COVID-19 Infections in Gonads: Consequences on Fertility?

COVID-19 may influence human fertility and sexuality in several ways. Different cell types in gonads show a constitutive expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2), which provide potential entry pathways for SARS-CoV-2. In addition to the biological effects of a COVID-19 infection on the gonads, the impact of the ongoing COVID-19 pandemic on mental health issues and sexual behavior may affect reproduction. This review summarizes the current knowledge on the influence of COVID-19 on the gonads and discusses possible consequences on human fertility. In this context, the close interaction between the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-gonadal axis in response to COVID-19-related stress is discussed. Some women noticed changes in their menstrual cycle during the COVID-19 pandemic, which could be due to psychological stress, for example. In addition, occasional cases of reduced oocyte quality and ovarian function are described after COVID-19 infection. In men, COVID-19 may cause a short-term decrease in fertility by damaging testicular tissue and/or impairing spermatogenesis. Moreover, decreased ratio testosterone/LH and FSH/LH in COVID-19 compared to aged-matched healthy men has been reported. Available data do not suggest any effect of the available SARS-CoV-2 vaccines on fertility. The effects of long COVID on human fertility have been reported and include cases with premature ovarian failure and oligomenorrhoea in women and erectile dysfunction in men. Despite the increasing knowledge about the effects of COVID-19 infections on human gonads and fertility, the long-term consequences of the COVID-19 pandemic cannot yet be assessed in this context

Dedicated mobile application for drug adverse reaction reporting by patients with relapsing remitting multiple sclerosis (Vigip-SEP study): study protocol for a randomized controlled trial

BackgroundThe reporting of adverse drug reactions (ADR) by patients represents an interesting challenge in the field of pharmacovigilance, but the reporting system is not adequately implemented in France. In 2015, only 20 MS patients in France reported ADR due to first-line disease-modifying drugs (DMD), while more than 3000 patients were initiated on DMD.The aim of this study is to validate a proof-of-concept as to whether the use of a mobile application (App) increases ADR reporting among patients with relapsing-remitting multiple sclerosis (RR-MS) receiving DMD.Methods/designWe designed a multi-centric, open cluster-randomized controlled trial, called the Vigip-SEP study (NCT03029897), using the App My eReport France® to report ADR to the appropriate authorities in E2B language, in accordance with European regulations. RR-MS patients who were initiated on, or switched, first-line DMD will be included. In the experimental arm, a neurologist will introduce the patient to the App to report ADR to the appropriate French authorities. In the control arm, the patient will be informed of the existence of the App but will not be introduced to its use and will then report ADR according to the usual reporting procedures. Primary assessment criteria are defined as the average number of ADR per patient and per center. We assume that the App will increase patient reporting by 10-fold. Therefore, we will require 24 centers (12 per arm: 6 MS academic expert centers, 3 general hospitals, 3 private practice neurologists), allowing for an expected enrollment of 180 patients (alpha risk 5%, power 90% and standard deviation 4%).DiscussionIncreasing patient reporting of ADR in a real-life setting is extremely important for therapeutic management of RR-MS, particularly for monitoring newly approved DMD to gain better knowledge of their safety profiles. To increase patient involvement, teaching patients to use tools, such as mobile applications, should be encouraged, and these tools should be tested rigorously

Enhanced Alamouti decoding scheme for DVB-T2 systems in SFN channels

The standard Alamouti space-frequency block code (SFBC) suffers from performance degradation when used over highly frequency-selective channels because the channel frequency response is not necessarily flat over the Alamouti block. In this paper, we present an enhanced Alamouti space frequency block decoding scheme for multiple-input multiple-output (MIMO) orthogonal frequency-division multiplexing (OFDM) systems over highly frequency selective channels. The enhanced Alamouti scheme uses the channel frequency variations in consecutive subcarriers to adapt the Alamouti decoder. Simulation results of DVB-T2 system confirm that the proposed method has substantial performance improvement in terms of bit error rate when compared to standard Alamouti decoder mainly over highly frequency-selective channels such as single frequency networks (SFN). 2011 IEEE.Scopu

Maximum likelihood detection of precoded SFBC in frequency-selective fading channels

In this paper, we derive the maximum likeli-hood detector (MLD) for precoded space-frequency block coded (SFBC) systems where orthogonal frequency divi-sion multiplexing (OFDM) is incorporated. The obtained results reveal that the precoding process can be exploited to construct low complexity MLD even when the channel frequency response is not equal across each SFBC block. The derived MLD structure is similar to the conventional Alamouti linear decoder except that the decoding matrix has to be selected from four possible matrices. However, the decoding matrix selection and symbols' detection can be performed jointly, which minimizes the additional computational complexity of the derived MLD as com-pared to the conventional Alamouti decoder. Monte Carlo simulation results show that the MLD outperforms the suboptimal detector reported in [1] by about 5 dB at bit error rate (BER) of 10-4 under various channel conditions. 2017 IEEE.Scopu

Joint secured and robust technique for OFDM systems

This work presents a novel technique for joint secured and robust transmission of orthogonal frequency division multiplexing (OFDM) based communication systems. The proposed system is implemented by developing a new OFDM symbol structure based on symmetric key cryptography. At the receiver side, data detection becomes infeasible without the knowledge of the secret key. For an intruder who tries to detect the data without the knowledge of the key, the signal will be a noise-like signal. In addition to the system security, theoretical and simulation results demonstrated that the proposed system provides time and frequency diversity, which makes the system highly robust against severe frequency-selective fading as well as other impairments such as impulsive noise and multiple access interference. For particular frequency-selective fading channels, the bit error rate (BER) improvements is about 15 dB at BER of 10 4. 2013 IEEE.Scopu

Liver, NAFLD and COVID-19.

Coronavirus disease 2019 (COVID-19) is characterized by a wide clinical spectrum that includes abnormalities in liver function indicative of liver damage. Conversely, people with liver diseases are at higher risk of severe COVID-19. In the current review, we summarize first the epidemiologic evidence describing the bidirectional relationship between COVID-19 and liver function/liver diseases. Additionally, we present the most frequent histologic findings as well as the most important direct and indirect mechanisms supporting a COVID-19 mediated liver injury. Furthermore, we focus on the most frequent liver disease in the general population, non-alcoholic or metabolic-associated fatty liver disease (NAFLD/MAFLD), and describe how COVID-19 may affect NAFLD/MAFLD development and progression and conversely how NAFLD/MAFLD may further aggravate a COVID-19 infection. Finally, we present the long-term consequences of the pandemic on the development and management of NAFLD

COVID-19 Infections in Gonads:Consequences on Fertility?

COVID-19 may influence human fertility and sexuality in several ways. Different cell types in gonads show a constitutive expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2), which provide potential entry pathways for SARS-CoV-2. In addition to the biological effects of a COVID-19 infection on the gonads, the impact of the ongoing COVID-19 pandemic on mental health issues and sexual behavior may affect reproduction. This review summarizes the current knowledge on the influence of COVID-19 on the gonads and discusses possible consequences on human fertility. In this context, the close interaction between the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-gonadal axis in response to COVID-19-related stress is discussed. Some women noticed changes in their menstrual cycle during the COVID-19 pandemic, which could be due to psychological stress, for example. In addition, occasional cases of reduced oocyte quality and ovarian function are described after COVID-19 infection. In men, COVID-19 may cause a short-term decrease in fertility by damaging testicular tissue and/or impairing spermatogenesis. Moreover, decreased ratio testosterone/LH and FSH/LH in COVID-19 compared to aged-matched healthy men has been reported. Available data do not suggest any effect of the available SARS-CoV-2 vaccines on fertility. The effects of long COVID on human fertility have been reported and include cases with premature ovarian failure and oligomenorrhoea in women and erectile dysfunction in men. Despite the increasing knowledge about the effects of COVID-19 infections on human gonads and fertility, the long-term consequences of the COVID-19 pandemic cannot yet be assessed in this context