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Tamayo-Velasco Á, López-Herrero R, Gómez-García LM, Sánchez-de Prada L, Aguilar-Monserrate G, Martín-Fernández M, Bardají-Carrillo M, Álvaro-Meca A, Tamayo E, Resino S, Miramontes-González JP, Peñarrubia-Ponce MJ. COVID-19-associated pulmonary aspergillosis (CAPA) in hematological patients: Could antifungal prophylaxis be necessary? A nationwide study. J Infect Public Health 2024; 17:939-946. [PMID: 38613930 DOI: 10.1016/j.jiph.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/31/2024] [Accepted: 04/05/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND COVID-19-associated pulmonary aspergillosis (CAPA) has emerged as a relatively common complication. Multiple studies described this relationship in critical patients, however its incidence and outcome in other risk groups such as immunosuppressed patients remains unknown. In this sense, we aimed to evaluate the rates and outcomes of CAPA in hematological patients and according to the different hematological malignances, comparing to invasive pulmonary aspergillosis (IPA) in non-COVID-19 ones. METHODS Nationwide, population-based and retrospective observational cohort study including all adult patients with hematological malignancies admitted in Spain since March 1, 2020 to December 31, 2021. The main outcome variable was the diagnosis of IPA during hospitalization in hematological patients with or without COVID-19 at admission. The rate of CAPA compared to IPA in non-COVID-19 patients in each hematological malignancy was also performed, as well as survival curve analysis. FINDINGS COVID-19 was diagnosed in 3.85 % (4367 out of 113,525) of the hematological adult inpatients. COVID-19 group developed more fungal infections (5.1 % vs. 3 %; p < 0.001). Candida spp. showed higher rate in non-COVID-19 (74.2 % vs. 66.8 %; p = 0.015), meanwhile Aspergillus spp. confirmed its predominance in COVID-19 hematological patients (35.4 % vs. 19.1 %; p < 0.001). IPA was diagnosed in 703 patients and 11.2 % (79 cases) were CAPA. The multivariate logistic regression analysis found that the diagnosis of COVID-19 disease at hospital admission increased more than two-fold IPA development [OR: 2.5, 95CI (1.9-3.1), p < 0.001]. B-cell malignancies - specifically B-cell non-Hodgkin lymphoma, multiple myeloma, chronic lymphocytic leukemia and acute lymphoblastic leukemia - showed between four- and six-fold higher CAPA development and 90-day mortality rates ranging between 50 % and 72 %. However, myeloid malignancies did not show higher CAPA rates compared to IPA in non-COVID-19 patients. CONCLUSION COVID-19 constitutes an independent risk factor for developing aspergillosis in B-cell hematological malignancies and the use of antifungal prophylaxis during hospitalizations may be warranted.
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Affiliation(s)
- Álvaro Tamayo-Velasco
- Hematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain; BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain.
| | - Rocío López-Herrero
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Lara María Gómez-García
- Hematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Laura Sánchez-de Prada
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Microbiology Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain
| | - Gerardo Aguilar-Monserrate
- Hematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Marta Martín-Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain; BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Miguel Bardají-Carrillo
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Alejandro Álvaro-Meca
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain; Departament of Preventive Medicine and Public Health, Faculty of Health Science, Universidad Rey Juan Carlos, 28933 Madrid, Spain
| | - Eduardo Tamayo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain; BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Salvador Resino
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Pablo Miramontes-González
- Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain; Internal Medicine Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain
| | - María Jesús Peñarrubia-Ponce
- Hematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain; Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
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Sánchez-de Prada L, Martínez-García AM, González-Fernández B, Gutiérrez-Ballesteros J, Rojo-Rello S, Garcinuño-Pérez S, Álvaro-Meca A, Ortiz De Lejarazu R, Sanz-Muñoz I, Eiros JM. Impact on the time elapsed since SARS-CoV-2 infection, vaccination history, and number of doses, on protection against reinfection. Sci Rep 2024; 14:353. [PMID: 38172152 PMCID: PMC10764833 DOI: 10.1038/s41598-023-50335-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
SARS-CoV-2 reinfections have been frequent, even among those vaccinated. The aim of this study is to know if hybrid immunity (infection + vaccination) is affected by the moment of vaccination and number of doses received. We conducted a retrospective study in 746 patients with a history of COVID-19 reinfection and recovered the dates of infection and reinfection and vaccination status (date and number of doses). To assess differences in the time to reinfection(tRI) between unvaccinated, vaccinated before 6 months, and later; and comparing one, two or three doses (incomplete, complete and booster regime) we performed the log-rank test of the cumulative incidence calculated as 1 minus the Kaplan-Meier estimator. Also, an adjusted Cox-regression was performed to evaluate the risk of reinfection in all groups. The tRI was significantly higher in those vaccinated vs. non-vaccinated (p < 0.001). However, an early incomplete regime protects similar time than not receiving a vaccine. Vaccination before 6 months after infection showed a lower tRI compared to those vaccinated later with the same regime (adj-p < 0.001). Actually, early vaccination with complete and booster regimes provided lower length of protection compared to vaccinating later with incomplete and complete regime, respectively. Vaccination with complete and booster regimes significantly increases the tRI (adj-p < 0.001). Vaccination increases the time it takes for a person to become reinfected with SARS-CoV-2. Increasing the time from infection to vaccination increases the time in which a person could be reinfected and reduces the risk of reinfection, especially in complete and booster regimes. Those results emphasize the role of vaccines and boosters during the pandemic and can guide strategies on future vaccination policy.
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Affiliation(s)
- Laura Sánchez-de Prada
- Faculty of Medicine, University of Valladolid, Valladolid, Spain.
- National Influenza Center of Valladolid, Valladolid, Spain.
| | - Ana María Martínez-García
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Belén González-Fernández
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Silvia Rojo-Rello
- Faculty of Medicine, University of Valladolid, Valladolid, Spain
- National Influenza Center of Valladolid, Valladolid, Spain
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Sonsoles Garcinuño-Pérez
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Alejandro Álvaro-Meca
- Department of Preventive Medicine and Public Health, Rey Juan Carlos University, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - José M Eiros
- Faculty of Medicine, University of Valladolid, Valladolid, Spain
- National Influenza Center of Valladolid, Valladolid, Spain
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Álvarez-del Río B, Sánchez-de Prada L, Álvaro-Meca A, Martín-Fernández M, Álvarez FJ, Tamayo E, Gutiérrez-Abejón E. Prevalence and cost of hospitalized patients with asymptomatic COVID-19 in 2020 in Spain. Front Public Health 2023; 11:1229561. [PMID: 37588119 PMCID: PMC10427243 DOI: 10.3389/fpubh.2023.1229561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction COVID-19 transmission has been characterized by the presence of asymptomatic patients. Additionally, most studies evaluating costs focus on symptomatic COVID-19 cases. Objective To describe the prevalence, characteristics, and costs of asymptomatic COVID-19 cases at admission in Spanish hospitals in 2020. Methods A nationwide study was performed, and data of hospitalized patients were collected of the Minimum Basic Data Set in Spain during 2020. Patients with COVID-19 codes as a primary and as a secondary diagnosis at admission were selected. Variables collected included age, sex, length of stay, in-hospital death, admission, length of stay and death in intensive care unit, mechanical ventilation and ventilatory assistance. COVID-19 related hospital costs were calculated using diagnosis-related groups from the Minimum Basic Data Set. Patients and costs were disaggregated by sex, age group, intensive care unit admission and epidemic wave (first or second) and main diagnosis. Results A total of 14,742 patients were admitted with asymptomatic COVID-19 in Spanish hospitals representing 6.35% of all COVID-19 admitted patients. The total cost of admissions with asymptomatic COVID-19 was €105,933,677.6 with a mean cost per patient of €7,185.8 with higher mean cost in the first wave despite only 2.7% of cases were found during that time. Based on primary diagnosis, the higher number of cases of asymptomatic COVID-19 were found in "Pregnancy, childbirth and the puerperium" followed by "diseases of the circulatory system". Conclusions There was a high prevalence of asymptomatic cases during screening at admission process in Spanish hospitals in 2020. The highest number of cases was found among the group of "pregnancy, childbirth, and puerperium" followed by "diseases of the circulatory system." The higher costs might be due not only to the main pathology at admission but to the associated healthcare provisions needed in case of positive COVID-19 testing.
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Affiliation(s)
- Blanca Álvarez-del Río
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - Laura Sánchez-de Prada
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Departamento de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro Nacional de Gripe de Valladolid, Valladolid, Spain
| | - Alejandro Álvaro-Meca
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, Spain
| | - Marta Martín-Fernández
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - F. Javier Álvarez
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Tamayo
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Gutiérrez-Abejón
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Dirección Técnica de Farmacia, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain
- Facultad de Empresa y Comunicación, Universidad Internacional de la Rioja (UNIR), Logroño, Spain
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Sánchez-de Prada L, Sanz-Muñoz I, Sun W, Palese P, Ortiz de Lejarazu R, Eiros JM, García-Sastre A, Aydillo T. Group 1 and group 2 hemagglutinin stalk antibody response according to age. Front Immunol 2023; 14:1194073. [PMID: 37313413 PMCID: PMC10258341 DOI: 10.3389/fimmu.2023.1194073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
Objective Antibodies elicited by seasonal influenza vaccines mainly target the head of hemagglutinin (HA). However, antibodies against the stalk domain are cross-reactive and have been proven to play a role in reducing influenza disease severity. We investigated the induction of HA stalk-specific antibodies after seasonal influenza vaccination, considering the age of the cohorts. Methods A total of 166 individuals were recruited during the 2018 influenza vaccine campaign (IVC) and divided into groups: <50 (n = 14), 50-64 (n = 34), 65-79 (n = 61), and ≥80 (n = 57) years old. Stalk-specific antibodies were quantified by ELISA at day 0 and day 28 using recombinant viruses (cH6/1 and cH14/3) containing an HA head domain (H6 or H14) from wild bird origin with a stalk domain from human H1 or H3, respectively. The geometric mean titer (GMT) and the fold rise (GMFR) were calculated, and differences were assessed using ANOVA adjusted by the false discovery rate (FDR) and the Wilcoxon tests (p <0.05). Results All age groups elicited some level of increase in anti-stalk antibodies after receiving the influenza vaccine, except for the ≥80-year-old cohort. Additionally, <65-year-old vaccinees had higher group 1 antibody titers versus group 2 before and after vaccination. Similarly, vaccinees within the <50-year-old group showed a higher increase in anti-stalk antibody titers when compared to older individuals (≥80 years old), especially for group 1 anti-stalk antibodies. Conclusion Seasonal influenza vaccines can the induction of cross-reactive anti-stalk antibodies against group 1 and group 2 HAs. However, low responses were observed in older groups, highlighting the impact of immunosenescence in adequate humoral immune responses.
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Affiliation(s)
- Laura Sánchez-de Prada
- National Influenza Center of Valladolid, Valladolid, Spain
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Weina Sun
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Peter Palese
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | - José María Eiros
- National Influenza Center of Valladolid, Valladolid, Spain
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Teresa Aydillo
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Sánchez-de Prada L, Eiros-Bachiller JM, Tamayo-Velasco Á, Martín-Fernández M, Álvarez FJ, Giner-Baixauli C, Tamayo E, Resino S, Alvaro-Meca A. Environmental factors are associated to hospital outcomes in COVID-19 patients during lockdown and post-lockdown in 2020: A nationwide study. Environ Res 2023; 229:115904. [PMID: 37080281 PMCID: PMC10112945 DOI: 10.1016/j.envres.2023.115904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/24/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE This study analyzed, at a postcode detailed level, the relation-ship between short-term exposure to environmental factors and hospital ad-missions, in-hospital mortality, ICU admission, and ICU mortality due to COVID-19 during the lockdown and post-lockdown 2020 period in Spain. METHODS We performed a nationwide population-based retrospective study on 208,744 patients admitted to Spanish hospitals due to COVID-19 based on the Minimum Basic Data Set (MBDS) during the first two waves of the pandemic in 2020. Environmental data were obtained from Copernicus Atmosphere Monitoring Service. The association was assessed by a generalized additive model. RESULTS PM2.5 was the most critical environmental factor related to hospital admissions and hospital mortality due to COVID-19 during the lockdown in Spain, PM10, NO2, and SO2and also showed associations. The effect was considerably reduced during the post-lockdown period. ICU admissions in COVID-19 patients were mainly associated with PM2.5, PM10, NO2, and SO2 during the lockdown as well. During the lockdown, exposure to PM2.5 and PM10 were the most critical environmental factors related to ICU mortality in COVID-19. CONCLUSION Short-term exposure to air pollutants impacts COVID-19 out-comes during the lockdown, especially PM2.5, PM10, NO2, and SO2. These pollutants are associated with hospital admission, hospital mortality and ICU admission, while ICU mortality is mainly associated with PM2.5 and PM10. Our findings reveal the importance of monitoring air pollutants in respiratory infectious diseases.
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Affiliation(s)
- Laura Sánchez-de Prada
- Department of Microbiology and Immunology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Biomedicine Group in Critical Care (BioCritic), Spain
| | | | - Álvaro Tamayo-Velasco
- Biomedicine Group in Critical Care (BioCritic), Spain; Department of Haematology and Hemotherapy, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Martín-Fernández
- Biomedicine Group in Critical Care (BioCritic), Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Department of Pharmacology, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain.
| | - F Javier Álvarez
- Biomedicine Group in Critical Care (BioCritic), Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Department of Pharmacology, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Carlos Giner-Baixauli
- Department of Statistics and Operations Research, Faculty of Mathematics, Universidad Complutense de Madrid, Madrid, Spain
| | - Eduardo Tamayo
- Biomedicine Group in Critical Care (BioCritic), Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Department of Anesthesiology and Critical Care, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Salvador Resino
- Biomedicine Group in Critical Care (BioCritic), Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Unit of Viral Infection and Immunity, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Alejandro Alvaro-Meca
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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6
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Álvarez-del Río B, Sánchez-de Prada L, Álvaro-Meca A, Martín-Fernández M, Álvarez FJ, Tamayo E, Gutiérrez-Abejón E. Economic Burden of the 2020 COVID-19 Hospitalizations in Spain. JAMA Netw Open 2023; 6:e2250960. [PMID: 36637826 PMCID: PMC9857216 DOI: 10.1001/jamanetworkopen.2022.50960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This economic evaluation reports the total and per patient costs of inpatient care for COVID-19 in Spain in 2020.
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Affiliation(s)
- Blanca Álvarez-del Río
- Pharmacology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - Laura Sánchez-de Prada
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- National Influenza Centre, Valladolid, Spain
| | - Alejandro Álvaro-Meca
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Preventive Medicine and Public Health Department, Rey Juan Carlos University, Madrid, Spain
| | - Marta Martín-Fernández
- Pharmacology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - F. Javier Álvarez
- Pharmacology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Tamayo
- Pharmacology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Gutiérrez-Abejón
- Pharmacology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Pharmacy Directorate, Castilla y León Health Council, Valladolid, Spain
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7
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Sanz-Muñoz I, López-Mongil R, Sánchez-Martínez J, Sánchez-de Prada L, González MDG, Pérez-SanJose D, Rojo-Rello S, Hernán-García C, Fernández-Espinilla V, de Lejarazu-Leonardo RO, Castrodeza-Sanz J, Eiros JM. Evolution of antibody profiles against SARS-CoV-2 in experienced and naïve vaccinated elderly people. Front Immunol 2023; 14:1128302. [PMID: 36911673 PMCID: PMC9992205 DOI: 10.3389/fimmu.2023.1128302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction The third dose of the COVID-19 vaccine is especially necessary in people over 65 years of age due to their lower immune response. Methods We designed a multicentre, prospective observational study including 98 people ≤65 years old who lived in two nursing homes in Valladolid, Spain. One of the groups had previous experience with SARS-CoV-2 (n=68;69.4%) and the other was naïve (n=30;30.6%). We evaluated the response to the three doses of the Comirnaty vaccine and the dynamics of antibodies during 5 consecutive serum samplings: 2 after the first two doses of vaccination, one three months after the first dose, another at 6 months and the last one month after the third dose. IgG antibodies against SARS-CoV-2 S1, RBD and N antigens were analysed. Results Both groups increased the level of Abs against S1 and RBD, but the experienced group showed a 130-fold higher humoral response due to hybrid immunisation (infection+vaccination). The response to vaccination with Comirnaty against COVID-19 was higher in those ≤65 years with previous experience than those who were naïve. However, the amount of antibodies against S1 and RBD equalised at 6 months. After the third dose, both groups raised the amount of antibodies to a similar level. The reinfections suggested by the analysis of antibodies against N were frequent in both groups. Discussion The third dose showed a clear benefit for elderly people, with the reinforcement of the antibody levels after the decline suffered after six months of the first two doses.
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Affiliation(s)
- Iván Sanz-Muñoz
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Instituto de Estudios de Ciencias de la Salud de Castilla y León, (ICSCYL), Soria, Spain
| | | | - Javier Sánchez-Martínez
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Instituto de Estudios de Ciencias de la Salud de Castilla y León, (ICSCYL), Soria, Spain
| | - Laura Sánchez-de Prada
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Marta Domínguez-Gil González
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | - Diana Pérez-SanJose
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Silvia Rojo-Rello
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Cristina Hernán-García
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Preventive Medicine and Public Health Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Virginia Fernández-Espinilla
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Preventive Medicine and Public Health Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Javier Castrodeza-Sanz
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Preventive Medicine and Public Health Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - José María Eiros
- National Influenza Centre, Edificio Rondilla, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain.,Microbiology Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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8
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de la Varga-Martínez O, Martín-Fernández M, Heredia-Rodríguez M, Ceballos F, Cubero-Gallego H, Priede-Vimbela JM, Bardají-Carrillo M, Sánchez-de Prada L, López-Herrero R, Jorge-Monjas P, Tamayo E, Gómez-Sánchez E. Influence of Renal Dysfunction on the Differential Behaviour of Procalcitonin for the Diagnosis of Postoperative Infection in Cardiac Surgery. J Clin Med 2022; 11:jcm11247274. [PMID: 36555891 PMCID: PMC9781060 DOI: 10.3390/jcm11247274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/26/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background: procalcitonin is a valuable marker in the diagnosis of bacterial infections; however, the impairment of renal function can influence its diagnostic precision. The objective of this study is to evaluate the differential behaviour of procalcitonin, as well as its usefulness in the diagnosis of postoperative pulmonary infection after cardiac surgery, depending on the presence or absence of impaired renal function. Materials and methods: A total of 805 adult patients undergoing cardiac surgery with extracorporeal circulation (CBP) were prospectively recruited, comparing the behaviour of biomarkers between the groups with and without postoperative pneumonia and according to the presence or absence of renal dysfunction. Results: Pulmonary infection was diagnosed in 42 patients (5.21%). In total, 228 patients (28.32%) presented postoperative renal dysfunction. Procalcitonin was significantly higher in infected patients, even in the presence of renal dysfunction. The optimal procalcitonin threshold differed markedly in patients with renal dysfunction compared to patients without renal dysfunction (1 vs. 0.78 ng/mL p < 0.05). The diagnostic accuracy of procalcitonin increased significantly when the procalcitonin threshold was adapted to renal function. Conclusions: Procalcitonin is an accurate marker of postoperative infection in cardiac surgery, even in the presence of renal dysfunction. Renal function is an important determinant of procalcitonin levels and, therefore, its diagnostic thresholds must be adapted in the presence of renal dysfunction.
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Affiliation(s)
- Olga de la Varga-Martínez
- Department of Anaesthesiology, Infanta Leonor University Hospital, Gran Via del Este 80, 28031 Madrid, Spain
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Correspondence: ; Tel.: +34-911918000
| | - Marta Martín-Fernández
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Carlos III Health Institute, 28029 Madrid, Spain
- Department of Medicine, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - María Heredia-Rodríguez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Carlos III Health Institute, 28029 Madrid, Spain
- Department of Anaesthesiology, Clinical University Hospital of Salamanca, P.° de San Vicente, 58, 37007 Salamanca, Spain
| | - Francisco Ceballos
- Viral Infection and Immunity Unit, National Center for Microbiology, Carlos III Health Institute, 28029 Madrid, Spain
| | - Hector Cubero-Gallego
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Juan Manuel Priede-Vimbela
- Department of Anaesthesiology, Clinic University Hospital of Valladolid, Ramon y Cajal Ave. 3, 47003 Valladolid, Spain
| | - Miguel Bardají-Carrillo
- Department of Anaesthesiology, Clinic University Hospital of Valladolid, Ramon y Cajal Ave. 3, 47003 Valladolid, Spain
| | - Laura Sánchez-de Prada
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Microbiology and Immunology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Rocío López-Herrero
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Department of Anaesthesiology, Clinic University Hospital of Valladolid, Ramon y Cajal Ave. 3, 47003 Valladolid, Spain
| | - Pablo Jorge-Monjas
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Carlos III Health Institute, 28029 Madrid, Spain
- Department of Anaesthesiology, Clinic University Hospital of Valladolid, Ramon y Cajal Ave. 3, 47003 Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Eduardo Tamayo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Carlos III Health Institute, 28029 Madrid, Spain
- Department of Anaesthesiology, Clinic University Hospital of Valladolid, Ramon y Cajal Ave. 3, 47003 Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Esther Gómez-Sánchez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Ramon y Cajal Ave. 7, 47005 Valladolid, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Carlos III Health Institute, 28029 Madrid, Spain
- Department of Anaesthesiology, Clinic University Hospital of Valladolid, Ramon y Cajal Ave. 3, 47003 Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
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Prada LSD, Sanz-Muñoz I, de Lejarazu RO, Eiros JM, García-Sastre A, Aydillo T. Immunodominance hierarchy after seasonal influenza vaccination. Emerg Microbes Infect 2022; 11:2670-2679. [PMID: 36219456 DOI: 10.1080/22221751.2022.2135460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Current influenza vaccines elicit humoral immune responses against the hemagglutinin (HA) protein of influenza viruses. Different antigenic sites have been identified in the HA head as the main target of hemagglutination inhibition (HAI) antibodies (Sb, Sa, Cb, Ca1 and Ca2). To determine immunodominance (ID) of each site, we performed HAI assays against a panel of mutant viruses, each one lacking one of the classically defined antigenic sites and compared it to wild type (Wt). Agglutinating antibodies were measured before and after vaccination in two different regimens: Quadrivalent Influenza Vaccine (QIV) in young adults; or Adjuvanted Trivalent influenza Vaccine (ATIV) in elderly. Our results showed abs before vaccination were significantly reduced against all antigenic sites in the elderly and only against Sb and Ca2 in young adults compared to the Wt. Humoral response to vaccination was significantly reduced against all viruses compared to the Wt for the ATIV and only against Sb and Ca2 for the QIV. The strongest reduction was observed in all cases against Sb followed by Ca2. We concluded that ID profile was clearly dominated by Sb followed by Ca2. Additionally, the antibody response evolved with age, increasing the response towards less immunodominant epitopes of HA head. Adjuvants can positively influence ID hierarchy broadening responses towards multiple antigenic sites of HA head.
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Affiliation(s)
- Laura Sánchez-de Prada
- National Influenza Centre of Valladolid, 47010, Spain.,Hospital Clínico Universitario de Valladolid, 47003, Spain
| | | | | | | | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Teresa Aydillo
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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10
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Sánchez-de Prada L, Gorgojo-Galindo Ó, Fierro I, Martínez-García AM, de Quintana GSL, Gutiérrez-Bustillo R, Pelaez-Jareño MT, Álvarez-Fuente E, Gómez-Sánchez E, Tamayo E, Tamayo-Velasco Á, Martín-Fernández M. Time evolution of cytokine profiles associated with mortality in COVID-19 hospitalized patients. Front Immunol 2022; 13:946730. [PMID: 36238287 PMCID: PMC9551198 DOI: 10.3389/fimmu.2022.946730] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background High cytokine levels have been associated with severe COVID-19 disease. Although many cytokine studies have been performed, not many of them include combinatorial analysis of cytokine profiles through time. In this study we investigate the association of certain cytokine profiles and its evolution, and mortality in SARS-CoV2 infection in hospitalized patients. Methods Serum concentration of 45 cytokines was determined in 28 controls at day of admission and in 108 patients with COVID-19 disease at first, third and sixth day of admission. A principal component analysis (PCA) was performed to characterize cytokine profiles through time associated with mortality and survival in hospitalized patients. Results At day of admission non-survivors present significantly higher levels of IL-1α and VEGFA (PC3) but not through follow up. However, the combination of HGF, MCP-1, IL-18, eotaxine, and SCF (PC2) are significantly higher in non-survivors at all three time-points presenting an increased trend in this group through time. On the other hand, BDNF, IL-12 and IL-15 (PC1) are significantly reduced in non-survivors at all time points with a decreasing trend through time, though a protective factor. The combined mortality prediction accuracy of PC3 at day 1 and PC1 and PC2 at day 6 is 89.00% (p<0.001). Conclusions Hypercytokinemia is a hallmark of COVID-19 but relevant differences between survivors and non-survivors can be early observed. Combinatorial analysis of serum cytokines and chemokines can contribute to mortality risk assessment and optimize therapeutic strategies. Three clusters of cytokines have been identified as independent markers or risk factors of COVID mortality.
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Affiliation(s)
- Laura Sánchez-de Prada
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Microbiology and Immunology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Óscar Gorgojo-Galindo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Inmaculada Fierro
- Faculty of Health Science, Universidad Europea Miguel de Cervantes, Valladolid, Spain
| | - Ana María Martínez-García
- Microbiology and Immunology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Rocío Gutiérrez-Bustillo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María Teresa Pelaez-Jareño
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Elisa Álvarez-Fuente
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Esther Gómez-Sánchez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- *Correspondence: Esther Gómez-Sánchez,
| | - Eduardo Tamayo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Álvaro Tamayo-Velasco
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Haematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Marta Martín-Fernández
- BioCritic, Group for Biomedical Research in Critical Care Medicine, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
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11
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Sánchez-de Prada L, Rojo-Rello S, Domínguez-Gil M, Tamayo-Gómez E, Ortiz de Lejarazu-Leonardo R, Eiros JM, Sanz-Muñoz I. Influenza B Lineages Have More in Common Than Meets the Eye. Trivalent Influenza Vaccines Trigger Heterotypic Antibodies Against Both Influenza B Viruses. Front Microbiol 2021; 12:737216. [PMID: 34858361 PMCID: PMC8632244 DOI: 10.3389/fmicb.2021.737216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Influenza B is accountable for an important burden during flu epidemics, causing special impact in children and the elderly. Vaccination is the best approach to address influenza infections. However, one of the main problems of this virus is that two different lineages circulate together, Victoria and Yamagata; and trivalent vaccines, that only contain one of these lineages, are still in use. For that reason, if during an epidemic, the lineage not included in the vaccine predominates, a mismatch would occur, and the vaccine effectiveness will be very poor. In this work, we evaluated the cross-protection given by the trivalent Influenza vaccine and compared serological profiles based on age, sex, and the type of vaccine used. We performed a retrospective analysis of serum samples obtained before and after seasonal influenza vaccination during 20 seasons (1998–2018). The results showed that heterotypic reactivity between both influenza B lineages is common, but always lower than the homologous response. Age is a relevant factor for this cross-reactivity between both lineages, while the sex and the type of vaccine not. Vaccination with trivalent influenza vaccines elicits cross-reactive antibodies against both lineages, however, this response might not be enough to provide an appropriate serological protection in case of mismatch.
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Affiliation(s)
- Laura Sánchez-de Prada
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,National Influenza Center of Valladolid, Valladolid, Spain
| | - Silvia Rojo-Rello
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,National Influenza Center of Valladolid, Valladolid, Spain
| | - Marta Domínguez-Gil
- National Influenza Center of Valladolid, Valladolid, Spain.,Department of Microbiology, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Eduardo Tamayo-Gómez
- Department of Anesthesia, Critical Care and Pain Medicine, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - José María Eiros
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,National Influenza Center of Valladolid, Valladolid, Spain.,Department of Microbiology, Hospital Universitario Río Hortega, Valladolid, Spain
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12
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Martín-Fernández M, Aller R, Heredia-Rodríguez M, Gómez-Sánchez E, Martínez-Paz P, Gonzalo-Benito H, Sánchez-de Prada L, Gorgojo Ó, Carnicero-Frutos I, Tamayo E, Tamayo-Velasco Á. Lipid peroxidation as a hallmark of severity in COVID-19 patients. Redox Biol 2021; 48:102181. [PMID: 34768063 PMCID: PMC8572041 DOI: 10.1016/j.redox.2021.102181] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/27/2021] [Accepted: 11/05/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Oxidative stress may be a key player in COVID-19 pathogenesis due to its significant role in response to infections. A defective redox balance has been related to viral pathogenesis developing a massive induction of cell death provoked by oxidative stress. The aim of this study is to perform a complete oxidative stress profile evaluation regarding antioxidant enzymes, total antioxidant capacity and oxidative cell damage in order to characterize its role in diagnosis and severity of this disease. METHODS Blood samples were obtained from 108 COVID-19 patients and 28 controls and metabolites representative of oxidative stress were assessed. The association between lipid peroxidation and 28-day intubation/death risk was evaluated by multivariable regression analysis. Probability of intubation/death to day-28 was analyzed by using Kaplan-Meier curves and tested with the log-rank test. RESULTS Antioxidant enzymes (Superoxide dismutase (SOD) and Catalase) and oxidative cell damage (Carbonyl and Lipid peroxidation (LPO)) levels were significantly higher in COVID-19 patients while total antioxidant capacity (ABTS and FRAP) levels were lower in these patients. The comparison of oxidative stress molecules' levels across COVID-19 severity revealed that only LPO was statistically different between mild and intubated/death COVID-19 patients. COX multivariate regression analysis identified LPO levels over the OOP (LPO>1948.17 μM) as an independent risk factor for 28-day intubation/death in COVID-19 patients [OR: 2.57; 95% CI: 1.10-5.99; p = 0.029]. Furthermore, Kaplan-Meier curve analysis revealed that COVID-19 patients showing LPO levels above 1948.17 μM were intubated or died 8.4 days earlier on average (mean survival time 15.4 vs 23.8 days) when assessing 28-day intubation/death risk (p < 0.001). CONCLUSION These findings deepen our knowledge of oxidative stress status in SARS-CoV-2 infection, supporting its important role in COVID-19. In fact, higher lipid peroxidation levels are independently associated to a higher risk of intubation or death at 28 days in COVID-19 patients.
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Affiliation(s)
- Marta Martín-Fernández
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Rocío Aller
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; Gastroenterology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - María Heredia-Rodríguez
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Salamanca, 37007 Salamanca, Spain.
| | - Esther Gómez-Sánchez
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain.
| | - Pedro Martínez-Paz
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Hugo Gonzalo-Benito
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Institute of Health Sciences of Castile and Leon (IECSCYL), 42002 Soria, Spain
| | - Laura Sánchez-de Prada
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Óscar Gorgojo
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Institute of Health Sciences of Castile and Leon (IECSCYL), 42002 Soria, Spain
| | - Irene Carnicero-Frutos
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Institute of Health Sciences of Castile and Leon (IECSCYL), 42002 Soria, Spain
| | - Eduardo Tamayo
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Álvaro Tamayo-Velasco
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain; Haematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
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13
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Sánchez-de Prada L, Ortiz de Lejarazu-Leonardo R, Castrodeza-Sanz J, Tamayo-Gómez E, Eiros-Bouza JM, Sanz-Muñoz I. Do Vaccines Need a Gender Perspective? Influenza Says Yes! Front Immunol 2021; 12:715688. [PMID: 34290718 PMCID: PMC8287332 DOI: 10.3389/fimmu.2021.715688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 01/22/2023] Open
Abstract
Background Sex differences in immune responses are well known. However, the humoral response in males and females in the case of influenza vaccination is yet to be characterized since studies have shown uneven results. Methods A retrospective study was conducted in 2,243 individuals (46.9% males) divided by age (15-64 and ≥65 years old). A serological analysis was performed by hemagglutination inhibition assay (HI) just before and 28 days after annual vaccination against seasonal influenza viruses in people vaccinated during the 2006-2018 seasons. A comparison of the humoral responses against influenza A and B viruses contained in the vaccine, between male and female individuals in young adults and elderly was conducted. Results Significative higher humoral response against classical influenza A (H1N1), A(H1N1)pdm09 subtype and B/Victoria lineage in terms of seroconversion rate were found in elderly women. No significant differences were found in the case of A(H3N2) subtype. Conclusions Elderly women seem to display a greater humoral response against classical A(H1N1), pandemic A(H1N1)pmd09 and B/Victoria lineage than elderly men. Sex dimorphism does not affect young adults.
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Affiliation(s)
- Laura Sánchez-de Prada
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Javier Castrodeza-Sanz
- National Influenza Center of Valladolid, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Department of Preventive Medicine and Public Health, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Eduardo Tamayo-Gómez
- Department of Anesthesia, Critical Care and Pain Medicine, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - José María Eiros-Bouza
- Department of Microbiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- National Influenza Center of Valladolid, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Department of Microbiology, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Iván Sanz-Muñoz
- National Influenza Center of Valladolid, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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