oxytocin and Pneumonia--Viral

Topics: Animals; Antiviral Agents; Betacoronavirus; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Humans; Immunity, Innate; Immunologic Factors; Nitric Oxide; Organ Specificity; Oxidative Stress; Oxytocin; Pandemics; Pneumonia, Viral; Receptors, Oxytocin; SARS-CoV-2; Vasodilation; Virus Replication

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a worldwide pandemic, infecting over 16 million people worldwide with a significant mortality rate. However, there is no current Food and Drug Administration-approved drug that treats coronavirus disease 2019 (COVID-19). Damage to T lymphocytes along with the cytokine storm are important factors that lead to exacerbation of clinical cases. Here, we are proposing intravenous oxytocin (OXT) as a candidate for adjunctive therapy for COVID-19. OXT has anti-inflammatory and proimmune adaptive functions. Using the Library of Integrated Network-Based Cellular Signatures (LINCS), we used the transcriptomic signature for carbetocin, an OXT agonist, and compared it to gene knockdown signatures of inflammatory (such as interleukin IL-1β and IL-6) and proimmune markers (including T cell and macrophage cell markers like CD40 and ARG1). We found that carbetocin's transcriptomic signature has a pattern of concordance with inflammation and immune marker knockdown signatures that are consistent with reduction of inflammation and promotion and sustaining of immune response. This suggests that carbetocin may have potent effects in modulating inflammation, attenuating T cell inhibition, and enhancing T cell activation. Our results also suggest that carbetocin is more effective at inducing immune cell responses than either lopinavir or hydroxychloroquine, both of which have been explored for the treatment of COVID-19.

Topics: Adaptive Immunity; Anti-Inflammatory Agents; Betacoronavirus; Cell Line; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Databases, Genetic; Gene Expression Profiling; Host-Pathogen Interactions; Humans; Oxytocin; Pandemics; Pneumonia, Viral; SARS-CoV-2; T-Lymphocytes; Transcriptome

The world's understanding of COVID-19 continues to evolve as the scientific community discovers unique presentations of this disease. This case report depicts an unexpected intraoperative coagulopathy during a cesarean section in an otherwise asymptomatic patient who was later found to have COVID-19. This case suggests that there may be a higher risk for intrapartum bleeding in the pregnant, largely asymptomatic COVID-positive patient with more abnormal COVID laboratory values.. The case patient displayed D-Dimer elevations beyond what is typically observed among this hospital's COVID-positive peripartum population and displayed significantly more oozing than expected intraoperatively, despite normal prothrombin time, international normalized ratio, fibrinogen, and platelets.. There is little published evidence on the association between D-Dimer and coagulopathy among the pregnant population infected with SARS-CoV-2. This case report contributes to the growing body of evidence on the effects of COVID-19 in pregnancy. A clinical picture concerning for intraoperative coagulopathy may be associated with SARS-CoV-2 infection during cesarean sections, and abnormal COVID laboratory tests, particularly D-Dimer, may help identify the patients in which this presentation occurs.

Topics: Adult; Antifibrinolytic Agents; Betacoronavirus; Blood Coagulation Disorders; Blood Loss, Surgical; Breech Presentation; C-Reactive Protein; Cautery; Cesarean Section; Coronavirus Infections; COVID-19; Female; Fibrin Fibrinogen Degradation Products; Fibrinogen; Hemostasis, Surgical; Humans; International Normalized Ratio; Methylergonovine; Oligohydramnios; Oxytocics; Oxytocin; Pandemics; Platelet Count; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Complications, Infectious; Prothrombin Time; SARS-CoV-2; Tranexamic Acid; Uterine Inertia