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Deshmukh R, Harwansh RK, Garg A, Mishra S, Agrawal R, Jangde R. COVID-19: Recent Insight in Genomic Feature, Pathogenesis, Immunological Biomarkers, Treatment Options and Clinical Updates on SARS-CoV-2. Curr Genomics 2024; 25:69-87. [PMID: 38751601 PMCID: PMC11092912 DOI: 10.2174/0113892029291098240129113500] [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: 12/04/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 05/18/2024] Open
Abstract
SARS-CoV-2 is a highly contagious and transmissible viral infection that first emerged in 2019 and since then has sparked an epidemic of severe respiratory problems identified as "coronavirus disease 2019" (COVID-19) that causes a hazard to human life and safety. The virus developed mainly from bats. The current epidemic has presented a significant warning to life across the world by showing mutation. There are different tests available for testing Coronavirus, and RT-PCR is the best, giving more accurate results, but it is also time-consuming. There are different options available for treating n-CoV-19, which include medications such as Remdesivir, corticosteroids, plasma therapy, Dexamethasone therapy, etc. The development of vaccines such as BNT126b2, ChAdOX1, mRNA-1273 and BBIBP-CorV has provided great relief in dealing with the virus as they decreased the mortality rate. BNT126b2 and ChAdOX1 are two n-CoV vaccines found to be most effective in controlling the spread of infection. In the future, nanotechnology-based vaccines and immune engineering techniques can be helpful for further research on Coronavirus and treatment of this deadly virus. The existing knowledge about the existence of SARS-CoV-2, along with its variants, is summarized in this review. This review, based on recently published findings, presents the core genetics of COVID-19, including heritable characteristics, pathogenesis, immunological biomarkers, treatment options and clinical updates on the virus, along with patents.
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Affiliation(s)
- Rohitas Deshmukh
- Department of Pharmaceutics, Institute of Pharmaceutical Research, GLA University, Mathura, 281406, Uttar Pradesh, India
| | - Ranjit Kumar Harwansh
- Department of Pharmaceutics, Institute of Pharmaceutical Research, GLA University, Mathura, 281406, Uttar Pradesh, India
| | - Akash Garg
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura, Delhi Road, Chhatikara, 281001, Uttar Pradesh, India
| | - Sakshi Mishra
- Department of Pharmaceutics, Institute of Pharmaceutical Research, GLA University, Mathura, 281406, Uttar Pradesh, India
| | - Rutvi Agrawal
- Department of Pharmaceutics, Rajiv Academy for Pharmacy, NH-2, Mathura, Delhi Road, Chhatikara, 281001, Uttar Pradesh, India
| | - Rajendra Jangde
- Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh, 492010, India
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Al Sulaiman K, Korayem GB, Aljuhani O, Altebainawi AF, Shawaqfeh MS, Alarfaj SJ, Alharbi RA, Ageeli MM, Alissa A, Vishwakarma R, Ibrahim A, Alenazi AA, Alghnam S, Alshehri N, Alshammari MM, Alhubaishi A, Aldhaeefi M, Alamri FF, Syed Y, Khan R, Alalawi M, Alanazi KA, Alresayes FS, Albarqi KJ, Al Ghamdi G. Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19-A multicenter cohort study. Front Med (Lausanne) 2023; 10:1237903. [PMID: 37692775 PMCID: PMC10484515 DOI: 10.3389/fmed.2023.1237903] [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] [Accepted: 07/27/2023] [Indexed: 09/12/2023] Open
Abstract
Background Despite insufficient evidence, vitamin D has been used as adjunctive therapy in critically ill patients with COVID-19. This study evaluates the effectiveness and safety of vitamin D as an adjunctive therapy in critically ill COVID-19 patients. Methods A multicenter retrospective cohort study that included all adult COVID-19 patients admitted to the intensive care units (ICUs) between March 2020 and July 2021. Patients were categorized into two groups based on their vitamin D use throughout their ICU stay (control vs. vitamin D). The primary endpoint was in-hospital mortality. Secondary outcomes were the length of stay (LOS), mechanical ventilation (MV) duration, and ICU-acquired complications. Propensity score (PS) matching (1:1) was used based on the predefined criteria. Multivariable logistic, Cox proportional hazards, and negative binomial regression analyses were employed as appropriate. Results A total of 1,435 patients were included in the study. Vitamin D was initiated in 177 patients (12.3%), whereas 1,258 patients did not receive it. A total of 288 patients were matched (1:1) using PS. The in-hospital mortality showed no difference between patients who received vitamin D and the control group (HR 1.22, 95% CI 0.87-1.71; p = 0.26). However, MV duration and ICU LOS were longer in the vitamin D group (beta coefficient 0.24 (95% CI 0.00-0.47), p = 0.05 and beta coefficient 0.16 (95% CI -0.01 to 0.33), p = 0.07, respectively). As an exploratory outcome, patients who received vitamin D were more likely to develop major bleeding than those who did not [OR 3.48 (95% CI 1.10, 10.94), p = 0.03]. Conclusion The use of vitamin D as adjunctive therapy in COVID-19 critically ill patients was not associated with survival benefits but was linked with longer MV duration, ICU LOS, and higher odds of major bleeding.
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Affiliation(s)
- Khalid Al Sulaiman
- Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Population Health Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia
| | - Ghazwa B. Korayem
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali F. Altebainawi
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi Arabia
| | - Mohammad S. Shawaqfeh
- Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sumaiah J. Alarfaj
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reham A. Alharbi
- Department of Pharmacy, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mawaddah M. Ageeli
- Department of Pharmacy, Prince Faisal Bin Khalid Cardiac Center PFKCC, Ministry of Health, Abha, Saudi Arabia
| | - Abdulrahman Alissa
- Pharmaceutical Care Services, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Ramesh Vishwakarma
- Department of Statistics, European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - Alnada Ibrahim
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abeer A. Alenazi
- Department of Pharmaceutical Care, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- Population Health Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nadiyah Alshehri
- Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Maqbulah M. Alshammari
- Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi Arabia
| | - Alaa Alhubaishi
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohammed Aldhaeefi
- Department of Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, DC, United States
| | - Faisal F. Alamri
- Department of Basic Sciences, College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Yadullah Syed
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Raymond Khan
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mai Alalawi
- Department of Pharmaceutical Care, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Khalaf A. Alanazi
- Department of Respiratory, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Faisal S. Alresayes
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid J. Albarqi
- College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ghassan Al Ghamdi
- Department of Intensive Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Abebe EC, Dejenie TA. Protective roles and protective mechanisms of neutralizing antibodies against SARS-CoV-2 infection and their potential clinical implications. Front Immunol 2023; 14:1055457. [PMID: 36742320 PMCID: PMC9892939 DOI: 10.3389/fimmu.2023.1055457] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/03/2023] [Indexed: 01/20/2023] Open
Abstract
Neutralizing antibodies (NAbs) are central players in the humoral immunity that defends the body from SARS-CoV-2 infection by blocking viral entry into host cells and neutralizing their biological effects. Even though NAbs primarily work by neutralizing viral antigens, on some occasions, they may also combat the SARS-CoV-2 virus escaping neutralization by employing several effector mechanisms in collaboration with immune cells like natural killer (NK) cells and phagocytes. Besides their prophylactic and therapeutic roles, antibodies can be used for COVID-19 diagnosis, severity evaluation, and prognosis assessment in clinical practice. Furthermore, the measurement of NAbs could have key implications in determining individual or herd immunity against SARS-CoV-2, vaccine effectiveness, and duration of the humoral protective response, as well as aiding in the selection of suitable individuals who can donate convalescent plasma to treat infected people. Despite all these clinical applications of NAbs, using them in clinical settings can present some challenges. This review discusses the protective functions, possible protective mechanisms against SARS-CoV-2, and potential clinical applications of NAbs in COVID-19. This article also highlights the possible challenges and solutions associated with COVID-19 antibody-based prophylaxis, therapy, and vaccination.
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Affiliation(s)
- Endeshaw Chekol Abebe
- Department of Medical Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zheng X, Duan RH, Gong F, Wei X, Dong Y, Chen R, yue Liang M, Tang C, Lu L. Accuracy of serological tests for COVID-19: A systematic review and meta-analysis. Front Public Health 2022; 10:923525. [PMID: 36589993 PMCID: PMC9800917 DOI: 10.3389/fpubh.2022.923525] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To determine the diagnostic accuracy of serological tests for coronavirus disease-2019 (COVID-19). Methods PubMed, Embase and the Cochrane Library were searched from January 1 2020 to September 2 2022. We included studies that measured the sensitivity, specificity or both qualities of a COVID-19 serological test and a reference standard of a viral culture or reverse transcriptase polymerase chain reaction (RT-PCR). The risk of bias was assessed by using quality assessment of diagnostic accuracy studies 2 (QUADAS-2). The primary outcomes included overall sensitivity and specificity, as stratified by the methods of serological testing [enzyme-linked immunosorbent assays (ELISAs), lateral flow immunoassays (LFIAs) or chemiluminescent immunoassays (CLIAs)] and immunoglobulin classes (IgG, IgM, or both). Secondary outcomes were stratum-specific sensitivity and specificity within the subgroups, as defined by study or participant characteristics, which included the time from the onset of symptoms, testing via commercial kits or an in-house assay, antigen target, clinical setting, serological kit as the index test and the type of specimen for the RT-PCR reference test. Results Eight thousand seven hundred and eighty-five references were identified and 169 studies included. Overall, we judged the risk of bias to be high in 47.9 % (81/169) of the studies, and a low risk of applicability concerns was found in 100% (169/169) of the studies. For each method of testing, the pooled sensitivity of the ELISAs ranged from 81 to 82%, with sensitivities ranging from 69 to 70% for the LFIAs and 77% to 79% for the CLIAs. Among the evaluated tests, IgG (80-81%)-based tests exhibited better sensitivities than IgM-based tests (66-68%). IgG/IgM-based CLIA had the highest sensitivity [87% (86-88%)]. All of the tests displayed high specificity (97-98%). Heterogeneity was observed in all of the analyses. The detection of nucleocapsid protein (77-80%) as the antigen target was found to offer higher sensitivity results than surface protein detection (66-68%). Sensitivity was higher in the in-house assays (78-79%) than in the commercial kits (47-48%). Conclusion Among the evaluated tests, ELISA and CLIA tests performed better in terms of sensitivity than did the LFIA. IgG-based tests had higher sensitivity than IgM-based tests, and combined IgG/IgM test-based CLIA tests had the best overall diagnostic test accuracy. The type of sample, serological kit and timing of use of the specific tests were associated with the diagnostic accuracy. Due to the limitations of the serological tests, other techniques should be quickly approved to provide guidance for the correct diagnosis of COVID-19.
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Affiliation(s)
- Xiaoyan Zheng
- School of Rehabilitation Sciences, Southern Medical University, Guangzhou, China
| | - Rui hua Duan
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fen Gong
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaojing Wei
- Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yu Dong
- Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rouhao Chen
- Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming yue Liang
- Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunzhi Tang
- Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China,*Correspondence: Chunzhi Tang
| | - Liming Lu
- Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China,Liming Lu
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Bao WJ, Fu SK, Zhang H, Zhao JL, Jin HM, Yang XH. Clinical characteristics and short-term mortality of 102 hospitalized hemodialysis patients infected with SARS-CoV-2 omicron BA.2.2.1 variant in Shanghai, China. New Microbes New Infect 2022; 49:101058. [PMCID: PMC9691279 DOI: 10.1016/j.nmni.2022.101058] [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: 08/29/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
Background The aim of this study was to analyze clinical features and short-term mortality in hemodialysis (HD) patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) omicron BA.2.2.1 variant. Methods In a retrospective single-center case series, 102 consecutive hospitalized HD patients infected with the coronavirus omicron variant were assessed at Pudong Hospital in Shanghai, China, from April 6 to April 18, 2022; the final date of follow-up was May 16, 2022. Clinical, laboratory, chest CT, and treatment data were collected and analyzed. The association between these factors and all-cause mortality was studied using univariate and multivariate analyses. The relationship between lymphocyte count and short-term mortality was based on receiver operating characteristic (ROC) curve analysis. Kaplan–Meier analysis was used to assess overall survival. Results In total, 102 patients were included in this study. The patients were divided into two groups: HD patients with pneumonia (N = 46) and without pneumonia (N = 56). Of the 102 patients, 12 (11.8%) died. Multivariate regression analysis revealed that all-cause mortality was correlated with lymphocyte counts and type B natriuretic peptide (BNP), C-reactive protein (CRP), and D-dimer levels (P < 0.05). The cut-off value of lymphocyte counts was 0.61 × 109/L for all-cause mortality. The overall survival rate was significantly different between HD patients with and without pneumonia (P < 0.05). Conclusions Lymphocyte counts are important for the prediction of short-term mortality in HD patients with SARS-CoV-2 infection. HD patients with lung involvement have poorer survival rates than those without lung involvement.
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Affiliation(s)
- Wen Jing Bao
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong New District, 2800 Gong Wei Road, Shanghai, China
| | - Shun Kun Fu
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong New District, 2800 Gong Wei Road, Shanghai, China
| | - Hua Zhang
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong New District, 2800 Gong Wei Road, Shanghai, China
| | - Jun Li Zhao
- Division of Nephrology, Zhoupu Hospital, Shanghai University, Pudong New District, 1500 Zhouyuan Road, Shanghai, China
- Corresponding author.
| | - Hui Min Jin
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong New District, 2800 Gong Wei Road, Shanghai, China
- Corresponding author.
| | - Xiu Hong Yang
- Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong New District, 2800 Gong Wei Road, Shanghai, China
- Corresponding author.
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Niaee MS, Zolghadr L, Hosseinkhani Z, Namdar P, Allami A, Amini F, Varnaseri M, Pourdast A, Gheibi N. Ivermectin-Induced Clinical Improvement and Alleviation of Significant Symptoms of COVID-19 Outpatients: A Cross-Sectional Study. IRANIAN JOURNAL OF SCIENCE AND TECHNOLOGY, TRANSACTIONS A: SCIENCE 2022; 46:1369-1375. [PMID: 36187299 PMCID: PMC9510226 DOI: 10.1007/s40995-022-01349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/20/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Leila Zolghadr
- Department of Chemistry, Imam Khomeini International University, Qazvin, Iran
| | - Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Peyman Namdar
- Department of Surgery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Abbas Allami
- Department of Infectious Diseases, Clinical Research Development Unit, Bou Ali Sina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Amini
- Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehran Varnaseri
- Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Allieh Pourdast
- Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Nematollah Gheibi
- Cellular and Molecular Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Mohamed Y, El-Maradny YA, Saleh AK, Nayl AA, El-Gendi H, El-Fakharany EM. A comprehensive insight into current control of COVID-19: Immunogenicity, vaccination, and treatment. Biomed Pharmacother 2022; 153:113499. [PMID: 36076589 PMCID: PMC9343749 DOI: 10.1016/j.biopha.2022.113499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 02/07/2023] Open
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Tolossa T, Wakuma B, Ayala D, Seyoum D, Fetensa G, Getahun A, Mulisa D, Atomssa EM, Tsegaye R, Shibiru T, Turi E, Bayisa L, Fekadu G, Bekele B, Feyisa I. Incidence and predictors of death from COVID-19 among patients admitted to treatment center of Wollega University Referral Hospital, Western Ethiopia: A retrospective cohort study. PLoS One 2022; 17:e0267827. [PMID: 35895703 PMCID: PMC9328505 DOI: 10.1371/journal.pone.0267827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 04/14/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Currently, COVID-19 contributes to mortality and morbidity in developed as well as in developing countries since December 2019. However, there is scarcity of evidence regarding the incidence and predictors of death among patients admitted with COVID-19 in developing country including Ethiopia, where the numbers of deaths are under-reported. Hence, this study aimed to assess the incidence and predictors of death among patients admitted with COVID-19 in Wollega University Referral Hospital (WURH), western Ethiopia. Methods An institution based retrospective cohort study design was conducted among 318 patients admitted with COVID-19 in WURH treatment center. Patients who were tested positive for COVID-19 by using rRT-PCR test and admitted with the diagnosis of severe COVID-19 cases from September 30, 2020 to June 10, 2021 were a source population. Epidata version 3.2 was used for data entry, and STATA version 14 for analysis. A Cox proportional hazard regression analysis was used to determine factors associated with mortality from COVID-19. Multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of mortality from COVID-19 at p-value < 0.05. Results A total of 318 patients were included in final analysis with mean age of 44 (SD±16.7) years and about two third (67.9%) were males. More than half (55.7%) of patients had no comorbidity on admission. The majority, 259 (81.45%) of patients recovered from COVID-19 and 267 (84%) of patients were censored at the end of follow up. The incidence rate of mortality was 14.1 per/1000 (95%CI: 10.7, 18.5) person days observation. Age ≥ 59 years (AHR: 5.76, 95%CI: 2.58, 12.84), low oxygen saturation (AHR: 2.34, 95% CI: (2.34, 4.17), and delayed presentation (AHR: 5.60, 95%CI: 2.97, 10.56) were independent predictors of mortality among COVID-19 patients. Conclusion The mortality rate of COVID-19 pandemic was high in the study area, and most of death was happened during the first 10 days. Being old age, low oxygen saturation and delayed presentation were factors which predict mortality due to COVID-19. Hence, strengthening the health care delivery system to satisfy the need of the patients should get due attention to reduce the incidence of mortality from COVID-19 cases.
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Affiliation(s)
- Tadesse Tolossa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- * E-mail:
| | - Bizuneh Wakuma
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Diriba Ayala
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Dejene Seyoum
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- Department of Health Behavior and Society, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Ayantu Getahun
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Diriba Mulisa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Emiru Merdassa Atomssa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Reta Tsegaye
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- Department of Pediatrics, School of Medicine, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Lami Bayisa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte Ethiopia
- Faculty of Medicine, School of Pharmacy, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Balay Bekele
- Wollega University Referral Hospital, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ilili Feyisa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Gupta SD, Nandy M, Song DG, Pan CH. Present therapeutic and diagnostic approaches for SARS-CoV-2 infection. COMPUTATIONAL APPROACHES FOR NOVEL THERAPEUTIC AND DIAGNOSTIC DESIGNING TO MITIGATE SARS-COV-2 INFECTION 2022. [PMCID: PMC9300475 DOI: 10.1016/b978-0-323-91172-6.00025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The novel Coronavirus (nCoV), severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2), has shaken the whole world and posed significant challenges to the global healthcare system for more than a year. The scientific community across the globe is trying to combat this virus by developing a safe vaccine that can provide long-term immunity against the virus. The other means of overcoming its pathogenicity is to treat the infected people with available drugs and/or novel therapeutic strategies. The available drugs were previously designed to combat viral infections and come with tested safety. This appears to be the most practical approach as a quick response to the highly infectious pandemic with high morbidity and mortality. Although many repurposed drugs like favipiravir and hydroxychloroquine have been tried, they have been proven toxic and/or less efficacious. This has led the world to find urgent therapeutic interventions (traditional and novel), to help decrease the severity of COVID-19 infection and aim towards recovery. This chapter of the book will discuss the most up-to-date published data with respect to prevention and treatment of COVID-19 infection. Diagnosis also plays an important part in controlling the pandemic caused by the virus. A cheap, accurate and fast identification test for the virus is the need of the hour. This chapter will also throw light on the various diagnostic procedures available for the identification of SARS-CoV-2, till date, along with their advantages and disadvantages.
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Gupta T, Kannan S, Kalra B, Thakkar P. Systematic review and meta-analysis of randomised controlled trials testing the safety and efficacy of convalescent plasma in the treatment of coronavirus disease 2019 (COVID-19): Evidence-base for practise and implications for research. Transfus Med 2021; 31:409-420. [PMID: 34189780 PMCID: PMC8447151 DOI: 10.1111/tme.12803] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Despite scientific advances, there is no effective medical therapy for coronavirus disease 2019 (COVID-19). This systematic review and meta-analysis aimed to evaluate the safety and efficacy of convalescent plasma therapy in COVID-19. METHODS This review was carried out in accordance with Cochrane methodology including risk of bias assessment and grading of the quality of evidence. Only prospective clinical trials randomly assigning COVID-19 patients to convalescent plasma plus standard of care therapy (test arm) versus placebo/standard of care (control arm) were included. Two reviewers independently read each preprint/publication and extracted relevant data from individual studies. Data were pooled using the random-effects model and expressed as risk ratio (RR) with 95% confidence interval (CI). RESULTS A total of 13 206 patients from 12 randomised controlled trials were included. There was no significant difference in clinical improvement rate (RR = 1.00, 95% CI: 0.98-1.02, p = 0.96) or time to clinical improvement (median difference of 1.08 days with 95% CI ranging from -0.15 to +2.30 days) between convalescent plasma versus placebo/standard of care therapy. The use of convalescent plasma was not associated with significantly reduced risk of death (RR = 0.81, 95% CI: 0.65-1.02, p = 0.08). Reassuringly, overall incidence of infusion-related serious adverse events was low (3.25%) and not significantly different (RR = 1.14, 95% CI: 0.93-1.40, p = 0.22) for convalescent plasma transfusion compared to placebo/standard of care therapy. CONCLUSIONS There is low to moderate certainty evidence that the addition of convalescent plasma to current standard of care therapy is generally safe but, does not result in any significant clinical benefit or reduction of mortality in COVID-19.
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Affiliation(s)
- Tejpal Gupta
- Department of Radiation OncologyClinical Research Centre, Advanced Centre for Treatment Research & Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute (HBNI)Navi MumbaiIndia
| | - Sadhana Kannan
- Clinical Research SecretariatClinical Research Centre, Advanced Centre for Treatment Research & Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute (HBNI)Navi MumbaiIndia
| | - Babusha Kalra
- Department of Radiation OncologyClinical Research Centre, Advanced Centre for Treatment Research & Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute (HBNI)Navi MumbaiIndia
| | - Prafulla Thakkar
- Division of Internal MedicineClinical Research Centre, Advanced Centre for Treatment Research & Education in Cancer (ACTREC), Tata Memorial Centre, Homi Bhabha National Institute (HBNI)Navi MumbaiIndia
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11
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Skorek A, Jaźwińska-Curyłło A, Romanowicz A, Kwaśniewski K, Narożny W, Tretiakow D. Assessment of anti-SARS-CoV-2 antibodies level in convalescents plasma. J Med Virol 2021; 94:1130-1137. [PMID: 34738646 PMCID: PMC8661642 DOI: 10.1002/jmv.27433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/18/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022]
Abstract
Despite extensive vaccination, the quantity of patients infected with the SARS-CoV-2 virus and its variants continues to grow worldwide. Treating patients with a severe course of COVID-19 is a difficult challenge. One of the generally accepted and specific therapy methods is the use of plasma rich in anti-SARS-CoV-2 antibodies. On the other hand, assessing the antibodies level depending on the time after infection allows for vaccine-decision. The study marked the level of anti-SARS-CoV-2 IgG antibodies in 351 COVID-19 convalescent residents of one geographical region in Poland. The study group included blood donors. The studies were cross-sectional and extended to a questionnaire to determine infection severity. These data were compiled statistically. The study considered epidemiological factors, the time from the end of the infection, and infection severity. The fastest increase of the antibodies level was observed up to 59 days after COVID-19, and it was statistically significantly higher among men. Higher levels of antibodies were found among people above the average age in both men and women. There was an increase in the level of antibodies since the onset of the disease in men, while in women, it decreased. The antibodies level was also found to depend on the severity of the course of COVID-19 infection. The optimal group of plasma donors in the studied geographical region is men and women above 39 years old. after a more severe infection. The titer of antibodies increases with time from the disease.
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Affiliation(s)
- Andrzej Skorek
- Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Aleksandra Romanowicz
- Student Scientific Club at the Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Kwaśniewski
- Vascular Surgery and Angiology Department, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Waldemar Narożny
- Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland
| | - Dmitry Tretiakow
- Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland
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12
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Abstract
As the coronavirus disease (COVID-19) pandemic led to a global health crisis, there were limited treatment options and no prophylactic therapies for those exposed to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Convalescent plasma is quick to implement, potentially provides benefits, and has a good safety profile. The therapeutic potential of COVID-19 convalescent plasma (CCP) is likely mediated by antibodies through direct viral neutralization and Fc-dependent functions such as a phagocytosis, complement activation, and antibody-dependent cellular cytotoxicity. In the United States, CCP became one of the most common treatments with over half million units transfused despite limited efficacy data. More than a dozen randomized trials now demonstrate that CCP does not provide benefit for those with moderate to severe disease. However, similar to other passive antibody therapies, CCP is beneficial for early disease, when provided to elderly outpatients within 72 hours after symptom onset. Only high-titer CCP should be transfused. CCP should also be considered for immunosuppressed COVID-19 patients. CCP collected in proximity, by time and location, to the patient may be more beneficial due to SARS-CoV-2 variants. Additional randomized trial data are still accruing and should be incorporated with other trial data to optimize CCP indications.
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13
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Salimi-Jeda A, Abbassi S, Mousavizadeh A, Esghaie M, Bokharaei-Salim F, Jeddi F, Shafaati M, Abdoli A. SARS-CoV-2: Current trends in emerging variants, pathogenesis, immune responses, potential therapeutic, and vaccine development strategies. Int Immunopharmacol 2021; 101:108232. [PMID: 34673335 PMCID: PMC8519814 DOI: 10.1016/j.intimp.2021.108232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/18/2021] [Accepted: 10/04/2021] [Indexed: 02/06/2023]
Abstract
More than a year after the SARS-CoV-2 pandemic, the Coronavirus disease 19 (COVID-19) is still a major global challenge for scientists to understand the different dimensions of infection and find ways to prevent, treat, and develop a vaccine. On January 30, 2020, the world health organization (WHO) officially announced this new virus as an international health emergency. While many biological and mechanisms of pathogenicity of this virus are still unclear, it seems that cytokine storm resulting from an immune response against the virus is considered the main culprit of the severity of the disease. Despite many global efforts to control the SARS-CoV-2, several problems and challenges have been posed in controlling the COVID-19 infection. These problems include the various mutations, the emergence of variants with high transmissibility, the short period of immunity against the virus, the possibility of reinfection in people improved, lack of specific drugs, and problems in the development of highly sensitive and specific vaccines. In this review, we summarized the results of the current trend and the latest research studies on the characteristics of the structure and genome of the SARS-CoV- 2, new mutations and variants of SARS-CoV-2, pathogenicity, immune response, virus diagnostic tests, potential treatment, and vaccine candidate.
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Affiliation(s)
- Ali Salimi-Jeda
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Sina Abbassi
- Department of Anesthesiology, Faculty of Medical Science, Tehran University of Medical Science, Tehran, Iran
| | - Atieh Mousavizadeh
- Department of Virology, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Maryam Esghaie
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farah Bokharaei-Salim
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Jeddi
- Department of Medical Genetics and Pathology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Maryam Shafaati
- Department of Microbiology, Jahrom Branch, Islamic Azad University, Fars, Iran
| | - Asghar Abdoli
- Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran.
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14
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Longueira Y, Polo ML, Turk G, Laufer N. Dynamics of SARS-CoV-2-specific antibodies among COVID19 biobank donors in Argentina. Heliyon 2021; 7:e08140. [PMID: 34642643 PMCID: PMC8494997 DOI: 10.1016/j.heliyon.2021.e08140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/24/2021] [Accepted: 10/04/2021] [Indexed: 02/08/2023] Open
Abstract
Biobanks are instrumental for accelerating research. Early in SARS-CoV-2 pandemic, the Argentinean Biobank of Infectious Diseases (BBEI) initiated the COVID19 collection and started its characterization. Blood samples from subjects with confirmed SARS-CoV-2 infection either admitted to health institutions or outpatients, were enrolled. Highly exposed seronegative individuals, were also enrolled. Longitudinal samples were obtained in a subset of donors, including persons who donated plasma for therapeutic purposes (plasma donors). SARS-CoV-2-specific IgM and IgG levels, IgG titers and IgG viral neutralization capacity were determined. Out of 825 donors, 57.1% were females and median age was 41 years (IQR 32-53 years). Donors were segregated as acute or convalescent donors, and mild versus moderate/severe disease donors. Seventy-eight percent showed seroconversion to SARS-CoV-2 specific antibodies. Specific IgM and IgG showed comparable positivity rates in acute donors. IgM detectability rate declined in convalescent donors while IgG detectability remained elevated in early (74,8%) and late (83%) convalescent donors. Among donors with follow-up samples, IgG levels seemed to decline more rapidly in plasma donors. IgG levels were higher with age, disease severity, number of symptoms, and more durable in moderate/severe disease donors. Levels and titers of anti-spike/RBD IgG strongly correlated with neutralization activity against WT virus. The BBEI-COVID19 collection serves a dual role in this SARS-CoV-2 global crisis. First, it feeds researchers and developers transferring samples and data to fuel research projects. Second, it generates highly needed local data to understand and frame the regional dynamics of the infection.
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Affiliation(s)
- Yesica Longueira
- Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina
- CONICET – Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
| | - María Laura Polo
- Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina
- CONICET – Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
| | | | | | - Gabriela Turk
- CONICET – Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
| | - Natalia Laufer
- CONICET – Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Buenos Aires, Argentina
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15
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Parikh PM, Sood T, Agarwala V, Kate S. Has Convalescent Plasma Therapy Hesitancy Increased COVID-19 Mortality? South Asian J Cancer 2021; 10:42-45. [PMID: 34430518 PMCID: PMC8380149 DOI: 10.1055/s-0041-1733351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We bring to you our viewpoint and a snapshot of the journey of convalescent plasma therapy (CPT) in the management of ongoing coronavirus disease 2019 (COVID-19) pandemic. We also discuss how best to use the updated data on this important treatment option and maximize benefit for our patients, thereby saving lives, especially in resource constraint settings.
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Affiliation(s)
| | - T Sood
- Department of Medical Oncology, Manipal Hospital, Bengaluru, Karnataka, India
| | - V Agarwala
- Department of Medical Oncology, Narayana Superspeciality Hospital, Kolkata, West Bengal, India
| | - S Kate
- Department of Medical Oncology, HCG Manavata Cancer Center, Nashik, Maharashtra, India
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16
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Moubarak M, Kasozi KI, Hetta HF, Shaheen HM, Rauf A, Al-kuraishy HM, Qusti S, Alshammari EM, Ayikobua ET, Ssempijja F, Afodun AM, Kenganzi R, Usman IM, Ochieng JJ, Osuwat LO, Matama K, Al-Gareeb AI, Kairania E, Musenero M, Welburn SC, Batiha GES. The Rise of SARS-CoV-2 Variants and the Role of Convalescent Plasma Therapy for Management of Infections. Life (Basel) 2021; 11:734. [PMID: 34440478 PMCID: PMC8399171 DOI: 10.3390/life11080734] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023] Open
Abstract
Novel therapies for the treatment of COVID-19 are continuing to emerge as the SARS-Cov-2 pandemic progresses. PCR remains the standard benchmark for initial diagnosis of COVID-19 infection, while advances in immunological profiling are guiding clinical treatment. The SARS-Cov-2 virus has undergone multiple mutations since its emergence in 2019, resulting in changes in virulence that have impacted on disease severity globally. The emergence of more virulent variants of SARS-Cov-2 remains challenging for effective disease control during this pandemic. Major variants identified to date include B.1.1.7, B.1.351; P.1; B.1.617.2; B.1.427; P.2; P.3; B.1.525; and C.37. Globally, large unvaccinated populations increase the risk of more and more variants arising. With successive waves of COVID-19 emerging, strategies that mitigate against community transmission need to be implemented, including increased vaccination coverage. For treatment, convalescent plasma therapy, successfully deployed during recent Ebola outbreaks and for H1N1 influenza, can increase survival rates and improve host responses to viral challenge. Convalescent plasma is rich with cytokines (IL-1β, IL-2, IL-6, IL-17, and IL-8), CCL2, and TNFα, neutralizing antibodies, and clotting factors essential for the management of SARS-CoV-2 infection. Clinical trials can inform and guide treatment policy, leading to mainstream adoption of convalescent therapy. This review examines the limited number of clinical trials published, to date that have deployed this therapy and explores clinical trials in progress for the treatment of COVID-19.
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Affiliation(s)
- Mohamed Moubarak
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt; (M.M.); (H.M.S.)
| | - Keneth Iceland Kasozi
- Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
- School of Medicine, Kabale University, Kabale P.O. Box 317, Uganda
| | - Helal F. Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Hazem M. Shaheen
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt; (M.M.); (H.M.S.)
| | - Abdur Rauf
- Department of Chemistry, University of Swabi, Swabi 23561, Pakistan;
| | - Hayder M. Al-kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriyia University, P.O. Box 14022 Baghdad, Iraq;
| | - Safaa Qusti
- Biochemistry Department, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Eida M. Alshammari
- Department of Chemistry, College of Sciences, University of Ha’il, Ha’il 2440, Saudi Arabia;
| | - Emmanuel Tiyo Ayikobua
- School of Health Sciences, Soroti University, Soroti P.O. Box 211, Uganda; (E.T.A.); (L.O.O.)
| | - Fred Ssempijja
- Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda; (F.S.); (I.M.U.); (J.J.O.)
| | - Adam Moyosore Afodun
- Department of Anatomy and Cell Biology, Faculty of Health Sciences, Busitema University, Tororo P.O. Box 236, Uganda; (A.M.A.); (E.K.)
| | - Ritah Kenganzi
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Kampala International University Teaching Hospital, Bushenyi P.O. Box 71, Uganda;
| | - Ibe Michael Usman
- Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda; (F.S.); (I.M.U.); (J.J.O.)
| | - Juma John Ochieng
- Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda; (F.S.); (I.M.U.); (J.J.O.)
| | - Lawrence Obado Osuwat
- School of Health Sciences, Soroti University, Soroti P.O. Box 211, Uganda; (E.T.A.); (L.O.O.)
| | - Kevin Matama
- School of Pharmacy, Kampala International University, Western Campus, Bushenyi P.O. Box 71, Uganda;
| | - Ali I. Al-Gareeb
- Department of Pharmacology, Toxicology and Medicine, College of Medicine Al-Mustansiriya University, Baghdad P.O. Box 14022, Iraq;
| | - Emmanuel Kairania
- Department of Anatomy and Cell Biology, Faculty of Health Sciences, Busitema University, Tororo P.O. Box 236, Uganda; (A.M.A.); (E.K.)
| | - Monica Musenero
- Ministry of Science Technology and Innovations, Government of Uganda, Kampala P.O. Box 7466, Uganda;
| | - Susan Christina Welburn
- Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh EH8 9JZ, UK
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining 314400, China
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt; (M.M.); (H.M.S.)
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Curtò D, Tomatis F, Gastoldi S, Galbusera M, Noris M, Raimondi F, Lorini FL, Falanga A, Marchetti M, Remuzzi G, Ruggenenti P. Case Report: Effects of Anti-SARS-CoV-2 Convalescent Antibodies Obtained With Double Filtration Plasmapheresis. Front Immunol 2021; 12:711915. [PMID: 34276706 PMCID: PMC8278474 DOI: 10.3389/fimmu.2021.711915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
Passive antibody therapy has been used to treat outbreaks of viral disease, including the ongoing pandemic of severe respiratory acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) or COVID-19. However, the real benefits of the procedure are unclear. We infused a concentrated solution of neutralizing anti-SARS-CoV-2 antibodies obtained from a convalescent donor with a single session of double filtration plasmapheresis (DFPP) into a 56-year-old woman with long history of unremitting, severe COVID-19. She was unable to establish an adequate antiviral immune response because of previous chemotherapy, including the infusion of the anti-CD20 monoclonal antibody rituximab, administered to treat a diffuse large B-cell lymphoma. The disease promptly recovered despite evidence of no endogenous anti-SARS-CoV-2 antibody production. The observation that passive antibody therapy might prove particularly effective in immunodepressed COVID-19 patients requires evaluation in prospective randomized controlled trial.
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Affiliation(s)
- Diego Curtò
- Departments of Renal Medicine, Rare Diseases and Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.,Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Federica Tomatis
- Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Sara Gastoldi
- Departments of Renal Medicine, Rare Diseases and Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Miriam Galbusera
- Departments of Renal Medicine, Rare Diseases and Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Marina Noris
- Departments of Renal Medicine, Rare Diseases and Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Federico Raimondi
- Unit of Pulmonary Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy.,Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Anna Falanga
- Immunohematology and Transfusion Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy.,School of Medicine, University of Milan Bicocca, Milan, Italy
| | - Marina Marchetti
- Immunohematology and Transfusion Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Remuzzi
- Departments of Renal Medicine, Rare Diseases and Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Piero Ruggenenti
- Departments of Renal Medicine, Rare Diseases and Molecular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.,Unit of Nephrology and Dialysis, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
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18
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Casadevall A, Dragotakes Q, Johnson PW, Senefeld JW, Klassen SA, Wright RS, Joyner MJ, Paneth N, Carter RE. Convalescent plasma use in the USA was inversely correlated with COVID-19 mortality. eLife 2021; 10:e69866. [PMID: 34085928 PMCID: PMC8205484 DOI: 10.7554/elife.69866] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022] Open
Abstract
Background The US Food and Drug Administration authorized COVID-19 convalescent plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the USA. Methods We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data. Results CCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = -0.52, p=0.002) between CCP usage per hospital admission and deaths occurring 2 weeks after admission, and this finding was robust to examination of deaths taking place 1, 2, or 3 weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021. Conclusions A strong inverse correlation between CCP use and mortality per admission in the USA provides population-level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths. Funding There was no specific funding for this study. AC was supported in part by RO1 HL059842 and R01 AI1520789; MJJ was supported in part by 5R35HL139854. This project has been funded in whole or in part with Federal funds from the Department of Health and Human Services; Office of the Assistant Secretary for Preparedness and Response; Biomedical Advanced Research and Development Authority under Contract No. 75A50120C00096.
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Affiliation(s)
- Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public HealthBaltimoreUnited States
| | - Quigly Dragotakes
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public HealthBaltimoreUnited States
| | - Patrick W Johnson
- Department of Quantitative Health Sciences, Mayo ClinicJacksonvilleUnited States
| | - Jonathon W Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo ClinicRochesterUnited States
| | - Stephen A Klassen
- Department of Anesthesiology and Perioperative Medicine, Mayo ClinicRochesterUnited States
| | - R Scott Wright
- Department of Cardiology, Mayo ClinicRochesterUnited States
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo ClinicRochesterUnited States
| | - Nigel Paneth
- Department of Epidemiology and Biostatistics and Department of Pediatrics and Human Development, College of Human Medicine, Michigan State UniversityEast LansingUnited States
| | - Rickey E Carter
- Department of Quantitative Health Sciences, Mayo ClinicJacksonvilleUnited States
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19
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Gharbharan A, Jordans CCE, GeurtsvanKessel C, den Hollander JG, Karim F, Mollema FPN, Stalenhoef-Schukken JE, Dofferhoff A, Ludwig I, Koster A, Hassing RJ, Bos JC, van Pottelberge GR, Vlasveld IN, Ammerlaan HSM, van Leeuwen-Segarceanu EM, Miedema J, van der Eerden M, Schrama TJ, Papageorgiou G, Te Boekhorst P, Swaneveld FH, Mueller YM, Schreurs MWJ, van Kampen JJA, Rockx B, Okba NMA, Katsikis PD, Koopmans MPG, Haagmans BL, Rokx C, Rijnders BJA. Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection. Nat Commun 2021; 12:3189. [PMID: 34045486 PMCID: PMC8160346 DOI: 10.1038/s41467-021-23469-2] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/31/2021] [Indexed: 02/08/2023] Open
Abstract
In a randomized clinical trial of 86 hospitalized COVID-19 patients comparing standard care to treatment with 300mL convalescent plasma containing high titers of neutralizing SARS-CoV-2 antibodies, no overall clinical benefit was observed. Using a comprehensive translational approach, we unravel the virological and immunological responses following treatment to disentangle which COVID-19 patients may benefit and should be the focus of future studies. Convalescent plasma is safe, does not improve survival, has no effect on the disease course, nor does plasma enhance viral clearance in the respiratory tract, influence SARS-CoV-2 antibody development or serum proinflammatory cytokines levels. Here, we show that the vast majority of patients already had potent neutralizing SARS-CoV-2 antibodies at hospital admission and with comparable titers to carefully selected plasma donors. This resulted in the decision to terminate the trial prematurely. Treatment with convalescent plasma should be studied early in the disease course or at least preceding autologous humoral response development.
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Affiliation(s)
| | | | | | | | - Faiz Karim
- Groene Hart Hospital, Gouda, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | - Jelle Miedema
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Thijs J Schrama
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | | | - Francis H Swaneveld
- Unit of Transfusion Medicine, Sanquin Blood Supply, Amsterdam, The Netherlands
| | - Yvonne M Mueller
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | | | - Barry Rockx
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nisreen M A Okba
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Peter D Katsikis
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Bart L Haagmans
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Casper Rokx
- Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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20
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Cui W, Ouyang T, Qiu Y, Cui D. Literature Review of the Implications of Exercise Rehabilitation Strategies for SARS Patients on the Recovery of COVID-19 Patients. Healthcare (Basel) 2021; 9:healthcare9050590. [PMID: 34070115 PMCID: PMC8158390 DOI: 10.3390/healthcare9050590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 01/07/2023] Open
Abstract
As a global pandemic, COVID-19 shows no sign of letting up. With the control of the epidemic in China, the proportion of patients with severe and critical diseases being cured and discharged from hospital has increased, and the recovery of COVID-19 patients has become an important issue that urgently needs attention and solutions. By summarizing the exercise rehabilitation strategies and progress of SARS in 2003, this paper analyzed the differences in clinical indicators and recovery characteristics of severe pneumonia caused by the two viruses, and provided comprehensive exercise guidance and intervention strategies for COVID-19 patients for rehabilitation and nursing by referring to the problems and treatment strategies in the rehabilitation and nursing work of SARS. In the post-epidemic period, China will build a multi-dimensional epidemic prevention system by improving the effectiveness of mass training and strengthening local risk prevention and control. This paper discusses the exercise rehabilitation strategy of SARS patients after recovery, which has guiding significance for exercise intervention and scientific fitness of COVID-19 patients after recovery during epidemic prevention period.
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Affiliation(s)
- Wei Cui
- Department of Physical Education, Hunan University, Changsha 410000, China; (W.C.); (T.O.)
| | - Ting Ouyang
- Department of Physical Education, Hunan University, Changsha 410000, China; (W.C.); (T.O.)
| | - Ye Qiu
- College of Biology, Hunan University, Changsha 410000, China;
| | - Di Cui
- Department of Physical Education, Hunan University, Changsha 410000, China; (W.C.); (T.O.)
- Correspondence:
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21
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22
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Rowaiye AB, Okpalefe OA, Onuh Adejoke O, Ogidigo JO, Hannah Oladipo O, Ogu AC, Oli AN, Olofinase S, Onyekwere O, Rabiu Abubakar A, Jahan D, Islam S, Dutta S, Haque M. Attenuating the Effects of Novel COVID-19 (SARS-CoV-2) Infection-Induced Cytokine Storm and the Implications. J Inflamm Res 2021; 14:1487-1510. [PMID: 33889008 PMCID: PMC8057798 DOI: 10.2147/jir.s301784] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/16/2021] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic constitutes an arduous global health challenge, and the increasing number of fatalities calls for the speedy pursuit of a remedy. This review emphasizes the changing aspects of the COVID-19 disease, featuring the cytokine storm's pathological processes. Furthermore, we briefly reviewed potential therapeutic agents that may modulate and alleviate cytokine storms. The literature exploration was made using PubMed, Embase, MEDLINE, Google scholar, and China National Knowledge Infrastructure databases to retrieve the most recent literature on the etiology, diagnostic markers, and the possible prophylactic and therapeutic options for the management of cytokine storm in patients hospitalized with COVID-19 disease. The causative agent, severe acute respiratory coronavirus-2 (SARS-CoV-2), continually threatens the efficiency of the immune system of the infected individuals. As the first responder, the innate immune system provides primary protection against COVID-19, affecting the disease's progression, clinical outcome, and prognosis. Evidence suggests that the fatalities associated with COVID-19 are primarily due to hyper-inflammation and an aberrant immune function. Accordingly, the magnitude of the release of pro-inflammatory cytokines such as interleukin (IL)-1, (IL-6), and tumor necrosis alpha (TNF-α) significantly differentiate between mild and severe cases of COVID-19. The early prediction of a cytokine storm is made possible by several serum chemistry and hematological markers. The prompt use of these markers for diagnosis and the aggressive prevention and management of a cytokine release syndrome is critical in determining the level of morbidity and fatality associated with COVID-19. The prophylaxis and the rapid treatment of cytokine storm by clinicians will significantly enhance the fight against the dreaded COVID-19 disease.
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Affiliation(s)
- Adekunle Babajide Rowaiye
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | | | - Olukemi Onuh Adejoke
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria
| | - Joyce Oloaigbe Ogidigo
- Bioresources Development Centre, Abuja, National Biotechnology Development Agency, Abuja, Nigeria
| | - Oluwakemi Hannah Oladipo
- Bioresources Development Centre, Ilorin, National Biotechnology Development Agency, Kwara State, Nigeria
| | - Amoge Chidinma Ogu
- Department of Medical Biotechnology, National Biotechnology Development Agency, Abuja, Nigeria
| | - Angus Nnamdi Oli
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
| | - Samson Olofinase
- Department of Genetics, Genomics, Bioinformatics, National Biotechnology Development Agency, Abuja, Nigeria
| | - Onyekachi Onyekwere
- Bioresources Development Centre, Ubulu-Uku, National Biotechnology Development Agency, Delta State, Nigeria
| | - Abdullahi Rabiu Abubakar
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, 700233, Nigeria
| | - Dilshad Jahan
- Department of Hematology, Asgar Ali Hospital, Gandaria, Dhaka, 1204, Bangladesh
| | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, 57000, Malaysia
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23
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Casadevall A, Dragotakes Q, Johnson PW, Senefeld JW, Klassen SA, Wright RS, Joyner MJ, Paneth N, Carter RE. Convalescent Plasma Use in the United States was inversely correlated with COVID-19 Mortality: Did Plasma Hesitancy cost lives? MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.07.21255089. [PMID: 33851186 PMCID: PMC8043483 DOI: 10.1101/2021.04.07.21255089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The US Food and Drug Administration authorized Convalescent Plasma (CCP) therapy for hospitalized COVID-19 patients via the Expanded Access Program (EAP) and the Emergency Use Authorization (EUA), leading to use in about 500,000 patients during the first year of the pandemic for the US. METHODS We tracked the number of CCP units dispensed to hospitals by blood banking organizations and correlated that usage with hospital admission and mortality data. RESULTS CCP usage per admission peaked in Fall 2020, with more than 40% of inpatients estimated to have received CCP between late September and early November 2020. However, after randomized controlled trials failed to show a reduction in mortality, CCP usage per admission declined steadily to a nadir of less than 10% in March 2021. We found a strong inverse correlation (r = -0.52, P = 0.002) between CCP usage per hospital admission and deaths occurring two weeks after admission, and this finding was robust to examination of deaths taking place one, two or three weeks after admission. Changes in the number of hospital admissions, SARS-CoV-2 variants, and age of patients could not explain these findings. The retreat from CCP usage might have resulted in as many as 29,000 excess deaths from mid-November 2020 to February 2021. CONCLUSIONS A strong inverse correlation between CCP use and mortality per admission in the USA provides population level evidence consistent with the notion that CCP reduces mortality in COVID-19 and suggests that the recent decline in usage could have resulted in excess deaths.
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Affiliation(s)
- Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Quigly Dragotakes
- Department of Molecular Microbiology and Immunology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Patrick W. Johnson
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL
| | - Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Steven A. Klassen
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | | | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Nigel Paneth
- Department of Epidemiology and Biostatistics and Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI
| | - Rickey E. Carter
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL
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24
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Abstract
PURPOSE OF REVIEW Coronavirus disease 2019 (COVID-19) is an acute multisystem disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Investigations are ongoing in the search for effective therapeutics, with clinical approaches evolving based upon such evidence. RECENT FINDINGS The antiviral agent, remdesivir, and the immunomodulator, dexamethasone, are the first therapeutics for which there is evidence of efficacy from randomized trials. Subgroup analyses suggest remdesivir is beneficial in hospitalized patients whose severity of illness falls at the lower end of the spectrum, while dexamethasone is more beneficial in hospitalized patients whose severity of illness falls at the higher end of the spectrum. We recommend that inpatients who require supplemental oxygen but are not mechanically ventilated receive both remdesivir and dexamethasone, and inpatients who require mechanical ventilation receive dexamethasone monotherapy. Additional evidence regarding anti-SARS-CoV-2 antibodies, convalescent plasma, and a variety of antiinterleukin therapies is forthcoming. SUMMARY The body of evidence related to COVID-19 therapeutics continues to evolve and, as a result, management is likely to change with time. As new evidence is generated and published, the optimal approach to managing patients with COVID-19 should be reconsidered.
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Affiliation(s)
- Kevin C Wilson
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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25
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Peng HT, Rhind SG, Beckett A. Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis. JMIR Public Health Surveill 2021; 7:e25500. [PMID: 33825689 PMCID: PMC8245055 DOI: 10.2196/25500] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by a novel coronavirus termed SARS-CoV-2, has spread quickly worldwide. Convalescent plasma (CP) obtained from patients following recovery from COVID-19 infection and development of antibodies against the virus is an attractive option for either prophylactic or therapeutic treatment, since antibodies may have direct or indirect antiviral activities and immunotherapy has proven effective in principle and in many clinical reports. OBJECTIVE We seek to characterize the latest advances and evidence in the use of CP for COVID-19 through a systematic review and quantitative analysis, identify knowledge gaps in this setting, and offer recommendations and directives for future research. METHODS PubMed, Web of Science, and Embase were continuously searched for studies assessing the use of CP for COVID-19, including clinical studies, commentaries, reviews, guidelines or protocols, and in vitro testing of CP antibodies. The screening process and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal of all clinical studies was conducted using a universal tool independent of study designs. A meta-analysis of case-control and randomized controlled trials (RCTs) was conducted using a random-effects model. RESULTS Substantial literature has been published covering various aspects of CP therapy for COVID-19. Of the references included in this review, a total of 243 eligible studies including 64 clinical studies, 79 commentary articles, 46 reviews, 19 guidance and protocols, and 35 in vitro testing of CP antibodies matched the criteria. Positive results have been mostly observed so far when using CP for the treatment of COVID-19. There were remarkable heterogeneities in the CP therapy with respect to patient demographics, donor antibody titers, and time and dose of CP administration. The studies assessing the safety of CP treatment reported low incidence of adverse events. Most clinical studies, in particular case reports and case series, had poor quality. Only 1 RCT was of high quality. Randomized and nonrandomized data were found in 2 and 11 studies, respectively, and were included for meta-analysis, suggesting that CP could reduce mortality and increase viral clearance. Despite promising pilot studies, the benefits of CP treatment can only be clearly established through carefully designed RCTs. CONCLUSIONS There is developing support for CP therapy, particularly for patients who are critically ill or mechanically ventilated and resistant to antivirals and supportive care. These studies provide important lessons that should inform the planning of well-designed RCTs to generate more robust knowledge for the efficacy of CP in patients with COVID-19. Future research is necessary to fill the knowledge gap regarding prevention and treatment for patients with COVID-19 with CP while other therapeutics are being developed.
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Affiliation(s)
- Henry T Peng
- Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada
| | - Shawn G Rhind
- Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada
| | - Andrew Beckett
- St. Michael's Hospital, Toronto, ON, Canada
- Royal Canadian Medical Services, Ottawa, ON, Canada
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26
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Ramphul K, Ramphul Y, Park Y, Lohana P, Dhillon BK, Sombans S. A comprehensive review and update on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Coronavirus disease 2019 (COVID-19): what do we know now in 2021? Arch Med Sci Atheroscler Dis 2021; 6:e5-e13. [PMID: 34027207 PMCID: PMC8117074 DOI: 10.5114/amsad.2021.105065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/01/2021] [Indexed: 01/08/2023] Open
Abstract
It has been more than a year since the new virus called severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China. The disease it causes was named Coronavirus disease 2019 (COVID-19), and on 11 March 2020 it was declared a pandemic. As the virus continues to spread, the number of patients worldwide has already crossed the 100 million mark with more than 2 million deaths. We sought to provide an update on the progress made in identifying the virus, its pathophysiology, risk factors such as hypertension, diabetes, and smoking, as well as various methods of treatment. Our review also provided an overview of the different vaccines.
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Affiliation(s)
- Kamleshun Ramphul
- Department of Pediatrics, Shanghai Xin Hua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yogeshwaree Ramphul
- Department of Medicine, Sir Seewoosagur Ramgoolam National Hospital, Pamplemousses, Mauritius
| | - Yun Park
- Department of Orthodontics, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Petras Lohana
- Department of Medicine, Liaquat University of Medical and Health Sciences Hospital Jamshoro, Pakistan
| | | | - Shaheen Sombans
- Department of Medicine, Bharati Vidyapeeth University Medical College and Hospital, Pune, India
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27
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Baig MH, Sharma T, Ahmad I, Abohashrh M, Alam MM, Dong JJ. Is PF-00835231 a Pan-SARS-CoV-2 Mpro Inhibitor? A Comparative Study. Molecules 2021; 26:1678. [PMID: 33802860 PMCID: PMC8002701 DOI: 10.3390/molecules26061678] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 outbreak continues to spread worldwide at a rapid rate. Currently, the absence of any effective antiviral treatment is the major concern for the global population. The reports of the occurrence of various point mutations within the important therapeutic target protein of SARS-CoV-2 has elevated the problem. The SARS-CoV-2 main protease (Mpro) is a major therapeutic target for new antiviral designs. In this study, the efficacy of PF-00835231 was investigated (a Mpro inhibitor under clinical trials) against the Mpro and their reported mutants. Various in silico approaches were used to investigate and compare the efficacy of PF-00835231 and five drugs previously documented to inhibit the Mpro. Our study shows that PF-00835231 is not only effective against the wild type but demonstrates a high affinity against the studied mutants as well.
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Affiliation(s)
- Mohammad Hassan Baig
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea; (M.H.B.); (T.S.)
| | - Tanuj Sharma
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea; (M.H.B.); (T.S.)
| | - Irfan Ahmad
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
| | - Mohammed Abohashrh
- Department of Basic Medical Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (M.A.); (M.M.A.)
| | - Mohammad Mahtab Alam
- Department of Basic Medical Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (M.A.); (M.M.A.)
| | - Jae-June Dong
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea; (M.H.B.); (T.S.)
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28
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Lynch HF, Bateman-House A, Joffe S. Emergency Approvals for COVID-19: Evolving Impact on Obligations to Patients in Clinical Care and Research. Ann Intern Med 2021; 174:256-257. [PMID: 33136427 PMCID: PMC7643168 DOI: 10.7326/m20-6703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
There currently is debate regarding whether U.S. institutions and clinicians may or should restrict patient access to COVID-19 drugs and vaccines that have been granted emergency use authorization by the U.S. Food and Drug Administration. The authors provide their views on the legal, ethical, and clinical ramifications of such restriction.
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Affiliation(s)
| | | | - Steven Joffe
- University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.J.)
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29
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Honjo K, Russell RM, Li R, Liu W, Stoltz R, Tabengwa EM, Hua Y, Prichard L, Kornbrust AN, Sterrett S, Marques MB, Lima JL, Lough CM, McCarty TP, Ketas TJ, Hatziioannou T, Bieniasz PD, Redden DT, Moore JP, Goepfert PA, Heath SL, Hahn BH, Davis RS. Convalescent plasma-mediated resolution of COVID-19 in a patient with humoral immunodeficiency. Cell Rep Med 2021; 2:100164. [PMID: 33521696 PMCID: PMC7817775 DOI: 10.1016/j.xcrm.2020.100164] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/31/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022]
Abstract
Convalescent plasma (CP) is widely used to treat COVID-19, but without formal evidence of efficacy. Here, we report the beneficial effects of CP in a severely ill COVID-19 patient with prolonged pneumonia and advanced chronic lymphocytic leukemia (CLL), who was unable to generate an antiviral antibody response of her own. On day 33 after becoming symptomatic, the patient received CP containing high-titer (ID50 > 5,000) neutralizing antibodies (NAbs), defervesced, and improved clinically within 48 h and was discharged on day 37. Hence, when present in sufficient quantities, NAbs to SARS-CoV-2 have clinical benefit even if administered relatively late in the disease course. However, analysis of additional CP units revealed widely varying NAb titers, with many recipients exhibiting endogenous NAb responses far exceeding those of the administered units. To obtain the full therapeutic benefits of CP immunotherapy, it will thus be important to determine the neutralizing activity in both CP units and transfusion candidates.
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Affiliation(s)
- Kazuhito Honjo
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ronnie M. Russell
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Microbiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ran Li
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Weimin Liu
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Regina Stoltz
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Edlue M. Tabengwa
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Yutao Hua
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Lynn Prichard
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ashton N. Kornbrust
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Sarah Sterrett
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Marisa B. Marques
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jose L. Lima
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Chris M. Lough
- LifeSouth Community Blood Centers, Gainesville, FL 32607, USA
| | - Todd P. McCarty
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Thomas J. Ketas
- Department of Microbiology and Immunology, Weill Medical College of Cornell University, New York, NY 10065, USA
| | | | - Paul D. Bieniasz
- Laboratory of Retrovirology, The Rockefeller University, New York, NY 10028, USA
- Howard Hughes Medical Institute, The Rockefeller University, New York, NY 10028, USA
| | - David T. Redden
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - John P. Moore
- Department of Microbiology and Immunology, Weill Medical College of Cornell University, New York, NY 10065, USA
| | - Paul A. Goepfert
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Sonya L. Heath
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Beatrice H. Hahn
- Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Microbiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Randall S. Davis
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Biochemistry & Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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30
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Perricone C, Triggianese P, Bursi R, Cafaro G, Bartoloni E, Chimenti MS, Gerli R, Perricone R. Intravenous Immunoglobulins at the Crossroad of Autoimmunity and Viral Infections. Microorganisms 2021; 9:microorganisms9010121. [PMID: 33430200 PMCID: PMC7825648 DOI: 10.3390/microorganisms9010121] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/24/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023] Open
Abstract
Intravenous immunoglobulins (IVIG) are blood preparations pooled from the plasma of donors that have been first employed as replacement therapy in immunodeficiency. IVIG interact at multiple levels with the different components of the immune system and exert their activity against infections. Passive immunotherapy includes convalescent plasma from subjects who have recovered from infection, hyperimmune globulin formulations with a high titer of neutralizing antibodies, and monoclonal antibodies (mAbs). IVIG are used for the prevention and treatment of several infections, especially in immunocompromised patients, or in case of a poorly responsive immune system. The evolution of IVIG from a source of passive immunity to a powerful immunomodulatory/anti-inflammatory agent results in extensive applications in autoimmune diseases. IVIG composition depends on the antibodies of the donor population and the alterations of protein structure due to the processing of plasma. The anti-viral and anti-inflammatory activity of IVIG has led us to think that they may represent a useful therapeutic tool even in COVID-19. The human origin of IVIG carries specific criticalities including risks of blood products, supply, and elevated costs. IVIG can be useful in critically ill patients, as well as early empirical treatment. To date, the need for further well-designed studies stating protocols and the efficacy/tolerability profile of IVIG and convalescent plasma in selected situations are awaited.
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Affiliation(s)
- Carlo Perricone
- Rheumatology, Department of Medicine, University of Perugia, 06129 Perugia, Italy; (C.P.); (R.B.); (G.C.); (E.B.); (R.G.)
| | - Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome, 00133 Rome, Italy; (M.S.C.); (R.P.)
- Correspondence: ; Tel.: +39-062-090-4444; Fax: +39-062-090-3749
| | - Roberto Bursi
- Rheumatology, Department of Medicine, University of Perugia, 06129 Perugia, Italy; (C.P.); (R.B.); (G.C.); (E.B.); (R.G.)
| | - Giacomo Cafaro
- Rheumatology, Department of Medicine, University of Perugia, 06129 Perugia, Italy; (C.P.); (R.B.); (G.C.); (E.B.); (R.G.)
| | - Elena Bartoloni
- Rheumatology, Department of Medicine, University of Perugia, 06129 Perugia, Italy; (C.P.); (R.B.); (G.C.); (E.B.); (R.G.)
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome, 00133 Rome, Italy; (M.S.C.); (R.P.)
| | - Roberto Gerli
- Rheumatology, Department of Medicine, University of Perugia, 06129 Perugia, Italy; (C.P.); (R.B.); (G.C.); (E.B.); (R.G.)
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, Department of “Medicina dei Sistemi”, University of Rome, 00133 Rome, Italy; (M.S.C.); (R.P.)
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31
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Rello J, Belliato M, Dimopoulos MA, Giamarellos-Bourboulis EJ, Jaksic V, Martin-Loeches I, Mporas I, Pelosi P, Poulakou G, Pournaras S, Tamae-Kakazu M, Timsit JF, Waterer G, Tejada S, Dimopoulos G. Update in COVID-19 in the intensive care unit from the 2020 HELLENIC Athens International symposium. Anaesth Crit Care Pain Med 2020; 39:723-730. [PMID: 33172592 PMCID: PMC7580531 DOI: 10.1016/j.accpm.2020.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 02/06/2023]
Abstract
The 2020 International Web Scientific Event in COVID-19 pandemic in critically ill patients aimed at updating the information and knowledge on the COVID-19 pandemic in the intensive care unit. Experts reviewed the latest literature relating to the COVID-19 pandemic in critically ill patients, such as epidemiology, pathophysiology, phenotypes of infection, COVID-19 as a systematic infection, molecular diagnosis, mechanical ventilation, thromboprophylaxis, COVID-19 associated co-infections, immunotherapy, plasma treatment, catheter-related bloodstream infections, artificial intelligence for COVID-19, and vaccination. Antiviral therapy and co-infections are out of the scope of this review. In this review, each of these issues is discussed with key messages regarding management and further research being presented after a brief review of available evidence.
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Affiliation(s)
- Jordi Rello
- Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Clinical Research in the ICU, Anaesthesia Department, CHU Nimes, Université de Nimes-Montpellier, France
| | - Mirko Belliato
- Anestesia e Rianimazione II Cardiopolmonare, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | | | - Ignacio Martin-Loeches
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Multidisciplinary Intensive Care Research Organization (MICRO), Department of Intensive Care Medicine, St. James's University Hospital, Dublin, Ireland; Trinity Centre for Health Sciences, Dublin, Ireland; Hospital Clínic, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Iosif Mporas
- School of Physics Engineering and Computer Science, University of Hertfordshire, Hatfield, United Kingdom
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy; Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Garyphallia Poulakou
- 3(rd) Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Sotiria General Hospital of Athens, Greece
| | - Spyridon Pournaras
- Laboratory of Clinical Microbioloy, ATTIKON University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maximiliano Tamae-Kakazu
- Division of Pulmonary, Critical Care and Sleep Medicine, Spectrum Health - Michigan State University, Grand Rapids, Michigan, USA
| | - Jean-François Timsit
- AP-HP, Bichat Hospital, Medical and Infectious Diseases ICU (MI2), F-75018 Paris, France; University of Paris, IAME, INSERM, F-75018 Paris, France
| | - Grant Waterer
- School of Medicine, University of Western Australia, Australia
| | - Sofia Tejada
- Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - George Dimopoulos
- Department of Critical Care Medicine, National and Kapodistrian University of Athens, Medical School, Greece
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