Emergence of transmissible SARS-CoV-2 variants with decreased sensitivity to antivirals in immunocompromised patients with persistent infections

Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)

Published: Sept. 18, 2024

Language: Английский

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Efficacy, immunogenicity, and safety of the Novavax COVID-19 vaccine in immunocompromised patients: A targeted literature review

Vaccine, Journal Year: 2025, Volume and Issue: 49, P. 126777 - 126777

Published: Jan. 31, 2025

Language: Английский

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How Immunocompromised Hosts Were Left Behind in the Quest to Control the Covid-19 Pandemic

Clinical Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown

Published: June 3, 2024

The immunocompromised population was disproportionately affected by the SARS-CoV-2 pandemic. However, these individuals were largely excluded from clinical trials of vaccines, monoclonal antibodies, and small molecule antivirals. While community scientists, researchers, funding agencies have proven that therapeutics can be made tested in record time, extending this progress to vulnerable medically complex start has been a missed opportunity. Here we advocate it is paramount plan for future pandemics investing specific trial infrastructure prepared when need arises.

Language: Английский

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Early initiation of combined therapy in severely immunocompromised patients with COVID-19: a retrospective cohort study

BMC Infectious Diseases, Journal Year: 2024, Volume and Issue: 24(1)

Published: June 6, 2024

Abstract This single-centre retrospective cohort study reports on the results of a descriptive (non-comparative) early initiation antivirals and combined monoclonal antibody therapy (mAbs) in 48 severely immunocompromised patients with COVID-19. The assessed outcomes duration viral shedding. started (ECT) median 2 days (interquartile range [IQR]: 1–3 days) after diagnosis SARS-CoV-2 infection. Except for 1 patient who died due COVID-19-related respiratory failure, had their first negative nasopharyngeal swab result 11 (IQR: 6–17 starting therapy. There were no severe side effects. During follow-up period 512 413–575 days), 6 (12.5%) 16 (33.3%) admitted to hospital. Moreover, 12 (25%) diagnosed reinfection 245 138–401 treatment. No relapses reported. Although there was comparison group, these compare favourably COVID-19 reported literature.

Language: Английский

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Characteristics and outcomes of COVID-19 patients presumed to be treated with sotrovimab in NHS hospitals in England

BMC Infectious Diseases, Journal Year: 2024, Volume and Issue: 24(1)

Published: April 22, 2024

Abstract Background The impact of the constantly evolving severe acute respiratory syndrome coronavirus 2 on effectiveness early disease 2019 (COVID-19) treatments is unclear. Here, we report characteristics and clinical outcomes patients with COVID-19 treated a monoclonal antibody (mAb; presumed to be sotrovimab) across six distinct periods covering emergence predominance Omicron subvariants (BA.1, BA.2, BA.5) in England. Methods Retrospective cohort study using data from Hospital Episode Statistics database January 1–July 31, 2022. Included received mAb delivered by National Health Service (NHS) hospital as day-case, for which primary diagnosis was COVID-19. Patients were have sotrovimab based NHS showing that 99.98% COVID-19-mAb-treated individuals during period. COVID-19-attributable hospitalizations reported overall subvariant prevalence. Subgroup analyses conducted renal active cancer. Results Among total 10,096 patients, 1.0% ( n = 96) had hospitalization, 4.6% 465) visit due any cause, 0.3% 27) died cause hospitalization rates consistent among subgroups, no significant differences observed predominance. Conclusions Levels deaths low mAb-treated subgroups. Similar whilst BA.1, BA.5 predominant, despite reductions vitro neutralization activity against BA.2 BA.5.

Language: Английский

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Does early combination vs. Monotherapy improve clinical outcomes of clinically extremely vulnerable patients with COVID-19? Results from a retrospective propensity-weighted analysis

European journal of medical research, Journal Year: 2024, Volume and Issue: 29(1)

Published: Oct. 4, 2024

Language: Английский

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Update on Early Combination Therapy with Lastest Monoclonal Antibodies and Antivirals as HIV, HCV, Influenza in Extremely Vulnerable Persons with Sars-Cov-2: A Literature Review and Clinical Experience

Journal of Clinical Medical Research, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 28

Published: Jan. 31, 2025

The emergence of new variants concern in immunocompromised persons with SARS-CoV-2, particularly those mutations the spike protein, has complicated treatment strategies. Some Therapies focused only on viral clearance effects and not major clinical outcomes. As virus continues to evolve, development broad-spectrum therapies, along personalized approaches treatment, will be crucial managing COVID-19 . After first year period which several treatments were employed early intervention strategies, including use antiretrovirals monoclonal antibodies, have emerged as promising mitigate severity fragile individuals prevent disease progression, hospitalization death even recent time less aggressive SARS-CoV-2 variants. Guidelines, high-quality data for combination exploiting antivirals neutralizing antibodies do exist outpatient setting, especially severe individuals. Nevertheless, studies attempted investigate efect this approach although these are often observational without control groups, generally no adverse reactions from therapy been reported. potential efficacy therapy, based an antiviral plus a antibody, severely patients is matter literature debate scientific word. To date, information concerning using combined therapies limited. In Literature Review we explain Last variant updates vulnerable Sars-Cov-2.

Language: Английский

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Effectiveness of early intervention and combination treatment with monoclonal antibodies and antivirals in oncohematological patients with SARS-CoV-2: a retrospective experience

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: March 28, 2025

Patients with acute SARS-CoV-2 and pre-existing oncohematological conditions challenge clinicians due to a heightened risk for severe COVID-19 forced deferral of cancer treatment. Different treatment approaches aim either prevent the progression mild disease ("early therapy") or treat more COVID-19. Currently, there is limited evidence supporting effectiveness tailored approach patients. We present real-world experience from two university hospitals. In this retrospective study we recruited patients hospitalized pneumonia between March 2020 June 2023 hospitals in Latium, Italy. received antiviral monoclonal antibodies (MoAb) alone, dual therapy (antiviral MoAb) triple (two different antivirals MoAb). The aimed evaluate practical management focused on impact related specific therapies, early treatment, tixagevimab-cilgavimab prophylaxis in-hospital mortality viral clearance time. Overall, 101 were recruited, 76 (75.24%) developed pneumonia, 16 (15.84%) died any cause. While most (75,25%) did not receive "early therapy", those who had higher chance survival (p=0.04). Furthermore, subgroup treated demonstrated rate as well (p=0.02). Out resulted lower (all survive group). This group also showed significant reduction time first day evaluated (6 days [IQR 4;9]), compared only remdesivir (17 8;37]) (p=0.03). Our findings demonstrate that significantly reduces mortality, while accelerates These results, line recent studies, underscore critical importance prompt multitargeted pharmacological optimizing outcomes SARS-CoV-2. Future research, involving larger cohorts, should delve deeper into strategies vulnerable population, particular emphasis elderly, continue high rates.

Language: Английский

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Predicting persistent SARS-CoV-2 shedding in immunocompromised patients: a probability-based approach

Infectious Diseases, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 10

Published: Jan. 3, 2025

Background Although recommended isolation periods for Coronavirus disease 2019 (COVID-19) have been shortened as the pandemic has subsided, prolonged Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) shedding remains common in immunocompromised patients. This study estimated probability of viral clearance these patients based on elapsed days and specific risk factors.

Language: Английский

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Efficacy and safety of antiviral therapies for the treatment of persistent COVID-19 in immunocompromised patients since the Omicron surge: a systematic review

Journal of Antimicrobial Chemotherapy, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 13, 2025

Abstract Background Persistent COVID-19 (pCOVID-19) in immunocompromised patients is characterized by unspecific symptoms and pulmonary infiltrates due to ongoing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) replication. Treatment options remain unclear, leading different approaches, including combination therapy extended durations. The purpose of this study was assess the efficacy safety antiviral therapies for pCOVID-19 since Omicron surge. Methods We searched MEDLINE Scopus from 1 January 2022 6 August 2024 cohort studies case series on nirmatrelvir/ritonavir, remdesivir, ensitrelvir molnupiravir. Evidence certainty rated using Grading Recommendations Assessment, Development, Evaluation outcomes viral clearance, recurrence/relapse, mortality, adverse events (AEs) symptom resolution. Results Thirteen involving 127 cases were included. very low. In with at least two direct agents, clearance 79%, a 16% recurrence rate. All-cause mortality 9%, 6% while SARS-CoV-2 positive. 47 cases, AEs reported 11%. Symptom resolution ranged 3 days studies. one agent passive immunization, 89%, an 11% rate no deaths. four documented observed. monotherapy, 100%, 15% One death, unrelated SARS-CoV-2, occurred. 12 Conclusions Based low evidence, combining immunization resulted high rates few recurrences. occurred treated antivirals. Controlled are needed.

Language: Английский

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