Data-driven identification of post-acute SARS-CoV-2 infection subphenotypes

Nature Medicine, Journal Year: 2022, Volume and Issue: 29(1), P. 226 - 235

Published: Dec. 1, 2022

Abstract The post-acute sequelae of SARS-CoV-2 infection (PASC) refers to a broad spectrum symptoms and signs that are persistent, exacerbated or newly incident in the period after acute infection. Most studies have examined these conditions individually without providing evidence on co-occurring conditions. In this study, we leveraged electronic health record data two large cohorts, INSIGHT OneFlorida+, from national Patient-Centered Clinical Research Network. We created development cohort validation OneFlorida+ including 20,881 13,724 patients, respectively, who were infected, investigated their diagnoses 30–180 days documented Through machine learning analysis over 137 conditions, identified four reproducible PASC subphenotypes, dominated by cardiac renal (including 33.75% 25.43% patients cohorts); respiratory, sleep anxiety (32.75% 38.48%); musculoskeletal nervous system (23.37% 23.35%); digestive respiratory (10.14% 12.74%) sequelae. These subphenotypes associated with distinct patient demographics, underlying before phase severity. Our study provides insights into heterogeneity may inform stratified decision-making management

Language: Английский

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Immunology of SARS-CoV-2 infection in children

Nature Immunology, Journal Year: 2022, Volume and Issue: 23(2), P. 177 - 185

Published: Feb. 1, 2022

Language: Английский

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Biological age is increased by stress and restored upon recovery

Cell Metabolism, Journal Year: 2023, Volume and Issue: 35(5), P. 807 - 820.e5

Published: April 21, 2023

Language: Английский

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Hyperinflammatory Immune Response and COVID-19: A Double Edged Sword

Frontiers in Immunology, Journal Year: 2021, Volume and Issue: 12

Published: Sept. 30, 2021

The coronavirus disease-19 (COVID-19) elicited by the severe acute respiratory syndrome 2 (SARS-CoV-2) has caused devastating health, economic and social impact worldwide. Its clinical spectrum ranges from asymptomatic to failure multi-organ or death. pathogenesis of SARS-CoV-2 infection is attributed a complex interplay between virus host immune response. It involves activation multiple inflammatory pathways leading hyperinflammation cytokine storm, resulting in tissue damage, distress (ARDS) failure. Accumulating evidence raised concern over long-term health effects COVID-19. Importantly, neuroinvasive potential may have consequences brain. This review provides conceptual framework on how tricks system induce cause disease. We also explore key differences mild COVID-19 its short- effects, particularly human

Language: Английский

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Fungal and bacterial coinfections increase mortality of severely ill COVID-19 patients

Journal of Hospital Infection, Journal Year: 2021, Volume and Issue: 113, P. 145 - 154

Published: April 21, 2021

SARS-CoV-2 predisposes patients to secondary infections; however, a better understanding of the impact coinfections on outcome hospitalized COVID-19 is still necessary.To analyse death risk due in patients.The odds 212 severely ill were evaluated, with detailed focus risks for each pathogen, site infection, comorbidities and length hospitalization.The mortality rate was 50.47%. Fungal and/or bacterial isolation occurred 89 patients, whom 83.14% died. Coinfected stayed longer had an increased dying (odds ratio (OR): 13.45; R2 = 0.31). The by (OR: 11.28) fungal 5.97) coinfections, levels creatinine, leucocytes, urea C-reactive protein. Coinfections if suffered from cardiovascular disease 11.53), diabetes 6.00) or obesity 5.60) comparison these but without pathogen isolation. detected coagulase-negative Staphylococcus 25.39), Candida non-albicans 11.12), S. aureus 10.72), Acinetobacter spp. 6.88), Pseudomonas 4.77), C. albicans 3.97). high-risk sites infection blood, tracheal aspirate, urine. Patients coinfection undergoing invasive mechanical ventilation 3.8 times more likely die than those positive cultures.Severe required hospitalization higher death. early diagnosis essential identify determine right interventions reduce mortality.

Language: Английский

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Antibody Responses in COVID-19: A Review

Frontiers in Immunology, Journal Year: 2021, Volume and Issue: 12

Published: April 15, 2021

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide as a pandemic. Although its seroprevalence is highly variable among territories, it has been reported at around 10%, but higher in health workers. Evidence regarding cross-neutralizing response between SARS-CoV and SARS-CoV-2 still controversial. However, other previous coronaviruses may interfere with infection, since they are phylogenetically related share the same target receptor. Further, seroconversion of IgM IgG occurs 12 days post onset symptoms most patients have neutralizing titers on 14-20, great titer variability. Neutralizing antibodies correlate positively age, male sex, severity disease. Moreover, use convalescent plasma shown controversial results terms safety efficacy, due immune individuals, measuring antibody before transfusion mostly required. Similarly, cellular immunity seems be crucial resolution SARS-CoV-2-specific CD4+ CD8+ T cells circulate some extent recovered patients. Of note, duration not well established yet.

Language: Английский

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Telmisartan for treatment of Covid-19 patients: An open multicenter randomized clinical trial

EClinicalMedicine, Journal Year: 2021, Volume and Issue: 37, P. 100962 - 100962

Published: June 18, 2021

Angiotensin receptor blockers (ARBs), such as telmisartan, have been postulated to treat Covid-19-induced lung inflammation.

Language: Английский

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Willingness, refusal and influential factors of parents to vaccinate their children against the COVID-19: A systematic review and meta-analysis

Preventive Medicine, Journal Year: 2022, Volume and Issue: 157, P. 106994 - 106994

Published: Feb. 18, 2022

Language: Английский

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Sex Differences in Immunity

Annual Review of Immunology, Journal Year: 2022, Volume and Issue: 40(1), P. 75 - 94

Published: Jan. 5, 2022

Strong epidemiological evidence now exists that sex is an important biologic variable in immunity. Recent studies, for example, have revealed differences are associated with the severity of symptoms and mortality due to coronavirus disease 2019 (COVID-19). Despite this evidence, much remains be learned about mechanisms underlying associations between immune-mediated conditions. A growing body experimental data has made significant inroads into understanding sex-influenced immune responses. As physicians seek provide more targeted patient care, it critical understand how sex-defining factors (e.g., chromosomes, gonadal hormones) alter responses health disease. In review, we highlight recent insights autoimmunity; virus infection, specifically severe acute respiratory syndrome 2 (SARS-CoV-2) infection; cancer immunotherapy. deeper will allow development a sex-based approach screening treatment.

Language: Английский

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First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality

The Lancet Regional Health - Americas, Journal Year: 2021, Volume and Issue: 6, P. 100107 - 100107

Published: Nov. 1, 2021

Background The second wave of the COVID-19 pandemic was more aggressive in Brazil compared to other countries around globe. Considering Brazilian peculiarities, we analyze in-hospital mortality concerning socio-epidemiological characteristics patients and health system all states during first waves COVID-19.We performed a cross-sectional study hospitalized with positive RT-PCR for SARS-CoV-2 Brazil. Data obtained from Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) comprised period February 25, 2020, April 30, 2021, separated two on November 5, 2020. We descriptive analyzing socio-demographic characteristics, symptoms, comorbidities, risk factors stratified by age. In addition, analyzed intensive care unit (ICU) both how it varies each state.Between 2020 678 235 were admitted SARS-CoV-2, 325 903 352 332 wave, respectively. mean age 59 · 65 (IQR 48 0 - 72 0). total, 379 817 (56 00%) had factor or comorbidity. In-hospital increased 34 81% 39 30% wave. there ICU admissions, use non-invasive invasive ventilation, younger groups. southern southeastern regions highest hospitalization rates per 100 000 inhabitants. However, rate higher northern northeastern country. Racial differences observed clinical outcomes, White being most prevalent population, but Blacks/Browns (Pardos) having rates. Younger groups considerable as without comorbidities waves.We burden hospital throughout Furthermore, north northeast Brazil, which present lower Human Development Indexes, concentrated worst are also shown among vulnerable social Finally, believe that results can help understand behavior helping define public policies, allocate resources, improve strategies vaccination priority groups.Coordinating Agency Advanced Training Graduate Personnel (CAPES) (C.F. 001), National Council Scientific Technological (CNPq) (No. 309537/2020-7).

Language: Английский

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