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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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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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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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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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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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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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7
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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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9
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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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10
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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] [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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11
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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 M, 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 hospitalised COVID-19 patients: A randomised trial. J Infect 2024:106217. [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 hospitalised COVID-19 patients. METHODS Participants were randomised to receive standard of care (SoC) or SoC with imatinib. Imatinib dosage was 400mg 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 randomised trials studying imatinib for 30-day mortality in hospitalised COVID-19 patients. RESULTS We randomised 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 hospitalised 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 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 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 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 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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12
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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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13
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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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14
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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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15
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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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16
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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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17
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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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18
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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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20
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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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21
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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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24
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Enriquez de Salamanca Gambara R, Sanz-García A, del Pozo Vegas C, López-Izquierdo R, Sánchez Soberón I, Delgado Benito JF, Martínez Diaz R, Pérez-Oleaga CM, López NMM, Domínguez Azpíroz I, Martín-Rodríguez F. A Comparison of the Clinical Characteristics of Short-, Mid-, and Long-Term Mortality in Patients Attended by the Emergency Medical Services: An Observational Study. Diagnostics (Basel) 2024; 14:1292. [PMID: 38928707 PMCID: PMC11203341 DOI: 10.3390/diagnostics14121292] [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: 05/09/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
AIM The development of predictive models for patients treated by emergency medical services (EMS) is on the rise in the emergency field. However, how these models evolve over time has not been studied. The objective of the present work is to compare the characteristics of patients who present mortality in the short, medium and long term, and to derive and validate a predictive model for each mortality time. METHODS A prospective multicenter study was conducted, which included adult patients with unselected acute illness who were treated by EMS. The primary outcome was noncumulative mortality from all causes by time windows including 30-day mortality, 31- to 180-day mortality, and 181- to 365-day mortality. Prehospital predictors included demographic variables, standard vital signs, prehospital laboratory tests, and comorbidities. RESULTS A total of 4830 patients were enrolled. The noncumulative mortalities at 30, 180, and 365 days were 10.8%, 6.6%, and 3.5%, respectively. The best predictive value was shown for 30-day mortality (AUC = 0.930; 95% CI: 0.919-0.940), followed by 180-day (AUC = 0.852; 95% CI: 0.832-0.871) and 365-day (AUC = 0.806; 95% CI: 0.778-0.833) mortality. DISCUSSION Rapid characterization of patients at risk of short-, medium-, or long-term mortality could help EMS to improve the treatment of patients suffering from acute illnesses.
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Affiliation(s)
| | - Ancor Sanz-García
- Faculty of Health Sciences, Universidad de Castilla la Mancha, 45600 Talavera de la Reina, Spain
| | - Carlos del Pozo Vegas
- Faculty of Medicine, Universidad de Valladolid, 47011 Valladolid, Spain; (C.d.P.V.); (F.M.-R.)
- Emergency Department, Hospital Clínico Universitario, 47003 Valladolid, Spain
| | - Raúl López-Izquierdo
- Emergency Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain; (R.E.d.S.G.); (R.L.-I.)
- Faculty of Medicine, Universidad de Valladolid, 47011 Valladolid, Spain; (C.d.P.V.); (F.M.-R.)
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Irene Sánchez Soberón
- Advanced Life Support, Emergency Medical Services (SACYL), 47007 Valladolid, Spain; (I.S.S.); (J.F.D.B.)
| | - Juan F. Delgado Benito
- Advanced Life Support, Emergency Medical Services (SACYL), 47007 Valladolid, Spain; (I.S.S.); (J.F.D.B.)
| | - Raquel Martínez Diaz
- Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain; (R.M.D.); (C.M.P.-O.); (N.M.M.L.); (I.D.A.)
- Department of Project Management, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Department of Project Management, Universidad de La Romana, La Romana 22000, Dominican Republic
| | - Cristina Mazas Pérez-Oleaga
- Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain; (R.M.D.); (C.M.P.-O.); (N.M.M.L.); (I.D.A.)
- Department of Project Management, Universidad Internacional Iberoamericana, Arecibo 00613, Puerto Rico
- Department of Project Management, Universidade Internacional do Cuanza, Cuito EN250, Angola
| | - Nohora Milena Martínez López
- Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain; (R.M.D.); (C.M.P.-O.); (N.M.M.L.); (I.D.A.)
- Department of Project Management, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Fundación Universitaria Internacional de Colombia, Bogotá 111321, Colombia
| | - Irma Domínguez Azpíroz
- Department of Project Management, Universidad Europea del Atlántico, 39011 Santander, Spain; (R.M.D.); (C.M.P.-O.); (N.M.M.L.); (I.D.A.)
- Department of Project Management, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Department of Project Management, Universidad de La Romana, La Romana 22000, Dominican Republic
| | - Francisco Martín-Rodríguez
- Faculty of Medicine, Universidad de Valladolid, 47011 Valladolid, Spain; (C.d.P.V.); (F.M.-R.)
- Advanced Life Support, Emergency Medical Services (SACYL), 47007 Valladolid, Spain; (I.S.S.); (J.F.D.B.)
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25
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Chen J, Gao X, Liang J, Wu Q, Shen L, Zheng Y, Ma Y, Peng Y, He Y, Yin J. Association between gut microbiota dysbiosis and poor functional outcomes in acute ischemic stroke patients with COVID-19 infection. mSystems 2024; 9:e0018524. [PMID: 38700338 PMCID: PMC11237522 DOI: 10.1128/msystems.00185-24] [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: 02/10/2024] [Accepted: 03/26/2024] [Indexed: 05/05/2024] Open
Abstract
Acute ischemic stroke (AIS) patients with active COVID-19 infection often have more severe symptoms and worse recovery. COVID-19 infection can cause gut microbiota dysbiosis, which is also a risk factor for poor outcomes in AIS patients. However, the association between gut microbiota and functional outcomes among AIS patients with COVID-19 infection has not been fully clarified yet. In this study, we performed 16S rRNA gene sequencing to characterize the gut microbial community among AIS patients with acute COVID-19 infection, AIS patients with post-acute COVID-19 infection, and AIS patients without COVID-19 infection. We found that AIS patients with acute COVID-19 experienced poorer recovery and significant gut dysbiosis, characterized by higher levels of Enterobacteriaceae and lower levels of Ruminococcaceae and Lachnospiraceae. Furthermore, a shorter time window (less than 28 days) between COVID-19 infection and stroke was identified as a risk factor for poor functional outcomes in AIS patients with COVID-19, and the enrichment of Enterobacteriaceae was indicated as a mediator in the relationship between infection time window and poor stroke outcomes. Our findings highlight the importance of early intervention after COVID-19 infection, especially by regulating the gut microbiota, which plays a role in the prognosis of AIS patients with COVID-19 infection.IMPORTANCEThe gut microbiota plays an important role in the association between respiratory system and cerebrovascular system through the gut-lung axis and gut-brain axis. However, the specific connection between gut bacteria and the functional outcomes of acute ischemic stroke (AIS) patients with COVID-19 is not fully understood yet. In our study, we observed a significant decrease in bacterial diversity and shifts in the abundance of key bacterial families in AIS patients with acute COVID-19 infection. Furthermore, we identified that the time window was a critical influence factor for stroke outcomes, and the enrichment of Enterobacteriaceae acted as a mediator in the relationship between the infection time window and poor stroke outcomes. Our research provides a new perspective on the complex interplay among AIS, COVID-19 infection, and gut microbiota dysbiosis. Moreover, recognizing Enterobacteriaceae as a potential mediator of poor stroke prognosis offers a novel avenue for future exploration and therapeutic interventions.
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Affiliation(s)
- Jiaying Chen
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Comprehensive Medical Treatment Ward, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuxuan Gao
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingru Liang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiheng Wu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Linlin Shen
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yifeng Zheng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu Ma
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuping Peng
- Department of Neurosurgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yan He
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for Laboratory Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Mental Health of the Ministry of Education, Guangzhou, Guangdong, China
| | - Jia Yin
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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26
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Entrenas-Castillo M, Entrenas-Costa LM, Pata MP, Jurado-Gamez B, Muñoz-Corroto C, Gomez-Rebollo C, Mira-Padilla E, Bouillon R, Quesada-Gómez JM. Calcifediol or Corticosteroids in the Treatment of COVID-19: An Observational Study. Nutrients 2024; 16:1910. [PMID: 38931265 PMCID: PMC11206538 DOI: 10.3390/nu16121910] [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: 04/01/2024] [Revised: 05/17/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Medical treatment of coronavirus 19 disease (COVID-19) is a therapeutic challenge. The available data strongly suggest that calcifediol treatment may reduce the severity of COVID-19, and corticosteroids are the treatment of choice worldwide for severe COVID-19. Both have a very similar action profile, and their combined use in patients may modify the contribution of each administered compound. OBJECTIVE To evaluate how treatment with calcifediol and/or corticosteroids in medical practice modified the need for ICU admission, death, or poor prognosis of patients hospitalized with COVID-19 during the first outbreaks. DESIGN, PATIENTS AND SETTING A retrospective observational cohort study of patients admitted for COVID-19 to the Pneumology Unit of the Hospital Universitario Reina Sofía (Córdoba, Spain). INTERVENTIONS Patients were treated with calcifediol or/and corticosteroids with the best available therapy and standard care, according to clinical practice guidelines. MEASUREMENTS Admission to the intensive care unit (ICU) or death during hospitalization and poor prognosis. RESULTS Seven hundred and twenty-eight patients were included. According to the treatment received, they were included in four groups: calcifediol (n = 68), glucocorticoids (n = 112), both (n = 510), or neither (n = 38). Of the 578 patients treated with calcifediol, 88 were admitted to the ICU (15%), while of the 150 not treated with calcifediol, 39 required ICU admission (26%) (p < 0.01). Among the patients taking calcifediol without glucocorticoids, only 4 of 68 (5.8%) required ICU admission, compared to 84 of 510 (16.5%) treated with both (p = 0.022). Of the 595 patients who had a good prognosis, 568 (82.01%) had received treatment with calcifediol versus the 133 patients with a poor prognosis, of whom 90 (67.66%) had received calcifediol (p < 0.001). This difference was not found for corticosteroids. INTERPRETATION The treatment of choice for hospitalized patients with moderate or mild COVID-19 could be calcifediol, not administering corticosteroids, until the natural history of the disease reaches a stage of hyperinflammation.
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Affiliation(s)
- Marta Entrenas-Castillo
- Hospital QuironSalud Córdoba, 14004 Córdoba, Spain; (M.E.-C.); (L.M.E.-C.)
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain;
| | - Luis Manuel Entrenas-Costa
- Hospital QuironSalud Córdoba, 14004 Córdoba, Spain; (M.E.-C.); (L.M.E.-C.)
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain;
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (C.M.-C.); (C.G.-R.); (E.M.-P.)
| | | | - Bernabe Jurado-Gamez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain;
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (C.M.-C.); (C.G.-R.); (E.M.-P.)
| | - Cristina Muñoz-Corroto
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (C.M.-C.); (C.G.-R.); (E.M.-P.)
| | - Cristina Gomez-Rebollo
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (C.M.-C.); (C.G.-R.); (E.M.-P.)
| | - Estefania Mira-Padilla
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain; (C.M.-C.); (C.G.-R.); (E.M.-P.)
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, 3000 Leuven, Belgium
| | - Jose Manuel Quesada-Gómez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain;
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain
- Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain
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27
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Chen LP, Singh-Verdeflor K, Kelly MM, Sklansky DJ, Shadman KA, Edmonson MB, Zhao Q, DeMuri GP, Coller RJ. Disparities in COVID-19 vaccine intentions, testing and trusted sources by household language for children with medical complexity. PLoS One 2024; 19:e0305553. [PMID: 38875256 PMCID: PMC11178204 DOI: 10.1371/journal.pone.0305553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/02/2024] [Indexed: 06/16/2024] Open
Abstract
OBJECTIVES Children with medical complexity experienced health disparities during the coronavirus disease 2019 (COVID-19) pandemic. Language may compound these disparities since people speaking languages other than English (LOE) also experienced worse COVID-19 outcomes. Our objective was to investigate associations between household language for children with medical complexity and caregiver COVID-19 vaccine intentions, testing knowledge, and trusted sources of information. METHODS This cross-sectional survey of caregivers of children with medical complexity ages 5 to 17 years was conducted from April-June 2022. Children with medical complexity had at least 1 Complex Chronic Condition. Households were considered LOE if they reported speaking any language other than English. Multivariable logistic regression examined associations between LOE and COVID-19 vaccine intentions, interpretation of COVID-19 test results, and trusted sources of information. RESULTS We included 1,338 caregivers of children with medical complexity (49% response rate), of which 133 (10%) had household LOE (31 total languages, 58% being Spanish). There was no association between household LOE and caregiver COVID-19 vaccine intentions. Caregivers in households with LOE had similar interpretations of positive COVID-19 test results, but significantly different interpretations of negative results. Odds of interpreting a negative test as expected (meaning the child does not have COVID-19 now or can still get the virus from others) were lower in LOE households (aOR [95% CI]: 0.56 [0.34-0.95]). Households with LOE were more likely to report trusting the US government to provide COVID-19 information (aOR [95% CI]: 1.86 [1.24-2.81]). CONCLUSION Differences in COVID-19 test interpretations based on household language for children with medical complexity were observed and could contribute to disparities in outcomes. Opportunities for more inclusive public health messaging likely exist.
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Affiliation(s)
- Laura P Chen
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kristina Singh-Verdeflor
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Michelle M Kelly
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Daniel J Sklansky
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kristin A Shadman
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - M Bruce Edmonson
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Gregory P DeMuri
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Ryan J Coller
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
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Prinelli F, Adorni F, Giovanelli A, Ravelli M, Ceresoli S, Asteria C. The EPICOVID19-BS study: a web-based epidemiological survey in bariatric patients. J Endocrinol Invest 2024:10.1007/s40618-024-02407-1. [PMID: 38858278 DOI: 10.1007/s40618-024-02407-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/31/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE To assess the occurrence and severity of SARS-CoV-2 infection/COVID-19, frequency of symptoms, clinical manifestations and behaviours in a sample of patients undergoing bariatric surgery (BS). METHODS The EPICOVID19-BS is an observational cross-sectional study conducted in Italy during the second wave of the COVID-19 pandemic (September 2021-February 2022). Patients with severe/extreme obesity undergoing BS were asked to complete an online multiple-choice questionnaire and to provide additional clinical information and blood biochemistry. Positive COVID-19 cases were defined by the combination of positive nasopharyngeal swab test results and/or positive serological test results. Sociodemographic, clinical and behavioural characteristics were compared between positive and negative COVID-19 cases. RESULTS A total of 745 participants were enrolled (mean age 44.5 ± 10.5 years SD, 78% female). The proportion of positive COVID-19 cases was 20.4%. They were more likely to be health care workers, to have close contacts with confirmed cases, to use anti-inflammatory drugs, to have immune system disorders, to have previous CMV infection, to have lower cholesterol levels and to have less metabolic syndrome than negative cases. Infected participants significantly increased their use of national health resources for minor health problems. The majority of participants experienced flu-like symptoms and taste and smell disturbances. Only 9.6% were hospitalised and none required intubation. CONCLUSIONS Our results seem to support the evidence that patients undergoing BS have a low rate of severe SARS-CoV2. Further longitudinal studies in multiple obesity treatment centres are needed to more effectively monitor and control obesity in this specific population.
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Affiliation(s)
- F Prinelli
- Epidemiology and Public Health Unit, Institute of Biomedical Technologies, National Research Council, Via Fratelli Cervi 93, 20054, Segrate, MI, Italy.
| | - F Adorni
- Epidemiology and Public Health Unit, Institute of Biomedical Technologies, National Research Council, Via Fratelli Cervi 93, 20054, Segrate, MI, Italy
| | - A Giovanelli
- National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, 20097, Milan, Italy
| | - M Ravelli
- National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, 20097, Milan, Italy
| | - S Ceresoli
- National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, 20097, Milan, Italy
| | - C Asteria
- National Institute of Obesity Cure (INCO)-Bariatric Unit, IRCCS, Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato Milanese, 20097, Milan, Italy
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29
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Zhou D, Zhao S, He K, Liu Q, Zhang F, Pu Z, Xiao L, Zhang L, Chen S, Qian X, Wu X, Shen Y, Yu L, Zhang H, Jin J, Xu M, Wang X, Zhu D, Xie Z, Xu X. Longitudinal dynamic single-cell mass cytometry analysis of peripheral blood mononuclear cells in COVID-19 patients within 6 months after viral RNA clearance. BMC Infect Dis 2024; 24:567. [PMID: 38844850 PMCID: PMC11157885 DOI: 10.1186/s12879-024-09464-0] [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: 09/09/2023] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
This study investigates the longitudinal dynamic changes in immune cells in COVID-19 patients over an extended period after recovery, as well as the interplay between immune cells and antibodies. Leveraging single-cell mass spectrometry, we selected six COVID-19 patients and four healthy controls, dissecting the evolving landscape within six months post-viral RNA clearance, alongside the levels of anti-spike protein antibodies. The T cell immunophenotype ascertained via single-cell mass spectrometry underwent validation through flow cytometry in 37 samples. Our findings illuminate that CD8 + T cells, gamma-delta (gd) T cells, and NK cells witnessed an increase, in contrast to the reduction observed in monocytes, B cells, and double-negative T (DNT) cells over time. The proportion of monocytes remained significantly elevated in COVID-19 patients compared to controls even after six-month. Subpopulation-wise, an upsurge manifested within various T effector memory subsets, CD45RA + T effector memory, gdT, and NK cells, whereas declines marked the populations of DNT, naive and memory B cells, and classical as well as non-classical monocytes. Noteworthy associations surfaced between DNT, gdT, CD4 + T, NK cells, and the anti-S antibody titer. This study reveals the changes in peripheral blood mononuclear cells of COVID-19 patients within 6 months after viral RNA clearance and sheds light on the interactions between immune cells and antibodies. The findings from this research contribute to a better understanding of immune transformations during the recovery from COVID-19 and offer guidance for protective measures against reinfection in the context of viral variants.
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Affiliation(s)
- Diwenxin Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Shuai Zhao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Keting He
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Qiuhong Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Fen Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Zhangya Pu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Lanlan Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Lingjian Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Shangci Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Xiaohan Qian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Xiaoxin Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Yangfan Shen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Ling Yu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Huafen Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Jiandi Jin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Min Xu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Xiaoyan Wang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Danhua Zhu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China
| | - Zhongyang Xie
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China.
| | - Xiaowei Xu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd., Hangzhou City, 310003, China.
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30
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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 2024:10.1007/s12185-024-03802-3. [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] [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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31
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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] [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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Bösebeck F, Worthmann H, Möller C, Konrad C. The social, psychological, and physical impact of COVID-19 restrictions for institutionalized adults with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:567-577. [PMID: 36999659 PMCID: PMC10067708 DOI: 10.1177/17446295231168293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
During the COVID-19 pandemic, drastic measures to interrupt SARS-CoV-2 infection chains were implemented. In our study we investigated the consequences of pandemic related restrictions on the social, psychological, and physical well-being of institutionalized adults with intellectual and developmental disabilities. Methods: Online survey among professional caregivers in 71 residential groups, caring for 848 residents. Findings: (i.) A lack of participation concerning infection protection measures of the residents, their relatives, and their caregivers; (ii.) A 20% increase in doctor contacts during the pandemic; (iii.) A considerable deterioration in at least one item of the subdomains mood (49%), everyday skills (51%), social interaction (29%), exercise and coordination skills (12%), behavior (11%) and cognition and communication (7%); (iv.) A deterioration of the overall condition in 41%; Summery: Intensive attempts should be made to find individual and less categorical contra-infectious measures without questioning the basic everyday needs of people with intellectual and developmental disabilities.
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Affiliation(s)
- F Bösebeck
- Medical Centre for Adults with Disabilities, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
| | - H Worthmann
- Psychological Service, Rotenburger Werke, Rotenburg, Germany
| | - C Möller
- Department for Research, Development and Innovation Management, Agaplesion gAG, Frankfurt, Germany
| | - C Konrad
- Medical Centre for Adults with Disabilities, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
- Psychiatric Department, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
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33
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Kim HJ, Kim MH, Park SJ, Choi MG, Chun EM. Autoimmune adverse event following COVID-19 vaccination in Seoul, South Korea. J Allergy Clin Immunol 2024; 153:1711-1720. [PMID: 38520423 DOI: 10.1016/j.jaci.2024.01.025] [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: 09/11/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND There is growing evidence that the coronavirus disease 2019 (COVID-19) vaccination can affect the regulation of the immune system, leading to the development of autoimmune diseases. However, the autoimmune adverse events (AEs) after COVID-19 vaccination remain largely unclear. OBJECTIVE We sought to investigate the autoimmune AEs after COVID-19 vaccination from a population-based cohort in South Korea. METHODS A total of 4,203,887 participants, representing 50% of the population residing in Seoul, were recruited from the National Health Insurance Service database and then divided into 2 groups on the basis of COVID-19 vaccination. The cumulative incidence, hazard ratios (HRs), and 95% CIs of autoimmune AEs were assessed following COVID-19 vaccination. RESULTS The incidence of vitiligo has been observed to be significantly higher in the vaccination group compared with the no vaccination group. The cumulative incidence of vitiligo began to show a significant difference starting 2 weeks after vaccination, and it reached 2.2% in the vaccination group and 0.6% in the no vaccination group by 3 months after COVID-19 vaccination. Vitiligo (HR, 2.714; 95% CI, 1.777-4.146) was an increased risk among autoimmune AEs. Furthermore, the risk of vitiligo was the highest for heterologous vaccination (HR, 3.890; 95% CI, 2.303-6.573) compared with using cDNA vaccine (HR, 2.861; 95% CI, 1.838-4.453) or mRNA vaccine (HR, 2.475; 95% CI, 1.607-3.813). CONCLUSIONS Vitiligo as an autoimmune AE was noted to be substantially higher in the COVID-19-vaccinated group compared with the controls. Therefore, the occurrence of vitiligo could be considered as one of the significant AEs post-COVID-19 vaccination.
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Affiliation(s)
- Hong Jin Kim
- Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Min-Ho Kim
- Informatization Department, Ewha Womans University Seoul Hospital, Ewha Womans University, Seoul, Korea
| | - Seong Jun Park
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Myeong Geun Choi
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Eun Mi Chun
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
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Chen X, Liu H, Li M, Kang J, Li Y, Luo Y, Du X, Tan D, Wang Q, Gu X, Zhao Z, Fu X, Tang J. Association between clinical symptoms during the COVID-19 infection and SARS-CoV-2 immunoglobulin G titers in COVID-19 convalescent whole-blood donors in China. Transfusion 2024; 64:1025-1039. [PMID: 38661221 DOI: 10.1111/trf.17843] [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: 08/23/2023] [Revised: 03/08/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Limited studies have explored the association between clinical symptoms and titers of SARS-CoV-2 antibodies. STUDY DESIGN AND METHODS In this cross-sectional study, whole-blood donors who had experienced a confirmed or suspected COVID-19 infection completed questionnaires at the time of blood donation. Plasma SARS-CoV-2 immunoglobulin G (IgG) titers were measured using an enzyme-linked immunosorbent assay. Logistic regression models were used to calculate odds ratios (ORs) for high-titer COVID-19 convalescent plasma (CCP) for each variable. RESULTS Among the total 386 donors, 120 (31%) donors with IgG titers ≥1:160 were classified as high-titer donors. The multivariable ORs (95% confidence intervals [CIs]) for high titers were 2.33 (1.45-3.75), 2.11 (1.29-3.43), 1.10 (1.01-1.21), 1.19 (1.00-1.43), and 1.97 (1.05-3.71) for sore throat, cough, symptom count, fever duration, and low fever (compared with non-fever), respectively. No significant association was observed between other symptoms and medical visits and the odds of high-titer CCP. The association between high-titer CCP and fever duration was restricted to confirmed COVID-19-infected donors, while associations with sore throat and cough remained significant in suspected infected donors. In addition, medical visit was positively associated with high-titer CCP in suspected donors, but not in confirmed donors. In bootstrapped logistic regression models, the associations remained significant and reproducible for medical visit in suspected donors and for sore throat and cough in both suspected donors and total donors. DISCUSSION Experiencing a sore throat and cough were associated with high-titer CCP in overall donors. We also identified sore throat, cough, and medical visits as potential predictors of high-titer CCP for suspected donors during the pandemic.
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Affiliation(s)
- Xue Chen
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Humin Liu
- Department of Blood Testing, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Meng Li
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Jianxun Kang
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Ying Li
- Department of Blood Testing, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Yue Luo
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Xinman Du
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Donglin Tan
- Department of Blood Processing, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Qing Wang
- Department of Blood Collection, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Xiaobo Gu
- Department of Blood Collection, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Zonghan Zhao
- Department of Blood Collection, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Xuemei Fu
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, China
| | - Jingyun Tang
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, China
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Oncu S, Korkmaz D. Evaluation of the relationship of treatment and vaccination with prognosis in patients with a diagnosis of COVID-19. Inflammopharmacology 2024; 32:1817-1826. [PMID: 38493271 PMCID: PMC11136715 DOI: 10.1007/s10787-024-01457-4] [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: 02/07/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide and caused mortality. Many factors have been reported to affect the prognosis of COVID-19. In this study, we aimed to investigate the effects of drug therapy and vaccination on prognosis in patients hospitalized with a COVID-19 diagnosis. METHODS In this single-center, cross-sectional study, data were retrospectively collected from patients receiving inpatient treatment at a university hospital with a diagnosis of COVID-19 between January 1, 2020, and April 30, 2022. The patients' demographic and clinical characteristics were recorded. The Chi-square, Cox and logistic regression was performed, P < 0.05 was considered statistically significant. RESULTS Total 1723 patients (50.1% were men, mean age: 60.6 ± 16.90) who had not been vaccinated rate was 27.0% (> 3 doses: 45.7%). Mortality rate was 17.0%. Increasing age, male, a high Charlson Comorbidity Index (CCI), and no vaccination significantly increased mortality (P < 0.05). The mortality rate was significantly lower in the chloroquine treatment group than in the other treatment groups. Increasing age, male, and a high CCI were determined to be factors that significantly increased the length of hospital stay (LOHS). LOHS found to be significantly lower in the favipiravir or chloroquine groups compared to the remaining treatment groups (P < 0.001). Both mortality and the LOHS significantly differed according to AST, d-dimer, ferritin, and GFR. CONCLUSION This study primarily investigated the effect of treatment and vaccination on the prognosis of COVID-19. This was determined to be prepared for another potential pandemic that may arise due to COVID-19.
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Affiliation(s)
- Seyma Oncu
- Department of Pharmacology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey.
| | - Derya Korkmaz
- Department of Infectious Disease, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Wu PC, Lin WC, Wang CW, Chung WH, Chen CB. Cutaneous adverse reactions associated with COVID-19 vaccines: Current evidence and potential immune mechanisms. Clin Immunol 2024; 263:110220. [PMID: 38642783 DOI: 10.1016/j.clim.2024.110220] [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: 09/26/2023] [Revised: 03/04/2024] [Accepted: 04/14/2024] [Indexed: 04/22/2024]
Abstract
As the number of vaccinated individuals has increased, there have been increasing reports of cutaneous hypersensitivity reactions. The main COVID-19 vaccines administered include messenger ribonucleic acid vaccines, non-replicating viral vector vaccines, inactivated whole-virus vaccines, and protein-based vaccines. These vaccines contain active components such as polyethylene glycol, polysorbate 80, aluminum, tromethamine, and disodium edetate dihydrate. Recent advances in understanding the coordination of inflammatory responses by specific subsets of lymphocytes have led to a new classification based on immune response patterns. We categorize these responses into four patterns: T helper (Th)1-, Th2-, Th17/22-, and Treg-polarized cutaneous inflammation after stimulation of COVID-19 vaccines. Although the association between COVID-19 vaccination and these cutaneous adverse reactions remains controversial, the occurrence of rare dermatoses and their short intervals suggest a possible relationship. Despite the potential adverse reactions, the administration of COVID-19 vaccines is crucial in the ongoing battle against severe acute respiratory syndrome coronavirus 2.
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Affiliation(s)
- Po-Chien Wu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chen Lin
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chuang-Wei Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
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Berdygulova Z, Maltseva E, Perfilyeva Y, Nizkorodova A, Zhigailov A, Naizabayeva D, Ostapchuk YO, Kuatbekova S, Dosmagambet Z, Kuatbek M, Bissenbay A, Cherusheva A, Mashzhan A, Abdolla N, Ashimbekov S, Ismagulova G, Dmitrovskiy A, Mamadaliyev S, Skiba Y. RT-qPCR investigation of post-mortem tissues during COVID-19. J Appl Biomed 2024; 22:115-122. [PMID: 38912867 DOI: 10.32725/jab.2024.013] [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] [Accepted: 06/20/2024] [Indexed: 06/25/2024] Open
Abstract
In 2020, there were numerous cases in Kazakhstan with clinical symptoms of COVID-19 but negative PCR results in nasopharyngeal and oropharyngeal swabs. The diagnosis was confirmed clinically and by CT scans (computed tomography). The problem with such negative PCR results for SARS-CoV-2 infection confirmation still exists and indicates the need to confirm the diagnosis in the bronchoalveolar lavage in such cases. There is also a lack of information about confirmation of SARS-CoV-2 infection in deceased patients. In this study, various tissue materials, including lungs, bronchi, and trachea, were examined from eight patients who died, presumably from SARS-CoV-2 infection, between 2020 and 2022. Naso/oropharyngeal swabs taken from these patients in hospitals tested PCR negative for SARS-CoV-2. This study presents a modified RNA isolation method based on a comparison of the most used methods for RNA isolation in laboratories: QIAamp Viral RNA Mini Kit and TRIzol-based method. This modified nucleic acid extraction protocol can be used to confirm SARS-CoV-2 infection by RT-qPCR in the tissues of deceased patients in disputed cases. RT-qPCR with RNA of SARS-CoV-2 re-extracted with such method from post-mortem tissues that were stored at -80 °C for more than 32 months still demonstrated high-yielding positive results.
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Affiliation(s)
- Zhanna Berdygulova
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | - Elina Maltseva
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
- Tethys Scientific Society, Almaty, Kazakhstan
| | - Yuliya Perfilyeva
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | - Anna Nizkorodova
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | - Andrey Zhigailov
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | - Dinara Naizabayeva
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
- Tethys Scientific Society, Almaty, Kazakhstan
| | - Yekaterina O Ostapchuk
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | - Saltanat Kuatbekova
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
| | - Zhaniya Dosmagambet
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Moldir Kuatbek
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Akerke Bissenbay
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | - Alena Cherusheva
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
| | - Akzhigit Mashzhan
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
| | - Nurshat Abdolla
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | | | - Gulnara Ismagulova
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
| | - Andrey Dmitrovskiy
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
| | - Seidigapbar Mamadaliyev
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
| | - Yuriy Skiba
- Almaty Branch of the National Center for Biotechnology, Central Reference Laboratory, Almaty, Kazakhstan
- M. A. Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
- Tethys Scientific Society, Almaty, Kazakhstan
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Tyrkalska SD, Pérez-Sanz F, Franco-Martínez L, Rubio CP, Tvarijonaviciute A, Martínez-Subiela S, Méndez-Hernández M, González-Aumatell A, Carreras-Abad C, Domènech-Marçal È, Cerón JJ, Cayuela ML, Mulero V, Candel S. Salivary biomarkers as pioneering indicators for diagnosis and severity stratification of pediatric long COVID. Front Cell Infect Microbiol 2024; 14:1396263. [PMID: 38881733 PMCID: PMC11176444 DOI: 10.3389/fcimb.2024.1396263] [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: 03/05/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), manifests as persistent and often debilitating symptoms enduring well beyond the initial COVID-19 infection. This disease is especially worrying in children since it can seriously alter their development. Presently, a specific diagnostic test or definitive biomarker set for confirming long COVID is lacking, relying instead on the protracted presence of symptoms post-acute infection. Methods We measured the levels of 13 biomarkers in 105 saliva samples (49 from children with long COVID and 56 controls), and the Pearson correlation coefficient was used to analyse the correlations between the levels of the different salivary biomarkers. Multivariate logistic regression analyses were performed to determine which of the 13 analysed salivary biomarkers were useful to discriminate between children with long COVID and controls, as well as between children with mild and severe long COVID symptoms. Results Pediatric long COVID exhibited increased oxidant biomarkers and decreased antioxidant, immune response, and stress-related biomarkers. Correlation analyses unveiled distinct patterns between biomarkers in long COVID and controls. Notably, a multivariate logistic regression pinpointed TOS, ADA2, total proteins, and AOPP as pivotal variables, culminating in a remarkably accurate predictive model distinguishing long COVID from controls. Furthermore, total proteins and ADA1 were instrumental in discerning between mild and severe long COVID symptoms. Discussion This research sheds light on the potential clinical utility of salivary biomarkers in diagnosing and categorizing the severity of pediatric long COVID. It also lays the groundwork for future investigations aimed at unravelling the prognostic value of these biomarkers in predicting the trajectory of long COVID in affected individuals.
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Affiliation(s)
- Sylwia D Tyrkalska
- Grupo de Inmunidad, Inflamación y Cáncer, Departamento de Biología Celular e Histología, Facultad de Biología, Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Pascual Parrilla, Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Pérez-Sanz
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Pascual Parrilla, Murcia, Spain
| | - Lorena Franco-Martínez
- Laboratorio Interdisciplinar de Análisis Clínicos, Facultad de Veterinaria, Universidad de Murcia (Interlab-UMU), Murcia, Spain
| | - Camila P Rubio
- Laboratorio Interdisciplinar de Análisis Clínicos, Facultad de Veterinaria, Universidad de Murcia (Interlab-UMU), Murcia, Spain
| | - Asta Tvarijonaviciute
- Laboratorio Interdisciplinar de Análisis Clínicos, Facultad de Veterinaria, Universidad de Murcia (Interlab-UMU), Murcia, Spain
| | - Silvia Martínez-Subiela
- Laboratorio Interdisciplinar de Análisis Clínicos, Facultad de Veterinaria, Universidad de Murcia (Interlab-UMU), Murcia, Spain
| | - María Méndez-Hernández
- Unidad de Covid Persistente Pediátrico. Servicio de Pediatría, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
- Departamento de Pediatría, Obstetricia y Ginecología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Alba González-Aumatell
- Unidad de Covid Persistente Pediátrico. Servicio de Pediatría, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
- Departamento de Pediatría, Obstetricia y Ginecología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Clara Carreras-Abad
- Unidad de Covid Persistente Pediátrico. Servicio de Pediatría, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
- Departamento de Pediatría, Obstetricia y Ginecología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Èlia Domènech-Marçal
- Unidad de Covid Persistente Pediátrico. Servicio de Pediatría, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
- Departamento de Pediatría, Obstetricia y Ginecología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - José J Cerón
- Laboratorio Interdisciplinar de Análisis Clínicos, Facultad de Veterinaria, Universidad de Murcia (Interlab-UMU), Murcia, Spain
| | - María L Cayuela
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Pascual Parrilla, Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Grupo de Telomerasa, Cáncer y Envejecimiento, Servicio de Cirugía, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Victoriano Mulero
- Grupo de Inmunidad, Inflamación y Cáncer, Departamento de Biología Celular e Histología, Facultad de Biología, Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Pascual Parrilla, Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Candel
- Grupo de Inmunidad, Inflamación y Cáncer, Departamento de Biología Celular e Histología, Facultad de Biología, Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Pascual Parrilla, Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
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Song K, Xue W, Li X, Chang Y, Liu M. Self-Assembly of Single-Virus SERS Hotspots for Highly Sensitive In Situ Detection of SARS-CoV-2 on Solid Surfaces. Anal Chem 2024; 96:8830-8836. [PMID: 38693713 DOI: 10.1021/acs.analchem.4c01607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Microbial surface transmission has aroused great attention since the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Developing a simple in situ detection method for viruses on solid surfaces is of great significance for timely public health surveillance. Taking advantage of the natural structure of SARS-CoV-2, we reported the assembly of Au@AgNPs on the surface of a single virus by the specific aptamer-spike protein interaction. Multiple hotspots can be created between the neighboring Au@AgNPs for the highly sensitive surface-enhanced Raman scattering (SERS) detection of SARS-CoV-2. Using two different aptamers labeled with Cy3 and Au@AgNPs, in situ SERS detection of pseudotyped SARS-CoV-2 (PSV) on packaging surfaces was achieved within 20 min, with a detection limit of 5.26 TCID50/mL. For the blind testing of 20 PSV-contaminated packaging samples, this SERS aptasensor had a sensitivity of 100% and an accuracy of 100%. This assay has been successfully applied to in situ detection of PSV on the surfaces of different packaging materials, suggesting its potential applicability.
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Affiliation(s)
- Kaiyun Song
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Wei Xue
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Xiaona Li
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Yangyang Chang
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
| | - Meng Liu
- School of Environmental Science and Technology, Key Laboratory of Industrial Ecology and Environmental Engineering (Ministry of Education), Dalian POCT laboratory, Dalian University of Technology, Dalian 116024, China
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40
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Duve K, Petakh P, Kamyshnyi O. COVID-19-associated encephalopathy: connection between neuroinflammation and microbiota-gut-brain axis. Front Microbiol 2024; 15:1406874. [PMID: 38863751 PMCID: PMC11165208 DOI: 10.3389/fmicb.2024.1406874] [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: 04/03/2024] [Accepted: 05/16/2024] [Indexed: 06/13/2024] Open
Abstract
While neurological complications of COVID-19, such as encephalopathy, are relatively rare, their potential significant impact on long-term morbidity is substantial, especially given the large number of infected patients. Two proposed hypotheses for the pathogenesis of this condition are hypoxia and the uncontrolled release of proinflammatory cytokines. The gut microbiota plays an important role in regulating immune homeostasis and overall gut health, including its effects on brain health through various pathways collectively termed the gut-brain axis. Recent studies have shown that COVID-19 patients exhibit gut dysbiosis, but how this dysbiosis can affect inflammation in the central nervous system (CNS) remains unclear. In this context, we discuss how dysbiosis could contribute to neuroinflammation and provide recent data on the features of neuroinflammation in COVID-19 patients.
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Affiliation(s)
- Khrystyna Duve
- Department of Neurology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Oleksandr Kamyshnyi
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
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Araújo JLFDE, Bonifácio VF, Batista LM, Ávila REDE, Aguiar RS, Bastos-Rodrigues L, Souza RPDE. IFITM3 rs12252 polymorphism association with COVID-19 severity and mortality in a Brazilian sample: an update and a meta-analysis. AN ACAD BRAS CIENC 2024; 96:e20231160. [PMID: 38808879 DOI: 10.1590/0001-3765202420231160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/04/2024] [Indexed: 05/30/2024] Open
Abstract
This study investigated the association between the IFITM3 rs12252 polymorphism and the severity and mortality of COVID-19 in hospitalized Brazilian patients. A total of 102 COVID-19 patients were included, and the outcomes of interest were defined as death and the need for mechanical ventilation. Genotypes were assessed using Taqman probes. No significant associations were found between the rs12252 polymorphism and COVID-19 outcomes in the original sample, both for death and the need for mechanical ventilation. A meta-analysis, incorporating previous studies that used death as a severity indicator, revealed no association in the allelic and C-recessive models. However, due to the rarity of the T allele and its absence in the sample, further replication studies in larger and more diverse populations are needed to clarify the role of rs12252 in COVID-19 prognosis.
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Affiliation(s)
- João L F DE Araújo
- Universidade Federal de Minas Gerais, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Laboratório de Biologia Integrativa, Grupo de Pesquisa em Bioestatística e Epidemiologia Molecular, Av. Presidente Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Victória F Bonifácio
- Universidade Federal de Minas Gerais, Departamento de Nutrição, Escola de Enfermagem, Av. Alfredo Balena, 190, Santa Efigência, 30130-100 Belo Horizonte, MG, Brazil
| | - Lorena M Batista
- Universidade Federal de Minas Gerais, Departamento de Nutrição, Escola de Enfermagem, Av. Alfredo Balena, 190, Santa Efigência, 30130-100 Belo Horizonte, MG, Brazil
| | - Renata Eliane DE Ávila
- Hospital Eduardo de Menezes, Rua Doutor Cristiano Resende, 2213, Bonsucesso, 30622-020 Belo Horizonte, MG, Brazil
| | - Renato S Aguiar
- Universidade Federal de Minas Gerais, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Laboratório de Biologia Integrativa, Grupo de Pesquisa em Bioestatística e Epidemiologia Molecular, Av. Presidente Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
- Instituto D'OR de Pesquisa e Ensino, Rua Diniz Cordeiro, 30, Botafogo, 22281-100 Rio de Janeiro, RJ, Brazil
| | - Luciana Bastos-Rodrigues
- Universidade Federal de Minas Gerais, Departamento de Nutrição, Escola de Enfermagem, Av. Alfredo Balena, 190, Santa Efigência, 30130-100 Belo Horizonte, MG, Brazil
| | - Renan P DE Souza
- Universidade Federal de Minas Gerais, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Laboratório de Biologia Integrativa, Grupo de Pesquisa em Bioestatística e Epidemiologia Molecular, Av. Presidente Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
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Kaelber K, Seifert LS, Nguyen ATH, McWhirter K. Anxiety on the internet: Describing person, provider, and organization online posts. THE JOURNAL OF GENERAL PSYCHOLOGY 2024:1-26. [PMID: 38801396 DOI: 10.1080/00221309.2024.2349765] [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: 07/17/2023] [Accepted: 02/27/2024] [Indexed: 05/29/2024]
Abstract
Anxiety is a pervasive phenomenon in contemporary society. With increased internet use in recent years, more people in the general population are seeking and providing help and participating in community online. The goal of our study was to evaluate the content of internet narratives among those who post about anxiety and determine what stakeholder groups are saying online. We used the bifurcated method; it is a multi-method (qualitative) approach with inductive, thematic analyses, and with quantification of content-related words via a computer program that crawls websites and counts the occurrences of specified terms (for cross-checking purposes). Themes of posts and webpages about anxiety were: using/reporting treatment strategies (83.3% saturation), providing help (77.8% saturation), telling personal stories (72.2% saturation), seeking help (61.1% saturation), and illustrating interpersonal impact (50% saturation). We argue that anxiety stakeholders may take part in health co-inquiry online (i.e., cooperating with others) in many of the same ways that they might collaborate in person. We recommend that clinicians query their clients about use of the internet in ways related to their anxiety (e.g., seeking information/treatment strategies, offering help to others, telling their personal stories, etc.) so that they might help them process what they experience online.
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Rinaldi L, Lugarà M, Simeon V, Perrotta F, Romano C, Iadevaia C, Sagnelli C, Monaco L, Altruda C, Fascione MC, Restivo L, Scognamiglio U, Laganà N, Nevola R, Oliva G, Coppola MG, Acierno C, Masini F, Pinotti E, Allegorico E, Tamburrini S, Vitiello G, Niosi M, Burzo ML, Franci G, Perrella A, Signoriello G, Frusci V, Mancarella S, Loche G, Pellicano GF, Berretta M, Calabria G, Pietropaolo L, Numis FG, Coppola N, Corcione A, Marfella R, Adinolfi LE, Bianco A, Sasso FC, de Sio I. Application and internal validation of lung ultrasound score in COVID-19 setting: The ECOVITA observational study. Pulmonology 2024:S2531-0437(24)00056-4. [PMID: 38806368 DOI: 10.1016/j.pulmoe.2024.04.012] [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: 06/06/2023] [Revised: 03/16/2024] [Accepted: 04/27/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The severe acute respiratory syndrome Coronarovirus-2 associated still causes a significant number of deaths and hospitalizations mainly by the development of respiratory failure. We aim to validate lung ultrasound score in order to predict mortality and the severity of the clinical course related to the need of respiratory support. METHODS In this prospective multicenter hospital-based cohort study, all adult patients with diagnosis of SARS-CoV-2 infection, performed by real-time reverse transcription polymerase chain reaction were included. Upon admission, all patients underwent blood gas analysis and lung ultrasound by expert operators. The acquisition of ultrasound scan was performed on 12 peculiar anatomic landmarks of the chest. Lung ultrasound findings were classified according to a scoring method, ranging 0 to 3: Score 0: normal A-lines. Score 1: multiple separated B-lines. Score 2: coalescent B-lines, alteration of pleural line. Score 3: consolidation area. RESULTS One thousand and seven patients were included in statistical analysis (male 62.4 %, mean age 66.3). Oxygen support was needed in 811 (80.5 %) patients. The median ultrasound score was 24 and the risk of having more invasive respiratory support increased in relation to higher values score computed. Lung ultrasound score showed negative strong correlation (rho: -0.71) with the P/F ratio and a significant association with in-hospital mortality (OR 1.11, 95 %CI 1.07-1.14; p < 0.001), even after adjustment with the following variables (age, sex, P/F ratio, SpO2, lactate, hypertension, chronic renal failure, diabetes, and obesity). CONCLUSIONS The novelty of this research corroborates and validates the 12-field lung ultrasound score as tool for predicting mortality and severity clinical course in COVID-19 patients. Baseline lung ultrasound score was associated with in-hospital mortality and requirement of intensive respiratory support and predict the risk of IOT among COVID-19 patients.
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Affiliation(s)
- L Rinaldi
- Department of Medicine and Health Sciences "V. Tiberio", Università degli Studi del Molise, Campobasso, Italy; Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy.
| | - M Lugarà
- Internal Medicine Unit, ASL Center Naples 1, P.O. Ospedale del Mare, Naples, Italy
| | - V Simeon
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - F Perrotta
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, "Monaldi" Hospital, Naples, Italy
| | - C Romano
- Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | - C Iadevaia
- Department of Pneumology and Oncology, Monaldi Hospital, Azienda dei Colli, Naples, Italy
| | - C Sagnelli
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - L Monaco
- Emergency Department, M.G. Vannini Hospital, "Istituto delle Figlie di San Camillo", Rome, Italy
| | - C Altruda
- Emergency Medicine Unit, S. M. delle Grazie Hospital, Pozzuoli, Italy
| | - M C Fascione
- Emergency Medicine Unit, Bassini Hospital, ASST North Milan, Italy
| | - L Restivo
- Department of Emergency Medicine, San Giovanni di Dio Hospital, Melfi, AOR Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - U Scognamiglio
- IX Division of Interventional Ultrasound Cotugno Hospital, Azienda dei Colli, Naples, Italy
| | - N Laganà
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - R Nevola
- Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | - G Oliva
- Internal Medicine Unit, ASL Center Naples 1, P.O. Ospedale del Mare, Naples, Italy
| | - M G Coppola
- Internal Medicine Unit, ASL Center Naples 1, P.O. Ospedale del Mare, Naples, Italy
| | - C Acierno
- Department of Emergency Medicine, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - F Masini
- Foundation "Policlinico Universitario Campus-Biomedico", Rome, Italy
| | - E Pinotti
- Internal Medicine Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | - E Allegorico
- Emergency Medicine Unit, S. M. delle Grazie Hospital, Pozzuoli, Italy
| | - S Tamburrini
- Department of Radiology, ASL Center Naples 1, P.O. Ospedale del Mare, Naples, Italy
| | - G Vitiello
- Internal Medicine Unit, ASL Center Naples 1, P.O. Ospedale del Mare, Naples, Italy
| | - M Niosi
- Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - M L Burzo
- IRCSS Ospedale Pediatrico Bambin Gesù, Rome, Italy; 5Emergency Department, M.G. Vannini Hospital, "Istituto delle Figlie di San Camillo", Rome, Italy
| | - G Franci
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - A Perrella
- Department of Highly Contagious Emerging Diseases, Azienda dei Colli, Cotugno Hospital, Naples, Italy
| | - G Signoriello
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - V Frusci
- Department of Emergency Medicine, San Giovanni di Dio Hospital, Melfi, AOR Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - S Mancarella
- Emergency Medicine Unit, Bassini Hospital, ASST North Milan, Italy
| | - G Loche
- Emergency Medicine Unit, Bassini Hospital, ASST North Milan, Italy
| | - G F Pellicano
- Unit of Infectious Disease, Department of Adult and Childhood Human pathology, "Gaetano Barresi", University of Messina, Italy
| | - M Berretta
- Unit of Infectious Disease, Department of Adult and Childhood Human pathology, "Gaetano Barresi", University of Messina, Italy
| | - G Calabria
- IX Division of Interventional Ultrasound Cotugno Hospital, Azienda dei Colli, Naples, Italy
| | - L Pietropaolo
- Emergency Department, M.G. Vannini Hospital, "Istituto delle Figlie di San Camillo", Rome, Italy
| | - F G Numis
- Emergency Medicine Unit, S. M. delle Grazie Hospital, Pozzuoli, Italy
| | - N Coppola
- Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - A Corcione
- Department of Critical Area, Monaldi Hospital, Azienda dei Colli, Naples, Italy
| | - R Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | - L E Adinolfi
- Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | - A Bianco
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, "Monaldi" Hospital, Naples, Italy
| | - F C Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | - I de Sio
- Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy
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Aboulela A, Taha M, Ghazal A, Baess A, Elsheredy A. Alternations in miR-155 and miR-200 serum levels can serve as biomarkers for COVID-19 in the post-mass vaccination era. Mol Biol Rep 2024; 51:689. [PMID: 38796651 DOI: 10.1007/s11033-024-09630-2] [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: 02/06/2024] [Accepted: 05/09/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Mass vaccination and natural immunity reduced the severity of COVID-19 cases. SARS-CoV-2 ongoing genome variations imply the use of confirmatory serologic biomarkers besides PCR for reliable diagnosis. MicroRNA molecules are intrinsic components of the innate immune system. The expression of miR155-5p and miR200c-3p was previously correlated with SARS-CoV-2 pathogenesis. This case-control study was conducted during the third peak of the COVID-19 pandemic in Egypt and aimed to calculate the accuracy of miR155-5p and miR200c-3p as biomarkers for COVID-19. METHODS AND RESULTS Thirty out of 400 COVID-19 patients at a main University hospital in Alexandria were included in the study along with 20 age-matched healthy controls. Plasma samples were collected for total and differential CBC. Relative quantitation of miR155-5p and miR200c-3p expression from WBCs was done by RT-qPCR. The expression of miR155-5p and miR200c-3p was positively correlated and was significantly downregulated in COVID-19 patients compared to the healthy control group (p ˂ 0.005). Both miR155-5p and miR200c-3p were of 76% and 74% accuracy as diagnostic biomarkers of COVID-19, respectively. Regarding the differentiation between mild and moderate cases, their accuracy was 80% and 70%, respectively. CONCLUSIONS miR155-5p and miR200c-3p expression can be used to confirm the diagnosis of COVID-19 and discriminate between mild and moderate cases, with a moderate degree of accuracy.
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Affiliation(s)
- Aliaa Aboulela
- Medical Research Institute, Microbiology Department, Alexandria University, Alexandria, Egypt
| | - Mona Taha
- Medical Research Institute, Microbiology Department, Alexandria University, Alexandria, Egypt
| | - Abeer Ghazal
- Medical Research Institute, Microbiology Department, Alexandria University, Alexandria, Egypt
| | - Ayman Baess
- Faculty of Medicine, Chest Diseases Department, Alexandria University, Alexandria, Egypt
| | - Amel Elsheredy
- Medical Research Institute, Microbiology Department, Alexandria University, Alexandria, Egypt.
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Álvarez-Macías A, Úbeda-Iglesias A, Macías-Seda J, Gómez-Salgado J. Factors related to mortality of patients with COVID-19 who are admitted to the ICU: Prognostic mortality factors of COVID-19 patients. Medicine (Baltimore) 2024; 103:e38266. [PMID: 38787973 PMCID: PMC11124599 DOI: 10.1097/md.0000000000038266] [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: 03/14/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
During the severe acute respiratory syndrome coronavirus 2 pandemic, hospital resources, particularly critical care units, were overburdened and this had a significant impact on both the therapies and the prognosis of these patients. This study aimed to identify factors and therapies that may improve prognosis and other factors associated with increased mortality. A secondary objective was to evaluate the impact that obesity had on these patients. An observational study was conducted on 482 patients aged 18 years or older who were diagnosed with SARS-CoV-2 pneumonia and admitted to the Intensive Care Units of 3 national hospitals registered in the CIBERESUCICOVID database between September 2020 and March 2021. After identifying the sample profile, risk factors were analyzed, the predictive model was constructed, and crude odd ratios were calculated for each factor. Additionally, logistic regression was used to build the multivariate model adjusting for potential confounders. The final model included only the variables selected using the Backward method. A sample of 335 men (69.5%) and 145 women (30.08%) aged 61.94 ± 12.75 years with a body mass index (BMI) of 28.05 (25.7; 31.2) was obtained. A total of 113 patients received noninvasive mechanical ventilation. The most common comorbidities were: high blood pressure (51.04%), obesity (28%), diabetes mellitus (23.44%), other metabolic diseases (21.16%), chronic heart failure (18.05%), chronic obstructive pulmonary disease (11.62%), and chronic kidney disease (10.16%). In-hospital, 3-month and 6-month post-discharge mortality in patients with BMI > 30 (n = 135) versus BMI ≤ 30 (n = 347) was significantly different (P = .06). Noninvasive mechanical ventilation failed in 42.4% of patients with BMI > 30 compared to 55% of patients with BMI ≤ 30. This study identified the factors associated with failure of mechanical ventilation. The most common comorbidities were congestive heart failure, high blood pressure, chronic kidney disease, severe liver disease, diabetes mellitus, and solid organ transplantation. In terms of ventilatory support, patients who received high-flow nasal oxygen therapy on admission had lower mortality rates. The use of renal replacement therapy was also significantly associated with higher mortality.
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Affiliation(s)
| | | | - Juana Macías-Seda
- Área de Gestión Sanitaria Campo de Gibraltar Oeste, Hospital Punta de Europa, Algeciras, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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Allo G, Sitarik AR, Redding A, Coleman CM, Cassidy-Bushrow AE, Gaba A, Straughen JK. Maternal COVID-19 exposure and placental characteristics. PLoS One 2024; 19:e0302682. [PMID: 38781150 PMCID: PMC11115219 DOI: 10.1371/journal.pone.0302682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 04/05/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION The impact of COVID-19 on the placenta is poorly described, particularly among minority women. MATERIALS AND METHODS This is a retrospective case-control study. Micro- and macroscopic placental pathologic findings were compared for 15 COVID-19 positive and 36 negative mothers. Cases and controls were frequency matched on gestational age, race, maternal comorbidities, and delivery type. Data from the electronic medical record were supplemented with independent review of microscopic slides. RESULTS Placentas from cases and controls were similar except the median distance from the site of the cord insertion to the nearest disk margin was statistically significantly shorter among placentas from COVID-19 positive cases (3.5 versus 6.0 cm, p = 0.006). Case status was not associated with an increased risk of placental pathologies. CONCLUSION There are few pathologic differences between placentas of COVID-19 positive and negative mothers. Additional studies are needed to investigate the role of timing of infection.
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Affiliation(s)
- Ghassan Allo
- Department of Pathology, Henry Ford Hospital, Detroit, MI, United States of America
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, United States of America
| | - Alexandra R. Sitarik
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, United States of America
| | - Ashley Redding
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, United States of America
| | - Chad M. Coleman
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, United States of America
| | | | - Arthur Gaba
- Department of Pathology, Henry Ford Hospital, Detroit, MI, United States of America
| | - Jennifer K. Straughen
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, United States of America
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, United States of America
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Zhong J, Guo L, Wang Y, Jiang X, Wang C, Xiao Y, Wang Y, Zhou F, Wu C, Chen L, Wang X, Wang J, Cao B, Li M, Ren L. Gut Microbiota Improves Prognostic Prediction in Critically Ill COVID-19 Patients Alongside Immunological and Hematological Indicators. RESEARCH (WASHINGTON, D.C.) 2024; 7:0389. [PMID: 38779486 PMCID: PMC11109594 DOI: 10.34133/research.0389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Abstract
The gut microbiota undergoes substantial changes in COVID-19 patients; yet, the utility of these alterations as prognostic biomarkers at the time of hospital admission, and its correlation with immunological and hematological parameters, remains unclear. The objective of this study is to investigate the gut microbiota's dynamic change in critically ill patients with COVID-19 and evaluate its predictive capability for clinical outcomes alongside immunological and hematological parameters. In this study, anal swabs were consecutively collected from 192 COVID-19 patients (583 samples) upon hospital admission for metagenome sequencing. Simultaneously, blood samples were obtained to measure the concentrations of 27 cytokines and chemokines, along with hematological and biochemical indicators. Our findings indicate a significant correlation between the composition and dynamics of gut microbiota with disease severity and mortality in COVID-19 patients. Recovered patients exhibited a higher abundance of Veillonella and denser interactions among gut commensal bacteria compared to deceased patients. Furthermore, the abundance of gut commensal bacteria exhibited a negative correlation with the concentration of proinflammatory cytokines and organ damage markers. The gut microbiota upon admission showed moderate prognostic prediction ability with an AUC of 0.78, which was less effective compared to predictions based on immunological and hematological parameters (AUC 0.80 and 0.88, respectively). Noteworthy, the integration of these three datasets yielded a higher predictive accuracy (AUC 0.93). Our findings suggest the gut microbiota as an informative biomarker for COVID-19 prognosis, augmenting existing immune and hematological indicators.
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Affiliation(s)
- Jiaxin Zhong
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Li Guo
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yeming Wang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital,
Capital Medical University, Beijing, China
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases,
Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xuan Jiang
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Chun Wang
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yan Xiao
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Zhou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital,
Capital Medical University, Beijing, China
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases,
Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chao Wu
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan Chen
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinming Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianwei Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital,
Capital Medical University, Beijing, China
- National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases,
Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Mingkun Li
- Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - LiLi Ren
- National Health Commission Key Laboratory of Systems Biology of Pathogens, State Key Laboratory of Respiratory Health and Multimorbidity and Christophe Mérieux Laboratory, National Institute of Pathogen Biology,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Respiratory Disease Pathogenomics,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Maldonado A, Endara P, Abril P, Carrión H, Largo C, Benavides P. ROX Index Variation as a Predictor of Outcomes in COVID-19 Patients. J Clin Med 2024; 13:3025. [PMID: 38892736 PMCID: PMC11172455 DOI: 10.3390/jcm13113025] [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: 03/19/2024] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 06/21/2024] Open
Abstract
Background: During the COVID-19 pandemic, emergency departments were overcrowded with critically ill patients, and many providers were confronted with ethical dilemmas in assigning respiratory support to them due to scarce resources. Quick tools for evaluating patients upon admission were necessary, as many existing scores proved inaccurate in predicting outcomes. The ROX Index (RI), a rapid and straightforward scoring system reflecting respiratory status in acute respiratory failure patients, has shown promise in predicting outcomes for COVID-19 patients. The 24 h difference in the RI accurately gauges mortality and the need for invasive mechanical ventilation (IMV) among patients with COVID-19. Methods: Study design: Prospective cohort study. A total of 204 patients were admitted to the emergency department from May to August 2020. Data were collected from the clinical records. The RI was calculated at admission and 24 h later, and the difference was used to predict the association with mortality and the need for IMV, a logistic regression model was used to adjust for age, sex, presence of comorbidities, and disease severity. Finally, the data were analyzed using ROC. Results: The difference in respiratory RI between admission and 24 h is a good predictor for death (AUC 0.92) and for mechanic ventilation (AUC: 0.75). Each one-unit decrease in the RI difference at 24 h was associated with an odds ratio of 1.48 for the risk of death (95%CI: 1.31-1.67) and an odds ratio of 1.16 for IMV (95% IC: 1.1-1.23). Conclusions: The 24 h variation of RI is a good prediction tool to allow healthcare professionals to identify the patients who will benefit from invasive treatment, especially in low-resource settings.
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Affiliation(s)
- Augusto Maldonado
- School of Medicine, Universidad San Francisco de Quito, Quito 170901, Ecuador; (P.E.); (H.C.)
- Hospital General Docente de Calderón, Quito 170201, Ecuador; (P.A.); (C.L.); (P.B.)
| | - Pablo Endara
- School of Medicine, Universidad San Francisco de Quito, Quito 170901, Ecuador; (P.E.); (H.C.)
| | - Patricio Abril
- Hospital General Docente de Calderón, Quito 170201, Ecuador; (P.A.); (C.L.); (P.B.)
| | - Henry Carrión
- School of Medicine, Universidad San Francisco de Quito, Quito 170901, Ecuador; (P.E.); (H.C.)
- Hospital General Docente de Calderón, Quito 170201, Ecuador; (P.A.); (C.L.); (P.B.)
| | - Carolina Largo
- Hospital General Docente de Calderón, Quito 170201, Ecuador; (P.A.); (C.L.); (P.B.)
| | - Patricia Benavides
- Hospital General Docente de Calderón, Quito 170201, Ecuador; (P.A.); (C.L.); (P.B.)
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Ding W, Wang MZ, Zeng XW, Liu ZH, Meng Y, Hu HT, Zhang Y, Guan YG, Meng FG, Zhang JG, Wang S. Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic: A multicenter cross-sectional study. World J Psychiatry 2024; 14:704-714. [PMID: 38808084 PMCID: PMC11129153 DOI: 10.5498/wjp.v14.i5.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/19/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Healthcare workers (HCWs) are at increased risk of contracting coronavirus disease 2019 (COVID-19) as well as worsening mental health problems and insomnia. These problems can persist for a long period, even after the pandemic. However, less is known about this topic. AIM To analyze mental health, insomnia problems, and their influencing factors in HCWs after the COVID-19 pandemic. METHODS This multicenter cross-sectional, hospital-based study was conducted from June 1, 2023 to June 30, 2023, which was a half-year after the end of the COVID-19 emergency. Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs. Symptoms such as anxiety, depression, and insomnia were evaluated by the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index. Factors influencing the symptoms were identified by multivariable logistic regression. RESULTS A total of 2000 participants were invited, for a response rate of 70.6%. A total of 1412 HCWs [618 (43.8%) doctors, 583 (41.3%) nurses and 211 (14.9%) nonfrontline], 254 (18.0%), 231 (16.4%), and 289 (20.5%) had symptoms of anxiety, depression, and insomnia, respectively; severe symptoms were found in 58 (4.1%), 49 (3.5%), and 111 (7.9%) of the participants. Nurses, female sex, and hospitalization for COVID-19 were risk factors for anxiety, depression, and insomnia symptoms; moreover, death from family or friends was a risk factor for insomnia symptoms. During the COVID-19 outbreak, most [1086 (76.9%)] of the participating HCWs received psychological interventions, while nearly all [994 (70.4%)] of them had received public psychological education. Only 102 (7.2%) of the HCWs received individual counseling from COVID-19. CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic, they still faced challenges and greater risks than did the general population. Identifying risk factors would help in providing targeted interventions. In addition, although a major proportion of HCWs have received public psychological education, individual interventions are still insufficient.
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Affiliation(s)
- Wei Ding
- Department of Public Health, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
| | - Min-Zhong Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Xian-Wei Zeng
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Zhen-Hua Liu
- Sleep Medicine Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Yao Meng
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
| | - Hui-Ting Hu
- Department of Neurology, Heze Mudan People’s Hospital, Heze 274000, Shandong Province, China
| | - Yuan Zhang
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Yu-Guang Guan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Fan-Gang Meng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Jian-Guo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Shu Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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50
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Sherak RAG, Sajjadi H, Khimani N, Tolchin B, Jubanyik K, Taylor RA, Schulz W, Mortazavi BJ, Haimovich AD. SOFA score performs worse than age for predicting mortality in patients with COVID-19. PLoS One 2024; 19:e0301013. [PMID: 38758942 PMCID: PMC11101117 DOI: 10.1371/journal.pone.0301013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/09/2024] [Indexed: 05/19/2024] Open
Abstract
The use of the Sequential Organ Failure Assessment (SOFA) score, originally developed to describe disease morbidity, is commonly used to predict in-hospital mortality. During the COVID-19 pandemic, many protocols for crisis standards of care used the SOFA score to select patients to be deprioritized due to a low likelihood of survival. A prior study found that age outperformed the SOFA score for mortality prediction in patients with COVID-19, but was limited to a small cohort of intensive care unit (ICU) patients and did not address whether their findings were unique to patients with COVID-19. Moreover, it is not known how well these measures perform across races. In this retrospective study, we compare the performance of age and SOFA score in predicting in-hospital mortality across two cohorts: a cohort of 2,648 consecutive adult patients diagnosed with COVID-19 who were admitted to a large academic health system in the northeastern United States over a 4-month period in 2020 and a cohort of 75,601 patients admitted to one of 335 ICUs in the eICU database between 2014 and 2015. We used age and the maximum SOFA score as predictor variables in separate univariate logistic regression models for in-hospital mortality and calculated area under the receiver operator characteristic curves (AU-ROCs) and area under precision-recall curves (AU-PRCs) for each predictor in both cohorts. Among the COVID-19 cohort, age (AU-ROC 0.795, 95% CI 0.762, 0.828) had a significantly better discrimination than SOFA score (AU-ROC 0.679, 95% CI 0.638, 0.721) for mortality prediction. Conversely, age (AU-ROC 0.628 95% CI 0.608, 0.628) underperformed compared to SOFA score (AU-ROC 0.735, 95% CI 0.726, 0.745) in non-COVID-19 ICU patients in the eICU database. There was no difference between Black and White COVID-19 patients in performance of either age or SOFA Score. Our findings bring into question the utility of SOFA score-based resource allocation in COVID-19 crisis standards of care.
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Affiliation(s)
- Raphael A. G. Sherak
- Yale Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Hoomaan Sajjadi
- Department of Computer Science and Engineering, Center for Remote Health Technologies and Systems, Texas A&M Univ, College Station, TX, United States of America
| | - Naveed Khimani
- Department of Computer Science and Engineering, Center for Remote Health Technologies and Systems, Texas A&M Univ, College Station, TX, United States of America
| | - Benjamin Tolchin
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States of America
- Yale New Haven Health Center for Clinical Ethics, New Haven, CT, United States of America
| | - Karen Jubanyik
- Yale Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - R. Andrew Taylor
- Yale Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Wade Schulz
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States of America
| | - Bobak J. Mortazavi
- Department of Computer Science and Engineering, Center for Remote Health Technologies and Systems, Texas A&M Univ, College Station, TX, United States of America
- Center for Outcomes Research and Evaluation, Yale University, New Haven, CT, United States of America
| | - Adrian D. Haimovich
- Yale Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
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