COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Influence de la lipophilisation de l'acide rosmarinique sur ses propriétés antioxydantes

De nos jours, l'apport de polyphénols s'avère être bénéfique dans la lutte contre les dommages oxydatifs liés au stress oxydant. Cependant, leur biodisponibilité est limitée par leur polarité. Pour contourner ce problème, une des stratégies consiste à ajuster la lipophilie de l'antioxydant par des réactions de lipophilisation mettant en jeu un vecteur lipidique. Ainsi, des précédentes études ont montré que l'activité antioxydante était directement liée à la longueur de la chaîne alkyle greffée et ont également révélé un effet non linéaire dit effet cut-off . L'objectif de notre étude a donc été de comprendre l'effet non linéaire de la lipophilisation sur l'activité antioxydante de l'acide rosmarinique. Ainsi, des rosmarinates d'alkyle et de diacylglycérol ont été synthétisés, et leurs propriétés antioxydantes évaluées sur des fibroblastes surexprimant une quantité d'EROs. L'effet cut-off a été à nouveau observé avec ces phénolipides. En effet, le rosmarinate de décyle et le 1-rosmarinoyl-2,3-dilauroyl glycérol sont les antioxydants les plus actifs. Cependant, la série des rosmarinates d'alkyle étant la plus efficace, l'influence du vecteur lipidique a été étudié uniquement sur cette dernière. Il a été ainsi constaté que la lipophilisation de l'acide rosmarinique avec une chaîne alkyle de 4 à 10 atomes de carbone améliore son transport au sein de la cellule, alors que les esters à 16 et 18 atomes de carbone s'organisent sous forme d'agrégats extracellulaires limitant ainsi leur internalisation. De plus, alors qu'une partie de ces esters est localisée dans le cytoplasme, tout comme l'acide rosmarinique et le rosmarinate de butyle, le rosmarinate de décyle est en revanche situé dans la mitochondrie. Cette propriété en fait donc une molécule très prometteuse pour la conception de nouveaux antioxydants à activité mitochondriale ciblée. Néanmoins, sa cytotoxicité joue un rôle majeur dans son mécanisme d'action. A fortes concentrations, il affecte la viabilité cellulaire, tandis qu'à faibles concentrations, aucun effet cytotoxique notable n'est mis en évidence.Nowadays, polyphenols supply has proved to be beneficial against oxidative damages linked to oxidative stress. However, their bioavaibility is limited by their polarity. To solve the issue, one strategy consists in adjusting the antioxidant hydrophobicity by lipophilization reactions with lipidic carriers. Indeed, previous studies showed that antioxidant activity was directly linked to the alkyl chain length grafted and also revealed a cut-off effect. The objective of this study is to understand this nonlinear effect of the lipophilization of rosmarinic acid on antioxidant activity. Thus, alkyl rosmarinate and diacylglycerol rosmarinate were synthesized and their antioxidant activity was evaluated into fibroblasts cells overexpressing radical oxygen species. The cut-off effect was again observed with these phenolipids. In fact, decyl rosmarinate and dilauroyl rosmarinate were shown to the best antioxydants. The lipophilization of rosmarinic acid with an alkyl chain from 4 to 10 carbon atoms improve its cell uptake whereas esters of 16 and 18 carbon atoms assemble in extracellular aggregate limiting their cell uptake. Furthermore, one part of these esters is located into cytoplasm like rosmarinic acid and butyl rosmarinate. On the contrary, the decyl rosmarinate (R10) is located into mitochondria. This property allows targeting mitochondria. Nevertheless, its cytotoxicity is involved in mechanism. At high concentration, R10 affects cell viability, while at low concentration, no cytotoxic effect is observed.MONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF

Identification des composés de la surface des mycobactéries impliqués dans leur reconnaissance et leur internalisation par les macrophages humains (outils pour une nouvelle approche pharmacologique des infections microbactériennes)

TOULOUSE3-BU Sciences (315552104) / SudocSudocFranceF

Dose-dependent activation of distinct hypertrophic pathways by serotonin in cardiac cells.

International audienceThere is substantial evidence supporting a hypertrophic action of serotonin [5-hydroxytryptamine (5-HT)] in cardiomyocytes. However, little is known about the mechanisms involved. We previously demonstrated that 5-HT-induced hypertrophy depends, in part, on the generation of reactive oxygen species by monoamine oxidase-A (MAO-A) (see Ref. 3). Cardiomyocytes express 5-HT(2) receptors, which may also participate in hypertrophy. Here, we analyzed the respective contribution of 5-HT(2) receptors and MAO-A in H9C2 cardiomyoblast hypertrophy. 5-HT induced a dose-dependent increase in [(3)H]leucine incorporation and stimulation of two markers of cardiac hypertrophy, ANF-luc and alphaSK-actin-luc reporter genes. Experiments using 1 microM 5-HT showed that hypertrophic response occurred independently from MAO-A. Using pharmacological inhibitors (M100907 and ketanserin), we identified a novel mechanism of action involving 5-HT(2A) receptors and requiring Ca(2+)/calcineurin/nuclear factor of activated T-cell activation. The activation of this hypertrophic pathway was fully prevented by 5-HT(2A) inhibitors and was unaffected by MAO inhibition. When 10 microM 5-HT was used, an additional hypertrophic response, prevented by the MAO inhibitors pargyline and RO 41-1049, was observed. Unlike the 5-HT(2A)-receptor-mediated H9C2 cell hypertrophy, MAO-A-dependent hypertrophic response required activation of extracellular-regulated kinases. In conclusion, our results show the existence of a dose-dependent shift of activation of distinct intracellular pathways involved in 5-HT-mediated hypertrophy of cardiac cells

Antioxidant properties and efficacies of synthesized alkyl caffeates, ferulates, and coumarates

Caffeic, ferulic, and coumaric acids were lipophilized with saturated fatty alcohols (C1?C20). The antioxidant properties of these hydroxycinnamic acids and their alkyl esters were evaluated in various assays. Furthermore, the antioxidant efficiency of the compounds was evaluated in a simple o/w microemulsion using the conjugated autoxidizable triene (CAT) assay. All evaluated phenolipids had radical scavenging, reducing power, and metal chelating properties. Only caffeic acid and caffeates were able to form a complex with iron via their catechol group in the phenolic ring. In the o/w emulsion, the medium chain phenolipids of the three homologues series were most efficient. The antioxidant properties and efficacies were dependent upon functional groups substituted to the ring structure and were in the following order: caffeic acid and caffeates > ferulic acid and ferulates > coumaric acid and coumarates. Moreover, the results demonstrated that the test system has an impact on the antioxidative properties measured. (Résumé d'auteur

Boosting antioxidants by lipophilization: A strategy toincrease cell uptake and target mitochondria

To explore the possibility to boost phenolic antioxidants through their structural modification by lipophilization and check the influence of such covalent modification on cellular uptake and mitochondria targeting. Rosmarinic acid was lipophilized by various aliphatic chain lengths (butyl, octyl, decyl, dodecyl, hexadecyl, and octadecyl) to give rosmarinate alkyl esters which were then evaluated for their ability (i) to reduce the level of reactive oxygen species (ROS) using 2',7'-dichlorodihydrofluorescein diacetate probe, (ii) to cross fibroblast cell membranes using confocal microscopy, and (iii) to target mitochondria using MitoTrackerA (R) Red CMXRos. Increasing the chain length led to an improvement of the antioxidant activity until a threshold is reached for medium chain (10 carbon atoms) and beyond which lengthening resulted in a decrease of activity. This nonlinear phenomenon-also known as the cut-off effect-is discussed here in connection to the previously similar results observed in emulsified, liposomal, and cellular systems. Moreover, butyl, octyl, and decyl rosmarinates passed through the membranes in less than 15 min, whereas longer esters did not cross membranes and formed extracellular aggregates. Besides cell uptake, alkyl chain length also determined the subcellular localization of esters: mitochondria for medium chains esters, cytosol for short chains and extracellular media for longer chains. The localization of antioxidants within mitochondria, the major site and target of ROS, conferred an advantage to medium chain rosmarinates compared to both short and long chains. In conjunction with changes in cellular uptake, this result may explain the observed decrease of antioxidant activity when lengthening the lipid chain of esters. This brings a proof-of-concept that grafting medium chain allows the design of mitochondriotropic antioxidants

Serotonin 5-HT2A receptor-mediated hypertrophy is negatively regulated by caveolin-3 in cardiomyoblasts and neonatal cardiomyocytes.

International audienceThe serotonin 5-HT(2A) receptor belongs to the G-protein-coupled receptors (GPCRs) superfamily and mediates the hypertrophic response to serotonin (5-HT) in cardiac myocytes. At present the regulatory mechanisms of 5-HT(2A) receptor-induced myocyte hypertrophy are not fully understood. The localization and the compartmentation of GPCRs within specialized membrane microdomains are known to modulate their signalling pathway. Therefore, we hypothesized that caveolae microdomains and caveolin-3, the predominant isoform of cardiac caveolae, might be regulators of 5-HT(2A) receptor signalling. We demonstrate that 5-HT(2A) receptors interact with caveolin-3 upon 5-HT stimulation and traffic into caveolae membrane microdomains. We provide evidence that caveolin-3 knockdown abolishes the redistribution of 5-HT(2A) receptors into caveolae and enhances 5-HT(2A) receptor-induced myocyte hypertrophic markers such as cell size, protein synthesis and ANF gene expression. Importantly, we demonstrate that caveolin-3 and caveolae structures are negative regulators of 5-HT(2A) receptor-induced nuclear factor of activated T cells (NFAT) transcriptional activation. Taken together, our data demonstrate that caveolin-3 and caveolae microdomains are important regulators of the hypertrophic response induced by 5-HT(2A) receptors. These findings thus open new insights to target heart hypertrophy under the enhanced serotonin system. This article is part of a Special Issue entitled "Local Signaling in Myocytes"