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Ortiz-de-Lejarazu R, Quiroga Gili B, López García A. Burden of COVID-19 variant omicron in immunocompromised patients in Spain: systematic review. Med Clin (Barc) 2024:S0025-7753(24)00299-9. [PMID: 38944615 DOI: 10.1016/j.medcli.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 07/01/2024]
Abstract
After the COVID-19 pandemic, the omicron variant of the SARS-CoV-2 virus became the dominant lineage in Spain in 2022. Although it possesses a milder pathogenicity than previous variants, it still poses a high risk of causing severe COVID-19 for immunocompromised populations. A systematic review was conducted to assess the burden of COVID-19 in Spain among immunocompromised patients during the omicron predominance (1/04/2022-1/04/2023), using PubMed, Cochrane Library, and EPICOVIDEHA between May and July 2023. The search retrieved 217 articles, of which a total of 5 were included. Upon analysis, it was observed that immunocompromised patients during the omicron lineage predominance continue to exhibit higher rates of hospitalizations, ICU admissions, and mortality compared to the general population affected by COVID-19. Although the pandemic has ended, the risk persists for immunocompromised individuals.
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Affiliation(s)
- Raúl Ortiz-de-Lejarazu
- Centro Nacional de Gripe, Hospital Clínico Universitario y Facultad de Medicina de Valladolid, Valladolid, España.
| | - Borja Quiroga Gili
- IIS-La Princesa, Servicio de Nefrología, Hospital Universitario de la Princesa, Madrid, España
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Piñana JL, Vazquez L, Heras I, Aiello TF, López-Corral L, Arroyo I, Soler-Espejo E, García-Cadenas I, Garcia-Gutierrez V, Aroca C, Chorao P, Olave MT, Lopez-Jimenez J, Gómez MA, Arellano E, Cuesta-Casas M, Avendaño-Pita A, González-Santillana C, Hernández-Rivas JÁ, Roldán-Pérez A, Mico-Cerdá M, Guerreiro M, Morell J, Rodriguez-Galvez P, Labrador J, Campos D, Cedillo Á, Vidal CG, Martino R, Solano C. Omicron SARS-CoV-2 infection management and outcomes in patients with hematologic disease and recipients of cell therapy. Front Oncol 2024; 14:1389345. [PMID: 39015498 PMCID: PMC11250586 DOI: 10.3389/fonc.2024.1389345] [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: 02/21/2024] [Accepted: 06/03/2024] [Indexed: 07/18/2024] Open
Abstract
Introduction Scarce real-life data exists for COVID-19 management in hematologic disease (HD) patients in the Omicron era. Purpose To assess the current clinical management and outcome of SARS-CoV-2 infection diagnosed, identify the risk factors for severe outcomes according to the HD characteristics and cell therapy procedures in a real-world setting. Methods A retrospective observational registry led by the Spanish Transplant Group (GETH-TC) with 692 consecutive patients with HD from December 2021 to May 2023 was analyzed. Results Nearly one-third of patients (31%) remained untreated and presented low COVID-19-related mortality (0.9%). Nirmatrelvir/ritonavir was used mainly in mild COVID-19 cases in the outpatient setting (32%) with a low mortality (1%), while treatment with remdesivir was preferentially administered in moderate-to-severe SARS-CoV-2 infection cases during hospitalization (35%) with a mortality rate of 8.6%. The hospital admission rate was 23%, while 18% developed pneumonia. COVID-19-related mortality in admitted patients was 14%. Older age, autologous hematopoietic stem cell transplantation (SCT), chimeric antigen receptor T-cell therapy, corticosteroids and incomplete vaccination were factors independently associated with COVID-19 severity and significantly related with higher rates of hospital admission and pneumonia. Incomplete vaccination status, treatment with prior anti-CD20 monoclonal antibodies, and comorbid cardiomyopathy were identified as independent risk factors for COVID-19 mortality. Conclusions The results support that, albeit to a lower extent, COVID-19 in the Omicron era remains a significant problem in HD patients. Complete vaccination (3 doses) should be prioritized in these immunocompromised patients. The identified risk factors may help to improve COVID-19 management to decrease the rate of severe disease, ICU admissions and mortality.
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Affiliation(s)
- José Luis Piñana
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Lourdes Vazquez
- Hematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | - Lucia López-Corral
- Hematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Ignacio Arroyo
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | | | | | | | - Cristina Aroca
- Hematology Division, Hospital Morales Meseguer, Murcia, Spain
| | - Pedro Chorao
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - María T. Olave
- Hematology Division, Hospital Clínico Universitario Lozano Blesa, IIS Aragon, Zaragoza, Spain
| | | | - Marina Acera Gómez
- Hematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Elena Arellano
- Hematology Division, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Marian Cuesta-Casas
- Hematology Division, Hospital Regional Universitario Carlos Haya, Malaga, Spain
| | - Alejandro Avendaño-Pita
- Hematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
| | | | | | | | - Mireia Mico-Cerdá
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Manuel Guerreiro
- Hematology Division, Hospital Clínico Universitario Lozano Blesa, IIS Aragon, Zaragoza, Spain
| | - Julia Morell
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Paula Rodriguez-Galvez
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Jorge Labrador
- Research unit, Hospital Universitario de Burgos, Burgos, Spain
| | - Diana Campos
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Ángel Cedillo
- Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC) office, Madrid, Spain
| | | | - Rodrigo Martino
- Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carlos Solano
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- INCLIVA Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine. University of Valencia, Valencia, Spain
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Nachtigall I, Kwast S, Hohenstein S, König S, Dang PL, Leiner J, Giesen N, Schleenvoigt BT, Bonsignore M, Bollmann A, Kuhlen R, Jah F. Retrospective, Observational Analysis on the Impact of SARS-CoV-2 Variant Omicron in Hospitalized Immunocompromised Patients in a German Hospital Network-The VISAGE Study. Vaccines (Basel) 2024; 12:634. [PMID: 38932363 PMCID: PMC11209028 DOI: 10.3390/vaccines12060634] [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: 04/23/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
AIMS Endemic SARS-CoV-2 infections still burden the healthcare system and represent a considerable threat to vulnerable patient cohorts, in particular immunocompromised (IC) patients. This study aimed to analyze the in-hospital outcome of IC patients with severe SARS-CoV-2 infection in Germany. METHODS This retrospective, observational study, analyzed administrative data from inpatient cases (n = 146,324) in 84 German Helios hospitals between 1 January 2022 and 31 December 2022 with regard to in-hospital outcome and health care burden in IC patients during the first 12 months of Omicron dominance. As the primary objective, in-hospital outcomes of patients with COVID-19-related severe acute respiratory infection (SARI) were analyzed by comparing patients with (n = 2037) and without IC diagnoses (n = 14,772). Secondary analyses were conducted on IC patients with (n = 2037) and without COVID-19-related SARI (n = 129,515). A severe in-hospital outcome as a composite endpoint was defined per the WHO definition if one of the following criteria were met: intensive care unit (ICU) treatment, mechanical ventilation (MV), or in-hospital death. RESULTS In total, 12% of COVID-related SARI cases were IC patients, accounting for 15% of ICU admissions, 15% of MV use, and 16% of deaths, resulting in a higher prevalence of severe in-hospital courses in IC patients developing COVID-19-related SARI compared to non-IC patients (Odds Ratio, OR = 1.4, p < 0.001), based on higher in-hospital mortality (OR = 1.4, p < 0.001), increased need for ICU treatment (OR = 1.3, p < 0.001) and mechanical ventilation (OR = 1.2, p < 0.001). Among IC patients, COVID-19-related SARI profoundly increased the risk for severe courses (OR = 4.0, p < 0.001). CONCLUSIONS Our findings highlight the vulnerability of IC patients to severe COVID-19. The persistently high prevalence of severe outcomes in these patients in the Omicron era emphasizes the necessity for continuous in-hospital risk assessment and monitoring of IC patients.
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Affiliation(s)
- Irit Nachtigall
- Department of Infectious Diseases and Infection Prevention, Helios Hospital Emil-von-Behring, 14165 Berlin, Germany;
- Medical School Berlin, Chair of Infectiology and Immunology, 14197 Berlin, Germany
| | - Stefan Kwast
- Helios Health Institute, Real World Evidence and Health Technology Assessment, 13125 Berlin, Germany; (S.H.); (S.K.); (J.L.)
| | - Sven Hohenstein
- Helios Health Institute, Real World Evidence and Health Technology Assessment, 13125 Berlin, Germany; (S.H.); (S.K.); (J.L.)
| | - Sebastian König
- Helios Health Institute, Real World Evidence and Health Technology Assessment, 13125 Berlin, Germany; (S.H.); (S.K.); (J.L.)
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany
| | | | - Johannes Leiner
- Helios Health Institute, Real World Evidence and Health Technology Assessment, 13125 Berlin, Germany; (S.H.); (S.K.); (J.L.)
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany
| | - Nicola Giesen
- Department of Hematology, Oncology and Palliative Care, Robert Bosch Hospital, 70376 Stuttgart, Germany
| | | | - Marzia Bonsignore
- Center for Clinical and Translational Research, Helios Universitätsklinikum Wuppertal, University of Witten/Herdecke, 42283 Wuppertal, Germany
| | - Andreas Bollmann
- Helios Health Institute, Real World Evidence and Health Technology Assessment, 13125 Berlin, Germany; (S.H.); (S.K.); (J.L.)
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany
| | | | - Fungwe Jah
- Medical Affairs, AstraZeneca, 22763 Hamburg, Germany
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Sakaguchi T, Mitsuke A, Osako Y, Yamada Y, Takeyama H, Ogawa R, Takahashi K, Hirohata Y, Yamamoto S, Arima J, Fukumoto W, Sugita S, Inoguchi S, Matsushita R, Yoshino H, Tatarano S, Enokida H. Assessing antiviral treatment efficacy and risk factors for severe COVID-19 in kidney transplant recipients during the Omicron subvariant-dominant period: a retrospective study. BMC Nephrol 2024; 25:124. [PMID: 38589827 PMCID: PMC11000285 DOI: 10.1186/s12882-024-03561-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Kidney transplant recipients (KTRs) are at risk of severe coronavirus disease 2019 (COVID-19), and even now that Omicron subvariants have become dominant, cases of severe disease are certain to occur. The aims of this retrospective study were to evaluate the efficacy of antiviral treatment for COVID-19 and to identify risk factors for severe disease in KTRs during Omicron subvariant-dominant periods. METHODS A total of 65 KTRs diagnosed with COVID-19 who received antiviral treatment between July 2022 and September 2023 were analyzed. Mild cases received oral molnupiravir (MP) as outpatient therapy, while moderate or worse cases received intravenous remdesivir (RDV) as inpatient therapy. In principle, mycophenolate mofetil was withdrawn and switched to everolimus. We investigated the efficacy of antiviral treatment and compared the clinical parameters of mild/moderate and severe/critical cases to identify risk factors for severe COVID-19. RESULTS Among 65 cases, 49 were mild, 6 were moderate, 9 were severe, and 1 was of critical severity. MP was administered to 57 cases; 49 (86%) improved and 8 (14%) progressed. RDV was administered to 16 cases; 14 (87%) improved and 2 (13%) progressed. Seventeen (26%) cases required hospitalization, and none died. Comparisons of the severe/critical group (n = 10) with the mild/moderate group (n = 55) demonstrated that the severe/critical group had a significantly higher median age (64 vs. 53 years, respectively; p = 0.0252), prevalence of diabetes (70% vs. 22%, respectively; p = 0.0047) and overweight/obesity (40% vs. 11%, respectively; p = 0.0393), as well as a significantly longer median time from symptom onset to initial antiviral therapy (3 days vs. 1 day, respectively; p = 0.0026). Multivariate analysis showed that a longer time from symptom onset to initial antiviral treatment was an independent risk factor for severe COVID-19 (p = 0.0196, odds ratio 1.625, 95% confidence interval 1.081-2.441). CONCLUSION These findings suggest that a longer time from symptom onset to initial antiviral treatment is associated with a higher risk of severe COVID-19 in KTRs. Initiating antiviral treatment as early as possible is crucial for preventing severe outcomes; this represents a valuable insight into COVID-19 management in KTRs.
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Affiliation(s)
- Takashi Sakaguchi
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Akihiko Mitsuke
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Yoichi Osako
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Yasutoshi Yamada
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Himawari Takeyama
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Risako Ogawa
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Katsuya Takahashi
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Yukiko Hirohata
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Sayuri Yamamoto
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Junya Arima
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Wataru Fukumoto
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Satoshi Sugita
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Satoru Inoguchi
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Ryosuke Matsushita
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Hirofumi Yoshino
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Shuichi Tatarano
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan
| | - Hideki Enokida
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, 890-8520, Kagoshima, Japan.
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Bournia VK, Fragoulis GE, Mitrou P, Mathioudakis K, Konstantonis G, Tektonidou MG, Tsolakidis A, Paraskevis D, Sfikakis PP. Outcomes of COVID-19 Omicron variant in patients with rheumatoid arthritis: a nationwide Greek cohort study. Rheumatology (Oxford) 2024; 63:1130-1138. [PMID: 37467059 PMCID: PMC10986801 DOI: 10.1093/rheumatology/kead354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVES Patients with RA were at increased risk for COVID-19-associated hospitalization and death during the first year of the pandemic in Greece. We aimed to examine their outcomes after the SARS-Cov-2 Omicron, a more contagious but with milder clinical impacts variant, prevailed. METHODS A retrospective, nationwide study was conducted between 1 January 2022 and 30 June 2022 in all RA patients under treatment and matched (1:5) on age, sex and region of domicile random general population comparators. Confirmed SARS-CoV-2 infections, hospitalizations and deaths, anti-rheumatic medications, prior COVID-19, vaccinations and anti-viral medications were recorded. RESULTS Among 34 182 RA patients, infections (n = 5569, 16.29%), hospitalizations (n = 489, 1.43%) and deaths (n = 106, 0.31%) were more frequent than among comparators. Incidence rates per 1000 person/years of infection [IRR (95% CI):1.19 (1.16, 1.23)], hospitalization [IRR (95% CI):2.0 (1.82, 2.24)], and death [IRR (95% CI):1.81 (1.44, 2.27)] were increased in RA despite better vaccination coverage (89% vs 84%) and more frequent use of anti-viral medications (2.37% vs 1.08). Logistic regression analysis after correcting for age, sex, vaccinations, prior COVID-19, and anti-viral medications in SARS-CoV-2 infected RA patients and comparators revealed increased risk of hospitalization (OR: 2.02, 95% CI: 1.79, 2.27) and death [OR: 1.73, (95% CI: 1.36, 2.20)] in RA. Among infected RA patients, rituximab treatment conferred increased risks for hospitalization [OR: 6.12, (95% CI: 2.89, 12.92)] and death [OR: 12.06 (95% CI: 3.90, 37.31)], while JAK inhibitors increased only hospitalization risk [OR: 2.18 (95% CI: 1.56, 3.06)]. CONCLUSION RA remains a risk factor for hospitalization and death in an era of a relatively low COVID-19 fatality rate, pointing to the need of perseverance in vaccination programs and wider use of anti-viral medications.
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Affiliation(s)
- Vasiliki-Kalliopi Bournia
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - George E Fragoulis
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | | | | | - George Konstantonis
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Maria G Tektonidou
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | | | - Dimitrios Paraskevis
- Department of Hygiene Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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Martinot M, Schieber A, Ongagna JC, Henric A, Eyriey M, Mohseni-Zadeh M, Ion C, Demesmay K, Gravier S, Kempf C. Clinical features and outcomes in adults with COVID-19 during the pre-Omicron and Omicron waves. Infect Dis Now 2024; 54:104833. [PMID: 37972817 DOI: 10.1016/j.idnow.2023.104833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES We conducted a single-center retrospective study to compare patient characteristics and death rates during the Omicron (O, December 01, 2021, to September 30, 2022) and pre-Omicron (PO, March 01, 1920, to October 31, 2021) periods. PATIENTS AND METHODS We retrospectively analyzed the data of 2932 patients (1242 (O) and 1690 (PO)) hospitalized (>24 h) with laboratory-confirmed COVID. RESULTS Compared to the PO period, O period patients were less frequently men, had a lower body mass index and fewer comorbidities except for immunosuppression and pregnancy. Nosocomial COVID-19 accounted for 18.2 % (O) and 15.4 % (PO) of cases (p = 0.05). Patient mortality rates during the O and PO periods were 11.0 % and 16.9 % (p < 0.001), respectively. Unvaccinated status (p < 0.001), existence of comorbidities, (p < 0.001) and high LDH value at baseline (p = 0.015), but not the period, were identified as factors likely to explain death. CONCLUSION During the Omicron period, the inpatient death rate remained > 10 %, especially among unvaccinated and comorbid patients. Nosocomial cases were more frequent.
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Affiliation(s)
- M Martinot
- Infectious Disease Department, Hôpitaux Civils de Colmar, Colmar, France.
| | - A Schieber
- Clinical Research Department, Hôpitaux Civils de Colmar, Colmar, France
| | - J C Ongagna
- Clinical Research Department, Hôpitaux Civils de Colmar, Colmar, France
| | - A Henric
- Clinical Research Department, Hôpitaux Civils de Colmar, Colmar, France
| | - M Eyriey
- Clinical Research Department, Hôpitaux Civils de Colmar, Colmar, France
| | - M Mohseni-Zadeh
- Infectious Disease Department, Hôpitaux Civils de Colmar, Colmar, France
| | - C Ion
- Infectious Disease Department, Hôpitaux Civils de Colmar, Colmar, France
| | - K Demesmay
- Pharmacy Department, Hôpitaux Civils de Colmar, Colmar, France
| | - S Gravier
- Infectious Disease Department, Hôpitaux Civils de Colmar, Colmar, France
| | - C Kempf
- Clinical Research Department, Hôpitaux Civils de Colmar, Colmar, France
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7
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Cheema HA, Akhlaq A, Mustafa B, Shahid A, Ayyan M, Edigin E. Outcomes in systemic sclerosis patients hospitalized with COVID-19: Insight from the National Inpatient Sample. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2024; 9:16-22. [PMID: 38333522 PMCID: PMC10848934 DOI: 10.1177/23971983231210340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 09/30/2023] [Indexed: 02/10/2024]
Abstract
Objective COVID-19, a respiratory infection caused by the novel coronavirus SARS-CoV-2, can cause varying degrees of illness ranging from mild respiratory illness to severe respiratory failure. Systemic sclerosis is a chronic autoimmune disease, with an increased prevalence of infections as compared to the general population. In this study, we compare the clinical outcomes and resource utilization for COVID-19 hospitalizations in patients with and without systemic sclerosis. Methods We used the National Inpatient Sample database, 2020, to study the characteristics, morbidity, mortality, cost, and resource utilization among primary COVID-19 hospitalizations with and without systemic sclerosis. Results There were 1,050,040 patients aged ⩾ 18 years with a diagnosis of COVID-19. Of these, 775 (0.07%) patients had a secondary diagnosis of systemic sclerosis. Although there was no statistically significant difference regarding individual outcomes; in-hospital mortality, vasopressor use, cardiac arrest, acute kidney injury, and disposition to facility were numerically higher in hospitalizations with systemic sclerosis. The composite endpoint of major adverse events was higher in the systemic sclerosis cohort (adjusted odds ratio 1.52, 95% confidence interval: 1.06-2.17, p = 0.022). Conclusion COVID-19 patients with systemic sclerosis had worse outcomes (i.e. higher composite endpoint of major adverse events) than those without systemic sclerosis. Further studies are needed to establish a better understanding of the relationship between COVID-19 and systemic sclerosis.
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Affiliation(s)
| | - Anum Akhlaq
- Department of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Biah Mustafa
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Abia Shahid
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Ayyan
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Ehizogie Edigin
- Department of Rheumatology, Loma Linda University Health, Loma Linda, CA, USA
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Evans RA, Dube S, Lu Y, Yates M, Arnetorp S, Barnes E, Bell S, Carty L, Evans K, Graham S, Justo N, Moss P, Venkatesan S, Yokota R, Ferreira C, McNulty R, Taylor S, Quint JK. Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 35:100747. [PMID: 38115964 PMCID: PMC10730312 DOI: 10.1016/j.lanepe.2023.100747] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 12/21/2023]
Abstract
Background Immunocompromised individuals are not optimally protected by COVID-19 vaccines and potentially require additional preventive interventions to mitigate the risk of severe COVID-19. We aimed to characterise and describe the risk of severe COVID-19 across immunocompromised groups as the pandemic began to transition to an endemic phase. Methods COVID-19-related hospitalisations, intensive care unit (ICU) admissions, and deaths (01/01/2022-31/12/2022) were compared among different groups of immunocompromised individuals vs the general population, using a retrospective cohort design and electronic health data from a random 25% sample of the English population aged ≥12 years (Registration number: ISRCTN53375662). Findings Overall, immunocompromised individuals accounted for 3.9% of the study population, but 22% (4585/20,910) of COVID-19 hospitalisations, 28% (125/440) of COVID-19 ICU admissions, and 24% (1145/4810) of COVID-19 deaths in 2022. Restricting to those vaccinated with ≥3 doses of COVID-19 vaccine (∼84% of immunocompromised and 51% of the general population), all immunocompromised groups remained at increased risk of severe COVID-19 outcomes, with adjusted incidence rate ratios (aIRR) for hospitalisation ranging from 1.3 to 13.1. At highest risk for COVID-19 hospitalisation were individuals with: solid organ transplant (aIRR 13.1, 95% confidence interval [95% CI] 11.2-15.3), moderate to severe primary immunodeficiency (aIRR 9.7, 95% CI 6.3-14.9), stem cell transplant (aIRR 11.0, 95% CI 6.8-17.6), and recent treatment for haematological malignancy (aIRR 10.6, 95% CI 9.5-11.9). Results were similar for COVID-19 ICU admissions and deaths. Interpretation Immunocompromised individuals continue to be impacted disproportionately by COVID-19 and have an urgent need for additional preventive measures beyond current vaccination programmes. These data can help determine the immunocompromised groups for which targeted prevention strategies may have the highest impact. Funding This study was funded by AstraZeneca UK.
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Affiliation(s)
- Rachael A. Evans
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Sabada Dube
- AstraZeneca UK Limited, BioPharmaceuticals Medical, Vaccines & Immunotherapies, Eastbrook House, First Floor, Shaftesbury Road, Cambridge, CB2 8DU, United Kingdom
| | - Yi Lu
- Evidera, The Ark, 201 Talgarth Road, London W6 8BJ, United Kingdom
| | - Mark Yates
- Data Analytics - Real World Evidence, Evidera, London, United Kingdom
| | - Sofie Arnetorp
- Vaccines and Immune Therapies, Global Market Access and Pricing, AstraZeneca R&D, 431 83 Mölndal, Sweden
| | - Eleanor Barnes
- Nuffield Department of Medicine, University of Oxford, OUH Hospital NHS Trust, Oxford, United Kingdom
| | - Samira Bell
- Population Health and Genomics, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Lucy Carty
- Medical and Payer Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
| | | | - Sophie Graham
- Evidera, The Ark, 201 Talgarth Road, London W6 8BJ, United Kingdom
| | - Nahila Justo
- Integrated Solutions – Real World Evidence, Evidera, Stockholm, Sweden
| | - Paul Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
- University Hospitals Birmingham, NHS Foundation Trust, Birmingham, United Kingdom
| | - Sudhir Venkatesan
- Medical and Payer Evidence, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
| | | | - Catia Ferreira
- AstraZeneca LP, 1800 Concord Pike, Wilmington, DE, 19850-5437, USA
| | - Richard McNulty
- Medical Affairs, AstraZeneca UK Limited, BioPharmaceuticals Medical, Vaccines & Immunotherapies, Eastbrook House, First Floor, Shaftesbury Road, Cambridge, CB2 8DU, United Kingdom
| | - Sylvia Taylor
- Medical Evidence, AstraZeneca UK Limited, BioPharmaceuticals Medical, Vaccines & Immunotherapies, Eastbrook House, First Floor, Shaftesbury Road, Cambridge, CB2 8DU, United Kingdom
| | - Jennifer K. Quint
- National Heart & Lung Institute, Imperial College London, United Kingdom
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Maaroufi I, Jamsransuren D, Hashida K, Matsuda S, Ogawa H, Takeda Y. An Abies Extract Containing Nonvolatile Polyphenols Shows Virucidal Activity against SARS-CoV-2 That Is Enhanced in Increased pH Conditions. Pathogens 2023; 12:1093. [PMID: 37764901 PMCID: PMC10534523 DOI: 10.3390/pathogens12091093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
Researching the beneficial health properties of wood byproducts can prevent wastage by turning them into valuable resources. In this study, the virucidal activity of two extracts from Abies sachalinensis byproducts, ASE1, and ASE2, against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was investigated. ASE1 is rich in monoterpenoid volatile compounds, whereas ASE2 contains nonvolatile polyphenols. SARS-CoV-2 solutions were mixed with ASE1 or ASE2, and viral titer reduction was evaluated. At their original acidic pH, ASE2 showed stronger virucidal activity than ASE1. The virucidal activity of ASE2 was also significantly enhanced when pH was increased to neutral or basic, which was not the case for ASE1. At a neutral pH, ASE2 induced statistically significant viral titer reduction in 1 min. HCl and NaOH solutions, which had a pH close to that of acidic and basic ASE2 test mixtures, respectively, exhibited no virucidal activity against SARS-CoV-2. Among the SARS-CoV-2 variants, Omicron showed the highest vulnerability to ASE2. Western blotting, RT-PCR, and electron microscopic analysis revealed that neutral ASE2 interacts with SARS-CoV-2 spike proteins and moderately disrupts the SARS-CoV-2 genome and viral envelope. These findings reveal the virucidal potential of ASE2.
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Affiliation(s)
- Imane Maaroufi
- Graduate School of Animal and Veterinary Sciences and Agriculture, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan;
| | - Dulamjav Jamsransuren
- Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan; (D.J.); (S.M.)
| | - Koh Hashida
- Department of Forest Resources Chemistry, Forestry and Forest Products Research Institute, Tsukuba 305-8687, Japan;
| | - Sachiko Matsuda
- Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan; (D.J.); (S.M.)
| | - Haruko Ogawa
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan;
| | - Yohei Takeda
- Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan; (D.J.); (S.M.)
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan;
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10
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Majoor K, Vorselaars AD. Home monitoring of coronavirus disease 2019 patients in different phases of disease. Curr Opin Pulm Med 2023; 29:293-301. [PMID: 37158218 PMCID: PMC10241420 DOI: 10.1097/mcp.0000000000000964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE OF REVIEW Various home monitoring programs have emerged through the COVID-19 pandemic in different phases of COVID-19 disease. RECENT FINDINGS The prehospital monitoring of COVID-19-positive patients detects early deterioration. Hospital care at home provides early discharge with oxygen to empty hospital beds for other patients. Home monitoring during recovery can be used for rehabilitation and detection of potential relapses. General goals of home monitoring in COVID-19 are early detection of deterioration and prompt escalation of care such as emergency department presentation, medical advice, medication prescription and mental support. Due to the innovations of vaccination and treatment changes, such as dexamethasone and tocilizumab, the challenge for the healthcare system has shifted from large numbers of admitted COVID-19 patients to lower numbers of admitted patients with specific risk profiles (such as immunocompromised). This also changes the field of home monitoring in COVID-19. Efficacy and cost-effectiveness of home monitoring interventions depend on the costs of the intervention (use of devices, apps and medical staff) and the proposed patient group (depending on risk factors and disease severity). SUMMARY Patient satisfaction of COVID-19 home monitoring programs was mostly high. Home monitoring programs for COVID-19 should be ready to be re-escalated in case of a new global pandemic.
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Affiliation(s)
| | - Adriane D.M. Vorselaars
- Division of Heart and Lungs, University Medical Center Utrecht
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
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11
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Wu Y, Pan Y, Su K, Zhang Y, Jia Z, Yi J, Lv H, Zhang L, Xue M, Cao D, Jiang J. Elder and booster vaccination associates with decreased risk of serious clinical outcomes in comparison of Omicron and Delta variant: A meta-analysis of SARS-CoV-2 infection. Front Microbiol 2023; 14:1051104. [PMID: 37125157 PMCID: PMC10140352 DOI: 10.3389/fmicb.2023.1051104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Abstract
Background The COVID-19 pandemic brings great pressure to the public health systems. This meta-analysis aimed to compare the clinical outcomes among different virus variants, to clarify their impact on medical resources and to provide evidence for the formulation of epidemic prevention policies. Methods A systematic literature search was performed in the PubMed, Embase, and Cochrane Library databases using the key words "Omicron" and "Delta." The adjusted Risk ratios (RRs), Odds ratios (ORs) and Hazard ratios (HRs) were extracted, and RRs and Rate difference % (RD%) were used to interpret the risk estimates of the outcomes ultimately. Results Forty-three studies were included, with 3,812,681 and 14,926,841 individuals infected with SARS-CoV-2 Delta and Omicron variant, respectively. The relative risks of hospitalization, death, ICU admission, and mechanical ventilation use after infection with the Omicron variant were all significantly reduced compared those after infection with the Delta variant (RRhospitalization = 0.45, 95%CI: 0.40-0.52; RRdeath = 0.37, 95%CI: 0.30-0.45; RRICU = 0.35, 95%CI: 0.29-0.42; RRmechanical ventilation = 0.33, 95%CI: 0.25-0.44). The change of both absolute and relative risks for hospitalization was more evident (RR = 0.47, 95%CI: 0.42-0.53;RD% =10.61, 95%CI: 8.64-12.59) and a significant increase was observed for the absolute differences in death in the elderly (RD% = 5.60, 95CI%: 4.65-6.55); the change of the absolute differences in the risk of hospitalization and death were most markedly observed in the patients with booster vaccination (RD%hospitalization = 8.60, 95CI%: 5.95-11.24; RD%death = 3.70, 95CI%: 0.34-7.06). Conclusion The ability of the Omicron variant to cause severe clinical events has decreased significantly, as compared with the Delta variant, but vulnerable populations still need to be vigilant. There was no interaction between the vaccination doses and different variants.
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Affiliation(s)
- Yanhua Wu
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yuchen Pan
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Kaisheng Su
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yangyu Zhang
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Zhifang Jia
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Jiaxin Yi
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Haiyong Lv
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Lihuan Zhang
- The Second Hospital of Jilin University, Changchun, China
| | - Mingyang Xue
- School of Public Health, Jilin University, Changchun, China
| | - Donghui Cao
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Jing Jiang
- Center of Infectious Diseases and Pathogen Biology, The First Hospital of Jilin University, Changchun, China
- Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
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12
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Gattinger P, Ohradanova-Repic A, Valenta R. Importance, Applications and Features of Assays Measuring SARS-CoV-2 Neutralizing Antibodies. Int J Mol Sci 2023; 24:ijms24065352. [PMID: 36982424 PMCID: PMC10048970 DOI: 10.3390/ijms24065352] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 03/17/2023] Open
Abstract
More than three years ago, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused the unforeseen COVID-19 pandemic with millions of deaths. In the meantime, SARS-CoV-2 has become endemic and is now part of the repertoire of viruses causing seasonal severe respiratory infections. Due to several factors, among them the development of SARS-CoV-2 immunity through natural infection, vaccination and the current dominance of seemingly less pathogenic strains belonging to the omicron lineage, the COVID-19 situation has stabilized. However, several challenges remain and the possible new occurrence of highly pathogenic variants remains a threat. Here we review the development, features and importance of assays measuring SARS-CoV-2 neutralizing antibodies (NAbs). In particular we focus on in vitro infection assays and molecular interaction assays studying the binding of the receptor binding domain (RBD) with its cognate cellular receptor ACE2. These assays, but not the measurement of SARS-CoV-2-specific antibodies per se, can inform us of whether antibodies produced by convalescent or vaccinated subjects may protect against the infection and thus have the potential to predict the risk of becoming newly infected. This information is extremely important given the fact that a considerable number of subjects, in particular vulnerable persons, respond poorly to the vaccination with the production of neutralizing antibodies. Furthermore, these assays allow to determine and evaluate the virus-neutralizing capacity of antibodies induced by vaccines and administration of plasma-, immunoglobulin preparations, monoclonal antibodies, ACE2 variants or synthetic compounds to be used for therapy of COVID-19 and assist in the preclinical evaluation of vaccines. Both types of assays can be relatively quickly adapted to newly emerging virus variants to inform us about the magnitude of cross-neutralization, which may even allow us to estimate the risk of becoming infected by newly appearing virus variants. Given the paramount importance of the infection and interaction assays we discuss their specific features, possible advantages and disadvantages, technical aspects and not yet fully resolved issues, such as cut-off levels predicting the degree of in vivo protection.
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Affiliation(s)
- Pia Gattinger
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Anna Ohradanova-Repic
- Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
- Karl Landsteiner University, 3500 Krems an der Donau, Austria
- Laboratory for Immunopathology, Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, 119435 Moscow, Russia
- NRC Institute of Immunology FMBA of Russia, 115478 Moscow, Russia
- Correspondence:
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