Decoding the historical tale: COVID-19 impact on haematological malignancy patients—EPICOVIDEHA insights from 2020 to 2022

EClinicalMedicine, Journal Year: 2024, Volume and Issue: 71, P. 102553 - 102553

Published: March 18, 2024

BackgroundThe COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, monoclonal antibodies have been effective the general population, their benefits these patients may not be as pronounced.MethodsThe EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers data from malignancy since pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over first three years (2020–2022).FindingsThe collected January 2020 December 2022, involving 8767 cases in 152 centers across 41 countries, 42% being female. Over this period, there was a significant reduction critical infections an overall decrease mortality 29% 4%. However, hospitalization, particularly ICU, remained associated higher rates. Factors contributing included age, multiple comorbidities, active at onset, pulmonary symptoms, hospitalization. On positive side, vaccination one two doses or doses, well encountering were improved survival.InterpretationPatients still face elevated risks, despite reductions rates time. Hospitalization, especially ICUs, remains concern. The study underscores importance of timing exposure 2022 enhanced survival patient group. Ongoing monitoring are essential support vulnerable emphasizing role timely diagnosis prompt treatment preventing cases.FundingNot applicable.

Language: Английский

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Eosinophils and COVID‐19: Insights into immune complexity and vaccine safety

Clinical and Translational Allergy, Journal Year: 2025, Volume and Issue: 15(3)

Published: March 1, 2025

Abstract Background COVID‐19 exhibits a variety of symptoms and may lead to multi‐organ failure death. This clinical complexity is exacerbated by significant immune dysregulation affecting nearly all cells the innate adaptive system. Granulocytes, including eosinophils, are affected SARS‐CoV‐2. Objectives Eosinophil responses remain poorly understood despite early recognition eosinopenia as hallmark feature severity. Results The heterogeneous nature eosinophil categorizes them dual‐function with contradictory effects. activation can suppress virus‐induced inflammation releasing type 2 cytokines like IL‐13 granular proteins antiviral action such eosinophil‐derived neurotoxins cationic protein, also acting antigen‐presenting cells. In contrast, accumulation in lungs induce tissue damage triggered or hormones IFN‐γ leptin. Additionally, they affect functions interacting T through direct formation membrane complexes soluble mediator action. Individuals allergic disorders who have elevated levels eosinophils tissues blood, asthma, do not appear be at an increased risk developing severe following SARS‐CoV‐2 infection. However, vaccine appears associated complications eosinophilic infiltrate‐induced immunopathogenicity, which mitigated corticosteroid, anti‐histamines anti‐IL‐5 therapy avoided modifying adjuvants excipients. Conclusion review highlights importance contributes better understanding their role during natural infection vaccination.

Language: Английский

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The mode and timing of administrating nutritional treatment of critically ill elderly patients in intensive care units: a multicenter prospective study

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: Feb. 7, 2024

Introduction Critically ill patients are more susceptible to malnutrition due their severe illness. Moreover, elderly who critically lack specific nutrition recommendations, with nutritional care in the intensive units (ICUs) deplorable for elderly. This study aims investigate treatment and its correlation mortality units. Method A multiple-center prospective cohort was conducted China from 128 (ICUs). total of 1,238 were included 26 April 2017. We analyzed characteristics ill, including initiated timing, route, ways enteral (EN), feeding complications, adverse aspects feeding, acute gastrointestinal injury (AGI), interruption. Multivariate logistic regression analysis used screen out impact on a 28-day survival prognosis ICU. Result median age 76 (IQR 70–83) enrolled study. The Sequential Organ Failure (SOFA) score 7 (interquartile range: IQR 5–10) Acute Physiology Chronic Health Evaluation (APACHE) II 21 16–25). all-cause 11.6%. percentage 24 h after ICU admission 58%, an EN 34.2% parenteral (PN) 16.0% ill. Patients had dysfunction AGI stage 2 4 25.2%. Compared survivors’ group, non-survivors group lower ratio delivery (57% vs. 71%; p = 0.015), higher post-pyloric (9% 2%; 0.027), frequency interrupt (24% 17%, 0.048). Multivariable logistics showed that above years old OR (odds ratio) 2.576 (95% CI, 1.127–5.889), respiratory rate > 22 beats/min, independent risk predictors Similarly, other those 2.385 (95%CI, 1.101–5.168), lactate >1.5 mmol/L, h, 7.004 2.395–20.717) early PN within admission, finally 5.401 1.175–24.821) as reference. Conclusion multi-center describes clinical characteristics, mode timing treatment, AGI, effects patients. According this survey, delivery, older age, faster rate, level may experience poor prognosis.

Language: Английский

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Changes in mortality associated with different hematologic malignancies during the pandemic in the United States

International Journal of Cancer, Journal Year: 2024, Volume and Issue: 154(10), P. 1703 - 1708

Published: Feb. 9, 2024

Patients with hematologic malignancies are at increased risk of adverse COVID-19 outcomes; nonetheless, only sparse population-based data available on mortality related to cancers during the pandemic. Number deaths and age-standardized rates for specific selected either as underlying cause death (UCOD), or mentioned in certificates (multiple causes death-MCOD) were extracted from US National Center Health Statistics, CDC WONDER Online Database. Joinpoint analysis was applied identify changes trends 1999 2021, estimate annual percent change 95% Confidence Intervals (CI) across time segments. Among most common malignancies, chronic lymphocytic leukemia showed marked peaks monthly number attributed epidemic waves; acute myeloid least variation, non-Hodgkin lymphoma multiple myeloma characterized by an intermediate pattern. Age-standardized relying solely UCOD did not show significant variations pandemic years. By contrast, based MCOD 14.0% (CI, 10.2-17.9%) per year leukemia, 5.1% 3.1-7.2%) 3.2% 0.3-6.1%) myeloma. Surveillance is warranted accurately measure impact other epidemics, including seasonal flu, patients assess effects vaccination campaigns preventive measures.

Language: Английский

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Interplay of inflammatory markers and anti-SARS-CoV-2 antibodies in COVID-19 mortality: A prospective cohort study

International Journal of Infectious Diseases, Journal Year: 2024, Volume and Issue: 143, P. 107016 - 107016

Published: March 22, 2024

Despite high global vaccination coverage, it remains unclear how and anti-SARS-CoV-2 antibodies affect immune responses inflammation levels in patients with COVID-19. It is further whether the inflammatory response differs depending on antibody combination of COVID-19 affects mortality rates.

Language: Английский

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Risk of SARS-CoV-2 infection and severe COVID-19 in hematological patients who received or not pre-exposure prophylaxis with tixagevimab/cilgavimab: a target trial emulation

Leukemia & lymphoma/Leukemia and lymphoma, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 8

Published: June 4, 2024

We emulated a hypothetical target trial in which hematological subjects cared at the University Hospital of Pisa (Italy) received or not SARS-CoV-2 prophylaxis with tixagevimab/cilgavimab. Subjects who (cases) were compared to those did (controls). The main outcome was infection subsequent 6 months. Inverse probability weighting (IPW) used adjust for confounders. A multivariable analysis performed identify variables associated infection. recruited 462 patients: 228 prophylaxis, 234 controls. COVID-19 lower cases controls (16.7% vs 24.8%, p = 0.03, after IPW 14.3% 24.6%, 0.01). On analysis, B-cell depleting therapies (HR 2.09, 95%CI 1.05-4.18, 0.037) increased risk COVID-19, while tixagevimab/cilgavimab 0.45, 0.27-0.73, 0.001) and previous 0.27, 0.14-0.51, < protective. In conclusion, monoclonal antibodies may reduce patients.

Language: Английский

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Respiratory Viruses in Patients With Hematological Malignancy in Boreal Autumn/Winter 2023–2024: EPICOVIDEHA‐EPIFLUEHA Report

American Journal of Hematology, Journal Year: 2024, Volume and Issue: 100(3), P. 358 - 374

Published: Dec. 23, 2024

Community-acquired respiratory viral infections (CARV) significantly impact patients with hematological malignancies (HM), leading to high morbidity and mortality. However, large-scale, real-world data on CARV in these is limited. This study analyzed from the EPICOVIDEHA-EPIFLUEHA registry, focusing HM diagnosed during 2023-2024 autumn-winter season. The assessed epidemiology, clinical characteristics, risk factors, outcomes. examined 1312 Of these, 59.5% required hospitalization, 13.5% needing ICU admission. overall mortality rate was 10.6%, varying by virus: parainfluenza (21.3%), influenza (8.8%), metapneumovirus (7.1%), RSV (5.9%), or SARS-CoV-2 (5.0%). Poor outcomes were associated smoking history, severe lymphopenia, secondary bacterial infections, highlights poses HM, especially those undergoing active treatment. rates of hospitalization stress need for better prevention, early diagnosis, targeted therapies. Given certain viruses like parainfluenza, tailored strategies are crucial improving patient future seasons.

Language: Английский

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Anti-SARS-CoV-2 Antibodies versus Vaccination Status in CAD Patients with COVID-19: A Prospective, Propensity Score-Matched Cohort Study

Vaccines, Journal Year: 2024, Volume and Issue: 12(8), P. 855 - 855

Published: July 30, 2024

Despite the currently prevailing, milder Omicron variant, coronary artery disease (CAD) patients constitute a major risk group in COVID-19, exhibiting 2.6 times mortality of non-CAD and representing over 22% non-survivors. No data are available on efficacy antibody levels CAD patients, nor relevance vaccination status versus for predicting severe courses COVID-19 mortality. Nor there definitive indicators to assess if individual sufficiently protected from adverse outcomes or determine necessity booster vaccinations.

Language: Английский

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An overview of SARS-CoV-2 viral proteins with relevance to improved diagnostic and therapeutic platforms

Frontiers in Virology, Journal Year: 2024, Volume and Issue: 4

Published: Oct. 3, 2024

In the past 25 years, world has witnessed outbreaks of illnesses in humans from three different coronaviruses. Both SARS-CoV outbreak 2003 and MERS-CoV 2013 resulted overall low fatalities part due to inefficient human-to-human spread each virus. contrast, SARS-CoV-2, which emerged 2019, was highly efficient at caused a global pandemic resulting millions casualties. Zoonotic transmission viruses, including coronaviruses, poses an ongoing threat that cannot be ignored. this review, we have focused on diagnostics therapeutics fronts using SARS-CoV-2 as model. Specifically, selected proteins associated with virus particles targets discussed various platform technologies. These insights hold potential inform development more effective vaccines not only for but also future viral pandemics, thus contributing health broader scale.

Language: Английский

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Progressive Cachexia: Tuberculosis, Cancer, or Thyrotoxicosis? Disease-Directed Therapy and Atypical Courses of Autoimmune and Malignant Thyroid Diseases in a High Specialization Era. Case-Control Study with a Critical Literature Review

Biomedicines, Journal Year: 2024, Volume and Issue: 12(12), P. 2722 - 2722

Published: Nov. 28, 2024

Background. Critical and progressive cachexia may be observed in numerous medical disciplines, but patients with various diseases, several pathways overlap (endocrine, inflammatory kidney heart failure, cancer). Methods. Unlike cohort studies that examine thyroid cancer risk factors, a different method was used to avoid bias analyze the sequence of events, i.e., pathway. A case-control analysis is presented on initial immune-mediated thyroiditis complicated by cachexia, presenting pulmonary pathology coexisting opportunistic infection, ultimately diagnosed (TC—thyroid cancer, misdiagnosed as lung Results. Contrary other were not active smokers exclusively women who developed existing autoimmune processes first phase. Furthermore, coexistence short overall survival without progression most seriously ill patients, well correlation sex (contrary history smoking) predisposition mycobacterial disease, are very suggestive. Although we describe three conditions (de Quervain’s, Graves’, atrophic thyroiditis), disturbances calcium metabolic homeostasis, under influence hormonal changes, crucial factors prognosis. Conclusions. The unique sheds light disease subclinical paraneoplastic process modified therapeutic regimens. However, it also associated systemic consequences, atypical sequelae, which require holistic approach. differential diagnosis severe adenocarcinoma localization, tuberculosis reactivation requires an immunological genetic backgrounds. highly specialized teams (e.g., units), immunotherapy general medicine aging populations multidisciplinary, holistic, inquiring lack differentiation, confusing biases, discrepancies literature main obstacles statistical research, limiting findings correlations common only. Time-lapse case such this one among build evidence pathway association between endocrine imbalances cachexia.

Language: Английский

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