pathophysiology
Clinical characteristics
Pathology
Conclusions and future perspectives
Take-home message
References
Chapter 16 Postmortem neuropathology in COVID-19
Abstract
Keywords
Introduction
Pathology of neuro-COVID-19
Perspectives
Take-home message
References
Chapter 17 Renal pathology in severe COVID-19
Abstract
Keywords
Introduction
Clinical features and initial evaluation
Pathology of COVID-19-associated renal dysfunction
Ancillary methods in anatomical pathology
Electron microscopy
Perspectives
Take-home message
References
Section 4: The blood vessels and COVID-19: Vascular dysfunction and coagulopathies
Introduction
Chapter 18 Vascular manifestations of COVID-19: Endothelial dysfunction and damage
Abstract
Keywords
Introduction
Evidence of endothelial damage and endothelial dysfunction in COVID-19
Endothelial dysfunction biomarkers in COVID-19
Inflammatory and cell adhesion biomarkers
Coagulation biomarkers
Biomarkers of endothelial damage and angiogenesis
Biomarkers of oxidative stress
Decreased NO bioavailability
Noninvasive assessment of endothelial dysfunction
Management of endothelial dysfunction in COVID-19
Vascular dysfunction management approaches
COVID-19-associated vascular dysfunction management
Conclusion
Take-home message
References
Chapter 19 Immunothrombotic involvement in COVID-19
Abstract
Keywords
Acknowledgment
Introduction
Immunothrombosis in severe COVID-19 infection
COVID-19-associated coagulopathy (CAC)
COVID-19-associated endotheliopathy
COVID-19-associated hyperinflammation: the cytokine storm
Immunothrombosis as a new therapeutic target
Immunothrombosis in long COVID
Endothelial damage and dysfunction
Persistent inflammation
Coagulation abnormalities
Microvascular thrombosis as a potential mechanism in long COVID
Treatment strategies
Immunothrombosis in vaccine-induced thrombotic thrombocytopenia (VITT)
Thrombotic manifestations in VITT
Mechanisms of immunothrombosis in VITT
Treatment strategies in VITT
Take-home message
Conflict of interest
References
Chapter 20 COVID-19 associated coagulopathy
Abstract
Keywords
Introduction
Risk factors, pathogenesis, and pathology
Immunothrombosis
Classical risk factors
Additional mechanisms
Clinical features
Pulmonary artery thrombosis and venous thromboembolic disease
Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS)
Acute coronary syndromes and intracardiac thrombosis
Acute ischemic and cryptogenic strokes
Renal thrombosis
Intraabdominal thrombosis
Peripheral arterial thrombotic events
Laboratory diagnostic markers
Treatment peculiarities of CAC
Conclusions
Take-home message
References
Chapter 21 D-dimer in systemic circulation and COVID-19 outcome
Abstract
Keywords
Introduction to coagulation
Hemostasis
Primary hemostasis
Secondary hemostasis
D-dimer
D-dimer testing and use in clinical practice
Issues with D-dimer testing
Thrombosis vs embolism, DVT, VTE, PE
Literature of correlation between D-dimer and COVID-19
D-dimer and COVID-19 vaccination
Disseminated intravascular coagulation and COVID-19
What is disseminated intravascular coagulation?
Is there a relationship between disseminated intravascular coagulation and COVID-19?
Therapeutic options under investigation
Conclusion
Take-home message
References
Chapter 22 Hypercoagulability in COVID-19
Abstract
Keywords
Coagulation cascade
What is hypercoagulability
Hypercoagulability mechanisms in COVID-19
Direct cellular injury
Cytokines
Neutrophil extracellular traps
Complement pathway
Hypoxia
Microvascular microthrombi and platelet activation
Fibrinolysis shutdown and plasminogen activator system
Complications from hypercoagulability in COVID-19 patients
Diagnosing hypercoagulability in COVID-19
TEG and ROTEM
aPTT
Prothrombin time
Fibrinogen
Platelet count
Possible treatments
Caution against antithrombotic therapies
Freedom COVID-19 anticoagulation trial
Hypercoagulability in long COVID
Inflammation
Formation of fibrinaloid microclots
Hypoxia and persistent inflammation
Endothelial dysfunction
Future considerations
Conclusions
Take-home message
References
Section 5: Neuro-COVID and its long term implications
Introduction
Chapter 23 COVID and nervous system: Mechanisms and consequences
Abstract
Keywords
Introduction
Fundamentals of SARS-COV-2 pathogenesis
Mechanisms of damage to the nervous system
Neuroinvasiveness and neurovirulence
SARS-CoV-2-induced immune dysregulation
Neurodegeneration and hippocampal involvement
Clinical manifestations of Neuro-COVID
Acute manifestations
Chronic manifestations
Conclusions
Take-home message
References
Chapter 24 Neuroinflammation: Unraveling acute and Long COVID symptoms
Abstract
Keywords
Acknowledgment
Introduction
COVID-19: A disease with inflammatory characteristics
Acute neuroinflammatory responses in COVID-19
Pathways of SARS-CoV-2 entry to the brain
Clinical manifestations of acute neuroinflammation
Long-term neuroinflammatory effects: The concept of Neuro-Long COVID or neuro-PASC
Neurocognitive and neuropsychiatric sequelae
Neuro-PASC across adult and pediatric populations
Diagnostic approaches and biomarkers
Therapeutic approaches targeting neuroinflammation in acute and Long COVID
Conclusions
Take-home message
References
Chapter 25 Acute and postacute neurologic and psychiatric manifestations in COVID-19
Abstract
Keywords
Introduction
The long and the short of it
Cerebrovascular
Acute cerebrovascular symptoms
Postacute cerebrovascular symptoms
Encephalopathic and neuropsychiatric outcomes
Acute encephalopathic and neuropsychiatric outcomes
Postacute encephalopathic and neuropsychiatric outcomes
Headaches and dizziness
Acute headache and dizziness symptoms
Postacute headache and dizziness symptoms
Anosmia and dysgeusia
Acute anosmia and dysgeusia symptoms
Postacute anosmia and dysgeusia symptoms
Other CNS-related symptoms of COVID-19
Seizures
Movement disorders
Additional psychiatric manifestations
Unanswered questions and future directions
Take-home message
References
Chapter 26 Pediatric neurological and neuropsychiatric manifestations of COVID-19
Abstract
Keywords
Neuroimaging
Pathophysiology
Children are adult differences
Outcomes
Take-home message
References
Chapter 27 COVID-19 and the peripheral nervous system
Abstract
Keywords
Introduction
Anterior horn cell disorders
Peripheral nerve disorders
Autonomic and small fiber nervous system disorders
Neuromuscular junction disorders
Muscle disorders
Peripheral nervous system complications associated with hospitalization for COVID-19
Special considerations for immune modulating therapies and COVID-19
Peripheral nervous system complications of SARS-CoV-2 vaccination
SARS-CoV-2 variants and the peripheral nervous system
Conclusions
Take-home message
References
Section 6: Should COVID-19 concern nephrologists? Why and to what extent?
Introduction
Chapter 28 Acute kidney injury with COVID-19: Mechanisms, management, and long-term outcomes
Abstract
Keywords
Introduction
Epidemiology
Pathophysiology of COVID-19-associated AKI
Direct viral effects
Indirect effects
Management of AKI in COVID-19
Initial assessment and diagnosis of AKI
Biomarkers of acute kidney injury
Treatment of COVID-19-associated AKI
Kidney function recovery and long-term outcomes
Conclusions
Take-home message
References
Chapter 29 Models and cellular monolayers to study the effect of SARS-CoV-2 on kidney
Abstract
Keywords
Introduction
Techniques for studying SARS-CoV-2 induced kidney injury in cell culture models
Cell monolayer studies and COVID-19
Organoids and COVID-19
Conclusions
Take-home message
References
Chapter 30 Clinical implications of COVID-19 in chronic kidney disease and end-stage kidney disease
Abstract
Keywords
Introduction
Chronic kidney disease: Epidemiology
Outcomes from COVID-19 in CKD
Clinical presentation and clinical course
COVID-19 infective responses in CKD
Managing risk in patient with CKD; safety on the dialysis unit, transplant program
Vaccination
Treatment of COVID-19
Current and future concerns related to COVID-19 effects on kidney disease
Other impacts of the pandemic
Take-home message
References
Section 7: Long COVID
Introduction
Chapter 31 Long COVID or postacute sequelae of COVID-19: An introduction
Abstract
Keywords
Conflict of interest
History
Names and definitions
Epidemiology
Clinical perspective
Long COVID in children
Clinical guides: Diagnosis and treatment
Long COVID biomarkers
Conclusion
Take-home message
References
Chapter 32 Long COVID: Pathophysiological and immunological dynamics
Abstract
Keywords
Pathophysiology of long COVID
Immune dysregulation
Chronic inflammation
Autoimmunity
Viral persistence and reactivation of latent viruses
Endothelial damage and microclot formation
Tissue damage
Microbiota dysbiosis
Mitochondrial dysfunction
Dysregulation of the renin-angiotensin system
Subclinical diseases and other comorbidities
Symptom-based classification of long COVID
Conclusion
Take-home message
References
Chapter 33 Gender differences in sequelae from COVID-19 infection
Abstract
Keywords
Introduction
Gender-specific variability in PASC susceptibility in epidemiological investigations
Gender-dependent immunological markers in COVID
Microbiome and gender disparities in PASC
Autoimmunity and PASC
Gender-specific vascular features in the cardiovascular system
The impact of endocrine and hormonal systems on PASC symptoms
Genetics and susceptibility to PASC
Gender disparities in mental health post-COVID-19
Therapeutic strategies for addressing PASC
Take-home message
References
Chapter 34 Understanding Long COVID: Clinical insights and lessons
Abstract
Keywords
Characterizing Long COVID-19: Lessons in the clinic
Prevalence
The overall prevalence of most common symptoms
Prognostic ability of symptom development
Associated disability
Clinical application scales
COVID-19 Yorkshire Rehabilitation Scale (C19-YRS)
The post-COVID-19 functional status (PCFS) scale
Quality-of-life scales
SF-36 questionnaire
Euro Qol-5D questionnaire
Questionnaire QLQ-C30
Pain scales
Spanish chronic pain grading scale
McGill pain questionnaire
Brief pain inventory
Dyspnea scales
Modified medical research council (mMRC) scale
New York Heart Association (NYHA) scale
Borg scale
Fatigue scales
Modified fatigue impact scale (MFIS)
Physical exercise scales
International physical activity questionnaire (IPAQ) scale
Global physical activity questionnaire (GPAQ)
Scales of sleep disorders
Oviedo sleep questionnaire (OSQ)
Pittsburgh sleep quality index (PSQI)
Insomnia severity index (ISI)
Rating scales for emotional disorders
Mood rating scale (MRS)
Hospital anxiety and depression (HAD) scale
Goldberg anxiety and depression scale (GADS)
Cognitive impairment assessment scales
Montreal cognitive assessment (MoCA) scale
Trail making test (TMT) scale
Modification of the memory failure in everyday life questionnaire (MEF-30)
Take-home message
References
Chapter 35 Implications of Long COVID on the global healthcare system
Abstract
Keywords
Introduction
Epidemiology of Long COVID
Global prevalence of Long COVID
Overview of persistent symptoms of Long COVID
Risk factors associated with developing post-COVID sequelae
Impact on daily life and healthcare utilization for Long COVID
Impact of Long COVID on the economy and its implications on healthcare systems
Management of Long COVID
Conclusions
Take-home message
References
Section 8: The vaccines
Introduction
Chapter 36 COVID-19: The vaccine development strategies
Abstract
Keywords
Conclusion
Take-home message
References
Chapter 37 mRNA vaccines: The new frontier
Abstract
Keywords
History of mRNA vaccines
mRNA application in other fields
Mechanism of mRNA vaccine
Delivery system of mRNA vaccines
Limitations and advancements of mRNA vaccines
Conclusion
Take-home message
References
Chapter 38 COVID-19 vaccines: A comprehensive review of safety and efficacy
Abstract
Keywords
Introduction
Vaccinating special populations against SARS-CoV-2
Geriatric populations
Heterologous vaccination
Conclusion
Take-home message
References
Section 9: Handling the spread: Public health and social measures
Introduction
Chapter 39 Lockdown measures during the COVID-19 pandemic
Abstract
Keywords
The development of models to inform lockdown measures
Fiscal approaches taken by different countries
The social and economic impact of lockdown measures and fiscal policies
Conclusion
Take-home message
References
Chapter 40 Efficacy of facial masks against COVID-19
Abstract
Keywords
Introduction
What is a facial mask?
Transmission of SARS-CoV-2
Efficacy of medical masks
Do respirators make difference?
Safety of face masks
Conclusion and future directions
Take-home message
References
Chapter 41 Vaccination policies
Abstract
Keywords
Introduction
Prioritizing access to vaccines
Optimizing vaccine uptake
Vaccine hesitancy
Incentives
Mandates
Global vaccine strategy
Interaction of vaccine policy with other public health policies
Conclusions
Take-home message
References
Chapter 42 Navigating the impact of COVID-19 school closures on child health, education, and society: A call to embrace civil discourse across identities, sectors, and disciplines
Abstract
Keywords
Introduction
Impact of COVID-19 on children
Rationale for school closures/opening
Impact of school closures
Social and mental Health
Society and civil discourse
Legacy effects—Learning gap and chronic disease
Recommendations
Adopt evidence-based pandemic protections
Acknowledge COVID-19 will not be the same as future pandemics
Prenegotiate parameters and thresholds
Enshrine collaborative policymaking
Be future-focused
Teach kids, families, and scholars how to dialogue across differences
Implement comprehensive social and community supports
Nurture, scale, and spread innovations in real time
Take-home message
References
Chapter 43 The effect of the pandemic on the care of other health conditions
Abstract
Keywords
Introduction
Emergency medicine, cardiovascular disease, and stroke care
Surgery
Cancer care
Mental health
Future pandemics and lessons learned
Take-home message
References
Chapter 44 The role of smartphone-assisted tools for COVID-19 diagnostic, treatment, and quarantine
Abstract
Keywords
Introduction
COVID-19 diagnostic tools
Contact-tracing using smartphones
Cardiovascular monitoring using smartphones
Respiratory monitoring using smartphones
Neurologic monitoring using smartphones
Perspectives and improvements
Take-home message
References
Section 10: From the Editors’ desk
Chapter 45 What have we learnt from the COVID-19 pandemic?
Abstract
Keywords
Introduction to the pandemic
Past pandemics
COVID-19 timelines and transmission
Ecology of SARS-CoV-2 and how it compares with SARS-CoV and MERS-CoV
Disparate experiences in pandemic response
Important lessons in pandemic preparedness
Improving testing capacity and quarantine policies
Assessment of risks in the infected
Improving preparedness of health systems
Policies to combat social vulnerability and income inequality
Household emergency preparedness
Challenges in vaccine development and distribution
Vaccine development and authorization timelines
Production and distribution (pricing and access issues)
Repurposing of old drugs and fast development of new therapeutics for COVID-19
Strategies for testing repurposed or new drugs
Repurposed drugs: Approval and therapeutic management of COVID-19
Therapeutic management of outpatients
Future strategies for handling Long COVID
Identifying distinct phenotypes and symptoms
Surmounting challenges in effective treatments for Long COVID
Improving management of Long COVID
The evolving virus
Variants and their effects on transmission and severity
Potential future of SARS-CoV-2 variants
Warnings and red flags for the future
Early detection of outbreaks
Harnessing artificial intelligence (AI) in addressing health crisis
Diagnostic tests and autopsy in pandemic preparedness
Global cooperation
Engagement with communities to detect, prevent, and respond to the emergence of a novel respiratory virus
Conclusion
Take-home message
References
Index

Shampa Chatterjee

Shampa Chatterjee is Associate Professor at the Department of Physiology, University of Pennsylvania School of Medicinein Philadelphia. Trained in India, Germany and the US, her current research is on inflammation-immune signaling with a focus on the vascular system. Her lab studies the role of redox signals in the onset and amplification of inflammation and immune responses. Toward this, recent work from her group showed that the systemic cytokine storm associated with COVID-19 activates an inflammation cascade in the vascular system that can potentially lead to vascular dysfunction. Research in her lab is funded by extramural research funding from the NIH and corporate sources. Dr. Chatterjee serves on the Editorial Board of several journals in the field of pulmonary physiology. She has published more than 100 papers in peer reviewed journals and edited two books on Endothelial Signaling, and on Inflammation and Immune responses. Dr. Chatterjee has received numerous awards such as the Caroline Tum Suden young Investigator Award, and the Hermann Rahn award for Excellence if Pulmonary Physiology. The topics addressed in this book are central to her research where she tries unraveling the balance between the onset of inflammation in host protection and resolution of inflammation in host injury.

Affiliations and expertise

University of Pennsylvania School of Medicine, Philadelphia, PA, USA

Amaro Nunes Duarte Neto

Amaro Nunes Duarte Neto is an infectious diseases physician and pathologist, and Associate Professor at the Department of Pathology, Faculty of Medicine, University of São Paulo (FMUSP). After graduating in medicine from the Universidade de Pernambuco in 1999, he moved to São Paulo, in the south-east of Brazil, to complete a fellowship in internal medicine and infectious diseases at the Hospital das Clínicas-FMUSP from 2000 to 2004. He also worked in the Intensive Care and Emergency Department at the University of São Paulo. After obtaining his PhD. in the field of leptospirosis pathology, he studied anatomical pathology and completed residency at the A.C. Camargo Cancer Centre in São Paulo from 2011-2014. Since then, he has been involved in autopsy and infectious disease pathology, with numerous publications on the pathology of COVID-19, yellow fever, AIDS, tuberculosis, and fungal infections. He is currently leading a project on preparedness in anatomical pathology for rapid response to future epidemics in the city of São Paulo, Brazil.

Affiliations and expertise

Professor, Disciplina de Emergências clínicas, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo Brazil, Brazil

Marco Cascella

Marco Cascella, MD, is an Associate Professor of Anesthesia, Intensive Care, and Pain Medicine at the University of Salerno. He graduated with honors in Medicine and Surgery in 1997 from the University “Vanvitelli” of Naples and later pursued postgraduate studies in anesthesia and intensive care in 2001. Prof. Cascella is actively engaged in research, with a particular focus on automatic pain assessment using AI techniques. He serves as an editorial board member for several medical journals and has delivered lectures at numerous conferences and conventions. With an extensive academic background, he has authored approximately 250 scientific publications, books, book chapters, etc., covering various medical domains ranging from anesthesia, pain treatment, and oncology to palliative care. Prof. Cascella plays a leadership role and actively participates in various research projects, showcasing his commitment to advancing medical knowledge and technology.

Affiliations and expertise

Professor, Anesthesia and Pain Medicine, Istituto Nazionale Tumori, Italy

Sonia Villapol

Dr. Sonia Villapol earned her bachelor's degree in Molecular Biology and Biotechnology from the University of Santiago of Compostela (Spain) in 2003. She furthered her academic journey by obtaining her master's degree and PhD in Neuroscience from the Autonomous University of Barcelona (Spain) in 2007. Following her doctoral studies, Dr. Villapol embarked on a fruitful research career. She served as a postdoctoral fellow at CNRS in the University Pierre and Marie Curie VI and at INSERM in Paris, France from 2007 to 2010. Subsequently, she continued her postdoctoral research at the National Institutes of Health, Center for Neuroscience and Regenerative Medicine, and Uniformed Services University (USUHS) in Bethesda, Maryland from 2010 to 2014. In May 2014, Dr. Villapol joined the Department of Neuroscience at Georgetown University in Washington, D.C., where she held the position of Research Assistant Professor. Then, in July 2018, she transitioned to the Center for Neuroregeneration at Houston Methodist Research Institute, assuming the role of Assistant Professor of Neurosurgery. Dr. Villapol's academic and research achievements include securing extramural research funding as a Principal Investigator from the National Institutes of Health (NIH), the Department of Defense (DoD), and several private foundations. Additionally, she plays a role as a standing member of the Molecular Neurogenetics NIH Study Section (MNG) and other Institutes from NIH and DoD agencies. To date, Dr. Villapol have authored over 70 publications in esteemed peer-reviewed journals, predominantly focusing on the neuroinflammatory processes across different animal models. Her current research explores the mechanisms that modulate neurodegeneration and inflammation, the intricacies of the brain-gut axis, the impact of gastrointestinal changes and gut microbiome changes on Long COVID-19, and the development of gender-specific strategies for drug delivery aimed at neuro-restoration

Affiliations and expertise

Associate Professor, Neurosurgery Research Institute, Houston Methodist, Weill Cornell Medical College, USA

Anand Viswanathan

Dr. Anand Viswanathan is the Director of Telestroke Services at Partners Healthcare and Associate Professor of Neurology at Harvard Medical School. He is a staff neurologist in the Stroke Service and in the Memory Disorders Unit at Massachusetts General Hospital.

Dr. Viswanathan is an executive member of the Massachusetts Alzheimer’s Research Center (MADRC). His research program at the J. Philip Kistler Stroke Research Center focuses on the contribution of stroke and vascular risk factors to dementia. His group has engaged in numerous multidisciplinary interactions and collaborations, including with economists, artists, and writers, in order to further understanding of mechanisms of disease and foster humanism in medicine.

Affiliations and expertise

Associate Professor, Neurology, Harvard Medical School, USA

Aravind Ganesh

Aravind Ganesh is a Vascular and Cognitive Neurologist. He completed his MD at the University of Calgary, followed by a DPhil in Clinical Neurosciences at the University of Oxford’s Centre for Prevention of Stroke and Dementia as a Rhodes scholar. He completed his neurology residency in Calgary, followed by a combined fellowship in stroke and cognitive neurology, funded by Alberta Innovates and the Canadian Institutes of Health Research. He is a Fellow of the Canadian Stroke Consortium and is actively involved in the development of best-practice guidelines for stroke and dementia care. His clinical research is focused on understanding the natural history, risk stratification, prevention, and treatment of stroke and cognitive impairment using multidisciplinary methods including neuroimaging, clinical epidemiology, artificial intelligence, mixed-method research, and clinical trials. His lab also leads the development and testing of innovative applications and devices for the diagnosis and treatment of dementia and stroke. He has received New Investigator Awards from the Heart and Stroke Foundation of Canada and the Alzheimer Society of Canada, as well as the Henry J. M. Barnett Scholarship and the Brain Canada Future Leaders in Brain Research award for outstanding contributions as a researcher in the field of dementia and stroke. During the COVID-19 pandemic, he was a coinvestigator in the Alberta HOPE COVID-19 trial, led the linked Alberta Neuro-COVID cohort study, and led studies examining pandemic-associated changes in stroke care and presentations.

Affiliations and expertise

Assistant professor, Clinical Neurosciences, University of Calgary, Canada

Ching Lung Lai

Ching-lung Lai is the Emeritus Professor and was the Simon K Y Lee Professor in Gastroenterology and the Chair Professor of Medicine and Hepatology at the Department of Medicine, University of Hong Kong, where he has been working since his graduation with honors at the University of Hong Kong. For the last four decades Dr. Lai has been extensively involved in research on various aspects of the hepatitis B virus, including molecular virology, natural history, treatment and its prevention. Professor Lai has published over 520 peer-reviewed papers and reviews in international journals. His publications have been widely cited and he is one of top scientists in the field of chronic hepatitis B infection.. Dr. Lai’s group has been extensively involved in studying the immune responses to COVID-19.

Affiliations and expertise

Professor of Medicine and Hepatology, University Department of Medicine, Queen Mary Hospital, Hong Kong

Giuseppe Remuzzi

Giuseppe Remuzzi, MD, FRCP, is Director of Mario Negri Institute for Pharmacological Research IRCCS and Chiara Fama Professor of Nephrology and the University of Milan. From 1996 until 2013, he was Director of the public-private Department of Immunology and Transplant Medicine (a collaboration between the Ospedali Riuniti of Bergamo and the Mario Negri Institute) and from 1999 until 2018, he was also the Head of the Division of Nephrology and Dialysis. From 2011 until 2015, he was Director of the Department of Medicine of the Azienda Ospedaliera Papa Giovanni XXIII (formerly the Ospedali Riuniti) of Bergamo. In June 2015, he was nominated Chiara Fama Professor of Nephrology at the University of Milan. Prof. Remuzzi was President of the International Society of Nephrology (ISN) for the biennium 2013-2015. From 2019, he has been the Vice President of the Italian Institute for Planetary Health (IIPH). He has been a member of the Consiglio Superiore di Sanità since February 2019.

Prof. Remuzzi’s main research interests include the causes of glomerulonephritis and the mechanisms of progression of kidney diseases. He has also conducted many studies in the field of transplant rejection. In recognition of his achievements, he received many national and international awards, among them the ISN Jean Hamburger Award in 2005 during the World Congress of Nephrology in Singapore, the John P. Peters Award (American Society of Nephrology 2007, San Francisco), the ISN AMGEN Award (World Congress of Nephrology: WCN 2011, Vancouver), the International Award "Luis Hernando" (Iñigo Alvarez de Toledo Renal Foundation FRIAT: Madrid, Spain) and the “Lennox K. Black International Prize for Excellence in Medicine” (Thomas Jefferson University, Philadelphia). ). Prof. Remuzzi was honored by the Italian President of the Republic with the title of Cavaliere di Gran Croce in 2022. Prof. Remuzzi is the author of more than a thousand publications in international medical journals and has written 24 books.

Affiliations and expertise

Director, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy

Life Sciences

Physical Sciences & Engineering

Social Sciences & Humanities

Health

Understanding the Pandemic

Pathophysiology, Transmission, and Treatment of COVID-19

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Shampa Chatterjee

Amaro Nunes Duarte Neto

Marco Cascella

Sonia Villapol

Anand Viswanathan

Aravind Ganesh

Ching Lung Lai

Giuseppe Remuzzi