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Velázquez-Pérez L, Rodríguez-Labrada R, Gonzalez-Garcés Y, Canales-Ochoa N, Medrano-Montero J, Domínguez-Barrios Y, Carrillo-Rodes FJ, Ramírez-Bautista MB, Caballero-Laguna A, Gámez-Rodríguez O, Hernández-Oliver MO, Sosa-Cruz Y, Zayas-Hernández A, Vázquez-Mojena Y, Ziemann U, Auburger G. COVID-19 Impacts the Mental Health and Speech Function in Spinocerebellar Ataxia Type 2: Evidences from a Follow-Up Study. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1101-1111. [PMID: 37861884 DOI: 10.1007/s12311-023-01612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 10/21/2023]
Abstract
Limited evidence suggests that the SARS-CoV-2 infection can accelerate the progression of neurodegenerative diseases, but this has been not verified in the spinocerebellar ataxias (SCA). The objective of this study is to assess the impact of COVID-19 on the mental health and motor features of SCA2. A follow-up study was carried out in 170 Cuban SCA2 subjects and 87 community controls between 2020 and 2021. All subjects underwent a structured questionnaire to assess the risks of exposure to COVID-19, the confirmation of COVID-19 diagnosis, and the Hospital Anxiety and Depression Scale (HADS). Moreover, 36 subjects underwent the Scale for the Assessment and Rating of ataxia (SARA). The risk of exposure to SARS-CoV-2 and the frequency of COVID-19 were similar between the ataxia cohort and the community controls. Within the ataxia group, significantly increased HADS scores existed at the 2nd visit in both groups, but this increase was more evident for the infected group regarding the depression score. Moreover, a significant within-group increase of SARA score was observed in the infected group but not the non-infected group, which was mainly mediated by the significant increase of the speech item score in the infected group. Similar results were observed within the subgroup of preclinical carriers. Our study identified no selective vulnerability nor protection to COVID-19 in SCA2, but once infected, the patients experienced a deterioration of mental health and speech function, even at preclinical disease stage. These findings set rationales for tele-health approaches that minimize the detrimental effect of COVID-19 on SCA2 progression and identify SCA2 individuals as clinical model to elucidate the link between SARS-CoV-2 infection and neurodegeneration.
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Affiliation(s)
- Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad 26, Holguín, Cuba.
- Cuban Academy of Sciences, Cuba St. 460, between Teniente Rey St., and Compostela St., Habana Vieja, 19100, Havana, Cuba.
| | - Roberto Rodríguez-Labrada
- Cuban Centre for Neuroscience, Playa. 198 St, between 27 and 25th Ave., 16 Cubanacan 19818, Playa, 11300, Havana, Cuba.
| | - Yasmany Gonzalez-Garcés
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad 26, Holguín, Cuba
| | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad 26, Holguín, Cuba
| | | | - Yennis Domínguez-Barrios
- Clinical & Surgical Hospital "Calixto Garcia", Universidad avenue & J st, Vedado, 14 Plaza de la Revolución, 10400, Havana, Cuba
| | - Frank J Carrillo-Rodes
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Libertad 26, Holguín, Cuba
| | | | | | - Osiel Gámez-Rodríguez
- University Hospital "Juan Bruno Zayas", Carretera del Caney Street. Pastorita, Santiago de Cuba, Cuba
| | | | | | | | - Yaimeé Vázquez-Mojena
- Cuban Centre for Neuroscience, Playa. 198 St, between 27 and 25th Ave., 16 Cubanacan 19818, Playa, 11300, Havana, Cuba
| | - Ulf Ziemann
- Department of Neurology and Stroke, Eberhard-Karls University of Tübingen, Hoppe-Seyler Str.3, 72076, Tübingen, Germany
- Hertie-Institute for Clinical Brain Research, Eberhard-Karls University of Tübingen, 22 Hoppe-Seyler Str.3, 72076, Tübingen, Germany
| | - Georg Auburger
- Experimental Neurology, Faculty of Medicine, Goethe University, 24, 60590, Frankfurt, Germany
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Lin J, Zheng D, Tian D, Zheng P, Zhang H, Li C, Lei C, Shi F, Wang H. High Frequency of Autoantibodies in COVID-19 Patients with Central Nervous System Complications: a Multicenter Observational Study. Mol Neurobiol 2024:10.1007/s12035-024-04109-4. [PMID: 38507030 DOI: 10.1007/s12035-024-04109-4] [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: 12/25/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
We present a panel of central nervous system (CNS) complications associated with coronavirus disease 2019 (COVID-19) and their clinical characteristics. We aim to investigate associations between neurological autoantibodies and COVID-19 patients with predominant CNS complications. In this retrospective multi-center study, we analyze neurologic complications associated with COVID-19 patients from Dec. 2022 to Feb. 2023 at four tertiary hospitals in China. CSF and/or serum in the enrolled patients were tested for autoantibodies using tissue-based assays (TBAs) and cell-based assays (CBAs). A total of 34 consecutive patients (median age was 40.5 years [range 15-83], 50% were female) were enrolled. CNS syndromes included encephalitis (n=15), encephalopathies (n=6), meningoencephalitis (n=3), ADEM (n=2), depression (n = 2), Alzheimer's disease (n=2), Parkinson disease (n=1), and central nervous system vasculitis (n=1). Twenty-eight specimens (of 44 tested; 11/27 [40.7%] CSF, 13/17 [76.5%] serums) were confirmed by TBAs to be autoantibodies positive. However, only a few autoantibodies (1 with MOG and 1 with NMDAR) were detected by CBAs assays. Twenty-four patients received immunotherapy. After a mean time of 7.26 months of follow-up, 75.8% (25/33) of patients had good outcome (mRS score ≤2). Although no significant difference was observed between the two groups, the proportion of positive CSF autoantibodies in the poor outcomes group was higher than that in the good outcomes group (57.1% vs 31.5%, P = 0.369). Autoantibodies were frequently observed in COVID-19-associated CNS complications. The identification of these autoantibody-positive COVID-19 cases is important as they respond favorably to immunotherapy.
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Affiliation(s)
- Jingfang Lin
- Department of Neurology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
| | - Dong Zheng
- Department of Neurology, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Decai Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Pei Zheng
- Center for Neurological Diseases, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hongya Zhang
- Department of Neurology, Shenzhen University General Hospital, Shenzhen, China
| | - Chuo Li
- Department of Neurology, Eight People's Hospital of Guangzhou, Guangzhou, China
| | - Chunliang Lei
- Eight People's Hospital of Guangzhou, Guangzhou, China
| | - Fudong Shi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center for Neurological Diseases, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Honghao Wang
- Department of Neurology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China.
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Ketkar A, Willey V, Glasser L, Dobie C, Wenziger C, Teng CC, Dube C, Hirpara S, Cunningham D, Verduzco-Gutierrez M. Assessing the Burden and Cost of COVID-19 Across Variants in Commercially Insured Immunocompromised Populations in the United States: Updated Results and Trends from the Ongoing EPOCH-US Study. Adv Ther 2024; 41:1075-1102. [PMID: 38216825 PMCID: PMC10879378 DOI: 10.1007/s12325-023-02754-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/28/2023] [Indexed: 01/14/2024]
Abstract
INTRODUCTION/METHODS EPOCH-US is an ongoing, retrospective, observational cohort study among individuals identified in the Healthcare Integrated Research Database (HIRD®) with ≥ 12 months of continuous health plan enrollment. Data were collected for the HIRD population (containing immunocompetent and immunocompromised [IC] individuals), individual IC cohorts (non-mutually exclusive cohorts based on immunocompromising condition and/or immunosuppressive [IS] treatment), and the composite IC population (all unique IC individuals). This study updates previous results with addition of the general population cohort and data specifically for the year of 2022 (i.e., Omicron wave period). To provide healthcare decision-makers the most recent trends, this study reports incidence rates (IR) and severity of first SARS-CoV-2 infection; and relative risk, healthcare utilization, and costs related to first COVID-19 hospitalizations in the full year of 2022 and overall between April 2020 and December 2022. RESULTS These updated results showed a 2.9% prevalence of immune compromise in the population. From April 2020 through December 2022, the overall IR of COVID-19 was 115.7 per 1000 patient-years in the composite IC cohort and 77.8 per 1000 patient-years in the HIRD cohort. The composite IC cohort had a 15.4% hospitalization rate with an average cost of $42,719 for first COVID-19 hospitalization. Comparatively, the HIRD cohort had a 3.7% hospitalization rate with an average cost of $28,848 for first COVID-19 hospitalization. Compared to the general population, IC individuals had 4.3 to 23 times greater risk of hospitalization with first diagnosis of COVID-19. Between January and December 2022, hospitalizations associated with first COVID-19 diagnosis cost over $1 billion, with IC individuals (~ 3% of the population) generating $310 million (31%) of these costs. CONCLUSION While only 2.9% of the population, IC individuals had a higher risk of COVID-19 hospitalization and incurred higher healthcare costs across variants. They also disproportionately accounted for over 30% of total costs for first COVID-19 hospitalization in 2022, amounting to ~ $310 million. These data highlight the need for additional preventive measures to decrease the risk of developing severe COVID-19 outcomes in vulnerable IC populations.
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Affiliation(s)
| | | | - Lisa Glasser
- AstraZeneca, Biopharmaceuticals Medical, Wilmington, DE, USA
| | - Casey Dobie
- Xcenda, a Cencora company, Conshohocken, PA, USA
| | | | | | - Christine Dube
- AstraZeneca, Biopharmaceuticals Medical, Wilmington, DE, USA
| | - Sunny Hirpara
- AstraZeneca, Biopharmaceuticals Medical, Wilmington, DE, USA
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Luo S, Zheng Z, Bird SR, Plebanski M, Figueiredo B, Jessup R, Stelmach W, Robinson JA, Xenos S, Olasoji M, Wan DWL, Sheahan J, Itsiopoulos C. An Overview of Long COVID Support Services in Australia and International Clinical Guidelines, With a Proposed Care Model in a Global Context. Public Health Rev 2023; 44:1606084. [PMID: 37811128 PMCID: PMC10556237 DOI: 10.3389/phrs.2023.1606084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/23/2023] [Indexed: 10/10/2023] Open
Abstract
Objective: To identify gaps among Australian Long COVID support services and guidelines alongside recommendations for future health programs. Methods: Electronic databases and seven government health websites were searched for Long COVID-specific programs or clinics available in Australia as well as international and Australian management guidelines. Results: Five Long COVID specific guidelines and sixteen Australian services were reviewed. The majority of Australian services provided multidisciplinary rehabilitation programs with service models generally consistent with international and national guidelines. Most services included physiotherapists and psychologists. While early investigation at week 4 after contraction of COVID-19 is recommended by the Australian, UK and US guidelines, this was not consistently implemented. Conclusion: Besides Long COVID clinics, future solutions should focus on early identification that can be delivered by General Practitioners and all credentialed allied health professions. Study findings highlight an urgent need for innovative care models that address individual patient needs at an affordable cost. We propose a model that focuses on patient-led self-care with further enhancement via multi-disciplinary care tools.
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Affiliation(s)
- Shiqi Luo
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Zhen Zheng
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Stephen Richard Bird
- Department of Health and Biostatistics, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Magdalena Plebanski
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Bernardo Figueiredo
- School of Economics, Finance and Marketing, College of Business, RMIT University, Melbourne, VIC, Australia
| | | | | | - Jennifer A. Robinson
- School of Media and Communication, College of Design and Social Context, RMIT University, Melbourne, VIC, Australia
| | - Sophia Xenos
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Micheal Olasoji
- Institute of Health and Wellbeing, Federation University Australia, Ballarat, VIC, Australia
| | - Dawn Wong Lit Wan
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Jacob Sheahan
- Institute for Design Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Catherine Itsiopoulos
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, Australia
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Jasukaitienė E, Šileikienė L, Augustis Š, Tamošiūnas A, Lukšienė D, Krančiukaitė-Butylkinienė D, Šakalytė G, Žaliaduonytė D, Radišauskas R. Sociodemographic Factors, Comorbidities, In-Hospital Complications, and Outcomes of Ischaemic Stroke Patients in the Context of the COVID-19 Pandemic in Lithuania: A Retrospective, Record-Based, Single-Centre Study. Cureus 2023; 15:e45553. [PMID: 37868513 PMCID: PMC10586473 DOI: 10.7759/cureus.45553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/24/2023] Open
Abstract
INTRODUCTION The role of COVID-19 regarding in-hospital complications and poor outcomes for patients with ischaemic stroke (IS) is still important to explore. The aim of this study was to evaluate the risk of in-hospital lethality for IS patients respectively to their comorbidities and in-hospital complications in the context of the COVID-19 pandemic. METHODS We identified 1898 acute IS patients (749 men and 1149 women) admitted to the Lithuanian University of Health Sciences Kaunas Hospital, Lithuania, from December 2020 to February 2022. The sociodemographic, clinical, and outcome features of the patients were evaluated deploying appropriate statistical tests. Hazard ratios and 95% confidence intervals were estimated by the Cox proportional hazards regression for hospital lethality. RESULTS The risk of in-hospital lethality was 2.22 times higher in men suffering from IS and chronic ischaemic heart disease (cIHD) compared to those with IS and isolated arterial hypertension (iAH) (p < 0.05). COVID-19 elevated the risk of in-hospital lethality in men by 3.16 times (p < 0.05). In comorbid women with type two diabetes mellitus (DM) or cIHD, the risk of in-hospital lethality was two times higher compared to those with iAH (p < 0.05). The risk of in-hospital lethality increased significantly in both men and women, with the total number of in-hospital complications increasing per one unit. CONCLUSIONS Of the comorbidities studied, DM and cIHD together with COVID-19 elevated the risk of in-hospital lethality significantly. Within the acute in-hospital complications, pneumonia with respiratory failure and acute renal failure showed the most significant prognostic value anticipating lethal outcomes for IS patients.
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Affiliation(s)
- Erika Jasukaitienė
- Department of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Lolita Šileikienė
- Department of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Šarūnas Augustis
- Department of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Abdonas Tamošiūnas
- Department of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Dalia Lukšienė
- Department of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Daina Krančiukaitė-Butylkinienė
- Department of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Gintarė Šakalytė
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Diana Žaliaduonytė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Ričardas Radišauskas
- Department of Population Studies, Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
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Mirmosayyeb O, Badihian S, Shaygannejad V, Hartung HP. Editorial: CNS autoimmune disorders and COVID-19. Front Neurol 2023; 14:1183998. [PMID: 37082445 PMCID: PMC10112508 DOI: 10.3389/fneur.2023.1183998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 04/22/2023] Open
Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Shervin Badihian
- Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Vahid Shaygannejad
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- *Correspondence: Hans-Peter Hartung
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