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Magawa S, Maki S, Tamaishi Y, Enomoto N, Takakura S, Nii M, Yamaguchi K, Hirata T, Nagao K, Maegawa Y, Osato K, Tanaka H, Kondo E, Ikeda T. Modes of delivery and indications in women with COVID-19: a regional observational study in Japan. J OBSTET GYNAECOL 2024; 44:2362968. [PMID: 38885134 DOI: 10.1080/01443615.2024.2362968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/27/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND During the coronavirus disease (COVID-19) pandemic, caesarean section (CS) has been the preferred deliver method for pregnant women with COVID-19 in order to limit the use of hospital beds and prevent morbidity among healthcare workers. METHODS To evaluate delivery methods used during the COVID-19 pandemic as well as the rates of adverse events and healthcare worker morbidity associated with caesarean deliveries. METHODS We investigated maternal and neonatal backgrounds, delivery methods, indications and complication rates among pregnant women with COVID-19 from December 2020 to August 2022 in Mie Prefecture, Japan. The predominant mutation period was classified as the pre-Delta, Delta and Omicron epoch. RESULTS Of the 1291 pregnant women with COVID-19, 59 delivered; 23 had a vaginal delivery and 36 underwent CS. Thirteen underwent CS with no medical indications other than mild COVID-19, all during the Omicron epoch. Neonatal complications occurred significantly more often in CS than in vaginal delivery. COVID-19 in healthcare workers was not attributable to the delivery process. CONCLUSION The number of CS with no medical indications and neonatal complications related to CS increased during the COVID-19 pandemic. Although this study included centres that performed vaginal deliveries during COVID-19, there were no cases of COVID-19 in healthcare workers. It is possible that the number of CS and neonatal complications could have been reduced by establishing a system for vaginal delivery in pregnant women with recent-onset COVID-19, given that there were no cases of COVID-19 among the healthcare workers included in the study.
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Affiliation(s)
- Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Yuya Tamaishi
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Naosuke Enomoto
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Sho Takakura
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Kyohei Yamaguchi
- Department of Obstetrics and Gynecology, Mie Central Medical Center, Tsu, Japan
| | - Toru Hirata
- Department of Obstetrics and Gynecology, Miyazaki University Faculty Medicine, Miyazaki, Japan
| | - Kenji Nagao
- Department of Obstetrics and Gynecology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Yuka Maegawa
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Ise, Japan
| | - Kazuhiro Osato
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
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Zheng K, Chong AY, Mentzer AJ. How could our genetics impact COVID-19 vaccine response? Expert Rev Clin Immunol 2024; 20:1027-1039. [PMID: 38676712 DOI: 10.1080/1744666x.2024.2346584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed unprecedented global health challenges since its emergence in December 2019. The rapid availability of vaccines has been estimated to save millions of lives, but there is variation in how individuals respond to vaccines, influencing their effectiveness at an individual, and population level. AREAS COVERED This review focuses on human genetic factors influencing the immune response and effectiveness of vaccines, highlighting the importance of associations across the HLA locus. Genome-Wide Association Studies (GWAS) and other genetic association analyses have identified statistically significant associations between specific HLA alleles including HLA-DRB1*13, DBQ1*06, and A*03 impacting antibody responses and the risk of breakthrough infections post-vaccination. Relationships between these associations and potential mechanisms and links with risks of natural infection or disease are explored, and this review concludes by emphasizing how understanding the mechanisms of these genetic determinants may inform the development of tailored vaccination strategies. EXPERT OPINION Although complex, we believe these findings from the SARS-CoV2 pandemic offer a unique opportunity to understand the relationships between HLA and infection and vaccine response, with a goal of optimizing individual protection against COVID-19 in the ongoing pandemic, and possibly influencing wider vaccine development in the future.
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Affiliation(s)
- Keyi Zheng
- Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Amanda Y Chong
- Centre for Human Genetics, University of Oxford, Oxford, UK
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Zarama V, Quintero JA, Barbosa MM, Rodriguez S, Angel AM, Muñoz AM, Muñoz JA, Maya-Portillo D, Rosso F. NEWS2, S/F-ratio and ROX-index at emergency department for the prediction of adverse outcomes in COVID-19 patients: An external validation study. Am J Emerg Med 2024; 83:101-108. [PMID: 39002495 DOI: 10.1016/j.ajem.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 07/15/2024] Open
Abstract
BACKGROUND In the context of the COVID-19 pandemic, the early and accurate identification of patients at risk of deterioration was crucial in overcrowded and resource-limited emergency departments. This study conducts an external validation for the evaluation of the performance of the National Early Warning Score 2 (NEWS2), the S/F ratio, and the ROX index at ED admission in a large cohort of COVID-19 patients from Colombia, South America, assessing the net clinical benefit with decision curve analysis. METHODS A prospective cohort study was conducted on 6907 adult patients with confirmed COVID-19 admitted to a tertiary care ED in Colombia. The study evaluated the diagnostic performance of NEWS2, S/F ratio, and ROX index scores at ED admission using the area under the receiver operating characteristic curve (AUROC) for discrimination, calibration, and decision curve analysis for the prediction of intensive care unit admission, invasive mechanical ventilation, and in-hospital mortality. RESULTS We included 6907 patients who presented to the ED with confirmed SARS-CoV-2 infection from March 2020 to November 2021. Mean age was 51 (35-65) years and 50.4% of patients were males. The rate of intensive care unit admission was 28%, and in-hospital death was 9.8%. All three scores have good discriminatory performance for the three outcomes based on the AUROC. S/F ratio showed miscalibration at low predicted probabilities and decision curve analysis indicated that the NEWS2 score provided a greater net benefit compared to other scores across at a 10% threshold to decide ED admission at a high-level of care facility. CONCLUSIONS The NEWS2, S/F ratio, and ROX index at ED admission have good discriminatory performances in COVID-19 patients for the prediction of adverse outcomes, but the NEWS2 score has a higher net benefit underscoring its clinical utility in optimizing patient management and resource allocation in emergency settings.
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Affiliation(s)
- Virginia Zarama
- Department of Emergency Medicine, Fundación Valle del Lili Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia.
| | - Jaime A Quintero
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia
| | - Mario M Barbosa
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia
| | - Sarita Rodriguez
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia
| | - Ana M Angel
- Department of Emergency Medicine, Fundación Valle del Lili Cali, Colombia
| | - Angela M Muñoz
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | - Juan A Muñoz
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
| | | | - Fernando Rosso
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Department of Internal Medicine, Division of Infectious Diseases, Fundación Valle del Lili, Cali, Colombia
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Ruck JM, Bush EL. Use of Extracorporeal Membrane Oxygenation for Patients with Coronavirus Disease 2019 Infection. Adv Surg 2024; 58:249-273. [PMID: 39089781 PMCID: PMC11294677 DOI: 10.1016/j.yasu.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic was a cataclysmic event that infected over 772 million and killed over 6.9 million people worldwide. The pandemic pushed hospitals and society to their limits and resulted in incredibly severe respiratory disease in millions of people. This severe respiratory disease often necessitated maximum medical therapy, including the use of extracorporeal membrane oxygenation. While our understanding of COVID-19 and its treatment continue to evolve, we review the current evidence to guide the care of patients with severe COVID-19 infection.
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Affiliation(s)
- Jessica M Ruck
- Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Errol L Bush
- Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Meisgeier A, Pienkohs S, Moosdorf L, Neff A. Impact of the COVID-19 pandemic on maxillofacial trauma surgery in Germany - implications from the national DRG database. Oral Maxillofac Surg 2024; 28:1241-1250. [PMID: 38600413 PMCID: PMC11330376 DOI: 10.1007/s10006-024-01248-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/29/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE The COVID-19 pandemic has affected the personal and social lives of millions of people and also impacted the etiological factors of midfacial trauma such as falls, interpersonal violence or traffic accidents. The aim of this study was to analyze the influence of the COVID-19 pandemic on maxillofacial trauma surgery in the German healthcare system. METHODS Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system used in all German hospitals was received from the German Federal Statistical Office. Various trauma-associated procedures of the Operation and Procedure Classification System (OPS), a German modification of the International Classification of Medical Procedures (ICPM), were statistically associated with different epidemiological factors between 2012 and 2021. RESULTS A statistically significant decrease (p < 0.05) in surgeries regarding maxillofacial fractures was registered during the years 2020 and 2021. Young male patients had the largest decline in maxillofacial trauma surgeries during this period (p < 0.05). In contrast. elderly patients 80 years and older showed a dramatic increase in the frequency of fractures in both the midface and the mandible (p < 0.05). CONCLUSIONS During the COVID 19 pandemic there has been a shift in the number, composition and etiology of maxillofacial fracture surgeries. Measures of social distancing and personal risk avoidance had a societal positive effect on the frequency of facial injuries. This stands in contrast to the drastic increase in fractures of elderly people who should be protected primarily by the measures taken. These results can help to understand these influences better in future pandemics. TRIAL REGISTRATION German Clinical Trials Register No: DRKS00032778.
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Affiliation(s)
- Axel Meisgeier
- Department of Oral and Craniomaxillofacial Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, 35043, Marburg, Germany.
| | - Simon Pienkohs
- Department of Oral and Craniomaxillofacial Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, 35043, Marburg, Germany
| | - Laura Moosdorf
- Center for Orthopaedics and Trauma Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, Marburg, Germany
| | - Andreas Neff
- Department of Oral and Craniomaxillofacial Surgery, Faculty of Medicine, UKGM GmbH, University Hospital Marburg, Philipps University, 35043, Marburg, Germany
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Sun X, Zhang H, Zhang M, Fei M, Xiong L, Li C. High myoglobin level as an independent risk factor for death in elderly patients with critical COVID-19 infection: a retrospective case-control study. BMC Infect Dis 2024; 24:842. [PMID: 39164612 DOI: 10.1186/s12879-024-09621-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 07/16/2024] [Indexed: 08/22/2024] Open
Abstract
AIM This study aimed to discover risk factors for death in patients with critical COVID-19 infection in order to identify patients with a higher risk of death at an early stage. METHODS We retrospectively analyzed the clinical data of patients with critical COVID-19 infection from April 2022 to June 2022. Data were collected from the electronic medical records. Propensity matching scores were used to reduce the effect of confounding factors, such as patient baseline variables. Independent risk factors affecting patient prognosis were assessed using univariate logistic regression and multivariate logistic regression analysis. Restricted cubic spline curves were used to assess the relationship between independent and dependent variables. RESULTS The data of 132 patients with critical COVID-19 infection were included in the study. Of the 132 patients, 79 survived and 53 died. Among laboratory indicators, patients who died had higher proportions of abnormalities in procalcitonin, aspartate aminotransferase (AST), creatinine, cardiac troponin I, and myoglobin. Univariate and multivariate logistic regression analyses suggested that abnormal AST (OR = 4.98, P = 0.02), creatinine (OR = 7.93, P = 0.021), and myoglobin (OR = 103.08, P = 0.002) were independent risk factors for death. After correction for AST and creatinine, a linear relationship between myoglobin and risk of death in patients was found using restricted cubic splines. CONCLUSION High myoglobin level is an independent risk factor for death and is therefore a prognostic marker in elderly patients with severe COVID-19 infection.
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Affiliation(s)
- Xiaoxiao Sun
- Department of Critical Care Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, No. 1279, Sanmen Road, Hongkou District, Shanghai, 200434, China
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Hui Zhang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Meixian Zhang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Miaomiao Fei
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China
| | - Lize Xiong
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China.
| | - Cheng Li
- Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China.
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Muratsu A, Oda S, Onishi S, Yoshimura J, Matsumoto H, Togami Y, Mitsuyama Y, Ito H, Okuzaki D, Ogura H, Oda J. Bacterial sepsis causes more dramatic pathogenetic changes in the Th1 pathway than does viral (COVID-19) sepsis: a prospective observational study of whole blood transcriptomes. Virol J 2024; 21:190. [PMID: 39160575 PMCID: PMC11334310 DOI: 10.1186/s12985-024-02451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 07/30/2024] [Indexed: 08/21/2024] Open
Abstract
OBJECTIVES This study aimed to comprehensively compare host responses of patients with bacterial sepsis and those with viral (COVID-19) sepsis by analyzing messenger RNA (mRNA) and microRNA (miRNA) profiles to shed light on their distinct pathophysiological mechanisms. DESIGN Prospective observational study. SETTING Whole blood RNA sequencing was used to analyze mRNA and miRNA profiles of patients diagnosed as having bacterial sepsis or viral (COVID-19) sepsis at the Department of Trauma and Emergency Medicine, Osaka University Graduate School of Medicine. PATIENTS Twenty-two bacterial sepsis patients, 35 viral (COVID-19) sepsis patients, and 15 healthy subjects admitted to the department were included. We diagnosed bacterial sepsis patients according to the sepsis-3 criterion that the Sequential Organ Failure Assessment score must increase to 2 points or more among patients with suspected infections. Viral (COVID-19) sepsis patients were diagnosed using SARS-CoV-2 RT-PCR testing, and presence of pneumonia was assessed through chest computed tomography scans. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS For RNA sequencing, 14,500 mRNAs, 1121 miRNAs, and 2556 miRNA-targeted mRNAs were available for analysis in the bacterial sepsis patients. Numbers of genes showing upregulated: downregulated gene expression (false discovery rate < 0.05, |log2 fold change| > 1.5) were 256:2887 for mRNA, 53:5 for miRNA, and 49:2507 for miRNA-targeted mRNA. Similarly, in viral (COVID-19) sepsis patients, 14,500 mRNAs, 1121 miRNAs, and 327 miRNA-targeted mRNAs were analyzed, with numbers of genes exhibiting upregulated: downregulated gene expression of 672:1147 for mRNA, 3:4 for miRNA, and 165:162 for miRNA-targeted mRNA. This analysis revealed significant differences in the numbers of upregulated and downregulated genes expressed and pathways between the bacterial sepsis and viral (COVID-19) sepsis patients. Bacterial sepsis patients showed activation of the PD-1 and PD-L1 cancer immunotherapy signaling pathway and concurrent suppression of Th1 signaling. CONCLUSION Our study illuminated distinct molecular variances between bacterial sepsis and viral (COVID-19) sepsis. Bacterial sepsis patients had a greater number of upregulated and downregulated genes and pathways compared to viral (COVID-19) sepsis patients. Especially, bacterial sepsis caused more dramatic pathogenetic changes in the Th1 pathway than did viral (COVID-19) sepsis.
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Affiliation(s)
- Arisa Muratsu
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Sayaka Oda
- Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
- Laboratory for Human Immunology (Single Cell Genomics), WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Shinya Onishi
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jumpei Yoshimura
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hisatake Matsumoto
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Yuki Togami
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yumi Mitsuyama
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Ito
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Okuzaki
- Laboratory for Human Immunology (Single Cell Genomics), WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Hiroshi Ogura
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Oda
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Xu L, Yu D, Xu M, Liu Y, Yang LX, Zou QC, Feng XL, Li MH, Sheng N, Yao YG. Primate-specific BTN3A2 protects against SARS-CoV-2 infection by interacting with and reducing ACE2. EBioMedicine 2024; 107:105281. [PMID: 39142074 DOI: 10.1016/j.ebiom.2024.105281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 07/24/2024] [Accepted: 07/30/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an immune-related disorder caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The complete pathogenesis of the virus remains to be determined. Unraveling the molecular mechanisms governing SARS-CoV-2 interactions with host cells is crucial for the formulation of effective prophylactic measures and the advancement of COVID-19 therapeutics. METHODS We analyzed human lung single-cell RNA sequencing dataset to discern the association of butyrophilin subfamily 3 member A2 (BTN3A2) expression with COVID-19. The BTN3A2 gene edited cell lines and transgenic mice were infected by live SARS-CoV-2 in a biosafety level 3 (BSL-3) laboratory. Immunoprecipitation, flow cytometry, biolayer interferometry and competition ELISA assays were performed in BTN3A2 gene edited cells. We performed quantitative real-time PCR, histological and/or immunohistochemical analyses for tissue samples from mice with or without SARS-CoV-2 infection. FINDINGS The BTN3A2 mRNA level was correlated with COVID-19 severity. BTN3A2 expression was predominantly identified in epithelial cells, elevated in pathological epithelial cells from COVID-19 patients and co-occurred with ACE2 expression in the same lung cell subtypes. BTN3A2 targeted the early stage of the viral life cycle by inhibiting SARS-CoV-2 attachment through interactions with the receptor-binding domain (RBD) of the Spike protein and ACE2. BTN3A2 inhibited ACE2-mediated SARS-CoV-2 infection by reducing ACE2 in vitro and in vivo. INTERPRETATION These results reveal a key role of BTN3A2 in the fight against COVID-19. Identifying potential monoclonal antibodies which mimic BTN3A2 may facilitate disruption of SARS-CoV-2 infection, providing a therapeutic avenue for COVID-19. FUNDING This study was supported by the National Natural Science Foundation of China (32070569, U1902215, and 32371017), the CAS "Light of West China" Program, and Yunnan Province (202305AH340006).
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Affiliation(s)
- Ling Xu
- Key Laboratory of Genetic Evolution and Animal Models, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650204, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, 650204, China; Kunming National High-Level Biosafety Research Center for Non-Human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650107, China.
| | - Dandan Yu
- Key Laboratory of Genetic Evolution and Animal Models, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650204, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, 650204, China; Kunming National High-Level Biosafety Research Center for Non-Human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650107, China
| | - Min Xu
- Key Laboratory of Genetic Evolution and Animal Models, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650204, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, 650204, China
| | - Yamin Liu
- Key Laboratory of Genetic Evolution and Animal Models, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650204, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, 650204, China
| | - Lu-Xiu Yang
- Key Laboratory of Genetic Evolution and Animal Models, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650204, China
| | - Qing-Cui Zou
- Kunming National High-Level Biosafety Research Center for Non-Human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650107, China
| | - Xiao-Li Feng
- Kunming National High-Level Biosafety Research Center for Non-Human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650107, China
| | - Ming-Hua Li
- Kunming National High-Level Biosafety Research Center for Non-Human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650107, China
| | - Nengyin Sheng
- Key Laboratory of Genetic Evolution and Animal Models, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650204, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, 650204, China.
| | - Yong-Gang Yao
- Key Laboratory of Genetic Evolution and Animal Models, Key Laboratory of Animal Models and Human Disease Mechanisms of Yunnan Province, and KIZ/CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650204, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, 650204, China; Kunming National High-Level Biosafety Research Center for Non-Human Primates, Center for Biosafety Mega-Science, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650107, China; National Research Facility for Phenotypic & Genetic Analysis of Model Animals (Primate Facility), National Resource Center for Non-Human Primates, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, 650107, China.
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Chen LM, Li JB, Wu R. Predictors of COVID-19 severity in autoimmune disease patients: A retrospective study during full epidemic decontrol in China. Heart Lung 2024; 68:272-278. [PMID: 39142089 DOI: 10.1016/j.hrtlng.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 08/07/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Early identification of risk factors for adverse COVID-19 progression in patients with autoimmune diseases is crucial for patient management, but data on the Chinese population are scarce. OBJECTIVES The purpose of this study was to identify predictors of severe COVID-19 in patients using blood cell ratios, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and other inflammatory markers. METHODS A retrospective study of 855 patients (746 females; median age 49 years) with autoimmune diseases and concurrent COVID-19 was conducted from December 2022 to February 2023 at the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University. Disease severity was assessed according to the 8th edition of the National Health Commission of the People's Republic of China's COVID-19 Diagnosis and Treatment Guidelines. The clinical classification criteria group mild and moderate cases as nonsevere cases and severe and critical cases as severe cases. A multivariate logistic regression model was established to evaluate the relationships between COVID-19 severity and demographic characteristics, comorbidities, medication use, and laboratory findings. RESULTS The PLR, NLR, and SII were significantly greater in the severe COVID-19 group than in the nonsevere group (all P < 0.05). In addition to classical independent clinical risk factors, increases in the PLR (OR: 1.004, 95 % CI: 1.001∼1.007, p = 0.001), NLR (OR: 1.180, 95 % CI: 1.041∼1.337, p = 0.010), and SII (OR: 0.999, 95 % CI: 0.998∼1.000, p = 0.005) were identified as risk factors for severe COVID-19 in patients with autoimmune diseases. After adjusting for clinical risk factors, the PLR (AUC: 0.592 vs. 0.865; P < 0.05), NLR (AUC: 0.670 vs. 0.866; P < 0.05), and SII (AUC: 0.616 vs. 0.864; P < 0.05) demonstrated higher predictive values. CONCLUSION Early prediction of severe COVID-19 in patients with autoimmune diseases can be achieved using the NLR, PLR, and SII.
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Affiliation(s)
- Li-Ming Chen
- Department of Rheumatology and Immunology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No 17 Yongwaizheng Street, Donghu District, Nanchang City, Jiangxi Province, 330006, China
| | - Jian-Bin Li
- Department of Rheumatology and Immunology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No 17 Yongwaizheng Street, Donghu District, Nanchang City, Jiangxi Province, 330006, China
| | - Rui Wu
- Department of Rheumatology and Immunology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No 17 Yongwaizheng Street, Donghu District, Nanchang City, Jiangxi Province, 330006, China.
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10
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Feng X, Li P, Hao X, Peng Y, Zhou R, Li W, Chen G, Zhu T. What are the frequent complaints voiced by inpatients and physicians amidst the emerging infectious diseases? - An illustrative instance of the COVID-19. BMC Infect Dis 2024; 24:792. [PMID: 39112945 PMCID: PMC11304773 DOI: 10.1186/s12879-024-09680-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 07/29/2024] [Indexed: 08/11/2024] Open
Abstract
INTRODUCTION Emerging infectious diseases (EIDs) can disrupt the healthcare system, causing regulatory changes that affect the healthcare-seeking process and potentially increase patient-physician dissatisfaction. This study aimed to collect and analyze patients' and physicians' complaints during an EID outbreak to inform potential clues regarding medical quality and patient safety enhancement in future dealing with EIDs, employing text mining methodologies. METHODS In this descriptive study, complaint records from January 2020 to February 2023 at West China Hospital, a national medical facility in China, were analyzed. Patient and physician complaints have been retrospectively retrieved from the record from the medical department, and then categorized into distinct groups based on reporting reasons, encompassing COVID-19-related policies, healthcare access, availability of medical resources, and financial concerns. RESULTS During the COVID-19 pandemic, 541 COVID-19-related complaints were identified: 330 (61.00%) from patients and 211 (39.00%) from physicians. The monthly volume of complaints fluctuated, starting at 10 in 2020, peaking at 21 in 2022, and dropping to 14 in 2023. Most complaints from inpatients were expressed by older males aged 40 to 65 (38.82%, 210/541). The primary source of complaints was related to mandatory COVID-19 policies (79.30%, 429/541), followed by concerns regarding timely healthcare services (31.61%, 171/541). Few complaints were expressed regarding the insufficiency of medical resources (2.77%, 15/541) and the high costs (4.25%, 23/541). The frequency of complaints expressed by doctors and patients in the emergency department was higher compared with other departments (24.58%, 133/541). CONCLUSIONS Increased complaints may serve as a primitive and timely resource for investigating the potential hazards and drawbacks associated with policies pertaining to EIDs. Prompt collection and systematical analysis of patient and physician feedback could help us accurately evaluate the efficacy and repercussions of these policies. Implementing complaints-based assessment might improve care standards in forthcoming healthcare environments grappling with EIDs.
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Affiliation(s)
- Xixia Feng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Peiyi Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Xuechao Hao
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Yalan Peng
- Department of Medical General, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruihao Zhou
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China Hospital, President's Office, Sichuan University, Chengdu, Sichuan, China
| | - Guo Chen
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China.
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China.
| | - Tao Zhu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Laboratory of Anesthesia and Critical Care Medicine, West China Hospital, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, Sichuan University, Chengdu, Sichuan, China.
- West China Hospital, The Research Units of West China (2018RU012)-Chinese Academy of Medical Sciences, Sichuan University, Chengdu, Sichuan, China.
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Santana A, Prestes GDS, da Silva MD, Girardi CS, Silva LDS, Moreira JCF, Gelain DP, Westphal GA, Kupek E, Walz R, Dal-Pizzol F, Ritter C. Identification of distinct phenotypes and improving prognosis using metabolic biomarkers in COVID-19 patients. CRITICAL CARE SCIENCE 2024; 36:e20240028en. [PMID: 39109758 PMCID: PMC11321718 DOI: 10.62675/2965-2774.20240028-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/09/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE To investigate the relationship between the levels of adipokines and other endocrine biomarkers and patient outcomes in hospitalized patients with COVID-19. METHODS In a prospective study that included 213 subjects with COVID-19 admitted to the intensive care unit, we measured the levels of cortisol, C-peptide, glucagon-like peptide-1, insulin, peptide YY, ghrelin, leptin, and resistin.; their contributions to patient clustering, disease severity, and predicting in-hospital mortality were analyzed. RESULTS Cortisol, resistin, leptin, insulin, and ghrelin levels significantly differed between severity groups, as defined by the World Health Organization severity scale. Additionally, lower ghrelin and higher cortisol levels were associated with mortality. Adding biomarkers to the clinical predictors of mortality significantly improved accuracy in determining prognosis. Phenotyping of subjects based on plasma biomarker levels yielded two different phenotypes that were associated with disease severity, but not mortality. CONCLUSION As a single biomarker, only cortisol was independently associated with mortality; however, metabolic biomarkers could improve mortality prediction when added to clinical parameters. Metabolic biomarker phenotypes were differentially distributed according to COVID-19 severity but were not associated with mortality.
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Affiliation(s)
- Andressa Santana
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
| | - Gabriele da Silveira Prestes
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
| | - Marinara Dagostin da Silva
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
| | - Carolina Saibro Girardi
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Lucas dos Santos Silva
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - José Cláudio Fonseca Moreira
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | - Daniel Pens Gelain
- Center for Oxidative Stress StudiesInstituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilDepartment of Biochemistry, Center for Oxidative Stress Studies, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.
| | | | - Emil Kupek
- Public Health DepartmentUniversidade Federal de Santa CatarinaFlorianópolisSCBrazilPublic Health Department, Universidade Federal de Santa Catarina - Florianópolis (SC), Brazil.
| | - Roger Walz
- Department of Clinical MedicineHospital UniversitárioUniversidade Federal de Santa CatarinaFlorianópolisSCBrazilCenter for Applied Neuroscience, Department of Clinical Medicine, Hospital Universitário, Universidade Federal de Santa Catarina - Florianópolis (SC), Brazil.
| | - Felipe Dal-Pizzol
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
- Intensive Care UnitHospital São JoséCriciúmaSCBrazilIntensive Care Unit, Hospital São José - Criciúma (SC), Brazil.
| | - Cristiane Ritter
- Laboratory of Experimental PathophysiologyPosgraduate Program in Health SciencesUniversidade do Extremo Sul CatarinenseCriciúmaSCBrazilLaboratory of Experimental Pathophysiology, Posgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil.
- Intensive Care UnitHospital São JoséCriciúmaSCBrazilIntensive Care Unit, Hospital São José - Criciúma (SC), Brazil.
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He TY, Zhou HY, Zhu MH, Zhang JL. COVID-19 acts like a stress test, uncovering the vulnerable part of the human body: a retrospective study of 1640 cases in China. Eur J Public Health 2024; 34:760-765. [PMID: 38607985 PMCID: PMC11293811 DOI: 10.1093/eurpub/ckae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exhibits multi-organ damage with diverse complications, the correlation between age, gender, medical history and clinical manifestations of novel coronavirus disease 2019 (COVID-19) patients was investigated. METHODS 1640 patients who were infected with SARS-CoV-2 and hospitalized at the First Affiliated Hospital of Ningbo University from 22 December 2022 to 1 March 2023 were categorized and analysed. Normal distribution test and variance homogeneity test were performed. Based on the test results, one-way analysis of variance, Pearson's chi-squared test and logistic regression analysis were conducted in the study. RESULTS According to the ANOVA, there was a significant difference in the age distribution (P = .001) between different clinical presentations, while gender did not (P = .06). And regression analysis showed that age, hypertension, atherosclerosis and cancer were significant hazard factors for the development of predominant clinical manifestations in patients hospitalized with novel COVID-19. Additionally, infection with SARS-CoV-2 has the potential to exacerbate the burden on specific diseased or related organs. CONCLUSION The elderly who are infected with SARS-CoV-2 ought to be treated with emphasis not only on antiviral therapy but also on individualized treatment that takes their medical history and comorbidities into account.
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Affiliation(s)
- Tian-Yi He
- Health Science Center, Ningbo University, Ningbo, China
| | - Hong-Yu Zhou
- The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Ming-Hui Zhu
- The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Ji-Li Zhang
- Health Science Center, Ningbo University, Ningbo, China
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Danesh V, Tellson A, Boehm LM, Stevens AB, Ogola GO, Shrestha A, Cho J, Jimenez EJ, Arroliga AC. Exploring the Association of Metabolic Syndrome with In-Hospital Survival of Older Patients Hospitalized with COVID-19: Beyond Chronological Age. J Gen Intern Med 2024; 39:1811-1819. [PMID: 38587729 PMCID: PMC11282001 DOI: 10.1007/s11606-024-08744-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Despite the variability and complexity of geriatric conditions, few COVID-19 reports of clinical characteristic prognostication provide data specific to oldest-old adults (over age 85), and instead generally report broadly as 65 and older. OBJECTIVE To examine metabolic syndrome criteria in adults across 25 hospitals with variation in chronological age. DESIGN AND PARTICIPANTS This cohort study examined 39,564 hospitalizations of patients aged 18 or older with COVID-19 who received inpatient care between March 13, 2020, and February 28, 2022. EXPOSURE ICU admission and/or in-hospital mortality. MAIN MEASURES Metabolic syndrome criteria and patient demographics were examined as risk factors. The main outcomes were admission to ICU and hospital mortality. KEY RESULTS Oldest old patients (≥ 85 years) hospitalized with COVID-19 accounted for 7.0% (2758/39,564) of all adult hospitalizations. They had shorter ICU length of stay, similar overall hospitalization duration, and higher rates of discharge destinations providing healthcare services (i.e., home health, skilled nursing facility) compared to independent care. Chronic conditions varied by age group, with lower proportions of diabetes and uncontrolled diabetes in the oldest-old cohort compared with young-old (65-74 years) and middle-old (75-84 years) groups. Evaluations of the effect of metabolic syndrome and patient demographics (i.e., age, sex, race) on ICU admission demonstrate minimal change in the magnitude of effect for metabolic syndrome on ICU admission across the different models. CONCLUSIONS Metabolic syndrome measures are important individual predictors of COVID-19 outcomes. Building on prior examinations that metabolic syndrome is associated with death and ARDS across all ages, this analysis supports that metabolic syndrome criteria may be more relevant than chronological age as risk factors for poor outcomes attributed to COVID-19.
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Affiliation(s)
- Valerie Danesh
- Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA.
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Alaina Tellson
- Nursing Research, Baylor Scott & White Health, Dallas, TX, USA
| | - Leanne M Boehm
- School of Nursing, Vanderbilt University, Nashville, TN, USA
- Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alan B Stevens
- Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Gerald O Ogola
- Biostatistics, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Anisha Shrestha
- Data Core, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Jinmyoung Cho
- Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, TX, USA
| | | | - Alejandro C Arroliga
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Baylor Scott & White Health, Dallas, TX, USA
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Hadano Y, Ohwaki K, Suyama A, Miura A, Fujii S, Suzuki Y, Tomoda Y, Awaya Y. The Changes in Broad-spectrum Antimicrobial Consumption during the COVID-19 Pandemic in a Japanese Acute Tertiary-care Hospital: An Interrupted Time-series Analysis. Intern Med 2024; 63:2125-2130. [PMID: 38104990 DOI: 10.2169/internalmedicine.2868-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Objective The novel coronavirus disease 2019 (COVID-19) pandemic has spread worldwide, and hospitals in Japan have been forced to respond to the situation. This study evaluated the broad-spectrum antimicrobial use before and during the COVID-19 pandemic in an acute tertiary-care hospital. Methods This single-center, retrospective study was conducted between January 2019 and June 2021. Patients We reviewed patients treated with three broad-spectrum antipseudomonal agents: carbapenems, tazobactam/piperacillin, and cefepime. Monthly aggregated hospital antimicrobial consumption was measured as days of therapy (DOTs) per 1,000 patient-days, and the monthly incidences of Clostridioides difficile infection (CDI), multidrug-resistant Pseudomonas aeruginosa (MRPA), and carbapenemase-producing Enterobacteriaceae (CPE) were recorded. Results The median monthly carbapenem-DOTs during the pre-pandemic and pandemic era were 8.4 and 8.2 per 1,000 patient-days, respectively. A time-series analysis showed non-significant changes in the level between periods (coefficients: 2.08; 95% confidence interval [CI]: -2.9 to 7.0; p=0.44). No change in the trend of monthly carbapenem-DOTs was observed after intervention. No post-intervention changes in the incidence of MRPA or CPE were observed; however, the trend in the incidence of CDI per 1,000 patient-days significantly differed between the two periods (coefficient: -0.04; 95% CI: -0.07, 0.00; p=0.01), and a downward trend was observed in the monthly CDI incidence during the COVID-19 period. Conclusion The consumption of broad intravenous antimicrobial agents has not changed significantly during the pandemic. We need to maintain the quality of medical care, including antimicrobial stewardship, even in specialized resource-limited facilities during a pandemic.
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Affiliation(s)
- Yoshiro Hadano
- Teikyo University Graduate School of Public Health, Japan
- Antimicrobial Stewardship Team, Itabashi Chuo Medical Center, Japan
- Division of Infection Control and Prevention, Shimane University Hospital, Japan
| | | | - Asuka Suyama
- Department of Pharmacy, Itabashi Chuo Medical Center, Japan
| | - Ayako Miura
- Department of Clinical Laboratory, Itabashi Chuo Medical Center, Japan
| | - Shigeo Fujii
- Department of Clinical Laboratory, Itabashi Chuo Medical Center, Japan
| | - Yoshiko Suzuki
- Department of Nursing, Itabashi Chuo Medical Center, Japan
| | - Yoshitaka Tomoda
- Department of Medicine, Division of General Medicine Itabashi Chuo Medical Center, Japan
- Department of Medicine, Division of Pulmonary Medicine, Itabashi Chuo Medical Center, Japan
| | - Yukikazu Awaya
- Department of Medicine, Division of General Medicine Itabashi Chuo Medical Center, Japan
- Department of Medicine, Division of Pulmonary Medicine, Itabashi Chuo Medical Center, Japan
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Zhao K, Xiang X, Zheng Z, Zhang Q, Gu B, Zhang Y, Tang Z, Wei Y, Yuan L, Yang S, Lang L. COVID-19 and retinal layer thickness: A bidirectional Mendelian randomization study. Mult Scler Relat Disord 2024; 88:105700. [PMID: 38880027 DOI: 10.1016/j.msard.2024.105700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/16/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Observational studies have reported that COVID-19 is associated with alterations in retinal layer thickness, including changes in the ganglion cell inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL). However, the causal relationships remain unknown. Therefore, we assessed the direction and strength of the causal relationship between COVID-19 and GCIPL and RNFL thicknesses using a bidirectional two-sample Mendelian randomization (MR) design. METHODS Data were obtained from a large-scale COVID-19 Host Genetics Initiative (Nsample = 6,512,887), GCIPL dataset (Ncase = 31,434), and RNFL dataset (Ncase = 31,434). The inverse-variance weighted (IVW) method is the primary approach used to estimate causal effects. MR Egger, weighted median, weighted mode, MR Egger (bootstrap), and penalized weighted median methods were applied. Sensitivity analyses were implemented with RadialMR, MRPRESSO, MR-Egger regression, Cochran's Q statistic, leave-one-out analysis, and the funnel plot. RESULTS Forward MR analysis revealed that genetically identified COVID-19 susceptibility significantly increased the risk of GCIPL thickness (OR = 2.428, 95 % confidence interval [CI]:1.493-3.947, PIVW = 3.579 × 10-4) and RNFL thickness (OR = 1.735, 95 % CI:1.198-2.513, PIVW = 3.580 × 10-3) after Bonferroni correction. Reverse MR analysis did not indicate a significant causal association between GCIPL and RNFL thicknesses and COVID-19 phenotypes. No significant horizontal pleiotropy was found in the sensitivity analysis. CONCLUSIONS The host genetic liability to COVID-19 susceptibility was causally associated with increased GCIPL and RNFL thicknesses. Documenting this association increases our understanding of the pathophysiological mechanisms underlying COVID -19 susceptibility in retinopathy.
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Affiliation(s)
- Kun Zhao
- Department of PET-CT Molecular Imaging Center, Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus, Shanghai, PR China
| | - Xiqiao Xiang
- Department of PET-CT Molecular Imaging Center, Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus, Shanghai, PR China
| | - Ziwei Zheng
- Department of Ultrasonography, Shanghai Eighth People's Hospital, Shanghai, PR China
| | - Qingwei Zhang
- Department of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases (Renji Hospital, Shanghai Jiaotong University School of Medicine), Shanghai, PR China
| | - Bingxin Gu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, PR China
| | - Yanyan Zhang
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, PR China
| | - Zhen Tang
- Department of PET-CT Molecular Imaging Center, Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus, Shanghai, PR China
| | - Yuanhao Wei
- School of Public Health, Harbin Medical University, Harbin, PR China
| | - Lin Yuan
- Department of PET-CT Molecular Imaging Center, Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus, Shanghai, PR China
| | - Shaoling Yang
- Department of Ultrasonography, Shanghai Eighth People's Hospital, Shanghai, PR China.
| | - Lili Lang
- Department of Ophthalmology, Shanghai JiaoTong University Affiliated Sixth People's Hospital South Campus, Shanghai, PR China.
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Guo Q, Wang T, Huang Y, Wang F, Hao P, Fang L. Multiple sclerosis and COVID-19: a northern China survey. Neurol Sci 2024; 45:3563-3571. [PMID: 38722503 PMCID: PMC11254961 DOI: 10.1007/s10072-024-07578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 05/03/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND There is insufficient data on severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2) infection in Chinese patients with multiple sclerosis (pwMS). This study aims to explore the manifestation of pwMS during the Coronavirus disease 2019 (COVID-19) pandemic and the effect of SARS-CoV-2 infection on the prognosis of MS in northern China. METHODS In this cross-sectional study, an online self-administered questionnaire and telephone interviews were conducted among pwMS of northern China. Clinical correlation of SARS-CoV-2 infection since the onset of the COVID-19 pandemic in northern China was analyzed. RESULTS 164 patients with an average age of 38.9 ± 12.2 years were included, of which 57.3% had a disease course ≤ 5 years. 33.5% of the patients were COVID-19 vaccinated. 87.2% received disease-modifying therapy (DMT), and the average immunotherapy duration was 1.9 ± 1.6 years. 83.5% were SARS-CoV-2 infected, 14.6% reported worsening of their original condition after infection, and 5.1% had a relapse of MS. Shorter disease course was independently related to infection risk (P = 0.046), whereas increasing age was related to aggravated behavioral symptoms (P = 0.008). However, gender, vaccination, and DMT were not associated with susceptibility or poor prognosis. CONCLUSION A shorter disease course is independently associated with an increased risk of SARS-CoV-2 infection, and age is associated with worsening disability. It seems to be safe and necessary to use DMT during the pandemic, however, the use of B cell-depletion agents should be approached with caution.
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Affiliation(s)
- Qian Guo
- Department of Neurology, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130000, China
| | - Tianwei Wang
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130000, China
| | - Yusen Huang
- Department of Neurology, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130000, China
| | - Fangruyue Wang
- The Third Bethune Hospital of Jilin University, Changchun, 130000, China
| | - Pingping Hao
- Department of Neurology, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130000, China
| | - Le Fang
- Department of Neurology, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, 130000, China.
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Konuma T, Hamatani-Asakura M, Nagai E, Adachi E, Kato S, Isobe M, Monna-Oiwa M, Takahashi S, Yotsuyanagi H, Nannya Y. Cellular and humoral immunogenicity against SARS-CoV-2 vaccination or infection is associated with the memory phenotype of T- and B-lymphocytes in adult allogeneic hematopoietic cell transplant recipients. Int J Hematol 2024; 120:229-240. [PMID: 38842630 DOI: 10.1007/s12185-024-03802-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 05/10/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
We conducted a cross-sectional study to evaluate cellular and humoral immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination or infection and examine how lymphocyte subpopulations in peripheral blood correlate with cellular and humoral immunogenicity in adult allogeneic hematopoietic cell transplantation (HCT) recipients. The median period from SARS-CoV-2 vaccination or infection to sample collection was 110.5 days (range, 6-345 days). The median SARS-CoV-2 spike-specific antibody level was 1761 binding antibody units (BAU)/ml (range, 0 to > 11,360 BAU/ml). Enzyme-linked immunosorbent spot (ELISpot) assay of T cells stimulated with SARS-CoV-2 spike antigens showed that interferon-gamma (IFN-γ)-, interleukin-2 (IL-2)-, and IFN-γ + IL-2-producing T cells were present in 68.9%, 62.0%, and 56.8% of patients, respectively. The antibody level was significantly correlated with frequency of IL-2-producing T cells (P = 0.001) and IFN-γ + IL-2-producing T cells (P = 0.006) but not IFN-γ-producing T cells (P = 0.970). Absolute counts of CD8+ and CD4+ central memory T cells were higher in both IL-2- and IFN-γ + IL-2-producing cellular responders compared with non-responders. These data suggest that cellular and humoral immunogenicity against SARS-CoV-2 vaccination or infection is associated with the memory phenotype of T cells and B cells in adult allogeneic HCT recipients.
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Affiliation(s)
- Takaaki Konuma
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, Japan.
| | - Megumi Hamatani-Asakura
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, Japan
| | - Etsuko Nagai
- Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Eisuke Adachi
- Department of Infectious Diseases and Applied Immunology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Seiko Kato
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, Japan
| | - Masamichi Isobe
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, Japan
| | - Maki Monna-Oiwa
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, Japan
| | - Satoshi Takahashi
- Division of Clinical Precision Research Platform, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Yotsuyanagi
- Department of Infectious Diseases and Applied Immunology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yasuhito Nannya
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, Japan
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18
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Salgueiro RB, Bolin AP, Andreotti S, Medeiros Komino AC, de Sousa É, de Fatima Silva F, Gomes de Proença AR, Laurato Sertié RA, Rodrigues AC, Lima FB. Long-term glucocorticoid infusion impairs epididymal adipocyte metabolism and maturation and affects miR-150-5p actions. Mol Cell Endocrinol 2024; 589:112250. [PMID: 38663485 DOI: 10.1016/j.mce.2024.112250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024]
Abstract
The most common form of hypercortisolism is iatrogenic Cushing's syndrome. Lipodystrophy and metabolic disorders can result from the use of exogenous glucocorticoids (GC). Adipocytes play an important role in the production of circulating exosomal microRNAs, and knockdown of Dicer promotes lipodystrophy. The aim of this study is to investigate the effect of GCs on epididymal fat and to assess their influence on circulating microRNAs associated with fat turnover. The data indicate that despite the reduction in adipocyte volume due to increased lipolysis and apoptosis, there is no difference in tissue mass, suggesting that epididymal fat pad, related to animal size, is not affected by GC treatment. Although high concentrations of GC have no direct effect on epididymal microRNA-150-5p expression, GC can induce epididymal adipocyte uptake of microRNA-150-5p, which regulates transcription factor Ppar gamma during adipocyte maturation. In addition, GC treatment increased lipolysis and decreased glucose-derived lipid and glycerol incorporation. In conclusion, the similar control and GC epididymal fat mass results from increased dense fibrogenic tissue and decreased adipocyte volume induced by the lipolytic effect of GC. These findings demonstrate the complexity of epididymal fat. They also highlight how this disease alters fat distribution. This study is the first in a series published by our laboratory showing the detailed mechanism of adipocyte turnover in this disease.
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Affiliation(s)
- Rafael Barrera Salgueiro
- University of São Paulo, Institute of Biomedical Sciences, Department of Physiology and Biophysics, São Paulo, SP, Brazil; University of Brasília, Biology Institute, Department of Physiological Sciences, Brasília, Federal District, Brazil.
| | - Anaysa Paola Bolin
- University of São Paulo, Institute of Biomedical Sciences, Department of Pharmacology, São Paulo, SP, Brazil
| | - Sandra Andreotti
- University of São Paulo, Institute of Biomedical Sciences, Department of Physiology and Biophysics, São Paulo, SP, Brazil
| | - Ayumi Cristina Medeiros Komino
- University of São Paulo, Institute of Biomedical Sciences, Department of Physiology and Biophysics, São Paulo, SP, Brazil
| | - Érica de Sousa
- University of São Paulo, Institute of Biomedical Sciences, Department of Pharmacology, São Paulo, SP, Brazil
| | - Flaviane de Fatima Silva
- University of São Paulo, Institute of Biomedical Sciences, Department of Physiology and Biophysics, São Paulo, SP, Brazil
| | | | - Rogério Antonio Laurato Sertié
- University of São Paulo, Institute of Biomedical Sciences, Department of Physiology and Biophysics, São Paulo, SP, Brazil
| | - Alice Cristina Rodrigues
- University of São Paulo, Institute of Biomedical Sciences, Department of Pharmacology, São Paulo, SP, Brazil
| | - Fabio Bessa Lima
- University of São Paulo, Institute of Biomedical Sciences, Department of Physiology and Biophysics, São Paulo, SP, Brazil
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19
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Miner D, Smith K, Wu PT, Price JH, Piscitelli D, Chui K. Pragmatic approach to mobilizing individuals with critical illness due to COVID-19: clinical perspective. Disabil Rehabil 2024; 46:4040-4048. [PMID: 37752855 DOI: 10.1080/09638288.2023.2263370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To provide pragmatic guidance for acute rehabilitation management and implementation of early mobility for individuals with critical illness due to COVID-19. METHODS Clinical perspective developed through reflective clinical practice and narrative review of best available evidence. RESULTS Current clinical practice guidelines do not provide guidance for implementation of early mobility interventions for individuals with critical illness due to COVID-19 who require enhanced ventilatory support or support of inhaled pulmonary artery vasodilators. Many individuals who may benefit from implementation of early mobility interventions are excluded by strict interpretation of current guidelines. CONCLUSIONS Risk vs benefit of implementing early mobility interventions in individuals with critical illness due to COVID-19 can be mitigated through coordinated efforts of interdisciplinary teams to promote shared decision-making through therapeutic alliances with patients and their families. Clinicians must clearly define the goals of care, understand the limitations of monitoring equipment in the intensive care unit, prepare to titrate levels of oxygen based on an individual's physiologic response to mobility interventions, and help individuals maintain external goal-directed focus of attention to optimize outcomes of early mobility interventions.
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Affiliation(s)
- Daniel Miner
- Department of Physical Therapy, Carilion Clinic, Radford University Carilion, Radford, VA, USA
| | - Kellen Smith
- Department of Physical Therapy, Carilion Clinic, Radford University, Roanoke, VA, USA
| | - Pei-Tzu Wu
- Department of Physical Therapy, Pacific University, Hillsboro, OR, USA
| | - Justin H Price
- Carilion Clinic, VA Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Daniele Piscitelli
- Department of Physical Therapy, University of Connecticut, Storrs, CT, USA
| | - Kevin Chui
- Department of Physical Therapy, Radford University, Radford, VA, USA
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20
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Dyas AR, Bronsert MR, Stuart CM, Thomas MB, Schulick RD, Franco SR, Gleisner A, Randhawa SK, David EA, Mitchell JD, Meguid RA. Analyzing the impact of the Coronavirus disease 2019 pandemic on initial oncologic presentation and treatment of non-small cell lung cancer in the United States. J Thorac Cardiovasc Surg 2024; 168:378-390.e7. [PMID: 37981103 DOI: 10.1016/j.jtcvs.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/09/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND A significantly lower rate of non-small cell lung cancer (NSCLC) screening, greater health care avoidance, and changes to oncologic recommendations were some consequences of the Coronavirus disease 2019 (COVID-19) pandemic affecting the medical environment. We sought to determine how the health care environment during the COVID-19 pandemic affected the oncologic treatment of patients diagnosed with non-small cell lung cancer (NSCLC). METHODS This was a retrospective cohort study evaluating patients with NSCLC in the National Cancer Database (2019-2020). Patients were divided into prepandemic (2019) and pandemic (2020) cohorts, and patient, oncologic, and treatment variables were compared. Multivariable logistic regression was performed to control for the impact of demographic characteristics on oncologic variables and the impact of oncologic variables on treatment variables. RESULTS The study population comprised 250,791 patients, including 114,533 patients (45.7%) in the pandemic cohort. There were 15% fewer new NSCLC diagnoses during the pandemic compared with prepandemic. Patients diagnosed during the pandemic had more advanced clinical TNM stage on presentation (P < .0001) and were more likely to have tumors in overlapping lobes or in a main bronchus (P = .0002). They were less likely to receive cancer treatment (P < .0001) and to undergo primary resection (P < .0001) and more likely to receive adjuvant systemic therapy (P = .004) and a combination of palliative treatment regimens (P < .0001). After risk adjustment, all these differences remained statistically significant (P < .05). CONCLUSIONS The COVID-19 pandemic was associated with increased clinical stage at presentation for patients with NSCLC, which impacted subsequent treatment strategies. However, treatment differed minimally when controlling for cancer stage. Future studies will examine the impact of these differences on overall survival and cancer-free survival.
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Affiliation(s)
- Adam R Dyas
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo.
| | - Michael R Bronsert
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, Colo
| | - Christina M Stuart
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo
| | - Madeline B Thomas
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo
| | - Richard D Schulick
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo
| | - Salvador Rodriguez Franco
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo
| | - Ana Gleisner
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo
| | - Simran K Randhawa
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo
| | - Elizabeth A David
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo
| | - John D Mitchell
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo
| | - Robert A Meguid
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colo; Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colo; Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, Colo
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21
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Castro NC, Bullock J, Haynesworth K, Loftus S, Metz J, North H, Kemp TJ, Pinto LA. Blood collection tube and anticoagulant influence on SARS-CoV-2 antibody and avidity levels. Heliyon 2024; 10:e34449. [PMID: 39114031 PMCID: PMC11305197 DOI: 10.1016/j.heliyon.2024.e34449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 07/09/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
SARS-CoV-2 serology plays a crucial role in assessing COVID-19 vaccine immunogenicity and antibody responses to SARS-CoV-2 infection. Tube type and anticoagulant may influence serology results. Thus, understanding the influence of these variables in test results is key. We evaluated the influence of serum collection tube type and anticoagulant on anti-SARS-CoV-2 spike antibody levels detected by enzyme-linked immunosorbent assays (ELISAs) and Luminex multiplex assays (11-plex) in serum and plasma samples. Anti-spike IgG avidity was also evaluated in both sample types. No significant differences were found between serology assay results using different blood (serum) collection tube types. However, significantly lower antibody concentrations (p < 0.05) were observed in tubes with the anticoagulants sodium citrate and acid citrate dextrose (ACD) in the ELISA and Multiplex assays (n = 29), compared to expected concentrations. These differences mostly disappeared after adjusting for the dilution factor caused by the anticoagulant volume, indicating that anticoagulant does not significantly impact the assay results, while anticoagulant volume does. There was a significant difference (p < 0.05) in IgG avidity (M) of plasma samples (p < 0.05) compared to serum, but anticoagulant type had no effect. Overall, these findings indicate that the choice of collection tube may introduce subtle variations in assay results if the volumes of anticoagulants are not taken into consideration. Additionally, differences between serum and anticoagulant-treated plasma matrices were observed in avidity ELISAs, indicating that these samples are not interchangeable for these assays; a finding that requires further investigation.
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Affiliation(s)
- Nicholas C. Castro
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
| | - Jimmie Bullock
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
| | - Katarzyna Haynesworth
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
| | - Sarah Loftus
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
| | - Jordan Metz
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
| | - Hayley North
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
| | - Troy J. Kemp
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
| | - Ligia A. Pinto
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, 21702, USA
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22
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Tanaka A, Wakayama K, Fukuda Y, Ohta S, Homma T, Ando K, Nishihara Y, Nakano R, Zhao J, Suzuki Y, Kyotani Y, Yano H, Kasahara K, Chung KP, Sagara H, Yoshizumi M, Nakahira K. Increased levels of circulating cell-free DNA in COVID-19 patients with respiratory failure. Sci Rep 2024; 14:17399. [PMID: 39075117 PMCID: PMC11286760 DOI: 10.1038/s41598-024-68433-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 07/23/2024] [Indexed: 07/31/2024] Open
Abstract
Cell-free DNA (cfDNA) is released from injured cells and aggravates inflammation. Patients with coronavirus disease (COVID-19) often develop pneumonia and respiratory failure, and require oxygen therapy (OT), including mechanical ventilation (MV). It remains unclear whether cfDNA predicts the risk of receiving OT or MV in COVID-19 patients. Therefore, we hypothesized that circulating cfDNA levels could reflect the severity of respiratory failure and determine a therapeutic approach for oxygenation in patients with COVID-19. We analyzed cfDNA levels in serum samples from 95 hospitalized patients with COVID-19 at Showa University Hospital (Tokyo, Japan). cfDNA levels were assessed by measuring the copy numbers of mitochondrial DNA (mtDNA) and nuclear DNA (nDNA) using quantitative real-time PCR (qPCR). Both cf-nDNA and cf-mtDNA levels were negatively correlated with adjusted SpO2 for FiO2 (SpO2/FiO2 ratio). Elevated cf-nDNA and cf-mtDNA levels were associated with the requirement for OT or MV during patient admission. Multivariate logistic regression analysis revealed that cf-nDNA and cf-mtDNA levels were independent risk factors for OT and MV. These results suggest that both serum cf-nDNA and cf-mtDNA could serve as useful early biomarkers to indicate the necessity of OT or MV in patients with COVID-19.
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Affiliation(s)
- Akihiko Tanaka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Katsuki Wakayama
- Department of Pharmacology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Yosuke Fukuda
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Shin Ohta
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Homma
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Koichi Ando
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Division of Internal Medicine, Showa University Dental Hospital Medical Clinic, Tokyo, Japan
| | - Yuji Nishihara
- Department of Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Ryuichi Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Jing Zhao
- Department of Pharmacology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Yuki Suzuki
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Yoji Kyotani
- Department of Pharmacology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Kei Kasahara
- Department of Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Kuei-Pin Chung
- Department of Laboratory Medicine, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, 100225, Taiwan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Masanori Yoshizumi
- Department of Pharmacology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Kiichi Nakahira
- Department of Pharmacology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
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23
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Marra AM, Giardino F, Anniballo A, Ferazzoli S, Salzano A, Arcopinto M, D’Assante R, De Mare A, Esposito G, Saldamarco L, Rurgo S, Sarnelli G, Cittadini A. Beneficial Effects on Exercise Capacity Associated with a Combination of Lactoferrin, Lysozyme, Lactobacillus, Resveratrol, Vitamins, and Oligoelements in Patients with Post-COVID-19 Syndrome: A Single-Center Retrospective Study. J Clin Med 2024; 13:4444. [PMID: 39124710 PMCID: PMC11313403 DOI: 10.3390/jcm13154444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/19/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: Although long-term COVID-19 symptoms are common, little is known about the management of post-COVID-19 condition. The aim of the current report is to evaluate the effects of a combination of lactoferrin, lysozyme, lactobacillus, resveratrol, vitamins, and oligoelements (PIRV-F20®) on the exercise capacity of post-COVID-19 patients. Methods: A retrospective analysis of consecutive patients referred to a specific outpatient clinic dedicated to post-COVID-19 condition from April 2022 to April 2023 was conducted. Subjects of both sexes, aged ≥18 years, with previous COVID-19 in the preceding 12 months, persistent symptoms consistent with post-COVID syndrome, and initial exercise impairment were included. Exclusion criteria were as follows: active cancer, end-stage conditions, severe musculoskeletal conditions, or patients with a history of limited functional capacity, pregnancy, or breastfeeding. Patients who reported having taken PIRV-F20® for at least 6 weeks were compared to patients who refused this treatment. Six-minute walking distance was the primary endpoint. Results: Forty-four patients (56.8% women, aged 49.1 ± 18.1 years) were included in the study. The group of patients who reported having taken PIRV-F20® exhibited a significant improvement of 6MWD (median: +40 m; IQR: 10-65 m, p vs. baseline: 0.02), which was significantly superior (p: 0.01) when compared to the controls (median: +10 m; IQR: -5-30 m). No differences were found with regard to muscular strength, echocardiographic parameters, and perception of symptoms. Conclusions: Post-COVID-19 individuals who reported having taken PIRV-F20® for at least six weeks showed a significant improvement in exercise capacity. This finding should be confirmed in larger, prospective, randomized controlled trials.
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Affiliation(s)
- Alberto Maria Marra
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, 80131 Naples, Italy;
- Interdepartmental Center for Gender Medicine Research—GENESIS, University of Naples Federico II, 80131 Naples, Italy;
| | - Federica Giardino
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
| | - Andrea Anniballo
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
| | - Simona Ferazzoli
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
| | - Andrea Salzano
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
- Interdepartmental Center for Gender Medicine Research—GENESIS, University of Naples Federico II, 80131 Naples, Italy;
| | - Michele Arcopinto
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
| | - Roberta D’Assante
- Interdepartmental Center for Gender Medicine Research—GENESIS, University of Naples Federico II, 80131 Naples, Italy;
| | - Andrea De Mare
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
| | - Giorgia Esposito
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
| | - Lavinia Saldamarco
- Department of Emergency Medicine, “Betania” Hospital, 80147 Naples, Italy;
| | - Sara Rurgo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Giovanni Sarnelli
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, 80131 Naples, Italy;
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Antonio Cittadini
- Division of Internal Medicine and Metabolism and Rehabilitation, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (A.M.M.); (F.G.); (A.A.); (S.F.); (A.S.); (M.A.); (A.D.M.); (G.E.)
- Interdisciplinary Research Centre on Biomaterials (CRIB), University of Naples Federico II, 80131 Naples, Italy;
- Interdepartmental Center for Gender Medicine Research—GENESIS, University of Naples Federico II, 80131 Naples, Italy;
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24
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Zheng X, Lu R, Pan D, Peng L, He R, Hu Y, Chen J, Tang J, Rong X, Teng S, Wang Y, Liu F, Xie T, Wu C, Tang Y, Liu W, Qu X. Regulatory T and CXCR3+ Circulating Tfh Cells Concordantly Shape the Neutralizing Antibody Responses in Individuals Who Have Recovered from Mild COVID-19. J Infect Dis 2024; 230:28-37. [PMID: 39052730 DOI: 10.1093/infdis/jiae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/16/2024] [Accepted: 02/05/2024] [Indexed: 02/09/2024] Open
Abstract
Regulatory T (Treg) cells are involved in the antiviral immune response in patients with coronavirus disease 2019 (COVID-19); however, whether Treg cells are involved in the neutralizing antibody (nAb) response remains unclear. Here, we found that individuals who recovered from mild but not severe COVID-19 had significantly greater frequencies of Treg cells and lower frequencies of CXCR3+ circulating T follicular helper (cTfh) cells than healthy controls. Furthermore, the frequencies of Treg and CXCR3+ cTfh cells were negatively and positively correlated with the nAb responses, respectively, and Treg cells was inversely associated with CXCR3+ cTfh cells in individuals who recovered from mild COVID-19 but not in those with severe disease. Mechanistically, Treg cells inhibited memory B-cell differentiation and antibody production by limiting the activation and proliferation of cTfh cells, especially CXCR3+ cTfh cells, and functional molecule expression. This study provides novel insight showing that mild COVID-19 elicits concerted nAb responses, which are shaped by both Treg and Tfh cells.
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Affiliation(s)
- Xingyu Zheng
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Rui Lu
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Dong Pan
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Liting Peng
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Rongzhang He
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Yabin Hu
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Jun Chen
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Jinyong Tang
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Xiaohan Rong
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Shishan Teng
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - You Wang
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
- School of Public Health, University of South China, Hengyang, China
| | - Fen Liu
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Tianyi Xie
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Chanfeng Wu
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
| | - Yinggen Tang
- Translational Medicine Institute, The First People's Hospital of Chenzhou, Hengyang Medical School, University of South China, Chenzhou, China
- School of Public Health, University of South China, Hengyang, China
| | - Wenpei Liu
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
| | - Xiaowang Qu
- College of Basic Medicine, Hengyang Medical School, University of South China, Hengyang, China
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Schmoke N, Nemeh C, Crum RW, McManus EC, Abramov A, Wang C, Kurlansky P, Zitsman J. Impact of COVID-19 pandemic on adolescents undergoing metabolic bariatric surgery. Surg Obes Relat Dis 2024:S1550-7289(24)00693-2. [PMID: 39152058 DOI: 10.1016/j.soard.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/17/2024] [Accepted: 07/14/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND While the lasting effect of the COVID-19 pandemic continues to unfold, the impact on adolescents undergoing bariatric surgery remains unseen. OBJECTIVE We examined the impact of the pandemic on adolescents undergoing metabolic bariatric surgery. SETTING Academic hospital, New York, NY. METHODS A single-institution review of prospectively collected data evaluated adolescents who underwent laparoscopic sleeve gastrectomy between 2010 and 2023, forming two cohorts: pre-COVID (before March 1, 2019) and COVID (after March 1, 2020). Absolute and percent weight loss and body mass index (BMI) change at 6 and 12 months postsurgery were compared between cohorts. Multivariable linear regression models were constructed to estimate the association between weight loss, adjusting for age, gender, ethnicity, and BMI. RESULTS A total of 358 patients were included: 245 in the pre-COVID cohort and 113 in the COVID cohort. There were no significant differences in baseline characteristics. There were no significant differences between cohorts at 6 months in weight loss (21.6 kg vs. 22.5 kg, P = .43), percent weight loss (18% vs. 18%, P = .63), and BMI change (8.0 vs. 8.4, P = .39) which was maintained at 12 months. In multivariate models, after adjusting for age, gender, ethnicity, and baseline BMI, undergoing surgery during the pandemic was not associated with a difference in weight loss or BMI change at 6 and 12 months postoperatively. CONCLUSION Despite the severe societal impact of the COVID-19 pandemic, laparoscopic sleeve gastrectomy remained a durable intervention for adolescent obesity, with no observed differences in weight loss in patients undergoing surgery during the pandemic compared to prepandemic.
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Affiliation(s)
- Nicholas Schmoke
- Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Christopher Nemeh
- Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Robert W Crum
- Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Emily C McManus
- Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Alexey Abramov
- Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York
| | - Chunhui Wang
- Center for Innovation and Outcomes Research, Department of Surgery, Columbia University Irving Medical Center, New York, New York
| | - Paul Kurlansky
- Center for Innovation and Outcomes Research, Department of Surgery, Columbia University Irving Medical Center, New York, New York; Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Jeffrey Zitsman
- Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / New York-Presbyterian Morgan Stanley Children's Hospital, New York, New York.
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Sibanda B, Haryanto B. Assessing the Impact of COVID-19 Vaccination Programs on the Reduction of COVID-19 Cases: A Systematic Literature Review. Ann Glob Health 2024; 90:45. [PMID: 39070079 PMCID: PMC11276414 DOI: 10.5334/aogh.4484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 06/29/2024] [Indexed: 07/30/2024] Open
Abstract
Background: Vaccination is the most effective way to prevent serious illness and death from COVID-19 among the various preventive interventions available. Objective: This review aimed to assess the actual effectiveness of COVID-19 vaccines in curbing the transmission and incidence of COVID-19 cases, to examine the role of different vaccine types in controlling the COVID-19 pandemic, as well as to identify the key factors influencing the efficacy of COVID-19 vaccines in containing the spread of the virus. Methods: The suggestions made by the PRISMA Framework were adhered to. To find the publications for the 2020-2023 timeframe, searches were performed through the PubMed databases, EMBASE, Scopus, and ProQuest. For the review, 17 reports satisfied the inclusion requirements. Ad26.CoV2.S or ChAdOx1-S, Gam-COVID-Vac(GAM), Sinovac Life Sciences Co., Oxford-AstraZeneca, Pfizer-BioNTech, and viral vector vaccines are among the vaccines that act on various variations. They dealt with the Delta, B.1.1.519, Omicron, and Alpha variations. Findings: Vaccinations against various Variants resulted in fewer COVID-19 infections, fewer deaths, and fewer hospitalizations. The emergency of the Delta variant, persons over 60, and vaccine hesitancy were the main issues affecting the effectiveness of COVID-19 vaccinations in containing the virus's spread. Conclusion: The collective evidence strongly supports the conclusion that COVID-19 vaccination plays a crucial role in mitigating the spread of the virus and reducing the severity of illness among those who contract the virus.
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Affiliation(s)
- Brightwell Sibanda
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
| | - Budi Haryanto
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
- Research Center for Climate Change, Universitas Indonesia, Depok, West Java, Indonesia
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Valiate BVS, Castro JTD, Marçal TG, Andrade LAF, Oliveira LID, Maia GBF, Faustino LP, Hojo-Souza NS, Reis MAAD, Bagno FF, Salazar N, Teixeira SR, Almeida GG, Gazzinelli RT. Evaluation of an RBD-nucleocapsid fusion protein as a booster candidate for COVID-19 vaccine. iScience 2024; 27:110177. [PMID: 38993669 PMCID: PMC11238127 DOI: 10.1016/j.isci.2024.110177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 04/30/2024] [Accepted: 05/31/2024] [Indexed: 07/13/2024] Open
Abstract
Despite successful vaccines and updates, constant mutations of SARS-CoV-2 makes necessary the search for new vaccines. We generated a chimeric protein that comprises the receptor-binding domain from spike and the nucleocapsid antigens (SpiN) from SARS-CoV-2. Once SpiN elicits a protective immune response in rodents, here we show that convalescent and previously vaccinated individuals respond to SpiN. CD4+ and CD8+ T cells from these individuals produced greater amounts of IFN-γ when stimulated with SpiN, compared to SARS-CoV-2 antigens. Also, B cells from these individuals were able to secrete antibodies that recognize SpiN. When administered as a boost dose in mice previously immunized with CoronaVac, ChAdOx1-S or BNT162b2, SpiN was able to induce a greater or equivalent immune response to homologous prime/boost. Our data reveal the ability of SpiN to induce cellular and humoral responses in vaccinated human donors, rendering it a promising candidate.
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Affiliation(s)
- Bruno Vinicius Santos Valiate
- Fundação Oswaldo Cruz-Minas, Belo Horizonte 30.190-002, MG, Brazil
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | - Julia Teixeira de Castro
- Fundação Oswaldo Cruz-Minas, Belo Horizonte 30.190-002, MG, Brazil
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | | | - Luis Adan Flores Andrade
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | - Livia Isabela de Oliveira
- Fundação Oswaldo Cruz-Minas, Belo Horizonte 30.190-002, MG, Brazil
- Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte 31.630-901, MG, Brazil
| | | | | | - Natalia S Hojo-Souza
- Fundação Oswaldo Cruz-Minas, Belo Horizonte 30.190-002, MG, Brazil
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | | | - Flávia Fonseca Bagno
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | - Natalia Salazar
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | - Santuza R Teixeira
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | - Gregório Guilherme Almeida
- Fundação Oswaldo Cruz-Minas, Belo Horizonte 30.190-002, MG, Brazil
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
| | - Ricardo Tostes Gazzinelli
- Fundação Oswaldo Cruz-Minas, Belo Horizonte 30.190-002, MG, Brazil
- Centro de Tecnologia de Vacinas, Universidade Federal de Minas Gerais, Parque Tecnológico de Belo Horizonte, Belo Horizonte 31.310-260, MG, Brazil
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28
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Nimgaonkar I, Yoke LH, Roychoudhury P, Flaherty PW, Oshima MU, Weixler A, Gauthier J, Greninger AL, Mielcarek M, Boeckh M, Liu C, Hill JA. Outcomes in Hematopoietic Cell Transplant and Chimeric Antigen Receptor T-Cell Therapy Recipients With Pre-Cellular Therapy SARS-CoV-2 Infection. Clin Infect Dis 2024; 79:86-95. [PMID: 38427848 DOI: 10.1093/cid/ciae116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Hematopoietic cell transplant (HCT) or chimeric antigen receptor (CAR) T-cell therapy recipients have high morbidity from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. There are limited data on outcomes from SARS-CoV-2 infection shortly before cellular therapy and uncertainty whether to delay therapy. METHODS We conducted a retrospective cohort study of patients with SARS-CoV-2 infection within 90 days before HCT or CAR-T-cell therapy between January 2020 and November 2022. We characterized the kinetics of SARS-CoV-2 detection, clinical outcomes following cellular therapy, and impact on delays in cellular therapy. RESULTS We identified 37 patients (n = 15 allogeneic HCT, n = 11 autologous HCT, n = 11 CAR-T-cell therapy) with SARS-CoV-2 infections within 90 days of cellular therapy. Most infections (73%) occurred between March and November 2022, when Omicron strains were prevalent. Most patients had asymptomatic (27%) or mild (68%) coronavirus disease 2019 (COVID-19). SARS-CoV-2 positivity lasted a median of 20.0 days (interquartile range, 12.5-26.25 days). The median time from first positive SARS-CoV-2 test to cellular therapy was 45 days (interquartile range, 37.75-70 days); 1 patient tested positive on the day of infusion. After cellular therapy, no patients had recrudescent SARS-CoV-2 infection or COVID-19-related complications. Cellular therapy delays related to SARS-CoV-2 infection occurred in 70% of patients for a median of 37 days. Delays were more common after allogeneic (73%) and autologous (91%) HCT compared to CAR-T-cell therapy (45%). CONCLUSIONS Patients with asymptomatic or mild COVID-19 may not require prolonged delays in cellular therapy in the context of contemporary circulating variants and availability of antiviral therapies.
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Affiliation(s)
- Ila Nimgaonkar
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Leah H Yoke
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Patrick W Flaherty
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Masumi Ueda Oshima
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Amelia Weixler
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Jordan Gauthier
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Alexander L Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Marco Mielcarek
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Michael Boeckh
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Catherine Liu
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Joshua A Hill
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
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29
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Al Sulaiman K, Aljuhani O, Korayem GB, AlFaifi M, Alharthi AF, Alshehri A, Alaboud MS, Alzahrani IS, Alenazi BA, Alanazi FF, Alrashidi H, Alotaibi SM, Aloufi K, Alotaibi RM, Alalawi M, Altebainawi AF, Alshami MY, Alenazi AA, Abalkhail GA, Bin Naheet R, Alnasr RMA, Alrashed M, Al Mutairi FE, Albarqi KJ, Alshammari RS, Abunayyan NM, Aldhmadi WJ, Vishwakarma R. Association Between Rhesus and ABO Blood Group Types and Their Impact on Clinical Outcomes in Critically Ill Patients with COVID-19: A Multi-Center Investigation. Infect Drug Resist 2024; 17:3161-3171. [PMID: 39050827 PMCID: PMC11268740 DOI: 10.2147/idr.s447010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 06/14/2024] [Indexed: 07/27/2024] Open
Abstract
Background There is increasing evidence suggesting that ABO blood type may play a role in the immunopathogenesis of COVID-19 infection. In addition to ABO blood type, the Rhesus (Rh) factor has also been implicated in various disease processes. Therefore, our study aimed to assess the association between both ABO and Rh blood types in critically ill patients with COVID-19 and their clinical outcomes. Methods A multicenter retrospective cohort study conducted in Saudi Arabia between March 1, 2020, and July 31, 2021, involving adult COVID-19 patients admitted to Intensive Care Units, aimed to explore potential associations between rhesus blood group types (Positive versus Negative) and clinical outcomes. The primary endpoint assessed was the hospital length of stay (LOS). Other endpoints were considered secondary. Results After propensity score matching (3:1 ratio), 212 patients were included in the final analysis. The hospital length of stay was longer in a negative Rh blood group compared with patients in the Rh-positive group (beta coefficient 0.26 (0.02, 0.51), p = 0.03). However, neither 30-day mortality (HR 0.28; 95% CI 0.47, 1.25, p = 0.28) nor in-hospital mortality (HR 0.74; 95% CI 0.48, 1.14, p = 0.17) reached statistical significance. Additionally, among the different ABO types, the A+ blood group exhibited a higher proportion of thrombosis/infarction and in-hospital mortality (28.1% and 31.2%, respectively). Conclusion This study highlights the potential impact of blood group type on the prognosis of critically ill patients with COVID-19. It has been observed that patients with a negative Rh blood group type tend to have a longer hospital stay, while their mortality rates and complications during ICU stay are similar to the patients with a Rh-positive group.
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Affiliation(s)
- Khalid Al Sulaiman
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
- Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia
- Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), Riyadh, Saudi Arabia
| | - Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghazwa B Korayem
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mashael AlFaifi
- Pharmaceutical Care Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Abdullah F Alharthi
- Department of Clinical Pharmacy, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Al-D, Al-Dawadmi, 11961Saudi Arabia
| | - Asma Alshehri
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mashael S Alaboud
- Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ibtesam Saeed Alzahrani
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Batoul Abdullah Alenazi
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fai Farhan Alanazi
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hessah Alrashidi
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sara Mohammad Alotaibi
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khuld Aloufi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Rawan M Alotaibi
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mai Alalawi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ali Faris Altebainawi
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Mohammad Y Alshami
- Pharmaceutical Care Services, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa, Saudi Arabia
| | - Abeer A Alenazi
- Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ghaida A Abalkhail
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Renad Bin Naheet
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | | | - Mohammed Alrashed
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia
| | - Faisal E Al Mutairi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Khalid J Albarqi
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rawan S Alshammari
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Norah M Abunayyan
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Wadha J Aldhmadi
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
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Abisheva S, Rutskaya-Moroshan K, Nuranova G, Batyrkhan T, Abisheva A. Antimalarial Drugs at the Intersection of SARS-CoV-2 and Rheumatic Diseases: What Are the Potential Opportunities? MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1171. [PMID: 39064600 PMCID: PMC11279047 DOI: 10.3390/medicina60071171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: The coronavirus disease of 2019 (COVID-19) pandemic has posed a serious threat to humanity and is considered a global health emergency. Antimalarial drugs (ADs) have been used in the treatment of immuno-inflammatory arthritis (IIA) and coronavirus infection (COVID-19). The aim of this review is to analyze the current knowledge about the immunomodulatory and antiviral mechanisms of action, characteristics of use, and side effects of antimalarial drugs. Material and Methods: A literature search was carried out using PubMed, MEDLINE, SCOPUS, and Google Scholar databases. The inclusion criteria were the results of randomized and cohort studies, meta-analyses, systematic reviews, and original full-text manuscripts in the English language containing statistically confirmed conclusions. The exclusion criteria were summary reports, newspaper articles, and personal messages. Qualitative methods were used for theoretical knowledge on antimalarial drug usage in AIRDs and SARS-CoV-2 such as a summarization of the literature and a comparison of the treatment methods. Results: The ADs were considered a "candidate" for the therapy of a new coronavirus infection due to mechanisms of antiviral activity, such as interactions with endocytic pathways, the prevention of glycosylation of the ACE2 receptors, blocking sialic acid receptors, and reducing the manifestations of cytokine storms. The majority of clinical trials suggest no role of antimalarial drugs in COVID-19 treatment or prevention. These circumstances do not allow for their use in the treatment and prevention of COVID-19. Conclusions: The mechanisms of hydroxychloroquine are related to potential cardiotoxic manifestations and demonstrate potential adverse effects when used for COVID-19. Furthermore, the need for high doses in the treatment of viral infections increases the likelihood of gastrointestinal side effects, the prolongation of QT, and retinopathy. Large randomized clinical trials (RCTs) have refuted the fact that there is a positive effect on the course and results of COVID-19.
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Affiliation(s)
- Saule Abisheva
- Department of Family Medicine №1, NJSC “Astana Medical University”, Astana 010000, Kazakhstan; (S.A.); (T.B.); (A.A.)
| | - Kristina Rutskaya-Moroshan
- Department of Family Medicine №1, NJSC “Astana Medical University”, Astana 010000, Kazakhstan; (S.A.); (T.B.); (A.A.)
| | - Gulnaz Nuranova
- Department of Children’s Diseases with Courses in Pulmonology and Nephrology, NJSC “Astana Medical University”, Astana 010000, Kazakhstan;
| | - Tansholpan Batyrkhan
- Department of Family Medicine №1, NJSC “Astana Medical University”, Astana 010000, Kazakhstan; (S.A.); (T.B.); (A.A.)
| | - Anilim Abisheva
- Department of Family Medicine №1, NJSC “Astana Medical University”, Astana 010000, Kazakhstan; (S.A.); (T.B.); (A.A.)
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31
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Abdelkader AA, Alsfouk BA, Saleh A, Abdelrahim MEA, Saeed H. Comparative Efficacy of Inhaled and Intravenous Corticosteroids in Managing COVID-19-Related Acute Respiratory Distress Syndrome. Pharmaceutics 2024; 16:952. [PMID: 39065649 PMCID: PMC11279829 DOI: 10.3390/pharmaceutics16070952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/07/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Acute respiratory distress syndrome (ARDS) is a life-threatening condition in which the lungs fail to provide sufficient oxygen to the body's vital organs. It is commonly associated with COVID-19 patients. Severe cases of COVID-19 can lead to lung damage and organ failure due to an immune response in the body. To mitigate these effects, corticosteroids, which are known for their anti-inflammatory properties, have been suggested as a potential treatment option. The primary focus of this study was to assess the impact of various corticosteroid administration methods on the outcomes of patients with COVID-19. Methods: The current study was conducted on COVID-19 patients divided into three groups. The first group was administered 6 mg of intravenous (IV) dexamethasone; the second group received 1 mg/kg of IV methylprednisolone (methylprednisolone); and the third group received budesonide respirable solution at a dosage of 1mg twice daily. The neubilizer used was a vibrating mesh nebulizer (VMN). All patients received standard care. We found that dexamethasone administered intravenously led to a significant reduction in C-reactive protein levels, surpassing the effectiveness of both IV methylprednisolone and inhaled budesonide. Oxygen saturation without mask change over time showed statistically significant differences (p = 0.004) in favor of the budesonide and dexamethasone groups for all days. Individuals who received methylprednisolone showed a significant decrease in mortality rate and an extended survival duration, with statistical significance observed at p = 0.024. The rest of the parameters, including ferritin, lymphocytes, total leukocyte count, platelets, hemoglobin, urea, serum potassium, serum sodium, serum creatinine, serum glutamic-pyruvic transaminase, serum glutamic-oxaloacetic transaminase, uric acid, albumin, globulin, erythrocyte sedimentation rate, international normalized ratio, oxygen saturation with flow, and oxygen flow, showed no statistically significant differences between the three drugs. In conclusion, treatment with IV methylprednisolone (1 mg/kg) resulted in a shorter hospital stay, decreased reliance on ventilation, and improved health outcomes for COVID-19 patients compared to using dexamethasone at a daily dosage of 6 mg or budesonide respirable solution at a dosage of 1mg twice daily.
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Affiliation(s)
- Ahmed A. Abdelkader
- Clinical Pharmacy Department, Faculty of Pharmacy, Heliopolis University, Cairo 11765, Egypt
| | - Bshra A. Alsfouk
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (B.A.A.); (A.S.)
| | - Asmaa Saleh
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (B.A.A.); (A.S.)
| | - Mohamed E. A. Abdelrahim
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt; (M.E.A.A.); (H.S.)
| | - Haitham Saeed
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62511, Egypt; (M.E.A.A.); (H.S.)
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Goury A, Houlla Z, Jozwiak M, Urbina T, Turpin M, Lavalard A, Laghlam D, Voicu S, Rosman J, Coutureau C, Mourvillier B. Effect of noninvasive ventilation on mortality and clinical outcomes among patients with severe hypoxemic COVID-19 pneumonia after high-flow nasal oxygen failure: a multicenter retrospective French cohort with propensity score analysis. Respir Res 2024; 25:279. [PMID: 39010097 PMCID: PMC11251296 DOI: 10.1186/s12931-024-02873-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/08/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND We assessed the effect of noninvasive ventilation (NIV) on mortality and length of stay after high flow nasal oxygenation (HFNO) failure among patients with severe hypoxemic COVID-19 pneumonia. METHODS In this multicenter, retrospective study, we enrolled COVID-19 patients admitted in intensive care unit (ICU) for severe COVID-19 pneumonia with a HFNO failure from December 2020 to January 2022. The primary outcome was to compare the 90-day mortality between patients who required a straight intubation after HFNO failure and patients who received NIV after HFNO failure. Secondary outcomes included ICU and hospital length of stay. A propensity score analysis was performed to control for confounding factors between groups. Exploratory outcomes included a subgroup analysis for 90-day mortality. RESULTS We included 461 patients with HFNO failure in the analysis, 233 patients in the straight intubation group and 228 in the NIV group. The 90-day mortality did not significantly differ between groups, 58/228 (25.4%) int the NIV group compared with 59/233 (25.3%) in the straight intubation group, with an adjusted hazard ratio (HR) after propensity score weighting of 0.82 [95%CI, 0.50-1.35] (p = 0.434). ICU length of stay was significantly shorter in the NIV group compared to the straight intubation group, 10.0 days [IQR, 7.0-19.8] versus 18.0 days [IQR,11.0-31.0] with a propensity score weighted HR of 1.77 [95%CI, 1.29-2.43] (p < 0.001). A subgroup analysis showed a significant increase in mortality rate for intubated patients in the NIV group with 56/122 (45.9%), compared to 59/233 (25.3%) for patients in the straight intubation group (p < 0.001). CONCLUSIONS In severely hypoxemic COVID-19 patients, no significant differences were observed on 90-day mortality between patients receiving straight intubation and those receiving NIV after HFNO failure. NIV strategy was associated with a significant reduction in ICU length of stay, despite an increase in mortality in the subgroup of patients finally intubated.
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Affiliation(s)
- Antoine Goury
- Unité de Médecine Intensive et Réanimation Polyvalente, CHU Reims, Reims, F-51100, France.
| | - Zeyneb Houlla
- Unité de Médecine Intensive et Réanimation Polyvalente, CHU Reims, Reims, F-51100, France
| | - Mathieu Jozwiak
- Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nice, Hôpital l'Archet 1, Nice, France
- UR2CA - Unité de Recherche Clinique Côte d'Azur, Université Côte d'Azur, Nice, France
| | - Tomas Urbina
- Service de Médecine Intensive Réanimation, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Matthieu Turpin
- Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Alexandra Lavalard
- Unité de Réanimation Polyvalente, Centre Hospitalier de Troyes, Troyes, France
| | - Driss Laghlam
- Service de Médecine Intensive et Réanimation, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Sebastian Voicu
- Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Jeremy Rosman
- Unité de Soins Intensifs et Réanimation, Groupe Hospitalier de Territoire Nord-Ardennes, Charleville-Mézières, France
| | - Claire Coutureau
- Université de Reims Champagne-Ardenne, VieFra, Reims, F-51100, France
- Unité d'Aide Méthodologique, CHU Reims, Reims, F-51100, France
| | - Bruno Mourvillier
- Unité de Médecine Intensive et Réanimation Polyvalente, CHU Reims, Reims, F-51100, France
- Université de Reims Champagne-Ardenne, EA-4684 CardioVir, Reims, F-51100, France
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Saito Z, Kanai O, Okamoto N, Watanabe I, Tsukino M. Efficacy of corticosteroid therapy for oxygen-free coronavirus disease 2019-derived pneumonia. Medicine (Baltimore) 2024; 103:e38932. [PMID: 38996125 PMCID: PMC11245202 DOI: 10.1097/md.0000000000038932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Corticosteroid therapy for oxygen-free coronavirus disease 2019 (COVID-19) is not recommended due to its negative prognostic impact, but the efficacy of corticosteroids when limited to COVID-19 pneumonia is unclear. We aimed to evaluate the efficacy of corticosteroid monotherapy for patients with COVID-19 pneumonia without supplemental oxygen. We retrospectively reviewed patients with oxygen-free COVID-19 pneumonia at our institute between September 2020 and August 2021 and assessed the use of corticosteroids and the timing of initiation. We classified the patients into the following 2 groups: those who were initiated corticosteroids without developing respiratory failure (early steroid group) and those who were not (standard of care [SOC] group). We used inverse probability of treatment weighting (IPW) to balance between the groups. The primary outcome was the incidence of respiratory failure. A total of 144 patient records were reviewed; 63 patients were in the early steroid group and 81 patients were in the SOC group. Of all patients, 14 (22.2%) and 27 (33.3%) patients in the early steroid and SOC group, respectively, required supplemental oxygen (P = .192). After adjusted by the IPW method, 10 (16.0%) and 32 (40.1%) patients in the early steroid and SOC groups, respectively, required supplemental oxygen (P = .004). The logistic regression analysis indicated that early corticosteroid use was significantly associated with a decreased incidence of respiratory failure (odds ratio; 0.17, 95% confidence intervals; 0.06-0.46, P < .001). Corticosteroid monotherapy may suppress the development of exacerbation requiring oxygen supply in patients with oxygen-free COVID-19 pneumonia.
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Affiliation(s)
- Zentaro Saito
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
- Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Osamu Kanai
- Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Natsumi Okamoto
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
| | - Isao Watanabe
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
| | - Mitsuhiro Tsukino
- Divison of Respiratory Medicine, Hikone Municipal Hospital, Hikone City, Japan
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Bustamante C, Pinilla Bonilla LB, Restrepo JC. Neurological symphony: post-acute COVID-19 syndrome, an innovative pathophysiological exploration from neuraltherapeutic medicine. Front Integr Neurosci 2024; 18:1417856. [PMID: 39070159 PMCID: PMC11275269 DOI: 10.3389/fnint.2024.1417856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/20/2024] [Indexed: 07/30/2024] Open
Abstract
The SARS-CoV-2 pandemic has affected 771 million people and caused 6.9 million confirmed deaths as of November 2023. Beyond the adversity, a crucial and less-explored chapter unfolds: adaptive sequelae. These have altered social, mental, and emotional conditions, leaving an imprint on biological systems. While some cases fully resolve the pathological process post-acute infection, others persist with symptoms, posing a challenge that underscores the need to comprehend pathophysiology from innovative perspectives. The article delves into “Long COVID” or Post-Acute COVID-19 Syndrome (PACS), where symptoms persist for ≥4 weeks irrespective of initial severity. Risk factors include a history of severe illness, in-hospital management, and intensive care. This article also explores theories, derived from various experimental models, that have demonstrated the involvement of the nervous system in coordination with the psychoneuroimmunoendocrine axes in the expression of inflammation. It is posited that PACS involves processes of peripheral and central sensitization (corticalization), facilitating dishomeostasis and the chronicity of the inflammatory process. In this context, various therapeutic strategies grounded in modulating the inflammatory reflex are reviewed, primarily through the infiltration of local anesthetics via linear and non-linear approaches. Neural therapeutic use is considered to stimulate the regulatory inflammatory circuits coordinated by the neuroimmune-endocrine system.
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Affiliation(s)
- Carlos Bustamante
- Institute for Advanced Integrative Medicine, Medellin, Colombia
- Faculty of Medicine, National University of Colombia, Bogotá, Colombia
| | - Laura Bibiana Pinilla Bonilla
- Institute for Advanced Integrative Medicine, Medellin, Colombia
- Research and Innovation Center, Integrated Subnetwork of Health Services of South, Bogotá, Colombia
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Pacheco-García U, Varela-López E, Serafín-López J. Immune Stimulation with Imiquimod to Best Face SARS-CoV-2 Infection and Prevent Long COVID. Int J Mol Sci 2024; 25:7661. [PMID: 39062904 PMCID: PMC11277483 DOI: 10.3390/ijms25147661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Through widespread immunization against SARS-CoV-2 prior to or post-infection, a substantial segment of the global population has acquired both humoral and cellular immunity, and there has been a notable reduction in the incidence of severe and fatal cases linked to this virus and accelerated recovery times for those infected. Nonetheless, a significant demographic, comprising around 20% to 30% of the adult population, remains unimmunized due to diverse factors. Furthermore, alongside those recovered from the infection, there is a subset of the population experiencing persistent symptoms referred to as Long COVID. This condition is more prevalent among individuals with underlying health conditions and immune system impairments. Some Long COVID pathologies stem from direct damage inflicted by the viral infection, whereas others arise from inadequate immune system control over the infection or suboptimal immunoregulation. There are differences in the serum cytokines and miRNA profiles between infected individuals who develop severe COVID-19 or Long COVID and those who control adequately the infection. This review delves into the advantages and constraints associated with employing imiquimod in human subjects to enhance the immune response during SARS-CoV-2 immunization. Restoration of the immune system can modify it towards a profile of non-susceptibility to SARS-CoV-2. An adequate immune system has the potential to curb viral propagation, mitigate symptoms, and ameliorate the severe consequences of the infection.
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Affiliation(s)
- Ursino Pacheco-García
- Department of Cardio-Renal Pathophysiology, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City 14080, Mexico
| | - Elvira Varela-López
- Laboratory of Translational Medicine, Instituto Nacional de Cardiología “Ignacio Chávez”, Mexico City 14080, Mexico;
| | - Jeanet Serafín-López
- Department of Immunology, Escuela Nacional de Ciencias Biológicas (ENCB), Instituto Politécnico Nacional (IPN), Mexico City 11340, Mexico;
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Abstract
Coronavirus Disease-19 (COVID-19) pandemic is caused by SARS-CoV-2 that has infected more than 600 million people and killed more than 6 million people worldwide. This infection affects mainly certain groups of people that have high susceptibility to present severe COVID-19 due to comorbidities. Moreover, the long-COVID-19 comprises a series of symptoms that may remain in some patients for months after infection that further compromises their health. Thus, since this pandemic is profoundly affecting health, economy, and social life of societies, a deeper understanding of viral replication cycle could help to envisage novel therapeutic alternatives that limit or stop COVID-19. Several findings have unexpectedly discovered that mitochondria play a critical role in SARS-CoV-2 cell infection. Indeed, it has been suggested that this organelle could be the origin of its replication niches, the double membrane vesicles (DMV). In this regard, mitochondria derived vesicles (MDV), involved in mitochondria quality control, discovered almost 15 years ago, comprise a subpopulation characterized by a double membrane. MDV shedding is induced by mitochondrial stress, and it has a fast assembly dynamic, reason that perhaps has precluded their identification in electron microscopy or tomography studies. These and other features of MDV together with recent SARS-CoV-2 protein interactome and other findings link SARS-CoV-2 to mitochondria and support that these vesicles are the precursors of SARS-CoV-2 induced DMV. In this work, the morphological, biochemical, molecular, and cellular evidence that supports this hypothesis is reviewed and integrated into the current model of SARS-CoV-2 cell infection. In this scheme, some relevant questions are raised as pending topics for research that would help in the near future to test this hypothesis. The intention of this work is to provide a novel framework that could open new possibilities to tackle SARS-CoV-2 pandemic through mitochondria and DMV targeted therapies.
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Affiliation(s)
- Pavel Montes de Oca-B
- Neurociencia Cognitiva, Instituto de Fisiologia-UNAM, CDMX, CDMX, 04510, Mexico
- Unidad de Neurobiologia Dinamica, Instituto Nacional de Neurologia y Neurocirugia, CDMX, CDMX, 14269, Mexico
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Halme ALE, Laakkonen S, Rutanen J, Nevalainen OPO, Sinisalo M, Horstia S, Mustonen JMJ, Pourjamal N, Vanhanen A, Rosberg T, Renner A, Perola M, Paukkeri EL, Patovirta RL, Parkkila S, Paajanen J, Nykänen T, Mäntylä J, Myllärniemi M, Mattila T, Leinonen MK, Külmäsu A, Kuutti P, Kuitunen I, Kreivi HR, Kilpeläinen TP, Kauma H, Kalliala IEJ, Järvinen P, Hankkio R, Hammarén T, Feuth T, Ansakorpi H, Ala-Karvia R, Guyatt GH, Tikkinen KAO. Short- and long-term effects of imatinib in hospitalized COVID-19 patients: A randomized trial. J Infect 2024; 89:106217. [PMID: 38969238 DOI: 10.1016/j.jinf.2024.106217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/21/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVES We studied the short- and long-term effects of imatinib in hospitalized COVID-19 patients. METHODS Participants were randomized to receive standard of care (SoC) or SoC with imatinib. Imatinib dosage was 400 mg daily until discharge (max 14 days). Primary outcomes were mortality at 30 days and 1 year. Secondary outcomes included recovery, quality of life and long COVID symptoms at 1 year. We also performed a systematic review and meta-analysis of randomized trials studying imatinib for 30-day mortality in hospitalized COVID-19 patients. RESULTS We randomized 156 patients (73 in SoC and 83 in imatinib). Among patients on imatinib, 7.2% had died at 30 days and 13.3% at 1 year, and in SoC, 4.1% and 8.2% (adjusted HR 1.35, 95% CI 0.47-3.90). At 1 year, self-reported recovery occurred in 79.0% in imatinib and in 88.5% in SoC (RR 0.91, 0.78-1.06). We found no convincing difference in quality of life or symptoms. Fatigue (24%) and sleep issues (20%) frequently bothered patients at one year. In the meta-analysis, imatinib was associated with a mortality risk ratio of 0.73 (0.32-1.63; low certainty evidence). CONCLUSIONS The evidence raises doubts regarding benefit of imatinib in reducing mortality, improving recovery and preventing long COVID symptoms in hospitalized COVID-19 patients.
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Affiliation(s)
- Alex L E Halme
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Sanna Laakkonen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Jarno Rutanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland; Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
| | - Olli P O Nevalainen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland; Faculty of Social Sciences, Tampere University, Tampere, Finland; Hatanpää Health Center, Wellbeing Services County of Pirkanmaa, Tampere, Finland.
| | - Marjatta Sinisalo
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
| | - Saana Horstia
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | | | - Negar Pourjamal
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Aija Vanhanen
- Laakso Hospital, City of Helsinki, Helsinki, Finland.
| | - Tuomas Rosberg
- Department of Pulmonology, Kanta-Häme Central Hospital, Hämeenlinna, Finland.
| | - Andreas Renner
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Pneumology, University Hospital Vienna, Medical University of Vienna, Vienna, Austria.
| | - Markus Perola
- Department of Public Health and Welfare, Population Health Unit, Public Health Research Team, Finnish Institute for Health and Welfare, Helsinki, Finland; Clinical and Molecular Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Erja-Leena Paukkeri
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
| | | | - Seppo Parkkila
- Faculty of Medicine and Health Technology, Tampere University and Fimlab Ltd., Tampere University Hospital, Tampere, Finland.
| | - Juuso Paajanen
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Taina Nykänen
- Department of Surgery, Hyvinkää Hospital, Hyvinkää, Finland.
| | - Jarkko Mäntylä
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
| | - Marjukka Myllärniemi
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Tiina Mattila
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
| | - Maarit K Leinonen
- Teratology Information Service, Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Alvar Külmäsu
- Department of Emergency Medicine, Päijät-Häme Central Hospital, Lahti, Finland.
| | - Pauliina Kuutti
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Ilari Kuitunen
- Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland; Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.
| | - Hanna-Riikka Kreivi
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
| | - Tuomas P Kilpeläinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Heikki Kauma
- Department of Internal Medicine, Oulu University Hospital, Oulu, Finland.
| | - Ilkka E J Kalliala
- Department of Obstetrics and Gynaecology, Helsinki University and Helsinki University Hospital, Helsinki, Finland; Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
| | - Petrus Järvinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Riina Hankkio
- Tampere University Hospital Pharmacy, Tampere University Hospital, Tampere, Finland.
| | | | - Thijs Feuth
- Department of Pulmonary Diseases and Allergology, Division of Medicine, University of Turku and Turku University Hospital, Turku, Finland.
| | - Hanna Ansakorpi
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland.
| | - Riikka Ala-Karvia
- Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Kari A O Tikkinen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Surgery, South Karelian Central Hospital, Lappeenranta, Finland.
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Chikopela T, Mwesigwa N, Masenga SK, Kirabo A, Shibao CA. The Interplay of HIV and Long COVID in Sub-Saharan Africa: Mechanisms of Endothelial Dysfunction. Curr Cardiol Rep 2024:10.1007/s11886-024-02087-6. [PMID: 38958890 DOI: 10.1007/s11886-024-02087-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE OF REVIEW Long COVID affects approximately 5 million people in Africa. This disease is characterized by persistent symptoms or new onset of symptoms after an acute SARS-CoV-2 infection. Specifically, the most common symptoms include a range of cardiovascular problems such as chest pain, orthostatic intolerance, tachycardia, syncope, and uncontrolled hypertension. Importantly, these conditions appear to have endothelial dysfunction as the common denominator, which is often due to impaired nitric oxide (NO) mechanisms. This review discusses the role of mechanisms contributing to endothelial dysfunction in Long COVID, particularly in people living with HIV. RECENT FINDINGS Recent studies have reported that increased inflammation and oxidative stress, frequently observed in Long COVID, may contribute to NO dysfunction, ultimately leading to decreased vascular reactivity. These mechanisms have also been reported in people living with HIV. In regions like Africa, where HIV infection is still a major public health challenge with a prevalence of approximately 26 million people in 2022. Specifically, endothelial dysfunction has been reported as a major mechanism that appears to contribute to cardiovascular diseases and the intersection with Long COVID mechanisms is of particular concern. Further, it is well established that this population is more likely to develop Long COVID following infection with SARS-CoV-2. Therefore, concomitant infection with SARS-CoV-2 may lead to accelerated cardiovascular disease. We outline the details of the worsening health problems caused by Long COVID, which exacerbate pre-existing conditions such as endothelial dysfunction. The overlapping mechanisms of HIV and SARS-CoV-2, particularly the prolonged inflammatory response and chronic hypoxia, may increase susceptibility to Long COVID. Addressing these overlapping health issues is critical as it provides clinical entry points for interventions that could improve and enhance outcomes and quality of life for those affected by both HIV and Long COVID in the region.
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Affiliation(s)
- Theresa Chikopela
- Department of Human Physiology, Faculty of Medicine, Lusaka Apex Medical University, Lusaka, Zambia
| | - Naome Mwesigwa
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, 37332-0615, USA
| | - Sepiso K Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone, Zambia
| | - Annet Kirabo
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, 37332-0615, USA
| | - Cyndya A Shibao
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, 37332-0615, USA.
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Bueno LM, Ramos HVL, Costa CC, Alves W, Velasco LC, De Biase NG. Voice handicap and voice-related quality of life in COVID-19 patients. Braz J Otorhinolaryngol 2024; 90:101437. [PMID: 38701618 PMCID: PMC11078625 DOI: 10.1016/j.bjorl.2024.101437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/11/2024] [Accepted: 03/30/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES Identifying voice handicap and voice-related quality of life in patients presenting pulmonary impairment associated with COVID-19 infection, comparing pulmonary parameters between these patients and individuals in the control group, as well as correlating pulmonary parameters to self-assessment questionnaires (IDV-10 and QVV). METHODS Thirty-five (35) patients presenting pulmonary impairment with COVID-19 infection were herein selected and compared to 35 individuals who were not affected by COVID-19 infection. Two self-assessment questionnaires were applied (vocal handicap index and voice quality of life protocol). Maximum phonation time Forced Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) were measured and videolaryngoscopy was performed. RESULTS There was statistically significant difference in scores recorded in voice self-assessment questionnaires (IDV-10 and QVV), Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) between patients with pulmonary impairment associated with COVID-19 infection and those in the control group. Correlation between PEF/PIF and scores recorded in voice self-assessment questionnaires was also observed. CONCLUSION Pulmonary impairment associated with COVID-19 infection has worsened voice handicap and voice-related quality of life in the assessed patients, as well as reduced their forced expiratory and inspiratory pressure in comparison to the control group. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Lourival Mendes Bueno
- Programa Interinstitucional de Pós-Graduação do Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), São Paulo, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, SP, Brazil.
| | - Hugo Valter Lisboa Ramos
- Programa Interinstitucional de Pós-Graduação do Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), São Paulo, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, SP, Brazil
| | - Claudiney Cândido Costa
- Programa Interinstitucional de Pós-Graduação do Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), São Paulo, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, SP, Brazil
| | - Wilder Alves
- Centro de Reabilitação e Readaptação Dr. Henrique Santillo Dr. Henrique Santillo (CRER), Goiânia, GO, Brazil
| | - Leandro Castro Velasco
- Programa Interinstitucional de Pós-Graduação do Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), São Paulo, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, SP, Brazil
| | - Noemi Grigoleto De Biase
- Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP-EPM), São Paulo, SP, Brazil; Pontifícia Universidade Católica de São Paulo (PUC-SP), São Paulo, SP, Brazil
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Zhu X, Wang B, Yu H, Li C, Zhao Y, Zhong Y, Tang W, Zhou Y, Huang X, Zhu H, Wu Y, Yang K, Wei Y, Gao Z, Dong J. Icariin attenuates asthmatic airway inflammation via modulating alveolar macrophage activation based on network pharmacology and in vivo experiments. J Gene Med 2024; 26:e3718. [PMID: 38979822 DOI: 10.1002/jgm.3718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/23/2024] [Accepted: 06/19/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Icariin (ICA) inhibits inflammatory response in various diseases, but the mechanism underlying ICA treating airway inflammation in asthma needs further understood. We aimed to predict and validate the potential targets of ICA against asthma-associated airway inflammation using network pharmacology and experiments. METHODS The ovalbumin-induced asthma-associated airway inflammation mice model was established. The effects of ICA were evaluated by behavioral, airway hyperresponsiveness, lung pathological changes, inflammatory cell and cytokines counts. Next, the corresponding targets of ICA were mined via the SEA, CTD, HERB, PharmMapper, Symmap database and the literature. Pubmed-Gene and GeneCards databases were used to screen asthma and airway inflammation-related targets. The overlapping targets were used to build an interaction network, analyze gene ontology and enrich pathways. Subsequently, flow cytometry, quantitative real-time PCR and western blotting were employed for validation. RESULTS ICA alleviated the airway inflammation of asthma; 402 targets of ICA, 5136 targets of asthma and 4531 targets of airway inflammation were screened; 216 overlapping targets were matched and predicted ICA possesses the potential to modulate asthmatic airway inflammation by macrophage activation/polarization. Additionally, ICA decreased M1 but elevated M2. Potential targets that were disrupted by asthma inflammation were restored by ICA treatment. CONCLUSIONS ICA alleviates airway inflammation in asthma by inhibiting the M1 polarization of alveolar macrophages, which is related to metabolic reprogramming. Jun, Jak2, Syk, Tnf, Aldh2, Aldh9a1, Nos1, Nos2 and Nos3 represent potential targets of therapeutic intervention. The present study enhances understanding of the anti-airway inflammation effects of ICA, especially in asthma.
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Affiliation(s)
- Xiaofei Zhu
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Bin Wang
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Hang Yu
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Congcong Li
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Yuhang Zhao
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Yuanyuan Zhong
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Weifeng Tang
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Yaolong Zhou
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Xi Huang
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Huahe Zhu
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Yueren Wu
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Kai Yang
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Ying Wei
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Zhen Gao
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
| | - Jingcheng Dong
- Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Integrative Medicine, Fudan University, Shanghai, China
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Rossi PAQ, Gomes R, Nascimento Salazar TCD, Lustosa Barros EM, Vasconcelos S, da Silva AS, Pereira EM, Melo VB, Fonseca MHG, Teixeira CR, Furtado GP, Pontes LQ, Khouri R, Vasconcelos B, Almeida SSD, Werneck GL, Rossi FE, Santos MAPD. Physical Activity at Different Life Stages and Its Consequence on the Initial Immunization and Inflammatory Response Against COVID-19. J Phys Act Health 2024; 21:717-725. [PMID: 38663845 DOI: 10.1123/jpah.2023-0370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/16/2024] [Accepted: 03/08/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND To evaluate the influence of previous physical activity (PA) during childhood, adolescence, and current PA practice on the production of antibodies and inflammatory response between the first and second doses of the COVID-19 vaccine. METHODS Fifty-nine men and 56 women were evaluated before the first vaccine, and 12 weeks later, blood samples were taken to quantify production of anti-severe acute respiratory syndrome coronavirus-2 immunoglobulin G antibodies and cytokines. Previous PA during childhood and adolescence was self-referred, and current PA was assessed using the International Physical Activity Questionnaire. RESULTS A positive and significant association was observed only between PA practice during adolescence and an increase in antibody production in adulthood (β = 2012.077, 95% confidence interval, 257.7953-3766.358, P = .025). Individuals who practiced PA during adolescence showed higher production of antibodies between the first and second vaccine dose compared to nonpractitioners (P = .025) and those that accumulated ≥150 minutes per week of current moderate-vigorous PA (MVPA), and presented higher antibody production in relation to who did <150 minutes per week of MVPA (P = .046). Individuals that were practitioners during childhood produced higher G-CSF (P = .047), and those that accumulated ≥150 minutes per week of current MVPA demonstrated lower IP-10 levels (P = .033). However, PA practitioners during adolescence presented higher G-CSF (P = .025), IL-17 (P = .038), IL-1RA (P = .005), IL-1β (P = .020), and IL-2 (P = .026) levels. CONCLUSION Our results suggest that adults that accumulated at least 150 minutes of MVPA per week or practiced PA during adolescence developed an improved immune and inflammatory response against COVID-19 vaccination.
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Affiliation(s)
- Priscila Almeida Queiroz Rossi
- Postgraduation Student in Science and Health, Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | - Regis Gomes
- Biotecnologia, Escritório Técnico da Fiocruz Ceará, Eusébio, CE, Brazil
| | - Teresa Cristina do Nascimento Salazar
- Postgraduation Student in Science and Health, Federal University of Piaui, Teresina, PI, Brazil
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | - Esmeralda Maria Lustosa Barros
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
| | | | | | | | - Vitoria Braga Melo
- Unidade de Apoio ao Diagnóstico de Covid-19 (UNADIG), Fiocruz Ceará, Eusébio, CE, Brazil
| | | | | | | | | | - Ricardo Khouri
- Gonçalo Moniz Institute, Fiocruz Bahia, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador,BA, Brazil
| | - Beatriz Vasconcelos
- Gonçalo Moniz Institute, Fiocruz Bahia, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador,BA, Brazil
| | - Sandro Soares de Almeida
- Department of Obstetrician, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo,SP, Brazil
- Faculdade Anhanguera de Guarulhos, Guarulhos,SP, Brazil
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Fabrício Eduardo Rossi
- Department of Physical Education, Immunometabolism of Skeletal Muscle and Exercise Research Group, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
- Graduate Program in Science and Health, Federal University of Piauí (UFPI), Teresina, PI, Brazil
- Graduate Program in Movement Science, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Marcos Antonio Pereira Dos Santos
- Department of Biophysics and Physiology, Nucleus of Study in Physiology Applied to Performance and Health (NEFADS), Federal University of Piaui, Teresina, PI, Brazil
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Ameratunga R, Jordan A, Lehnert K, Leung E, Mears ER, Snell R, Steele R, Woon ST. SARS-CoV-2 evolution has increased resistance to monoclonal antibodies and first-generation COVID-19 vaccines: Is there a future therapeutic role for soluble ACE2 receptors for COVID-19? Antiviral Res 2024; 227:105894. [PMID: 38677595 DOI: 10.1016/j.antiviral.2024.105894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
COVID-19 has caused calamitous health, economic and societal consequences. Although several COVID-19 vaccines have received full authorization for use, global deployment has faced political, financial and logistical challenges. The efficacy of first-generation COVID-19 vaccines is waning and breakthrough infections are allowing ongoing transmission and evolution of SARS-CoV-2. Furthermore, COVID-19 vaccine efficacy relies on a functional immune system. Despite receiving three primary doses and three or more heterologous boosters, some immunocompromised patients may not be adequately protected by COVID-19 vaccines and remain vulnerable to severe disease. The evolution of new SARS-CoV-2 variants has also resulted in the rapid obsolescence of monoclonal antibodies. Convalescent plasma from COVID-19 survivors has produced inconsistent results. New drugs such as Paxlovid (nirmatrelvir/ritonavir) are beyond the reach of low- and middle-income countries. With widespread use of Paxlovid, it is likely nirmatrelvir-resistant clades of SARS-CoV-2 will emerge in the future. There is thus an urgent need for new effective anti-SARS-CoV-2 treatments. The in vitro efficacy of soluble ACE2 against multiple SARS-CoV-2 variants including omicron (B.1.1.529), was recently described using a competitive ELISA assay as a surrogate marker for virus neutralization. This indicates soluble wild-type ACE2 receptors are likely to be resistant to viral evolution. Nasal and inhaled treatment with soluble ACE2 receptors has abrogated severe disease in animal models of COVID-19. There is an urgent need for clinical trials of this new class of antiviral therapeutics, which could complement vaccines and Paxlovid.
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Affiliation(s)
- Rohan Ameratunga
- Department of Clinical Immunology, Auckland Hospital, Park Rd, Grafton, 1010, Auckland, New Zealand; Department of Virology and Immunology, Auckland Hospital, Park Rd, Grafton, 1010, Auckland, New Zealand; Department of Molecular Medicine and Pathology, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Anthony Jordan
- Department of Clinical Immunology, Auckland Hospital, Park Rd, Grafton, 1010, Auckland, New Zealand
| | - Klaus Lehnert
- Applied Translational Genetics Group, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Euphemia Leung
- Auckland Cancer Society Research Centre, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Emily R Mears
- Applied Translational Genetics Group, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Russell Snell
- Applied Translational Genetics Group, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Richard Steele
- Department of Virology and Immunology, Auckland Hospital, Park Rd, Grafton, 1010, Auckland, New Zealand
| | - See-Tarn Woon
- Department of Virology and Immunology, Auckland Hospital, Park Rd, Grafton, 1010, Auckland, New Zealand; Department of Molecular Medicine and Pathology, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Almeida AFSD, Silva TDD, Moraes ÍAPD, Menezes LDCD, Dias ED, Araújo LVD, Monteiro CBDM, Dawes H, Simcsik AO, Alberissi CADO, Silva VYHD, Brunherotti MAA, Tonello MGM. Virtual reality as a telerehabilitation strategy for people with autism spectrum disorder during the COVID-19 quarantine scenario: physical activity, motor performance and enjoyment. Disabil Rehabil Assist Technol 2024; 19:2046-2056. [PMID: 37695272 PMCID: PMC11229792 DOI: 10.1080/17483107.2023.2249031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 08/09/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE People with autism spectrum disorder could benefit from physical activity during the pandemic and COVID-19 restrictions, mainly to maintain adequate physical activity. We aimed to evaluate the feasibility, enjoyment, and potential effect of telerehabilitation using a serious game named 'MoveHero'. MATERIALS AND METHODS Registered in Clinical Trials (NCT04402034). We adopted a remotely run Telerehabilitation research design with 44 participants recruited: 22 People with ASD people and 22 non-ASD individuals. RESULTS All participants safely participated, 100% adherence to sessions, ∼60% enjoying the task, and significantly improved performance, with better performance for the NA group at most practice moments. CONCLUSIONS Our findings support both how to implement a gaming intervention and the need to investigate the efficacy of serious games to motivate moderate intensity physical activity in people with ASD.
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Affiliation(s)
| | - Talita Dias da Silva
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Faculdade de Medicina, Universidade Cidade de São Paulo (UNICID). R. Butantã, São Paulo, Brazil
| | - Íbis Ariana Peña de Moraes
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
- Faculdade de Medicina, Universidade Cidade de São Paulo (UNICID). R. Butantã, São Paulo, Brazil
- Faculdade de Medicina, Universidade de São Paulo (USP), Cidade Universitária, São Paulo, Brazil
- NIHR Exeter Biomedical Research Centre, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Lilian Del Ciello de Menezes
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Eduardo Dati Dias
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
- Faculdade de Medicina, Universidade de São Paulo (USP), Cidade Universitária, São Paulo, Brazil
| | - Luciano Vieira de Araújo
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
| | - Carlos Bandeira de Mello Monteiro
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
- Faculdade de Medicina, Universidade de São Paulo (USP), Cidade Universitária, São Paulo, Brazil
| | - Helen Dawes
- NIHR Exeter Biomedical Research Centre, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Amanda Orasmo Simcsik
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
| | - Camila Aparecida de Oliveira Alberissi
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
| | - Victoria Yanara Hernandes da Silva
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitaçaõ (PATER) da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (EACH-USP), São, Brazilulo
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Zhao F, Wang M, Zhou Q, Du Y, Cheng Q, Sun X, Zhang J, Liang Y, Shen N, Sun Y. Analysis of risk factors for weaning failure from mechanical ventilation in critically ill older patients with coronavirus disease 2019. Heliyon 2024; 10:e32835. [PMID: 38975064 PMCID: PMC11225823 DOI: 10.1016/j.heliyon.2024.e32835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 06/09/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Objective This study aimed to investigate the factors influencing weaning failure from invasive mechanical ventilation (IMV) in critically ill older patients with coronavirus disease 2019 (COVID-19). Methods We enrolled critically ill older patients with COVID-19 who were admitted to the medical intensive care unit (ICU) and received IMV between December 2022 and June 2023. Results We included 68 critically ill older patients with COVID-19 (52 male [76.5 %] and 16 female individuals [23.5 %]). The patients' median age (interquartile range) was 75.5 (70.3-82.8) years. The median length of ICU stay was 11.5 (7.0-17.8) days; 34 cases (50.0 %) were successfully weaned from IMV. The successfully weaned group had a higher proportion of underlying chronic obstructive pulmonary disease [6 (17.6 %) vs. 0, P = 0.033] and fewer cases of diabetes [7 (20.6 %) vs. 16 (47.1 %), P = 0.021] compared with the weaning failure group. Serum lactate levels [1.5 (1.2-2.3) vs. 2.6 (1.9-3.1) mmol/L, P < 0.001], blood urea nitrogen [8.2 (6.3-14.4) vs. 11.4 (8.0-21.3) mmol/L, P = 0.033], Acute Physiology and Chronic Health Evaluation (APACHE) II score [19.0 (12.0-23.3) vs. 22.5 (16.0-29.3), P = 0.014], and hospitalization days before endotracheal intubation [1.0 (0.0-5.0) vs. 3.0 (0.0-11.0), P = 0.023] were significantly decreased in the successfully weaned group, whereas PaO2/FiO2 [148.3 (94.6-200.3) vs. 101.1 (67.0-165.1), P = 0.038] and blood lymphocyte levels [0.6 (0.4-1.0) vs. 0.5 (0.2-0.6) 109/L, P = 0.048] were significantly increased, compared with the weaning failure group. Multivariate logistic regression analysis showed that diabetes (OR= 3.413, 95 %CI 1.029-11.326), P = 0.045), APACHE II Score (OR = 1.089, 95 % CI 1.008-1.175), P = 0.030), and hospitalization days before endotracheal intubation (OR = 1.137, 95 % CI 1.023-1.264), P = 0.017) were independent risk factors for weaning failure. Conclusion In critically ill older patients with COVID-19 with diabetes, higher APACHE II Score, and longer hospitalization days before endotracheal intubation, weaning from IMV was more challenging. The study could help develop strategies for improving COVID-19 treatment.
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Affiliation(s)
- Feifan Zhao
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Meng Wang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Qingtao Zhou
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yipeng Du
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Qin Cheng
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Xiaoyan Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Jing Zhang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Ying Liang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Ning Shen
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, China
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Xavier MS, Araujo-Pereira M, de Oliveira QM, Sant’Anna FM, Ridolfi FM, de Andrade AMS, Figueiredo MC, Sterling TR, Gordhan BG, Kana BD, Andrade BB, Rolla VC, Gomes-Silva A. The effect of previous SARS-CoV-2 infection on systemic immune responses in individuals with tuberculosis. Front Immunol 2024; 15:1357360. [PMID: 38994357 PMCID: PMC11236595 DOI: 10.3389/fimmu.2024.1357360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 06/07/2024] [Indexed: 07/13/2024] Open
Abstract
Background The impact of previous SARS-CoV-2 infection on the systemic immune response during tuberculosis (TB) disease has not been explored. Methods An observational, cross-sectional cohort was established to evaluate the systemic immune response in persons with pulmonary tuberculosis with or without previous SARS-CoV-2 infection. Those participants were recruited in an outpatient referral clinic in Rio de Janeiro, Brazil. TB was defined as a positive Xpert-MTB/RIF Ultra and/or a positive culture of Mycobacterium tuberculosis from sputum. Stored plasma was used to perform specific serology to identify previous SARS-CoV-2 infection (TB/Prex-SCoV-2 group) and confirm the non- infection of the tuberculosis group (TB group). Plasmatic cytokine/chemokine/growth factor profiling was performed using Luminex technology. Tuberculosis severity was assessed by clinical and laboratory parameters. Participants from TB group (4.55%) and TB/Prex-SCoV-2 (0.00%) received the complete COVID-19 vaccination. Results Among 35 participants with pulmonary TB, 22 were classified as TB/Prex-SCoV-2. The parameters associated with TB severity, together with hematologic and biochemical data were similar between the TB and TB/Prex-SCoV-2 groups. Among the signs and symptoms, fever and dyspnea were significantly more frequent in the TB group than the TB/Prex-SCoV-2 group (p < 0,05). A signature based on lower amount of plasma EGF, G-CSF, GM-CSF, IFN-α2, IL-12(p70), IL-13, IL-15, IL-17, IL-1β, IL-5, IL-7, and TNF-β was observed in the TB/Prex-SCoV-2 group. In contrast, MIP-1β was significantly higher in the TB/Prex-SCoV-2 group than the TB group. Conclusion TB patients previously infected with SARS-CoV-2 had an immunomodulation that was associated with lower plasma concentrations of soluble factors associated with systemic inflammation. This signature was associated with a lower frequency of symptoms such as fever and dyspnea but did not reflect significant differences in TB severity parameters observed at baseline.
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Affiliation(s)
- Mariana S. Xavier
- Pós-graduação em Pesquisa Clínica em Doenças Infecciosas, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Mariana Araujo-Pereira
- Laboratório de Pesquisa Clínica e Translacional, Instituto Gonçalo Moniz, FIOCRUZ, Bahia, Brazil
- Curso de Medicina, Faculdade ZARNS, Bahia, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Bahia, Brazil
| | - Quezia M. de Oliveira
- Laboratório de Pesquisa Clínica em Micobacterioses, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Flavia M. Sant’Anna
- Laboratório de Pesquisa Clínica em Micobacterioses, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Felipe M. Ridolfi
- Laboratório de Pesquisa Clínica em Micobacterioses, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Alice M. S. de Andrade
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Bahia, Brazil
| | - Marina C. Figueiredo
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States
| | - Timothy R. Sterling
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, United States
| | - Bhavna G. Gordhan
- Department of Science and Innovation/National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and the National Health Laboratory Service, Johannesburg, South Africa
| | - Bavesh D. Kana
- Department of Science and Innovation/National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and the National Health Laboratory Service, Johannesburg, South Africa
| | - Bruno B. Andrade
- Laboratório de Pesquisa Clínica e Translacional, Instituto Gonçalo Moniz, FIOCRUZ, Bahia, Brazil
- Curso de Medicina, Faculdade ZARNS, Bahia, Brazil
- Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative, Bahia, Brazil
| | - Valeria C. Rolla
- Laboratório de Pesquisa Clínica em Micobacterioses, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
| | - Adriano Gomes-Silva
- Laboratório de Pesquisa Clínica em Micobacterioses, Instituto Nacional de Infectologia Evandro Chagas, FIOCRUZ, Rio de Janeiro, Brazil
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
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Zegarra-Valdivia J, Arana-Nombera H, Perez-Fernandez L, Alamo-Medina R, Casimiro MDR, Bustamante-Delgado D, Matallana-Sanchez M, Gallegos-Manayay V, Álvarez-Bravo E, Arteaga-Cancino T, Abanto-Saldaña E, Oliva-Piscoya MDR, Cruz-Ordinola MC, Chavarry P, Chino-Vilca B, Paredes-Manrique C, Chirinos C, Custodio N, Ibañez A. The impact of COVID-19 post-infection on the cognition of adults from Peru. Front Psychol 2024; 15:1325237. [PMID: 38984273 PMCID: PMC11232419 DOI: 10.3389/fpsyg.2024.1325237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/10/2024] [Indexed: 07/11/2024] Open
Abstract
Introduction The COVID-19 pandemic, with over 83 million confirmed cases and 1.8 million deaths, has raised concerns about long-term cognitive issues, especially in populations facing disparities. Despite a few years since Peru's first COVID-19 wave, the cognitive effects on adults remain unclear. This study is the first in Peru to explore COVID-19's impact on general cognition and executive function. Methods A retrospective cross-sectional study compared individuals with COVID-19 history to controls, assessing general cognition, verbal fluency, attention, and executive function. Among 240 assessed, 154 met the study inclusion criteria, with about 60% female and an average age of 38.89 ± 16.001 years. Groups included controls (n = 42), acute phase (AP, n = 74) (1-14 days of symptoms), and hyperinflammatory phase (HP, n = 38) (>14 days of symptoms). Results Significant cognitive differences were observed. The HP group exhibited lower general cognitive performance (p = 0.02), working memory (p = 0.01), and executive function (planning; p < 0.001; flexibility; p = 0.03) than controls. Those with <14 days of illness (AP vs. HP) had deficits in general cognitive performance (p = 0.02), working memory (p = 0.02), and planning (p < 0.001), mainly during the hyperinflammatory phase, showing differences in working memory (p = 0.003) and planning (p = 0.01). Gender differences emerged, with males in the HP phase having poorer working memory (p = 0.003) and planning (p = 0.01). Discussion This study underscores COVID-19's negative impact on cognitive function, even in mild cases, with potential heightened effects in men during acute or hyperinflammatory phases. The findings provide Peru's first evidence, highlighting the vulnerability of populations facing socioeconomic disparities.
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Affiliation(s)
| | | | | | - Reyna Alamo-Medina
- Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru
| | | | | | | | | | | | | | | | | | | | - Patricia Chavarry
- Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru
| | - Brenda Chino-Vilca
- Achucarro Basque Center for Neuroscience, Leioa, Biscay, Spain
- Center of Cognitive and Computational Neuroscience-UCM, Madrid, Spain
| | | | - Carlos Chirinos
- Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru
| | - Nilton Custodio
- Instituto Peruano de Neurociencias, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Agustín Ibañez
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
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Hu Z, Wang W, Lin Y, Guo H, Chen Y, Wang J, Yu F, Rao L, Fan Z. Extracellular Vesicle-Inspired Therapeutic Strategies for the COVID-19. Adv Healthc Mater 2024:e2402103. [PMID: 38923772 DOI: 10.1002/adhm.202402103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Indexed: 06/28/2024]
Abstract
Emerging infectious diseases like coronavirus pneumonia (COVID-19) present significant challenges to global health, extensively affecting both human society and the economy. Extracellular vesicles (EVs) have demonstrated remarkable potential as crucial biomedical tools for COVID-19 diagnosis and treatment. However, due to limitations in the performance and titer of natural vesicles, their clinical use remains limited. Nonetheless, EV-inspired strategies are gaining increasing attention. Notably, biomimetic vesicles, inspired by EVs, possess specific receptors that can act as "Trojan horses," preventing the virus from infecting host cells. Genetic engineering can enhance these vesicles by enabling them to carry more receptors, significantly increasing their specificity for absorbing the novel coronavirus. Additionally, biomimetic vesicles inherit numerous cytokine receptors from parent cells, allowing them to effectively mitigate the "cytokine storm" by adsorbing pro-inflammatory cytokines. Overall, this EV-inspired strategy offers new avenues for the treatment of emerging infectious diseases. Herein, this review systematically summarizes the current applications of EV-inspired strategies in the diagnosis and treatment of COVID-19. The current status and challenges associated with the clinical implementation of EV-inspired strategies are also discussed. The goal of this review is to provide new insights into the design of EV-inspired strategies and expand their application in combating emerging infectious diseases.
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Affiliation(s)
- Ziwei Hu
- Institute of Otolaryngology Head and neck surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, 510282, P. R. China
| | - Wei Wang
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Ying Lin
- Institute of Otolaryngology Head and neck surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, 510282, P. R. China
| | - Hui Guo
- Department of Dermatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P. R. China
| | - Yiwen Chen
- Institute of Otolaryngology Head and neck surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, 510282, P. R. China
| | - Junjie Wang
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Feng Yu
- Institute of Otolaryngology Head and neck surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, 510282, P. R. China
| | - Lang Rao
- Institute of Biomedical Health Technology and Engineering, Shenzhen Bay Laboratory, Shenzhen, 518132, P. R. China
| | - Zhijin Fan
- Institute for Engineering Medicine, Kunming Medical University, Kunming, 650500, P. R. China
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Ben S, Gao F, Xu Z, Zhang R, Zhang X, Wang N, Zhang M, Hou L. The role of hematological parameters in asymptomatic and non-severe cases of Omicron variant infection. Virol J 2024; 21:143. [PMID: 38915037 PMCID: PMC11197332 DOI: 10.1186/s12985-024-02414-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Omicron variants are currently the predominant circulating lineage worldwide and most cases are mild or asymptomatic. The Omicron variant is characterized by high transmissibility and immune evasion. Early identification of Omicron cases in clinical settings is crucial for controlling its spread. Previous studies have indicated that changes in hematological parameters can be used to predict the severity of coronavirus disease 2019 (COVID-19). However, the role of hematological parameters in non-severe and asymptomatic cases remains unknown. This study aimed to investigate the role of hematological parameters in non-severe and asymptomatic Omicron variant infections. METHODS Hematological parameters and results were analyzed and compared in symptomatic (n = 356) and asymptomatic (n = 171) groups respectively, and between these two groups with positive COVID-19 tests. The utility of hematological parameters for predicting positive COVID-19 tests was analyzed using receiver operating characteristic curves. RESULTS Individuals with non-severe cases exhibited decreased levels of platelets, lymphocytes, eosinophils, basophils, lymphocytes (%), eosinophils (%), and basophils (%), while exhibiting elevated counts of monocytes, neutrophils (%), monocytes (%), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) when compared to suspected cases or asymptomatic carriers. In asymptomatic patients, positive carriers had lower leukocyte, neutrophil, and lymphocyte counts but higher monocyte, monocyte (%), PLR, and CRP levels than negative carriers. Basophil counts combined with lymphocytes or the PLR demonstrated a more significant predictive value in screening non-severe cases earlier compared to other parameters. The combined assessment of the monocyte (%) and the PLR had the highest area under the curve for diagnosing asymptomatic carriers. CONCLUSIONS Circulating basophils, alone or in combination with other hematological parameters, may be used as efficient biomarkers for early screening of non-severe Omicron cases.
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Affiliation(s)
- Suqin Ben
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 HainingRoad, Hongkou District, Shanghai, 200080, China
- Department of Infectious Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201620, China
| | - Fengying Gao
- Department of Pulmonary Disease, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, PR China
| | - Ziheng Xu
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 HainingRoad, Hongkou District, Shanghai, 200080, China
| | - Rulin Zhang
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Xingyi Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 HainingRoad, Hongkou District, Shanghai, 200080, China
| | - Ning Wang
- Department of Infectious Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201620, China
| | - Min Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 HainingRoad, Hongkou District, Shanghai, 200080, China.
| | - Lili Hou
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 HainingRoad, Hongkou District, Shanghai, 200080, China.
- Department of Respiratory and Critical Care Medicine, Jiuquan Branch of Shanghai General Hospital, Gansu, 735099, China.
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Siddiq A, D’lamanda VG, Anggi MD, Rakhmilla LE, Pramatirta AY, Pusianawati D, Lismayanti L, Widjajakusuma A, Nugrahani AD, Santoso DPJ. Characteristics of COVID-19 comorbidities and severity profiles among pregnant women from a single-center cross-sectional study. Medicine (Baltimore) 2024; 103:e38636. [PMID: 38905361 PMCID: PMC11191956 DOI: 10.1097/md.0000000000038636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 05/29/2024] [Indexed: 06/23/2024] Open
Abstract
The study aimed to determine the characteristics of comorbidities, association between comorbidities and coronavirus disease 2019 (COVID-19), as well as characteristics of COVID-19 severity among pregnant women at a tertiary hospital in Bandung. We conducted a cross-sectional study by taking secondary data between January 2020 and December 2021 involving 278 pregnant women aged 16 to 45 years that confirmedly diagnosed with COVID-19 via RT-PCR. We collected information from the medical record on severity and comorbidities. The admission C-reactive protein (CRP) profiles were compared between the severe and nonsevere COVID-19 patients. This study employed bivariate analysis, t test, and multivariate analysis with logistic regression models. Of the 278 data included in this study, 120 cases had comorbidities. Most patients were asymptomatic (82%). Obesity was the most common comorbid proportion. Only hypertension as comorbid showed a significant association with symptomatic or asymptomatic COVID-19 (<0.05). Pregnant women with hypertension were 6 times more likely to show symptoms than those without hypertension (OR = 6.092; 95% CI 3.103-11.962). Pregnant women with comorbidities were at higher risk of cesarean sections and stillbirth. The CRP levels which were found to have statistically significant association with COVID-19 severity (<0.05). The domination of asymptomatic COVID-19 in pregnant women was found in this study. Hypertension comorbid has a significant association with COVID-19 symptoms. Maternal and neonatal outcomes appear to be influenced by maternal comorbidities. Moreover, the CRP levels were found to be significant risk factors for COVID-19 severity in pregnant women that might have association with comorbidities.
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Affiliation(s)
- Amillia Siddiq
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Vischila Geray D’lamanda
- Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Muhamad Dwi Anggi
- Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Lulu Eva Rakhmilla
- Department of Public Health (Epidemiology), Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Akhmad Yogi Pramatirta
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Dini Pusianawati
- Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Leni Lismayanti
- Department of Clinical Pathology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Anggraini Widjajakusuma
- Department of Internal Medicine, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Annisa Dewi Nugrahani
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
| | - Dhanny Primantara Johari Santoso
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia
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Zaidan M, Puebla Neira D, Polychronopoulou E, Yong-Fang K, Sharma G. Healthcare utilization 9 months pre- and post- COVID-19 hospitalization among patients discharged alive. PLoS One 2024; 19:e0303509. [PMID: 38900737 PMCID: PMC11189225 DOI: 10.1371/journal.pone.0303509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 04/25/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Emerging evidence suggests that there is an increase in healthcare utilization (HCU) in patients due to Coronavirus Disease 2019 (COVID-19). We investigated the change in HCU pre and post hospitalization among patients discharged home from COVID-19 hospitalization for up to 9 months of follow up. STUDY DESIGN AND METHODS This retrospective study from a United States cohort used Optum® de-identified Clinformatics Data Mart; it included adults discharged home post hospitalization with primary diagnosis of COVID-19 between April 2020 and March 2021. We evaluated HCU of patients 9 months pre and post -discharge from index hospitalization. We defined HCU as emergency department (ED), inpatient, outpatient (office), rehabilitation/skilled nursing facility (SNF), telemedicine visits, and length of stay, expressed as number of visits per 10,000 person-days. RESULTS We identified 63,161 patients discharged home after COVID-19 hospitalization. The cohort of patients was mostly white (58.8%) and women (53.7%), with mean age 72.4 (SD± 12) years. These patients were significantly more likely to have increased HCU in the 9 months post hospitalization compared to the 9 months prior. Patients had a 47%, 67%, 65%, and 51% increased risk of ED (rate ratio 1.47; 95% CI 1.45-1.49; p < .0001), rehabilitation (rate ratio 1.67; 95% CI 1.61-1.73; p < .0001), office (rate ratio1.65; 95% CI 1.64-1.65; p < .0001), and telemedicine visits (rate ratio 1.5; 95% CI 1.48-1.54; p < .0001), respectively. We also found significantly different rates of HCU for women compared to men (women have higher risk of ED, rehabilitation, and telemedicine visits but a lower risk of inpatient visits, length of stay, and office visits than men) and for patients who received care in the intensive care unit (ICU) vs those who did not (ICU patients had increased risk of ED, inpatient, office, and telemedicine visits and longer length of stay but a lower risk of rehabilitation visits). Outpatient (office) visits were the highest healthcare service utilized post discharge (64.5% increase). Finally, the risk of having an outpatient visit to any of the specialties studied significantly increased post discharge. Interestingly, the risk of requiring a visit to pulmonary medicine was the highest amongst the specialties studied (rate ratio 3.35, 95% CI 3.26-3.45, p < .0001). CONCLUSION HCU was higher after index hospitalization compared to 9 months prior among patients discharged home post-COVID-19 hospitalization. The increases in HCU may be driven by those patients who received care in the ICU.
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Affiliation(s)
- Mohammed Zaidan
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America
| | - Daniel Puebla Neira
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States of America
| | - Efstathia Polychronopoulou
- Office of Biostatistics, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America
| | - Kuo Yong-Fang
- Office of Biostatistics, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America
- Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America
| | - Gulshan Sharma
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America
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