ABSTRACT
To better understand COVID-19 infection in patients receiving biologic and immunomodulatory therapies, we evaluated prevalence and outcomes for symptomatic cases of COVID-19 at a large therapeutic infusion center in New York City during the height of the pandemic. 2074 patients received treatment with biologic infusions at our center between March and May 2020, and 34 patients developed symptomatic COVID-19 infection, for an overall low rate of 1.64%. The majority of infections and deaths were in a small subset of patients with a primary immunodeficiency. Patients with inflammatory or autoimmune conditions requiring biologic therapies tended to have mild cases. Higher inflammatory responses were observed in patients who died.
Subject(s)
Ambulatory Care Facilities , Autoimmune Diseases/therapy , Biological Factors/administration & dosage , COVID-19/epidemiology , SARS-CoV-2 , Biomarkers , COVID-19/complications , COVID-19/mortality , Comorbidity , Female , Humans , Incidence , Inflammation/metabolism , Male , Middle Aged , New York City/epidemiology , PrevalenceABSTRACT
BACKGROUND AND AIM: Since the outbreak of COVID-19, concerns have been raised as to whether inflammatory bowel disease (IBD) patients under biologic therapy may be more susceptible to the disease. This study aimed to determine the incidence and outcomes of COVID-19 in a large cohort of IBD patients on biologic therapy. METHODS: This observational retrospective multicenter study collected data about COVID-19 in IBD patients on biologic therapy in Italy, between February and May 2020. The main end-points were (i) to assess both the cumulative incidence and clinical outcome of COVID-19, according to different biologic agents and (ii) to compare them with the general population and a cohort IBD patients undergoing non-biologic therapies. RESULTS: Among 1816 IBD patients, the cumulative incidence of COVID-19 was 3.9 per 1000 (7/1816) with a 57% hospitalization rate and a 29% case-fatality rate. The class of biologic agents was the only risk factor of developing COVID-19 (P = 0.01). Non-gut selective agents were associated with a lower incidence of COVID-19 cases, related symptoms, and hospitalization (P < 0.05). Compared with the general population of Lombardy, an overall lower incidence of COVID-19 was observed (3.9 vs 8.5 per 1000, P = 0.03). Compared with 565 IBD patients on non-biologic therapies, a lower rate of COVID-19 symptoms was observed in our cohort (7.5% vs 18%, P < 0.001). CONCLUSIONS: Compared with the general population, IBD patients on biologic therapy are not exposed to a higher risk of COVID-19. Non-gut selective agents are associated with a lower incidence of symptomatic disease, supporting the decision of maintaining the ongoing treatment.
Subject(s)
Biological Factors/administration & dosage , Biological Therapy/adverse effects , COVID-19/epidemiology , Inflammatory Bowel Diseases/drug therapy , Adolescent , Adult , Aged , Child , Child, Preschool , Colitis , Female , Humans , Incidence , Infant , Infant, Newborn , Inflammatory Bowel Diseases/epidemiology , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Young AdultSubject(s)
COVID-19/complications , Cytokine Release Syndrome/prevention & control , Practice Guidelines as Topic , Psoriasis/drug therapy , Withholding Treatment/standards , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Biological Factors/administration & dosage , Biological Factors/adverse effects , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , Clinical Decision-Making , Comorbidity , Cytokine Release Syndrome/immunology , Dermatology/standards , Dose-Response Relationship, Drug , Humans , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/adverse effects , Patient Selection , Psoriasis/epidemiology , Psoriasis/immunology , Risk Assessment , Risk Factors , SARS-CoV-2/immunology , Societies, Medical/standards , Thalidomide/administration & dosage , Thalidomide/adverse effects , Thalidomide/analogs & derivativesSubject(s)
Biological Factors/therapeutic use , Coronavirus Infections/epidemiology , Medication Adherence/statistics & numerical data , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Veterans/statistics & numerical data , Adrenal Cortex Hormones/therapeutic use , Aged , Betacoronavirus , Biological Factors/administration & dosage , COVID-19 , Female , Humans , Inflammatory Bowel Diseases/drug therapy , Infusions, Intravenous/statistics & numerical data , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , United States/epidemiologyABSTRACT
SARS-CoV-2 remains a significant burden on human health. Several lines of evidence suggest that surveillance of sewage and waste can provide an early warning sign for COVID-19 recurrence in a community. In support, SARS-CoV-2 traces were found in sewage in several countries. With this in mind, it is notable that pests, such as cockroaches, are exposed to pathogenic microbes routinely, yet thrive in polluted environments. Such species have likely developed mechanisms to protect themselves against pathogens. In support, recent studies showed that cockroaches possess potent antibacterial molecules to shield themselves from pathogenic bacteria. Among hundreds of molecules, some contained thiazine groups, imidazoles, chromene derivatives, isoquinoline group, sulfonamides, pyrrole-containing analogs, flavanones, and furanones. Here, we propose that cockroaches are a potential source of antiviral molecules to thwart infections. Because this is an unexploited resource for potential antivirals, we believe that cockroaches offer a unique source for novel bioactive molecule(s) to counter COVID-19 with huge clinical impact worldwide.