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Objectives: Severe acute respiratory syndrome-coronavirus 2/COVID-19 infection is still a global concern, with pregnant women are considered as vulnerable population. Until now, the characteristics of pregnant women in Indonesia who are infected with COVID-19, as well as pregnancy and neonatal outcomes, are still unknown. This study aims to obtain national data, which are expected to be useful for the prevention and management of COVID-19 in pregnant women in Indonesia. Method(s): There were 1,427 patients recruited in this retrospective multicenter study. This study involved 11 hospitals in 10 provinces in Indonesia and was carried out using secondary patient data from April 2020 to July 2021. COVID-19 severity was differentiated into asymptomatic-to-mild symptoms and moderate-to-severe symptoms. The collected data include maternal characteristics, laboratory examinations, imaging, pregnancy outcomes, and neonatal outcomes. Result(s): Leukocyte, platelets, basophil, neutrophils segment, lymphocytes, monocytes, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), urea, and creatinine were found to be significantly associated with severity differences (p < 0.05). Moderate-severe symptoms of COVID-19 also shown to have suggestive pneumonia findings on chest X-ray findings. Patients with asymptomatic-to-mild symptoms had significantly (p < 0.001) higher recovery rate, shorter hospital stay, less intensive care unit (ICU) admission, and had more vaginal delivery. Neonates from mother with mild symptoms also had significantly (p < 0.001) higher survival rate, higher birth weight, and higher APGAR score. Conclusion(s): Several laboratory and radiology components, as well as maternal and neonatal outcomes are related to the severity of COVID-19 in pregnant women in Indonesia.Copyright © The Author(s). 2023.
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[This corrects the article DOI: 10.3389/falgy.2022.818049.].
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Introduction: COVID-19 coagulopathy is associated with poor prognosis and a state of coexisting 'hypercoagulopathy' (HyperC) and hypofibrinolysis, only detected by viscoelastic tests (VET). VET technology has been useful in areas where conventional tests are inadequate, such as screening for HyperC, thrombotic risk assessment and systemic anticoagulants' effect. We aim to characterize the evolution profile of coagulopathy in patients with COVID-19 infection during their intensive care unit (ICU) stay. Method(s): Consecutive recruitment of adult COVID-19 patients admitted to our hospital's ICU, during a 6 months period. Patients with thrombosis in the previous 3 months, pregnancy, under hormone therapy, and congenital coagulopathies were excluded. VET were executed every 5 days, at discharge and in complications and all of them were under low weight molecular heparin (LMWH) therapy. Group 1 (G1), n = 24-less than 10 days in ICU and group 2 (G2), n = 16-more than 10 days in ICU. In G1 there was 1 death (day 3) and in G2 there were 5 deaths (between days 15 and 42). We focused current analysis on VET-Rotem parameters (see Fig. 1). Result(s): Prognostic scores APACHE II, SAPS II and SOFA were higher in G2, but surprisingly G1 patients are more obese. G2 patients had shorter aPTT and lower platelets. The variables CT-HepTem and MCF Extem-MCF-Fib-Tem present a greater difference between groups, but no statistical significance. We observed an initial correlation between basophils number (which is lower) on CT Intem and CT Hep-Tem, lost as progression to cure, probably due to cytoplasm heparin granules. As expected, VET were in accordance with HyperC: short CTs, increased MCFs, and decreased lysis. Conclusion(s): We expected to guide/adjust LMWH dosage, using Rotem profiles, however these were not corrected by LMWH, used transversally, and remained unchanged in all patients during their stay in ICU.
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Case report Trometamol (tromethamine, tris(hydroxymethyl)aminomethane (TRIS)) is an excipient frequently used as buffer in fluids and semisolid agents, including many drugs such as antibiotics, iodinated contrast agents and the COVID-19 vaccine mRNA-1273. Here, we report the first case of a delayed-type hypersensitivity after oral intake of trometamol. A 64-year- old female patient presented to our emergency department with generalized erythematous rash, pruritus and swelling of the face five hours after the intake of one tablet of fosfomycin trometamol for a urinary tract infection. Further medical history revealed a previous erythematous rash five to six hours after administration of the iodinated contrast agent iopromide. We performed skin prick and intradermal tests with trometamol, fosfomycin trometamol and various iodinated contrast agents, including iopromide, iomeprol, iobitridol, iopamidol and iodixanol. These tests showed no reactions initially. However, 48 hours after intradermal testing, macular erythematous lesions developed at the sites tested with trometamol 0.1%, trometamol 0.01% and all sites tested with iodinated contrast agents. Furthermore, when we performed a lymphocyte transformation test with trometamol, fosfomycin trometamol and iopromide, we recorded a positive reaction with cytokine release after stimulating T cells with trometamol and iopromide. In contrast, basophil activation testing showed a negative result for these agents. Based on these results and our patient's history, we diagnosed a clinically relevant type IV sensitization to trometamol. There are only a few case reports about immediate-type allergic reactions to gadolinium contrast agents caused by the excipient trometamol. There are some published cases which report contact dermatitis after topical administration of trometamol-containing agents. To our knowledge, ours is the first case to report a delayed hypersensitivity reaction to oral administration of trometamol. Excipients are indispensable for drugs, vaccines and other products since they stabilize and preserve the active agents. Nevertheless, excipients should always be considered during an allergy workup, especially if the patient reports prior drug reactions that cannot be explained by a chemical cross-reaction. In our case, we diagnosed delayed-type hypersensitivity to the excipient trometamol. This is a consequential diagnosis for the patient, because trometamol is contained in many drugs and in the COVID-19 vaccine mRNA-1273.
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Allergic and hypersensitivity reactions induced by COVID-19 vaccines are increasingly reported and some patients may develop prolonged urticarial reactions following COVID-19 vaccination. Herein, we investigated the risk factors and immune mechanisms for patients with COVID-19 vaccines-induced immediate allergy and chronic urticaria (CU). We prospectively recruited and analyzed 129 patients with COVID-19 vaccine-induced immediate allergic and urticarial reactions as well as 115 COVID-19 vaccines-tolerant individuals from multiple medical centers during 2021-2022. The clinical manifestations included acute urticaria, anaphylaxis, and delayed to chronic urticaria developed after COVID-19 vaccinations. The serum levels of histamine, IL-2, IL-4, IL-6, IL-8, IL-17A, TARC, and PARC were significantly elevated in allergic patients comparing to tolerant subjects (P-values=4.5x10-5-0.039). Ex vivo basophil revealed that basophils from allergic patients could be significantly activated by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P-values from 3.5x10-4 to 0.043). Further BAT study stimulated by patients' autoserum showed positive in 81.3% of patients with CU induced by COVID-19 vaccination (P=4.2x10-13), and the reactions could be attenuated by anti-IgE antibody. Autoantibodies screening also identified the significantly increased of IgE-anti-IL-24, IgG-anti-FceRI, IgG-anti-TPO, and IgG-anti-thyroid-related proteins in COVID-19 vaccines-induced CU patients comparing to SARS-COV-2 vaccines-tolerant controls (P-values= 4.6x10-10-0.048). Patients with COVID-19 vaccines-induced recalcitrant CU patients could be successfully treated with anti-IgE therapy. In conclusion, our results revealed that multiple vaccine components, inflammatory cytokines, and autoreactive IgG/IgE antibodies contribute to COVID-19 vaccine-induced immediate allergic and autoimmune urticarial reactions (Minor revision in Journal of Autoimmunity [IF=14.551]).Copyright © 2023
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Case report: Chronic urticaria is defined as the presence of urticaria for a period exceeding six weeks. Infections are known as possible triggers for urticaria manifestations, and, as such, SARS-CoV- 2 infection can be recognized as causative. An 8-year- old boy, with a previous history of idiopathic chronic urticaria, came to the Emergency Department for the appearance of generalized urticaria and lips angioedema associated with vomit and shortening of breath normal vital signs by age. Thus, due to the significant reaction, intravenous corticosteroids and antihistamines were promptly administered, with a rapid improvement of symptoms. Since the systemic reaction, the tryptase dosage was performed with the identification of an elevation at the time of the arrival and a complete normalization after the twelfth hour from the beginning of the reaction. Figure 1 shows the kinetic of the tryptase over time. SARS-CoV2 swab was performed before hospitalization and a positive test was identified. To investigate the etiopathogenesis of reaction, the patient was submitted to the extensive clinical, laboratory, and instrumental investigations that revealed only a positive in vitro basophil activation test (BAT) as evidence of functional serum histamine-releasing autoantibodies that are directed against IgE or high-affinity IgE receptors. The viral infection did not need any medication, and the urticaria was resolute in a couple of days. Daily treatment with oral antihistamines was then prescribed, and no further urticarious episodes occurred. A negative SARS-CoV- 2 swab was detected within 12 days of beginning symptoms. Approximately 40% of patients with idiopathic chronic urticaria have circulating antibodies versus IgE epitopes or the IgE receptor, but as it occurs in many autoimmune conditions, the presence of autoantibodies does not necessarily result in a disease phenotype. It is demonstrated that infections can elicit an autoimmune condition, and as our report shows, SARS-CoV2 could explain the reaction observed in our patient. The autoimmune precondition could have been the primer of the systemic reaction, pre-activating the mastocyte degranulation, as the tryptase elevation demonstrated. On the other hand, the SARS-CoV2 virus reducing the ACE2 expression, due to virus endocytosis, could create an imbalance in the RAS system, increasing the bradykinin levels. Bystander activation of pre-activated mastocytes caused by an inflammatory environment could explain the systemic reaction described above.
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Background: Drug hypersensitivity reactions (DHRs) of the immediate type are diagnosed in approximately 1-2% per 100 thousand people. During the COVID-19 pandemic, the use of antibiotics increased, and cases of immediate reactions to these drugs became more frequent. However, due to the lack of medical centers which have the necessary conditions for carrying out provocation tests, the use of in vitro diagnostic methods for hypersensitivity reactions to antibiotics is becoming even more relevant during the pandemic. Flow CAST Basophil Activation Test (BAT) Flow Cytometry can be used for the in vitro detection of immediate type allergic reactions and hypersensitivities to suspected allergens in patients at risk for DHRs. The purpose is to study the possibility of diagnosing hypersensitivity reactions to antibiotics using BAT to antibiotics. Method(s): The Patient Questionnaire Card and the Patient Review Card were used to survey 32 (8.7%) individuals (f -56.3%, m -43.7%) who met the inclusion criteria (the presence of hypersensitivity reactions to beta-lactam antibiotics during the last 3 years). We used Flow CAST to identify the DHRs to beta-lactam antibiotics (Ceftriaxone (conc. 4 mg/ml);Cefuroxime (conc. 2.5 mg/ml);Amoxicillinum (conc. 2.5 mg/ml) from CAST Allergens for CASTFlow CAST) BUHLMANN LABORATORIES AG, Switzerland) in whole blood. Flow cytometric acquisition was performed on a flow cytometer BD FacsCalibur (USA), and 300 basophilic cells were analyzed. Result(s): The most common clinical manifestations included acute urticaria + angioedema (40.6%), generalized urticaria (28.1%), anaphylactic shock (21.9%), bronchospasm (9.4%). The percentage of patients diagnosed with an immediate reaction based on the time of its occurrence was 62.5%, whereas the percentage of patients diagnosed with an immediate reaction based on the clinical manifestations was 81.25%, which was confirmed by positive BAT results (p > 0.05). 68.75% of people with clinical manifestations of reactions to one antibiotic (ceftriaxone or amoxicillin) showed increased values on the BAT test to other beta antibiotics, which may indicate the presence of cross-reactivity between these groups of drugs. Conclusion(s): Diagnostics of immediate hypersensitivity reactions to antibiotics based on in vitro BAT is a highly accurate method. However, in cases of possible cross-reactivity between antibiotics and in cases of delayed reactions, in-depth studies are required.
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Background: Use of ultrasound contrast agent spread increasingly in worldwide. Although few side effects are published, number of increase anaphylactic reaction is reported. A recent cautionary remark was published about polyethylene glycol (PEG) as culprit for some ultrasound contrast agent hypersensitivity (Krantz et al. JACIP. Avril 2020). A 22 years-old woman was referred for a severe anaphylaxis after a second injection of Sulphur Hexafluoride (SonoVue, Bracco, Milan, Italy). The investigation was performed to explore hepatic multinods. She already had presented with uncomfortable feeling, generalized pruritus and nausea few minutes after the first injection of Sonovue, 10 months earlier. Three months before, she has recieved also a first injection of SPIKEVAX without any reaction. As Sonovue and SPIKEVAX contain PEG, we looked for a hypersensitivity to PEG and RNAm COVID-19 vaccine. Method(s): Skin tests and basophil activation test (BAT) with expression of CD63 were performed for SonoVue, PEG 3350 and 4000 and COMIRNATY. Result(s): Skin tests were negative for all products except the undiluted IDT to COMIRNATY. BAT to PEG and SonoVue were negative but positive to COMIRNATY. Despite a fractioned administration of COMIRNATY, the patient presented with an acute urticaria few minutes after the last injection Conclusion(s): The relationship between PEG, RNAm vaccine, and hypersensitivity to SonoVue is once again highlighted by this new report. (Soni et al. J Am Soc Echocardiogr, Oct 2021).
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Background: The newly developed mRNA-based COVID-19 vaccines can provoke anaphylaxis, possibly induced by polyethylene glycol (PEG) contained in the vaccine. The management of persons with a history of PEG allergy or with a suspected allergic reaction after the first dose remains to be defined. Methods: In this real-life study, we defined two cohorts of individuals: one pre-vaccination including 187 individuals with high-risk profiles for developing anaphylaxis and a second post-vaccination including 87 individuals with suspected allergic reactions after the COVID-19 mRNA vaccine. Upon negative skin test with an mRNA vaccine, a two-step (10-90%) vaccination protocol was performed. Positive skin tests were confirmed with the basophil activation test (BAT). Results: Among 604,267 doses of vaccine, 87 suspected allergic reactions (5 after the booster) were reported to our division for further investigations: 18/87 (21%) were consistent with anaphylaxis, 78/87 (90%) were female, and 47/87 (54%) received the BNT162b2 mRNA vaccine. Vaccine skin tests were negative in 96% and 76% of the pre- and post-vaccination cohorts, respectively. A two-step vaccination was tolerated in 232/236 (98%) of individuals with negative tests. Four individuals experienced isolated asthmatic reactions during the two-step challenge. Vaccine-positive skin tests were consistently confirmed by BAT; CD63 and CD203c expression was selectively inhibited with ibrutinib, suggesting an IgE-dependent mechanism. Conclusion: Sensitization to SARS-CoV-2 mRNA vaccines can be detected with intradermal testing. Significantly more individuals were sensitized to mRNA vaccines in the post-vaccination cohort. A two-step 10-90%-vaccination protocol can be safely administered upon negative skin testing.
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Novel messenger RNA (mRNA) vaccines have proven to be effective tools against coronavirus disease 2019, and they have changed the course of the pandemic. However, early reports of mRNA vaccine-induced anaphylaxis resulted in public alarm, contributing toward vaccine hesitancy. Although initial reports were concerning for an unusually high rate of anaphylaxis to the mRNA vaccines, the true incidence is likely comparable with other vaccines. These reactions occurred predominantly in young to middle-aged females, and many had a history of allergies. Although initially thought to be triggered by polyethylene glycol (PEG), lack of reproducibility of these reactions with subsequent dosing and absent PEG sensitization point away from an IgE-mediated PEG allergy in most. PEG skin testing has poor posttest probability and should be reserved for evaluating non-vaccine-related PEG allergy without influencing decisions for subsequent mRNA vaccination. Immunization stress-related response can closely mimic vaccine-induced anaphylaxis and warrants consideration as a potential etiology. Current evidence suggests that many individuals who developed anaphylaxis to the first dose of an mRNA vaccine can likely receive a subsequent dose after careful evaluation. The need to understand these reactions mechanistically remains critical because the mRNA platform is rapidly finding its way into other vaccinations and therapeutics.
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Introduction: Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 recognized on 31st December 2019 in Wuhan, China which was declared a worldwide pandemic by the World Health Organization on 11 March 2020. Haematological and inflammatory test results are found to be peculiar in COVID-19 patients. Aim(s): This study was conducted to add to the knowledge database of haematological values in Covid patients and to correlate with clinical findings wherever possible to carry out timely intervention. Method(s): This was a prospective cohort study conducted from July 2020 to December 2021 in a tertiary care centre at Pune in Western Maharashtra region. The study included 603 RTPCR Covid positive patients. The patients were grouped clinically according to the severity score based on the CT/chest x-ray and SpO2 findings and their blood samples were analyzed at the Central Clinical Laboratory of our hospital for complete haematological profile. Result(s): The haematological parameters were tabulated and statistically analyzed. The mean Hb, PCV, Eosinophil, Basophil, Lymphocyte and Monocyte counts were significantly low in severe category. The mean MCV, MCH, NLR, PLR, ESR and D-dimer was high in severe category. Leucocytosis and Neutrophilia were seen in severe category patients. The mean PT was prolonged in severe category patients. Overall, there were 15% deaths. Significantly, more deaths were found in severe category. Conclusion(s): Hematological and coagulation parameters are closely related to the covid-19 disease severity. Among various parameters, some like ESR, D-Dimer, NLR/PLR Ratio can be used as a reliable predictor of severity. Copyright © 2022 Authors. All rights reserved.
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Background: There have been scientific papers in the Indian setting that describe demographics, clinical characteristics, hospital course, morbidity, and death in patients with coronavirus disease 2019 (COVID-19);however, they are based on limited numbers of cases. The current study of patients with known outcomes enabled us to acquire a better understanding of the disease process and progression in COVID-19 individuals, as well as correlate the factors affecting the outcome. Method(s): This study was carried out at a COVID-19 tertiary care facility at Dr. D. Y.Patil Medical College, Hospital and Research Centre, Pune. The demographic and clinical information, laboratory parameters of admitted COVID19 patients were collected were subsequently analysed. Categorical variables were analysed using either the chi-square test or Fisher's exact test. The level of significance was set at p<0.05. Result(s): Out of 603, 515 (85.4%) patients were discharged while 88 (15.8%) patients were died. The mean age of dead COVID-19 patients was significantly higher as compared to discharged COVID-19 patients. Serum urea, Serum Creatinine, serum AST, Serum total bilirubin, Serum Conjugated Bilirubin, serum LDH, Serum CRP and Serum Ferritin, Hb, PCV, TLC, neutrophils, eosinophils, basophils, lymphocytes, monocytes, neutrophils to lymphocyte ratio, platelets to lymphocyte ratio, ESR and D-dimer were differ significantly between discharged and dead COVID-19 cases whereas the levels of Serum ALT, Serum ALP, Serum Unconjugated bilirubin, MCV,MCH platelet count, PT and aPTT were remained comparable between discharged and dead COVID-19 cases. Multivariate analysis showed that Serum urea, D-dimer, ESR, NLR, PLR neutrophil and TLC were the significant predictors of COVID-19 death in our study. Conclusion(s): This study revealed that in hospitalised COVID-19 patients, older age, male sex, hypertension, diabetes, serum LDH, and urea levels were strongly linked to an increased risk of mortality. To enhance patient care and results, healthcare professionals should identify these aspects at the time of diagnosis. Copyright © 2022 Authors. All rights reserved.
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Introduction: Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 recognized on 31st December 2019 in Wuhan, China which was declared a worldwide pandemic by the World Health Organization on 11 March 2020. Haematological and inflammatory test results are found to be peculiar in COVID-19 patients. Aim(s): This study was conducted to add to the knowledge database of haematological values in Covid patients and to correlate with clinical findings wherever possible to carry out timely intervention. Method(s): This was a prospective cohort study conducted from July 2020 to December 2021 in a tertiary care centre at Pune in Western Maharashtra region. The study included 603 RTPCR Covid positive patients. The patients were grouped clinically according to the severity score based on the CT/chest x-ray and SpO2 findings and their blood samples were analyzed at the Central Clinical Laboratory of our hospital for complete haematological profile. Result(s): The haematological parameters were tabulated and statistically analyzed. The mean Hb, PCV, Eosinophil, Basophil, Lymphocyte and Monocyte counts were significantly low in severe category. The mean MCV, MCH, NLR, PLR, ESR and D-dimer was high in severe category. Leucocytosis and Neutrophilia were seen in severe category patients. The mean PT was prolonged in severe category patients. Overall, there were 15% deaths. Significantly, more deaths were found in severe category. Conclusion(s): Hematological and coagulation parameters are closely related to the covid-19 disease severity. Among various parameters, some like ESR, D-Dimer, NLR/PLR Ratio can be used as a reliable predictor of severity. Copyright © 2022 Authors. All rights reserved.
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In confirmed positive patients, the purpose of this study is to assess the relationship between Coronavirus Disease 19 (COVID-19) and the primary complete blood count (CBC) parameters. In a retrospective cross-sectional study, 192 files of patients with a confirmed diagnosis of COVID-19 who were being treated at Govt medical College &Hospital Rajouri in India were randomly chosen as a study group for haematological parameters, and an additional 192 files of patients without a confirmed diagnosis of COVID-19 whose medical histories did not include any conditions that might have an impact on their haematological profile were chosen as a control group. The control group's gender, age, and nationality were matched to those of the study group. In contrast to COVID-19 negative patients, anaemia and thrombocytopenia weresignificantly more common in COVID-19 positive patients.However, the prevalence of leukopenia did not differ statistically between the two groups, but the positive individuals were 3.4 times more likely to be anaemic and around 5.3 times more likely to be thrombocytopenic. The median values for mean cell volume (MCV), total white blood cell (WBC) count, lymphocyte count, and basophil count between the two groups, however, did not indicate any statistically significant differences. Further research is advised to corroborate these findings because severe positive individuals may have highly developed anaemia and thrombocytopenia. Copyright © 2022 Ubiquity Press. All rights reserved.
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Allergic reactions to COVID-19 vaccine components are rare but should be considered. Polyethylene glycol (PEG) is responsible for anaphylaxis in mRNA vaccines. Skin tests have been used in the allergological work-up programs for COVID-19 vaccine evaluation. However, the reproducibility of the skin prick test is time-dependent and the reactivity declines over time. Therefore, we combined the administration of the skin tests with the basophil activation test (BAT) using PEG2000, PEG4000 and DMG-PEG2000, where the BAT was considered positive when the percentage of activated basophils was higher than 6%, 5% and 6.5%, for PEG 4000, PEG2000 and DMG-PEG2000, respectively. To this end, among the subjects that underwent allergy counseling at the Allergy Unit of our Institution during the 2020/2021 vaccination campaign, 13 patients had a suggested medical history of PEG/drug hypersensitivity and were enrolled together with 10 healthy donors. Among the enrolled patients 2 out of 13 tested patients were positive to the skin test. The BAT was negative in terms of the percentages of activated basophils in all analyzed samples, but the stimulation index (SI) was higher than 2.5 in 4 out of 13 patients. These data evidenced that, when the SI is higher than 2.5, even in the absence of positivity to BAT, the BAT to PEG may be a useful tool to be coupled to skin tests to evidence even low-grade reactions.
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Anaphylaxis , COVID-19 , Hypersensitivity , Humans , Basophil Degranulation Test , COVID-19 Vaccines , Reproducibility of Results , Basophils , Hypersensitivity/diagnosis , Skin Tests , Polyethylene Glycols/adverse effectsABSTRACT
Lipidic nanoparticles (LNP), particularly liposomes, have been proven to be a successful and versatile platform for intracellular drug delivery for decades. Whilst primarily developed for small molecule delivery, liposomes have recently undergone a renaissance due to their success in vaccination strategies, delivering nucleic acids, in the COVID-19 pandemic. As such, liposomes are increasingly being investigated for the delivery of nucleic acids, beyond mRNA, as non-viral gene delivery vectors. Although not generally considered toxic, liposomes are increasingly shown to not be immunologically inert, which may have advantages in vaccine applications but may limit their use in other conditions where immunological responses may lead to adverse events, particularly those associated with complement activation. We sought to assess a small panel of liposomes varying in a number of physico-chemical characteristics associated with complement activation and inflammatory responses, and examine how basophil-like cells may respond to them. Basophils, as well as other cell types, are involved in the anaphylactic responses to liposomes but are difficult to isolate in sufficient numbers to conduct large scale analysis. Here, we report the use of the human KU812 cell line as a surrogate for primary basophils. Multiple phenotypic markers of activation were assessed, as well as the release of histamine and inflammasome activity within the cells. We found that larger liposomes were more likely to result in KU812 activation, and that non-PEGylated liposomes were potent stimulators of inflammasome activity (four-fold greater IL-1ß secretion than untreated controls), and a lower ratio of cholesterol to lipid was also associated with greater IL-1ß secretion ([Cholesterol:DSPC ratio] 1:10; 0.35 pg/mL IL-1ß vs. 5:10; 0.1 pg/mL). Additionally, PEGylation appeared to be associated with direct KU812 activation. These results suggest possible mechanisms related to the consequences of complement activation that may be underpinned by basophilic cells, in addition to other immune cell types. Investigation of the mechanisms behind these responses, and their impact on use in vivo, are now warranted.
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Introduction: The COVID-19 pandemic has been raging across the globe since early January 2020. Various geographical regions have been passing multiple swells of upsurge of cases which aren't matched temporally as well as in severity. The diapason of the complaint ranges from asymptomatic to severe life-hanging complaint. Advanced age and the presence of comorbidities similar as cardiovascular complaint, diabetes mellitus, hypertension, chronic lung complaint, chronic kidney complaint, cancer, and obesity are among the major threat factors for severe disease. Aims and objectives: Significance of lab parameter among Corona Patients. Materials and methods: The covid- 19 opinion was verified by reverse transcription- polymerase chain reaction (RT- PCR) assay of nasopharyngeal swab sample. Hematology blood samples were used to analyze by flow cytometry. Biochemical samples were used to analyze by completely auto analyzer diagnostic outfit. Serology tests were carried out the styles based on indirect ELISA technique, immune plates are coated with a admixture of purified viral antigen and probe using the patient serum. Results: It is found that there is statistically significant (p-value<0.05) mean difference within the lab parameters (IL-6, LDH and Ferritin) in Covid patients using the Post Hoc Analysis. It is also found that there statistically significant (p-value<0.05) mean difference between RBC, Hb level, Hematocrit, MCV, MCH, MCHC, Platelet, RDW, PCT and NL ratio while Age, WBC, MPV, M(Monocyte), E(Eosinophil), B(Basophil), D-dimer and PDW were found to be statistically insignificant (p-value>0.05) with respect to gender. Discussion: CBC, D- dimer, IL-6, LDH and Ferritin were analysed and found associated with adverse outcomes. There is significant association of age, gender, comorbidity. Conclusion: High NLR at admission associated with a higher mortality. Laboratory features (e.g., IL-6, LDH, Ferritin D-dimer etc.) were associated with poor outcomes.
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Background: The COVID-19 vaccines from Moderna and Pfizer represent 62% and 37% of the doses administered in Switzerland, respectively. By 28 June 2022, 1,228 reports of urticaria were submitted to Swissmedic, mainly after the first booster ( = 3rd dose) after primary vaccination. Aims: To define the patient's characteristics, timing, and mechanisms driving the onset of chronic spontaneous urticaria (CSU) after mRNA vaccines. Methods: Based on a collaborative effort with local practitioners, we identified 88 patients suffering from CSU. An online survey was submitted for further characterization of CSU. Basophil activation tests (BAT) with the mRNA vaccines were performed in 27 patients. Results: Seventy-one patients (80%) completed the survey. 75% were women. The median age was 41 (IQR:35-48). In 92% of the cases, urticaria started after the 3rd dose. Median days between vaccination and onset of CSU were 10 (IQR: 8-12). In 93% of the cases, patients received the Moderna vaccine. At the time of the survey, CSU was active in 86% of the cases representing a median duration of 115 days (IQR: 101-140). Inductile urticaria was reported in 38 patients (54%), mainly as symptomatic dermographism. BAT were not interpretable in 26% (n = 7), yet in 50% (n = 10) of the cases, they were positive for the mRNA vaccines. Conclusion: CSU was mainly reported after the booster dose of Moderna in adults at their 40s. It was associated with a high rate of sensitization against mRNA vaccines. Urgent studies are needed to establish whether a definitive link exists between CSU and booster doses with mRNA vaccines.