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1.
Journal of Microbiology, Immunology and Infection ; 2022.
Article in English | ScienceDirect | ID: covidwho-1983503

ABSTRACT

Objectives This study investigated the clinical efficacy and safety of oral Janus kinase inhibitors (JAKis) in the treatment of hospitalized patients with COVID-19. Methods The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for relevant articles written before January 29, 2022. Only randomized controlled trials (RCTs) that assessed the clinical efficacy and safety of oral JAKis in patients with COVID-19 were included. Results In the pooled analysis of the 7 RCTs, the all-cause 28-day mortality rate in the study group receiving JAKis was significantly lower than that in the control group (9.4% [183/1941] vs. 10.9% [184/1687], risk ratio [RR] = 0.69, 95% confidence interval [CI], 0.58–0.81, I2 = 0%). In addition, the risk of 14-day mortality was in the study group was lower than that in the control group (RR = 0.65, 95% CI, 0.46–0.92, I2 = 0%). Finally, the study group and the control group exhibited similar risks of any adverse events (RR = 0.96, 95% CI, 0.89–1.04, I2 = 0%). Conclusions Oral JAKis can significantly reduce the risk of death among patients with COVID-19. In addition, JAKis are tolerable for hospitalized patients with COVID-19.

2.
Med Clin (Engl Ed) ; 155(6): 249-253, 2020 Sep 25.
Article in English | MEDLINE | ID: covidwho-1796343

ABSTRACT

PURPOSE: Influenza virus infection is associated with a high disease burden. COVID-19 caused by SARS-CoV-2 has become a pandemic outbreak since January 2020. Taiwan has effectively contained COVID-19 community transmission. We aimed to validate whether fighting COVID-19 could help to control other respiratory infections in Taiwan. METHOD: We collected week-case data of severe influenza, invasive Streptococcus pneumoniae disease and death toll from pneumonia among 25 calendar weeks of the influenza season for four years (2016-2020), which were reported to Taiwan CDC. Trend and slope differences between years were compared. RESULT: A downturn trend of severe influenza, invasive S. pneumoniae disease and the death toll from pneumonia per week in 2019/2020 season and significant trend difference in comparison to previous seasons were noted, especially after initiation of several disease prevention measures to fight potential COVID-19 outbreak in Taiwan. CONCLUSIONS: Fighting COVID-19 achieved collateral benefits on significant reductions of severe influenza burden, invasive S. pneumoniae disease activity, and the death toll from pneumonia reported to CDC in Taiwan.


PROPÓSITOS: La COVID-19, causada por SARS-CoV-2, se ha convertido en un brote de pandemia desde enero de 2020. Taiwán ha contenido efectivamente la transmisión comunitaria de la COVID-19. Por otra parte, la influenza también es una enfermedad que se asocia con una alta carga de morbilidades. El objetivo del estudio es validar si combatir la COVID-19 podría ayudar a controlar otras infecciones respiratorias en Taiwán. MÉTODOS: Recopilamos datos semanales de casos de influenza grave, infecciones invasivas por Streptococcus pneumoniae y número de muertes por neumonía, que se informaron a los CDC de Taiwán en las 25 semanas de la temporada de influenza durante 4 años (2016-2020). Comparamos las diferencias de tendencia y de pendiente entre los años. RESULTADOS: Se observó una tendencia a la baja de la influenza grave, de las infecciones invasivas por Streptococcus pneumoniae y del número de muertes por neumonía por semana en la temporada de influenza de 2019-2020. Se observaron diferencias significativas en la tendencia en comparación con las temporadas anteriores, especialmente después del inicio de varias medidas de prevención de enfermedades para combatir el posible brote de COVID-19 en Taiwán. CONCLUSIONES: Por el número de casos reportados a los CDC de Taiwán, encontramos que la lucha contra la COVID-19 logró beneficios colaterales en cuanto a reducción significativa de la carga de la influenza grave, a las infecciones invasivas por Streptococcus pneumoniae y al número de muertes por neumonía.

3.
J Microbiol Immunol Infect ; 2022 Apr 14.
Article in English | MEDLINE | ID: covidwho-1796470

ABSTRACT

BACKGROUND: In Taiwan, there were only 799 confirmed COVID-19 cases in 2020. The unique backdrop amidst a pandemic and promotion of nonpharmaceutical interventions generated some distinct changes in the epidemiology of common respiratory pathogens. In this study, we aimed to investigate the dynamic changes in respiratory pathogens in children during 2020. METHODS: We performed a retrospective cohort study at a tertiary hospital in southern Taiwan during 2020. Patients aged 0-18 years who visited the pediatric emergency department were enrolled. Children who presented with clinical symptoms (fever or respiratory illness) and received nasopharyngeal swabs for multiplex polymerase chain reaction (PCR) were included in our analysis. We also compared respiratory syncytial virus (RSV) trends from previous years by PCR and lateral flow immunochromatographic assays from 2017 to 2020. RESULTS: A total of 120 children were tested. The overall detection rate was 55%. With strengthened restrictions, the detection rate dropped from 70% to 30%. However, non-enveloped viruses (rhinovirus/enterovirus and adenovirus) were in constant circulation. Upon easing prevention measures, the detection rate remained above 60%, and an outbreak of an enveloped virus (RSV and parainfluenza virus) was noted. Compared with 2017-2019, the cyclical RSV epidemic was delayed, with a large surge in late 2020. CONCLUSIONS: We observed a constant circulation of non-enveloped viruses when strict nonpharmaceutical interventions were employed and a delayed surge of enveloped viruses during the easing of restrictions. Continuous surveillance and monitoring of the evolutionary dynamics of respiratory viruses is important, while easing restrictions requires balanced judgment.

4.
Antibiotics (Basel) ; 11(4)2022 Apr 03.
Article in English | MEDLINE | ID: covidwho-1776113

ABSTRACT

This study was conducted to compare the number of cases of airborne/droplet-transmitted notifiable infectious disease (NID) between the pandemic period (defined as from January 2020 to December 2021) and the pre-pandemic period (defined as the period from January 2018 to December 2019). The annual case numbers of airborne/droplet-transmitted NIDs from 2018 to 2021 were collected for comparison. Fourteen airborne/droplet-transmitted NIDs including measles, rubella, pertussis, influenza with severe complications, invasive pneumococcal diseases (IPD), Q fever, mumps, meningococcal meningitis, varicella, legionellosis, invasive Haemophilus influenzae type b infection, hantavirus syndrome, TB, and multidrug-resistant TB (MDRTB), were included for the analysis. Overall, the annual case number of these 14 airborne/droplet-transmitted NID was 11,930, 12,747, 9477, and 8268 in 2018, 2019, 2020, and 2021, respectively, and the overall incidence was 50.3, 53.6, 39.8, 34.6 per 100,000 populations in in 2018, 2019, 2020, and 2021. The case number of influenza with severe complications had the largest reduction from the pre-pandemic period to the pandemic period, with a reduction of 3076 cases, followed by TB (-2904), IPD (-490), mumps (-292), measles (-292), pertussis (-57), MDRTB (-43), rubella (-35), Q fever (-20), varicella (-12), meningococcal meningitis (-5), invasive H. influenzae type B (-4). In contrast, the case number of legionellosis increased from 492 during the pre-pandemic period to 676 during the pandemic period. In addition, hantavirus syndrome also increased from zero cases during the pre-pandemic period to three during the pandemic period. In conclusion, the occurrence of most airborne/droplet-transmitted NIDs, including both domestic and imported cases in Taiwan, was lower during the pandemic period than during the pre-pandemic period.

5.
Antibiotics (Basel) ; 11(3)2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1742290

ABSTRACT

The outbreak of COVID-19 has significantly changed the epidemiology of respiratory tract infection in several ways. The implementation of non-pharmaceutical interventions (NPIs) including universal masking, hand hygiene, and social distancing not only resulted in a decline in reported SARS-CoV-2 cases but also contributed to the decline in the non-COVID-19 respiratory tract infection-related hospital utilization. Moreover, it also led to the decreased incidence of previous commonly encountered respiratory pathogens, such as influenza and Streptococcus pneumoniae. Although antimicrobial agents are essential for treating patients with COVID-19 co-infection, the prescribing of antibiotics was significantly higher than the estimated prevalence of bacterial co-infection, which indicated the overuse of antibiotics or unnecessary antibiotic use during the COVID-19 pandemic. Furthermore, inappropriate antimicrobial exposure may drive the selection of drug-resistant microorganisms, and the disruption of infection control in COVID-19 setting measures may result in the spread of multidrug-resistant organisms (MDROs). In conclusion, NPIs could be effective in preventing respiratory tract infection and changing the microbiologic distribution of respiratory pathogens; however, we should continue with epidemiological surveillance to establish updated information, antimicrobial stewardship programs for appropriate use of antibiotic, and infection control prevention interventions to prevent the spread of MDROs during the COVID-19 pandemic.

6.
J Microbiol Immunol Infect ; 55(2): 215-224, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1274336

ABSTRACT

BACKGROUND/PURPOSE: Streptococcus pneumoniae causes pneumonia and other invasive diseases, and is a leading cause of mortality in the elderly population. The present study aimed to provide current antimicrobial resistance and epidemiological profiles of S. pneumoniae infections in Taiwan. METHODS: A total of 252 nonduplicate S. pneumoniae isolates were collected from patients admitted to 16 hospitals in Taiwan between January 2017 and December 2019, and were analyzed. The minimum inhibitory concentration of antibiotics was determined using the Vitek 2 automated system for antimicrobial susceptibility testing. Furthermore, epidemiological profiles of S. pneumoniae infections were analyzed. RESULTS: Among the strains analyzed, 88% were recognized as invasive pneumococcal strains. According to the Clinical and Laboratory Standards Institute criteria for non-meningitis, the prevalence of penicillin-non-susceptible S. pneumoniae demonstrated a declining trend from 43.6% in 2017 to 17.2% in 2019. However, the rate of penicillin-non-susceptible S. pneumoniae was 85.7% based on the criteria for meningitis. Furthermore, the prevalence of ceftriaxone-non-susceptible S. pneumoniae was 62.7% based on the criteria for meningitis. Isolates demonstrated higher susceptibility toward doripenem and ertapenem than toward meropenem and imipenem. An increased rate of non-susceptibility toward levofloxacin was observed in southern Taiwan (15.1%) and elderly patients (≥65 years; 11.4%). Most isolates were susceptible to vancomycin and linezolid. CONCLUSION: Empirical treatment with ceftriaxone monotherapy for pneumococcal meningitis should be carefully monitored owing to its high non-susceptibility rate. The susceptibility rates of most isolates to penicillin (used for treating non-meningitis pneumococcal diseases), carbapenems (ertapenem and doripenem), respiratory quinolones (moxifloxacin and levofloxacin), vancomycin, and linezolid suggested the potential of these antibiotics in treating pneumococcal diseases in Taiwan.


Subject(s)
Meningitis, Pneumococcal , Pneumococcal Infections , Aged , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/pharmacology , Doripenem/therapeutic use , Drug Resistance, Bacterial , Ertapenem/therapeutic use , Humans , Levofloxacin/therapeutic use , Linezolid/therapeutic use , Meningitis, Pneumococcal/drug therapy , Microbial Sensitivity Tests , Penicillins/pharmacology , Penicillins/therapeutic use , Pneumococcal Infections/drug therapy , Pneumococcal Infections/epidemiology , Streptococcus pneumoniae , Taiwan/epidemiology , Vancomycin/pharmacology
13.
Med Clin (Barc) ; 155(6): 249-253, 2020 09 25.
Article in English, Spanish | MEDLINE | ID: covidwho-548589

ABSTRACT

PURPOSE: Influenza virus infection is associated with a high disease burden. COVID-19 caused by SARS-CoV-2 has become a pandemic outbreak since January 2020. Taiwan has effectively contained COVID-19 community transmission. We aimed to validate whether fighting COVID-19 could help to control other respiratory infections in Taiwan. METHOD: We collected week-case data of severe influenza, invasive Streptococcus pneumoniae disease and death toll from pneumonia among 25 calendar weeks of the influenza season for four years (2016-2020), which were reported to Taiwan CDC. Trend and slope differences between years were compared. RESULT: A downturn trend of severe influenza, invasive S. pneumoniae disease and the death toll from pneumonia per week in 2019/2020 season and significant trend difference in comparison to previous seasons were noted, especially after initiation of several disease prevention measures to fight potential COVID-19 outbreak in Taiwan. CONCLUSIONS: Fighting COVID-19 achieved collateral benefits on significant reductions of severe influenza burden, invasive S. pneumoniae disease activity, and the death toll from pneumonia reported to CDC in Taiwan.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Influenza, Human/prevention & control , Pandemics/prevention & control , Pneumococcal Infections/prevention & control , Pneumonia, Viral/prevention & control , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Humans , Influenza, Human/epidemiology , Influenza, Human/transmission , Pneumococcal Infections/epidemiology , Pneumococcal Infections/transmission , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Retrospective Studies , SARS-CoV-2 , Taiwan/epidemiology
14.
Int J Antimicrob Agents ; 55(3): 105924, 2020 Mar.
Article in English | MEDLINE | ID: covidwho-1132

ABSTRACT

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously provisionally named 2019 novel coronavirus or 2019-nCoV) disease (COVID-19) in China at the end of 2019 has caused a large global outbreak and is a major public health issue. As of 11 February 2020, data from the World Health Organization (WHO) have shown that more than 43 000 confirmed cases have been identified in 28 countries/regions, with >99% of cases being detected in China. On 30 January 2020, the WHO declared COVID-19 as the sixth public health emergency of international concern. SARS-CoV-2 is closely related to two bat-derived severe acute respiratory syndrome-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21. It is spread by human-to-human transmission via droplets or direct contact, and infection has been estimated to have mean incubation period of 6.4 days and a basic reproduction number of 2.24-3.58. Among patients with pneumonia caused by SARS-CoV-2 (novel coronavirus pneumonia or Wuhan pneumonia), fever was the most common symptom, followed by cough. Bilateral lung involvement with ground-glass opacity was the most common finding from computed tomography images of the chest. The one case of SARS-CoV-2 pneumonia in the USA is responding well to remdesivir, which is now undergoing a clinical trial in China. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary intervention being used. However, public health authorities should keep monitoring the situation closely, as the more we can learn about this novel virus and its associated outbreak, the better we can respond.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pneumonia, Viral , COVID-19 , China , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Disease Outbreaks , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Severe Acute Respiratory Syndrome/virology , World Health Organization
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