ABSTRACT
Background: Although the use of remdesivir and systemic corticosteroids have reduced deaths from COVID-19, COVID-19 still has a high mortality rate. Aims: To know the effectiveness of the combined use of remdesivir and regdanvimab (CT-P59) in patients with severe COVID-19. Methods: From March to early May 2021, 124 severe COVID-19 patients were admitted to Ulsan University Hospital (Ulsan, Korea), and received oxygen therapy and remdesivir. Among them, 25 were administered regdanvimab before oxygen/remdesivir. We retrospectively compared the outcomes of the two groups: remdesivir alone group (n = 99 [79.8%]) vs. regdanvimab/remdesivir group (n = 25 [20.2%]). Results: The oxygen-free days at day 28 (primary outcome), defined as the number of days a patient was alive and oxygen-free for 28 days from oxygen/remdesivir start, were significantly higher in regdanvimab/remdesivir group (mean ± SD [standard deviation]: 19.36 ± 7.87 vs. 22.72 ± 3.66, P = 0.003). The association between the regdanvimab/ remdesivir group and the oxygen-free days was also significant in multivariate analysis (logistic regression), where the initial SpO2/FiO2 ratio (severity index) was adjusted. Further, in the regdanvimab/remdesivir group, the lowest SpO2/FiO2 ratio during treatment was significantly higher (mean ± SD: 237.05 ± 89.68 vs. 295.63 ± 72.74, P = 0.003), and the Kaplan-Meier Estimate of oxygen supplement days in surviving patients (at day 28) were significantly shorter (mean ± SD: 8.24 ± 7.43 vs. 5.28 ± 3.66, P (log-rank test) = 0.024). Conclusions: In severe COVID-19 patients, clinical outcomes could be improved by using regdanvimab in addition to remdesivir.
ABSTRACT
BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, various adverse skin reactions to long-term mask wearing have been reported. AIM: To assess the clinical features of mask-induced dermatoses and to recommend prevention and treatment options. METHODS: From April to August 2020, questionnaires including topics such as demographic information, pre-existing skin disorders, reported mask-related symptoms, daily mask-wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments. RESULTS: Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new-onset contact dermatitis (33.94%), followed by new-onset acne (16.97%) and worsening of pre-existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new-onset contact dermatitis. More than half of patients with pre-existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare-up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias. CONCLUSION: Mask-induced/-triggered dermatoses contribute to increase the dermatological burden during the pandemic.
Subject(s)
Dermatitis, Occupational/etiology , Facial Dermatoses/etiology , Masks/adverse effects , Personnel, Hospital , Acne Vulgaris/etiology , Adult , COVID-19/prevention & control , Female , Hospitals, University , Humans , Male , Middle Aged , Pandemics/prevention & control , Pruritus/etiology , Republic of Korea , SARS-CoV-2 , Tertiary Care CentersABSTRACT
The spike glycoprotein attached to the envelope of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binds to and exploits angiotensin-converting enzyme 2 (ACE2) as an entry receptor to infect pulmonary epithelial cells. A subset of integrins that recognize the arginyl-glycyl-aspartic acid (RGD) sequence in the cognate ligands has been predicted in silico to bind the spike glycoprotein and, thereby, to be exploited for viral infection. Here, we show experimental evidence that the beta1 integrins predominantly expressed on human pulmonary epithelial cell lines and primary mouse alveolar epithelial cells bind to this spike protein. The cellular beta1 integrins support adhesive interactions with the spike protein independently of ACE2, suggesting the possibility that the beta1 integrins may function as an alternative receptor for SARS-CoV-2, which could be targeted for the prevention of viral infections.