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Felgner J, Clarke E, Hernandez-Davies JE, Jan S, Wirchnianski AS, Jain A, Nakajima R, Jasinskas A, Strahsburger E, Chandran K, Bradfute S, Davies DH. Broad antibody and T cell responses to Ebola, Sudan, and Bundibugyo ebolaviruses using mono- and multi-valent adjuvanted glycoprotein vaccines. Antiviral Res 2024; 225:105851. [PMID: 38458540 DOI: 10.1016/j.antiviral.2024.105851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/16/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
Currently, there are two approved vaccine regimens designed to prevent Ebola virus (EBOV) disease (EVD). Both are virus-vectored, and concerns about cold-chain storage and pre-existing immunity to the vectors warrant investigating additional vaccine strategies. Here, we have explored the utility of adjuvanted recombinant glycoproteins (GPs) from ebolaviruses Zaire (EBOV), Sudan (SUDV), and Bundibugyo (BDBV) for inducing antibody (Ab) and T cell cross-reactivity. Glycoproteins expressed in insect cells were administered to C57BL/6 mice as free protein or bound to the surface of liposomes, and formulated with toll-like receptor agonists CpG and MPLA (agonists for TLR 9 and 4, respectively), with or without the emulsions AddaVax or TiterMax. The magnitude of Ab cross-reactivity in binding and neutralization assays, and T cell cross-reactivity in antigen recall assays, correlated with phylogenetic relatedness. While most adjuvants screened induced IgG responses, a combination of CpG, MPLA and AddaVax emulsion ("IVAX-1") was the most potent and polarized in an IgG2c (Th1) direction. Breadth was also achieved by combining GPs into a trivalent (Tri-GP) cocktail with IVAX-1, which did not compromise antibody responses to individual components in binding and neutralizing assays. Th1 signature cytokines in T cell recall assays were undetectable after Tri-GP/IVAX-1 administration, despite a robust IgG2c response, although administration of Tri-GP on lipid nanoparticles in IVAX-1 elevated Th1 cytokines to detectable levels. Overall, the data indicate an adjuvanted trivalent recombinant GP approach may represent a path toward a broadly reactive, deployable vaccine against EVD.
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Affiliation(s)
- Jiin Felgner
- Vaccine Research & Development Center, University of California Irvine, USA
| | - Elizabeth Clarke
- Center for Global Health, Department of Internal Medicine, University of New Mexico, USA
| | | | - Sharon Jan
- Vaccine Research & Development Center, University of California Irvine, USA
| | - Ariel S Wirchnianski
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, USA
| | - Aarti Jain
- Vaccine Research & Development Center, University of California Irvine, USA
| | - Rie Nakajima
- Vaccine Research & Development Center, University of California Irvine, USA
| | | | - Erwin Strahsburger
- Vaccine Research & Development Center, University of California Irvine, USA
| | - Kartik Chandran
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, USA
| | - Steven Bradfute
- Center for Global Health, Department of Internal Medicine, University of New Mexico, USA
| | - D Huw Davies
- Vaccine Research & Development Center, University of California Irvine, USA.
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2
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Pati I, Cruciani M, Candura F, Massari MS, Piccinini V, Masiello F, Profili S, De Fulvio L, Pupella S, De Angelis V. Hyperimmune Globulins for the Management of Infectious Diseases. Viruses 2023; 15:1543. [PMID: 37515229 PMCID: PMC10385259 DOI: 10.3390/v15071543] [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: 06/14/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
This review is focused on the use of hyperimmune globulin therapy to treat some infectious diseases of viral or bacterial origin. Despite the introduction of antibiotics and vaccines, plasma immunoglobulin therapy from whole blood donation can still play a key role. These treatments provide passive transfer of high-titer antibodies that either reduces the risk or the severity of the infection and offer immediate but short-term protection against specific diseases. Antibody preparations derived from immunized human donors are commonly used for the prophylaxis and treatment of rabies, hepatitis A and B viruses, varicella-zoster virus, and pneumonia caused by respiratory syncytial virus, Clostridium tetani, Clostridium botulinum. The use of hyperimmune globulin therapy is a promising challenge, especially for the treatment of emerging viral infections for which there are no specific therapies or licensed vaccines.
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Affiliation(s)
- Ilaria Pati
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | - Mario Cruciani
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | - Fabio Candura
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | | | - Vanessa Piccinini
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | - Francesca Masiello
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | - Samantha Profili
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | - Lucia De Fulvio
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | - Simonetta Pupella
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
| | - Vincenzo De Angelis
- National Blood Centre, Italian National Institute of Health, 00161 Rome, Italy
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3
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Souan L, Sughayer MA, Abu Alhowr MM. Establishing the First COVID-19 Convalescent Plasma Biobank in Jordan. Biopreserv Biobank 2022; 20:423-428. [PMID: 35904406 DOI: 10.1089/bio.2022.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Antibodies with the specialized ability to fight infection can be found in the blood of individuals who have recovered from or have been vaccinated against COVID-19. As a result, plasma from these individuals could be used to treat critically ill patients. This treatment is known as convalescent plasma (CCP) therapy. Methods: Plasma units from 1555 consented healthy blood bank donors were collected from February to September 2021. Blood units were tested for the quantitative determination of Immunoglobulin G (IgG) antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus using one of the following assays based on the availability of the kits: The LIAISON® SARS-CoV-2 TrimericS IgG assay or the Abbott SARS-CoV-2 IgG II Quant assay. Results: Among the tested donors, 1027 participants tested positive for neutralizing anti-SARS-CoV-2 IgG antibodies (66.04%). There were 484 donors whose plasma qualified to be used for CCP therapy (47.13%) and 214 CCP units were stored in the COVID-19 convalescent biobank. Conclusion: We were able to identify and store 214 fresh frozen plasma units qualified for CCP-plasma therapy for COVID-19 patients according to World Health Organization standards. Hence, we established the first COVID-19-convalescent plasma data and plasma biobank for treating COVID-19-infected cancer patients in Jordan and the region.
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Affiliation(s)
- Lina Souan
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Maher A Sughayer
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Maha M Abu Alhowr
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
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Tharmalingam T, Han X, Wozniak A, Saward L. Polyclonal hyper immunoglobulin: A proven treatment and prophylaxis platform for passive immunization to address existing and emerging diseases. Hum Vaccin Immunother 2022; 18:1886560. [PMID: 34010089 PMCID: PMC9090292 DOI: 10.1080/21645515.2021.1886560] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
Passive immunization with polyclonal hyper immunoglobulin (HIG) therapy represents a proven strategy by transferring immunoglobulins to patients to confer immediate protection against a range of pathogens including infectious agents and toxins. Distinct from active immunization, the protection is passive and the immunoglobulins will clear from the system; therefore, administration of an effective dose must be maintained for prophylaxis or treatment until a natural adaptive immune response is mounted or the pathogen/agent is cleared. The current review provides an overview of this technology, key considerations to address different pathogens, and suggested improvements. The review will reflect on key learnings from development of HIGs in the response to public health threats due to Zika, influenza, and severe acute respiratory syndrome coronavirus 2.
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Affiliation(s)
- Tharmala Tharmalingam
- Therapeutics Business Unit, Emergent BioSolutions Incorporated, Winnipeg, MB, Canada
| | - Xiaobing Han
- Therapeutics Business Unit, Emergent BioSolutions Incorporated, Winnipeg, MB, Canada
- Department of Immunology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Ashley Wozniak
- Therapeutics Business Unit, Emergent BioSolutions Incorporated, Winnipeg, MB, Canada
| | - Laura Saward
- Therapeutics Business Unit, Emergent BioSolutions Incorporated, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Perplexing issues for convalescent immune plasma therapy in COVID-19. North Clin Istanb 2022; 8:634-643. [PMID: 35284793 PMCID: PMC8848483 DOI: 10.14744/nci.2021.73604] [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: 03/05/2021] [Accepted: 05/22/2021] [Indexed: 11/20/2022] Open
Abstract
Convalescent immune plasma (CIP) therapy in coronavirus disease 2019 (COVID-19) is presently a trendy choice of treatment. On March 24, 2020, the United States Food and Drug Administration approved of CIP treatment for seriously ill COVID-19 patients as an emergency investigational new drug. The precise mechanisms of action for CIP in COVID-19 have not yet been undoubtedly recognized. However, earlier research demonstrated that the main mechanism of CIP such as in other viral infections is viral neutralization. Systematic reviews and meta-analyses of the CIP transfusion in severe infectious diseases have shown that CIP has some beneficial effects and it is a harmless process to cure infectious diseases early after symptom beginning. It is suggested that SARS-CoV-2 neutralizing antibody titers in CIP should be ideally higher than 1:320, but lower thresholds could also be useful. The suggested minimum dose for one individual is one unit (200 mL) of CIP. The second unit can be given 48 h succeeding the end of the transfusion of the first unit of CIP. Moreover, CIP can be applied up to a maximum of three units (600 mL). CIP could be administered in other systemic diseases, viral infections coincidentally associated with SARS-CoV-2 infection, as well as other therapeutic approaches for COVID-19. There are generally no serious adverse events described from CIP transfusion in these recipients. CIP may have a significant role as one of the therapeutic modalities for various viral infections when enough vaccines or other specific therapeutic agents are not on hand.
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Conan PL, Ficko C, Chueca M, Rolland C, Javaudin O, Bigaillon C, Durand GA, Leparc-Goffart I, Verret C, Aletti M, Dutasta F, Savini H, Bosson JL, Martinaud C. COVID-19 Repeated Convalescent Plasma Collection: Analysis of 149 Donations from 88 French Military Health Workers. Transfus Med Hemother 2021; 395:1-6. [PMID: 34580580 PMCID: PMC8450834 DOI: 10.1159/000515843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/16/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Passive therapy with convalescent plasma (CP) could be an effective and safe treatment option in COVID-19 patients. Neutralizing antibodies present in CP generated in response to SARS-CoV-2 infection and directed against the receptor-binding domain of the spike protein are considered to play a major role in the viral clearance. CP infusion may also contribute to the modulation of the immune response through its immunomodulatory effect. We describe for the first time the effectiveness of a CP collection protocol from repeated donations in young patients. MATERIALS AND METHODS We enrolled health service workers who experienced mild to moderate COVID-19 and from whom several donations have been collected. No minimal severity threshold and no biological cure criteria were required. Donors could return to a second plasma donation 14 days after the first donation. A minimal neutralizing antibody titer of 1:40 was considered for clinical use. RESULTS Eighty-eight donors were included (median age 35 [28-48] years, 41 women), and 149 plasma products were collected. COVID-19 were mainly WHO stage 2 infections (96%). Among the 88 first donations, 76% had neutralizing antibody titers higher than or equal to 1:40. Eighty-eight percent of donors who came for a second donation had a neutralizing antibody titer of 1:40. Median durations were 15 (15-19) and 38 (33-46) days from the first to the second donation and from recovery to the second donation, respectively. Sixty-nine percent of donors who came for a third donation had a neutralizing antibody titer of 1:40. Median durations were 16 (13-37) and 54 (49-61) days from the second to the third donation and from recovery to the third donation, respectively. No significant difference was observed between the IgG ratio and the age of the donors or the time between recovery and donation. The average IgG ratio did not significantly vary between donations. When focused on repeated blood donors, no significant differences were observed either. CONCLUSION The recruitment of young patients with a mild to moderate CO-VID-19 course is an efficient possibility to collect CP with a satisfactory level of neutralizing antibodies. Repeated donations are a well-tolerated and effective way of CP collection.
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Affiliation(s)
- Pierre-Louis Conan
- Service de maladies infectieuses et tropicales − Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France
| | - Cécile Ficko
- Service de maladies infectieuses et tropicales − Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France
| | - Marine Chueca
- Centre de transfusion des Armées - Hôpital d'Instruction des Armées Percy, Clamart, France
| | - Carole Rolland
- Laboratoire TIMC-IMAG, UMR, CNRS 5525, Université Grenoble Alpes, Grenoble, France
| | - Olivier Javaudin
- Centre de transfusion des Armées - Hôpital d'Instruction des Armées Percy, Clamart, France
| | - Christine Bigaillon
- Service de Biologie - Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France
| | - Guillaume-André Durand
- French Armed Forces Biomedical Research Institute, National Reference Laboratory for Arboviruses, Marseille, France
| | - Isabelle Leparc-Goffart
- French Armed Forces Biomedical Research Institute, National Reference Laboratory for Arboviruses, Marseille, France
| | - Catherine Verret
- Direction de la Formation de la Recherche et de l'Innovation, Direction Centrale du Service de Santé des Armées, Paris, France
| | - Marc Aletti
- Service de médecine interne − Hôpital d'Instruction des Armées Percy, Clamart, France
| | - Fabien Dutasta
- Service de médecine interne et maladies infectieuses et tropicales − Hôpital d'Instruction des Armées Saint-Anne, Toulon, France
| | - Hélène Savini
- Service de maladies infectieuses et tropicales − Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Jean-Luc Bosson
- Laboratoire TIMC-IMAG, UMR, CNRS 5525, Université Grenoble Alpes, Grenoble, France
| | - Christophe Martinaud
- Centre de transfusion des Armées - Hôpital d'Instruction des Armées Percy, Clamart, France
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7
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Carlos WG, Gross JE, Cruz CD, Jamil S. Monoclonal Antibodies: Medical Uses for the Prevention and Treatment of Disease. Am J Respir Crit Care Med 2021; 203:P26-P27. [PMID: 33861166 DOI: 10.1164/rccm.2021c3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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8
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Anand U, Cabreros C, Mal J, Ballesteros F, Sillanpää M, Tripathi V, Bontempi E. Novel coronavirus disease 2019 (COVID-19) pandemic: From transmission to control with an interdisciplinary vision. ENVIRONMENTAL RESEARCH 2021; 197:111126. [PMID: 33831411 PMCID: PMC8020611 DOI: 10.1016/j.envres.2021.111126] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/09/2021] [Accepted: 04/01/2021] [Indexed: 05/06/2023]
Abstract
There a lot of review papers addressing specific COVID-19 research sectors, then devoted to specialists. This review provides an in-depth summary of the available information about SARS-CoV-2 and the corresponding disease (also known as COVID-19), with a multi-disciplinary approach. After the paper introduction, the first section treats the virological characteristics of SARS-CoV-2, the medical implications of the infection, and the human susceptivity. Great attention is devoted to the factor affecting the infection routes, distinguishing among the possible human-to-human, environmental-to-human, and pollution-to-human transmission mechanisms. The second section is devoted to reporting the impact of SARS-CoV-2 not only on the healthcare systems but also on the economy and society. The third section is devoted to non-pharmaceutical behaviours against COVID-19. In this context, this review section presents an analysis of the European second wave allowing not only to focalize the importance of some restrictions, but also the relevance of social acceptance of some measures. The data reassumed in this work are very useful for interdisciplinary researchers that work in a team to find the basic available information about all the aspects connected with this pandemic (from virus diffusion mechanism to health information, from economic and social impacts to measures to reduce the pandemic spread), with great attention to social acceptance of restriction measures and of vaccines (that currently results to be insufficient to achieve community immunity). Then, this review paper highlights the fundamental role of the trans-multi-disciplinary research that is devoted not only to understand the basics of the pandemic to propose solutions but has also the commitment to find strategies to increase population resilience. For this aim, the authors strongly suggest the establishment of an international health-care trans-multi-disciplinary workforce devoted to investigate, mitigate, and control also future viral events.
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Affiliation(s)
- Uttpal Anand
- Department of Life Sciences, National Institute for Biotechnology in the Negev, Ben-Gurion, University of the Negev, Beer-Sheva, 84105, Israel
| | - Carlo Cabreros
- Environmental Engineering Program, National Graduate School of Engineering, University of the Philippines, 1101, Diliman, Quezon City, Philippines
| | - Joyabrata Mal
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, 211004, Uttar Pradesh, India
| | - Florencio Ballesteros
- Environmental Engineering Program, National Graduate School of Engineering, University of the Philippines, 1101, Diliman, Quezon City, Philippines; Department of Chemical Engineering, College of Engineering, University of the Philippines, 1101, Diliman, Quezon City, Philippines
| | - Mika Sillanpää
- Institute of Research and Development, Duy Tan University, Da Nang, 550000, Viet Nam; Faculty of Environment and Chemical Engineering, Duy Tan University, Da Nang, 550000, Viet Nam; School of Chemical and Metallurgical Engineering, University of the Witwatersrand, 2050, Johannesburg, South Africa
| | - Vijay Tripathi
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, Uttar Pradesh, India.
| | - Elza Bontempi
- INSTM and Chemistry for Technologies, University of Brescia, Via Branze 38, 25123, Brescia, Italy.
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9
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Anand U, Cabreros C, Mal J, Ballesteros F, Sillanpää M, Tripathi V, Bontempi E. Novel coronavirus disease 2019 (COVID-19) pandemic: From transmission to control with an interdisciplinary vision. ENVIRONMENTAL RESEARCH 2021; 197:111126. [PMID: 33831411 DOI: 10.1016/j.envres.2021a.111126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/09/2021] [Accepted: 04/01/2021] [Indexed: 05/18/2023]
Abstract
There a lot of review papers addressing specific COVID-19 research sectors, then devoted to specialists. This review provides an in-depth summary of the available information about SARS-CoV-2 and the corresponding disease (also known as COVID-19), with a multi-disciplinary approach. After the paper introduction, the first section treats the virological characteristics of SARS-CoV-2, the medical implications of the infection, and the human susceptivity. Great attention is devoted to the factor affecting the infection routes, distinguishing among the possible human-to-human, environmental-to-human, and pollution-to-human transmission mechanisms. The second section is devoted to reporting the impact of SARS-CoV-2 not only on the healthcare systems but also on the economy and society. The third section is devoted to non-pharmaceutical behaviours against COVID-19. In this context, this review section presents an analysis of the European second wave allowing not only to focalize the importance of some restrictions, but also the relevance of social acceptance of some measures. The data reassumed in this work are very useful for interdisciplinary researchers that work in a team to find the basic available information about all the aspects connected with this pandemic (from virus diffusion mechanism to health information, from economic and social impacts to measures to reduce the pandemic spread), with great attention to social acceptance of restriction measures and of vaccines (that currently results to be insufficient to achieve community immunity). Then, this review paper highlights the fundamental role of the trans-multi-disciplinary research that is devoted not only to understand the basics of the pandemic to propose solutions but has also the commitment to find strategies to increase population resilience. For this aim, the authors strongly suggest the establishment of an international health-care trans-multi-disciplinary workforce devoted to investigate, mitigate, and control also future viral events.
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Affiliation(s)
- Uttpal Anand
- Department of Life Sciences, National Institute for Biotechnology in the Negev, Ben-Gurion, University of the Negev, Beer-Sheva, 84105, Israel
| | - Carlo Cabreros
- Environmental Engineering Program, National Graduate School of Engineering, University of the Philippines, 1101, Diliman, Quezon City, Philippines
| | - Joyabrata Mal
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, 211004, Uttar Pradesh, India
| | - Florencio Ballesteros
- Environmental Engineering Program, National Graduate School of Engineering, University of the Philippines, 1101, Diliman, Quezon City, Philippines; Department of Chemical Engineering, College of Engineering, University of the Philippines, 1101, Diliman, Quezon City, Philippines
| | - Mika Sillanpää
- Institute of Research and Development, Duy Tan University, Da Nang, 550000, Viet Nam; Faculty of Environment and Chemical Engineering, Duy Tan University, Da Nang, 550000, Viet Nam; School of Chemical and Metallurgical Engineering, University of the Witwatersrand, 2050, Johannesburg, South Africa
| | - Vijay Tripathi
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007, Uttar Pradesh, India.
| | - Elza Bontempi
- INSTM and Chemistry for Technologies, University of Brescia, Via Branze 38, 25123, Brescia, Italy.
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Ebola virus antibody decay-stimulation in a high proportion of survivors. Nature 2021; 590:468-472. [PMID: 33505020 PMCID: PMC7839293 DOI: 10.1038/s41586-020-03146-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/18/2020] [Indexed: 11/29/2022]
Abstract
Neutralizing antibody function provides a foundation for the efficacy of vaccines and therapies1–3. Here, using a robust in vitro Ebola virus (EBOV) pseudo-particle infection assay and a well-defined set of solid-phase assays, we describe a wide spectrum of antibody responses in a cohort of healthy survivors of the Sierra Leone EBOV outbreak of 2013–2016. Pseudo-particle virus-neutralizing antibodies correlated with total anti-EBOV reactivity and neutralizing antibodies against live EBOV. Variant EBOV glycoproteins (1995 and 2014 strains) were similarly neutralized. During longitudinal follow-up, antibody responses fluctuated in a ‘decay–stimulation–decay’ pattern that suggests de novo restimulation by EBOV antigens after recovery. A pharmacodynamic model of antibody reactivity identified a decay half-life of 77–100 days and a doubling time of 46–86 days in a high proportion of survivors. The highest antibody reactivity was observed around 200 days after an individual had recovered. The model suggests that EBOV antibody reactivity declines over 0.5–2 years after recovery. In a high proportion of healthy survivors, antibody responses undergo rapid restimulation. Vigilant follow-up of survivors and possible elective de novo antigenic stimulation by vaccine immunization should be considered in order to prevent EBOV viral recrudescence in recovering individuals and thereby to mitigate the potential risk of reseeding an outbreak. In many survivors of Ebola virus infection, antibody responses show long-term patterns of decline followed by restimulation, possibly owing to recrudescence of persisting virus.
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11
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Albahri OS, Al-Obaidi JR, Zaidan AA, Albahri AS, Zaidan BB, Salih MM, Qays A, Dawood KA, Mohammed RT, Abdulkareem KH, Aleesa AM, Alamoodi AH, Chyad MA, Zulkifli CZ. Helping doctors hasten COVID-19 treatment: Towards a rescue framework for the transfusion of best convalescent plasma to the most critical patients based on biological requirements via ml and novel MCDM methods. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105617. [PMID: 32593060 PMCID: PMC7305916 DOI: 10.1016/j.cmpb.2020.105617] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/16/2020] [Indexed: 05/04/2023]
Abstract
CONTEXT People who have recently recovered from the threat of deteriorating coronavirus disease-2019 (COVID-19) have antibodies to the coronavirus circulating in their blood. Thus, the transfusion of these antibodies to deteriorating patients could theoretically help boost their immune system. Biologically, two challenges need to be surmounted to allow convalescent plasma (CP) transfusion to rescue the most severe COVID-19 patients. First, convalescent subjects must meet donor selection plasma criteria and comply with national health requirements and known standard routine procedures. Second, multi-criteria decision-making (MCDM) problems should be considered in the selection of the most suitable CP and the prioritisation of patients with COVID-19. OBJECTIVE This paper presents a rescue framework for the transfusion of the best CP to the most critical patients with COVID-19 on the basis of biological requirements by using machine learning and novel MCDM methods. METHOD The proposed framework is illustrated on the basis of two distinct and consecutive phases (i.e. testing and development). In testing, ABO compatibility is assessed after classifying donors into the four blood types, namely, A, B, AB and O, to indicate the suitability and safety of plasma for administration in order to refine the CP tested list repository. The development phase includes patient and donor sides. In the patient side, prioritisation is performed using a contracted patient decision matrix constructed between 'serological/protein biomarkers and the ratio of the partial pressure of oxygen in arterial blood to fractional inspired oxygen criteria' and 'patient list based on novel MCDM method known as subjective and objective decision by opinion score method'. Then, the patients with the most urgent need are classified into the four blood types and matched with a tested CP list from the test phase in the donor side. Thereafter, the prioritisation of CP tested list is performed using the contracted CP decision matrix. RESULT An intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19 to help doctors hasten treatments. DISCUSSION The proposed framework implies the benefits of providing effective care and prevention of the extremely rapidly spreading COVID-19 from affecting patients and the medical sector.
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Affiliation(s)
- O S Albahri
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - Jameel R Al-Obaidi
- Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, Tanjong Malim, Perak 35900, Malaysia
| | - A A Zaidan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia.
| | - A S Albahri
- Informatics Institute for Postgraduate Studies (IIPS), Iraqi Commission for Computers and Informatics (ICCI), Baghdad, Iraq
| | - B B Zaidan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - Mahmood M Salih
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Tikrit 34001, Iraq
| | - Abdulhadi Qays
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - K A Dawood
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - R T Mohammed
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Karrar Hameed Abdulkareem
- Faculty of Computer Science and Information Technology, Universiti Tun Hussein Onn Malaysia, Parit Raja, Malaysia
| | - A M Aleesa
- Faculty of Electronic and Electrical Engineering, Universiti Tun Hussein Onn, Batu Pahat, Johor 86400, Malaysia
| | - A H Alamoodi
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - M A Chyad
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - Che Zalina Zulkifli
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
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12
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Kong Y, Cai C, Ling L, Zeng L, Wu M, Wu Y, Zhang W, Liu Z. Successful treatment of a centenarian with coronavirus disease 2019 (COVID-19) using convalescent plasma. Transfus Apher Sci 2020; 59:102820. [PMID: 32467007 PMCID: PMC7239781 DOI: 10.1016/j.transci.2020.102820] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Because treatment options for coronavirus disease 2019 (COVID-19) are very limited, the use of convalescent plasma has bee explored. CASE PRESENTATION AND TREATMENT A male centenarian with cough and dyspnea for 2 months was diagnosed with COVID-19. Without effective treatments and with the increased risks of antiviral therapy for the elderly, this patient was given convalescent plasma. The viral load, complete blood count, inflammatory indicators, vital signs, and clinical symptoms were observed before and after COVID-19 convalescent plasma transfusion. RESULTS After convalescent plasma transfusion, significant improvement was observed on laboratory indicators and clinical symptoms of the patient. Concurrently, SARS-CoV-2 viral load decreased sharply after the first transfusion (from 2.55 × 104 to 1.39 × 103 copies/mL) and became undetectable after the second transfusion. CONCLUSIONS With the substantial increase of COVID-19 in recent months,treatment for elderly patients has become restricted in some countries. The successful treatment of this 100-year-old patient using convalescent plasma suggests that we should consider adding convalescent plasma in th management of the elderly.
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Affiliation(s)
- Yujie Kong
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, 610052, Chengdu, Sichuan Province, PR China; Key laboratory of transfusion adverse reactions, CAMS, 610052, Chengdu, Sichuan Province, PR China
| | - Chen Cai
- Department of Special Clinic, First affiliated hospital, the Second Military Medical University, Shanghai, 200433, Shanghai, PR China; Guanggu District, the Maternal and Child Health Hospital of Hubei Province, 430070, Wuhan, Hubei Province, PR China
| | - Li Ling
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, 610052, Chengdu, Sichuan Province, PR China; Key laboratory of transfusion adverse reactions, CAMS, 610052, Chengdu, Sichuan Province, PR China
| | - Li Zeng
- Guanggu District, the Maternal and Child Health Hospital of Hubei Province, 430070, Wuhan, Hubei Province, PR China; Department of Organ Transplantation, First affiliated hospital, the Second Military Medical University, Shanghai, 200433, Shanghai, PR China
| | - Meihong Wu
- Guanggu District, the Maternal and Child Health Hospital of Hubei Province, 430070, Wuhan, Hubei Province, PR China; Department of oncology, First affiliated hospital, the Second Military Medical University, Shanghai, 200433, Shanghai, PR China
| | - Yanyun Wu
- University of Miami, Miami, Florida, United States
| | - Wei Zhang
- Guanggu District, the Maternal and Child Health Hospital of Hubei Province, 430070, Wuhan, Hubei Province, PR China; Department of Respiratory and Critical Care Medicine, First affiliated hospital, the Second Military Medical University, Shanghai, 200433, Shanghai, PR China.
| | - Zhong Liu
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, 610052, Chengdu, Sichuan Province, PR China; Key laboratory of transfusion adverse reactions, CAMS, 610052, Chengdu, Sichuan Province, PR China.
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13
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Novel Antiviral Strategies in the Treatment of COVID-19: A Review. Microorganisms 2020; 8:microorganisms8091259. [PMID: 32825283 PMCID: PMC7569957 DOI: 10.3390/microorganisms8091259] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS–CoV-2), is still a global public health problem for humans. It has caused more than 10,000,000 infections and more than 500,000 deaths in the world so far. Many scientists have tried their best to discover safe and effective drugs for the treatment of this disease; however, there are still no approved standard therapeutics or effective antiviral drugs on the market. Many new drugs are being developed, and several traditional drugs that were originally indicated or proposed for other diseases are likely to be effective in treating COVID-19, but their safety and efficacy are controversial, under study, or in clinical trial phases. Fortunately, some novel antiviral strategies, such as convalescent plasma, clustered regularly interspaced short palindromic repeats (CRISPR), and mesenchymal stem cell (MSC) therapy, potentially offer an additional or alternative option or compassionate use for the people suffering from COVID-19, especially for critically ill patients, although their safety and efficacy are also under study. In this review, we explore the applications, possible mechanisms, and efficacy in successful cases using convalescent plasma, CRISPR, and MSC therapy for COVID-19 treatment, respectively. Furthermore, the perspectives and limitations of these novel antiviral strategies are evaluated.
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14
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Santos IDA, Grosche VR, Bergamini FRG, Sabino-Silva R, Jardim ACG. Antivirals Against Coronaviruses: Candidate Drugs for SARS-CoV-2 Treatment? Front Microbiol 2020; 11:1818. [PMID: 32903349 PMCID: PMC7438404 DOI: 10.3389/fmicb.2020.01818] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/10/2020] [Indexed: 01/08/2023] Open
Abstract
Coronaviruses (CoVs) are a group of viruses from the family Coronaviridae that can infect humans and animals, causing mild to severe diseases. The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global threat, urging the development of new therapeutic strategies. Here we present a selection of relevant compounds that have been described from 2005 until now as having in vitro and/or in vivo antiviral activities against human and/or animal CoVs. We also present compounds that have reached clinical trials as well as further discussing the potentiality of other molecules for application in (re)emergent CoVs outbreaks. Finally, through rationalization of the data presented herein, we wish to encourage further research encompassing these compounds as potential SARS-CoV-2 drug candidates.
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Affiliation(s)
- Igor de Andrade Santos
- Laboratory of Virology, Institute of Biomedical Science, Federal University of Uberlândia, Uberlândia, Brazil
| | - Victória Riquena Grosche
- Laboratory of Virology, Institute of Biomedical Science, Federal University of Uberlândia, Uberlândia, Brazil
- Institute of Biosciences, Language and Exact Sciences, São Paulo State University, São José do Rio Preto, Brazil
| | | | - Robinson Sabino-Silva
- Department of Physiology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Ana Carolina Gomes Jardim
- Laboratory of Virology, Institute of Biomedical Science, Federal University of Uberlândia, Uberlândia, Brazil
- Institute of Biosciences, Language and Exact Sciences, São Paulo State University, São José do Rio Preto, Brazil
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15
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Li L, Yang R, Wang J, Lv Q, Ren M, Zhao L, Chen H, Xu H, Xie S, Xie J, Lin H, Li W, Fang P, Gong L, Wang L, Wu Y, Liu Z. Feasibility of a pilot program for COVID-19 convalescent plasma collection in Wuhan, China. Transfusion 2020; 60:1773-1777. [PMID: 32491199 PMCID: PMC7300543 DOI: 10.1111/trf.15921] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND A novel coronavirus has caused an international outbreak. Currently, there are no specific therapeutic agents for coronavirus infections. Convalescent plasma (CP) therapy is a potentially effective treatment option. METHODS Patients who had recovered from COVID‐19 and had been discharged from the hospital for more than 2 weeks were recruited. COVID‐19 convalescent plasma (CCP)‐specific donor screening and selection were performed based on the following criteria: 1) aged 18‐55 years; 2) eligible for blood donation; 3) diagnosed with COVID‐19; 4) had two consecutive negative COVID‐19 nasopharyngeal swab tests based on PCR (at least 24 hr apart) prior to hospital discharge; 5) had been discharged from the hospital for more than 2 weeks; and 6) had no COVID‐19 symptoms prior to convalescent plasma donation. In addition, preference was given to CCP donors who had a fever lasting more than 3 days or a body temperature exceeding 38.5°C (101.3°F), and who donated 4 weeks after the onset of symptoms. CCP collection was performed using routine plasma collection procedures via plasmapheresis. In addition to routine donor testing, the CCP donorsʼ plasma was also tested for SARS‐CoV‐2 nucleic acid and S‐RBD‐specific IgG antibody. RESULTS Of the 81 potential CCP donors, 64 (79%) plasma products were collected. There were 18 female donors and 46 male donors. There were 34 first‐time blood donors and 30 repeat donors. The average time between CCP collection and initial symptom onset was 49.1 days, and the average time between CCP collection and hospital discharge was 38.7 days. The average volume of CCP collected was 327.7 mL. All Alanine transaminase (ALT) testing results met blood donation requirements. HIV Ag/Ab, anti‐HCV, anti‐syphilis, and HBsAg were all negative; NAT for HIV, HBV, and HCV were also negative. In addition, all of the CCP donorsʼ plasma units were negative for SARS‐CoV‐2 RNA. Of the total 64 CCP donors tested, only one had an S‐RBD‐specific IgG titer of 1:160, all others had a titer of ≥1:320. CONCLUSION Based on a feasibility study of a pilot CCP program in Wuhan, China, we demonstrated the success and feasibility of CCP collection. In addition, all of the CCP units collected had a titer of ≥1:160 for S‐RBD‐specific IgG antibody, which met the CCP quality control requirements based on the Chinese national guidelines for CCP.
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Affiliation(s)
- Ling Li
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Ru Yang
- Wuhan Blood Center, Wuhan, Hubei, China
| | - Jue Wang
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Qilu Lv
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Ming Ren
- Wuhan Blood Center, Wuhan, Hubei, China
| | - Lei Zhao
- Wuhan Blood Center, Wuhan, Hubei, China
| | | | - Haixia Xu
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | | | - Jin Xie
- Wuhan Blood Center, Wuhan, Hubei, China
| | - Hui Lin
- Wuhan Blood Center, Wuhan, Hubei, China
| | - Wenjuan Li
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China.,Anhui Medical University, Hefei, China
| | - Peng Fang
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China.,Anhui Medical University, Hefei, China
| | - Li Gong
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China.,Anhui Medical University, Hefei, China
| | - Lan Wang
- Wuhan Blood Center, Wuhan, Hubei, China
| | - Yanyun Wu
- University of Miami, Miami, Florida, USA
| | - Zhong Liu
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
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16
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Li L, Tong X, Chen H, He R, Lv Q, Yang R, Zhao L, Wang J, Xu H, Liu C, Chen G, Chen S, Li C, Qiao J, Yang J, Wu Y, Liu Z. Characteristics and serological patterns of COVID-19 convalescent plasma donors: optimal donors and timing of donation. Transfusion 2020; 60:1765-1772. [PMID: 32627216 PMCID: PMC7361741 DOI: 10.1111/trf.15918] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The lack of effective treatments against the 2019 coronavirus disease (COVID‐19) has led to the exploratory use of convalescent plasma for treating COVID‐19. Case reports and case series have shown encouraging results. This study investigated SARS‐CoV‐2 antibodies and epidemiological characteristics in convalescent plasma donors, to identify criteria for donor selection. METHODS Recovered COVID‐19 patients, aged 18‐55 years, who had experienced no symptoms for more than 2 weeks, were recruited. Donor characteristics such as disease presentations were collected and SARS‐CoV‐2 N‐specific IgM, IgG, and S‐RBD‐specific IgG levels were measured by enzyme‐linked immunosorbent assay (ELISA). RESULTS Whereas levels of N‐specific IgM antibody declined after recovery, S‐RBD‐specific and N‐specific IgG antibodies increased after 4 weeks from the onset of symptoms, with no significant correlation to age, sex, or ABO blood type. Donors with the disease presentation of fever exceeding 38.5°C or lasting longer than 3 days exhibited higher levels of S‐RBD‐specific IgG antibodies at the time of donation. Of the 49 convalescent plasma donors, 90% had an S‐RBD‐specific IgG titer of ≥1:160 and 78% had a titer of ≥1:640 at the time of plasma donation. Of the 30 convalescent plasma donors, who had donated plasma later than 28 days after the onset of symptoms and had a disease presentation of fever lasting longer than 3 days or a body temperature exceeding 38.5°C, 100% had an S‐RBD‐specific IgG titer of ≥1:160 and 93% had a titer of ≥1:640. CONCLUSION This study indicates that the S‐RBD‐specific IgG antibody reaches higher levels after 4 weeks from the onset of COVID‐19 symptoms. We recommend the following selection criteria for optimal donation of COVID‐19 convalescent plasma: 28 days after the onset of symptoms and with a disease presentation of fever lasting longer than 3 days or a body temperature exceeding 38.5°C. Selection based on these criteria can ensure a high likelihood of achieving sufficiently high S‐RBD‐specific IgG titers.
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Affiliation(s)
- Ling Li
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Xunliang Tong
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Respiratory Quality Control Center, National Center of Gerontology, Beijing, China
| | | | - Rui He
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Qilu Lv
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Ru Yang
- Wuhan Blood Center, Wuhan, Hubei, China
| | - Lei Zhao
- Wuhan Blood Center, Wuhan, Hubei, China
| | - Jue Wang
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Haixia Xu
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | | | | | - Sitian Chen
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Chenyue Li
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Jiajia Qiao
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
| | - Juntao Yang
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yanyun Wu
- University of Miami, Miami, Florida, USA
| | - Zhong Liu
- Clinical Transfusion Research Center, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, Sichuan, China.,Key Laboratory of Transfusion Adverse Reactions, CAMS, Chengdu, Sichuan, China
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17
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Rajagopal K, Keller SP, Akkanti B, Bime C, Loyalka P, Cheema FH, Zwischenberger JB, El Banayosy A, Pappalardo F, Slaughter MS, Slepian MJ. Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO-A "Living Working Document". ASAIO J 2020; 66:588-598. [PMID: 32358232 PMCID: PMC7217129 DOI: 10.1097/mat.0000000000001180] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome (SARS)-CoV-2 is an emerging viral pathogen responsible for the global coronavirus disease 2019 (COVID)-19 pandemic resulting in significant human morbidity and mortality. Based on preliminary clinical reports, hypoxic respiratory failure complicated by acute respiratory distress syndrome is the leading cause of death. Further, septic shock, late-onset cardiac dysfunction, and multiorgan system failure are also described as contributors to overall mortality. Although extracorporeal membrane oxygenation and other modalities of mechanical cardiopulmonary support are increasingly being utilized in the treatment of respiratory and circulatory failure refractory to conventional management, their role and efficacy as support modalities in the present pandemic are unclear. We review the rapidly changing epidemiology, pathophysiology, emerging therapy, and clinical outcomes of COVID-19; and based on these data and previous experience with artificial cardiopulmonary support strategies, particularly in the setting of infectious diseases, provide consensus recommendations from ASAIO. Of note, this is a "living document," which will be updated periodically, as additional information and understanding emerges.
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Affiliation(s)
- Keshava Rajagopal
- From the Departments of Clinical and Biomedical Sciences, University of Houston College of Medicine, Houston, TX
- Houston Heart, HCA Houston Healthcare, Houston, TX
| | - Steven P. Keller
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Bindu Akkanti
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, McGovern Medical School, University of Texas-Houston, Houston, TX
| | - Christian Bime
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Arizona College of Medicine - Tucson and Banner Health, Tucson, AZ
| | | | - Faisal H. Cheema
- From the Departments of Clinical and Biomedical Sciences, University of Houston College of Medicine, Houston, TX
- Houston Heart, HCA Houston Healthcare, Houston, TX
- HCA Research Institute, Nashville, TN
| | - Joseph B. Zwischenberger
- Department of Surgery, University of Kentucky College of Medicine and Medical Center, Lexington, KY
| | - Aly El Banayosy
- Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK
| | | | - Mark S. Slaughter
- Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine and Jewish Hospital, Louisville, KY
| | - Marvin J. Slepian
- Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine and Jewish Hospital, Louisville, KY
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18
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Crosby JC, Heimann MA, Burleson SL, Anzalone BC, Swanson JF, Wallace DW, Greene CJ. COVID-19: A review of therapeutics under investigation. J Am Coll Emerg Physicians Open 2020; 1:231-237. [PMID: 32838367 PMCID: PMC7262361 DOI: 10.1002/emp2.12081] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 outbreak has disrupted global health care networks and caused thousands of deaths and an international economic downturn. Multiple drugs are being used on patients with COVID-19 based on theoretical and in vitro therapeutic targets. Several of these therapies have been studied, but many have limited evidence behind their use, and clinical trials to evaluate their efficacy are either ongoing or have not yet begun. This review summarizes the existing evidence for medications currently under investigation for treatment of COVID-19, including remdesivir, chloroquine/hydroxychlorquine, convalescent plasma, lopinavir/ritonavir, IL-6 inhibitors, corticosteroids, and angiotensin-converting enzyme inhibitors.
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Affiliation(s)
- James C. Crosby
- Department of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Matthew A. Heimann
- Department of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Samuel L. Burleson
- Department of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Brendan C. Anzalone
- Department of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Jonathan F. Swanson
- Department of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Douglas W. Wallace
- Department of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Christopher J. Greene
- Department of Emergency MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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19
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Cao H, Shi Y. Convalescent plasma: possible therapy for novel coronavirus disease 2019. Transfusion 2020; 60:1078-1083. [PMID: 32359090 PMCID: PMC7267548 DOI: 10.1111/trf.15797] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Huiling Cao
- Department of Neonatology, Ministry of Education Key Laboratory of Child, Development and Disorders; National Clinical Research Center for Child Health, and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical University, Chongqing Key Laboratory of PediatricsChongqingChina
| | - Yuan Shi
- Department of Neonatology, Ministry of Education Key Laboratory of Child, Development and Disorders; National Clinical Research Center for Child Health, and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical University, Chongqing Key Laboratory of PediatricsChongqingChina
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20
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Rajagopal K, Keller SP, Akkanti B, Bime C, Loyalka P, Cheema FH, Zwischenberger JB, El-Banayosy A, Pappalardo F, Slaughter MS, Slepian MJ. Advanced Pulmonary and Cardiac Support of COVID-19 Patients: Emerging Recommendations From ASAIO -a Living Working Document. Circ Heart Fail 2020; 13:e007175. [PMID: 32357074 PMCID: PMC7304497 DOI: 10.1161/circheartfailure.120.007175] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The severe acute respiratory syndrome-CoV-2 is an emerging viral pathogen responsible for the global coronavirus disease 2019 pandemic resulting in significant human morbidity and mortality. Based on preliminary clinical reports, hypoxic respiratory failure complicated by acute respiratory distress syndrome is the leading cause of death. Further, septic shock, late-onset cardiac dysfunction, and multiorgan system failure are also described as contributors to overall mortality. Although extracorporeal membrane oxygenation and other modalities of mechanical cardiopulmonary support are increasingly being utilized in the treatment of respiratory and circulatory failure refractory to conventional management, their role and efficacy as support modalities in the present pandemic are unclear. We review the rapidly changing epidemiology, pathophysiology, emerging therapy, and clinical outcomes of coronavirus disease 2019; and based on these data and previous experience with artificial cardiopulmonary support strategies, particularly in the setting of infectious diseases, provide consensus recommendations from American Society for Artificial Internal Organs. Of note, this is a living document, which will be updated periodically, as additional information and understanding emerges.
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Affiliation(s)
- Keshava Rajagopal
- University of Houston College of Medicine, Houston, TX
- Houston Heart, HCA Houston Healthcare, Houston, TX
| | - Steven P. Keller
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Bindu Akkanti
- University of Texas-Houston & Memorial Hermann-Texas Medical Center, Houston, TX
| | - Christian Bime
- University of Arizona College of Medicine and Banner Health, Tucson, AZ
| | | | - Faisal H. Cheema
- University of Houston College of Medicine, Houston, TX
- Houston Heart, HCA Houston Healthcare, Houston, TX
- HCA Research Institute, Nashville, TN
| | | | | | | | - Mark S. Slaughter
- University of Louisville School of Medicine and Jewish Hospital, Louisville, KY
| | - Marvin J. Slepian
- University of Arizona College of Medicine and Banner Health, Tucson, AZ
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21
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Zhang L, Pang R, Xue X, Bao J, Ye S, Dai Y, Zheng Y, Fu Q, Hu Z, Yi Y. Anti-SARS-CoV-2 virus antibody levels in convalescent plasma of six donors who have recovered from COVID-19. Aging (Albany NY) 2020; 12:6536-6542. [PMID: 32320384 PMCID: PMC7202482 DOI: 10.18632/aging.103102] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
Abstract
Background: Anti-SARS-CoV-2 virus antibody levels in convalescent plasma (CP), which may be useful in severe Anti-SARS-CoV-2 virus infections, have been rarely reported. Results: A total of eight donors were considered for enrollment; two of them were excluded because of ineligible routine check. Of the six remaining participants, five samples were tested weakly positive by the IgM ELISA. Meanwhile, high titers of IgG were observed in five samples. The patient treated with CP did not require mechanical ventilation 11 days after plasma transfusion, and was then transferred to a general ward. Conclusions: Our serological findings in convalescent plasma from recovered patients may help facilitate understanding of the SARS-CoV-2 infection and establish CP donor screening protocol in COVID-19 outbreak. Methods: Anti-SARS-CoV-2 antibodies including IgM and IgG were measured by two enzyme-linked immunosorbent assays (ELISA) in convalescent plasma from six donors who have recovered from coronavirus disease 2019 (COVID-19) in Nanjing, China. CP was also utilized for the treatment of one severe COVID-19 patient.
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Affiliation(s)
- Libo Zhang
- Department of Laboratory Medicine, Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, China
| | - Rongrong Pang
- Department of Laboratory Medicine, Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, China
| | - Xiang Xue
- Department of Biochemistry and Molecular Biology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Jingjing Bao
- Department of Laboratory Medicine, Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, China
| | - Sheng Ye
- Department of Apheresis, Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, China
| | - Yudong Dai
- Department of Blood Management, Administrative Office, Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, China
| | - Yishan Zheng
- Department of Critical Medicine, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu, China
| | - Qiang Fu
- Department of Blood Management, Administrative Office, Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, China
| | - Zhiliang Hu
- Nanjing Infectious Disease Center, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu, China.,School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China
| | - Yongxiang Yi
- Nanjing Infectious Disease Center, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, Jiangsu, China
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22
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Dhama K, Karthik K, Khandia R, Chakraborty S, Munjal A, Latheef SK, Kumar D, Ramakrishnan MA, Malik YS, Singh R, Malik SVS, Singh RK, Chaicumpa W. Advances in Designing and Developing Vaccines, Drugs, and Therapies to Counter Ebola Virus. Front Immunol 2018; 9:1803. [PMID: 30147687 PMCID: PMC6095993 DOI: 10.3389/fimmu.2018.01803] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/23/2018] [Indexed: 01/10/2023] Open
Abstract
Ebola virus (EBOV), a member of the family Filoviridae, is responsible for causing Ebola virus disease (EVD) (formerly named Ebola hemorrhagic fever). This is a severe, often fatal illness with mortality rates varying from 50 to 90% in humans. Although the virus and associated disease has been recognized since 1976, it was only when the recent outbreak of EBOV in 2014-2016 highlighted the danger and global impact of this virus, necessitating the need for coming up with the effective vaccines and drugs to counter its pandemic threat. Albeit no commercial vaccine is available so far against EBOV, a few vaccine candidates are under evaluation and clinical trials to assess their prophylactic efficacy. These include recombinant viral vector (recombinant vesicular stomatitis virus vector, chimpanzee adenovirus type 3-vector, and modified vaccinia Ankara virus), Ebola virus-like particles, virus-like replicon particles, DNA, and plant-based vaccines. Due to improvement in the field of genomics and proteomics, epitope-targeted vaccines have gained top priority. Correspondingly, several therapies have also been developed, including immunoglobulins against specific viral structures small cell-penetrating antibody fragments that target intracellular EBOV proteins. Small interfering RNAs and oligomer-mediated inhibition have also been verified for EVD treatment. Other treatment options include viral entry inhibitors, transfusion of convalescent blood/serum, neutralizing antibodies, and gene expression inhibitors. Repurposed drugs, which have proven safety profiles, can be adapted after high-throughput screening for efficacy and potency for EVD treatment. Herbal and other natural products are also being explored for EVD treatment. Further studies to better understand the pathogenesis and antigenic structures of the virus can help in developing an effective vaccine and identifying appropriate antiviral targets. This review presents the recent advances in designing and developing vaccines, drugs, and therapies to counter the EBOV threat.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Rekha Khandia
- Department of Biochemistry and Genetics, Barkatullah University, Bhopal, India
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, Agartala, India
| | - Ashok Munjal
- Department of Biochemistry and Genetics, Barkatullah University, Bhopal, India
| | - Shyma K. Latheef
- Immunology Section, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Deepak Kumar
- Division of Veterinary Biotechnology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | | | - Yashpal Singh Malik
- Division of Biological Standardization, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Rajendra Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Satya Veer Singh Malik
- Division of Veterinary Public Health, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Raj Kumar Singh
- ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Wanpen Chaicumpa
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine SIriraj Hospital, Mahidol University, Bangkok, Thailand
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23
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Filovirus – Auslöser von hämorrhagischem Fieber. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 61:894-907. [DOI: 10.1007/s00103-018-2757-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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