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32 emner vises.
Kathy Jackson, Sara Bonanzinga, Ros Edwards, Kumar Visvanathan, Xin Li, Samuel Hall, Alison Kuchta, Jesse A. Canchola, Alex J. Thompson
Journal of Medical Virology, 19.08.2022
Tilføjet 19.08.2022
Journal of Infectious Diseases, 18.08.2022
Tilføjet 19.08.2022
AbstractThe Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised concerns regarding vaccine effectiveness. We investigated humoral and cellular immune responses against SARS-CoV-2 in healthcare workers before and after a third (booster) dose of the BNT162b2 mRNA vaccine. It significantly enhanced both humoral and cellular immunity in previously uninfected individuals. However, cellular immunity was not enhanced in previously infected persons, suggesting that three antigenic stimuli by vaccination or natural infection reached a plateau of cellular immunity. Even with reinforced immunity to SARS-CoV-2, we confirmed several post-booster breakthrough cases caused by the Omicron variant.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 18.08.2022
Tilføjet 19.08.2022
AbstractBackgroundToxoplasma gondii infection is usually benign in Europe due to the strong predominance of type II strains. Few studies have been conducted to examine the immunological course of infection in humans and have yielded conflicting results, maybe influenced by heterogeneous parasite strains.MethodsWe measured 23 immune mediators in 39, 40, and 29 sera of French non-infected, acutely infected, and chronically infected immunocompetent pregnant women, respectively.ResultsFour different cytokine patterns were identified regarding their dynamics through infection phases. For eleven of the cytokines, IFN-β, IFN-γ, IL-4, IL5, IL-6, IL-10, IL-12, IL-15, CXCL9, CCL2 and CSF2, the serum levels were significantly elevated during acute infection. The inflammatory mediators IL-1β, IL-17A, IL-18, TNF-α and CSF3 remained unchanged during acute infection, while they were significantly lower in chronically infected compared to non-infected patients. As for the anti-inflammatory cytokines TGF-β and CCL5, their levels remained significantly elevated during chronic infection. We also observed a significant negative correlation of several cytokine concentrations with IgG levels, indicating a rapid decline of serum concentrations during the acute phase.DiscussionThese results indicate an anti-inflammatory pattern in chronically infected patients in a type II dominated setting and demonstrate the highly dynamic immune situation during acute infection.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundObesity dysregulates immunity to influenza infection. Therefore, there is a critical need to investigate how obesity impairs immunity and to establish therapeutic approaches that mitigate the impact of increased adiposity. One mechanism by which obesity may alter immune response is through changes in cellular metabolism.MethodsWe studied inflammation and cellular metabolism of PBMCs isolated from individuals with obesity relative to lean controls. We also investigated if impairments to PBMC metabolism were reversible upon short-term weight loss following bariatric surgery.ResultsObesity was associated with systemic inflammation and poor inflammation resolution. Unstimulated PBMCs from subjects with obesity had lower oxidative metabolism and ATP production compared to PBMCs from lean controls. PBMC secretome analyses showed that ex vivo stimulation with A/Cal/7/2009 H1N1 influenza led to a notable increase in IL-6 with obesity. Short-term weight loss via bariatric surgery improved biomarkers of systemic metabolism but did not improve markers of inflammation resolution, PBMC metabolism, or the PBMC secretome.ConclusionsThese results show obesity drives a signature of impaired PBMC metabolism, which may be due to persistent inflammation. PBMC metabolism was not reversed after short-term weight loss despite improvements in measures of systemic metabolism.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundSARS-CoV-2 infection may be associated with worse clinical outcomes in people with HIV (PWH). We report anti-SARS-CoV-2 antibody responses in COVID-19 hospitalized patients in Durban, South Africa during the second SARS-CoV-2 infection wave dominated by the Beta (B.1.351) variant.MethodsThirty-four participants with confirmed SARS-CoV-2 infection were followed up with weekly blood sampling to examine antibody levels and neutralization potency against SARS-CoV-2 variants. Participants included 18 PWH, of whom 11 were HIV viremic.ResultsSARS-CoV-2 specific antibody concentrations were generally lower in viremic PWH relative to virologically suppressed PWH and HIV-negative participants and neutralization of the Beta variant was 4.9-fold lower in viremic PWH. Most HIV-negative participants and ART-suppressed PWH also neutralized the Delta (B.1.617.2) variant, whereas the majority of viremic PWH did not. CD4 counts <500 cells/μL were associated with lower frequencies of IgG and IgA seroconversion. In addition, there was a high correlation between a surrogate virus neutralization test and live virus neutralization against ancestral SARS-CoV-2 virus in both PWH and HIV-negative individuals, but correlation decreased for the Beta variant neutralization in PWH.ConclusionsHIV viremia was associated with reduced Beta variant neutralization. This highlights the importance of HIV suppression in maintaining an effective SARS-CoV-2 neutralization response.
Læs mere Tjek på PubMedClinical Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
Clinical Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
AbstractBackgroundHuman immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) have been suggested as persistent even with effective antiretroviral therapy (ART). Aims were to evaluate HAND prevalence and associated factors, in a large cohort of people-living-with-HIV (PLWH).MethodsART-treated PLWH, underwent a neuropsychological examination through a battery of 12 tests exploring 5 different domains, between 2009-2020, were included in this cross-sectional analysis. HAND were classified according to Frascati's criteria. Participants were defined as complaining or not-complaining if a cognitive complaint was reported or not. Chi-square for trend and multivariable logistic regression were fitted.ResultsOverall, 1,424 PLWH were enrolled during four three-years periods. HAND prevalence was 24%. Among complainers (572/1,424), HAND prevalence was 38%, higher than among not-complainers (15%). Over the study period, a decreasing HAND prevalence was found in the entire population (p < 0.001) and in complaining (p < 0.001); in not-complaining it remained stable (p = 0.182). Factors associated with HAND were older age, lower educational level, lower current CD4+ T-cell count and HCV co-infection. Compared to Non-Nucleoside Reverse Transcriptase Inhibitors, individuals receiving dual and Integrase Strand Transfer Inhibitor (INSTI)-based therapies were associated with a decreased risk of HAND, as well as participants tested in more recent years.ConclusionsIn this large cohort of ART-treated PLWH, mostly virologically suppressed, a remarkable decreasing HAND prevalence was observed. Besides HIV- and patient-related factors, the reduced risk of HAND found with dual and INSTI-based regimens along with a more recent ART initiation, could suggest a potential role of new treatment strategies in this decline, due to their greater virologic efficacy and better tolerability.
Læs mere Tjek på PubMedClinical Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
AbstractBackgroundMost HIV seroconversions in people who have initiated pre-exposure prophylaxis (PrEP) occur in the context of insufficient adherence. We describe participants who seroconverted after being dispensed PrEP in a large PrEP implementation study in Australia.MethodsExpanded PrEP Implementation in Communities in New South Wales was an implementation study of daily oral PrEP in individuals at high risk for acquiring HIV aged ≥18 years. HIV seroconversions were defined as a positive HIV test by either antigen, antibody or detectable HIV viral load after enrolment. Insufficient adherence, measured by dispensing logs or participant self-report, was defined as < four PrEP doses per week.Results9,596 participants were enrolled and dispensed PrEP between March 1, 2016, and April 30, 2018; 30 were diagnosed with HIV by March 31, 2019. The median (IQR) age was 31 (25-38) years, all identified as male, 29 (97%) identified as gay or homosexual, and 20 (69%) lived in a postcode with a low concentration of gay male residents. The median (IQR) days from first PrEP dispensing to diagnosis was 409 (347-656). There was no evidence that participants who seroconverted had been sufficiently adherent to PrEP. Nineteen (63%) participants who seroconverted were diagnosed with chlamydia, gonorrhoea, syphilis, or new hepatitis C infection. One participant had resistance to emtricitabine (M184V mutation) at diagnosis.ConclusionsParticipants who seroconverted were insufficiently adherent to PrEP despite being at high risk for acquiring HIV. Understanding the reasons for poor PrEP adherence in individuals who subsequently acquire HIV is critical to improving PrEP effectiveness.
Læs mere Tjek på PubMedClinical Infectious Diseases, 19.08.2022
Tilføjet 19.08.2022
AbstractBackgroundSocial network analysis can elucidate Tuberculosis (TB) transmission dynamics outside of the home and may inform novel network-based case-finding strategies.MethodsWe assessed the association between social network characteristics and prevalent TB infection among residents (≥15 years) of 9 rural communities in Eastern Uganda. Social contacts named during a census were used to create community-specific non-household social networks. We evaluated whether social network structure and characteristics of first-degree contacts (gender, HIV status, TB infection) were associated with prevalent TB infection (positive TST) after adjusting for individual-level risk factors (age, gender, HIV status, TB contact, wealth, occupation, and BCG vaccination) with Targeted Maximum Likelihood Estimation.ResultsAmong 3,335 residents sampled for TST, 32% had a positive TST, 4% reported a TB contact. The social network contained 15,328 first-degree contacts. Persons with the most network centrality (top 10%) (aRR: 1.3 (1.1-1.1) and the most (top 10%) male contacts (aRR: 1.5 (95% CI: 1.3-1.9) had a higher risk of prevalent TB, compared to those in the remaining 90%. People with ≥1 contacts with HIV (aRR 1.3; 95% CI:1.1-1.6) and ≥2 contacts with TB infection were more likely to themselves have TB (aRR: 2.6; 95% CI: 2.2-2.9).ConclusionsSocial networks with higher centrality, more men, contacts with HIV, and TB infection, were positively associated with TB infection. TB transmission within measurable social networks may explain prevalent TB not associated with a household contact. Further study on network-informed TB case finding interventions is warranted.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
Clinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
Clinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
Clinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
Clinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundCytomegalovirus (CMV) infection is thought to result in increased immune activation in people with HIV (PWH). While some data have linked asymptomatic CMV infection to cardiovascular disease among PWH, it remains unknown whether CMV is associated with increased or high-risk coronary plaque.MethodsThe Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) enrolled PWH aged 40-75 years on stable antiretroviral therapy (ART) with low-to-moderate atherosclerotic cardiovascular disease (ASCVD) risk. Among a subset of US REPRIEVE participants, coronary plaque was assessed by coronary computed tomography angiography. Here, we assessed the relationship between CMV IgG titer and 1) levels of immune activation, 2) inflammatory biomarkers, and 3) coronary plaque phenotypes at study entry.ResultsOf 672 participants, mean age was 51 years, 83% were men, median ASCVD risk score was 4.5%, and 66% had current CD4+ T-cell count ≥500 cells/mm3. Higher CMV IgG quartile group was associated with older age and lower current and nadir CD4+ T-cell counts. CMV IgG titer was associated with specific inflammatory biomarkers (sCD163, MCP-1, IL-6, hsCRP) in univariate analysis, but not after controlling for HIV-specific factors. In contrast, CMV IgG titer was not associated with coronary artery disease indices, including presence of plaque, coronary artery calcium (CAC) score >0, vulnerable plaque presence, or Leaman score >5.ConclusionsNo meaningful association was seen between CMV IgG titer and coronary artery disease indices among ART-treated PWH at study enrollment. Longitudinal assessments in REPRIEVE will determine the relationship of CMV IgG titer to plaque progression and cardiovascular events.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractHemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder characterized by an uncontrolled, persistent, hyperimmune response. It can be triggered by an infectious, neoplastic, or autoimmune event. The involvement of cytomegalovirus (CMV) in the onset of HLH is subject to debate, and the epidemiology of CMV-associated HLH (HLH-CMV) remains poorly characterized. We identified five cases of HLH-CMV in our hospital, systematically searched the PubMed database for publications on HLH-CMV and reviewed 57 publications with a total of 67 cases of HLH-CMV. Only 48 patients (71.6%) were immunodeficient, suggesting that HLH-CMV can occur in immunocompetent patients. The major cause of underlying immunodepression (51%) was inflammatory bowel disease (mainly treated with azathioprine). CMV infection was nearly always symptomatic, and lung involvement was frequent (31 cases). Fifty-five patients recovered. Nineteen patients were treated for CMV infection only and have a good outcome - suggesting that antiviral drugs might be the cornerstone of HLH-CMV treatment.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractWe report 11 critically-ill burn patients treated with cefiderocol for carbapenem-resistant Acinetobacter baumannii infections. Clinical success was achieved in 36% and complicated by treatment-emergent resistance and inter-patient transmission of cefiderocol-resistant A. baumannii between patients. Resistant isolates harbored disrupted pirA and piuA genes that were not disrupted among susceptible isolates.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundA major goal of COVID-19 vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of mRNA and ChAdOx1 COVID-19 vaccines against severe outcomes in four Canadian provinces between December 2020 and September 2021.MethodsWe conducted this multiprovincial retrospective test-negative study among community-dwelling adults aged ≥18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random effects models.ResultsWe included 2,508,296 tested subjects, with 31,776 COVID-19 hospitalizations and 5,842 deaths. Vaccine effectiveness was 83% after a first dose, and 98% after a second dose, against both hospitalization and death (separately). Against severe outcomes (hospitalization or death), effectiveness was 87% (95%CI: 71%–94%) ≥84 days after a first dose of mRNA vaccine, increasing to 98% (95%CI: 96%–99%) ≥112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95%CI: 75%–94%) ≥56 days after a first dose, increasing to 97% (95%CI: 91%–99%) ≥56 days after a second dose. Lower one-dose effectiveness was observed for adults aged ≥80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules, and against Alpha, Gamma, and Delta variants.ConclusionsTwo doses of mRNA or ChAdOx1 vaccines provide excellent protection against severe outcomes of hospitalization and death.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.08.2022
Tilføjet 19.08.2022
AbstractBackgroundEngland’s third trimester maternal pertussis vaccination, introduced in October 2012, was extended to the second trimester in 2016. Maternal vaccination provides high protection against infant disease but routine second trimester vaccination has not previously been assessed.MethodsNational laboratory-confirmed pertussis case-surveillance determined vaccination history, maternal vaccination history and hospitalisation. Pertussis hospital admissions between 2012-2019 were extracted from the Hospital Episode Statistics dataset. Vaccine effectiveness (VE) was calculated for pertussis cases born between October 2012 and September 2018 using the screening method and matching with a nationally representative dataset.ResultsHigher coverage was observed after earlier maternal vaccination with approximately 40% of pregnant women vaccinated ≥13 weeks before delivery. Cases and hospitalisations stabilised at low levels in younger infants but remained elevated in older infants, children and adults. No deaths arose in infants with vaccinated mothers after 2016.Of 1162 laboratory-confirmed pertussis cases in the study, 599 (52%) were aged <93 days: 463 (77%) with unvaccinated mothers and 136 (23%) with vaccinated.Vaccine effectiveness was equivalent in infants with mothers vaccinated at different gestational periods excepting infants with mothers vaccinated between 7-days pre- and 41-days post-delivery. Children whose mothers were unvaccinated but with vaccination in a previous pregnancy had a VE against disease of 44% (19% to 75%). There was no increased disease risk after primary vaccination in children with mothers vaccinated at least 7 days before delivery.ConclusionsNational policy recommending vaccination from second trimester increased earlier maternal vaccine uptake with sustained high effectiveness and impact against early infant disease.
Læs mere Tjek på PubMedZikun Ma, Yize Mao, Yuanyuan Wang, Zhizhou Duan, Diyang Qu, Chaofeng Li, Runsen Chen, Zhuowei Liu
Journal of Medical Virology, 19.08.2022
Tilføjet 19.08.2022
Md. Azahar Ali, George Fei Zhang, Chunshan Hu, Bin Yuan, Sanjida Jahan, Georgios D. Kitsios, Alison Morris, Shou‐Jiang Gao, Rahul Panat
Journal of Medical Virology, 19.08.2022
Tilføjet 19.08.2022
HongBo Liu, Qingfeng Li, Ying Xiang, Hong Li, Kangkang Liu, Xinying Du, Chaojie Yang, Hongbo Liu, Mengjing Shi, Xueqian Hu, Hui Wang, Xiaohong Zhang, Xiangda Li, Sai Tian, Renlong Bao, Ligui Wang, Shaofu Qiu, Hongbin Song
Journal of Medical Virology, 19.08.2022
Tilføjet 19.08.2022
Aili Cui, Zhibo Xie, Jing Xu, Kongxin Hu, Runan Zhu, Zhong Li, Yan Li, Liwei Sun, Xingyu Xiang, Baoping Xu, Rongbo Zhang, Zhenguo Gao, Yan Zhang, Wenbo Xu
Journal of Medical Virology, 19.08.2022
Tilføjet 19.08.2022
Ana Sainz-García, Paula Toledano, Ignacio Muro-Fraguas, Lydia Álvarez-Erviti, Rodolfo Múgica-Vidal, María López, Elisa Sainz-García, Beatriz Rojo-Bezares, Yolanda Sáenz, Fernando Alba-Elías
International Journal of Infectious Diseases, 18.08.2022
Tilføjet 19.08.2022
: The mask usage has increased over the last years due to COVID-19 pandemic resulting in a mask shortage. Furthermore, their prolonged use causes skin problems related to bacteria overgrowth. To overcome those problems, atmospheric pressure cold plasma (APCP) was studied as an alternative technology for mask disinfection.
Læs mere Tjek på PubMedFernando Dominguez, Neil Gaffin, Kusha Davar, Noah Wald-Dickler, Emi Minejima, Dominique Werge, Paul Holtom, Brad Spellberg, Rachel Baden
Clinical Microbiology and Infection, 18.08.2022
Tilføjet 19.08.2022
Based on multiple randomized controlled clinical trials, shorter antibiotic courses are equally effective as traditional longer courses for many types of infections. However, longer courses are still being used widely in clinical practice.
Læs mere Tjek på PubMedAisylu Shaidullina, Alexander Harms
Trends in Microbiology, 18.08.2022
Tilføjet 19.08.2022
Toxin–antitoxin systems can defend bacteria against phages by shutting down infected cells, but the links between their molecular mechanisms and biological functions have remained underexplored. LeRoux et al. now show how the DNA-targeting ADP-ribosylation activity of DarTG impairs phage replication but is overcome by dedicated viral inhibitors and evolved tolerance.
Læs mere Tjek på PubMedJocalyn Clark
Lancet, 20.08.2022
Tilføjet 19.08.2022
Firdausi Qadri, infectious disease specialist and Senior Scientist at icddr,b, found time on a hectic day to speak with me. She was taking a lunch break on day 5 of Bangladesh's 7-day vaccination blitz in July, 2022, during which more than 2·4 million people were immunised with oral cholera vaccine (OCV). A vaccination roll-out of this speed and scale is not unusual for Bangladesh. But this year's campaign is different because “it is aimed at breaking the cycle of infection in the country's worst cholera outbreak in 60 years”, says Qadri.
Læs mere Tjek på PubMedJuthipong Benjanuwattra, Annia Cavasos, Mahmoud Abdelnabi
Lancet, 20.08.2022
Tilføjet 19.08.2022
We thank Vincent Descamps for his Correspondence on Mahmoud Abdelnadi and colleagues’ published incidence of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome.1 Descamps suggested that testing for human herpesvirus is best done with PCR, rather than a Monospot test, which we concur with. The detection and quantification of viral DNA via PCR is the method of choice in determining an active human herpesvirus 6 infection including viral reactivation.2,3 Serological assay is mostly made use of to identify primary infection in patients with no history of infection; its usefulness is, unfortunately, reduced for the diagnosis of viral reactivation due to its poor specificity, as IgM can persist for months after primary infection.
Læs mere Tjek på PubMedKenneth C Shadlen
Lancet, 9.07.2022
Tilføjet 19.08.2022
From October to November, 2021, the pharmaceutical firms Merck and Pfizer licensed their new COVID-19 oral antiviral medications to the Medicines Patent Pool (MPP).1 In both cases, the drugs were licensed quickly, before they were launched, and the MPP then reached agreements with pharmaceutical firms across the globe (27 firms for Merck's molnupiravir2 and 36 firms for Pfizer's nirmatrelvir3) to provide generic versions of these to roughly 100 low-income and middle-income countries. This Viewpoint examines the importance of these licences for the global production of, and access to, new medicines, during the pandemic and beyond.
Læs mere Tjek på PubMedHannah Imlay, Nicholas C. Laundy, Graeme N. Forrest, Monica A. Slavin
Clinical Microbiology and Infection, 18.08.2022
Tilføjet 18.08.2022
A growing number of studies have demonstrated similar outcomes with shorter courses of antibiotics for bacterial infections. Immunocompromised patients are frequently excluded from these studies despite anticipated benefit associated with shortening antibiotic courses (including lower risks of antibiotic toxicity, Clostridioides difficile infection (CDI), drug resistant pathogens, and microbiome alterations).
Læs mere Tjek på PubMedLise Goltermann, Kasper Langebjerg Andersen, Helle Krogh Johansen, Søren Molin, Ruggero La Rosa
Clinical Microbiology and Infection, 18.08.2022
Tilføjet 18.08.2022
Pseudomonas aeruginosa colonizes the cystic fibrosis (CF) airways causing chronic bacterial lung infections. CF patients are routinely treated with macrolides, however, P. aeruginosa is considered insusceptible as consequence of inadequate susceptibility testing leaving resistance mechanism completely overlooked. Here we investigated a new mechanism of macrolide resistance caused by ribosomal protein mutations.
Læs mere Tjek på PubMedKeran Moll, Shayan Hobbi, Cindy Ke Zhou, Kathryn Fingar, Timothy Burrell, Veronica Hernandez-Medina, Joyce Obidi, Nader Alawar, Steven A. Anderson, Hui-Lee Wong, Azadeh Shoaibi
PLoS One Infectious Diseases, 18.08.2022
Tilføjet 18.08.2022
by Keran Moll, Shayan Hobbi, Cindy Ke Zhou, Kathryn Fingar, Timothy Burrell, Veronica Hernandez-Medina, Joyce Obidi, Nader Alawar, Steven A. Anderson, Hui-Lee Wong, Azadeh Shoaibi
The Food and Drug Administration’s Biologics Effectiveness and Safety Initiative conducts active surveillance to protect public health during the coronavirus disease 2019 (COVID-19) pandemic. This study evaluated performance of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code U07.1 in identifying COVID-19 cases in claims compared with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid amplification test results in linked electronic health records (EHRs). Care episodes in three populations were defined using COVID-19-related diagnoses (population 1), SARS-CoV-2 nucleic acid amplification test procedures (population 2), and all-cause hospitalizations (population 3) in two linked claims-EHR databases: IBM® MarketScan® Explorys® Claims-EMR Data Set (commercial) and OneFlorida Data Trust linked Medicaid-EHR. Positive and negative predictive values were calculated. Respectively, populations 1, 2, and 3 included 26,686, 26,095, and 2,564 episodes (commercial) and 29,117, 23,412, and 9,629 episodes (Florida Medicaid). The positive predictive value was >80% and the negative predictive value was >95% in each population, with the highest positive predictive value in population 3 (commercial: 91.9%; Medicaid: 93.1%). Findings did not vary substantially by patient age. Positive predictive values in populations 1 and 2 fluctuated during April–June 2020. They then stabilized in the commercial but not the Medicaid population. Negative predictive values were consistent over time in all populations and databases. Our findings indicate that U07.1 has high performance in identifying COVID-19 cases and noncases in claims databases. Performance may vary across populations and periods.
Læs mere Tjek på PubMedTanaka Arthur Choto, Ian Makupe, Andrew Zolani Cakana, Elopy Nimele Sibanda, Takafira Mduluza
PLoS One Infectious Diseases, 18.08.2022
Tilføjet 18.08.2022
by Tanaka Arthur Choto, Ian Makupe, Andrew Zolani Cakana, Elopy Nimele Sibanda, Takafira Mduluza
Coronavirus disease 2019 (COVID-19) is caused by a recently identified virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease is a pandemic. Although the hallmarks of severe COVID-19 have been established, the underlying mechanisms that promote severe pathology have not been thoroughly studied. A better understanding of the immune response in severe COVID-19 patients may help guide the development of therapeutic strategies and predict immuno-pathogenicity. This study was set to determine the lymphocyte and cytokine profiles associated with COVID-19 severity. A total of 43 hospitalised COVID-19 patients were recruited for the study and whole blood samples were drawn from each patient. Complete blood counts, lymphocyte subset profiles and C-reactive protein statuses of patients were determined. Cytometric bead array was performed to analyse the cytokine profiles of each patient. The demographic characteristics showed that the median age of the patients was 48.72 years, with an interquartile range from 40 to 60 years, and 69.77% of the patients were male. COVID-19 patients exhibited significantly low CD4+ lymphocyte expansion and leucocytosis augmented by elevated neutrophil and immature granulocytes. Stratification analysis revealed that reduced monocytes and elevated basophils and immature granulocytes are implicated in severe pathology. Additionally, cytokine results were noted to have significant incidences of interleukin 17A (IL-17A) expression associated with severe disease. Results from this study suggest that a systemic neutrophilic environment may preferentially skew CD4+ lymphocytes towards T-helper 17 and IL-17A promotion, thus, aggravating inflammation. Consequently, results from this study suggest broad activity immunomodulation and targeting neutrophils and blocking IL-17 production as therapeutic strategies against severe COVID-19.
Læs mere Tjek på PubMed