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1.
Diagn Microbiol Infect Dis ; 104(4):115789, 2022.
Article in English | PubMed | ID: covidwho-2035944

ABSTRACT

We evaluated the performance of SARS-CoV-2 TaqMan real-time reverse-transcription PCR (RT-qPCR) assays (ThermoFisher) for detecting 2 nonsynonymous spike protein mutations, E484K and N501Y. Assay accuracy was evaluated by whole genome sequencing (WGS). Residual nasopharyngeal SARS-CoV-2 positive samples (N = 510) from a diverse patient population in New York City submitted for routine SARS-CoV-2 testing during January-April 2020 were used. We detected 91 (18%) N501Y and 101 (20%) E484K variants. Four samples (0.8%) were positive for both variants. The assay had nearly perfect concordance with WGS in the validation subset, detecting B.1.1.7 and B.1.526 variants among others. Sensitivity and specificity ranged from 0.95 to 1.00. Positive and negative predictive values were 0.98-1.00. TaqMan genotyping successfully predicted the presence of B.1.1.7, but had significantly lower sensitivity, 62% (95% CI, 0.53, 0.71), for predicting B.1.526 sub-lineages lacking E484K. This approach is rapid and accurate for detecting SARS-CoV-2 variants and can be rapidly implemented in routine clinical setting.

2.
Nanotechnological Applications in Virology ; : 329-345, 2022.
Article in English | Scopus | ID: covidwho-2035631

ABSTRACT

The COVID-19 pandemic has severely impacted human lives. This massive disruptive outbreak of the SARS-Cov-2 virus rapidly became the cause of universal fatality on a large scale. History demonstrates that vaccination is the most effective approach to prevent or sustainably control diverse infectious diseases. This scenario demanded the global urgency to develop a successful vaccine to set human lives’ normalcy back. The global health-care community established a new paradigm of rapid vaccine development at unprecedented speed. In this regard, nanomaterials played a remarkable role in designing innovative vaccine platforms. In this chapter, we discuss promises and challenges associated with the deployment of nanomaterials for successful execution of vaccination programs that mainly comprise vaccine design, precise delivery, and administration. Vaccine efficacy largely depends on the strength of the defensive response generated by immune cells. Nanostructure materials favor vaccine customization by convenient tailoring to mimic natural targets of the host immune system. © 2022 Elsevier Inc. All rights reserved.

3.
Mayo Clin Proc Innov Qual Outcomes ; 2022 Aug 08.
Article in English | MEDLINE | ID: covidwho-2031554

ABSTRACT

Background: Cardiovascular disease (CVD) patients with COVID-19 are at higher risk of morbidity and mortality. This study describes the risks and outcome of CVD patients with COVID-19 attending primary health care corporation (PHCC) settings in Qatar. Aim/Objectives: To report whether CVD increase the risk for hospitalization and further complications in COVID-19 patients. Methods: Retrospective cohort study. Results: A total of 10,178 CVD patients' data who tested COVID-19 positive were extracted from electronic medical records based on the inclusion criteria and analysed during the period of February-December 2020 (11 months). Among these 64% (n=6527) were men and 36%(n=3651) were women, 23% (n=2299) were Qatari and 77%(n=7879) were non-Qatari. Among the selected age group of > 25 years and < 75 years, the median age was 50.83. More than half of the patients had diabetes (69.62%; n=7086) followed by hypertension (68.43%; n=6965) and dyslipidemia (45.1%; n= 4590). Other comorbidities are obesity (18.29%; n=1862) and kidney disease (6.5%; n=659), hematological problems (4.18%; n=425), liver disorders (1.4; n=142), rhematic heart disease (1.3%; n=131) and neurological complaints (1.26%; n=128). Multivariate analysis for factor associated with in patient admission in last 28 days for Cardiovascular patients shows that patients with age >70 years are 2.79 (1.86-4.18) times more likely to have the risk of hospital admission compared with the age 25-30 years. Conclusion: The pre-existing CVD with age and other comorbidities predict risk for hospitalization and further complications in COVID 19 patients. Further studies are needed to investigate the data from primary and secondary care about the long-term cardiovascular outcomes of patients who have survived COVID-19.

4.
J Theor Biol ; 554:111278, 2022.
Article in English | ScienceDirect | ID: covidwho-2031496

ABSTRACT

The concept of doubling time has been increasingly used since the onset of the coronavirus disease 2019 (COVID-19) pandemic, but its characteristics are not well understood, especially as applied to infectious disease epidemiology. The present study aims to be a practical guide to monitoring the doubling time of infectious diseases. Via simulation exercise, we clarify the epidemiological characteristics of doubling time, allowing possible interpretations. We show that the commonly believed relationship between the doubling time and intrinsic growth rate in population ecology does not strictly apply to infectious diseases, and derive the correct relationship between the two. We examined the impact of varying (i) the growth rate, (ii) the starting point of counting cumulative number of cases, and (iii) the length of observation on statistical estimation of doubling time. It was difficult to recover values of growth rate from doubling time, especially when the growth rate was small. Starting time period is critical when the statistical estimation of doubling time occurs during the course of an epidemic. The length of observation was critical in determining the overall magnitude of doubling time, and when only the latest 1-2 weeks' data were used, the resulting doubling time was very short, regardless of the intrinsic growth rate r. We suggest that doubling time estimates of infectious disease epidemics should at a minimum be accompanied by descriptions of (i) the starting time at which the cumulative count is initiated and (ii) the length of observation.

5.
Endoscopic Surgery ; 28(4):5-11, 2022.
Article in Russian | Scopus | ID: covidwho-2025839

ABSTRACT

Objective. The aim of the work was to analyze the results and treatment of acute appendicitis (AA) in patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19. Material and methods. From March 16, 2020 to October 31, 2021, 139 patients with suspected AA were tread. In 104 patients (62 men and 42 women) the diagnosis of AA was confirmed. Inclusion criteria were: AA, a positive PCR (polymerase chain re-action) result for COVID-19, or a characteristic picture of viral pneumonia for COVID-19 based on computed tomography (CT). To clarify the diagnosis of acute appendicitis, all patients underwent CT scan of the abdominal organs. Results. When evaluating the symptoms of AA in patients with COVID-19, no specific signs were identified. The systematic inflammatory response could be due to both surgical disease and viral infection, making it difficult to interpret the chang-es. But, in 88 patients (84.61%) in the blood test was leukocytosis from 11.81 to 34.83·109/l, which is uncommon for patients with COVID-19 at the onset of the disease. The average time from the onset of clinical manifestations of AA to the operation was 57±14 hours. 139 diagnostic laparoscopies were performed. The diagnosis of AA was confirmed in 104 patients. 102 patients underwent laparoscopic appendectomy with pelvic drainage. One patient had laparotomy, appendectomy, intestinal intubation. One patient had laparoscopic resection of Meckel’s diverticulum plus appendectomy. A positive PCR result for SARS-CoV-2 effu-sion from the abdominal cavity was confirmed in 45 out of 75 patients (60%). According to the results of a pathomorphological study, 89 (85.58%) patients had phlegmonous appendicitis, 8 (7.69%) had gangrenous appendicitis, and 7 (6.73%) had gangre-nous-perforated appendicitis. Mortality was 0.96% (1 patient). Conclusion. Diagnostic problems of AA in patients with COVID-19 are associated with difficulties in interpreting local symptoms and systemic inflammatory response. Laparoscopy is the leading diagnostic method for suspected AA, including patients with COVID-19. In the absence of severe pneumonia, laparoscopic appendectomy is possible in most patients. All operations should be carried out in accordance with anti-epidemic measures. The clinical significance of detecting SARS-CoV-2 in the abdominal cavity needs further evaluation. The prognosis for patients is determined to a greater extent by the course of COVID-19. The tactics of treatment of patients with COVID-19, for whom surgical intervention is associated with an extremely high risk, needs to be clarified. © 2022, Media Sphera Publishing Group. All rights reserved.

6.
Journal of Clinical Biochemistry and Nutrition ; 71(2):129-135, 2022.
Article in English | ProQuest Central | ID: covidwho-2022551

ABSTRACT

COVID-19 is pandemic since 2020 and further information is necessary on the risk factors associated with the infection of SARS-CoV-2. As an entry mechanism, SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) as receptor and transmembrane serine protease 2 (TMPRSS2) to activate fusion with host plasma membrane. Because dysgeusia is an early symptom of COVID-19, we here studied the expression of ACE2 and TMPRSS2 in the tongue and the associated tissues of mice and humans with immunohistochemistry and immunoblot analysis. ACE2 expression was low in the human tongue but was observed in the squamous epithelium, perineurium, arterial wall, salivary glands as well as taste buds. In contrast, mice showed high expression. In sharp contrast, TMPRSS2 expression was high in all the cells mentioned above in humans but relatively low in mice except for salivary glands. We then performed semi-quantitation of immunohistochemistry data of human ACE2 and TMPRSS2 and analyzed for age, sex, alcohol intake, and smoking habit with logistic regression analysis. We found that alcohol intake and female gender were the significant risk factors for increasing TMPRSS2 expression. In conclusion, TMPRSS2 is an important factor to be considered regarding SARS-CoV-2 entry and amplification in the oral cavity, which is promoted through drinking habit.

8.
25th International Conference on Miniaturized Systems for Chemistry and Life Sciences, MicroTAS 2021 ; : 935-936, 2021.
Article in English | Scopus | ID: covidwho-2012751

ABSTRACT

The requirement for diversification of methods for sample preparation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is increasingly important to circumvent analysis bottlenecks and continue widespread surveillance testing. We report a centrifugally-driven microfluidic platform for automated affinity nanoparticle enrichment and enzymatic RNA extraction of SARS-CoV-2. The microfluidic disc (μCD) and accompanying mechatronic system(s) are capable of sample preparation from up to six patient samples simultaneously and under 20 minutes. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

10.
AIDS Behav ; : 1-9, 2022.
Article in English | PMC | ID: covidwho-2007175

ABSTRACT

Gay, bisexual, and other men who have sex with men (GBM) have developed community norms for regular HIV/STI testing. We investigated factors associated with self-reported COVID-19 testing in response to reported COVID-19 cases and public health restrictions. Participants responded to weekly cohort surveys between 10th May 2021 and 27th September 2021. We used the Andersen-Gill extensions to the Cox proportional hazards model for multivariable survival data to predict factors influencing COVID-19 testing. Mean age of the 942 study participants was 45.6 years (SD: 13.9). In multivariable analysis, GBM were more likely to report testing during periods of high COVID-19 caseload in their state of residence;if they were younger;university educated;close contact of someone with COVID-19;or reported coping with COVID-19 poorly. COVID-19 testing was higher among men who: were more socially engaged with other GBM;had a higher proportion of friends willing to vaccinate against COVID-19;and were willing to contact sexual partners for contact tracing. Social connection with other gay men was associated with COVID-19 testing, similar to what has been observed throughout the HIV epidemic, making community networks a potential focus for the promotion of COVID-19 safe practices.

11.
Clinical Immunology ; : 109106, 2022.
Article in English | ScienceDirect | ID: covidwho-2003938

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infections that occurs in the pediatric population. We sought to characterize T cell responses in MIS-C compared to COVID-19 and pediatric hyperinflammatory syndromes. MIS-C was distinct from COVID-19 and hyperinflammatory syndromes due to an expansion of T cells expressing TRBV11–2 that was not associated with HLA genotype. Children diagnosed with MIS-C, but who were negative for SARS-CoV-2 by PCR and serology, did not display Vβ skewing. There was no difference in the proportion of T cells that became activated after stimulation with SARS-CoV-2 peptides in children with MIS-C compared to convalescent COVID-19. The frequency of SARS-CoV-2-specific TCRs and the antigens recognized by these TCRs were comparable in MIS-C and COVID-19. Expansion of Vβ11–2+ T cells was a specific biomarker of MIS-C patients with laboratory confirmed SARS-CoV-2 infections. Children with MIS-C had robust antigen-specific T cell responses to SARS-CoV-2.

12.
Biologicals ; 2022.
Article in English | ScienceDirect | ID: covidwho-2003881

ABSTRACT

The conventional PCR remains a valuable method to detect the newly emergent coronavirus rapidly and accurately. Our investigation aimed to establish the standard materials of SARS-CoV-2 for NAAT detection. We provided formalin-inactivated SARS-CoV-2 and confirmed RNA copy numbers. In addition, the virus genome was confirmed with whole-genome sequencing and identified as Wuhan/WI04/2019. Seven laboratories were invited for this collaborative study, according to the reporting data, we determined the SARS-CoV-2 with the unit of 6.35 Log10 copies/mL as the national standard. The availability of the national standard (NS) of SARS-CoV-2 will facilitate the standardization and harmonization of SARS-CoV-2 NAAT assays.

13.
Virus Evolution ; 8(2), 2022.
Article in English | Web of Science | ID: covidwho-1997081

ABSTRACT

Retrospective evaluation of past waves of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic is key for designing optimal interventions against future waves and novel pandemics. Here, we report on analysing genome sequences of SARS-CoV-2 from the first two waves of the epidemic in 2020 in Hungary, mirroring a suppression and a mitigation strategy, respectively. Our analysis reveals that the two waves markedly differed in viral diversity and transmission patterns. Specifically, unlike in several European areas or in the USA, we have found no evidence for early introduction and cryptic transmission of the virus in the first wave of the pandemic in Hungary. Despite the introduction of multiple viral lineages, extensive community spread was prevented by a timely national lockdown in March 2020. In sharp contrast, the majority of the cases in the much larger second wave can be linked to a single transmission lineage of the pan-European B.1.160 variant. This lineage was introduced unexpectedly early, followed by a 2-month-long cryptic transmission before a soar of detected cases in September 2020. Epidemic analysis has revealed that the dominance of this lineage in the second wave was not associated with an intrinsic transmission advantage. This finding is further supported by the rapid replacement of B.1.160 by the alpha variant (B.1.1.7) that launched the third wave of the epidemic in February 2021. Overall, these results illustrate how the founder effect in combination with the cryptic transmission, instead of repeated international introductions or higher transmissibility, can govern viral diversity.

14.
Journal of Clinical Virology ; 155:105269, 2022.
Article in English | ScienceDirect | ID: covidwho-1996328

ABSTRACT

Background The concentration of antibodies against the SARS-CoV-2 spike protein is frequently being measured for clinical and epidemiological purposes. The aim of this study was to examine whether the results of different quantitative SARS-CoV-2 spike antibody assays are comparable. Material and methods The Siemens SARS-CoV-2 IgG, Abbott SARS-CoV-2 IgG II Quant, Roche ElecsysT Anti-SARS-CoV-2 S, and Euroimmun Anti-SARS-CoV-2-QuantiVac assay were compared with 110 sera from patients 6-9 months after SARS-CoV-2 infection and the WHO First International SARS-CoV-2 antibody standard 20/136. The antibody values were converted into WHO binding antibody units (BAU)/ml. The diagnostic sensitivity of the assays was determined and the antibody values were compared. Results The diagnostic sensitivity ranged from 57.3% (Euroimmun) to 100% (Roche). The antibody concentration values of different assays correlated with Pearson coefficients of correlation between 0.729 and 0.953. The geometric mean antibody values of the Abbott, Siemens and Euroimmun assay varied by a factor of 1.1-1.2. The geometric mean antibody values of the Roche assay were 2.4-2.8 times higher than those from the other assays. The assays yielded varying results with the WHO International antibody standard. Conclusions The quantitative SARS-CoV-2 antibody assays from Abbott, Siemens, Roche and Euroimmun correlate strongly but differ in the antibody concentrations. Therefore, the same assay should be used when testing patients repeatedly. In addition, the name of the assay used and the manufacturer should be indicated along with the test results.

15.
Diagnostic Microbiology and Infectious Disease ; : 115789, 2022.
Article in English | ScienceDirect | ID: covidwho-1996107

ABSTRACT

We evaluated the performance of SARS-CoV-2 TaqMan real-time reverse-transcription PCR (RT-qPCR) assays (ThermoFisher) for detecting two nonsynonymous spike protein mutations, E484K and N501Y. Assay accuracy was evaluated by whole genome sequencing (WGS). Residual nasopharyngeal SARS-CoV-2 positive samples (N=510) from a diverse patient population in New York City submitted for routine SARS-CoV-2 testing during January-April 2020 were used. We detected 91 (18%) N501Y and 101 (20%) E484K variants. Four samples (0.8%) were positive for both variants. The assay had nearly perfect concordance with WGS in the validation subset, detecting B.1.1.7 and B.1.526 variants among others. Sensitivity and specificity ranged from 0.95-1.00. Positive and negative predictive values were 0.98-1.00. TaqMan genotyping successfully predicted the presence of B.1.1.7, but had significantly lower sensitivity, 62% (95% CI, 0.53, 0.71), for predicting B.1.526 sub-lineages lacking E484K. This approach is rapid and accurate for detecting SARS-CoV-2 variants and can be rapidly implemented in routine clinical setting.

16.
Kexue Tongbao/Chinese Science Bulletin ; 67(21):2509-2521, 2022.
Article in Chinese | Scopus | ID: covidwho-1993426

ABSTRACT

The novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a public health emergency of international concern. Exposure to droplets produced in the coughs and sneezes of infected individuals has been perceived as the dominant transmission mode for COVID-19. However, increasingly more evidence supports claims of COVID-19 having airborne transmission. An in-depth understanding of the transmission pathways and influencing factors of SARS-CoV-2 is of great significance for formulating more effective intervention strategies. A large number of epidemiological investigations into the influence of atmospheric environmental conditions on virus transmission have been conducted. In this paper, we review current understandings of the association between COVID-19 and atmospheric environmental conditions. We first summarize the epidemiological investigations on the impact of atmospheric environmental factors (including solar radiation, temperature and humidity, wind speed, particulate matters, and gaseous pollutants) on the spread of COVID-19, and 164 epidemiological investigations are included, in which air temperature and relative humidity received the greatest attention. However, the impact of these factors on the prevalence of COVID-19 remains largely uncertain. 56% and 41% of investigations of temperature and humidity, respectively, show that cold and dry weather promotes COVID-19 transmission, while some studies come to the opposite conclusion, and still others do not show a significant relationship between them. Investigations of solar radiation are limited, but have come to the consistent conclusion that weak solar radiation is linked to increased severity of COVID-19 infection. Investigation of the impact of air pollution mainly focuses on particulate matters, and more than 70% of investigations indicate that PM2.5 likely contributes to the spread of COVID-19. Similarly, 62%, 51%, and 31% of investigations of NOx, O3, and SO2, respectively, indicate that the exposure to severe pollution can aggravate COVID-19 transmission. Therefore, the available findings reveal the complexity of the impact of atmospheric environmental conditions on the spread of COVID-19. We further discuss their mechanisms from three perspectives: (1) Atmospheric environmental conditions influence the generation of virus-laden aerosols and the occurrence of SARS-CoV-2 in the atmosphere. Relative humidity can affect the evaporation process of water on virus-laden aerosol, and thus affect its atmospheric life and probability of being inhaled by human body. (2) Atmospheric environmental conditions directly affect the stability of infection activity of SARS-CoV-2. Generally, high temperature, medium relative humidity, and intense solar radiation promote the inactivation of SARS-CoV-2. (3) Atmospheric environmental conditions indirectly affect the infection ability of SARS-CoV-2 by changing the defense ability of host cells. Air pollutants, especially PM2.5, can affect human susceptibility to the virus by increasing the expression of the SARS-CoV-2 receptor (angiotensin converting enzyme 2) in host cells. Meanwhile, meteorological conditions and air pollution can lead to respiratory system and other diseases in the human body, thus reducing human immunity and increasing the risk of virus infection, as well as the numbers of severely infected and fatal cases. All three mechanisms may contribute to the prevalence of COVID-19, but the dominant mechanism remains unclear. Finally, future directions of in-depth studies regarding the association between the epidemic and atmospheric conditions are proposed. © 2022 Chinese Academy of Sciences. All rights reserved.

17.
Trop Med Health ; 50(1):55, 2022.
Article in English | PubMed | ID: covidwho-1993399

ABSTRACT

BACKGROUND: COVID-19 has spread rapidly across the world, producing significant morbidity and mortality. We investigated the cardiovascular complications and association of laboratory parameters with severity and mortality predictors in COVID-19 hospitalized patients. METHODS: Between May 2020 and June 2021, 730 COVID-19 patients were included in this retrospective observational study in the Coastal Karnataka region of South India. Acute coronary syndrome (ACS), myocarditis, arrhythmias, and all-cause mortality were reported as cardiovascular consequences. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), serum creatinine, D-dimer, troponin T, N-terminal pro-brain natriuretic peptide (NT-ProBNP), serum ferritin, and serum lactate dehydrogenase (LDH) were among the laboratory parameters measured. RESULTS: Most common electrocardiogram (ECG) changes were prolonged QTc interval (45.6%) followed by ST-T changes (40.7%) and sinus tachycardia (24.2%). 9.2% patients presented with ACS, with 38.8% having ST-elevation myocardial infarction (STEMI) and 61.2% having non-ST elevation myocardial infarction (NSTEMI). In non-survivors, NLR (p < 0.001) and PLR (p = 0.001) were significantly higher. Multivariable regression analysis showed that age (OR:1.019, 95% CI 1.003-1.034;p = 0.017), acute kidney injury (OR:3.562, 95% CI 1.737-7.301;p = 0.001), white blood cell count (WBC) (OR = 1.100, 95% CI 1.035-1.169;p = 0.002), platelet count (OR = 0.994, 95% CI 0.990-0.997;p = 0.001), PLR (OR = 1.002, 95% CI 1.000-1.004;p = 0.023) and severe COVID-19 (OR = 9.012, 95% CI 3.844-21.129;p = 0.001) were independent predictors of mortality in COVID-19 patients. CONCLUSIONS: Age, WBC count, neutrophil%, NLR, PLR, creatinine, D-dimer, ferritin, LDH, tachycardia, and lymphocytes% strongly correlated with the severity of the disease. Age, acute kidney injury, elevated WBC count, a greater PLR, low platelet count, and COVID-19 severity were independent predictors of mortality.

18.
J Zhejiang Univ Sci B ; 23(8): 655-665, 2022 Aug 15.
Article in English | MEDLINE | ID: covidwho-1993603

ABSTRACT

The global outbreak of the coronavirus disease 2019 (COVID-19) led to the suspension of most treatments with assisted reproductive technique (ART). However, with the recent successful control of the pandemic in China, there is an urgent public need to resume full reproductive care. To determine whether the COVID-19 pandemic had any adverse effects on female fertility and the pregnancy outcomes of women undergoing ART, a systematic review and meta-analysis was conducted using the electronic Chinese and English databases. Dichotomous outcomes were summarized as prevalence, and odds ratios (ORs) and continuous outcomes as standardized mean difference (SMD) with 95% confidence interval (CI). The risk of bias and subgroup analyses were assessed using Stata/SE 15.1 and R 4.1.2. The results showed that compared with women treated by ART in the pre-COVID-19 time frame, women undergoing ART after the COVID-19 pandemic exhibited no significant difference in the clinical pregnancy rate (OR 1.07, 95% CI 0.97 to 1.19; I2=0.0%), miscarriage rate (OR 0.95, 95% CI 0.79 to 1.14; I2=38.4%), embryo cryopreservation rate (OR 2.90, 95% CI 0.17 to 48.13; I2=85.4%), and oocyte cryopreservation rate (OR 0.30, 95% CI 0.03 to 3.65; I2=81.6%). This review provided additional evidence for gynecologists to guide the management of women undergoing ART treatment during the COVID-19 pandemic timeframe.


Subject(s)
COVID-19 , Pregnancy Outcome , Female , Humans , Pandemics , Pregnancy , Pregnancy Outcome/epidemiology , Pregnancy Rate , Reproductive Techniques, Assisted
19.
Expert Rev Respir Med ; 2022.
Article in English | PubMed | ID: covidwho-1991954

ABSTRACT

BACKGROUND: Due to the high incidence and mortality of the worldwide COVID-19 pandemic, beneficial effects of effective antiviral and anti-inflammatory drugs used in other diseases, especially rheumatic diseases, were observed in the treatment of COVID-19. METHODS: Clinical and laboratory parameters of eight included cohort studies and five Randomized Control Trials between the baricitinib group and the control group were analyzed on the first day of admission and days 7, 14, and 28 during hospitalization. RESULTS: According to the meta-analysis result of eight included cohort studies with 2088 patients, the Pooled Risk Ratios were 0.46 (P<0.001) for mortality, 6.14 (P< 0.001) for hospital discharge, and the mean differences of 76.78 (P< 0.001) for PaO(2)/FiO(2) ratio was -47.32 (P= 0.02) for CRP, in the baricitinib group vs. control group on the seventh or fourteenth day of the treatment compared to the first day. Based on the meta-analysis of five RCT studies with 11825 patients, the pooled RR was 0.84 (P= 0.001) for mortality and 1.07 (P= 0.014) for patients' recovery. The mean differences were -0.80 (P<0.001) for hospitalization days, -0.51(P= 0.33) for time to recovery in the baricitinib group vs. control group. CONCLUSIONS: Baricitinib prescription is strongly recommended in moderate to severe COVID-19. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42021254541.

20.
Front Immunol ; 13: 897748, 2022.
Article in English | MEDLINE | ID: covidwho-1987493

ABSTRACT

Sphingosine-1-phosphate receptor modulators and anti-CD20 treatment are widely used disease-modifying treatments for multiple sclerosis. Unfortunately, they may impair the patient's ability to mount sufficient humoral and T-cellular responses to vaccination, which is of special relevance in the context of the SARS-CoV-2 pandemic. We present here a case series of six multiple sclerosis patients on treatment with sphingosine-1-phosphate receptor modulators who failed to develop SARS-CoV-2-specific antibodies and T-cells after three doses of vaccination. Due to their ongoing immunotherapy, lacking vaccination response, and additional risk factors, we offered them pre-exposure prophylactic treatment with monoclonal SARS-CoV-2-neutralizing antibodies. Initially, treatment was conducted with the antibody cocktail casirivimab/imdevimab. When the SARS-CoV-2 Omicron variant became predominant, we switched treatment to monoclonal antibody sotrovimab due to its sustained neutralizing ability also against the Omicron strain. Since sotrovimab was approved only for the treatment of COVID-19 infection and not for pre-exposure prophylaxis, we switched treatment to tixagevimab/cilgavimab as soon as it was granted marketing authorization in the European Union. This antibody cocktail has retained, albeit reduced, neutralizing activity against the Omicron variant and is approved for pre-exposure prophylaxis. No severe adverse events were recorded for our patients. One patient had a positive RT-PCR for SARS-CoV-2 under treatment with sotrovimab, but was asymptomatic. The other five patients did not develop symptoms of an upper respiratory tract infection or evidence of a SARS-CoV-2 infection during the time of treatment up until the finalization of this report. SARS-CoV-2-neutralizing antibody treatment should be considered individually for multiple sclerosis patients lacking adequate vaccination responses on account of their immunomodulatory treatment, especially in times of high incidences of SARS-CoV-2 infection.


Subject(s)
COVID-19 , Multiple Sclerosis , Pre-Exposure Prophylaxis , Antibodies, Monoclonal , Antibodies, Monoclonal, Humanized , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , Humans , Multiple Sclerosis/drug therapy , SARS-CoV-2 , Sphingosine-1-Phosphate Receptors , Vaccination
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