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Rheumatology (United Kingdom) ; 62(Supplement 2):ii142, 2023.
Article in English | EMBASE | ID: covidwho-2321776


Background/Aims Haemophagocytic lymphiohistiocytosis (HLH) is a rare, underrecognised hyperinflammatory syndrome, characterised by immune dysregulation. Without treatment, the ensuing cytokine storm leads to high mortality. Secondary HLH (sHLH) is triggered by malignancy, infection, autoimmunity and medicines;treatment with immunosuppression is consensus- rather than evidence-based and extrapolated from primary HLH. Sheffield hosts a mature HLH multidisciplinary advisory group (MDAG). Here we evaluate the cause, treatment, requirement for critical care and mortality of people with HLH managed through the MDAG in a period including the coronavirus pandemic but prior to NHS England approval of anakinra (IL-1 antagonist) for HLH. Methods This retrospective evaluation (approved locally STH 10850) identified patients from MDAG records 1st October 2016 to 30th September 2021. Data from electronic/paper records was analysed using Microsoft Excel. Results HLH triggers were infection (viral 34%, bacterial 10%), haematological (35%), rheumatological (13%) and other (8%). Rheumatological causes were Still's disease (n=5);antiphospholipid syndrome (n=2);JO1 dermatomyositis (n=1);SLE (n=1);and rheumatoid arthritis (n=1). Other causes included unknown (n=3);combined systemic JIA and sickle cell crisis (n=1);medication (alemtuzumab) (n=1);and primary HLH (n=1). Overall mortality was 53% and highest in HLH with a haematological malignancy trigger (82%) Prior to the COVID19 pandemic (pre-March 2020), the commonest trigger of HLH was haematological malignancy (47%);after March 2020, the commonest trigger was infection (64%);COVID-19 explained 42% of cases. Mortality fell from 72% to 31%. Conclusion In this real-world series of people with HLH, mortality and critical care requirement was high. HLH triggers reflect published evidence as does poor prognosis in haematological malignancy-associated HLH. No-HLH associated with non-haematological malignancy was identified;we may need to improve MDAG reach into oncology. Seeming reduction in mortality following the COVID-19 pandemic may reflect increased recognition of COVID-19 induced hyperinflammation along with locallyagreed access to anakinra for COVID-19-induced HLH. The increase in infection related HLH cases since March 2020 is explained largely by COVID-19 cases. This has led to a relative reduction in cases related to haematological malignancy. HLH requires multidisciplinary management and better research to improve treatment. (Table Presented).

International Journal of Infectious Diseases ; 130(Supplement 2):S116, 2023.
Article in English | EMBASE | ID: covidwho-2326325


Intro: Patients receiving B-cell depleting or inhibiting therapies (BCDT), such as anti-CD20 monoclonal antibodies (CD20-MAB), are at risk for severe COVID-19. BCDT decreases production of neutralizing antibodies, causing delayed viral clearance and prolonged viral shedding. Passive antibody therapy (PAT), including COVID-19 convalescent plasma (CCP) and monoclonal antibodies (MAB), is hypothesized to be an effective Findings: * At the time of treatment, all patients (19/19) receiving CCP were hospitalized compared with10/53 patients treated with MAB. 2/10(20%) hospitalized patients treated with MAB died, compared with 3/19(15%) treated with CCP. **5/43 patients treated outpatient with MAB were hospitalized for COVID following CCP/MAB treatment with no COVID related deaths. Conclusion(s): Our data suggest that patients with COVID-19 who received BCDT within the last year may have improved outcomes after treatment with MAB or CCP. Elderly patients with >3 comorbidities and underlying hematological malignancy who contracted COVID-19 within 30 days of last BCDT had increased morbidity and mortality. To improve clinical outcomes, passive antibody therapy should be administered prior to the development of severe disease requiring hospitalization. Further prospective studies and comparisons to COVID-19 patients that did not receive MAB or CCP are needed to help confirm this association.Copyright © 2023

European Journal of Molecular and Clinical Medicine ; 7(8):5653-5659, 2020.
Article in English | EMBASE | ID: covidwho-2325266


Background: coronaviral pandemic (COVID-19) induced by severe acute coronaviral syndrome 2 has imminent consequences for COVID-19 patients. To determine the effect of this pandemic on oncological treatment, Netherlands cancer patients performed a national study . Method(s): From 11 April 2020 to 11 Jan 2021, the oncological care perspective was discussed by an online study. The survey included 20 questions on four topics: patient characteristics, hospital engagement, COVID-19 and COVID-19 problems. Result(s): A total of 2418 (64.53%) patients were female and the remainder (57.5%) were <50 years of age. The most prevalent cancer diagnosis were haematological malignancies (26.1%), breast cancer (22.8%) and other cancers (19.2%). Depending on their illness environment, 34.7% of patients had incurable conditions while 21.6% and 31.8% had curable or healed diseases. The (expected) result of their illness was 'unknown' for 11.9% of patients. According to outpatient environment, 1691 (45.1%) patients have been oncologically examined and have taken follow-up, contrasted with 529 (14.1%) and 1527 (40.8%) patients presently or pending for therapy. Conclusion(s): This is the first research exploring cancer patients' experiences after the COVID-19 pandemic in Iraq. The research indicates the major effect of COVID-19 on oncological treatment, showing the need for psycho-oncological assistance during this pandemic.Copyright © 2020 Ubiquity Press. All rights reserved.

Pediatric Hematology Oncology Journal ; 7(4):109-110, 2022.
Article in English | Scopus | ID: covidwho-2320587
Pediatric Hematology Oncology Journal ; 7(2):61-63, 2022.
Article in English | Scopus | ID: covidwho-2320583
Current Fungal Infection Reports ; 2023.
Article in English | EMBASE | ID: covidwho-2316360
Medical Journal of Malaysia Conference: 15th National Conference for Clinical Research, NCCR ; 77(Supplement 5), 2022.
Article in English | EMBASE | ID: covidwho-2312548
BioPharm International ; 36(3):14-15, 2023.
Article in English | EMBASE | ID: covidwho-2304106
Enfermedades Infecciosas y Microbiologia Clinica ; 41(3):176-180, 2023.
Article in English, Spanish | EMBASE | ID: covidwho-2302675
Annals of Blood ; 8 (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-2297760
Cochrane Database of Systematic Reviews ; 2023(2) (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-2296485
China Oncology ; 32(6):499-511, 2022.
Article in Chinese | EMBASE | ID: covidwho-2263392
Jurnal Infektologii ; 14(4):26-37, 2022.
Article in Russian | EMBASE | ID: covidwho-2260763
Tumor Diagnostik und Therapie ; 44(2):98, 2023.
Article in German | EMBASE | ID: covidwho-2249871