ABSTRACT
Purpose: The radiation recall phenomenon (RRP) is a rare and unexpected late complication of radiation therapy (RT). Although predominantly in the skin, RRP of the upper respiratory tract has also been reported. In general, RRP is caused by anticancer agents, and the COVID-19 vaccine has also been reported to cause RRP in recent years. Methods and Materials: A 50-year-old woman who had received RT around the larynx 3 years prior and was receiving a docetaxel + ramucirumab (RAM) regimen experienced recurrent sore throat. The administration of RAM was discontinued after a gastroscopic examination revealed mucosal bleeding from around the larynx, which was thought to be RRP caused by RAM, a vascular endothelial growth factor inhibitor. Results: After the remission of the RRP, the patient received a COVID-19 vaccine (Pfizer-BioNTech). Five days later, the appearance of cough and recurrence of sore throat worsened with time, and marked stridor was observed. The patient was admitted, and steroid pulse therapy was administered for 3 days starting on day 18 after vaccination. On day 50 after vaccination, edema of the vocal cords improved. Conclusions: When administering COVID-19 vaccines, considering that these vaccines may cause RRP is important, because RRP can be fatal in patients with a history of RT in the laryngeal region and treated with vascular endothelial growth factor inhibitors.
ABSTRACT
This is the first report of COVID-19 in a human T-cell lymphotropic virus type-1 (HTLV-1) carrier. HTLV-1 infection can cause immune dysfunction even in asymptomatic carriers. This case highlights the need for guidance on management of COVID-19-HTLV-1 coinfection, specifically on the appropriate use of corticosteroid treatment while considering secondary infection.
ABSTRACT
Condition:
COVID-19Intervention:
Patients will be randomized to the following 3 groups.1) Group with 150mg/day
In addition to ordinary therapyies for COVID-19, the study drug 150 mg/day will be administered to patients for 14 days.
2) Group with 300mg/day
In addition to ordinary therapyies for COVID-19, the study drug 300 mg/day (150mg for one dose, 2 times per day) will be administered to patients for 14 days.
3) Control group
Patients will receive only ordinary therapies for COVID-19 as doctors indicated.
Primary outcome:
The change rate of CD8+ T cells between before and 7 days after the administration of the study drugCriteria:
Inclusion criteria: 1) Patients who are positive for SARS-CoV-2 by PCR or antigen test2) Patients who do not need continuous (24h) oxygen inhalation
3) Patients who can eat and drink
4) Patients older or equal to 20 years old and younger than 75 years old
5) Patients who can sign the informed consent form by themselves
Exclusion criteria: 1) Patients with hypersensitivity for tetracycline compound
2) Patients showing SpO2 < 93% without oxygen inhalation
3) Patients who are or have a possibility to be pregnant, or hope to be pregnant during the study.
4) Patients with liver failure (AST and/or ALT >= the standard value)
5) Patients with kidney failure (eGFR < 30 ml/min/1.73m2)
6) Patients who had a COVID-19 vaccination
7) Patients who are considered unsuitable for the study by the PI or sub investigators