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1.
Boletin de Malariologia y Salud Ambiental ; 61(Edicion Especial II 2021):181-187, 2021.
Article in Spanish | GIM | ID: covidwho-2033928

ABSTRACT

The COVID-19 pandemic has wreaked havoc in the lives of workers in different parts of the world. The instability inherent to this stage of health emergency has had repercussions on the mental health of this population. The aim was to evaluate the psychometric properties of a financial stress scale for Peruvian dependent workers. Observational, analytical, instrumental and cross-sectional study in 749 workers. An exploratory factor analysis (EFA), by unweighted least squares, was performed after analysis of Bartlett's test and the Kaiser-Meyer-Olkin coefficient (KMO). The absolute and incremental goodness of fit was determined by means of the comparative fit index (CFI) and the Tucker-Lewis Index (TLI). A PFA was performed after analysis of the Kaiser-Meyer-Olkin index (KMO = 0.903) and Bartlett's test of sphericity (1751.9;gl = 36;p < 0.001), which were adequate. The items converged into a single factor. The EFT-Cov19 correlated positively with the LABOR-PE (r = 0.564, p < 0.01) and with a medium effect size. The reliability of the EFT-Cov19 was calculated with Cronbach's a coefficient, obtaining an acceptable value (a = 0.896;95% CI = 0.88 - 0.90). In conclusion, the EFT-Cov19 scale is a valid, reliable and adequate scale to measure financial stress in dependent workers during the COVID-19 pandemic.

2.
HemaSphere ; 6:365-367, 2022.
Article in English | EMBASE | ID: covidwho-2032120

ABSTRACT

Background: Patients with lymphoproliferatie diseases (LPD) appear particularly ulnerable to SARS-CoV-2 infection, partly because of the effects of the anti-neoplastic regimens (chemotherapy, signaling pathway inhibitors, and monoclonal antibodies) on the immune system. The real impact of COVID-19 on the life expectancy of patients with different subtypes of lymphoma and targeted treatment is still unknown. Aims: The aim of this study is to describe and analyse the outcome of COVID-19 patients with underlying LPD treated with targeted drugs such as monoclonal antibodies (obinutuzumab, ofatumumab, brentuximab, niolumab or pembrolizumab), BTK inhibitors (ibrutinib, acalabrutinib), PI3K inhibitors (idelalisib), BCL2 inhibitors (enetoclax) and IMIDs, (lenalidomide). Methods: The surey was supported by EPICOVIDEHA registry. Adult patients with baseline CLL or non-Hodgkin Lymphoma (NHL) treated with targeted drugs and laboratory-confirmed COVID-19 diagnosed between January 2020 and January 2022 were selected. Results: The study included 368 patients (CLL n=205, 55.7%;NHL n=163, 44.3%) treated with targeted drugs (Table 1). Median follow-up was 70.5 days (range 19-159). Most used targeted drugs were ITKs (51.1%), anti-CD20 other than rituximab (16%), BCL2 inhibitors (7.3%) and lenalidomide (7.9%). Of note, only 16.0% of the patients were accinated with 2 or more doses of accine at the onset of COVID-19. Pulmonary symptoms were present at diagnosis in 244 patients (66.2%). Seere COVID-19 was obsered in 47.8 % patients while 21.7% were admitted to to intensie care unit (ICU), being 55 (26.8%) CLL patients and 25 (15.3%) NHL patients. More comorbidities were reported in patients with seere-critical COVID-19 compared to those with mild- asymptomatic infection (p=0.002). This difference was releant in patients with chronic heart diseases (p=0.005). Oerall, 134 patients (36.4%) died. Primary cause of death was COVID-19 in 92 patients (68.7%), LPD in 14 patients (10.4%), and a combination of both in 28 patients (20.9%).Mortality was 24.2% (89/368) at day 30 and 34.5%(127/368) at day 200. After a Cox multiariable regression age >75 years (p<0.001, HR 1.030), actie malignancy (p=0.011, HR 1.574) and admission to ICU (p<0.00, HR 4.624) were obsered as risk factors. Surial in patients admitted to ICU was 33.7% (LLC 38.1%, NHL 24%). Mortality rate decreased depending on accination status, being 34.2% in not accinated patients, 15.9-18% with one or two doses, decreasing to 9.7% in patients with booster dose (p<0.001). There was no difference in OS in NLH s CLL patients (p=0.344), nor in ITKs s no ITKs treated patients (p=0.987). Additionally, mortality rate dropped from the first semester 2020 (41.3%) to last semester 2021 (25%). Summary/Conclusion: - Our results confirm that patients with B--mallignancies treatted with targeted drugs hae a high risk off seere infection (47.8%) and mortality (36.4%) from COVID-19. - Pressence of comorbidities,, especially heart disease,, is a risk factor for seere COVIID--19 infection in ourr series. - Age >75 years,, actie mallignancy att COVIID--19 onset and ICU admission were mortality risk factors. - COVIID--19 acination was a protectie factor for mortality,, een iin this popullation wiitth humorall immunity impairment. - The learning cure in the management of the infection throughout the pandemiic and the deelopmentt off COVIID--19 treatments showed benefit in this partticullarlly ullnerablle popullation? (Table Presented).

3.
Rna Biology ; 19(1):1019-1044, 2022.
Article in English | MEDLINE | ID: covidwho-2028922

ABSTRACT

Similar to other RNA viruses, the emergence of Betacoronavirus relies on cross-species viral transmission, which requires careful health surveillance monitoring of protein-coding information as well as genome-wide analysis. Although the evolutionary jump from natural reservoirs to humans may be mainly traced-back by studying the effect that hotspot mutations have on viral proteins, it is largely unexplored if other impacts might emerge on the structured RNA genome of Betacoronavirus. In this survey, the protein-coding and viral genome architecture were simultaneously studied to uncover novel insights into cross-species horizontal transmission events. We analysed 1,252,952 viral genomes of SARS-CoV, MERS-CoV, and SARS-CoV-2 distributed across the world in bats, intermediate animals, and humans to build a new landscape of changes in the RNA viral genome. Phylogenetic analyses suggest that bat viruses are the most closely related to the time of most recent common ancestor of Betacoronavirus, and missense mutations in viral proteins, mainly in the S protein S1 subunit: SARS-CoV (G > T;A577S);MERS-CoV (C > T;S746R and C > T;N762A);and SARS-CoV-2 (A > G;D614G) appear to have driven viral diversification. We also found that codon sites under positive selection on S protein overlap with non-compensatory mutations that disrupt secondary RNA structures in the RNA genome complement. These findings provide pivotal factors that might be underlying the eventual jumping the species barrier from bats to intermediate hosts. Lastly, we discovered that nearly half of the Betacoronavirus genomes carry highly conserved RNA structures, and more than 90% of these RNA structures show negative selection signals, suggesting essential functions in the biology of Betacoronavirus that have not been investigated to date. Further research is needed on negatively selected RNA structures to scan for emerging functions like the potential of coding virus-derived small RNAs and to develop new candidate antiviral therapeutic strategies.

4.
Frontiers in Immunology ; 13, 2022.
Article in English | Web of Science | ID: covidwho-2022728

ABSTRACT

The current pandemic generated by SARS-CoV-2 has led to mass vaccination with different biologics that have shown wide variations among human populations according to the origin and formulation of the vaccine. Studies evaluating the response in individuals with a natural infection before vaccination have been limited to antibody titer analysis and evaluating a few humoral and cellular response markers, showing a more rapid and intense humoral response than individuals without prior infection. However, the basis of these differences has not been explored in depth. In the present work, we analyzed a group of pro and anti-inflammatory cytokines, antibody titers, and cell populations in peripheral blood of individuals with previous SARS-CoV-2 infection using BNT162b2 biologic. Our results suggest that higher antibody concentration in individuals with an earlier disease could be generated by higher production of plasma cells to the detriment of the presence of memory B cells in the bloodstream, which could be related to the high baseline expression of cytokines (IL-6 and IL-10) before vaccination.

5.
PLoS Pathog ; 18(9):e1010811, 2022.
Article in English | PubMed | ID: covidwho-2021986

ABSTRACT

SARS-CoV-2 non-structural protein Nsp14 is a highly conserved enzyme necessary for viral replication. Nsp14 forms a stable complex with non-structural protein Nsp10 and exhibits exoribonuclease and N7-methyltransferase activities. Protein-interactome studies identified human sirtuin 5 (SIRT5) as a putative binding partner of Nsp14. SIRT5 is an NAD-dependent protein deacylase critical for cellular metabolism that removes succinyl and malonyl groups from lysine residues. Here we investigated the nature of this interaction and the role of SIRT5 during SARS-CoV-2 infection. We showed that SIRT5 interacts with Nsp14, but not with Nsp10, suggesting that SIRT5 and Nsp10 are parts of separate complexes. We found that SIRT5 catalytic domain is necessary for the interaction with Nsp14, but that Nsp14 does not appear to be directly deacylated by SIRT5. Furthermore, knock-out of SIRT5 or treatment with specific SIRT5 inhibitors reduced SARS-CoV-2 viral levels in cell-culture experiments. SIRT5 knock-out cells expressed higher basal levels of innate immunity markers and mounted a stronger antiviral response, independently of the Mitochondrial Antiviral Signaling Protein MAVS. Our results indicate that SIRT5 is a proviral factor necessary for efficient viral replication, which opens novel avenues for therapeutic interventions.

6.
Cirugia Cardiovascular ; 29(4):258, 2022.
Article in Spanish | Es | ID: covidwho-2003932

ABSTRACT

Introducción: La pandemia COVID-19 ha podido tener influencia en la incidencia de endocarditis infecciosa nosocomial (EIN). Objetivos: Describir la incidencia, características y evolución de la EIN durante la pandemia COVID-19. Material y métodos: Estudio retrospectivo unicéntrico incluyendo las EIN definidas, según los criterios de Duke, desde marzo 2020 hasta marzo 2021. Se dividieron a los pacientes en ingreso por COVID-19 (grupo COVID) o por otros motivos (grupo no COVID). Se comparó la incidencia de EIN con el mismo periodo de 2019-2020. Resultados: Durante el periodo de estudio se diagnosticaron 22 EIN, 7 (31,8%) en COVID, 15 (68,2%) en no COVID. La incidencia fue 9,7 casos/10.000 ingresos (22/22.596). La incidencia en el mismo periodo 2019-2020 fue 4,6/10.000 (10/21.668), siendo la diferencia significativa (OR 1,91, IC95% 1,03-3,96, p = 0,038). Durante el periodo 2020-2021, la incidencia de EIN en COVID fue 24,6/10.000 (7/2.846) frente a 7,5/10.000 (15/19.750) en no COVID, siendo la diferencia significativa (OR 3,23 IC95% 1,32-7,95, p < 0,001). La mediana de edad fue 75 años (RIQ 68-80), siendo varones 68,2%. La mediana de Índice de Charlson fue 5 (RIQ 4-6). Un 36,4% presentaban válvula protésica, mientras un 22,7% valvulopatías significativa no protésica. Los pacientes COVID habían recibido más frecuentemente inmunosupresores (71,4% vs. 13,3%, p = 0,014), sin otras diferencias entre grupos. El foco primario fue considerado vascular en 86,4% (19/22;10 por vía periférica (VP), 5 por catéter venoso central (CVC), 4 no se pudo diferenciar origen entre VP o CVC). 3 pacientes presentaron foco no vascular (1 genitourinario, 2 gastrointestinal). No hubo diferencias entre grupos. Las manifestaciones fueron: fiebre 95,5%;insuficiencia cardiaca 68,2%;embolismos 45,5%;ictus 40,9%;insuficiencia renal 40,9%;bacteriemia persistente 38,1%;y shock séptico 14,3%. Los pacientes no COVID presentaron con más frecuencia clínica subaguda (0 vs. 46,7%, p = 0,042), sin otras diferencias estadísticamente significativas. La etiología fue: estafilococos coagulasa negativo 6 (27,3%);Enterococcus faecalis 6 (27,3%);Staphylococcus aureus 4 (18,2%);Candida albicans 3 (13,6%). En 3 casos no hubo aislamiento microbiológico (13.6%). No hubo diferencias entre grupos. La mortalidad a 30 días fue 45,5%, siendo la EIN o sus complicaciones la causa en todos los casos salvo 1 (no COVID). No hubo diferencias de mortalidad entre grupos (28,6% vs. 53,3%, p = 0,381). Conclusiones: La incidencia de EIN ha aumentado durante la pandemia, especialmente en pacientes ingresados por COVID-19. El foco primario de las EIN fue predominantemente vascular. Afectaron frecuentemente a pacientes con comorbilidad y patología valvular previa. Las manifestaciones, etiología y evolución fueron similares en COVID y no COVID, destacando una elevada frecuencia de eventos embólicos, especialmente ictus. Las EIN asocian elevada morbimortalidad y es importante extremar las medidas de prevención.

7.
Horizonte Medico ; 22(2), 2022.
Article in Spanish | EMBASE | ID: covidwho-1979898

ABSTRACT

Objective: To describe the concentration of neutralizing antibodies in serum from healthcare professionals who received any of the SARS-CoV-2 vaccines developed by Sinopharm, Pfizer or Johnson & Johnson, or CureVac’s vaccine candidate. Materials and methods: An observational, descriptive, retrospective, cross-sectional research which included 217 healthcare professionals fully vaccinated with Sinopharm, Pfizer or Johnson & Johnson’s vaccines, or CureVac’s vaccine candidate. The presence of anti-SARS-CoV-2 neutralizing antibodies in serum was determined in these individuals using the electrochemiluminescence immunoassay (ECLIA). Variables such as age, sex, history of infection with SARS-CoV-2, concentration of neutralizing antibodies and brand of vaccine administered were considered. Results: Sixteen point six zero percent (16.60 %) of the healthcare professionals stated that they had already had COVID-19 before receiving the vaccine. They were immunized with the vaccines developed by Sinopharm (74.65 %), Pfizer (12.90 %) or Johnson & Johnson (5.07 %), or CureVac’s vaccine candidate (7.37 %). Regardless of the vaccine received, 42.50 % of the individuals who had not been previously infected with SARS-CoV-2 and 16.70 % of those who had been previously infected did not develop neutralizing antibodies. Pfizer’s vaccine produced the highest concentration of neutralizing antibodies (196.27 AU/mL) in patients with or without previous infection. Conclusions: The study demonstrates that vaccination boosts immunity in people previously infected with the novel coronavirus and suggests that Pfizer’s vaccine produces the highest concentration of neutralizing antibodies.

8.
PLoS One ; 17(7): e0264566, 2022.
Article in English | MEDLINE | ID: covidwho-1962989

ABSTRACT

Current medical guidelines consider pregnant women with COVID-19 to be a high-risk group. Since physiological gestation downregulates the immunological response to maintain "maternal-fetal tolerance", SARS-CoV-2 infection may constitute a potentially threatening condition to both the mother and the fetus. To establish the immune profile in pregnant COVID-19+ patients, a cross-sectional study was conducted. Pregnant women with COVID-19 (P-COVID-19+; n = 15) were analyzed and compared with nonpregnant women with COVID-19 (NP-COVID-19+; n = 15) or those with physiological pregnancy (P-COVID-19-; n = 13). Serological cytokine and chemokine concentrations, leucocyte immunophenotypes, and mononuclear leucocyte responses to polyclonal stimuli were analyzed in all groups. Higher concentrations of serological TNF-α, IL-6, MIP1b and IL-4 were observed within the P-COVID-19+ group, while cytokines and chemokines secreted by peripheral leucocytes in response to LPS, IL-6 or PMA-ionomicin were similar among the groups. Immunophenotype analysis showed a lower percentage of HLA-DR+ monocytes in P-COVID-19+ than in P-COVID-19- and a higher percentage of CD39+ monocytes in P-COVID-19+ than in NP-COVID-19+. After whole blood polyclonal stimulation, similar percentages of T cells and TNF+ monocytes between groups were observed. Our results suggest that P-COVID-19+ elicits a strong inflammatory response similar to NP-COVID19+ but also displays an anti-inflammatory response that controls the ATP/adenosine balance and prevents hyperinflammatory damage in COVID-19.


Subject(s)
COVID-19 , Monocytes , Apyrase/immunology , Cross-Sectional Studies , Cytokines , Female , Humans , Interleukin-6 , Pregnancy , SARS-CoV-2
10.
Basic and Clinical Pharmacology and Toxicology ; 130(SUPPL 2):50, 2022.
Article in English | EMBASE | ID: covidwho-1916040

ABSTRACT

Objective: Proper identification of patients at risk of developing serious disease in the context of SARS-CoV-2 infection, as well as the initiation of early treatment, is essential for COVID19 successful management. The main objective of this study was to evaluate the usefulness of serum biomarkers (i.e., neutrophils, lymphocytes, Creactive protein, lactate dehydrogenase, D-dimer, ferritin and interleukin-6) to predict the early response to immunosuppressant therapy in COVID19 patients. Material and/or methods: This is a case-control study nested in a retrospective cohort, which included hospitalized patients with COVID19 pneumonia and presented elevation of some pro-inflammatory parameters. Each of the individuals who died during the 28-day follow-up was defined as a case. For each case, four controls were selected, matched by age, sex and comorbidities. Results: Overall, 856 patients were included in the initial cohort. The incidence of therapeutic failure in the cohort was 14%, thus a total of 119 cases were identified. After applying a Cox regression model, high serum concentrations of LDH (>451 IU/L), ferritin (>1014 ng/mL) and D-Dimer (>1300 ng/mL) were identified as predictors of poor response to treatment. High-specific cut-off points could not be established for any of these biomarkers. Conclusions: Some inflammatory biomarkers, such as LDH, ferritin and D-dimer, may be helpful in identifying patients for whom an early immunomodulatory therapeutic intervention should be considered in the treatment of COVID19 patients with pneumonia.

11.
Enfermeria Nefrologica ; 25(1):54-58, 2022.
Article in Spanish | Scopus | ID: covidwho-1912753

ABSTRACT

In December 2019, a new coronavirus appeared and generated a pandemic. Considering the characteristics of the transplanted patient, it is relevant to know the impact regarding SARS-CoV-2 infection, aiming to describe the incidence of SARS-CoV-2 in renal transplant patients. A retrospective observational cohort study of patients with a renal transplant and under follow-up by the transplant clinic of a tertiary hospital was conducted during the period from 1 March 2020 to 1 March 2021. A total of 604 individuals were included, with a mean age of 61.6 ±12.8 years. 62.3% (n=376) were men. SARS-CoV-2 incidence was 14.9% (n=90). Mortality due to SARS-CoV-2 was 3.8% (n=23), giving a case fatality of 25.5%. No significant differences were found according to  sex and age, being 60.9±11.8 years in those infected and 61.7±12.9 years in those not infected. Significant differences (p=0.005) were found for the mean number of years since transplantation;8.7±5.6 years in those infected and 11±7.3 years in those not infected. The incidence of SARS-CoV-2 infection in renal transplant recipients was much higher than that described for the general population. Case fatality and mortality were also higher than in the general population, but in line with other series of individuals with renal transplantation. © 2022, Sociedad Espanola de Enfermeria Nefrologica. All rights reserved.

13.
14.
Journal of Current Southeast Asian Affairs ; 2022.
Article in English | Scopus | ID: covidwho-1846753

ABSTRACT

We examine the Thai government's politicised COVID-19 containment strategies, which have been challenged by Thai protesters. Although we use securitisation theory as an explanatory framework, we argue that researchers using this theory can explain the issues only if they simultaneously use social-conflict theory to explain the interactions between securitising actors and their audiences. By supplementing securitisation theory with social-conflict theory, we have found that the roles of securitising actors and audiences are not fixed. In our case study of Thailand, the Thai government and protesters have played two roles simultaneously: the role of a securitising actor and the role of an audience. This finding suggests that successful securitisation is impermanent;that is, it is subject to change over time. Securitisation may be successful, but the success can only be temporary because as new actors or resources enter the picture, the previously successful securitisation will, at some point, diminish. © The Author(s) 2022.

15.
2022 International Conference on Innovative Trends in Information Technology, ICITIIT 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1831820

ABSTRACT

Fingerprint recognition is a safe and convenient technology, increasingly being used for biometric identification of the intended beneficiaries of welfare programmes. Kerala's pubic distribution system, with Ration Shops being its point of contact, also uses fingerprint scanners for identification of beneficiaries. The outbreak of COVID-19 has adversely affected the safety of fingerprint authentication. Touching the sensors by multiple persons can cause the transmission of viruses. Studies have shown that COVID-19 can survive on common surfaces like wood, plastic, metal, and glass for a minimum of 5 days. Despite all the standard operating procedures, it is a common sight to see people crowding at public spaces like Ration Shops that has increased the risk of transmission of the virus. In this context, the present work aims to create a safe and healthy environment for the consumers of Kerala's ration shops, through a UVC based self-sanitizing system for fingerprint scanners. © 2022 IEEE.

16.
Frontiers in Education ; 7, 2022.
Article in English | Scopus | ID: covidwho-1809367

ABSTRACT

This study examined the impact of the first wave of COVID-19 pandemic community quarantine on university students’ physical activity (PA) levels, sedentary behaviors, and health states in the Philippines. A total of 1,042 university students completed the International Physical Activity Questionnaire (IPAQ) short version and rated their health states using an online survey. The Wilcoxon signed-rank test and Spearman’s rank correlation coefficient were used for statistical analyses to compare changes in PA and sedentary behaviors (prior to and during COVID-19) and determine the relationship between changes in the total volume of PA and various health states of male and female students respectively. Overall, the total PA of students significantly declined during COVID-19 compared to before the pandemic. Total PA of male students did not significantly change during COVID-19 but did for females. Female students’ sitting time significantly reduced during weekdays. Changes in PA was associated with different aspects of health, particularly for female students, during the COVID-19 community quarantine. The finding extends the literature about the impact of COVID-19 on students’ PA and health and underscores the importance of PA as a way in alleviating negative perceptions related to health in university students despite the implemented community quarantine regulations. Copyright © 2022 Cruz, Cando and Kim.

17.
4th European International Conference on Industrial Engineering and Operations Management, IEOM 2021 ; : 308-315, 2021.
Article in English | Scopus | ID: covidwho-1749359

ABSTRACT

In 2020, the COVID-19 pandemic had a profound effect on all supply chains and markets worldwide. However, most of the analysis has taken place from the brick and mortar or buyer's perspective. The purpose of this paper is to capture the effects of these closures and business limitations further upstream at the supplier level. Specifically, the metal casting business that supplies all sorts of industries, from medical implants to construction. Due to the cancellation of non-essential surgeries at hospitals, demand for medical implants has stagnated while the demand for construction has continued. By surveying stakeholders in California's metal casting industry, this research explores how this complex and diverse vocation fulfills these demands and how they have adapted to these changes. © IEOM Society International.

18.
Open Forum Infectious Diseases ; 8(SUPPL 1):S15, 2021.
Article in English | EMBASE | ID: covidwho-1746816

ABSTRACT

Background. Given the limited collaborative international studies that evaluated COVID-19 in patients with cancer in comparison to patients without cancer, we aimed to determine the independent risk factors associated with increased 30-day mortality and the impact of novel treatment modalities in a large group of cancer and non-cancer patients with COVID-19 from multiple countries. Methods. We retrospectively collected de-identified data on cancer and non-cancer patients diagnosed with COVID-19 between January and November 2020, at 16 centers in Asia, Australia, Europe, North America, and South America. A logistic regression model was used to identify independent predictors of all-cause mortality within 30 days after COVID-19 diagnosis. Results. Of the total 4015 COVID-19 confirmed patients entered, we analyzed 3966 patients, 1115 cancer and 2851 non-cancer patients. Cancer patients were older than non-cancer patients (median age, 61 vs 50 years;p< 0.0001);more likely to be pancytopenic , had pulmonary disorders, hypertension, diabetes mellitus. In addition, they were more likely to present with higher inflammatory biomarkers (D-dimer, ferritin and procalcitonin), but were less likely to present with clinical symptoms. By multivariable logistic regression analysis, cancer was an independent risk factor for 30-day mortality (OR 1.46;95% CI 1.03 to 2.07;p=0.035). Older age (≥65 years) was the strongest predictor of 30-day mortality in all patients (OR 4.55;95% CI 3.34 to 6.20;p< 0.0001). Remdesivir was the only therapeutic agent independently associated with decreased 30-day mortality (OR 0.58;CI 0.39-0.88;p=0.009). Among patients on lowflow oxygen at admission, patients who received remdesivir had a lower 30-day mortality rate than those who were on high flow oxygen (5.9% vs 17.6%;p=0.03). Patients transfused with convalescent plasma within 1 day of diagnosis had a lower 30-day mortality rate than those transfused later (1% vs 7%, p=0.04). Conclusion. Cancer is an independent risk factor for increased 30-day all-cause mortality from COVID-19. Remdesivir, particularly in patients receiving low-flow oxygen, can reduce 30-day all-cause mortality, as well as convalescent plasma given early after COVID-19 diagnosis.

19.
Open Forum Infectious Diseases ; 8(SUPPL 1):S253-S254, 2021.
Article in English | EMBASE | ID: covidwho-1746702

ABSTRACT

Background. Fungemia is associated with high rates of morbidity, mortality and increase in length of hospital stay. Several studies have recognized increased rates of candidemia since the COVID-19 pandemic. Methods. A retrospective cohort study was conducted at a tertiary healthcare system in Detroit, Michigan to evaluate the impact of the COVID-19 pandemic on incidence of candidemia. The "pre COVID-19" timeframe was defined as January - May 2019 while the "during COVID-19" timeframe was January - May 2020. To compare incidence and patient characteristics between cohorts, t-tests and chi-square analysis was used. Additional sub-analysis was performed in candidemia patients during COVID-19 timeframe comparing outcomes of patients based on COVID-19 status. A Fisher Exact and Satterthwaite Test were used for analysis of categorical and continuous variables, respectively. Results. Overall, 46 cases of candidemia were identified in both the pre COVID-19 and during COVID-19 periods. Pre COVID-19, the average number of cases was 3.0 ± 1.2 per month. The incidence more than doubled during COVID-19 to 6.2 ± 4.2 cases per month (p = 0.14) (Figure 1). No significant differences in patient demographics were detected between cohorts, however, patients in the COVID-19 cohort had higher rates of corticosteroid use, mechanical ventilation and vasopressors (Table 1). In the 2020 period, 31 patients developed candidemia and 12 (38.7%) patients tested SARS-CoV-2 positive. On average, COVID-19 patients developed candidemia 12.1 days from admission, compared to 17.8 days in the COVID-19 negative cohort (p = 0.340). Additionally, COVID-19 patients with candidemia coinfection were significantly more likely to expire;83.3% (n=10) COVID-19 patients expired compared to 36.8 (n=7) in the COVID-19 negative cohort (p = 0.025) (Table 2). Conclusion. The prevalence of fungemia markedly increased during the COVID-19 surge. Increased use of corticosteroids and broad spectrum antimicrobials, prolonged use of central venous catheters and prolonged ICU length of stay likely contributed to this increase. Patients who developed candidemia co-infection with COVID-19 were found to have poorer outcomes as compared to those who were SARS-CoV-2 negative or untested.

20.
Open Forum Infectious Diseases ; 8(SUPPL 1):S254, 2021.
Article in English | EMBASE | ID: covidwho-1746700

ABSTRACT

Background. Several studies have shown that underlying cancer is a risk factor for progression of COVID-19 to severe illness and fatal outcome but there is very little data that specifies which underlying cancer puts this patient population at the highest risk. Methods. We retrospectively collected de-identified data on 1115 cancer patients diagnosed with COVID-19 between January and November 2020, at 12 centers in Asia, Australia, Europe, North America, and South America. Patient characteristics including age, type of malignancy (hematologic malignancy [HM], lung cancer, and non-lung cancer were determined in association with severe illness as well as all-cause mortality within 30 days after COVID-19 diagnosis. Results. By multivariable logistic regression analysis, independent risk factors for 30-day mortality in cancer patients included age > 65 (OR 6.64;95% CI 3.351to 12.55;p< 0.0001), ALC < 0.5 K/microliter (OR 2.10;95% CI 1.16 to 3.79;p=0.014), and anemia at < 10g/dl (OR 2.41;95% CI 1.30 to 4.44;p=0.005). Among cancer patients, the 30-day mortality rate was significantly higher in patients with lung cancer than in patients with non-lung cancer solid tumors, including those with lung metastases (22% vs 9%;p=0.001). Patients with HM tended to have higher 30-day mortality than patients with non-lung cancer solid tumors (13% vs 9% p=0.07) and tended to have a lower mortality rate than patients with lung cancer (p=0.07). Furthermore, HM patients were more likely to be lymphopenic and anemic at diagnosis as well as progress to LRTI and be placed on ventilatory support compared to non-lung cancer solid tumor patients ( p= or < 0.01). In addition, lung cancer and HM patients were more likely to develop hypoxia and require hospital admission than non-lung cancer solid tumor patients ( p=0.01). Conclusion. Lung cancer and HM patients are associated with the highest risk of progressing to severe disease and mortality in cancer patients with COVID-19. Hence, cancer patient population should be given the highest priority as far as prevention [vaccination with boosters if needed] as well as preemptive early therapy with monoclonal antibodies right after the onset of COVID-19.

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