Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 39
Filter
1.
Journal of Water Process Engineering ; 50, 2022.
Article in English | Web of Science | ID: covidwho-2211024

ABSTRACT

The outbreak of COVID-19 has led to the increase in face mask waste globally. In this study, face mask-derived carbocatalysts doped with nitrogen (N-Mask) were fabricated through one-step pyrolysis of 1:5 w/w mixture of face mask and urea at different temperatures to activate peroxymonosulfate (PMS) for gatifloxacin (GAT) degradation. The N-Mask prepared at 800 degrees C (N-Mask800) exhibited the highest GAT degradation rate with k(app) = 0.093 min(-1) which could be attributed to its high N doping level (17.1 wt%) and highest specific surface area (237.13 m(2) g(-1)). The relationship between k(app), catalyst loading and PMS dosage at various pHs on GAT degradation were successfully established. It was also found that the GAT degradation rate was inhibited in the sequential operating mode compared to the simultaneous operating mode. It was construed that adsorption and catalysis share the same active sites. Deterioration in catalytic performance was observed over successive cycles due to the surface chemistry change during catalysis, and difficulty in catalyst recovery after treatment. Radical scavenger study revealed that both radical and nonradical pathways were involved during GAT degradation, with nonradical pathway playing a dominant role. XPS analysis revealed that pyrrolic N and graphitic N can facilitate PMS activation via radical and nonradical pathways. Based on the LC-MS/MS analysis, the GAT degradation intermediates were identified, and the possible degradation pathways were tentatively proposed. Overall, this study demonstrated that carbocatalyst derived from face mask could be transformed into costeffective and environmentally friendly PMS activator for environmental wastewater treatment applications.

2.
Journal of Microbiology, Immunology and Infection ; Part 1. 55(6):1005-1012, 2022.
Article in English | EMBASE | ID: covidwho-2180782

ABSTRACT

Background: To contain the coronavirus disease 2019 (Covid-19) pandemic, non-pharmacologic interventions, including lockdown and social distancing, may have adverse impact on access to HIV testing and care. This study investigated the impact of Covid-19 on HIV testing and care at a major hospital in Taiwan in 2020-2021. Method(s): The numbers of clients seeking anonymous HIV voluntary counseling and testing were compared 2 years before (2018-2019) and 2 years after Covid-19 outbreak (2020-2021). People living with HIV (PLWH) who sought care at the hospital during 2018-2021 were included to examine the status of HIV care delivery and disposition. Result(s): The annual number of HIV screening tests performed had significantly decreased from 2507 to 2794 in 2018 and 2019, respectively, to 2161 and 1737 in 2020 and 2021, respectively. The rate of discontinuation of HIV care among PLWH was 3.7% in 2019, which remained unchanged in 2020 (3.7%) and 2021 (3.8%). The respective percentage of annual plasma HIV RNA testing <2 times increased from 8.4% to 7.8% in 2018 and 2019 to 7.0% and 10.7% in 2020 and 2021, so was that of annual syphilis testing <2 times (10.1% and 8.8%-7.9% and 12.0%). The rates of plasma HIV RNA <200 copies/ml ranged from 97.0% to 98.1% in 2018-2021. Conclusion(s): During the Covid-19 pandemic, access to HIV counseling and testing was significantly limited. While the number of HIV-related testing decreased, the impact of Covid-19 on the continuity of antiretroviral therapy and viral suppression among PLWH appeared to be minimal in Taiwan. Copyright © 2022

3.
Cjem ; 2023.
Article in English | PubMed | ID: covidwho-2175637

ABSTRACT

OBJECTIVE: The primary objective was to quantify the prognostic association between various D-dimer thresholds and 30-day PE diagnosis among emergency department (ED) patients with suspected SARS-CoV-2 infection. METHODS: This was a retrospective study of patients enrolled in the Canadian COVID-19 ED Rapid Response Network (CCEDRRN) registry from March 1, 2020 to July 2, 2021. We included consecutive adults (≥ 18 years) presenting to 49 EDs with chest pain, shortness of breath, hypoxia, syncope, presyncope, or hemoptysis who were tested for both SARS-CoV-2 and D-dimer at index ED visit. The primary outcome measure was the sensitivity, specificity, and negative predictive value of D-dimer test thresholds for the outcome of 30-day PE diagnosis. RESULTS: Among 10,837 patients included in our study, 404 (3.7%) were diagnosed with PE at 30-days. A standard D-Dimer threshold of 500 ng/mL had a sensitivity of 97.8% (95% confidence interval [CI] 95.8-99.0%), specificity of 40.9% (95% CI 39.9-41.8%), and negative predictive value of 99.8% (95% CI 99.6-99.9%). An age-adjusted D-dimer threshold had a sensitivity of 96.0% (95% CI 93.6-97.7%), specificity of 48.5% (95% CI 47.5-49.4%), and negative predictive value of 99.7% (95% CI 99.5-99.8%). D-dimer testing had slightly lower prognostic performance among SARS-CoV-2 positive compared to SARS-CoV-2 negative patients in predicting 30-day PE diagnosis. CONCLUSIONS: Among ED patients with suspected SARS-CoV-2, the standard 500 ng/mL and age-adjusted D-dimer thresholds were comparable for the prediction of PE at 30-days. The prognostic performance of D-dimer was lower among SARS-CoV-2 positive patients. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04702945.

4.
Front Microbiol ; 13, 2022.
Article in English | PubMed Central | ID: covidwho-2199022

ABSTRACT

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, the early detection and isolation of individuals infected with severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) through mass testing can effectively prevent disease transmission. SARS-CoV-2 nucleic acid rapid detection based on loop-mediated isothermal amplification (LAMP) may be appropriate to include in testing procedures. Methods: We used 860 nasopharyngeal specimens from healthcare workers of Huashan Hospital and COVID-19 patients collected from April 7th to 21st, 2022, to assess the clinical diagnostic performance of the LAMP assay marketed by Shanghai GeneSc Biotech and compared it to the result of a rapid antigen test (RAT) head-to-head. Results: Overall, the diagnostic performance of LAMP assay and RAT were as follows. The LAMP assay represented higher sensitivity and specificity than RAT, especially in the extracted RNA samples. The sensitivity was 70.92% and 92.91% for direct LAMP and RNA-LAMP assay, respectively, while the specificity was 99.86% and 98.33%. The LAMP assay had overall better diagnostic performance on the specimens with relatively lower Ct values or collected in the early phase (≤7 days) of COVID-19. The combination of LAMP assay and RAT improved diagnostic efficiency, providing new strategies for rapidly detecting SARS-CoV-2. Conclusion: The LAMP assay are suitable for mass screenings of SARS-CoV-2 infections in the general population.

5.
Journal of Virus Eradication ; 8(4):100308, 2022.
Article in English | MEDLINE | ID: covidwho-2181183

ABSTRACT

Background: A community COVID-19 outbreak caused by the B.1.1.7 SARS-CoV-2 variant occurred in Taiwan in May 2021. High-risk populations such as people living with HIV (PLWH) were recommended to receive two doses of COVID-19 vaccines. While SARS-CoV-2 vaccines have demonstrated promising results in general population, real-world information on the serological responses remains limited among PLWH.

6.
Front Genet ; 13, 2022.
Article in English | PubMed Central | ID: covidwho-2163009

ABSTRACT

The COVID-19 pandemic has resulted in great morbidity and mortality worldwide and human genetic factors have been implicated in the susceptibility and severity of COVID-19. However, few replicate researches have been performed, and studies on associated genes mainly focused on genic regions while regulatory regions were a lack of in-depth dissection. Here, based on previously reported associated variants and genes, we designed a capture panel covering 1,238 candidate variants and 25 regulatory regions of 19 candidate genes and targeted-sequenced 96 mild and 145 severe COVID-19 patients. Genetic association analysis was conducted between mild and severe COVID-19 patients, between all COVID-19 patients and general population, or between severe COVID-19 patients and general population. A total of 49 variants were confirmed to be associated with susceptibility or severity of COVID-19 (p < 0.05), corresponding to 18 independent loci. Specifically, rs1799964 in the promoter of inflammation-related gene TNF, rs9975538 in the intron of interferon receptor gene IFNAR2, rs429358 in the exon of APOE, rs1886814 in the intron of FOXP4-AS1 and a list of variants in the widely reported 3p21.31 and ABO gene were confirmed. It is worth noting that, for the confirmed variants, the phenotypes of the cases and controls were highly consistent between our study and previous reports, and the confirmed variants identified between mild and severe patients were quite different from those identified between patients and general population, suggesting the genetic basis of susceptibility and severity of SARS-CoV-2 infection might be quite different. Moreover, we newly identified 67 significant associated variants in the 12 regulatory regions of 11 candidate genes (p < 0.05). Further annotation by RegulomeDB database and GTEx eQTL data filtered out two variants (rs11246060 and rs28655829) in the enhancer of broad-spectrum antiviral gene IFITM3 that might affect disease severity by regulating the gene expression. Collectively, we confirmed a list of previously reported variants and identified novel regulatory variants associated with susceptibility and severity of COVID-19, which might provide biological and clinical insights into COVID-19 pathogenesis and treatment.

7.
Virus Evolution ; 8(2):veac106, 2022.
Article in English | MEDLINE | ID: covidwho-2161171

ABSTRACT

Variants of severe acute respiratory syndrome coronavirus 2 frequently arise within infected individuals. Here, we explored the level and pattern of intra-host viral diversity in association with disease severity. Then, we analyzed information underlying these nucleotide changes to infer the impetus including mutational signatures and immune selection from neutralizing antibody or T-cell recognition. From 23 January to 31 March 2020, a set of cross-sectional samples were collected from individuals with homogeneous founder virus regardless of disease severity. Intra-host single-nucleotide variants (iSNVs) were enumerated using deep sequencing. Human leukocyte antigen (HLA) alleles were genotyped by Sanger sequencing. Medical records were collected and reviewed by attending physicians. A total of 836 iSNVs (3-106 per sample) were identified and distributed in a highly individualized pattern. The number of iSNVs paced with infection duration peaked within days and declined thereafter. These iSNVs did not stochastically arise due to a strong bias toward C > U/G > A and U > C/A > G substitutions in reciprocal proportion with escalating disease severity. Eight nonsynonymous iSNVs in the receptor-binding domain could escape from neutralization, and eighteen iSNVs were significantly associated with specific HLA alleles. The level and pattern of iSNVs reflect the in vivo viral-host interaction and the disease pathogenesis.

8.
Pharmacoepidemiology & Drug Safety ; 04:04, 2022.
Article in English | MEDLINE | ID: covidwho-2148445

ABSTRACT

BACKGROUND: We sought to develop and prospectively validate a dynamic model that incorporates changes in biomarkers to predict rapid clinical deterioration in patients hospitalized for COVID-19.

9.
Zhonghua Er Ke Za Zhi ; 60(12): 1307-1311, 2022 Dec 02.
Article in Chinese | MEDLINE | ID: covidwho-2143847

ABSTRACT

Objective: To understand the characteristics and associated factors of viral nucleic acid conversion in children infected with Omicron variant strain of SARS-CoV-2 in Shanghai. Methods: The clinical symptoms, laboratory results and other data of 177 children infected with SARS-CoV-2 who were hospitalized in Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University (designated hospital for SARS-CoV-2 infection in Shanghai) from April 25 to June 8, 2022 were retrospectively analyzed. According to the chest imaging findings, the children were divided into mild and common type groups. According to their age, the unvaccinated children were divided into<3 years old group and 3-<18 years old group. According to the vaccination status, the children aged 3-<18 year were divided into non-vaccination group, 1-dose vaccination group and 2-dose vaccination group. Comparison between groups was performed by independent sample t-test and analysis of variance, and multivariate linear regression analysis was used for multivariate analysis. Results: Among the 177 children infected with Omicron variant of SARS-CoV-2, 96 were males and 81 were females, aged 3 (1, 6) years. The time of viral nucleic acid negative conversion was (10.3±3.1) days. The 177 children were 138 cases of mild type and 39 cases of common type. Among the children aged 3-<18 years old, 55 cases were not vaccinated, 5 cases received 1-dose and 36 cases received 2-dose vaccination. Among the 36 children who received 2 doses of vaccination, the time of viral nucleic acid negative conversion was shorter in those vaccinated within 6 months than those over 6 months ((7.1±1.9) vs. (10.8±3.0) d, t=-3.23, P=0.004). Univariate analysis showed that the time of nucleic acid negative conversion of SARS-CoV-2 was associated with age, underlying diseases, gastrointestinal symptoms, white blood cell count, proportion of neutrophils, proportion of lymphocytes, and the number of doses of SARS-CoV-2 vaccine (t=3.87, 2.55, 2.04, 4.24, 3.51, 2.92, F=16.27, all P<0.05). Multiple linear regression analysis showed that older age (ß=-0.33, 95% CI -0.485--0.182, P<0.001) and more doses of vaccination (ß=-0.79, 95% CI -1.463--0.120, P=0.021) were associated with shortened nucleic acid negative conversion time in children, while lower lymphocyte proportion (ß=-0.02, 95% CI -0.044--0.002, P=0.031) and underlying diseases (ß=1.52, 95% CI 0.363-2.672, P=0.010) were associated with prolonged nucleic acid negative conversion time in children. Conclusion: The children infected with Omicron variant of SARS-CoV-2 with reduced lymphocyte proportion and underlying diseases may have longer time of viral nucleic acid negative conversion,while children with older age and more doses of vaccination may have shorter time of viral nucleic acid negative conversion.


Subject(s)
COVID-19 , Nucleic Acids , Child , Female , Male , Humans , Child, Preschool , Adolescent , SARS-CoV-2 , COVID-19 Vaccines , Retrospective Studies , China/epidemiology , Translocation, Genetic , Hospitals, Pediatric
11.
Chest ; 162(4):A585-A586, 2022.
Article in English | EMBASE | ID: covidwho-2060638

ABSTRACT

SESSION TITLE: COVID-19 Case Report Posters 1 SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: COVID-19 patients requiring admission to an ICU have a higher risk of invasive pulmonary aspergillosis (IPA) with a reported incidence of 19.6%-33.3%. CASE PRESENTATION: A 63-year-old male presented with progressively worsening dyspnea for one week. He has a past medical history of atrial fibrillation, hypertension, and obesity. He was tested positive for COVID about two weeks prior. He did receive a single dose of Moderna vaccine. Initial chest x-ray(CXR) showed diffuse ground-glass opacities. He was initiated on Remdesivir and decadron, and later received a dose of tocilizumab. He was intubated on hospital day 3 for worsened hypoxemia. Repeat CXR suggested some improvement but a new left lower lobe airspace haziness. He also had new-onset leukocytosis with elevated procalcitonin level. He was started on cefepime for concern of superimposed hospital-acquired pneumonia. A second dose of tocilizumab was administered. No clinical improvement was seen, and additional workups were obtained. Serial CXRs revealed increasing diffuse airspace opacities concerning for ARDS. Tracheal aspirate culture grew coagulase-negative staphylococcus and Aspergillosis Fumigatus. Cefepime was changed to vancomycin, and voriconazole and caspofungin were added. Unfortunately, the patient's respiratory status worsened with increasing ventilation requirement. He also developed septic shock and acute renal failure requiring CVVH. He became even more hypotensive after CVVH initiation, and multiple vasopressors were required to maintain his hemodynamics. Unfortunately, he continued to deteriorate and he also developed profound respiratory acidosis. He died shortly afterwards after family decided to withdraw care. DISCUSSION: In this case, in addition to superimposed bacterial pneumonia, pulmonary aspergillosis likely also contributed to his clinical deterioration. The mechanism by which fungal infections develop in COVID-19 infection is not well-understood. Severe COVID-related immune dysregulation, ARDS, and high-dose steroids use are potential culprits for the increased risk of IPA. Tocilizumab, an IL-6 receptor monoclonal antibody used in patients with severe COVID-19 infection, may also predispose the patient to IPA according to post-marketing data. The mortality rate from current case reports is as high as 64.7%. Diagnosis and treatment in such a scenario remain a challenge. Sputum culture, serum Beta-galactomannan, Beta-D glucan, and aspergillosis PCR have low sensitivity. Tissue biopsy and CT scan in critically ill patients are often not feasible. Voriconazole is usually considered the first-line treatment in IPA. CYP3A4-mediated drug interactions between azoles and antiviral agents require further investigation. CONCLUSIONS: Clinicians should be aware that severe COVID-19 patients are at higher risk of IPA. The prognosis is poor. Early detection and treatment in clinically deteriorated patients are warranted. Reference #1: Borman, A.M., Palmer, M.D., Fraser, M., Patterson, Z., Mann, C., Oliver, D., Linton, C.J., Gough, M., Brown, P., Dzietczyk, A. and Hedley, M., 2020. COVID-19-associated invasive aspergillosis: data from the UK National Mycology Reference Laboratory. Journal of clinical microbiology, 59(1), pp.e02136-20. Reference #2: Lai CC, Yu WL. COVID-19 associated with pulmonary aspergillosis: A literature review. J Microbiol Immunol Infect. 2021;54(1):46-53. doi:10.1016/j.jmii.2020.09.004 Reference #3: Thompson Iii GR, Cornely OA, Pappas PG, et al. Invasive Aspergillosis as an Under-recognized Superinfection in COVID-19. Open Forum Infect Dis. 2020;7(7):ofaa242. Published 2020 Jun 19. doi:10.1093/ofid/ofaa242 DISCLOSURES: No relevant relationships by Jason Chang No relevant relationships by Jason Chang No relevant relationships by kaiqing Lin No relevant relationships by Guangchen Zou

12.
8th International Conference on E-Business and Mobile Commerce, ICEMC 2022 ; : 169-173, 2022.
Article in English | Scopus | ID: covidwho-2053356

ABSTRACT

Leisure farm tourism would not only allow tourists to experience agricultural activities but also can increase farmers' income and deeply root rural culture. However, during the recent period of COVID-19 leisure farm should consider and evaluate its competitive ability for attracting tourists to go to leisure farm again. In this research LTOPSIS and SWOT technology is applied to evaluate and analyze competitive ability for leisure farms. According to quasi-experimental analysis, case leisure farm should be operated its business carefully due to uncertainty of COVID-19. Leisure farm should retain some fund to avoid the possibility of collapse in the future. © 2022 ACM.

13.
International Journal of Radiation Oncology, Biology, Physics ; 114(3):e466-e467, 2022.
Article in English | CINAHL | ID: covidwho-2036120
14.
Sustainable Environment ; 8(1), 2022.
Article in English | Web of Science | ID: covidwho-2017559

ABSTRACT

Eight to ten percent of total global greenhouse gas emissions are associated with food loss and waste. Tackling the challenges of food loss and sustainable food waste management is key to fulfilling the Paris Agreement. However, among the Nationally Determined Contributions to the Paris Agreement, very few countries make references to food loss and waste. In this work, we reviewed the problem of food loss and waste from a global viewpoint and highlighted the opportunities of managing food loss and waste towards carbon mitigation and beyond. The importance of developing a coherent collaboration among all associated stakeholders was implied. Some recent policy developments and the impacts of COVID-19 pandemic are discussed followed by the summarization of potential solutions to tackling the fool loss and waste challenge.

15.
Formosan Journal of Surgery ; 55(4):158-160, 2022.
Article in English | EMBASE | ID: covidwho-2010413

ABSTRACT

The authors reported the clinical course of a 58-year-old female suffering from cerebral venous sinus thrombosis associated with hemorrhage after the ChAdOx1 nCov-19 vaccination. Emergent decompressive craniectomy was performed, and aggressive blood transfusion was given. Nevertheless, progressive intracerebral hemorrhage and thrombocytopenia developed. A delayed diagnosis was made on a rare complication of vaccine-induced immune thrombotic thrombocytopenia (VITT) with a positive result of anti-platelet factor 4 antibodies (PF4 Ab). The patient died 4 days postoperative due to brainstem failure.

16.
Journal of Crohn's & colitis ; 16(Suppl 1):i023-i025, 2022.
Article in English | EuropePMC | ID: covidwho-1999022

ABSTRACT

Background Antibody responses following SARS-CoV-2 infection or a single-dose of SARS-CoV-2 vaccine are impaired in patients with inflammatory bowel disease treated with anti-TNF compared to those treated with vedolizumab, a gut-selective anti-integrin α4β7 monoclonal antibody. Here we sought to determine if patients treated with infliximab have attenuated serological and T cell responses and an increased risk of breakthrough COVID-19 infection following primary SARS-CoV-2 vaccination. Methods Anti-spike (S) receptor binding domain (RBD) antibody concentration in 2306 infliximab-treated patients were compared to a cohort of 1045 vedolizumab-treated patients. Our primary outcome was anti-S RBD antibodies 2 to 10 weeks after a second dose of the BNT162b2 or ChAdOx1 nCoV-19 vaccines. Secondary outcomes were anti-spike T cell responses, durability of vaccine responses and risk of breakthrough infections following two doses of vaccine. Results Anti-S RBD antibody concentrations were lower in patients treated with infliximab than in those treated with vedolizumab, following a second dose of BNT162b2 (567.3 U/mL [6.1] vs 4601.1 U/mL [5.3], p <0.0001) and ChAdOx1 nCoV-19 (183.9 U/mL [5.0] vs 789.4 U/mL [3.5], p <0.0001) vaccines (Fig. 1). Vaccination with the BNT162b2 vaccine compared to the ChAdOx1 nCoV-19 was independently associated with a 3.7-fold [95% CI 3.30 – 4.13] higher anti-S RBD antibody concentration (p < 0.0001) (Fig. 2). There were no significant differences in the magnitude of anti-spike T cell responses observed in infliximab- compared with vedolizumab-treated patients after one or two doses of either vaccine. Antibody half-life was shorter in infliximab- than vedolizumab-treated patients following two-doses of BNT162b2 (4.0 weeks [95% CI 3.8 – 4.1] vs 7.2 weeks [95% CI 6.8 – 7.6]) and ChAdOx1 nCoV-19 (5.3 weeks [95% CI 5.1 – 5.5] vs 9.3 weeks [95% CI 8.5 – 10.2], p value < 0.0001). Breakthrough SARS-CoV-2 infections were more frequent (5.8% (202/3467) vs 3.9% (66/1691), p = 0.0032) and the time to breakthrough shorter in patients treated with infliximab than vedolizumab (p = 0.0023) (Fig. 3). Higher anti-S RBD antibody concentrations following a second dose of SARS-CoV-2 vaccine protected against breakthrough SARS-CoV-2 infection: overall, for every 10-fold rise in anti-S RBD antibody level we observed a 0.8-fold reduction in odds of breakthrough infection ([95% CI 0.70 – 0.99], p = 0.035). Conclusion Infliximab was associated with attenuated, less durable vaccine induced anti-S RBD antibody responses and a 50% increase in breakthrough SARS-CoV-2 infection. Further follow-up is required to assess whether third primary doses can mitigate the effects of infliximab on anti-S RBD antibody responses.

18.
Topics in Antiviral Medicine ; 30(1 SUPPL):174-175, 2022.
Article in English | EMBASE | ID: covidwho-1881004

ABSTRACT

Background: Symptoms reduction is a crucial outcome to be considered when testing novel treatments for COVID-19. The goal was to assess the impact of casirivimab+imdevimab (cas+imd) dose/exposure on the trajectory and resolution time of symptoms in outpatients with COVID-19. Methods: Analysis used data from the COV-2067 trial (NCT04425629). Cas+imd was administered intravenously (total dose 1.2 to 8 g). Symptoms data were collected using SE-C19, a patient-reported survey developed de novo to assess the symptomatic course of COVID-19. Based on patients' responses on SE-C19, a Rasch analysis was used to derive a latent score to infer their overall underlying symptom severity. A direct response model was fitted to the latent score-time data to quantify the effects of dose/exposure, demographic and clinical characteristics on latent symptom trajectory. Symptoms resolution time was defined as time from randomization to the 1st day during which the patient scored "no symptom". Several parametric models were tested as structural model, assuming a known distribution, eg, exponential or Weibull, for time to symptoms resolution data. Risk variables (eg, binary treatment or categorical dose levels, exposure metrics, baseline demographic, clinical, and biological characteristics) were tested as covariates using a proportional hazard model. Results: Results from the direct response model suggest that each dose, as compared to placebo, remarkably reduced IT50 (time taken to achieve half of the maximal response of reducing symptom) by ∼40%. By excluding data from placebo arm, none of the tested doses or predicted exposures, were significant covariates on any of the model parameters. Results from the parametric regression analysis further confirmed that cas+imd (HR=1.25) is a major factor shortening the symptoms resolution time in a dose-and exposure-independent manner. Males (HR=1.13) have a shorter symptoms resolution time. Older age (HR=0.991), higher BMI (HR=0.988), and more severe baseline symptoms (HR=0.783 for moderate and 0.589 for severe) significantly contribute to longer symptoms resolution time. Conclusion: Treatment with cas+imd (1.2 g or above), rapidly resolved symptoms in outpatients in a dose-and exposure-independent manner as indicated by a direct response model using derived latent score and further confirmed by a survival analysis using time to symptoms resolution. In addition, symptom severity, age, BMI, sex were major risk factors affecting the symptoms resolution time.

19.
Topics in Antiviral Medicine ; 30(1 SUPPL):176, 2022.
Article in English | EMBASE | ID: covidwho-1880117

ABSTRACT

Background: Casirivimab+imdevimab (hereinafter referred to as drug) remains vital in reducing hospitalization/death by 70% when administered early in the course of the infection. Our aim was to illustrate the mechanism of drug action in vivo and determine the magnitude of antiviral efficacy of various dose regimens given to outpatients with COVID-19, evaluating the presence of SARS-CoV-2 sero-antibody and ≥1 high-risk factor for developing severe COVID-19 illness as predictors of viral kinetics. Methods: Analysis data came from 2 clinical studies in SARS-CoV-2 infected outpatients with no or ≥1 risk factor for severe COVID-19 (NCT04425629 and NCT04666441), who received single dose of placebo or drug IV (300mg to 8g) or SC (600mg to 1.2g), had assessed viral load in nasopharyngeal swab and drug concentrations in serum (N=4500). The median number of viral load assessments per patient was 5 (range 1-8) within up to 14 days of follow-up time. Drug concentrations were predicted using the individual pharmacokinetic parameters yielded by a population model. The median patient age was 42 years, with similar proportion of males and females. The median viral load at baseline was 6.79 log10 copies/mL, and the median time of symptom onset was 3 days before study baseline. A standard target cell-limited model was used to estimate the time of infection and reconstruct viral kinetic profiles. Various relationships between exposure and resulting antiviral response were evaluated, where the drug could block de novo infection, increase the elimination rate of infected cells, or reduce viral production from infected cells. Results: The results support that the main mechanism of drug action is blocking de novo infection with an estimated decrease in the infectivity rate of 96.6%, for all dose regimens evaluated herein. High-risk factor for severe COVID-19 and baseline sero-antibody-positive/other status were associated with a 4.71% decrease and a 4.96% increase in the elimination rate of infected cells, respectively. The estimated median and 95th percentile of time to viral clearance (ie, viral count reaches below assay quantification limit) were 1.4 and 3.4 days shorter in drug vs placebo (median 10.6 vs 12.0 days, and 95th percentile 15.2 vs 18.6 days). Conclusion: All IV and SC casirivimab+imdevimab dose regimens evaluated herein showed similar near-maximal antiviral activity by blocking de novo infection;hence, shortening the time to virus clearance.

20.
Topics in Antiviral Medicine ; 30(1 SUPPL):349, 2022.
Article in English | EMBASE | ID: covidwho-1880517

ABSTRACT

Background: A large-scale community COVID-19 outbreak occurred between April and August 2021 in Taiwan, where non-pharmaceutical interventions (NPIs) have been strictly implemented and COVID-19 vaccination program was not implemented until 1 March, 2021. Although COVID-19 vaccination is recommended for at-risk populations, the vaccine effectiveness in people living with HIV (PLWH) remains incompletely understood. We evaluated the effectiveness of COVID-19 vaccination among PLWH during a COVID-19 outbreak in Taiwan. Methods: From 1 March to 30 September, 2021, all adult PLWH without previous SARS-CoV-2 infection were included and advised to receive 2 doses of COVID-19 vaccine. The government-funded vaccination campaign provided different types of COVID-19 vaccine, including ChAdOx1 nCoV-19 (AZD1222), BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and MVC-COV1901 (Medigen) vaccines. The primary endpoint of this study was the vaccine effectiveness in preventing COVID-19 among PLWH, which was estimated by comparing incidence rates between the unvaccinated, partially vaccinated, and fully vaccinated groups in a dynamic cohort. Results: During the study period, 3131 PLWH were included, with 99.9% on antiretroviral therapy, 99.8% being MSM and median CD4 count of 627 cells/mm3. In the dynamic cohort, 3128 PLWH contributed 516892 person-days of follow-up (PDFU) to the unvaccinated group, 2476 PLWH contributed 139163 PDFU to the partially vaccinated group, and 236 PLWH contributed 12011 PDFU to the fully vaccinated group (Table). During the follow-up, 37 PLWH (1.2%) acquired SARS-CoV-2 infections. The incidence rate of SARS-CoV-2 infection was 6.4 per 100,000 PDFU in the unvaccinated group, which decreased to 2.9 and 0 per 100,000 PDFU in the partially and fully vaccinated groups, respectively. The adjusted incidence rate ratios were 0.47 (95% CI, 0.17-1.32) in the partially vaccinated group and <0.01 in the fully vaccinated group compared with the unvaccinated group, resulting in vaccine effectiveness rates of 53.4% and 99.9% for single-and 2-dose COVID-19 vaccination, respectively. Conclusion: COVID-19 vaccination was clinically effective among PLWH during the outbreak setting where NPIs were strictly implemented.

SELECTION OF CITATIONS
SEARCH DETAIL