ABSTRACT
Background: The therapeutic effectiveness of interleukin-6 receptor inhibitor in critically ill hospitalized patients with coronavirus disease 2019 (COVID-19) is uncertain. Methods: To evaluate the efficacy and safety of the outcome as recovery or death of tocilizumab for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, we conducted a randomized, double-blinded, placebo-controlled phase 2 trial in critically ill COVID-19 adult patients. The patients were randomly assigned in a 4:1 ratio to receive standard medical treatment plus the recommended dose of either tocilizumab or the placebo drug. Randomization was stratified. The primary outcome was the recovery or death after administration of tocilizumab or a placebo drug. The secondary outcomes were clinical recovery or worsening of the patients' symptoms and inflammatory markers and discharge from the hospital. Results: Of 190 patients included in this study, 152 received tocilizumab, and 38 received a placebo. The duration of hospital stay of the interventional group was 12.9 ± 9.2, while the placebo group had a more extended hospital stay (15.6 ± 8.8). The mortality ratio for the primary outcome, ie, mortality or recovery in the tocilizumab group was 17.8%;p = 0.58 by log-rank test). The mortality ratio in the placebo group was 76.3%;p = 0.32 by log-rank test). The inflammatory markers in the tocilizumab group significantly declined by day 16 compared to the placebo group. Conclusions: The use of tocilizumab was associated with decreased mortality, earlier improvement of inflammatory markers, and reduced hospital stay in patients with severe COVID-19. © 2022 The Author(s)
ABSTRACT
Objectives: Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is efficacious for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). However, the frequent treatment and monitoring required for optimal real-world outcomes can be burdensome to patients and can impact adherence to treatment. This study aimed to understand patient treatment experience with anti-VEGF standard of care. Method(s): A cross-sectional survey was employed comprising de novo questions, patient-reported outcome (PRO) measures and medical chart extraction. Adult patients with nAMD or DME treated with intravitreal anti-VEGF injections for >=12 months were recruited via 38 clinical sites (6 Canada, 6 France, 4 Italy, 7 Spain, 6 United Kingdom, 9 United States). Result(s): Surveys were completed by 391 patients with nAMD and 183 patients with DME. PRO scores indicated that patients across both conditions had relatively high vision-related functioning and were generally satisfied with their current treatment. Mean number of anti-VEGF injections over 12 months across countries ranged from 6.3-9.7 for nAMD and 4.3-8.0 for DME. Nineteen patients with nAMD (19/391;5%) and 27 patients with DME (27/183;15%) missed >=1 injection or examination visit in the past 12 months. Reported barriers were mainly related to treatment (eg, pain and discomfort during/after anti-VEGF injection), clinic (eg, not having someone to accompany them to appointments) and, to a lesser extent, the COVID-19 pandemic. After treatment, the majority recovered in <=1 day;however, 24% (139/574) needed >1 day to recover. Impairment in daily activities due to treatment was reported by 45% (258/574) of patients. Among working patients 62% (41/66) reported productivity impairment from absenteeism. Conclusion(s): Patients reported impairment of daily activities, burden and barriers related to intravitreal anti-VEGF therapy, despite high adherence and treatment satisfaction levels. More durable therapy options, requiring less frequent treatments may be able to reduce treatment-related burden and barriers. Copyright © 2022
ABSTRACT
The current coronavirus disease 2019 (COVID-19) pandemic is one of the international crises and researchers are working collaboratively to develop a safe and effective COVID-19 vaccine. The World Health Organization recognizes vaccine hesitancy as the world's top threat to public health safety, particularly in low middle-income countries. Vaccine hesitancy can be due to a lack of knowledge, false religious beliefs, or anti-vaccine misinformation. The current situation regarding anti-vaccine beliefs is pointing towards dreadful outcomes. It raises the concern that will people believe and accept the new COVID-19 vaccines despite all anti-vaccine movements and COVID-19-related myths and conspiracy theories. This review discusses the possible detrimental impacts of myths and conspiracy theories related to COVID-19 and vaccine on COVID-19 vaccine refusals as well as other vaccine programs.
La pandemia actual de COVID-19 (enfermedad por coronavirus de 2019) es una crisis internacional y los investigadores están trabajando conjuntamente para desarrollar una vacuna efectiva contra ella. La Organización Mundial de la Salud reconoce la renuencia a la vacuna como una de las principales amenazas para la seguridad de la salud pública, particularmente en los países con bajos ingresos medios. Dicho rechazo a la vacuna puede deberse a falta de conocimiento, falsas creencias religiosas o desinformación acerca de la anti-vacunación. La situación actual con respecto a las creencias apunta a resultados terribles. Suscita la inquietud de que las personas crean y acepten las nuevas vacunas frente a la COVID-19 a pesar de todos los movimientos anti-vacunación y los mitos y teorías conspiradoras relacionados con esta enfermedad. Esta revisión trata sobre el posible impacto perjudicial de los mitos y teorías conspiradoras relacionados con la COVID-19 y el rechazo a la vacunación frente a la misma, así como a otros programas de vacunación.