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Pizzamiglio C, Machado PM, Thomas RH, Gorman GS, McFarland R, Hanna MG, Pitceathly RDS. COVID-19-Related Outcomes in Primary Mitochondrial Diseases: An International Study. Neurology 2022; 98:576-582. [PMID: 35190464 PMCID: PMC8992603 DOI: 10.1212/wnl.0000000000200240] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/03/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To identify factors associated with severe coronavirus disease 2019 (COVID-19), defined by hospitalization status, in patients with primary mitochondrial diseases (PMDs), thereby enabling future risk stratification and informed management decisions. METHODS We undertook a cross-sectional, international, registry-based study. Data were extracted from the International Neuromuscular COVID-19 Database and collected between May 1, 2020, and May 31, 2021. The database included subjects with (1) PMD diagnosis (any age), clinically/histopathologically suspected and/or genetically confirmed; and (2) COVID-19 diagnosis classified as "confirmed", "probable", or "suspected" based on World Health Organization definitions. The primary outcome was hospitalization because of COVID-19. We collected demographic information, smoking status, coexisting comorbidities, outcomes after COVID-19 infection, and PMD genotype-phenotype. Baseline status was assessed using the modified Rankin scale (mRS) and the Newcastle Mitochondrial Disease Adult Scale (NMDAS). RESULTS Seventy-nine subjects with PMDs from 10 countries were included (mean age 41.5 ± 18 years): 25 (32%) were hospitalized, 48 (61%) recovered fully, 28 (35%) improved with sequelae, and 3 (4%) died. Statistically significant differences in hospitalization status were observed in baseline status, including the NMDAS score (p = 0.003) and mRS (p = 0.001), presence of respiratory dysfunction (p < 0.001), neurologic involvement (p = 0.003), and more than 4 comorbidities (p = 0.002). In multivariable analysis, respiratory dysfunction was independently associated with COVID-19 hospitalization (odds ratio, 7.66; 95% CI, 2-28; p = 0.002). DISCUSSION Respiratory dysfunction is an independent risk factor for severe COVID-19 in PMDs while high disease burden and coexisting comorbidities contribute toward COVID-19-related hospitalization. These findings will enable risk stratification and informed management decisions for this vulnerable population.
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Affiliation(s)
- Chiara Pizzamiglio
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Pedro M Machado
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Rhys H Thomas
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Gráinne S Gorman
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Robert McFarland
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Michael G Hanna
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Robert D S Pitceathly
- From the Department of Neuromuscular Diseases (C.P., P.M.M., M.G.H., R.D.S.P.), UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London; and Wellcome Centre for Mitochondrial Research (R.H.T., G.S.G., R.M.), Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Caponio VCA, Lipsi MR, Fortunato F, Arena F, Lo Muzio L. Symptomatic SARS-CoV-2 Infection with Ageusia after Two mRNA Vaccine Doses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:886. [PMID: 35055707 PMCID: PMC8775558 DOI: 10.3390/ijerph19020886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 02/04/2023]
Abstract
To raise awareness about preventive measures in COVID-19 pandemic, even though fully vaccinated. Although recent trials showed high efficacy of vaccines in preventing symptomatic infections, there are some individuals experiencing symptomatic SARS-CoV-2 infection. In this case report, a fully vaccinated young dental practitioner experienced symptomatic SARS-CoV-2 infection 55 days postvaccination with BNT162b2 Pfizer vaccine with evident ageusia. Diagnostic swabs were performed and used for viral genome sequencing. The patient fully recovered 15 days after diagnosis. Loss of smell and taste, together with nasal congestion were the main reported symptoms. The use of personal protective equipment prevented spread of infection in patients and co-workers. With the increase of people being fully vaccinated, it is still necessary to follow infection preventive protocols by correctly applying personal protective equipment. Although high efficacy has been proved, some individuals may still be vulnerable to symptomatic infection and new guidelines and markers should be adopted and investigated to find out patients for whom vaccination may not determine full immunization.
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Affiliation(s)
- Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (V.C.A.C.); (F.A.)
| | - Maria Rosaria Lipsi
- Microbiology and Virology Unit, Policlinico Riuniti Foggia Hospital, 71122 Foggia, Italy;
| | - Francesca Fortunato
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, 71122 Foggia, Italy;
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Fabio Arena
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (V.C.A.C.); (F.A.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (V.C.A.C.); (F.A.)
- Consorzio Interuniversitario Nazionale per la Bio-Oncologia, 66100 Chieti, Italy
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