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Lamprinakou S, Gandy A. Stratified epidemic model using a latent marked Hawkes process. Math Biosci 2024; 375:109260. [PMID: 39032914 DOI: 10.1016/j.mbs.2024.109260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 06/26/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
We extend the unstructured homogeneously mixing epidemic model introduced by Lamprinakou et al. (2023) to a finite population stratified by age bands. We model the actual unobserved infections using a latent marked Hawkes process and the reported aggregated infections as random quantities driven by the underlying Hawkes process. We apply a Kernel Density Particle Filter (KDPF) to infer the marked counting process, the instantaneous reproduction number for each age group and forecast the epidemic's trajectory in the near future. Taking into account the individual inhomogeneity in age does not increase significantly the computational cost of the proposed inference algorithm compared to the cost of the proposed algorithm for the homogeneously unstructured epidemic model. We demonstrate that considering the individual heterogeneity in age, we can derive the instantaneous reproduction numbers per age group that provide a real-time measurement of interventions and behavioural changes of the associated groups. We illustrate the performance of the proposed inference algorithm on synthetic data sets and COVID-19-reported cases in various local authorities in the UK, and benchmark our model to the unstructured homogeneously mixing epidemic model. Our paper is a "demonstration" of a methodology that might be applied to factors other than age for stratification.
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Affiliation(s)
| | - Axel Gandy
- Department of Mathematics, Imperial College London, London, United Kingdom.
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2
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Hechter RC, Qian L, Liu ILA, Sy LS, Ryan DS, Xu S, Williams JTB, Klein NP, Kaiser RM, Liles EG, Glanz JM, Jackson LA, Sundaram ME, Weintraub ES, Tseng HF. COVID-19 Vaccination Coverage and Factors Associated With Vaccine Uptake Among People With HIV. JAMA Netw Open 2024; 7:e2415220. [PMID: 38842808 PMCID: PMC11157350 DOI: 10.1001/jamanetworkopen.2024.15220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/03/2024] [Indexed: 06/07/2024] Open
Abstract
Importance People with HIV (PWH) may be at increased risk for severe outcomes with COVID-19 illness compared with people without HIV. Little is known about COVID-19 vaccination coverage and factors associated with primary series completion among PWH. Objectives To evaluate COVID-19 vaccination coverage among PWH and examine sociodemographic, clinical, and community-level factors associated with completion of the primary series and an additional primary dose. Design, Setting, and Participants This retrospective cohort study used electronic health record data to assess COVID-19 vaccination information from December 14, 2020, through April 30, 2022, from 8 health care organizations of the Vaccine Safety Datalink project in the US. Participants were adults diagnosed with HIV on or before December 14, 2020, enrolled in a participating site. Main Outcomes and Measures The percentage of PWH with at least 1 dose of COVID-19 vaccine and PWH who completed the COVID-19 vaccine primary series by December 31, 2021, and an additional primary dose by April 30, 2022. Rate ratios (RR) and 95% CIs were estimated using Poisson regression models for factors associated with completing the COVID-19 vaccine primary series and receiving an additional primary dose. Results Among 22 058 adult PWH (mean [SD] age, 52.1 [13.3] years; 88.8% male), 90.5% completed the primary series by December 31, 2021. Among 18 374 eligible PWH who completed the primary series by August 12, 2021, 15 982 (87.0%) received an additional primary dose, and 4318 (23.5%) received a booster dose by April 30, 2022. Receipt of influenza vaccines in the last 2 years was associated with completion of the primary series (RR, 1.17; 95% CI, 1.15-1.20) and an additional primary dose (RR, 1.61; 95% CI, 1.54-1.69). PWH with uncontrolled viremia (HIV viral load ≥200 copies/mL) (eg, RR, 0.90 [95% CI, 0.85-0.95] for viral load 200-10 000 copies/mL vs undetected or <200 copies/mL for completing the primary series) and Medicaid insurance (eg, RR, 0.89 [95% CI, 0.87-0.90] for completing the primary series) were less likely to be fully vaccinated. By contrast, greater outpatient utilization (eg, RR, 1.07 [95% CI, 1.05-1.09] for ≥7 vs 0 visits for primary series completion) and residence in counties with higher COVID-19 vaccine coverage (eg, RR, 1.06 [95% CI, 1.03-1.08] for fourth vs first quartiles for primary series completion) were associated with primary series and additional dose completion (RRs ranging from 1.01 to 1.21). Conclusions and Relevance Findings from this cohort study suggest that, while COVID-19 vaccination coverage was high among PWH, outreach efforts should focus on those who did not complete vaccine series and those who have uncontrolled viremia.
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Affiliation(s)
- Rulin C. Hechter
- Kaiser Permanente Southern California, Pasadena, California
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Lei Qian
- Kaiser Permanente Southern California, Pasadena, California
| | - In-Lu Amy Liu
- Kaiser Permanente Southern California, Pasadena, California
| | - Lina S. Sy
- Kaiser Permanente Southern California, Pasadena, California
| | | | - Stanley Xu
- Kaiser Permanente Southern California, Pasadena, California
| | | | | | | | | | - Jason M. Glanz
- Institute for Health Research, Kaiser Permanente, Denver, Colorado
| | | | | | | | - Hung Fu Tseng
- Kaiser Permanente Southern California, Pasadena, California
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Kee YK, Park HC, Yoon SJ, Yu S, Ko E, Cho AJ, Kim DH, Kim J, Lee YK. Effectiveness of regdanvimab on mortality in COVID-19 infected patients on hemodialysis. Kidney Res Clin Pract 2024; 43:111-121. [PMID: 38268125 PMCID: PMC10846986 DOI: 10.23876/j.krcp.23.137] [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: 05/23/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (COVID-19), there are lack of effective and proven treatments for end-stage renal disease (ESRD). The present study aims to evaluate the effectiveness of regdanvimab on mortality in COVID-19-infected patients on hemodialysis (HD). METHODS We conducted an observational retrospective study in 230 COVID-19-infected patients on HD, of whom 77 (33.5%) were administered regdanvimab alone or in combination with dexamethasone or remdesivir during hospitalization (regdanvimab group) and 153 patients (66.5%) were not (no regdanvimab group). The primary outcome was in-hospital mortality. We compared mortality rates according to the use of regdanvimab and investigated the factors associated with mortality. RESULTS Fifty-nine deaths occurred during hospitalization, 49 in the no regdanvimab group (32.0%) and 10 in the regdanvimab group (13.0%), and the mortality rate was significantly higher in the no regdanvimab group than that in the regdanvimab group (p = 0.001). Multivariate Cox regression analysis showed that malignancy (p = 0.001), SPO2 of <95% at admission (p = 0.003), and administration of antibiotics and regdanvimab (p = 0.007 and p = 0.002, respectively) were significantly associated factors with mortality. CONCLUSION Regdanvimab administration is beneficial in improving prognosis in hospitalized COVID-19 patients on HD. Considering the vulnerability to infection and high mortality of ESRD patients, regdanvimab may be considered as a therapeutic option in COVID-19 patients on HD.
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Affiliation(s)
- Youn Kyung Kee
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Hayne Cho Park
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Su Jin Yoon
- Department of Internal Medicine, Good Samaritan Bagae Hospital, Pyeongtaek, Republic of Korea
| | - Sungbong Yu
- Department of General Surgery, Good Samaritan Bagae Hospital, Pyeongtaek, Republic of Korea
| | - Eunsil Ko
- National Emergency Medical Center, National Medical Center, Seoul, Republic of Korea
| | - AJin Cho
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Do Hyoung Kim
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jinseog Kim
- Department of Bigdata and Applied Statistics, Dongguk University, Gyeongju, Republic of Korea
| | - Young-Ki Lee
- Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
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Gize A, Belete Y, Kassa M, Tsegaye W, Hundie GB, Belete BM, Bekele M, Ababaw B, Tadesse Y, Fantahun B, Sirgu S, Ali S, Tizazu AM. Baseline and early changes in laboratory parameters predict disease severity and fatal outcomes in COVID-19 patients. Front Public Health 2023; 11:1252358. [PMID: 38152668 PMCID: PMC10751315 DOI: 10.3389/fpubh.2023.1252358] [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: 07/03/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has become the worst catastrophe of the twenty-first century and has led to the death of more than 6.9 million individuals across the globe. Despite the growing knowledge of the clinicopathological features of COVID-19, the correlation between baseline and early changes in the laboratory parameters and the clinical outcomes of patients is not entirely understood. Methods Here, we conducted a time series cross-sectional study aimed at assessing different measured parameters and socio-demographic factors that are associated with disease severity and the outcome of the disease in 268 PCR-confirmed COVID-19 Patients. Results We found COVID-19 patients who died had a median age of 61 years (IQR, 50 y - 70 y), which is significantly higher (p < 0.05) compared to those who survived and had a median age of 54 years (IQR, 42y - 65y). The median RBC count of COVID-19 survivors was 4.9 × 106/μL (IQR 4.3 × 106/μL - 5.2 × 106/μL) which is higher (p < 0.05) compared to those who died 4.4 × 106/μL (3.82 × 106/μL - 5.02 × 106/μL). Similarly, COVID-19 survivors had significantly (p < 0.05) higher lymphocyte and monocyte percentages compared to those who died. One important result we found was that COVID-19 patients who presented with severe/critical cases at the time of first admission but managed to survive had a lower percentage of neutrophil, neutrophil to lymphocyte ratio, higher lymphocyte and monocyte percentages, and RBC count compared to those who died. Conclusion To conclude here, we showed that simple laboratory parameters can be used to predict severity and outcome in COVID-19 patients. As these parameters are simple, inexpensive, and radially available in most resource-limited countries, they can be extrapolated to future viral epidemics or pandemics to allocate resources to particular patients.
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Affiliation(s)
- Addisu Gize
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- CIHLMU Center for International Health, LMU University Hospital, LMU Munich, Germany
| | - Yerega Belete
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Melkayehu Kassa
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wondewosen Tsegaye
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Gadissa Bedada Hundie
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Birhan Mesele Belete
- Department of Internal Medicine, School of Medicine, College of Health Science and Medicine, Wollo University, Dessie, Ethiopia
| | - Mahteme Bekele
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Berhan Ababaw
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yosef Tadesse
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bereket Fantahun
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sisay Sirgu
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Solomon Ali
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Anteneh Mehari Tizazu
- School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Limachi-Choque J, Guitian J, Leyns C, Guzman-Rivero M, Eid D. Risk factors for COVID-19 mortality in hospitalized patients in Bolivia. IJID REGIONS 2023; 9:95-101. [PMID: 38020182 PMCID: PMC10643226 DOI: 10.1016/j.ijregi.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023]
Abstract
Objectives This study aimed to ascertain which factors are associated with higher risk of mortality among hospitalized COVID-19 Bolivian patients. Methods This retrospective observational study assessed risk factors associated with mortality in patients (n = 549) hospitalized for SARS-CoV-2 infection in a Bolivian hospital between April 6, 2020, and August 18, 2022. Results The results provide evidence of association between male sex (odds ratio [OR] = 1.6, 95% confidence interval [CI] 1.06-2.6), older age, 51-61 years-old (OR = 5.2, 95% CI 2.2-12.6), 62-70 years-old (OR = 8.7, 95% CI 3.7-20.5), >70 years-old (OR = 16.9, 95% CI 7.1-39.9), and blood group A (OR = 1.9, 95% CI: 1.1-3.4) with higher mortality risk. The strong association between mortality and relatively young age, may be due to high frequency of undiagnosed comorbidities. Vaccination was associated with a reduction in mortality only when time period of hospitalization was not adjusted for. Conclusion Among hospitalized patients in Bolivia male sex, older age, and blood group A are associated with higher mortality risk. Mortality risk increased markedly from a relatively young age and decreased in parallel to the uptake of the vaccination program. However, the gradual reduction in mortality can also be due to improved patient management and changes in natural immunity and virulence of circulating strains as the pandemic progressed.
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Affiliation(s)
- Jhonny Limachi-Choque
- Centro Universitario de Medicina Tropical (CUMETROP), Faculty of Medicine, Universidad Mayor de San Simon, Cochabamba, Bolivia
- Unidad de Epidemiologia, Corporación del Seguro Social Militar (COSSMIL), Cochabamba, Bolivia
- Institute of Biomedical Research and Social Research, Faculty of Medicine, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Javier Guitian
- The Royal Veterinary College, University of London, London, United Kingdom
- Instituto de Investigaciones en Ciencias Sociales, Facultad de Ciencias Sociales, Universidad Mayor de San Simon, Cochabamba, Bolivia
| | - Christine Leyns
- Instituto de Investigaciones en Ciencias Sociales, Facultad de Ciencias Sociales, Universidad Mayor de San Simon, Cochabamba, Bolivia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Miguel Guzman-Rivero
- Centro Universitario de Medicina Tropical (CUMETROP), Faculty of Medicine, Universidad Mayor de San Simon, Cochabamba, Bolivia
- Institute of Biomedical Research and Social Research, Faculty of Medicine, Universidad Mayor de San Simón, Cochabamba, Bolivia
| | - Daniel Eid
- Centro Universitario de Medicina Tropical (CUMETROP), Faculty of Medicine, Universidad Mayor de San Simon, Cochabamba, Bolivia
- Institute of Biomedical Research and Social Research, Faculty of Medicine, Universidad Mayor de San Simón, Cochabamba, Bolivia
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Ughi N, Bernasconi DP, Del Gaudio F, Dicuonzo A, Maloberti A, Giannattasio C, Tarsia P, Travi G, Scaglione F, Colombo F, Bertuzzi M, Adinolfi A, Valsecchi MG, Rossetti C, Epis OM. Effectiveness and Safety of Remdesivir in Treating Hospitalised Patients with COVID-19: A Propensity Score Analysis of Real-Life Data from a Monocentric Observational Study in Times of Health Emergency. Clin Drug Investig 2023; 43:763-771. [PMID: 37740148 DOI: 10.1007/s40261-023-01304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Remdesivir is an antiviral agent, which was shown to be safe and effective in treating early COVID-19, but its favourable impact in hospitalised patients with non-critical disease is still under investigation. The present study aimed to assess the effectiveness and safety of remdesivir as a treatment for hospitalised patients with COVID-19 by a propensity score analysis of observational data. METHODS In this monocentric retrospective cohort study, the effectiveness and safety of a 5-day course of remdesivir (200 mg intravenously at Day 1, then 100 mg from Days 2-5) in association with the standard of care were assessed in comparison with the standard of care only. The primary endpoint was the proportion of recovery on Day 14. RESULTS Of 3662 eligible inpatients who tested positive for the severe acute respiratory syndrome coronavirus 2 genome by nasopharyngeal swab at admission, 861 (24%) non-critical patients were included in a propensity score analysis and 281 (33%) were exposed to remdesivir. In total, 242/281 (86.1%) and 435/580 (75.0%) patients recovered in exposed and non-exposed, respectively, with a relative improvement of 11.1% (95% CI + 5.8 to 16.5%; unadjusted odds ratio: 2.07, 95% CI 1.40-3.05, p = 0.0001; after adjustment by propensity score weighting, odds ratio: 1.92, 95% CI 1.30-2.83, p = 0.001). In treated patients, 1 (0.03%) anaphylactic reaction and 1 (0.03%) acute reaction during drug injection were reported, and 24 (8.5%) patients stopped the treatment due to adverse reactions. No significant differences were found with respect to the secondary efficacy endpoints (in-hospital all-cause death, need for intensive care treatments, clinical improvement score at Day 28) and safety endpoints (any and serious adverse reactions). CONCLUSION A 5-day course of remdesivir in association with the standard of care effectively promoted recovery from COVID-19 among non-critical in-hospital patients and had an acceptable safety profile.
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Affiliation(s)
- Nicola Ughi
- Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, p.zza Ospedale Maggiore 3, 20162, Milan, MI, Italy.
| | - Davide Paolo Bernasconi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Francesca Del Gaudio
- Functional Department for Higher Education, Research, and Development, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Armanda Dicuonzo
- Functional Department for Higher Education, Research, and Development, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alessandro Maloberti
- Division of Cardiology 4, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - Cristina Giannattasio
- Division of Cardiology 4, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - Paolo Tarsia
- Division of Pneumology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giovanna Travi
- Division of Infectious Disease, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Francesco Scaglione
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Division of Chemical-Clinical and Microbiological Analyses, Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Fabrizio Colombo
- Division of Internal Medicine 1, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Michaela Bertuzzi
- Division of Quality and Clinical Risk, Continuous Quality Improvement, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Antonella Adinolfi
- Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, p.zza Ospedale Maggiore 3, 20162, Milan, MI, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Claudio Rossetti
- Functional Department for Higher Education, Research, and Development, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Functional Department for Higher Education, Research, and Development, Interhospital Functional Department of Nuclear Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Oscar Massimiliano Epis
- Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, p.zza Ospedale Maggiore 3, 20162, Milan, MI, Italy
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Tang CYL, Chua WM. Ipsilateral Upper-Limb Lymphedema After COVID-19 Vaccine Booster: Reply. Clin Nucl Med 2023; 48:837. [PMID: 37276502 PMCID: PMC10417318 DOI: 10.1097/rlu.0000000000004741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Charlene Yu Lin Tang
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore
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Adjobimey T, Meyer J, Hennenfent A, Bara AJ, Lagnika L, Kocou B, Adjagba M, Laleye A, Hoerauf A, Parcina M. Negative association between ascaris lumbricoides seropositivity and Covid-19 severity: insights from a study in Benin. Front Immunol 2023; 14:1233082. [PMID: 37622109 PMCID: PMC10446766 DOI: 10.3389/fimmu.2023.1233082] [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: 06/01/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
Introduction The COVID-19 pandemic has had devastating effects worldwide, but the trajectory of the pandemic has been milder in Low-and-Middle-Income Countries (LMICs), including those in Africa. Co-infection with helminths, such as Ascaris lumbricoides, has been suggested as a possible factor contributing to the reduced severity observed in these regions. Methods The present study investigated the association between Ascaris-specific antibody levels and COVID-19 severity in 276 SARS-CoV-2-infected individuals in Benin. Participants were categorized into asymptomatic (n=100), mild (n=150), and severe (n=26) groups based on clinical disease severity. Sera were collected and analyzed using ELISA to measure Ascaris and SARS-CoV-2-specific antibodies, while Luminex was used to assess cytokines and SARS-CoV-2-specific neutralizing antibody expression. Results and discussion The results demonstrated that asymptomatic SARS-CoV-2 seropositive individuals expressed, on average, 1.7 and 2.2-times higher levels of Ascaris antibodies compared to individuals with mild and severe COVID-19, respectively. This finding suggests an inverse correlation between Ascaris antibody levels and COVID-19 severity. Notably, logistic regression analysis showed that Ascaris seropositivity was significantly associated with a reduced risk of severe COVID-19 (OR = 0.277, p = 0.021). Interestingly, COVID-19 patients with comorbidities such as type 2 diabetes and high blood pressure showed lower expression of Ascaris antibodies. Strikingly, no correlation was observed between Ascaris antibody levels and SARS-CoV-2-specific neutralizing antibodies. On the other hand, individuals seronegative for Ascaris displayed significantly higher levels of systemic pro-inflammatory markers compared to seropositive individuals. These findings suggest that higher expression of Ascaris antibodies is associated with asymptomatic SARS-CoV-2 infections and may contribute to the reduction of the risk to develop severe COVID-19. The beneficial effect of Ascaris seropositivity on COVID-19 outcomes in Benin may be attributed to a decrease in comorbidities and pro-inflammatory markers. These observations provide valuable insights into the milder COVID-19 trajectory observed in Africa and may have implications for future therapeutic strategies.
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Affiliation(s)
- Tomabu Adjobimey
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
- Laboratoire de Biologie intégrative pour l’Innovation thérapeutique (BioInov), Faculté des Sciences et Techniques (FAST), Université d’Abomey Calavi, Abomey Calavi, Benin
| | - Julia Meyer
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Anneka Hennenfent
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Anick J. Bara
- Laboratoire de Biologie intégrative pour l’Innovation thérapeutique (BioInov), Faculté des Sciences et Techniques (FAST), Université d’Abomey Calavi, Abomey Calavi, Benin
| | - Latifou Lagnika
- Laboratoire de Biologie intégrative pour l’Innovation thérapeutique (BioInov), Faculté des Sciences et Techniques (FAST), Université d’Abomey Calavi, Abomey Calavi, Benin
| | - Bienvenu Kocou
- Laboratoire de Biologie intégrative pour l’Innovation thérapeutique (BioInov), Faculté des Sciences et Techniques (FAST), Université d’Abomey Calavi, Abomey Calavi, Benin
| | - Marius Adjagba
- Laboratoire de Cytogénétique, Faculté des Sciences de la Santé (FSS), Université d’Abomey-Calavi, Cotonou, Benin
| | - Anatole Laleye
- Laboratoire de Cytogénétique, Faculté des Sciences de la Santé (FSS), Université d’Abomey-Calavi, Cotonou, Benin
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
- Bonn-Cologne Site, German Center for Infectious Disease Research (DZIF), Bonn, Germany
| | - Marijo Parcina
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
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Jin X, Yang H, Ma W, Yuan Y, Li T. Elevated High Sensitivity Cardiac Troponin T is Nonlinearly Associated with Poor Prognosis in Aging COVID-19 Patients: A Retrospective Study. Infect Drug Resist 2023; 16:5155-5163. [PMID: 37581166 PMCID: PMC10423578 DOI: 10.2147/idr.s422492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023] Open
Abstract
Objective To evaluate the relationship between high-sensitivity cardiac troponin T (hs-cTnT) and prognosis in elderly patients with coronavirus disease 2019 (COVID-19). Methods This study recruited 1399 COVID-19 patients aged 65 years or older admitted to Taizhou Hospital or Enze Hospital in Zhejiang Province from December 15, 2022, to January 4, 2023. The Cox regression model was used to evaluate the relationship between hs-cTnT level and in-hospital death. The logistic regression model was used to evaluate the relationship between hs-cTnT level and major adverse events. The restricted cubic spline (RCS) model is used for nonlinear analysis. Results The increase of peak hs-cTnT was associated with the increased risk of death (HR 9.49; 95% CI 1.19-75.48; trend p = 0.012) and major adverse events (OR 20.59; 95% CI 10.41-40.71; trend p < 0.001). RCS model showed the association between peak hs-cTnT and death and major adverse events were nonlinear (P for non-line < 0.001). Starting from the limit of quantification of hs-cTnT (3ng/L), the risk of death and major adverse events had a steep S-shaped increase until hs-cTnT reached the 90th percentile point (hs-cTnT = 131 ng/L), followed by a plateau period. Peak hs-cTnT has good predictive value for death and major adverse events, with AUC of 0.834 and 0.804, respectively. Conclusion Peak hs-cTnT has high predictive value for the risk of in-hospital death and major adverse events in elderly patients with COVID-19. The association between peak hs-cTnT and death and major adverse events were nonlinear.
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Affiliation(s)
- Xiaxia Jin
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Haideng Yang
- Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Weiwei Ma
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Yuan Yuan
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Tao Li
- Department of Cardiovascular Medicine, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
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Michels EHA, Appelman B, de Brabander J, van Amstel RBE, Chouchane O, van Linge CCA, Schuurman AR, Reijnders TDY, Sulzer TAL, Klarenbeek AM, Douma RA, Bos LDJ, Wiersinga WJ, Peters-Sengers H, van der Poll T, van Agtmael M, Algera AG, Appelman B, van Baarle F, Beudel M, Bogaard HJ, Bomers M, Bonta P, Bos L, Botta M, de Brabander J, de Bree G, de Bruin S, Bugiani M, Bulle E, Buis DTP, Chouchane O, Cloherty A, Dijkstra M, Dongelmans DA, Dujardin RWG, Elbers P, Fleuren L, Geerlings S, Geijtenbeek T, Girbes A, Goorhuis B, Grobusch MP, Hagens L, Hamann J, Harris V, Hemke R, Hermans SM, Heunks L, Hollmann M, Horn J, Hovius JW, de Jong HK, de Jong MD, Koning R, Lemkes B, Lim EHT, van Mourik N, Nellen J, Nossent EJ, Olie S, Paulus F, Peters E, Pina-Fuentes DAI, van der Poll T, Preckel B, Prins JM, Raasveld J, Reijnders T, de Rotte MCFJ, Schinkel M, Schultz MJ, Schrauwen FAP, Schuurman A, Schuurmans J, Sigaloff K, Slim MA, Smeele P, Smit M, Stijnis CS, Stilma W, Teunissen C, Thoral P, Tsonas AM, Tuinman PR, van der Valk M, Veelo DP, Volleman C, de Vries H, Vught LA, van Vugt M, Wouters D, Zwinderman AHK, Brouwer MC, Wiersinga WJ, Vlaar APJ, van de Beek D. Age-related changes in plasma biomarkers and their association with mortality in COVID-19. Eur Respir J 2023; 62:2300011. [PMID: 37080568 PMCID: PMC10151455 DOI: 10.1183/13993003.00011-2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19)-induced mortality occurs predominantly in older patients. Several immunomodulating therapies seem less beneficial in these patients. The biological substrate behind these observations is unknown. The aim of this study was to obtain insight into the association between ageing, the host response and mortality in patients with COVID-19. METHODS We determined 43 biomarkers reflective of alterations in four pathophysiological domains: endothelial cell and coagulation activation, inflammation and organ damage, and cytokine and chemokine release. We used mediation analysis to associate ageing-driven alterations in the host response with 30-day mortality. Biomarkers associated with both ageing and mortality were validated in an intensive care unit and external cohort. RESULTS 464 general ward patients with COVID-19 were stratified according to age decades. Increasing age was an independent risk factor for 30-day mortality. Ageing was associated with alterations in each of the host response domains, characterised by greater activation of the endothelium and coagulation system and stronger elevation of inflammation and organ damage markers, which was independent of an increase in age-related comorbidities. Soluble tumour necrosis factor receptor 1, soluble triggering receptor expressed on myeloid cells 1 and soluble thrombomodulin showed the strongest correlation with ageing and explained part of the ageing-driven increase in 30-day mortality (proportion mediated: 13.0%, 12.9% and 12.6%, respectively). CONCLUSIONS Ageing is associated with a strong and broad modification of the host response to COVID-19, and specific immune changes likely contribute to increased mortality in older patients. These results may provide insight into potential age-specific immunomodulatory targets in COVID-19.
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Affiliation(s)
- Erik H A Michels
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Brent Appelman
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Justin de Brabander
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Rombout B E van Amstel
- Amsterdam UMC, location University of Amsterdam, Department of Intensive Care Medicine, Amsterdam, The Netherlands
| | - Osoul Chouchane
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Christine C A van Linge
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Alex R Schuurman
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Tom D Y Reijnders
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Titia A L Sulzer
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Augustijn M Klarenbeek
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
| | - Renée A Douma
- Flevo Hospital, Department of Internal Medicine, Almere, The Netherlands
| | - Lieuwe D J Bos
- Amsterdam UMC, location University of Amsterdam, Department of Intensive Care Medicine, Amsterdam, The Netherlands
| | - W Joost Wiersinga
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
- Amsterdam UMC, location University of Amsterdam, Division of Infectious Diseases, Amsterdam, The Netherlands
| | - Hessel Peters-Sengers
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Tom van der Poll
- Amsterdam UMC, location University of Amsterdam, Center for Experimental and Molecular Medicine (CEMM), Amsterdam, The Netherlands
- Amsterdam UMC, location University of Amsterdam, Division of Infectious Diseases, Amsterdam, The Netherlands
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11
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Gul S, Ali A, Sheikh NA, Gul I, Sheikh TS, Prajjwal P. Comparative assessment of SARS CoV2-associated mortalities in 3 COVID waves and related risk factors: The South Kashmir's experience. J Family Med Prim Care 2023; 12:1430-1434. [PMID: 37649761 PMCID: PMC10465047 DOI: 10.4103/jfmpc.jfmpc_2318_22] [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: 11/27/2022] [Revised: 04/24/2023] [Accepted: 05/25/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) pandemic have spurted in three major waves in India at different times and had different levels of severity in different waves. The objective of our study was to determine the comparative mortality rate in three COVID-19 waves and determine the factors associated with mortality. Methods We identified a cohort of 1,132 COVID-19 patients who were admitted between April 14, 2020 and February 08, 2022 at our center. All the admitted patients with positive COVID-polymerase chain reaction were included in the study. Sample characteristics were determined by screening age, sex, socio-economic status, occupation, symptomatology of COVID, patient status on admission, baseline investigations, comorbidities, medical history, oxygen dosage needed during admission, the span of hospital stay, diagnosis, and vitals such as blood pressure, pulse, and oxygen saturation. All the data were procured from an institutional database. Results In total, 1,132 patients included in the study, the mean age was 65.08 ± 12.29 and 56% were males. The affliction rate was 42.13% in >60 years, 29.5% in 46-60 years, 20.8% in 31-45 years, and 7.4% in 30 years' group. In the first, second, and third waves of COVID-19, the mortality rates were 13.21%, 23.53%, and 11.39%, respectively. Among the comorbidities, mortality rates were proportionately higher in those with hypertension (6.7%), and diabetes (5.5%), than those with chronic obstructive pulmonary disease (3.3%), chronic kidney disease (CKD) (1.5%), heart disease (1.6%), and malignancy (0.2%). Conclusion We identify the peaked mortalities in the second encounter which was predicted by age, comorbidities such as hypertension, and diabetes.
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Affiliation(s)
- Shujat Gul
- Department of Internal Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Asifa Ali
- Department of Gynaecology and Obstetrics, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Nawaz Ahmad Sheikh
- Department of Internal Medicine, Government Medical College, Anantnag, Jammu and Kashmir, India
| | - Irfan Gul
- Department of Internal Medicine, Government Medical College, Anantnag, Jammu and Kashmir, India
| | - Tariq Sultan Sheikh
- Department of Respiratory Medicine, Government Medical College, Anantnag, Jammu and Kashmir, India
| | - Priyadarshi Prajjwal
- Department of Internal Medicine, Bharati Vidyapeeth University Medical College, Pune, Maharashtra, India
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12
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Valero-Bover D, Monterde D, Carot-Sans G, Cainzos-Achirica M, Comin-Colet J, Vela E, Clèries M, Folguera J, Abilleira S, Arrufat M, Lejardi Y, Solans Ò, Dedeu T, Coca M, Pérez-Sust P, Pontes C, Piera-Jiménez J. Is Age the Most Important Risk Factor in COVID-19 Patients? The Relevance of Comorbidity Burden: A Retrospective Analysis of 10,551 Hospitalizations. Clin Epidemiol 2023; 15:811-825. [PMID: 37408865 PMCID: PMC10319286 DOI: 10.2147/clep.s408510] [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: 02/14/2023] [Accepted: 05/26/2023] [Indexed: 07/07/2023] Open
Abstract
Purpose To assess the contribution of age and comorbidity to the risk of critical illness in hospitalized COVID-19 patients using increasingly exhaustive tools for measuring comorbidity burden. Patients and Methods We assessed the effect of age and comorbidity burden in a retrospective, multicenter cohort of patients hospitalized due to COVID-19 in Catalonia (North-East Spain) between March 1, 2020, and January 31, 2022. Vaccinated individuals and those admitted within the first of the six COVID-19 epidemic waves were excluded from the primary analysis but were included in secondary analyses. The primary outcome was critical illness, defined as the need for invasive mechanical ventilation, transfer to the intensive care unit (ICU), or in-hospital death. Explanatory variables included age, sex, and four summary measures of comorbidity burden on admission extracted from three indices: the Charlson index (17 diagnostic group codes), the Elixhauser index and count (31 diagnostic group codes), and the Queralt DxS index (3145 diagnostic group codes). All models were adjusted by wave and center. The proportion of the effect of age attributable to comorbidity burden was assessed using a causal mediation analysis. Results The primary analysis included 10,551 hospitalizations due to COVID-19; of them, 3632 (34.4%) experienced critical illness. The frequency of critical illness increased with age and comorbidity burden on admission, irrespective of the measure used. In multivariate analyses, the effect size of age decreased with the number of diagnoses considered to estimate comorbidity burden. When adjusting for the Queralt DxS index, age showed a minimal contribution to critical illness; according to the causal mediation analysis, comorbidity burden on admission explained the 98.2% (95% CI 84.1-117.1%) of the observed effect of age on critical illness. Conclusion Comorbidity burden (when measured exhaustively) explains better than chronological age the increased risk of critical illness observed in patients hospitalized with COVID-19.
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Affiliation(s)
- Damià Valero-Bover
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - David Monterde
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Catalan Institute of Health, Barcelona, Spain
| | - Gerard Carot-Sans
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Miguel Cainzos-Achirica
- Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Josep Comin-Colet
- Cardiology Department, Bellvitge University Hospital (IDIBELL), Barcelona, Spain
- Department of Medicine, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain
- CIBER Cardiovascular (CIBERCV), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Emili Vela
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Montse Clèries
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Júlia Folguera
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | - Sònia Abilleira
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | | | - Òscar Solans
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Health Department, eHealth Unit, Barcelona, Spain
| | - Toni Dedeu
- WHO European Centre for Primary Health Care, Almaty, Kazakhstan
| | - Marc Coca
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
| | | | - Caridad Pontes
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Department of Pharmacology, Autonomous University of Barcelona, Barcelona, Spain
| | - Jordi Piera-Jiménez
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3) – Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), Barcelona, Spain
- Faculty of Informatics, Telecommunications and Multimedia, Universitat Oberta de Catalunya, Barcelona, Spain
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Alvarez-Moreno C, Valderrama-Beltran SL, Silva R, De La Hoz Siegler IH, Varón Vega FA, Martínez-Vernaza S, Blanco TO, Padilla M, Mesa-Rubio ML, Castañeda Pascagaza LC, Rojas JA, Bravo Ojeda JS, Villa J, Chacón Sarmiento JA, Yomayusa N, Patiño S, Gómez-Nieto K, Martínez Pinzón VL, Ramírez Cogollo AM, Toloza C, Diaz-Puentes M, Cañas-Arboleda A, Manrique-Andrade M, Ayub RT, López Mora MJ, Pachón Espinosa MJ, Cortés JA, Sánchez LC, Chacón Acevedo KR, Rengifo P, Tambini G, Bertagnolio S, Diaz J, Thwin SS, Reveiz L. Associated factors for mortality in a COVID-19 colombian cohort: is the third wave relevant when Mu variant was predominant epidemiologically? Travel Med Infect Dis 2023; 53:102579. [PMID: 37169233 PMCID: PMC10167780 DOI: 10.1016/j.tmaid.2023.102579] [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: 12/29/2022] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES To evaluate the association between Colombia's third wave when the Mu variant was predominant epidemiologically (until 75%) in Colombia and COVID-19 all-cause in-hospital mortality. METHODS In this retrospective cohort, we included hospitalized patients ≥18 years with SARS-CoV-2 infection between March 2020 to September 2021 in ten hospitals from three cities in Colombia. Description analysis, survival, and multivariate Cox regression analyses were performed to evaluate the association between the third epidemic wave and in-hospital mortality. RESULTS A total of 25,371 patients were included. The age-stratified time-to-mortality curves showed differences according to epidemic waves in patients ≥75 years (log-rank test p = 0.012). In the multivariate Cox analysis, the third wave was not associated with increased mortality relative to the first wave (aHR 0.95; 95%CI 0.84-1.08), but there was an interaction between age ≥75 years and the third wave finding a lower HR for mortality (aHR 0.56, 95%CI 0.36-0.86). CONCLUSIONS We did not find an increase in in-hospital mortality during the third epidemic wave in which the Mu variant was predominant in Colombia. The reduced hazard in mortality in patients ≥75 years hospitalized in the third wave could be explained by the high coverage of SARS-CoV-2 vaccination in this population and patients with underlying conditions.
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Affiliation(s)
- Carlos Alvarez-Moreno
- National Clinical Coordinator COVID-19- WHO Studies, Colombia. Clinica Colsanitas and Facultad de Medicina, Universidad Nacional de Colombia, Colombia.
| | - Sandra Liliana Valderrama-Beltran
- Hospital Universitario San Ignacio. Pontificia Universidad Javeriana. Internal Medicine Department, Colombia; Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics. Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | | | - Samuel Martínez-Vernaza
- Hospital Universitario San Ignacio. Pontificia Universidad Javeriana. Internal Medicine Department, Colombia
| | - Tatiana Ordoñez Blanco
- Hospital Universitario San Ignacio. Pontificia Universidad Javeriana. Internal Medicine Department, Colombia
| | - Mónica Padilla
- World Health Organization, PanAmerican Health Organization, Bogotá, Colombia
| | | | | | - José Antonio Rojas
- Clínica Universitaria Colombia. Fundación Universitaria Sanitas. Bogotá, Colombia
| | | | | | | | | | | | | | | | | | - Carlos Toloza
- Clínica Universitaria Colombia. Fundación Universitaria Sanitas. Bogotá, Colombia
| | - Melissa Diaz-Puentes
- Hospital Universitario San Ignacio, Research Office. Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Alejandra Cañas-Arboleda
- Hospital Universitario San Ignacio. Pontificia Universidad Javeriana. Internal Medicine Department, Colombia
| | | | | | | | | | - Jorge Alberto Cortés
- Hospital Universitario Nacional de Colombia, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Laura Catalina Sánchez
- Hospital Universitario Nacional de Colombia, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | | | - Ginna Tambini
- World Health Organization, PanAmerican Health Organization, Department of Evidence and Intelligence for Action in Health (EIH), Washington, USA; World Health Organization, PanAmerican Health Organization, Bogotá, Colombia
| | | | - Janet Diaz
- World Health Organization. Geneva, Switzerland
| | | | - Ludovic Reveiz
- World Health Organization, PanAmerican Health Organization, Department of Evidence and Intelligence for Action in Health (EIH), Washington, USA
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den Uil CA, Termorshuizen F, Rietdijk WJR, Sablerolles RSG, van der Kuy HPM, Haas LEM, van der Voort PHJ, de Lange DW, Pickkers P, de Keizer NF. Age Moderates the Effect of Obesity on Mortality Risk in Critically Ill Patients With COVID-19: A Nationwide Observational Cohort Study. Crit Care Med 2023; 51:484-491. [PMID: 36762902 PMCID: PMC10012838 DOI: 10.1097/ccm.0000000000005788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVES A high body mass index (BMI) is associated with an unfavorable disease course in COVID-19, but not among those who require admission to the ICU. This has not been examined across different age groups. We examined whether age modifies the association between BMI and mortality among critically ill COVID-19 patients. DESIGN An observational cohort study. SETTING A nationwide registry analysis of critically ill patients with COVID-19 registered in the National Intensive Care Evaluation registry. PATIENTS We included 15,701 critically ill patients with COVID-19 (10,768 males [68.6%] with median [interquartile range] age 64 yr [55-71 yr]), of whom 1,402 (8.9%) patients were less than 45 years. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS In the total sample and after adjustment for age, gender, Acute Physiology and Chronic Health Evaluation IV, mechanical ventilation, and use of vasoactive drugs, we found that a BMI greater than or equal to 30 kg/m 2 does not affect hospital mortality (adjusted odds ratio [OR adj ] = 0.98; 95% CI, 0.90-1.06; p = 0.62). For patients less than 45 years old, but not for those greater than or equal to 45 years old, a BMI greater than or equal to 30 kg/m 2 was associated with a lower hospital mortality (OR adj = 0.59; 95% CI, 0.36-0.96; p = 0.03). CONCLUSIONS A higher BMI may be favorably associated with a lower mortality among those less than 45 years old. This is in line with the so-called "obesity paradox" that was established for other groups of critically ill patients in broad age ranges. Further research is needed to understand this favorable association in young critically ill patients with COVID-19.
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Affiliation(s)
- Corstiaan A den Uil
- Department of Intensive Care, Maasstad Hospital, Rotterdam, The Netherlands
- Department of Intensive Care, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands
- Department of Medical Informatics, Amsterdam UMC, Amsterdam Public Health research institute, University of Amsterdam, Amsterdam, The Netherlands
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Intensive Care, Diakonessenhuis, Utrecht, The Netherlands
- Department of Intensive Care, University Medical Center Groningen, Groningen, The Netherlands
- Department of Intensive Care, Dutch Poisons Information Center (DPIC), University Medical Center, Utrecht University, Utrecht, The Netherlands
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Fabian Termorshuizen
- National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands
- Department of Medical Informatics, Amsterdam UMC, Amsterdam Public Health research institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim J R Rietdijk
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Roos S G Sablerolles
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hugo P M van der Kuy
- Department of Hospital Pharmacy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Lenneke E M Haas
- Department of Intensive Care, Diakonessenhuis, Utrecht, The Netherlands
| | - Peter H J van der Voort
- Department of Intensive Care, University Medical Center Groningen, Groningen, The Netherlands
| | - Dylan W de Lange
- Department of Intensive Care, Dutch Poisons Information Center (DPIC), University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Peter Pickkers
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicolette F de Keizer
- National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands
- Department of Medical Informatics, Amsterdam UMC, Amsterdam Public Health research institute, University of Amsterdam, Amsterdam, The Netherlands
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15
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Torres P, Sancho-Saldaña A, Gil Sánchez A, Peralta S, Solana MJ, Bakkioui S, González-Mingot C, Quibus L, Ruiz-Fernández E, San Pedro-Murillo E, Brieva L. A prospective study of cellular immune response to booster COVID-19 vaccination in multiple sclerosis patients treated with a broad spectrum of disease-modifying therapies. J Neurol 2023; 270:2380-2391. [PMID: 36933032 PMCID: PMC10024306 DOI: 10.1007/s00415-023-11575-8] [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: 10/27/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Most people with Multiple Sclerosis (pwMS) are subjected to immunomodulatory disease-modifying treatments (DMTs). As a result, immune responses to COVID-19 vaccinations could be compromised. There are few data on cellular immune responses to the use of COVID-19 vaccine boosters in pwMS under a broad spectrum of DMTs. METHODS In this prospective study, we analysed cellular immune responses to SARS-CoV-2 mRNA booster vaccinations in 159 pwMS with DMT, including: ocrelizumab, rituximab, fingolimod, alemtuzumab, dimethyl fumarate, glatiramer acetate, teriflunomide, natalizumab and cladribine. RESULTS DMTs, and particularly fingolimod, interact with cellular responses to COVID-19 vaccination. One booster dose does not increase cellular immunity any more than two doses, except in the cases of natalizumab and cladribine. SARS-CoV-2 infection combined with two doses of vaccine resulted in a greater cellular immune response, but this was not observed after supplementary booster jabs. Ocrelizumab-treated pwMS who had previously received fingolimod did not develop cellular immunity, even after receiving a booster. The time after MS diagnosis and disability status negatively correlated with cellular immunity in ocrelizumab-treated pwMS in a booster dose cohort. CONCLUSIONS After two doses of SARS-CoV-2 vaccination, a high response yield was achieved, except in patients who had received fingolimod. The effects of fingolimod on cellular immunity persisted for more than 2 years after a change to ocrelizumab (which, in contrast, conserved cellular immunity). Our results confirmed the need to find alternative protective measures for fingolimod-treated people and to consider the possible failure to provide protection against SARS-CoV-2 when switching from fingolimod to ocrelizumab.
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Affiliation(s)
- Pascual Torres
- Metabolic Pathophysiology Research Group, Department of Experimental Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
| | - Agustín Sancho-Saldaña
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
- Department of Neurology, Hospital Universitari Arnau de Vilanova, 25198, Lleida, Spain
| | - Anna Gil Sánchez
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
| | - Silvia Peralta
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
- Department of Neurology, Hospital Universitari Arnau de Vilanova, 25198, Lleida, Spain
| | - Maria José Solana
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
- Department of Neurology, Hospital Universitari Arnau de Vilanova, 25198, Lleida, Spain
| | - Sofian Bakkioui
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
| | - Cristina González-Mingot
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
- Department of Neurology, Hospital Universitari Arnau de Vilanova, 25198, Lleida, Spain
| | - Laura Quibus
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain
- Department of Neurology, Hospital Universitari Arnau de Vilanova, 25198, Lleida, Spain
| | - Emilio Ruiz-Fernández
- Department of Neurology, Hospital Universitari Arnau de Vilanova, 25198, Lleida, Spain
| | | | - Luis Brieva
- Neuroimmunology Group, Department of Medicine, University of Lleida (UdL)-IRBLleida, 25198, Lleida, Spain.
- Department of Neurology, Hospital Universitari Arnau de Vilanova, 25198, Lleida, Spain.
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16
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López-Pérez CA, Santa Cruz-Pavlovich FJ, Montiel-Cortés JE, Núñez-Muratalla A, Morán-González RB, Villanueva-Gaona R, Franco-Mojica X, Moreno-Sandoval DG, González-Bañuelos JA, López-Pérez AU, Flores-González M, Grijalva-Ruiz C, Valdez-Mendoza ED, González-Lucano LR, López-Zendejas M. Risk Factors for Mortality of Hospitalized Adult Patients with COVID-19 Pneumonia: A Two-Year Cohort Study in a Private Tertiary Care Center in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4450. [PMID: 36901460 PMCID: PMC10001871 DOI: 10.3390/ijerph20054450] [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] [Received: 01/20/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, the high prevalence of comorbidities and the disparities between the public and private health subsystems in Mexico substantially contributed to the severe impact of the disease. The objective of this study was to evaluate and compare the risk factors at admission for in-hospital mortality of patients with COVID-19. A 2-year retrospective cohort study of hospitalized adult patients with COVID-19 pneumonia was conducted at a private tertiary care center. The study population consisted of 1258 patients with a median age of 56 ± 16.5 years, of whom 1093 recovered (86.8%) and 165 died (13.1%). In the univariate analysis, older age (p < 0.001), comorbidities such as hypertension (p < 0.001) and diabetes (p < 0.001), signs and symptoms of respiratory distress, and markers of acute inflammatory response were significantly more frequent in non-survivors. The multivariate analysis showed that older age (p < 0.001), the presence of cyanosis (p = 0.005), and previous myocardial infarction (p = 0.032) were independent predictors of mortality. In the studied cohort, the risk factors present at admission associated with increased mortality were older age, cyanosis, and a previous myocardial infarction, which can be used as valuable predictors for patients' outcomes. To our knowledge, this is the first study analyzing predictors of mortality in COVID-19 patients attended in a private tertiary hospital in Mexico.
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Affiliation(s)
| | | | - Juan Eduardo Montiel-Cortés
- Departamento de Medicina Interna, Hospital San Javier, Guadalajara 44670, Mexico
- Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Zapopan 44340, Mexico
| | - Adriana Núñez-Muratalla
- Departamento de Medicina Interna, Hospital San Javier, Guadalajara 44670, Mexico
- Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Mexico
| | | | | | - Xochitl Franco-Mojica
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Zapopan 45201, Mexico
| | | | | | | | - Marily Flores-González
- Departamento de Medicina Interna, Hospital San Javier, Guadalajara 44670, Mexico
- Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Mexico
| | - Cristina Grijalva-Ruiz
- Departamento de Medicina Interna, Hospital San Javier, Guadalajara 44670, Mexico
- Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Mexico
| | - Edna Daniela Valdez-Mendoza
- Departamento de Medicina Interna, Hospital San Javier, Guadalajara 44670, Mexico
- Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Mexico
| | | | - Martín López-Zendejas
- Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Zapopan 45201, Mexico
- Departamento de Medicina Interna, Hospital San Javier, Guadalajara 44670, Mexico
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17
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Takakura K, Suka M, Kajihara M, Koido S. Clinical features, therapeutic outcomes, and recovery period of long COVID. J Med Virol 2023; 95:e28316. [PMID: 36412057 PMCID: PMC10108287 DOI: 10.1002/jmv.28316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 11/23/2022]
Abstract
To characterize the clinical features of long COVID, 286 patients who received care in our outpatient clinic for long COVID from May to December 2021 were surveyed. The recovery periods of each symptom and the key factors contributing to early recovery were statistically analysed. The median age of the patients was 35.8 years, with 137 men and 149 women. The median number of symptoms was 2.8. The most frequent symptoms were respiratory manifestations (52.1%), followed by fatigue (51.4%). Respiratory symptoms, fatigue, and headache/arthralgia were major complaints in the initial phase, whereas hair loss was a major complaint in the late phase, suggesting that the chief complaint of patients with long COVID may vary temporally. The best treatment outcome was observed for pulmonary symptoms, and hair loss had the worst outcome. COVID-19 severity, the number of manifestations, and the delay in starting treatment exerted a negative effect on the recovery period of long COVID. In addition, the smoking habit was an independent risk factor for slowing the recovery period from long COVID. This study provides insights into the clinical course of each manifestation and therapeutic options with a more certain future of long COVID to meet the unmet medical needs.
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Affiliation(s)
- Kazuki Takakura
- Department of Internal Medicine, UnMed Clinic Motomachi, Yokohama, Kanagawa, Japan
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Mikio Kajihara
- Department of Internal Medicine, Kajihara Clinic, Hiratsuka, Kanagawa, Japan
| | - Shigeo Koido
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, The Jikei University Kashiwa Hospital, Chiba, Japan
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18
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Tan SP, Ng LC, Lyndon N, Aman Z, Kannan P, Hashim K, Teo HM, Che Ibrahim MS. A review on post-COVID-19 impacts and opportunities of agri-food supply chain in Malaysia. PeerJ 2023; 11:e15228. [PMID: 37151297 PMCID: PMC10158762 DOI: 10.7717/peerj.15228] [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: 12/23/2022] [Accepted: 03/24/2023] [Indexed: 05/09/2023] Open
Abstract
Background Malaysia is strongly supported by the agriculture sector as the backbone to drive the economy. However, COVID-19 has significantly affected agriculture across the production, supply, and marketing chains. It also disturbs the balance of food supply and demand in Malaysia. COVID-19 was an unexpected pandemic that resulted in shock and panic and caused a huge global impact. However, the impacts of this pandemic on the agriculture sector in Malaysia, particularly in the production and supply chains, are still unclear and scarce. This review offers insights into the challenges, particularly in sustaining agri-food production and supply chains. It also highlights the opportunity and relevant measures towards sustainability in agriculture to avoid agri-food disasters in the future. Methods This study was carried out through a desk review of the secondary source of information covering the impact of COVID-19 in Malaysia particularly in the agri-food aspect, and a wide range of strategies and initiatives as the effective measures to overcome the crisis of this pandemic. Online desk research of the government published data and customer desk research were utilized to complete this study. Search engines such as Google Scholar and the statistical data from the official websites including the Department of Statistics Malaysia (DOSM) and the Food and Fertilizer Technology Center for the Asian and Pacific Region (FFTC-AP), were utilized. Keywords such as impact of COVID-19, pandemic, and agri-food supply chain were used to conduct the searches. The articles identified to be related to the study's objective were then downloaded and included in the study. Descriptive methods were used as the primary analysis technique following the descriptive analysis and visual data analysis in performing the sources obtained. Results This devastating impact damages the lives by causing 4.3 million confirmed infections and more than 290,000 deaths. This disease presents an unprecedented challenge to the public health. The lockdown restriction under the movement control order (MCO), for more than of the world's population in the year 2020 to control the virus from spreading, has disrupted most of the economic sectors. The agriculture industry was seen as one of the essential industries and allowed to operate under strict standard operating procedures (SOP). Working under strict regulations came with a huge price paid for almost all industries. Conclusion This pandemic has affected the national agri-food availability and accessibility in Malaysia. This outbreak created a reflection of opportunity for sharing a more flexible approaches in handling emergencies on agricultural food production and supply chains. Therefore, the government should be ready with the roadmap and enforce the measures to control the pandemic without disrupting the agri-food supply chain in the near future.
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Affiliation(s)
- Say Peng Tan
- Malaysian Palm Oil Board (MPOB), Bandar Baru Bangi, Selangor, Malaysia
- Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Lee Chuen Ng
- Faculty of Fisheries and Food Science (FFFS), Research Interest Group of Resource Sustainability (Bio-interaction and Crop Health), Laboratory of Pest, Disease and Microbial Biotechnology (LAPDiM), Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Novel Lyndon
- Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Zaki Aman
- Malaysian Palm Oil Board (MPOB), Bandar Baru Bangi, Selangor, Malaysia
| | - Parthiban Kannan
- Malaysian Palm Oil Board (MPOB), Bandar Baru Bangi, Selangor, Malaysia
| | - Khairuman Hashim
- Malaysian Palm Oil Board (MPOB), Bandar Baru Bangi, Selangor, Malaysia
| | - Han Meng Teo
- Faculty of Fisheries and Food Science (FFFS), Research Interest Group of Resource Sustainability (Bio-interaction and Crop Health), Laboratory of Pest, Disease and Microbial Biotechnology (LAPDiM), Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Muhamad Syazlie Che Ibrahim
- Faculty of Fisheries and Food Science (FFFS), Research Interest Group of Resource Sustainability (Bio-interaction and Crop Health), Laboratory of Pest, Disease and Microbial Biotechnology (LAPDiM), Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
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19
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Srivastava A, Hollenbach JA. The immunogenetics of COVID-19. Immunogenetics 2022; 75:309-320. [PMID: 36534127 PMCID: PMC9762652 DOI: 10.1007/s00251-022-01284-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/19/2022] [Indexed: 12/23/2022]
Abstract
The worldwide coronavirus disease 2019 pandemic was sparked by the severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2) that first surfaced in December 2019 (COVID-19). The effects of COVID-19 differ substantially not just between patients individually but also between populations with different ancestries. In humans, the human leukocyte antigen (HLA) system coordinates immune regulation. Since HLA molecules are a major component of antigen-presenting pathway, they play an important role in determining susceptibility to infectious disease. It is likely that differential susceptibility to SARS-CoV-2 infection and/or disease course in COVID-19 in different individuals could be influenced by the variations in the HLA genes which are associated with various immune responses to SARS-CoV-2. A growing number of studies have identified a connection between HLA variation and diverse COVID-19 outcomes. Here, we review research investigating the impact of HLA on individual responses to SARS-CoV-2 infection and/or progression, also discussing the significance of MHC-related immunological patterns and its use in vaccine design.
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Affiliation(s)
- Anshika Srivastava
- grid.266102.10000 0001 2297 6811University of California San Francisco, San Francisco, CA USA
| | - Jill A. Hollenbach
- grid.266102.10000 0001 2297 6811University of California San Francisco, San Francisco, CA USA
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20
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Recio-Vivas AM, Mansilla-Domíngez JM, Belzunegui-Eraso Á, Peña-Otero D, Díaz-Pérez D, Lorenzo-Allegue L, Font-Jiménez I. Compliance with COVID-19 Prevention Measures in the Spanish Population during the New Normal: Will the Need for Greater Community Involvement Be One of the Lessons Learned? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15983. [PMID: 36498056 PMCID: PMC9737321 DOI: 10.3390/ijerph192315983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Throughout the pandemic, national and international health authorities have called on the population to collaborate and contribute with their behavior to control the problem. The aim of this study is to analyze the implementation of the protective measures against COVID-19 and to determine the factors involved in their compliance. To respond to the objectives, a cross-sectional study was performed involving a total of 5560 individuals. An ad hoc online questionnaire was created and shared through social networks, scientific societies, and various health institutions. The probability of high or total compliance with the protective measures was higher in women (OR = 1.401) and as age increases, with an OR = 2.524 in the interval between 31 and 64 years old and an OR = 2.896 in the oldest interval (65 and over). This study shows the characteristics of the population that considers it more likely to be infected by SARS-CoV-2, thus adopting greater adherence to prevention measures. Knowing which factors are associated with adherence to protective measures is essential for establishing effective pandemic control measures. Our findings may be useful for designing future awareness campaigns adapted to different socio-demographic characteristics in settings affected by COVID-19.
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Affiliation(s)
- Ana María Recio-Vivas
- Department of Nursing, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain
| | | | - Ángel Belzunegui-Eraso
- Medical Anthropology Research Center, Faculty of Nursing, Rovira i Virgili University, 43002 Tarragona, Spain
| | - David Peña-Otero
- Sub-Directorate of Caring, Cantabrian Health Service, Material Resources Unit, Management of Products, Equipment and Health Technology, Hospital Universitario Marqués de Valdecilla, 39011 Cantabria, Spain
- Nursing Area, IDIVAL Research Institutes Valdecilla, 39011 Cantabria, Spain
- Respiratory Nursing Department at Sociedad Española de Neumología y Cirugía Torácica (SEPAR), 08029 Barcelona, Spain
| | - David Díaz-Pérez
- Respiratory Nursing Department at Sociedad Española de Neumología y Cirugía Torácica (SEPAR), 08029 Barcelona, Spain
- Pneumology and Thoracic Surgery Service of the Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain
| | - Laura Lorenzo-Allegue
- Department of Nursing, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Isabel Font-Jiménez
- Department of Nursing, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain
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21
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Colnago M, Benvenuto GA, Casaca W, Negri RG, Fernandes EG, Cuminato JA. Risk Factors Associated with Mortality in Hospitalized Patients with COVID-19 during the Omicron Wave in Brazil. Bioengineering (Basel) 2022; 9:584. [PMID: 36290552 PMCID: PMC9598428 DOI: 10.3390/bioengineering9100584] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Considering the imminence of new SARS-CoV-2 variants and COVID-19 vaccine availability, it is essential to understand the impact of the disease on the most vulnerable groups and those at risk of death from the disease. To this end, the odds ratio (OR) for mortality and hospitalization was calculated for different groups of patients by applying an adjusted logistic regression model based on the following variables of interest: gender, booster vaccination, age group, and comorbidity occurrence. A massive number of data were extracted and compiled from official Brazilian government resources, which include all reported cases of hospitalizations and deaths associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Brazil during the "wave" of the Omicron variant (BA.1 substrain). Males (1.242; 95% CI 1.196-1.290) aged 60-79 (3.348; 95% CI 3.050-3.674) and 80 years or older (5.453; 95% CI 4.966-5.989), and hospitalized patients with comorbidities (1.418; 95% CI 1.355-1.483), were more likely to die. There was a reduction in the risk of death (0.907; 95% CI 0.866-0.951) among patients who had received the third dose of the anti-SARS-CoV-2 vaccine (booster). Additionally, this big data investigation has found statistical evidence that vaccination can support mitigation plans concerning the current scenario of COVID-19 in Brazil since the Omicron variant and its substrains are now prevalent across the entire country.
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Affiliation(s)
- Marilaine Colnago
- Institute of Chemistry, São Paulo State University (UNESP), Araraquara 14800-060, Brazil
| | - Giovana A. Benvenuto
- Faculty of Science and Technology (FCT), São Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Wallace Casaca
- Institute of Biosciences, Letters and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto 15054-000, Brazil
| | - Rogério G. Negri
- Science and Technology Institute, São Paulo State University (UNESP), São José dos Campos 12247-004, Brazil
| | - Eder G. Fernandes
- Immunization Division—Centre of Epidemiology Surveillance of the São Paulo State Health Department, São Paulo 01246-000, Brazil
| | - José A. Cuminato
- Institute of Mathematics and Computer Science, São Paulo University (USP), São Carlos 13566-590, Brazil
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22
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Rodriguez M, Dai W, Lund H, Osinski K, Zhang Z, Silverstein R, Zheng Z. The correlations among racial/ethnic groups, hypertriglyceridemia, thrombosis, and mortality in hospitalized patients with COVID-19. Best Pract Res Clin Haematol 2022; 35:101386. [PMID: 36494155 PMCID: PMC9527214 DOI: 10.1016/j.beha.2022.101386] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 01/08/2023]
Abstract
Reports of racial and ethnic disparities regarding both rates of infection of the SARS-CoV-2 virus and morbidity of the coronavirus disease-19 (COVID-19) contain profound differences depending on the population. Our previous study has shown that patients with COVID-19 who developed hypertriglyceridemia during hospitalization have a 2.3 times higher mortality rate. However, whether the correlation between hypertriglyceridemia and mortality has disparity among different racial and ethnic groups is unknown. In this study, we investigated the impact of race/ethnicity on the correlation between hypertriglyceridemia and mortality in hospitalized patients with COVID-19. De-identified information from 904 hospitalized patients diagnosed with COVID-19 between March 2020 and June 2021 were extracted from the Medical College of Wisconsin Clinical Data Warehouse. A multivariable regression analysis suggested that the Asians and non-White Hispanics had 4 or 3.9 times higher mortality rate, respectively, after adjusting for age, morbid obesity (BMI ≥40), and gender. The hypertriglyceridemia (≥150 mg/dL) was associated with higher mortality, after adjusting for age, gender, and morbid obesity. The baseline hypertriglyceridemia occurrence had relevantly more consistent percentages among all racial/ethnic groups. However, non-White Hispanic and Asian patients had the highest frequencies of peak hypertriglyceridemia occurrence during hospitalization. The peak hypertriglyceridemia developed during hospitalization correlates with the incidence of thrombosis after adjusting for morbid obesity, age, and sex. In summary, in this retrospective study of 904 hospitalized COVID-19 patients, Asians and non-White Hispanics had a greater likelihood of developing hypertriglyceridemia during hospitalization and mortality than White patients.
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Affiliation(s)
- Maya Rodriguez
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA,Diversity Summer Health-Related Research Education Program (DSHREP), Medical College of Wisconsin, Milwaukee, WI, USA,College of Arts and Sciences, Marquette University, Milwaukee, WI, USA
| | - Wen Dai
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hayley Lund
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kristen Osinski
- Clinical & Translational Science Institute (CTSI) Biomedical Informatics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ziyu Zhang
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Roy Silverstein
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ze Zheng
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA,Corresponding author. Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
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23
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Bansal D, Abdulmajeed J, Al-Shamali MHMA, Albayat SSA, Himatt SM, Cyprian FS, Chivese T, Mundodan JMA, Khogali HS, Baaboura R, Kaleeckal AH, Kandy MC, Latif AN, Al-Kuwari MG, Al-Romaihi HE, Al Khal A, Bertollini R, Al-Thani MH, Farag E, Doi SAR. Duration of COVID-19 mRNA Vaccine Effectiveness against Severe Disease. Vaccines (Basel) 2022; 10:1036. [PMID: 35891199 PMCID: PMC9321581 DOI: 10.3390/vaccines10071036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 02/07/2023] Open
Abstract
Waning immunity following administration of mRNA-based COVID-19 vaccines remains a concern for many health systems. We undertook a study to determine if recent reports of waning for severe disease could have been attributed to design-related bias by conducting a study only among those detected with a first SARS-CoV-2 infection. We used a matched case-control study design with the study base being all individuals with first infection with SARS-CoV-2 reported in the State of Qatar between 1 January 2021 and 20 February 2022. Cases were those detected with first SARS-CoV-2 infection requiring intensive care (hard outcome), while controls were those detected with first SARS-CoV-2 infection who recovered without the need for intensive care. Cases and controls were matched in a 1:30 ratio for the calendar month of infection and the comorbidity category. Duration and magnitude of conditional vaccine effectiveness against requiring intensive care and the number needed to vaccinate (NNV) to prevent one more case of COVID-19 requiring intensive care was estimated for the mRNA (BNT162b2/mRNA-1273) vaccines. Conditional vaccine effectiveness against requiring intensive care was 59% (95% confidence interval (CI), 50 to 76) between the first and second dose, and strengthened to 89% (95% CI, 85 to 92) between the second dose and 4 months post the second dose in persons who received a primary course of the vaccine. There was no waning of vaccine effectiveness in the period from 4 to 6, 6 to 9, and 9 to 12 months after the second dose. This study demonstrates that, contrary to mainstream reports using hierarchical measures of effectiveness, conditional vaccine effectiveness against requiring intensive care remains robust till at least 12 months after the second dose of mRNA-based vaccines.
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Affiliation(s)
- Devendra Bansal
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Jazeel Abdulmajeed
- Primary Health Care Corporation, Al Mina Street, Doha 26555, Qatar; (J.A.); (M.C.K.); (M.G.A.-K.)
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, University Street, Doha 2713, Qatar;
| | - Maha H. M. A. Al-Shamali
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Soha S. A. Albayat
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Sayed M. Himatt
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Farhan S. Cyprian
- Immunology Division, Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Arab League Street, Doha 2713, Qatar;
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, University Street, Doha 2713, Qatar;
| | - Jesha M. A. Mundodan
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Hayat S. Khogali
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Rekayahouda Baaboura
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Anvar H. Kaleeckal
- Hamad Medical Corporation, Doha 3050, Qatar; (A.H.K.); (A.N.L.); (A.A.K.)
| | - Mujeeb C. Kandy
- Primary Health Care Corporation, Al Mina Street, Doha 26555, Qatar; (J.A.); (M.C.K.); (M.G.A.-K.)
| | - Ali Nizar Latif
- Hamad Medical Corporation, Doha 3050, Qatar; (A.H.K.); (A.N.L.); (A.A.K.)
| | - Mohamed Ghaith Al-Kuwari
- Primary Health Care Corporation, Al Mina Street, Doha 26555, Qatar; (J.A.); (M.C.K.); (M.G.A.-K.)
| | - Hamad Eid Al-Romaihi
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Abdullatif Al Khal
- Hamad Medical Corporation, Doha 3050, Qatar; (A.H.K.); (A.N.L.); (A.A.K.)
| | - Roberto Bertollini
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Mohamed Hamad Al-Thani
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Elmobashar Farag
- Ministry of Public Health, Ras Qertas Street, Doha 26555, Qatar; (D.B.); (M.H.M.A.A.-S.); (S.S.A.A.); (S.M.H.); (J.M.A.M.); (H.S.K.); (R.B.); (H.E.A.-R.); (R.B.); (M.H.A.-T.); (E.F.)
| | - Suhail A. R. Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, University Street, Doha 2713, Qatar;
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Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:1058813. [PMID: 35746958 PMCID: PMC9210126 DOI: 10.1155/2022/1058813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/14/2022] [Accepted: 05/31/2022] [Indexed: 01/08/2023]
Abstract
Background Activation of the immune system response is associated with the generation of oxidative stress (OS). Several alterations are involved in OS, such as excessive production of reactive oxygen species (ROS) and decreased antioxidant activity, which together lead to an imbalance in redox status. The role of OS during SARS-CoV-2 infection is not fully understood. The aim of this study was to determine OS biomarkers and assess their usefulness as a predictor of mortality in COVID-19 patients. Methods Baseline characteristics and serum samples were collected from hospitalized COVID-19 patients and compared with healthy controls. The serum OS biomarkers, including malondialdehyde (MDA) and total antioxidant capacity (TAC), were assessed by spectrophotometric and oxygen radical absorbance capacity (ORAC) methods, respectively. Results A total of 152 individuals were analyzed (COVID-19 patients vs. healthy controls). Compared with healthy controls (n = 76), patients infected with SARS-CoV-2 (n = 76) presented higher levels of MDA (p < 0.001) and decreased TAC (p < 0.001). A total of 37 (49%) patients with COVID-19 died. The area under the receiver operating characteristic (ROC) curve (AUC) estimated that the combination of the OS biomarkers (MDA+TAC) (AUC = 0.6394, p = 0.037) was a significant predictor of mortality. A higher level of MDA was associated with mortality (HR, 1.05, 95% CI, 1.00-1.10, p = 0.045). Conclusion This study concludes that OS is increased in patients with COVID-19 and is associated with mortality. To our knowledge, this is the first evidence of the expression of OS biomarkers and their association with mortality among the Mexican population.
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Lasica R, Djukanovic L, Mrdovic I, Savic L, Ristic A, Zdravkovic M, Simic D, Krljanac G, Popovic D, Simeunovic D, Rajic D, Asanin M. Acute Coronary Syndrome in the COVID-19 Era-Differences and Dilemmas Compared to the Pre-COVID-19 Era. J Clin Med 2022; 11:3024. [PMID: 35683411 PMCID: PMC9181081 DOI: 10.3390/jcm11113024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has led to numerous negative implications for all aspects of society. Although COVID-19 is a predominant lung disease, in 10-30% of cases, it is associated with cardiovascular disease (CVD). The presence of myocardial injury in COVID-19 patients occurs with a frequency between 7-36%. There is growing evidence of the incidence of acute coronary syndrome (ACS) in COVID-19, both due to coronary artery thrombosis and insufficient oxygen supply to the myocardium in conditions of an increased need. The diagnosis and treatment of patients with COVID-19 and acute myocardial infarction (AMI) is a major challenge for physicians. Often the presence of mixed symptoms, due to the combined presence of COVID-19 and ACS, as well as possible other diseases, nonspecific changes in the electrocardiogram (ECG), and often elevated serum troponin (cTn), create dilemmas in diagnosing ACS in COVID-19. Given the often-high ischemic risk, as well as the risk of bleeding, in these patients and analyzing the benefit/risk ratio, the treatment of patients with AMI and COVID-19 is often associated with dilemmas and difficult decisions. Due to delays in the application of the therapeutic regimen, complications of AMI are more common, and the mortality rate is higher.
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Affiliation(s)
- Ratko Lasica
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Lazar Djukanovic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Igor Mrdovic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Lidija Savic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Arsen Ristic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | | | - Dragan Simic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | - Gordana Krljanac
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Dejana Popovic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | - Dejan Simeunovic
- Department of Cardiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (A.R.); (D.S.); (D.P.); (D.S.)
| | - Dubravka Rajic
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
| | - Milika Asanin
- Department of Cardiology, Emergency Center, Clinical Center of Serbia, 11000 Belgrade, Serbia; (L.D.); (I.M.); (L.S.); (G.K.); (D.R.); (M.A.)
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Tsilingiris D, Nasiri-Ansari N, Spyrou N, Magkos F, Dalamaga M. Management of Hematologic Malignancies in the Era of COVID-19 Pandemic: Pathogenetic Mechanisms, Impact of Obesity, Perspectives, and Challenges. Cancers (Basel) 2022; 14:2494. [PMID: 35626099 PMCID: PMC9139192 DOI: 10.3390/cancers14102494] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic brought about an unprecedented societal and healthcare system crisis, considerably affecting healthcare workers and patients, particularly those with chronic diseases. Patients with hematologic malignancies faced a variety of challenges, pertinent to the nature of an underlying hematologic disorder itself as well as its therapy as a risk factor for severe SARS-CoV-2 infection, suboptimal vaccine efficacy and the need for uninterrupted medical observation and continued therapy. Obesity constitutes another factor which was acknowledged since the early days of the pandemic that predisposed people to severe COVID-19, and shares a likely causal link with the pathogenesis of a broad spectrum of hematologic cancers. We review here the epidemiologic and pathogenetic features that obesity and hematologic malignancies share, as well as potential mutual pathophysiological links predisposing people to a more severe SARS-CoV-2 course. Additionally, we attempt to present the existing evidence on the multi-faceted crucial challenges that had to be overcome in this diverse patient group and discuss further unresolved questions and future challenges for the management of hematologic malignancies in the era of COVID-19.
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Affiliation(s)
- Dimitrios Tsilingiris
- First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 17 St Thomas Street, 11527 Athens, Greece
| | - Narjes Nasiri-Ansari
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Faidon Magkos
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, DK-2200 Frederiksberg, Denmark
| | - Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
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