ABSTRACT
Evusheld (tixagevimab/cilgavimab), a combination of two monoclonal antibodies against SARS-CoV-2, was authorized in January 2022 as prophylaxis in immunocompromised patients. Data on Evusheld efficacy in lung transplant patients is lacking. This study aimed to determine if Evusheld reduces SARS-CoV-2 infection or is associated with improved clinical outcomes in lung transplant recipients. We performed a single-center retrospective study of lung transplant recipients at our institution who were alive in 2022. SARS-CoV-2 diagnoses from 1/1/2022 to 6/30/22 were recorded. Demographics, number of COVID vaccine doses, Evusheld administration, and COVID-19 clinical outcomes were recorded. The primary outcome was rate of SARS-CoV-2 infection between patients who received Evusheld and those who did not. Secondary outcomes included death, hospitalization, hospital length of stay, and decline in FEV1. Data were analyzed using Fisher's exact test or logistic regression controlling for age and vaccine doses. 336 patients were included in the study (57% male, 84% double lung transplants, 51% prior interstitial lung disease, median of 3 years post-transplant, median of 3 COVID vaccine doses). 136 (40%) received Evusheld 600mg. Among patients who received Evusheld, 7 (5%) were diagnosed with SARS-CoV-2 infection, compared to 30 (15%) of patients without Evusheld (p=0.005, Figure). After controlling for age and COVID vaccine doses received, Evusheld reduced the risk of SARS-CoV-2 by 92% (OR 0.084, 95%CI 0.02-0.29, p<0.001). There were no significant differences between groups in symptom development (86% with Evusheld vs 93%, p=0.47), hospitalization rate (14% vs 23%, p=1.0), hospital length of stay (1 vs 9 days, p=0.29), >10% decline in FEV1 (18% vs 29%, p=0.61), or death (0% vs 13%, p=0.57). After controlling for age and COVID vaccine doses received, Evusheld substantially lowered the risk of SARS-CoV-2 infection, with limited impact on clinical outcomes once infected. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Lung transplant (LTx) recipients have increased risk of infection with SARS-CoV-2 and have reduced efficacy from COVID-19 vaccination. The Delta variant of SARS-CoV-2 has increased virulence compared to earlier variants. We hypothesized that LTx recipients would have increased susceptibility to Delta variant infection despite vaccination. We performed a retrospective cohort study of 314 LTx recipients followed between 1/1/2020-9/30/2021. Diagnosis of SARS-CoV-2 infection by PCR was recorded;Delta variant comprised >99% of strains from 6/1/2021-9/30/2021. Data regarding COVID-19 vaccination status, symptom development, hospitalization, intubation, and death were collected. Forty-four patients (14%) were diagnosed with COVID-19, 18 (41%) of which were Delta variant. The rate of infection with Delta was 4-fold higher than with earlier strains (Figure, 0.016 vs. 0.004 cases / patient months, p<0.001). Fifteen (83%) patients diagnosed with Delta variant were fully vaccinated at the time of infection (p<0.001). The rate of infection with Delta variant in vaccinated and unvaccinated individuals was similar (0.017/patient months with vaccine, 0.015/patient months without vaccine, p=0.84). The majority (>89%) of patients had respiratory symptoms in both groups. More patients with Delta variant received monoclonal antibody infusions (89% vs. 54%, p=0.021) and fewer patients with Delta variant had resolution of disease (50% vs. 92%, p<0.001). There was a trend towards greater O 2 needs with Delta variant (p=0.07). Hospitalization (38% vs. 23%), intubation (11% vs. 4%), and death (11% vs. 4%) were numerically greater with Delta variant, although not statistically significant. The incidence rate of SARS-CoV-2 infection was significantly greater with Delta variant in LTx recipients, despite high prevalence of full vaccination during the Delta wave. Further study in larger cohorts is needed to determine whether booster vaccines can reduce such infectivity. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Dr. Deborah Birx, the White House Coronavirus Task Force coordinator, told NBC News on "Meet the Press" that "[T]he U.S. needs a 'breakthrough' in coronavirus testing to help screen Americans and get a more accurate picture of the virus' spread." We have been involved with biopathogen detection since the 2001 anthrax attacks and were the first to detect anthrax in real-time. A variation on the laser spectroscopic techniques we developed for the rapid detection of anthrax can be applied to detect the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2 virus). In addition to detecting a single virus, this technique allows us to read its surface protein structure. In particular, we have been conducting research based on a variety of quantum optical approaches aimed at improving our ability to detect Corona Virus Disease-2019 (COVID-19) viral infection. Indeed, the detection of a small concentration of antibodies, after an infection has passed, is a challenging problem. Likewise, the early detection of disease, even before a detectible antibody population has been established, is very important. Our team is researching both aspects of this problem. The paper is written to stimulate the interest ofboth physical and biological scientists in this important problem. It is thus written as a combination of tutorial (review) and future work (preview). We join Prof. Federico Capasso and Editor Dennis Couwenberg in expressing our appreciation to all those working so heroically on all aspects of the COVTD-19 problem. And we thank Drs. Capasso and Couwenberg for their invitation to write this paper. © 2021 Walter de Gruyter GmbH, Berlin/Boston. All rights reserved.
ABSTRACT
Background: Interprofessional Student Hotspotting addresses patients with complex medical and social needs. In 2015, Johnson et al found that 82% of these patients have multiple comorbidities, 41% have a serious mental health condition, and 30% report homelessness. High utilization patients have four times more inpatient admissions, four to eight times more readmissions, 30% longer and more expensive hospital stays than the average patient. Our project, a collaboration between the Camden Coalition, University of Montana, Montana Geriatric Education Center and Partnership Health Center, aims to decrease emergency department (ED) visits and increase primary care engagement. By using student teams, we aim to increase understanding of interprofessional collaborative practice (IPCP). Methods: Through home-based, non-clinical interventions to address social determinants, teams worked for 6 months to improve patients' quality of life, integrate medical, behavioral, and social care, and increase utilization of primary care. At the onset of COVID-19, faculty determined that ending services for these vulnerable older adults could be determinantal. Thus, students continued the program in a virtual format through mid-June. Patient utilization of the ED and primary care and PHQ-9 depression scores were monitored before, during and after program participation. The student outcomes were assessed using the Student Perception of Interprofessional Clinical Education - Revised (SPICE-R). Results: Patients decreased ED utilization, increased appropriate use of primary care, and improved depression scores. During the first months of the pandemic, patients in the virtual hotspotting increased their comfort in using technology for medical appointments as well as engaging in online social interactions. The students improved their understanding of and skills for IPCP as demonstrated by increased SPICE-R scores. Conclusion: Student Hotspotting is an educational tool to support IPE and training in patient-centered care while improving health outcomes and decreasing healthcare expenditures in patients with high utilization.
ABSTRACT
Dr. Deborah Birx, the White House Coronavirus Task Force coordinator, told NBC News on "Meet the Press"that "[T]he U.S. needs a 'breakthrough' in coronavirus testing to help screen Americans and get a more accurate picture of the virus' spread."We have been involved with biopathogen detection since the 2001 anthrax attacks and were the first to detect anthrax in real-time. A variation on the laser spectroscopic techniques we developed for the rapid detection of anthrax can be applied to detect the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2 virus). In addition to detecting a single virus, this technique allows us to read its surface protein structure. In particular, we have been conducting research based on a variety of quantum optical approaches aimed at improving our ability to detect Corona Virus Disease-2019 (COVID-19) viral infection. Indeed, the detection of a small concentration of antibodies, after an infection has passed, is a challenging problem. Likewise, the early detection of disease, even before a detectible antibody population has been established, is very important. Our team is researching both aspects of this problem. The paper is written to stimulate the interest of both physical and biological scientists in this important problem. It is thus written as a combination of tutorial (review) and future work (preview). We join Prof. Federico Capasso and Editor Dennis Couwenberg in expressing our appreciation to all those working so heroically on all aspects of the COVID-19 problem. And we thank Drs. Capasso and Couwenberg for their invitation to write this paper. © 2020 Navid Rajil et al., published by De Gruyter, Berlin/Boston 2020.