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Background: Serum interleukin 6 (IL-6) levels have been studied in the diagnostic evaluation of patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19). Methods: We studied the utility of treatment with tocilizumab in COVID-19 patients (n=19) with a negative nasopharyngeal swab real time reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 who had suggestive computed tomography (CT) findings, namely, COVID-19 Reporting and Data System (CO-RADS) 4,5. Results: Receiver operator characteristic (ROC) curve analysis showed that serum IL 6 at a cut-off of >56.9 pg/L was a predictor of mortality in nasopharyngeal swab RT-PCR negative patients with suggestive CT findings. Tocilizumab had no significant effect on the mortality. Conclusions: In nasopharyngeal swab RT-PCR negative patients with suggestive chest CT findings, elevated serum IL-6 levels > 56.9 pg/L predicted mortality. However, treatment with tocilizumab had no effect on mortality.
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Background: Concern about vaccine hesitancy is growing worldwide. Vaccine hesitancy can have effects for both the individual and the community, especially in the context of severe acute respiratory syndrome coronavirus 2 disease (COVID-19) pandemic. Methods: A 16-item questionnaire was administered to 385 healthcare workers to find out the reasons for COVID-19 vaccine hesitancy. Results: Their mean age was 36.6 +or- 9.6 years. 'Fear of getting side effects' (61.8%) was the most common reason for vaccine hesitancy, followed by reasons such as 'to wait and observe for some more time' (60.3%), 'doubts on safety and efficacy of vaccine' (49.4%), 'The intensity of COVID-19 has come down' (36.6%), 'self-perception of having good immunity' (33.8%), 'need to apply for leave' (30.3%) and 'Fear of death' (29.0%). 'To wait and observe for some more time' was the major reason for hesitancy amongst men. Security guards were more hesitant to take the vaccine, because of side effects, whereas doctors and sanitary workers wanted to wait and observe for some more time. Conclusions: Factors identified in the present study need to be addressed for overcoming vaccine hesitancy.
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The disease COVID-19 caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that develops into severe illness and death in some people who contract the virus has propelled terms associated with biosecurity such as vector transmission and herd immunity into the public domain. However, little is known about how young people understand these terms. Considering that maintaining biosecurity is a key concept in New Zealand society, education about it is very scant. In this paper, data collected during a biosecurity outbreak in Auckland, New Zealand, is used to argue for biosecurity education in schools for young people. The purpose of this study was to uncover perceptions of biosecurity of teachers who were affected by the regulations set in place during the fruit fly outbreak in Auckland. Data was gathered via personal interviews with teachers. The results show that teachers support the inclusion of biosecurity teaching and learning in schools. Furthermore, teachers predicted social consequences if biosecurity education was not implemented. Given the support from teachers, this paper argues that such education could provide a platform from which the next generation of young people could be better informed on how to deal with biosecurity-related pandemics at both national and global levels. © 2022, The Author(s) under exclusive licence to Australian Curriculum Studies Association.
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The disease COVID-19 caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that develops into severe illness and death in some people who contract the virus has propelled terms associated with biosecurity such as vector transmission and herd immunity into the public domain. However, little is known about how young people understand these terms. Considering that maintaining biosecurity is a key concept in New Zealand society, education about it is very scant. In this paper, data collected during a biosecurity outbreak in Auckland, New Zealand, is used to argue for biosecurity education in schools for young people. The purpose of this study was to uncover perceptions of biosecurity of teachers who were affected by the regulations set in place during the fruit fly outbreak in Auckland. Data was gathered via personal interviews with teachers. The results show that teachers support the inclusion of biosecurity teaching and learning in schools. Furthermore, teachers predicted social consequences if biosecurity education was not implemented. Given the support from teachers, this paper argues that such education could provide a platform from which the next generation of young people could be better informed on how to deal with biosecurity-related pandemics at both national and global levels.
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Objectives: Along the course human history of scientific research, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is the most concerning global health problem. Second wave of COVID-19 has adversely affected India. However, India embarked on its immunization program on January 16, 2021, operating 3006 vaccination centers onset Covaxin and CoviShield. This study aimed to ascertain if there is an association amidst ABO blood type and probability of COVID-19 infection in wave. Method(s): This is analytical and observational study conducted on 713 SARS-COVID-19-positive patients of a known ABO blood type, who attended outpatient department and inpatient department during March 26-May 20, 2021, in tertiary care hospital Udaipur (Raj.) Serum inflammatory markers were evaluated by Cobas 6000. Result(s): Out of the 713 patients who were tested positive, 15.56% was blood group Type A, 19.91% was blood group Type B, 13.65% was blood group Type AB, and 46.28% was blood group Type O. On statistical analysis, there were positive association between O+ blood type and peak inflammatory marker (interleukin-6 and D-Dimer). Patients with blood Type O who received a test were more likely to test positive and blood Type B+, A+, A+, AB+, O-, A-, B-, and AB- were less likely to test positive. Conclusion(s): The present study shows an evidence for interrelation between ABO blood groups and SARS-COVID-19. Reported infection prevalence is moderately increased among O+ blood type individuals. Determination of level of inflammatory markers might prove to be helpful to clinicians so as to keep track of severity of infection and evaluate the prognosis of SARS-COVID-19 with specific ABO blood groups. Copyright © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
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BACKGROUND: This study presents our data on mortality in end stage renal disease (ESRD) patients on peritoneal dialysis (PD) who developed COVID-19. MATERIALS AND METHODS: Sri Padmavathi Medical College Hospital, Sri Venkateswara Institute of Medical Sciences University, was designated the State COVID Hospital in March 2020. In a retrospective observational study, we collected the data of ESRD patients on PD and identified the risk factors for mortality. RESULTS: Prior to the pandemic, 136 patients with ESRD were on peritoneal dialysis at our Institute. Among them, 27 (19.8%) eventually developed COVID-19, and 14 of them (51.8%) died. Serum albumin levels were lower and D-dimer levels were significantly higher in deceased patients than in survivors. DISCUSSION: The mortality rate in ESRD patients on PD with COVID-19 at our institution was higher than in other published studies.
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This paper uses recent multiyear harmonized data on multidimensional poverty for 75 developing countries to judge prospects for attaining SDG Target 1.2 of reducing multidimensional poverty by one-half. Exponential rate of decline in multidimensional poverty headcount is calculated and extrapolated to the SDG period 2015-2030 to see whether the rate of decline would lower multidimensional poverty headcount by 50% over the 15-year period. There are 43 countries in which the observed rate of decline is large enough to reduce the headcount by half in 15 years. These countries had a total population of 3.9 billion and multidimensional poverty headcount of 580.7 million. There are 24 countries, with multidimensional poverty headcount of 549.9 million, where rate of reduction is not large enough to lower MDP headcount by one-half in 15 years. There are 8 countries that may or may not make the target. The international community needs to focus on the 24 countries that are likely to miss the target even in the pre-COVID scenario studied in this research. When post-COVID data become available in a few years, it should be possible to reassess the situation and to judge the effect of COVID on prospects for reaching the SDG Target 1.2.
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Social distancing has been suggested as one of the effective measures to break the chain of viral transmission in the ongoing COVID-19 pandemic. We herein describe a computer vision-based AI-assisted solution to aid compliance with social distancing norms. The solution consists of modules to detect and track people, and to identify distance violations. It provides the flexibility to choose between a tool-based mode requiring user input or a fully automated mode of camera calibration (devised in-house), making the latter suitable for large-scale deployments. We also outline a strategy to estimate the number of video feeds which can be supported in parallel for scalability. Finally, we discuss different metrics to assess the risk associated with social distancing violations, including the use of 'violation clusters', and how we can differentiate between transient or persistent violations. Our proposed solution performs satisfactorily under different test scenarios, processes video feed at real-time speed, as well as addresses data privacy regulations by blurring faces of detected people, making it ideal for deployments. © 2021 IEEE.
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Background: The Pfizer/BioNTech BNT162b2 vaccine, employing mRNA technology, has been recently approved by both the FDA and EMA for the prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, demonstrating a 94.6% protection rate in a phase 3 study. While this vaccine is recommended by the FDA, EBMT and ASH-ASTCT for immunosuppressed patients, data regarding protection efficacy and safety in patients undergoing immunologic cell therapy are scarce. Aims: We aimed to evaluate efficacy and toxicity of the BNT162b2 vaccine in patients that underwent hematopoietic cell transplantation and CAR-T therapy. Methods: All patients under active treatment at the long-term follow-up HCT clinic (n=124) at the Tel Aviv Sourasky Medical Center, were evaluated for immunologic recovery (CD19+, CD4+, and CD8+ cell blood levels) pre-vaccination and were recommended to receive the commercial vaccination based on the EBMT recommendations. Patients were prospectively followed for vaccination-safety profile (laboratory tests, GVHD monitoring, and symptom-based questionnaire). We evaluated the humoral immune response to vaccine, 7-14 days after the second vaccine dose, by in vitro quantitative determination of anti-SARSCoV- 2S antibodies using Elecsys. assay and cellular immune response by ELISpot, estimating IL-2 and IFN-gamma secretion in response to a pool of lyophilized SARS-COV-2 S and M peptides (PepTivator;Miltenyi). The trial was approved by the local Ethics Committee and was registered by the clinical trials network (NCT04724642). Results: From 23-Dec-2020 all sequential patients (allogeneic, n=101 and CAR-T, n=23) were assessed for eligibility based on the EBMT recommendations (Version 5.0, Feb 21, 2021). Of those, 100 patients were eligible and 79 patients (allogeneic, n=65 and CAR-T, n=14) were vaccinated per-protocol. Characteristics of patients are depicted in Table 1. Overall, the 2 vaccine doses were well tolerated. Adverse events were reported in 39% of allogeneic HCT recipients (4.6% grade ≥3) and 32% of CART recipients (7% grade ≥3). All events resolved within few days, with the exception of 1 secondary graft rejection which is still under investigation. Among the CAR-T group, 5 patients (36%) had humoral antibody response. Patients with CD19+ lymphocytes >0 had a higher likelihood to develop antibodies compared to those with B cell aplasia (67% vs. 12.5%, p=.036). Among the allogeneic HCT group - 47 patients (81%) had a humoral antibody response. Incidence of positive serology was lower in patients with concomitant high intensity immunosuppressive therapy (IST) compared to those with low intensity IST (69% vs. 94%, p=.016). Linear regressions identified that male sex (beta=-.380, p=.012) and high intensity IST (beta=-.497, p=.014) were associated with lower antibody titer, while age, months from HCT, intensity of conditioning, low CD19 cell count, and active GVHD did not predict response. Analysis of peptide induced cytokine release by ELISpot is ongoing and will be presented at the EHA meeting. Summary/Conclusion: Humoral response to the BNT162b2 mRNA COVID-19 vaccine in CAR-T patients with B cell aplasia is significantly impaired, while overall response in patients after allogeneic HCT is encouraging. Patients on concomitant high intensity IST had impaired humoral response to BNT162b2. Longer follow-up is mandatory to test persistence of antibodies, and general preventive practices should be continued until more data are available.
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Background: Chimeric antigen receptor T cells (CAR-T) cells targeting CD19, demonstrate highly effective anti-tumor response in Diffuse Large B Cell Lymphoma (DLBCL). However, can result in significant side effects such as prolong neutropenia and infections. The incidence of infections in the setting of real world data hasn't been completely identified. Aims: To perform a comprehensive analysis of infection rate and profile in the first month after CAR-T cells in a cohort of infirm patients treated with commercially available CAR-T cells. Methods: This is a retrospective, single center study conducted in the Bone marrow transplant unit, Tel Aviv, analyzing the infection rate in consecutive patients with DLBCL who were treated with commercially available axicabtagene ciloleucel or tisagenlecleucel. Following a local protocol, all patients were treated with prophylaxis with ciprofloxacin and fluconazole when neutrophil counts decreased below 0.5∗103/μl. Acyclovir was administered at conditioning initiation. Microbiology and clinical documented infections (MDI and CDI, respectively) were defined according to the ECIL guidelines. Following white blood cell recovery, patients carried out weekly full blood count, and monthly CMV and HHV-6. A logistic regression was performed for the association between baseline characteristics and documented infections. Results: From June 2019 to December 2020, we included 60 consecutive patients with DLBCL treated with axicabtagene ciloleucel (n=16, 27%) or tisagenlecleucel (n=44, 73%). The median age was 69.3 (range, 19.8-85.2) years and ECOG-Performance status(PS) was 2-3 in most patients (58%). Broad spectrum antibiotics was administered to patients experiencing neutropenic fever (n=53, 88%). Overall infections were noted in 27/60 patients (45%).Bacterial infections were seen in 16 patients (27%) and included CDI in 7 (Pneumonia, n=5;periodontal infection, n=1 and cellulitis, n=1) and MDI in 9 patients (Gram negative rod bacteremia (GNR), n= 5;Gram positive cocci(GPC) bacteremia, n= 3;Both GNR and GPC, n=1). Viral infection was described in 14 patients (23%). The most common viral infection was CMV reactivation (n=10, 17%) leading to initiation of anti-CMV treatment in 6 among these patients. None had CMV disease. HHV-6 was positive in 3 patients (5%) with one of these patients presenting with acute encephalitis. Other viral infections reported were RSV (n=2)COVID-19 (n=1). No fungal infection was documented. Incidence of documented infections was higher in patients with CRS/ICANS compared with patients without [23/44 (52%) vs 4/16 (25%), p=0.005]. While CRP levels predicted documented infections (p= 0.041), ferritin blood levels did not (p=0.130). In univariate analysis, ICANS (OR= 4.5, p = 0.018) was associated with higher incidence of bacterial infection while there was a trend for lower incidence of bacterial infections in patients with chemo-sensitive disease to bridging therapy (OR= 0.375, p= 0.074)(Table 1). Age or ECOG-PS were not associated with increased risk of bacterial infection. Patients with documented infection had an increase in hospitalization days compared to those without documented infection (26.44 vs 21.7 days, p= 0.085). Summary/Conclusion: Infections were common in the first month following CAR-T cell administration, however were not increased in elderly patients or those presenting with poorer PS. Patients refractory to bridging therapy and ICANS should be monitored cautiously for the occurrence of infections. CMV monitoring should also be considered.