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Massimo Franchini, Mario Cruciani, Carlo Mengoli, Arturo Casadevall, Claudia Glingani, Michael J. Joyner, Liise-anne Pirofski, Jonathon W. Senefeld, Shmuel Shoham, David J. Sullivan, Matteo Zani, Daniele Focosi
Clinical Microbiology and Infection, 27.07.2024
Tilføjet 27.07.2024
Plasma collected from recovered COVID-19 patients (COVID-19 convalescent plasma, CCP) was the first antibody-based therapy employed to fight the COVID-19 pandemic. While the therapeutic effect of early administration of CCP in COVID-19 outpatients has been recognized, conflicting data exist regarding the efficacy of CCP administration in hospitalized patients.
Læs mere Tjek på PubMedHarrison, E., Kathir Kamarajah, S., NIHR Global Health Research Unit on Global Surgery, Kamarajah, Kouli, Alexander, Avellaneda, Cameron, Dawson, Dermanis, Ghosh, Griffiths, Guest, Haque, Kehoe, Lawani, Martin, Medina, Bravo, Morton, Pius, Primrose, Roberts, Siriwardena, Satoi, Shaw, Sutcliffe, Han, Harrison
BMJ Open, 26.07.2024
Tilføjet 26.07.2024
IntroductionCholecystectomy is one of the most common operations performed worldwide. Although laparoscopic surgery has been the ‘gold-standard’ approach for this operation, there is a paucity of global evidence around the variations of safe provision of cholecystectomy, including low-income and middle-income countries. This international collaborative study will allow contemporaneous data collection on the quality of cholecystectomies using measures covering infrastructure, care processes and outcomes, with the primary aim define the global variation in compliance with preoperative, intraoperative and postoperative audit standards. Methods and analysisGlobal Evaluation of Cholecystectomy Knowledge and Outcomes is a prospective, international, multicentre, observational cohort study delivered by the GlobalSurg Collaborative. Consecutive patients undergoing cholecystectomy between 31 July 2023 and 19 November 2023 will be recruited, with follow-up at 30 days and 1-year postoperatively. The study will be undertaken at any hospital providing emergency or elective surgical services for biliary disease. The primary endpoint of this study is compliance with preoperative, intraoperative and postoperative audit standards. Secondary outcomes include rates of 30-day complications, achievement of critical view of safety and rates of gallbladder cancer. Ethics and disseminationThis project will not affect clinical practice and has been classified as clinical audit following research ethics review at University Hospital Birmingham NHS Trust. The protocol will be disseminated through the international GlobalSurg and CovidSurg network. Trial registration numberNCT06223061.
Læs mere Tjek på PubMedBMC Infectious Diseases, 26.07.2024
Tilføjet 26.07.2024
Abstract Background The prognosis of immunocompromised individuals with COVID-19 remains a significant concern. Information regarding the clinical and virological characteristics of immunocompromised patients infected with SARS-CoV-2 during the Omicron variant period is limited. Methods Medical records of patients admitted to our hospital with COVID-19 during the Omicron (BA.1–5) epidemic were retrospectively reviewed. Clinical, virological (nasopharyngeal swabs and blood), and serological data were compared between immunocompromised patients receiving immunosuppressive medications (calcineurin inhibitors, mycophenolate mofetil, or steroids) and control patients not receiving immunosuppressive medications. Results Twenty-eight immunocompromised patients (25 transplant recipients) and 26 control patients were included. Fourteen of the immunocompromised patients (50%) received monoclonal antibodies. The immunocompromised group included 15 mild/moderate (53.6%), 10 severe (35.7%), and three critical (10.7%) disease severities. The mortality rate due to COVID-19 during hospitalization was 3.6% (1/28) in the immunocompromised group, with no difference between the two groups. Three cases of re-exacerbation after discharge occurred in the immunocompromised group and none in the control group. Linear regression based on nasopharyngeal real-time-PCR cycle threshold (Ct) values according to the time since symptom onset showed markedly slower viral clearance in the immunocompromised group than in the control group (Pslope = 0.078). In the immunocompromised group, patients who received monoclonal antibodies showed faster viral clearance than those who did not receive monoclonal antibodies. The convalescent anti-spike IgG titers were comparable to those in the control group in patients who received monoclonal antibodies and significantly lower than those in the control patients in patients who did not receive monoclonal antibodies (P
Læs mere Tjek på PubMedMarcia Triunfol
Lancet, 26.07.2024
Tilføjet 26.07.2024
Several employees of the Prevent Senior hospital chain have been charged over the care of patients during the COVID-19 pandemic. Marcia Triunfol reports.
Læs mere Tjek på PubMedMary T Bassett
Lancet, 26.07.2024
Tilføjet 26.07.2024
In 2022 about 48 000 people died of gun-related injuries in the USA. The same year, there were almost 25 000 homicides and nearly 80% of them resulted from guns. Gun violence increased during the COVID-19 pandemic in the USA and although rates are now declining, the number of deaths from gun violence remains among the highest in decades. Gun violence is a leading cause of death nationally among young people aged up to 19 years. Young Black people in the USA make up a disproportionate share of these numbing statistics.
Læs mere Tjek på PubMedPablo N Perez-Guzman, Stephen Longa Chanda, Albertus Schaap, Kwame Shanaube, Marc Baguelin, Sarah T Nyangu, Muzala Kapina Kanyanga, Patrick Walker, Helen Ayles, Roma Chilengi, Robert Verity, Katharina Hauck, Edward S Knock, Anne Cori
International Journal of Infectious Diseases, 26.07.2024
Tilføjet 26.07.2024
The World Health Organization\'s (WHO) Pandemic and Resilience for Emerging Threats (PRET) initiative calls for the formulation of preparedness plans and priority actions underpinned by learnings from the COVID-19 pandemic [1]. Yet, four years on from the emergence of SARS-CoV-2, the true burden of the pandemic and the impact of constraints to scale-up mitigation strategies in resource-limited settings remain poorly understood. Systematic issues with epidemiological surveillance data have been highlighted as a key challenge to undertake such retrospective assessments robustly [2].
Læs mere Tjek på PubMedHui Li, Xia Wang, Guangting Zeng
Clinical Microbiology and Infection, 26.07.2024
Tilføjet 26.07.2024
Sun et al. conducted a systematic review and meta-analysis to evaluate the efficacy of antivirals, corticosteroids, and mAbs as acute COVID treatments in reducing the incidence of long COVID[1]. Their study suggested that the use of corticosteroids during acute COVID-19 infection not only fails to prevent long COVID, but even slightly increases the incidence of long COVID after treatment. Since the COVID-19 pandemic, there has been a clear association between dysregulation of inflammation and adverse clinical outcomes.
Læs mere Tjek på PubMedMugeni, R., Ruranga, C., Mutezimana, E., Nishimwe, A., Nzabanita, J., Masabo, E., Akili, V., Twizeyimana, L., Bahati, O., Uwimana, A., Musabanabaganwa, C., Semakula, M., Rukundo, G., Jansen, S., Mukamana, L., Rubagiza, J., Twagirumukiza, M.
BMJ Open, 26.07.2024
Tilføjet 26.07.2024
ObjectiveTo assess the level of compliance with COVID-19 preventive measures and compliance-associated factors in the Rwanda community. DesignCross-sectional study. SettingsCountry-wide community survey in Rwanda. Participants4763 participants were randomly sampled following the sampling frame used for the recent Rwanda Demographic Health Survey. Participants were aged between 22 years and 94 years. OutcomesThe participants’ compliance with three preventive measures (wearing a face mask, washing hands and social distancing) was the main outcome. MethodsFrom 14 February 2022 to 27 February 2022, a cross-sectional survey using telephone calls was conducted. Study questionnaires included different questions such as participants’ demographics and compliance with COVID-19 preventives measures. Verbal consent was obtained from each participant. The compliance on three main preventive measures (wearing a mask, washing hands and social distancing) were the main outcomes. Univariate and multivariable logistic regression analyses were performed to evaluate factors associated with compliance (age, gender, level of education, socioeconomic status). ResultsCompliance with the three primary preventive measures (washing hands 98%, wearing a mask 97% and observing social distance 98%) was at a rate of 95%. The respondents’ mean age was 46±11 SD (range 22–98) years. In addition, 69% were female and 86% had attended primary education. Bivariate and regression analyses indicated a significant association among the three primary preventive measures (p
Læs mere Tjek på PubMedLee, J., Lee, D., Kwon, O.
BMJ Open, 26.07.2024
Tilføjet 26.07.2024
ObjectivesWe compared the cost-effectiveness of hospital-based treatment and that of community treatment centres (CTCs). DesignWe performed statistical analysis to compare the expenses incurred by COVID-19 patients who received hospital care with those incurred by COVID-19 patients who went to CTCs. Setting and participantsA study was conducted on 411 530 COVID-19 inpatients and 243 329 CTC patients from January 2020 to December 2021. Main outcome measuresWe calculated the probability of severe disease, hospitalisation period and medical expenses for inpatients and CTC patients. Subsequently, we analysed the cost-effectiveness of CTC compared with hospitalisation. ResultsComparing medical expenses, CTC patients incurred 2 220 000 KRW on average, which is less than the expenses incurred by hospitalised COVID-19 patients. ConclusionsThe study suggests that using a CTC may be more cost-effective than a hospital service alone.
Læs mere Tjek på PubMedYillah, R. M., Wurie, H. R., Reindorf, B., Sawaneh, A., Hodges, M. H., Turay, H.
BMJ Open, 26.07.2024
Tilføjet 26.07.2024
ObjectiveThis study aimed to identify the primary sources of COVID-19 health information for adolescent girls in Sierra Leone and evaluate their perceived trustworthiness and influence on their behaviour. DesignUsing a convenience sampling strategy grounded in the social cognitive theory, the study explored adolescents\' navigation and appraisal of health information sources, their understanding of COVID-19, and the impact of societal and observational influences on their health beliefs and actions. Data analysis involved thematic analysis using NVivo V.12 software, focusing on patterns within responses related to observational learning, trusted sources and behavioural outcomes. SettingSierra Leone, July 2020. Participants16 focus group discussions were conducted among 86 adolescents (6–8 per group) aged 15–19 years in Sierra Leone. Outcome measurePrimary sources of COVID-19 information. ResultsAdolescent girls identified a diverse range of health information sources, including schools, social media, health workers and radio, with notable differences in trust and preference based on geographical and social contexts. A noteworthy finding was the significant trust placed in health workers, marking a stark contrast to fear and mistrust during the Ebola emergency only 5 years previously. This renewed trust in health professionals emerged as a critical factor influencing adolescents’ health behaviours and acceptance of COVID-19 preventive measures. ConclusionThis study underscores the complexity of navigating health information among adolescent girls during the COVID-19 pandemic. It highlights the importance of tailored public health messaging that accounts for local cultural contexts, addresses misconceptions and builds on trusted information sources to foster effective health behaviours. Future interventions could prioritise enhancing educational resources, leveraging trusted community figures, and ensuring that health communication is scientifically accurate and culturally sensitive.
Læs mere Tjek på PubMedDowling-Cullen, C., Sakellariou, D.
BMJ Open, 26.07.2024
Tilføjet 26.07.2024
ObjectiveReductions in paediatric unscheduled healthcare utilisation were seen during the COVID-19 pandemic, with concerns around their impact on children’s health. The reasons for these changes are not well described. This review aims to explore the factors reported by parents that influenced their decision-making around accessing paediatric unscheduled healthcare during the COVID-19 pandemic. DesignMixed methods rapid review and thematic synthesis based on the Enhancing Transparency of Reporting the Synthesis of Qualitative research framework. Data sourcesMEDLINE, Embase, Web of Science, PsycEXTRA, PsycINFO, Global Health, Global Index Medicus, Dissertations and Theses Global, Google Scholar and OAISter. Studies published from January 2020 to July 2023 were included. Eligibility criteria for selecting studiesQualitative, quantitative and mixed methods studies that assessed the perspectives of parents on decisions to access or delay or avoid accessing paediatric unscheduled healthcare during the COVID-19 pandemic. Data extraction and synthesisNvivo 14.23.0 was used to code results the of the primary studies and develop themes, following a thematic synthesis approach. ResultsTwelve studies were included, all from high-income settings, mainly in Europe. The studies were conducted across varying times and levels of COVID-19-related restrictions. The principal descriptive themes identified were (i) concerns about COVID-19 infection, (ii) balancing and navigating risks, (iii) perception of healthcare service status and conditions and (iv) perception of information and advice. These were developed into analytic themes to further describe the decision-making process. ConclusionsParents balanced a range of risks, concerns, advice and responsibilities when considering accessing paediatric unscheduled healthcare during the COVID-19 pandemic. External sources of advice and information were important; misconceptions around public health advice may reflect the multitude of information sources and the rapidly changing circumstances of the pandemic. Public health policy and planning should consider parent perspectives when developing measures to ensure equitable access to appropriate paediatric healthcare services.
Læs mere Tjek på PubMedLewandowska, K., Lipski, D., Uruski, P., Narkiewicz, K., Januszewicz, A., Wolf, J., Prejbisz, A., Rajzer, M., Wiecek, A., Tykarski, A.
BMJ Open, 26.07.2024
Tilføjet 26.07.2024
IntroductionNumerous studies, but not all, have suggested a positive effect of allopurinol on the cardiovascular system. The randomised, double-blind, placebo-controlled study evaluating the effect of allopurinol on the risk of cardiovascular events in patients with high and very high cardiovascular risk, including the presence of long-COVID-19 syndrome (ALL-VASCOR) study aims to evaluate the efficacy of allopurinol therapy for improving cardiovascular outcomes in patients at high and very high cardiovascular risk excluding ischaemic heart disease. This is particularly important due to the high cost of cardiovascular disease treatment and its status as one of the leading causes of mortality. Methods and analysisThe ALL-VASCOR study is a randomised, double-blind, placebo-controlled, multicentre trial that examines the effect of allopurinol therapy (200–500 mg of allopurinol daily) versus an equivalent dose of placebo on the risk of cardiovascular events in 1116 patients aged 40–70 with serum uric acid levels above 5 mg/dL at high and very high risk of cardiovascular disease. The ALL-VASCOR study will also assess the occurrence of long-COVID-19 syndrome. The study will measure primary and secondary as well as additional endpoints and the planned intervention will end on 31 July 2028 unless advised otherwise by the Safe Monitoring Board or other applicable authorities. Participant recruitment is planned to begin in March 2024 in Poland. Ethics and disseminationThe study was ethically approved by the Bioethics Committee of Poznan University of Medical Sciences (No 03/23, 12 January 2023). The results are expected after 2028 and will be disseminated in peer-reviewed journals and at international conferences. Protocol version number01–15 November 2022. Trial registration numberEudraCT: 2022-003573-32, 27 October 2022, ClinicalTrials: NCT05943821, 13 July 2023.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Abstract Background and intention Erectile dysfunction (ED) is an underappreciated clinical condition in men. This study aims to compare the dynamic changes in the distribution of ED among male kidney transplant recipients (mKTRs) in four epochs: end-stage renal disease period (ESRDp), early post-transplant period (EPTP), pre-COVID-19, and post-COVID-19. Methods General information was gathered through interviews, follow-ups, and medical records. The International Index of Erectile Function Questionnaire-5 was used to assess erectile function. The Mann–Whitney U test and chi-square test were used to analyze differences in ED strength. Univariate and logistic regression analyses were conducted to identify risk factors for ED. Results The database contains 230 mKTRs. In the ESRDp, 17.0% had normal erectile function, 53.5% had mild ED, 18.3% had moderate ED, and 11.3% had severe ED. In the EPTP, the distribution was 38.2% normal, 42.6% mild, 10.8% moderate, and 8.2% severe. In the pre-COVID-19 period, it was 34.3%, 47.3%, 10.4%, and 7.8%, and in the post-COVID-19 period, it was 23.0%, 45.6%, 21.3%, and 10.0%. Overall, erectile function improved after kidney transplant (KT). However, post-COVID-19, the proportion of erectile function significantly decreased compared to EPTP and pre-COVID-19 periods. Risk factors for post-pandemic ED included degree, Generalized Anxiexy Disorder-7, kidney donor type, postoperative time, hypertension and hemoglobin concentration. Conclusion KT improves erectile function in mKTRs within 5 years, but post-SARS-CoV-2 viral infection, ED worsens due to altered risk factors. These findings inform future research for comprehensive ED prevention and management strategies in this population.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Abstract Background The global impact of the coronavirus disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality. Immunocompromised patients, particularly those treated for B-cell lymphoma, have shown an increased risk of persistent infection with SARS-CoV-2 and severe outcomes and mortality. Multi-mutational SARS-CoV-2 variants can arise during the course of such persistent cases of COVID-19. No optimal, decisive strategy is currently available for patients with persistent infection that allows clinicians to sustain viral clearance, determine optimal timing to stop treatment, and prevent virus reactivation. We introduced a novel treatment combining antivirals, neutralizing antibodies, and genomic analysis with frequent monitoring of spike-specific antibody and viral load for immunocompromised patients with persistent COVID-19 infection. The aim of this retrospective study was to report and evaluate the efficacy of our novel treatment for immunocompromised B-cell lymphoma patients with persistent COVID-19 infection. Methods This retrospective descriptive analysis had no controls. Patients with B-cell lymphoma previously receiving immunotherapy including anti-CD20 antibodies, diagnosed as having COVID-19 infection, and treated in our hospital after January 2022 were included. We selected anti-SARS-CoV-2 monoclonal antibodies according to subvariants. Every 5 days, viral load was tested by RT-PCR, with antivirals continued until viral shedding was confirmed. Primary outcome was virus elimination. Independent predictors of prolonged viral shedding time were determined by multivariate Cox regression. Results Forty-four patients were included in this study. Thirty-five patients received rituximab, 19 obinutuzumab, and 26 bendamustine. Median treatment duration was 10 (IQR, 10–20) days; 22 patients received combination antiviral therapy. COVID-19 was severe in 16 patients, and critical in 2. All patients survived, with viral shedding confirmed at median 28 (IQR, 19–38) days. Bendamustine use or within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma significantly prolonged time to viral shedding. Conclusions Among 44 consecutive patients treated, anti-SARS-CoV-2 monoclonal antibodies and long-term administration of antiviral drugs, switching, and combination therapy resulted in virus elimination and 100% survival. Bendamustine use, within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma were the significant independent predictors of prolonged viral shedding time.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Abstract Background The use of telemedicine has grown significantly since the COVID-19 pandemic and has the potential to improve access to specialized care for otherwise underserved populations. Incarcerated people living with HIV (PLWH) could potentially benefit from expanded access to HIV care through telemedicine. Methods All PLWH who were incarcerated within the Tennessee Department of Corrections and received care through the HIV telemedicine clinic at Regional One Hospital between 5/1/2019 through 2/28/2022 were identified from the electronic health records (EHR). Demographics, laboratory data, vaccine history, and treatment outcomes were abstracted from the EHR. Retention in care and viral suppression were defined using Centers for Disease Control and Prevention definitions. Results Of the 283 incarcerated PLWH receiving care from this telemedicine clinic, 78% remained retained in care and 94% achieved or maintaining viral suppression at 12 months. Many preventative care measures remained unperformed or undocumented, including vaccinations and testing for concurrent sexually transmitted infections. There were 56 patients (20%) found to have chronic hepatitis C in this population, with 71% either cured or still on treatment in this study period. Conclusions Retention in care and viral suppression rates were excellent among incarcerated PLWH receiving telemedicine care for their HIV. HIV related primary health care screenings and vaccinations, however, were less consistently documented and represent areas for improvement.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Abstract Background Evidence on ivermectin as a treatment for Covid-19 is controversial. A Cochrane review concluded that the efficacy and safety of ivermectin is uncertain (evidence up to April 2022) and WHO recommended its use only in the setting of clinical trials. This study aimed to assess the efficacy and safety of oral ivermectin in hospitalized patients with mild to moderate Covid-19. Trial design and methods A double-blind, randomized placebo-controlled clinical trial was conducted among RT-PCR-confirmed, adults, hospitalised within the first four days of symptoms. Patients received oral ivermectin 24 mg or placebo daily for five days. RT-PCR was repeated on days five and ten. Clinical progression was monitored using the World Health Organization Clinical Progression Scale. Serum ivermectin levels were measured on days three, five, and seven. The primary outcome was the difference in the viral load between day zero and ten in the two groups. Results Out of 1699 patients screened, 249 underwent randomization and 127 received ivermectin, and 122 placebo. D10 median viral load for E gene (IQR) was 2,000 copies/mL (100 − 20,500) with ivermectin (n = 80) and 4,100 copies/mL (1,000–65,600) with placebo (n = 81, p = 0.028), per protocol analysis. The difference in Log viral load between day zero and ten between ivermectin and placebo was 3.72 and 2.97 respectively (p = 0.022). There was no significant difference in the WHO clinical progression scale or the adverse effects. Ivermectin blood levels taken before or with meals were not significantly different. Only 7 and 17 patients achieved blood levels above 160ng/ML and 100ng/ML respectively and they did not achieve a significantly lower viral load. Conclusion Although ivermectin resulted in statistically significant lower viral load in patients with mild to moderate Covid-19, it had no significant effect on clinical symptoms. Trial registration number SLCTR/2021/020, Sri Lanka Clinical Trials Registry. 19/07/2021.
Læs mere Tjek på PubMedLidia Morawska, Yuguo Li, Tunga Salthammer
Science, 25.07.2024
Tilføjet 25.07.2024
Clinical Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Infectious Disease Modelling, 25.07.2024
Tilføjet 25.07.2024
Publication date: Available online 24 July 2024 Source: Infectious Disease Modelling Author(s): Christiane Dings, Dominik Selzer, Nicola Luigi Bragazzi, Eva Möhler, Markus Wenning, Thomas Gehrke, Ulf Richter, Alexandra Nonnenmacher, Folke Brinkmann, Tobias Rothoeft, Michael Zemlin, Thomas Lücke, Thorsten Lehr
Læs mere Tjek på PubMedMichael S. Sinha, Wendy E. Parmet, and Gregg S. GonsalvesFrom the Center for Health Law Studies, St. Louis University School of Law, St. Louis (M.S.S.); the Center for Health Policy and Law, Northeastern University School of Law, Boston (W.E.P.); and the Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT (G.S.G.).
New England Journal of Medicine, 25.07.2024
Tilføjet 25.07.2024
Lok, K. Y. W., Choi, M. S. L., Ko, R. W. T., Chau, P. P. H., Lam, C. C. O., Chang, Y.-S., Bick, D.
BMJ Open, 25.07.2024
Tilføjet 25.07.2024
IntroductionBreastfeeding is associated with many health benefits for both women and their newborns. Exclusive breastfeeding has been recommended for at least 6 months to optimise infant growth, development and health. In addition to standard care, community-based peer support is recommended to help mothers improve breastfeeding. A recent survey reveals that the rate of exclusive breastfeeding at 6 months post partum in Hong Kong is low, and half of all breastfeeding mothers never exclusively breastfeed. Taking into account the local practice for women to stay home during the first month post partum and social isolation during and post-COVID-19 pandemic, a home-based peer support programme with the aid of Zoom or Facetime is proposed. This study aims to evaluate the effectiveness of a home-based breastfeeding peer support programme in improving breastfeeding practices and achieving exclusive breastfeeding rate among women with low breastfeeding self-efficacy. Methods and analysisThe study is a two-armed randomised control trial and will include a total of 442 participants. Potential cases will be recruited and screened at four postnatal wards in Hong Kong public hospital. Eligible and consented cases will be randomly allocated into intervention or control groups at a 1:1 ratio. Control group (n=221) will receive standard care, while the intervention group (n=221) will receive home-based peer support as well as standard care. Trained peer counsellors will provide breastfeeding-related support through Zoom or Facetime at 10 days and 1 month post partum. Telephone follow-ups will be conducted at 1 month, 2 months, 3 months and 6 months post partum. Breastfeeding status, mother’s breastfeeding self-efficacy and postpartum depression will be assessed and compared between the two arms. Ethics and disseminationThe study has been reviewed and approved by the Institutional Review Board of the University of Hong Kong and Hospital Authority Hong Kong West Cluster (UW 20-564). The findings will be updated in trial registries and disseminated in peer-reviewed journals and academic conferences. Trial registration number NCT04621266.
Læs mere Tjek på PubMedBMC Infectious Diseases, 25.07.2024
Tilføjet 25.07.2024
Abstract Background and intention Erectile dysfunction (ED) is an underappreciated clinical condition in men. This study aims to compare the dynamic changes in the distribution of ED among male kidney transplant recipients (mKTRs) in four epochs: end-stage renal disease period (ESRDp), early post-transplant period (EPTP), pre-COVID-19, and post-COVID-19. Methods General information was gathered through interviews, follow-ups, and medical records. The International Index of Erectile Function Questionnaire-5 was used to assess erectile function. The Mann–Whitney U test and chi-square test were used to analyze differences in ED strength. Univariate and logistic regression analyses were conducted to identify risk factors for ED. Results The database contains 230 mKTRs. In the ESRDp, 17.0% had normal erectile function, 53.5% had mild ED, 18.3% had moderate ED, and 11.3% had severe ED. In the EPTP, the distribution was 38.2% normal, 42.6% mild, 10.8% moderate, and 8.2% severe. In the pre-COVID-19 period, it was 34.3%, 47.3%, 10.4%, and 7.8%, and in the post-COVID-19 period, it was 23.0%, 45.6%, 21.3%, and 10.0%. Overall, erectile function improved after kidney transplant (KT). However, post-COVID-19, the proportion of erectile function significantly decreased compared to EPTP and pre-COVID-19 periods. Risk factors for post-pandemic ED included degree, Generalized Anxiexy Disorder-7, kidney donor type, postoperative time, hypertension and hemoglobin concentration. Conclusion KT improves erectile function in mKTRs within 5 years, but post-SARS-CoV-2 viral infection, ED worsens due to altered risk factors. These findings inform future research for comprehensive ED prevention and management strategies in this population.
Læs mere Tjek på PubMedGovindan, Sushant; Spicer, Alexandra; Bearce, Matthew; Schaefer, Richard S.; Uhl, Andrea; Alterovitz, Gil; Kim, Michael J.; Carey, Kyle A.; Shah, Nirav S.; Winslow, Christopher; Gilbert, Emily; Stey, Anne; Weiss, Alan M.; Amin, Devendra; Karway, George; Martin, Jennie; Edelson, Dana P.; Churpek, Matthew M.
Critical Care Explorations, 25.07.2024
Tilføjet 25.07.2024
BACKGROUND AND OBJECTIVE: To develop the COVid Veteran (COVet) score for clinical deterioration in Veterans hospitalized with COVID-19 and further validate this model in both Veteran and non-Veteran samples. No such score has been derived and validated while incorporating a Veteran sample. DERIVATION COHORT: Adults (age ≥ 18 yr) hospitalized outside the ICU with a diagnosis of COVID-19 for model development to the Veterans Health Administration (VHA) (n = 80 hospitals). VALIDATION COHORT: External validation occurred in a VHA cohort of 34 hospitals, as well as six non-Veteran health systems for further external validation (n = 21 hospitals) between 2020 and 2023. PREDICTION MODEL: eXtreme Gradient Boosting machine learning methods were used, and performance was assessed using the area under the receiver operating characteristic curve and compared with the National Early Warning Score (NEWS). The primary outcome was transfer to the ICU or death within 24 hours of each new variable observation. Model predictor variables included demographics, vital signs, structured flowsheet data, and laboratory values. RESULTS: A total of 96,908 admissions occurred during the study period, of which 59,897 were in the Veteran sample and 37,011 were in the non-Veteran sample. During external validation in the Veteran sample, the model demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.88. This was significantly higher than NEWS (0.79; p < 0.01). In the non-Veteran sample, the model also demonstrated excellent discrimination (0.86 vs. 0.79 for NEWS; p < 0.01). The top three variables of importance were eosinophil percentage, mean oxygen saturation in the prior 24-hour period, and worst mental status in the prior 24-hour period. CONCLUSIONS: We used machine learning methods to develop and validate a highly accurate early warning score in both Veterans and non-Veterans hospitalized with COVID-19. The model could lead to earlier identification and therapy, which may improve outcomes.
Læs mere Tjek på PubMedMukherjee, Vikramjit; Postelnicu, Radu; Parker, Chelsie; Rivers, Patrick S.; Anesi, George L.; Andrews, Adair; Ables, Erin; Morrell, Eric D.; Brett-Major, David M.; Broadhurst, M. Jana; Cobb, J. Perren; Irwin, Amy; Kratochvil, Christopher J.; Krolikowski, Kelsey; Kumar, Vishakha K.; Landsittel, Douglas P.; Lee, Richard A.; Liebler, Janice M.; Segal, Leopoldo N.; Sevransky, Jonathan E.; Srivastava, Avantika; Uyeki, Timothy M.; Wurfel, Mark M.; Wyles, David; Evans, Laura E.; Lutrick, Karen; Bhatraju, Pavan K.; on behalf of the Severe Acute Respiratory Infection-Preparedness (SARI-PREP) Study Group
Critical Care Explorations, 25.07.2024
Tilføjet 25.07.2024
IMPORTANCE: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has evolved through multiple phases in the United States, with significant differences in patient centered outcomes with improvements in hospital strain, medical countermeasures, and overall understanding of the disease. We describe how patient characteristics changed and care progressed over the various pandemic phases; we also emphasize the need for an ongoing clinical network to improve the understanding of known and novel respiratory viral diseases. OBJECTIVES: To describe how patient characteristics and care evolved across the various COVID-19 pandemic periods in those hospitalized with viral severe acute respiratory infection (SARI). DESIGN: Severe Acute Respiratory Infection-Preparedness (SARI-PREP) is a Centers for Disease Control and Prevention Foundation-funded, Society of Critical Care Medicine Discovery-housed, longitudinal multicenter cohort study of viral pneumonia. We defined SARI patients as those hospitalized with laboratory-confirmed respiratory viral infection and an acute syndrome of fever, cough, and radiographic infiltrates or hypoxemia. We collected patient-level data including demographic characteristics, comorbidities, acute physiologic measures, serum and respiratory specimens, therapeutics, and outcomes. Outcomes were described across four pandemic variant periods based on a SARS-CoV-2 sequenced subsample: pre-Delta, Delta, Omicron BA.1, and Omicron post-BA.1. SETTING: Multicenter cohort of adult patients admitted to an acute care ward or ICU from seven hospitals representing diverse geographic regions across the United States. PARTICIPANTS: Patients with SARI caused by infection with respiratory viruses. MAIN OUTCOMES AND RESULTS: Eight hundred seventy-four adult patients with SARI were enrolled at seven study hospitals between March 2020 and April 2023. Most patients (780, 89%) had SARS-CoV-2 infection. Across the COVID-19 cohort, median age was 60 years (interquartile range, 48.0–71.0 yr) and 66% were male. Almost half (430, 49%) of the study population belonged to underserved communities. Most patients (76.5%) were admitted to the ICU, 52.5% received mechanical ventilation, and observed hospital mortality was 25.5%. As the pandemic progressed, we observed decreases in ICU utilization (94% to 58%), hospital length of stay (median, 26.0 to 8.5 d), and hospital mortality (32% to 12%), while the number of comorbid conditions increased. CONCLUSIONS AND RELEVANCE: We describe increasing comorbidities but improved outcomes across pandemic variant periods, in the setting of multiple factors, including evolving care delivery, countermeasures, and viral variants. An understanding of patient-level factors may inform treatment options for subsequent variants and future novel pathogens.
Læs mere Tjek på PubMedHochberg, Chad H.; Case, Aaron S.; Psoter, Kevin J.; Brodie, Daniel; Dezube, Rebecca H.; Sahetya, Sarina K.; Outten, Carrie; Street, Lara; Eakin, Michelle N.; Hager, David N.
Critical Care Explorations, 25.07.2024
Tilføjet 25.07.2024
OBJECTIVE: During the COVID-19 pandemic, some centers converted intermediate care units (IMCUs) to COVID-19 ICUs (IMCU/ICUs). In this study, we compared adherence to lung protective ventilation (LPV) and outcomes for patients with COVID-19-related acute respiratory distress syndrome (ARDS) treated in an IMCU/ICU versus preexisting medical ICUs (MICUs). DESIGN: Retrospective observational study using electronic medical record data. SETTING: Two academic medical centers from March 2020 to September 2020 (period 1) and October 2020 to May 2021 (period 2), which capture the first two COVID-19 surges in this health system. PATIENTS: Adults with COVID-19 receiving invasive mechanical ventilation who met ARDS oxygenation criteria (Pao2/Fio2 ≤ 300 mm Hg or Spo2/Fio2 ≤ 315). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We defined LPV adherence as the percent of the first 48 hours of mechanical ventilation that met a restrictive definition of LPV of, tidal volume/predicted body weight (Vt/PBW) less than or equal to 6.5 mL/kg and plateau pressure (Pplat) less than or equal to 30 cm H2o. In an expanded definition, we added that if Pplat is greater than 30 cm H2o, Vt/PBW had to be less than 6.0 mL/kg. Using the restricted definition, period 1 adherence was lower among 133 IMCU/ICU versus 199 MICU patients (92% [95% CI, 50–100] vs. 100% [86–100], p = 0.05). Period 2 adherence was similar between groups (100% [75–100] vs. 95% CI [65–100], p = 0.68). A similar pattern was observed using the expanded definition. For the full study period, the adjusted hazard of death at 90 days was lower in IMCU/ICU versus MICU patients (hazard ratio [HR] 0.73 [95% CI, 0.55–0.99]), whereas ventilator liberation by day 28 was similar between groups (adjusted subdistribution HR 1.09 [95% CI, 0.85–1.39]). CONCLUSIONS: In patients with COVID-19 ARDS treated in an IMCU/ICU, LPV adherence was similar to, and observed survival better than those treated in preexisting MICUs. With adequate resources, protocols, and staffing, IMCUs provide an effective source of additional ICU capacity for patients with acute respiratory failure.
Læs mere Tjek på PubMedAarskog, Nikolai Ravn; Hallem, Ronja; Godhavn, Jakob Strand; Rostrup, Morten
Critical Care Explorations, 25.07.2024
Tilføjet 25.07.2024
OBJECTIVES (BACKGROUND): Under normal conditions, pulmonary megakaryocytes are an important source of circulating thrombocytes, causing thrombocyte counts to be higher in arterial than venous blood. In critical COVID-19, thrombocytes may be removed from the circulation by the lungs because of immunothrombosis, possibly causing venous thrombocyte counts to be higher than arterial thrombocyte counts. In the present study, we investigated time-dependent changes in pulmonary turnover of thrombocytes during critical COVID-19 by measuring arteriovenous thrombocyte differences. We hypothesized that the early stages of the disease would be characterized by a net pulmonary removal of circulating thrombocytes because of immunothrombosis and that later stages would be characterized by a net pulmonary release of thrombocytes as normal pulmonary function is restored. DESIGN: Cohort study with repeated measurements of arterial and central venous thrombocyte counts. SETTING: ICU in a large university hospital. PATIENTS: Thirty-one patients with critical COVID-19 that were admitted to the ICU and received invasive or noninvasive mechanical ventilation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We found a significant positive association between the arteriovenous thrombocyte difference and time since symptom debut. This finding indicates a negative arteriovenous thrombocyte difference and hence pulmonary removal of thrombocytes in the early stages of the disease and a positive arteriovenous thrombocyte difference and hence pulmonary release of thrombocytes in later stages. Most individual arteriovenous thrombocyte differences were smaller than the variance coefficient of the analysis. CONCLUSIONS: The results of this study support our hypothesis that early stages of critical COVID-19 are characterized by pulmonary removal of circulating thrombocytes because of immunothrombosis and that later stages are characterized by the return of normal pulmonary release of thrombocytes. However, in most cases, the arteriovenous thrombocyte difference was too small to say anything about pulmonary thrombocyte removal and release on an individual level.
Læs mere Tjek på PubMedKyung-Shin Lee, Min Jin Go, Youn Young Choi, Min-Kyung Kim, Jaehyun Seong, Ho Kyung Sung, Jaehyun Jeon, Hee-Chang Jang, Myoung-Hee Kim
PLoS One Infectious Diseases, 24.07.2024
Tilføjet 24.07.2024
by Kyung-Shin Lee, Min Jin Go, Youn Young Choi, Min-Kyung Kim, Jaehyun Seong, Ho Kyung Sung, Jaehyun Jeon, Hee-Chang Jang, Myoung-Hee Kim
Læs mere Tjek på PubMedDaniela Tregnago, Alice Avancini, Lorenzo Belluomini, Ilaria Trestini, Marco Sposito, Jessica Insolda, Federica Bianchi, Teodoro Sava, Chiara Gaiani, Lidia Del Piccolo, Valentina Guarneri, Giuseppe Verlato, Ahmad Tfaily, Roberta Vesentini, Serena Zuliani, Sara Pilotto, Michele Milella
PLoS One Infectious Diseases, 24.07.2024
Tilføjet 24.07.2024
by Daniela Tregnago, Alice Avancini, Lorenzo Belluomini, Ilaria Trestini, Marco Sposito, Jessica Insolda, Federica Bianchi, Teodoro Sava, Chiara Gaiani, Lidia Del Piccolo, Valentina Guarneri, Giuseppe Verlato, Ahmad Tfaily, Roberta Vesentini, Serena Zuliani, Sara Pilotto, Michele Milella
Læs mere Tjek på PubMedNamoonga M. Mantina, Maiya G. Block Ngaybe, Katharine H. Zeiders, Kayla M. Osman, Ada M. Wilkinson-Lee, Antoinette M. Landor, Lindsay T. Hoyt
PLoS One Infectious Diseases, 24.07.2024
Tilføjet 24.07.2024
by Namoonga M. Mantina, Maiya G. Block Ngaybe, Katharine H. Zeiders, Kayla M. Osman, Ada M. Wilkinson-Lee, Antoinette M. Landor, Lindsay T. Hoyt Introduction The Latinx population has the second highest COVID-19 death rate among racial/ethnic groups in the United States and less than half of Latinx youth aged 5–17 years old completed their COVID-19 primary vaccination series as of September 2022. COVID-19 vaccine misinformation detrimentally impacts vaccination rates. In this study, we examined factors that predicted Latinx youth COVID-19 vaccine hesitancy and vaccination status. Methods A community-based sample of 290 Latinx parent and adolescent dyads from a Southwestern metropolitan area of the United States who were recruited to complete an online survey at baseline at T1 (August 2020 –March 2021) and one year later. We tested a longitudinal mediation model in which we examined individual and family factors that would predict youth COVID-19 vaccine hesitancy and vaccination status over time. Results Youth’s pandemic disbelief (i.e., the belief that the COVID-19 pandemic is a conspiracy or not real) predicted greater youth’s COVID-19 vaccine hesitancy, and in turn, a lower likelihood of youth’s COVID-19 vaccination. Youth’s pandemic disbelief also predicted greater parent’s vaccination hesitancy which, in turn, predicted greater youth’s vaccination hesitancy and a lower likelihood of COVID-19 vaccination. Parents’ pandemic disbelief predicted their own COVID-19 hesitancy, but not youth hesitancy. Discussion Our study findings provide initial evidence that general pandemic disbelief was a significant driver of vaccine hesitancy and vaccination among Latinx families. The study contributes to the limited research investigating COVID-19 vaccination in the Latinx community and among Latinx youth, further aiding how COVID-19 vaccine disparities can be mitigated among racial/ethnic populations.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 24.07.2024
Tilføjet 24.07.2024
Abstract Therapeutic monoclonal antibodies (mAbs) have been studied in humans, but the impact on immune memory of mAb treatment during an ongoing infection has remained unclear. We evaluated the effect of infusion of the anti-SARS-CoV-2 spike receptor binding domain (RBD) mAb bamlanivimab on memory B cells (MBCs) in SARS-CoV-2–infected individuals. Bamlanivimab treatment skewed the repertoire of memory B cells targeting Spike towards non-RBD epitopes. Furthermore, the relative affinity of RBD memory B cells was weaker in mAb-treated individuals compared to placebo-treated individuals over time. Subsequently, after mRNA COVID-19 vaccination, memory B cell differences persisted and mapped to a specific reduction in recognition of the class II RBD site, the same RBD epitope recognized by bamlanivimab. These findings indicate a substantial role of antibody feedback in regulating memory B cell responses to infection, and single mAb administration can continue to impact memory B cell responses to additional antigen exposures months later.
Læs mere Tjek på PubMedBMC Infectious Diseases, 24.07.2024
Tilføjet 24.07.2024
Abstract Background Evidence on ivermectin as a treatment for Covid-19 is controversial. A Cochrane review concluded that the efficacy and safety of ivermectin is uncertain (evidence up to April 2022) and WHO recommended its use only in the setting of clinical trials. This study aimed to assess the efficacy and safety of oral ivermectin in hospitalized patients with mild to moderate Covid-19. Trial design and methods A double-blind, randomized placebo-controlled clinical trial was conducted among RT-PCR-confirmed, adults, hospitalised within the first four days of symptoms. Patients received oral ivermectin 24 mg or placebo daily for five days. RT-PCR was repeated on days five and ten. Clinical progression was monitored using the World Health Organization Clinical Progression Scale. Serum ivermectin levels were measured on days three, five, and seven. The primary outcome was the difference in the viral load between day zero and ten in the two groups. Results Out of 1699 patients screened, 249 underwent randomization and 127 received ivermectin, and 122 placebo. D10 median viral load for E gene (IQR) was 2,000 copies/mL (100 − 20,500) with ivermectin (n = 80) and 4,100 copies/mL (1,000–65,600) with placebo (n = 81, p = 0.028), per protocol analysis. The difference in Log viral load between day zero and ten between ivermectin and placebo was 3.72 and 2.97 respectively (p = 0.022). There was no significant difference in the WHO clinical progression scale or the adverse effects. Ivermectin blood levels taken before or with meals were not significantly different. Only 7 and 17 patients achieved blood levels above 160ng/ML and 100ng/ML respectively and they did not achieve a significantly lower viral load. Conclusion Although ivermectin resulted in statistically significant lower viral load in patients with mild to moderate Covid-19, it had no significant effect on clinical symptoms. Trial registration number SLCTR/2021/020, Sri Lanka Clinical Trials Registry. 19/07/2021.
Læs mere Tjek på PubMedSubekshya Bidari, Wan Yang
International Journal of Infectious Diseases, 23.07.2024
Tilføjet 23.07.2024
Measles cases and deaths increased globally following the disruptions to health services caused by the COVID-19 pandemic [1]. Even before the pandemic, measles cases were on the rise, including in countries that had previously eliminated the disease. For instance, countries in three World Health Organization (WHO) regions – Brazil, Venezuela, Albania, Slovakia, Uzbekistan, Cambodia and Mongolia saw a re-establishment of measles since 2016 after previously achieving elimination status [2]. Understanding the determinants of measles incidence and key drivers of this resurgence during recent years is crucial for informing effective public health strategies for measles control and eradication.
Læs mere Tjek på PubMedJournal of the American Medical Association, 23.07.2024
Tilføjet 23.07.2024
This study evaluated the uptake of Healthcare Common Procedure Coding System code M0201 after initial implementation to inform future policy related to in-home preventive care.
Læs mere Tjek på PubMedJournal of the American Medical Association, 23.07.2024
Tilføjet 23.07.2024
In this issue of JAMA, the US Preventive Services Task Force (USPSTF) releases updated recommendations for interventions for high body mass index (BMI) in children and adolescents. Child and adolescent obesity continues to be one of the most significant health challenges in the US and globally. In 2017-2020, 19.7% of US children and adolescents aged 2 to 19 years had obesity (BMI ≥95th percentile for age and sex), and the rate of BMI increase nearly doubled during the first 9 months of the COVID-19 pandemic. Obesity is associated with significant social, psychological, and medical burdens among children, as well as increased risks of adult obesity, diabetes, heart disease and stroke, many cancers, many other chronic illnesses, and early mortality. Youth from low socioeconomic status families and Black, Hispanic, or Indigenous youth have higher rates of obesity and its related comorbidities.
Læs mere Tjek på PubMedCabada, M. M., Aguilar, P. V., Rodas, J. D., Hidalgo, M., Mozo, K., Gonzalez-Diaz, E. S., Jimenez-Coello, M., Diaz, F. J., Dacso, M. M., Ortega-Pacheco, A., Arboleda, M., Walker, D. H., Weaver, S. C., Melby, P. C.
BMJ Open, 23.07.2024
Tilføjet 23.07.2024
IntroductionAcute undifferentiated febrile illnesses (AUFIs) impose a large burden in the tropics. Understanding of AUFI’s epidemiology is limited. Insufficient diagnostic capacity hinders the detection of outbreaks. The lack of interconnection in healthcare systems hinders timely response. We describe a protocol to study the epidemiology and aetiologies of AUFI and pathogen discovery in strategic areas of Latin America (LA). Methods and analysisGlobal Infectious Diseases Network investigators comprising institutions in Colombia, Dominican Republic, México, Perú and the USA, developed a common cohort study protocol. The primary objective is to determine the aetiologies of AUFI at healthcare facilities in high-risk areas. Data collection and laboratory testing for viral, bacterial and parasitic agents are performed in rural and urban healthcare facilities and partner laboratories. Centralised laboratory and data management cores deploy diagnostic tests and data management tools. Subjects >6 years with fever for
Læs mere Tjek på PubMedHu, D., Stewart, V., Wheeler, A. J., Lau, G., Chapman, J.
BMJ Open, 23.07.2024
Tilføjet 23.07.2024
IntroductionMental health concerns globally impact millions of people, resulting in significant financial impact and adverse health outcomes. People living with mental health concerns are at higher risk of developing physical health issues, which can lead to a shortened life expectancy. Barriers to physical healthcare, such as limited service capacity, low help seeking and stigma, contribute to health disadvantage. Quality improvement (QI) interventions can address these challenges by addressing staff-level and service-level factors to improve the focus on physical healthcare in mental health settings. The aim of this scoping review is to describe studies of QI interventions to improve physical healthcare in mental health settings. Methods and analysisThe proposed scoping review will be conducted in accordance with guidance for scoping reviews from the Joanna Briggs Institute Manual and in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A systematic review search for peer-reviewed and published articles will be conducted across eight databases: PubMed, MEDLINE (Ovid), Web of Science, CINAHL (EBSCOhost), ProQuest Central, PsycINFO (Ovid), Scopus and Embase (Elsevier). Two independent reviewers will screen the titles, abstracts and full text using Covidence. Any disagreement will be resolved through discussion or with a third reviewer. Data collection will be facilitated using Microsoft Excel. The details of included studies will be extracted by two authors independently. Ethics and disseminationNo ethical approval is required for the scoping review. The results of this review will be presented at conferences and published in a peer-reviewed scientific journal. This review will also inform the development of a QI strategy to influence mental health staff practices in the provision of physical healthcare in Australian mental health settings.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.07.2024
Tilføjet 23.07.2024
Abstract Background The global impact of the coronavirus disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality. Immunocompromised patients, particularly those treated for B-cell lymphoma, have shown an increased risk of persistent infection with SARS-CoV-2 and severe outcomes and mortality. Multi-mutational SARS-CoV-2 variants can arise during the course of such persistent cases of COVID-19. No optimal, decisive strategy is currently available for patients with persistent infection that allows clinicians to sustain viral clearance, determine optimal timing to stop treatment, and prevent virus reactivation. We introduced a novel treatment combining antivirals, neutralizing antibodies, and genomic analysis with frequent monitoring of spike-specific antibody and viral load for immunocompromised patients with persistent COVID-19 infection. The aim of this retrospective study was to report and evaluate the efficacy of our novel treatment for immunocompromised B-cell lymphoma patients with persistent COVID-19 infection. Methods This retrospective descriptive analysis had no controls. Patients with B-cell lymphoma previously receiving immunotherapy including anti-CD20 antibodies, diagnosed as having COVID-19 infection, and treated in our hospital after January 2022 were included. We selected anti-SARS-CoV-2 monoclonal antibodies according to subvariants. Every 5 days, viral load was tested by RT-PCR, with antivirals continued until viral shedding was confirmed. Primary outcome was virus elimination. Independent predictors of prolonged viral shedding time were determined by multivariate Cox regression. Results Forty-four patients were included in this study. Thirty-five patients received rituximab, 19 obinutuzumab, and 26 bendamustine. Median treatment duration was 10 (IQR, 10–20) days; 22 patients received combination antiviral therapy. COVID-19 was severe in 16 patients, and critical in 2. All patients survived, with viral shedding confirmed at median 28 (IQR, 19–38) days. Bendamustine use or within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma significantly prolonged time to viral shedding. Conclusions Among 44 consecutive patients treated, anti-SARS-CoV-2 monoclonal antibodies and long-term administration of antiviral drugs, switching, and combination therapy resulted in virus elimination and 100% survival. Bendamustine use, within 1 year of last treatment for B-cell lymphoma, and multiple treatment lines for B-cell lymphoma were the significant independent predictors of prolonged viral shedding time.
Læs mere Tjek på PubMedBMC Infectious Diseases, 23.07.2024
Tilføjet 23.07.2024
Abstract Background The use of telemedicine has grown significantly since the COVID-19 pandemic and has the potential to improve access to specialized care for otherwise underserved populations. Incarcerated people living with HIV (PLWH) could potentially benefit from expanded access to HIV care through telemedicine. Methods All PLWH who were incarcerated within the Tennessee Department of Corrections and received care through the HIV telemedicine clinic at Regional One Hospital between 5/1/2019 through 2/28/2022 were identified from the electronic health records (EHR). Demographics, laboratory data, vaccine history, and treatment outcomes were abstracted from the EHR. Retention in care and viral suppression were defined using Centers for Disease Control and Prevention definitions. Results Of the 283 incarcerated PLWH receiving care from this telemedicine clinic, 78% remained retained in care and 94% achieved or maintaining viral suppression at 12 months. Many preventative care measures remained unperformed or undocumented, including vaccinations and testing for concurrent sexually transmitted infections. There were 56 patients (20%) found to have chronic hepatitis C in this population, with 71% either cured or still on treatment in this study period. Conclusions Retention in care and viral suppression rates were excellent among incarcerated PLWH receiving telemedicine care for their HIV. HIV related primary health care screenings and vaccinations, however, were less consistently documented and represent areas for improvement.
Læs mere Tjek på PubMedBenjamin A. Katz, Iftah Yovel
PLoS One Infectious Diseases, 22.07.2024
Tilføjet 22.07.2024
Mauricio Tano, Juha Baek, Adriana Ordonez, Rita Bosetti, Terri Menser, George Naufal, Bita Kash
PLoS One Infectious Diseases, 22.07.2024
Tilføjet 22.07.2024
by Mauricio Tano, Juha Baek, Adriana Ordonez, Rita Bosetti, Terri Menser, George Naufal, Bita Kash
Læs mere Tjek på PubMedNing Xie, Haixin Fan, Xiaochun Liu, Feng Ye, Zhenlin Weng
PLoS One Infectious Diseases, 22.07.2024
Tilføjet 22.07.2024
by Ning Xie, Haixin Fan, Xiaochun Liu, Feng Ye, Zhenlin Weng Using weekly data from January 2020 to December 2021 on the prices of various links in the Chinese broiler industry chain and the COVID-19 epidemic, we employed a time-varying parametric vector auto-regressive (TVP-VAR) model to investigate the dynamic effects of public health events on price fluctuations of upstream, midstream, and downstream products in the Chinese broiler industry chain. Our findings showed that the COVID-19 epidemic had different effects on the prices of various broiler products, both in direction and magnitude, at different lags and time intervals. Chicken and live chicken prices were impacted the most, followed by broiler chick prices, while broiler feed prices were impacted the least. The epidemic constantly impacted broiler chick and chicken prices, while its effect on live chicken prices was initially negative but turned positive afterwards. Additionally, the impact of the COVID-19 epidemic on broiler product prices consistently increased with more extended lag periods. The impulse responses at different epidemic time points were heterogeneous. With the results of this study, policy recommendations can be suggested to relevant government departments to optimize the prevention and control measures for public health emergencies and ensure price stability in the broiler industry.
Læs mere Tjek på PubMedBurcu Ünlütabak, Graciela Trujillo Hernandez, İlayda Velioğlu, David Menendez, Karl S. Rosengren
PLoS One Infectious Diseases, 22.07.2024
Tilføjet 22.07.2024
by Burcu Ünlütabak, Graciela Trujillo Hernandez, İlayda Velioğlu, David Menendez, Karl S. Rosengren Question-asking is a crucial tool for acquiring information about unseen entities, such as viruses; thus, examining children’s questions within the context of COVID-19 is particularly important for understanding children’s learning about the coronavirus. The study examined 3-12-year-old children’s questions and teachers’ responses about the COVID-19 pandemic in Türkiye, a non-Western developing context, and the United States, a Western cultural context. A total of 119 teachers from Türkiye and 95 teachers from the US participated in the study. Teachers completed an online survey consisting of a demographic form and a questionnaire asking them to report three questions about COVID-19 asked by children in their classrooms and their responses to these questions. We analyzed children’s questions and teachers’ responses for their type and content and examined demographic factors associated with children’s questions and teachers’ responses. Consistent with the literature, children from Türkiye asked fewer explanation-seeking (i.e., why/how) questions than children from the United States. Children asked questions about viruses and precautions. Teachers responded to children’s questions realistically in both countries. The findings have important implications for how children gain knowledge from teachers when discussing health, disease, and virus topics in two countries.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 21.07.2024
Tilføjet 21.07.2024
Abstract Background To address the need for novel COVID-19 therapies, we evaluated the fully-human polyclonal antibody product SAB-185 in a phase 3 clinical trial.Methods Non-hospitalized high-risk adults within 7 days of COVID-19 symptom onset were randomized 1:1 to open-label SAB-185 3,840 units/kg or casirivimab/imdevimab 1200 mg. Non-inferiority comparison was undertaken for the pre-Omicron population (casirivimab/imdevimab expected to be fully active) and superiority comparison for the Omicron population (casirivimab/imdevimab not expected to be active). Primary outcomes were the composite of all-cause hospitalizations/deaths and grade ≥3 treatment-emergent adverse events (TEAEs) through day 28. Secondary outcomes included time to sustained symptom improvement and resolution.Results Enrollment was terminated early due to low hospitalization/death rates upon Omicron emergence. 733 adults were randomized, 255 included in pre-Omicron and 392 in Omicron analysis populations. Hospitalizations/deaths occurred in 6 (5.0%) and 3 (2.2%) of pre-Omicron SAB-185 and casirivimab/imdevimab arms, respectively (absolute difference [95% CI] 2.7% [-2.3%, 8.6%]), inconclusive for non-inferiority; and 5 (2.5%) versus 3 (1.5%) (absolute difference 1.0% [-2.3%, 4.5%]) for Omicron. Risk ratios for grade ≥3 TEAEs were 0.94 [0.52, 1.71] (pre-Omicron) and 1.71 [0.96, 3.07] (Omicron). Time to symptom improvement and resolution were shorter for SAB-185, median 11 vs 14 (pre-Omicron) and 11 vs 13 days (Omicron) (symptom improvement), and 16 vs 24 days and 18 vs >25 days (symptom resolution), p
Læs mere Tjek på PubMedJournal of Infectious Diseases, 21.07.2024
Tilføjet 21.07.2024
Abstract Within a multi-state viral genomic surveillance program, we evaluated whether proportions of SARS-CoV-2 infections attributed to the JN.1 variant and to XBB-lineage variants (including HV.1 and EG.5) differed between inpatient and outpatient care settings during periods of cocirculation. Both JN.1 and HV.1 were less likely than EG.5 to account for infections among inpatients versus outpatients (aOR=0.60 [95% CI: 0.43-0.84; p=0.003] and aOR=0.35 [95% CI: 0.21-0.58; p
Læs mere Tjek på PubMedClinical & Experimental Immunology, 20.07.2024
Tilføjet 20.07.2024
Summary Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces pneumonia and acute respiratory failure in Coronavirus Disease 2019 (COVID-19) patients with inborn errors of immunity to type I interferon (IFN-I). The impact of SARS-CoV-2 infection varies widely, ranging from mild respiratory symptoms to life-threatening illness and organ failure, with a higher incidence in men than in women. Approximately 3 to 5% of critical COVID-19 patients under 60 and a smaller percentage of elderly patients exhibit genetic defects in IFN-I production, including X-chromosome-linked TLR7 and autosomal TLR3 deficiencies. Around 15 to 20% of cases over 70 years old, and a smaller percentage of younger patients, present with preexisting autoantibodies neutralizing type I interferons. Additionally, innate errors affecting the control of the response to type I interferon have been associated with pediatric multisystem inflammatory syndrome (MIS-C). Several studies have described rare errors of immunity, such as XIAP deficiency, CYBB, SOCS1, OAS1/2, and RNASEL, as underlying factors in MIS-C susceptibility. However, further investigations in expanded patient cohorts are needed to validate these findings and pave the way for new genetic approaches to MIS-C. This review aims to present recent evidence from the scientific literature on genetic and immunological abnormalities predisposing individuals to critical SARS-CoV-2 infection through IFN-I. We will also discuss multisystem inflammatory syndrome in children (MIS-C). Understanding the immunological mechanisms and pathogenesis of severe COVID-19 may inform personalized patient care and population protection strategies against future serious viral infections.
Læs mere Tjek på PubMedBMC Infectious Diseases, 20.07.2024
Tilføjet 20.07.2024
Abstract Background Camostat mesylate, an oral serine protease inhibitor, is a powerful TMPRSS2 inhibitor and has been reported as a possible antiviral treatment against COVID-19. Therefore, we aim to assess the safety and efficacy of camostat mesylate for COVID-19 treatment. Methods A systematic review and meta-analysis synthesizing randomized controlled trials from PubMed, Scopus, Embase, Cochrane, Web of Science, clinical trials.gov, and medrxiv until June 2023. The outcomes were pooled using Mean difference (MD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes. The protocol is registered in PROSPERO with ID CRD42023439633. Results Nine RCTs, including 1,623 patients, were included in this analysis. There was no difference between camostat mesylate and placebo in producing negative PCR test results at 1–7 days (RR: 0.76, 95% CI: [0.54, 1.06] P = 0.1), 8–14 days (RR: 1.02, 95% CI: [0.84, 1.23] P = 0.87), or 15–21 days (RR: 0.99, 95% CI: [0.82, 1.19] P = 0.90); clinical resolution of symptoms at 1–7 days (RR: 0.94 (95% CI: 0.58, 1.53) P = 0.81), 8–14 days (RR: 0.91, 95% CI: [0.74, 1.11] P = 0.33, ), or 15–21 days (RR: 0.77, 95% CI: [0.40, 1.51] P = 0.45); and time to symptom improvement (MD:-0.38 weeks (95% CI: [-1.42, 0.66] P = 0.47, I2 = 85%). Conclusion Camostat mesylate did not improve clinical outcomes in patients with COVID-19, compared to placebo.
Læs mere Tjek på PubMedAashish Gupta, Payal Hathi, Murad Banaji, Prankur Gupta, Ridhi Kashyap, Vipul Paikra, Kanika Sharma, Anmol Somanchi, Nikkil Sudharsanan, Sangita Vyas
Science Advances, 20.07.2024
Tilføjet 20.07.2024
Astrid Loiseau, Tiphaine Davit-Béal, Damien Brézulier
PLoS One Infectious Diseases, 20.07.2024
Tilføjet 20.07.2024
by Astrid Loiseau, Tiphaine Davit-Béal, Damien Brézulier Purpose The Covid-19 epidemic has imposed profound changes on the practice of orthodontics. It was in this anxiety-inducing context that drastic measures were imposed on orthodontists. The main aim of this online survey is to highlight the measures that are still in place in French orthodontic practices three years after the emergence of the pandemic. Methods A cross-sectional online survey was distributed to French orthodontists from march to June 2023. The questionnaire, consisting of 32 questions, was divided into five sections covering habits before and after the pandemic, and the feelings of professionals. Results In this survey 230 complete answers were recorded. Three years later, the daily pace had returned to its pre-crisis level. Disinfection and aeration times were still present (p < 0.001). Orthodontists maintained and generalized the use of protective glasses (p = 0.17) and visors (p < 0.001). The same was true for the FFP2 mask and its frequency of change, as well as rigorous hand washing. Finally, the dedicated layout of the practices was maintained: protective screen, filtration system, supply of SHA, travel paths, removal of magazines (for all, p < 0.001). Conclusion This study shows that the professional practices imposed by the Covid-19 crisis have been adopted by the majority of French orthodontists, and now appear to be anchored in their routine practice. Trial registration number opinion n°2023–004, dated 01.25.2023.
Læs mere Tjek på PubMedMahsa Karimi, Mohammad Reza Khami, Shabnam Varmazyari, Ahmad Reza Shamshiri, Mahmoud Hormozi, Nourhan M. Aly, Morẹ́nikẹ́ Oluwátóyìn Foláyan
PLoS One Infectious Diseases, 20.07.2024
Tilføjet 20.07.2024
by Mahsa Karimi, Mohammad Reza Khami, Shabnam Varmazyari, Ahmad Reza Shamshiri, Mahmoud Hormozi, Nourhan M. Aly, Morẹ́nikẹ́ Oluwátóyìn Foláyan Background The Coronavirus disease 2019 pandemic increased global psychological distress, emotional distress, and sleep disturbances, all known risk factors for compromised oral health. Despite this, there is limited understanding of the impacts of these psychological factors on oral health in certain populations, including Iranians. Thus, the present study investigates the associations between sociodemographic characteristics, emotional distress, sleep pattern changes, tooth brushing frequency, and oral ulcer reports in a sample of Iranian adults during the Coronavirus disease 2019 pandemic. Materials and methods This cross-sectional, web-based study collected data from Iranian adults between July and September 2022 using respondent-driven sampling. The Mental Health and Wellness questionnaire was used to gather information on sociodemographic characteristics, emotional distress, sleep pattern changes, toothbrushing frequency, and oral ulcer reports. Simple and multiple logistic regression served for statistical analysis. Results Among the 240 participants, comprising 164 females and 76 males, with a mean age of 35.3 years (±13.3), 28 individuals (11.7%) reported reduced tooth brushing frequency, and 35 individuals (14.6%) reported oral ulcers. Male gender (OR = 2.75, p = 0.016) and sleep patterns changes (OR = 2.93, p = 0.01) increased the likelihood of reduced tooth brushing frequency. Additionally, being younger than 30 (OR = 2.87, p = 0.025) and fearing coronavirus transmission (OR = 3.42, p = 0.009) increased the odds of oral ulcers. Conclusions Male gender and sleep pattern changes were risk factors for reduced tooth brushing frequency among the present sample of Iranian adults during the Coronavirus disease 2019 pandemic. Additionally, being under 30 and fearing coronavirus transmission were identified as risk factors for oral ulcers in this population. To preserve and promote adults’ oral health during public health crises, targeted educational initiatives, public health awareness campaigns, and integrated mental and oral healthcare approaches are encouraged.
Læs mere Tjek på PubMedKasim Abdulai, Abdul Rauf Alhassan, Safianu Osman Aleboko, Mohammed Doobia Ahmed, Awal Seidu Mohammed, Odei-Asare Fremah Adom, Rhoda Kumah
PLoS One Infectious Diseases, 20.07.2024
Tilføjet 20.07.2024
by Kasim Abdulai, Abdul Rauf Alhassan, Safianu Osman Aleboko, Mohammed Doobia Ahmed, Awal Seidu Mohammed, Odei-Asare Fremah Adom, Rhoda Kumah Background The coronavirus Disease 2019 (COVID-19) pandemic has brought about unique challenges in healthcare and nutrition, particularly for people living with HIV (PLHIV). Understanding their dietary patterns and nutritional status is crucial for developing targeted interventions and improving health outcomes. Therefore, this study assessed the dietary diversity and nutritional status of PLHIV during the COVID-19 era. Methods We adopted a facility-based cross-sectional study design to enroll 220 PLHIV from two hospitals in the Central Region of Ghana. Dietary intakes were assessed using 24-hour recall. Anthropometric and body composition data were collected with a stadiometer and a body composition monitor. Dietary diversity was evaluated using the FAO’s Individual Dietary Diversity Score (IDDS). Data analysis was conducted with SPSS version 20. Significance level was set p-value less than 0.05. Results A significant proportion (33.2%) of PLHIV had low dietary diversity, with the majority (55.5%) categorized as needing dietary improvement. Approximately 2 out of every 10 of the participants were identified as underweight. Participants aged 40 to 59 years were more likely to exhibit higher dietary diversity (adjusted odds ratio (AOR) = 1.966, 95% Confidence Interval (CI): 1.045–4.987). Participants who consumed meals at least three times daily were more likely to have a high IDDS (AOR = 1.641, 95% CI: 1.221, 8.879). Employed participants (public sector and private sector) were also more likely to have a high IDDS compared to unemployed participants (AOR = 1.448, 95% CI: 1.028–3.042; AOR = 1.165, 95% CI: 1.030–9.329, respectively). Factors associated with undernutrition included being female (AOR = 1.829, 95% CI: 1.294, 3.872) and first-line antiretroviral therapy ART (AOR = 1.683, 95% CI: 1.282–2.424). Conclusion The study emphasizes the need for nutritional interventions for PLHIV, particularly during crises. It advocates for a policy collaboration to address food insecurity and promote resilient health outcomes.
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