Overview of autoantibodies in COVID‐19 convalescents Dobrowolska, Krystyna; Zarębska‐Michaluk, Dorota; Poniedziałek, Barbara ...
Journal of medical virology,
June 2023, 2023-Jun, 2023-06-00, 20230601, Letnik:
95, Številka:
6
Journal Article
Recenzirano
Accumulating evidence shows that SARS‐CoV‐2 can potentially trigger autoimmune processes, which can be responsible for the long‐term consequences of COVID‐19. Therefore, this paper aims to review the ...autoantibodies reported in COVID‐19 convalescents. Six main groups were distinguished: (i) autoantibodies against components of the immune system, (ii) autoantibodies against components of the cardiovascular system, (iii) thyroid autoantibodies, (iv) autoantibodies specific for rheumatoid diseases, (v) antibodies against G‐protein coupled receptors, and (vi) other autoantibodies. The evidence reviewed here clearly highlights that SARS‐CoV‐2 infection may induce humoral autoimmune responses. However, the available studies share number of limitations, such as: (1) the sole presence of autoantibodies does not necessarily implicate the clinically‐relevant risks, (2) functional investigations were rarely performed and it is often unknown whether observed autoantibodies are pathogenic, (3) the control seroprevalence, in healthy, noninfected individuals was often not reported; thus it is sometimes unknown whether the detected autoantibodies are the result of SARS‐CoV‐2 infection or the accidental post‐COVID‐19 detection, (4) the presence of autoantibodies was rarely correlated with symptoms of the post‐COVID‐19 syndrome, (5) the size of the studied groups were often small, (6) the studies focused predominantly on adult populations, (7) age‐ and sex‐related differences in seroprevalence of autoantibodies were rarely explored, (8) genetic predispositions that may be involved in generation of autoantibodies during SARS‐CoV‐2 infections were not investigated, and (9) the autoimmune reactions following infection with SARS‐CoV‐2 variants that vary in the clinical course of infection remain unexplored. Further longitudinal studies are advocated to assess the link between identified autoantibodies and particular clinical outcomes in COVID‐19 convalescents.
Chronic infection with hepatitis C virus (HCV) is one of the leading causes of liver disease globally, affecting approximately 71 million people. The majority of them are infected with genotype (GT) ...1 but infections with GT3 are second in frequency. For many years, GT3 was considered to be less pathogenic compared to other GTs in the HCV family due to its favorable response to interferon (IFN)-based regimen. However, the growing evidence of a higher rate of steatosis, more rapid progression of liver fibrosis, and lower efficacy of antiviral treatment compared to infection with other HCV GTs has changed this conviction. This review presents the specifics of the course of GT3 infection and the development of therapeutic options for GT3-infected patients in the era of direct-acting antivirals (DAA). The way from a standard of care therapy with pegylated IFN-alpha (pegIFNα) and ribavirin (RBV) through a triple combination of pegIFNα + RBV and DAA to the highly potent IFN-free pangenotypic DAA regimens is discussed along with some treatment options which appeared to be dead ends. Although the implementation of highly effective pangenotypic regimens is the most recent stage of revolution in the treatment of GT3 infection, there is still room for improvement, especially in patients with liver cirrhosis and those who fail to respond to DAA therapies, particularly those containing inhibitors of HCV nonstructural protein 5A.
Understanding how the infectious disease burden was affected throughout the COVID‐19 pandemic is pivotal to identifying potential hot spots and guiding future mitigation measures. Therefore, our ...study aimed to analyze the changes in the rate of new cases of Poland's most frequent infectious diseases during the entire COVID‐19 pandemic and after the influx of war refugees from Ukraine. We performed a registry‐based population‐wide study in Poland to analyze the changes in the rate of 24 infectious disease cases from 2020 to 2023 and compared them to the prepandemic period (2016–2019). Data were collected from publicly archived datasets of the Epimeld database published by national epidemiological authority institutions. The rate of most of the studied diseases (66.6%) revealed significantly negative correlations with the rate of SARS‐CoV‐2 infections. For the majority of infectious diseases, it substantially decreased in 2020 (in case of 83%) and 2021 (63%), following which it mostly rebounded to the prepandemic levels and, in some cases, exceeded them in 2023 when the exceptionally high annual rates of new cases of scarlet fever, Streptococcus pneumoniae infections, HIV infections, syphilis, gonococcal infections, and tick‐borne encephalitis were noted. The rate of Clostridioides difficile enterocolitis was two‐fold higher than before the pandemic from 2021 onward. The rate of Legionnaires’ disease in 2023 also exceeded the prepandemic threshold, although this was due to a local outbreak unrelated to lifted COVID‐19 pandemic restrictions or migration of war refugees. The influx of war migrants from Ukraine could impact the epidemiology of sexually transmitted diseases. The present analysis indicates that continued efforts are needed to prevent COVID‐19 from overwhelming healthcare systems again and decreasing the control over the burden of other infectious diseases. It also identifies the potential tipping points that require additional mitigation measures, which are also discussed in the paper, to avoid escalation in the future.
Air pollution may affect the clinical course of respiratory diseases, including COVID‐19. This study aimed to evaluate the relationship between exposure of adult patients to mean 24 h levels of ...particulate matter sized <10 μm (PM10) and <2.5 μm (PM2.5) and benzo(a)pyrene (B(a)P) during a week before their hospitalization due to SARS‐CoV‐2 infection and symptomatology, hyperinflammation, coagulopathy, the clinical course of disease, and outcome. The analyses were conducted during two pandemic waves: (i) dominated by highly pathogenic Delta variant (n = 1440) and (ii) clinically less‐severe Omicron (n = 785), while the analyzed associations were adjusted for patient's age, BMI, gender, and comorbidities. The exposure to mean 24 h B(a)P exceeding the limits was associated with increased odds of fever and fatigue as early COVID‐19 symptoms, hyperinflammation due to serum C‐reactive protein >200 mg/L and interleukin‐6 >100 pg/mL, coagulopathy due to
d‐dimer >2 mg/L and fatal outcome. Elevated PM10 and PM2.5 levels were associated with higher odds of respiratory symptoms, procalcitonin >0.25 ng/mL and interleukin >100 pg/mL, lower oxygen saturation, need for oxygen support, and death. The significant relationships between exposure to air pollutants and the course and outcomes of COVID‐19 were observed during both pandemic waves. Short‐term exposure to elevated PM and B(a)P levels can be associated with a worse clinical course of COVID‐19 in patients requiring hospitalization and, ultimately, contribute to the health burden caused by SARS‐CoV‐2 variants of higher and lower clinical significance.
Early administration of oral antivirals in patients with mild-to-moderate COVID-19 was associated with a significantly lower risk of all-cause mortality (hazard ratio 0·48 95% CI 0·40–0·59, p<0·0001 ...for molnupiravir vs matched controls; 0·34 0·23–0·50, p<0·0001 for nirmatrelvir–ritonavir vs matched controls). Reduced risk of the composite outcome of disease progression (which consisted of all-cause mortality, initiation of invasive mechanical ventilation, admission to an intensive care unit, or the need for oxygen therapy) was also found in oral antiviral recipients compared with their respective control groups (0·60 0·52–0·69, p<0·0001 for molnupiravir; 0·57 0·45–0·72, p<0·0001 for nirmatrelvir–ritonavir). Another real-world study, from Poland, which also included inpatients from the omicron wave period, showed that molnupiravir administered in the first 5 days after symptom onset reduced the frequency of death among patients older than 80 years by more than half.6 Three more real-world analyses evaluating the use of nirmatrelvir–ritonavir during the omicron wave are also available.7–9 One study from the USA that included patients aged 50 years and older,7 one from Israel that analysed a subgroup of patients aged 65 years and older,8 and another from Israel that included patients with a mean age of 68·5 years,9 showed that early nirmatrelvir–ritonavir therapy was associated with reductions in the risks of hospitalisation or death, or both, in these groups of patients with COVID-19.
The cause of Ludwig van Beethoven's health deterioration, i.e., hearing loss and cirrhosis, have been subject to various studies. The genomic analysis of his hair indicates infection with the ...hepatitis B virus (HBV) at least 6 months prior to death. However, considering his first documented case of jaundice in the summer of 1821, second jaundice months prior to his death, and increased risk of hearing loss in HBV-infected patients, we offer an alternative hypothesis of chronic HBV infection as a cause of deafness and cirrhosis. According to it, HBV was acquired early, progressed from immune-tolerant to an immune-reactive phase, and triggered Beethoven's hearing issues when aged 28. Later, HBV infection entered the non-replication phase with at least two episodes of reactivation in the fifth decade of life accompanied by jaundice. More studies examining hearing loss in patients with chronic HBV infection are encouraged to better understand their potential otologic needs.
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•We hypothesize that Beethoven’s hearing loss was due to a chronic HBV infection.•Hearing loss is not classically attributed to hepatitis B.•HBV infection increases the odds of sudden sensorineural hearing loss.•Hearing loss in HBV patients should be communicated to hepatologists.•More studies addressing otologic issues in hepatitis B are needed.
According to the recent data presented by Central‐European HCV experts, the estimated prevalence of HCV is between 0.2% and 1.7% in certain countries in this region. There are no financial ...limitations to access to treatment in most countries. Patients in these countries have access to at least one pangenotypic regimen. The most common barriers to the elimination of HCV in Central Europe are a lack of established national screening programmes and limited political commitment to the elimination of HCV. Covid‐19 has significantly affected the number of patients who have been diagnosed and treated, thus, delaying the potential elimination of HCV. These data suggest that the elimination of HCV elimination projected by WHO before 2030 will not be possible in the Central Europe.
Eliminating hepatitis C virus (HCV) infection in the population of women of reproductive age is important not only for the health of women themselves but also for the health of newborns. This study ...aimed to evaluate the implementation of this goal by analysing the effectiveness of contemporary therapy in a large cohort from everyday clinical practice along with identifying factors reducing therapeutic success. The analysed population consisted of 7861 patients, including 3388 women aged 15-49, treated in 2015-2022 in 26 hepatology centres. Data were collected retrospectively using a nationwide EpiTer-2 database. Females were significantly less often infected with HCV genotype 3 compared to males (11.2% vs. 15.7%) and less frequently showed comorbidities (40.5% vs. 44.2%) and comedications (37.2% vs. 45.2%). Hepatocellular carcinoma, liver transplantation, HIV and HBV coinfections were reported significantly less frequently in women. Regardless of the treatment type, females significantly more often reached sustained virologic response (98.8%) compared to males (96.8%). Regardless of gender, genotype 3 and cirrhosis were independent factors increasing the risk of treatment failure. Women more commonly reported adverse events, but death occurred significantly more frequently in men (0.3% vs. 0.1%), usually related to underlying advanced liver disease. We have demonstrated excellent effectiveness and safety profiles for treating HCV infection in women. This gives hope for the micro-elimination of HCV infections in women, translating into a reduced risk of severe disease in both women and their children.
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