CoViD-19 and Spanish flu, 100 years make the difference!

This is a Letter to the Editor commenting on the differences between CoViD-19 and "Spanish flu"

Animal models and pathogenetic insights to CoViD-19

As a veterinary pathologist I feel "reassured" by the recent data originating from the autopsies and the ancillary investigations performed on CoViD-19-affected patients. In this respect, the comparative pathology data obtained from experimentally challenged animals such as non-human primates, cats and ferrets, the latter two highly susceptible to experimental infection, may prove additionally useful in dissecting the pathogenesis of SARS-CoV-2 disease. Indeed, vasculitis and intravascular coagulation, along with pulmonary endoalveolar fibrin leakage, have been reported in the two aforementioned CoViD-19 experimental disease models. Noteworthy, abnormal coagulation parameters compatible with disseminated intravascular coagulation (DIC) have been linked to a poor prognosis in SARS-CoV-2-infected patients, who may suddenly develop very severe forms of disease leading to death. This most likely results from viral targeting of endothelial cells, as the virus likely gains access to host cells through angiotensin-converting enzyme 2 (ACE-2) receptors, which are widely expressed by endothelial cells. The viral damage to the inner vascular wall throughout the body, including the blood-brain-barrier endothelium, may well explain the DIC and "cytokine storm" experienced by those individuals developing very severe disease forms. Endothelial cells are, in fact, immunologically active, with heparin having been indicated as a drug efficiently counteracting the DIC associated with SARS-CoV-2 infection. In other words, the "popular" view of CoViD-19 as a"viral pneumonia" is being progressively complemented by that of a disease characterized by DIC and an excessive immune response, causing in turn a severe and swift"multiorgan dysfunction". We should give special thanks to pathologists, whomI believe are not being given the credit they deserve by the media in Italy and in many other countries

Testing for SARS-CoV-2 antibodies in Cetaceans

This is a Letter to the Editor (Rapid Response) commenting on an interesting article recently published in BMJ

COVID-19, A Principle of Precaution-Based Approach

Bovine spongiform encephalopathy (BSE), popularly known as mad cow disease, likely represents the most paradigmatic example of adoption of the principle of precaution (POP). Whenever coping, in fact, with any public health emergency characterized (like BSE) by significant knowledge gaps, adequate, POP-inspired measures should be rapidly put into force to minimize human exposure. The newly identified 2019-nCoV, the seventh human coronavirus, which has been renamed SARS-CoV-2 by the International Committee on Taxonomy of Viruses, and which had been previously classified as a global emergency by the World Health Organization (WHO), is no exception to the rule. As a matter of fact, at the date of February 14, 2020, over 1,500 deaths and almost 50,000 laboratory confirmed cases of COVID-19 (Coronavirus Disease 2019, the official denomination of the illness caused by SARS-CoV-2) have been recorded in patients from China. Viral interhuman transmission, reported in China and elsewhere in Asia and Europe, has pushed the Chinese Health Authorities to adopt a number of POP-inspired, "draconian" measures, with special reference to Hubei Province, where 80% of the COVID-2019 cases in that Country have been ascertained. This is largely justified by the knowledge gaps existing, among others, on the animal reservoir(s) from which SARS-CoV-2 jumped into humans and on the pathogen-human/ animal host interaction dynamics, including the development of a long-lasting and protective immunity to the virus. The aforementioned and other SARS-CoV-2- and host-related uncertainties make extremely hard, if not impossible, to draw reliable forecasts on the epidemic's evolutionary pathways at this stage. Within such context, a safe and effective vaccine could not be ready for use before 18, if not even 24 months. Nevertheless, anti-Measles Virus (MV) immunization should be strongly recommended and widely implemented on a global scale, since measles-affected patients are known to experience a prominent immune memory loss towards previously encountered pathogens. To this aim, every possible effort should be made in achieving and maintaining an adequate "herd immunity" to measles (which is globally responsible for a dramatic death toll per year), thus preventing that the immunity gained - either from natural infection or vaccination - towards SARS-CoV-2 could be abolished by MV-induced immune memory loss. In few words, a virtuous process still sharing POP as the common denominator

SARS-CoV-2, a spillover from animals to man, a spillback from man to animals and… what next?

This is a Letter to the Editor addressing the complex ecology and epidemiology of SARS-CoV-2 infection within the "One Health" framework

SARS-CoV-2-linoleic acid interaction

This is a Letter to the Editor commenting on an article recently published in Science

Human Neuropathies: Clues from Dolphins

This is a short Commentary addressing the role played by dolphins as potentially useful comparative pathology models for the study of some human neuropathies

CoViD-19, a "syndemic" rather than a "pandemic" disease

This is a Letter to the Editor providing insightful comments on a paper published in BMJ

"Long CoViD-19" and SARS-CoV-2 reinfections

This is a Letter to the Editor ("Rapid Response") providing insightful comment on a paper recently published in BMJ

Virus-neuropilin-1 interaction and animal models of SARS-CoV-2 infection

This is a Letter to the Editor (e.Letter) commenting on an interesting article recently published in Science