Until now, the treatment protocols for COVID‐19 have been revised multiple times. The use and approval of therapeutic monoclonal antibodies (mAbs) for COVID‐19 treatment represent exceptional ...achievements in modern science, technology and medicine. SARS‐CoV‐2 Omicron evasion of pre‐existing immunity represents a serious public health problem nowadays. This systematic review with meta‐analysis provided comprehensive and up‐to‐date evidence of the clinical efficacy of therapeutic anti‐SARS‐CoV‐2 mAbs against Omicron subvariants in COVID‐19 patients and included 10 articles. The prevalence of hospitalisation among Omicron‐positive patients treated with anti‐SARS‐CoV‐2 mAbs was 2.8% (89/3169) while it controls (Omicron‐positive patients treated with other therapies) 11% (154/1371). There was a statistically significantly different number of hospitalisations between the two studied groups in favour of the anti‐SARS‐CoV‐2 mAbs treated group. (OR = 0.56, 95% CI OR = 0.41–0.77, p < 0.001, respectively). Eight deaths (0.30%) out of 2619 Omicron‐positive patients occurred in the anti‐SARS‐CoV‐2 mAbs treated group, while in the control group (Omicron‐positive patients treated with other therapies), 27 patients died out of 1401 (1.93%). There was a significantly different number of deaths between the two studied groups in favour of Omicron‐positive patients treated with anti‐SARS‐CoV‐2 mAbs (OR = 0.38, 95% CI OR = 0.17–0.85, p = 0.020). Using sotrovimab in treating Omicron‐positive patients indicated a reduction of hospitalisation and mortality for 49% and 89% in favour of sotrovimab, respectively (OR = 0.51, 95% CI OR = 0.34–0.79, p = 0.002; OR = 0.11, 95% CI OR = 0.03–0.39, p = 0.001). We could only provide evidence of the positive impact in reducing hospitalisation and mortality rates when anti‐SARS‐CoV‐2 mAbs were used to treat patients infected with Omicron variants BA.1 or BA.2 and not on other Omicron variants.
Systemic lupus erythematosus (SLE) is characterized by an imbalance between proinflammatory and anti-inflammatory mediators. Single-nucleotide polymorphisms (SNPs) in genes coding IL10RA, IL10RB, and ...IL22RA could affect their expression or function and disrupt immune homeostasis. We aimed to analyze the associations of IL10RA, IL10RB, and IL22RA polymorphisms/haplotypes with patients’ susceptibility to and clinical manifestations of SLE. Our study included 103 SLE patients and 99 healthy controls. The genotypes of the selected polymorphisms within IL10RA (rs10892202, rs4252270, rs3135932, rs2228055, rs2229113, and rs9610), IL10RB (rs999788, rs2834167, and rs1058867), and IL22RA (rs3795299 and rs16829204) genes were determined by TaqMansup.® Assays. IL10RB rs1058867 G allele carriers were significantly more frequent among the controls than among the SLE patients (76.8% vs. 61.2%; p = 0.017, OR = 0.477, 95% CI: 0.258–0.879). The IL10RB CAA haplotype was more frequent among the SLE patients than in the control group (42.7% vs. 30.7%; p = 0.027). The IL22RA rs3795299 C allele and rs16829204 CC genotype were associated with Hashimoto thyroiditis in the SLE patients (n = 103; p = 0.002 and p = 0.026, respectively), and in all the included participants (n = 202, p < 0.000 and p = 0.007, respectively), and the IL22RA CC haplotype was more frequent in the SLE patients with Hashimoto thyroiditis (p = 0.047) and in the overall participants with Hashimoto thyroiditis (n = 32, p = 0.004). The IL10RA, IL10RB, and IL22RA polymorphisms/haplotypes could be associated with SLE susceptibility and various clinical manifestations, and the IL22RA CC haplotype could be associated with Hashimoto thyroiditis.
After the Serbian community hospitals had reached their full capacity during the pandemic, new institutions were enrolled into the coronavirus disease 2019 (COVID-19) system as temporary COVID ...hospitals (TCH). These hospitals usually had no intensive care units (ICU) and no possibility to treat severely ill patients. The aim of this study was to identify risk factors at the time of triage that could help identify patients that will require ICU treatment and cannot be treated in a TCH.
In this retrospective study, a total of 158 patients with COVID-19 infection were enrolled. The demographic information, underlying comorbidities, laboratory findings, chest X-rays, computed tomography scans, and clinical outcomes were obtained from medical records. Deterioration of a patient's condition was regarded as a need for further transfer to ICU.
During the hospitalization 15.2% of patients required transfer to ICU. Patients with deterioration were significantly older and there was no difference between genders. We observed a higher prevalence of hypertension, other cardiovascular diseases, lower lymphocyte and platelet counts, and higher IL-6 and troponin T in patients with deterioration. The multivariate logistical regression model showed that only age was an independent risk factor for deterioration and with each year of age, the risk for poor outcome increased by 8%.
Patients with cardiovascular risk factors, low lymphocyte and platelet counts, high IL-6 and troponin T and, especially, increased age should not be treated in a TCH because of the high possibility for deterioration and need for transfer to an ICU.
Abstract
Objectives
Epstein–Barr virus (EBV) has been associated with several types of cancers, most often with nasopharyngeal carcinomas and hematological malignancies. It is also suggested that EBV ...has significant role in the pathogenesis of different types of autoimmune diseases including systemic lupus erythematosus (SEL). The exact mechanisms behind these processes are not elucidated.
Case presentation
We present a case of a 52-years old female patients with moderately active SLE presenting with severe fatigue, purpuric lesions, alopecia, polyarthritis, mucosal ulcerations, and progressive thrombocytopenia over a period of 10 months. During the work-up, the patient was evaluated for several viral infections. Serology testing showed elevation of anti-EBV, anti-CMV and anti-HSV1/2 IgM antibodies with the presence of IgG antibodies against all mentioned viruses except HSV2. Corticosteroid therapy was escalated, and azathioprine was introduced. Due to the persistence of significant thrombocytopenia and monoclonal IgG sternal puncture was performed. Morphological and immunohistochemical analysis of bone marrow specimen presented infiltration with metastatic deposits of adenocarcinoma and monoclonal plasmacytosis. Esophagogastroduodenoscopy showed multiple prepyloric erosions of gastric mucosa, which were biopsied. Pathohistological analysis demonstrated infiltration of gastric mucosa with diffuse type adenocarcinoma. Further PCR testing of biopsied gastric adenocarcinoma revealed the presence of EBV DNA in carcinoma tissue. The patient was sent to the oncologist for further evaluation.
Conclusions
Assessment of SLE patients with persistently active disease should include the analysis of the herpesvirus infection status. Reactivations of EBV may be considered as possible trigger for lupus flares and the factor for increased risk of developing malignancies.
In immunocompromised individuals, especially in patients with T cell immunodeficiency, reactivation of JCPyV can cause serious life-threatening diseases. Nowadays, HIV infection is one of the most ...important factor for reactivation of JCPyV and the development of of the progressive multifocal leukoencephalopathy (PML). Mutations in the outer loops of the VP1 region can lead to the selection of the viral variants with changed tropism and increased pathological potential. The aims of this study were to determine sequence variation and amino acid changes within VP1 loops and the structure of non-coding control region (NCCR) of urinary excreted JCPyV isolates among HIV-infected patients and healthy donors. Single urine samples from 114 HIV-infected patients and 120 healthy donors were collected. PCR was performed for amplification of VP1 and NCCR. Amplified fragments were directly sequenced and analyzed by using bioinformatics tools. Nucleotide substitutions were detected within DE and EF loops and in the β-sheets of both studied groups. In HIV-infected patients group, 70% of mutations were detected within receptor domains. Among healthy donors, one mutation was identified within β-sheets while the remaining were located within receptor domains. The most prevalent mutation was L157V in both groups. Analysis of NCCR revealed that all isolates had archetype structure with some minor changes. Since single point mutations at specific place within outer loop of VP1 region can cause formation of variants with changed receptor specificity, identification of these mutations in HIV-infected patients can help to single out those with higher risk for development of polyomavirus-associated diseases.
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