Postacute Sequelae of COVID (PASC or Long COVID): An Evidenced-Based Approach

Open Forum Infectious Diseases, Journal Year: 2024, Volume and Issue: 11(9)

Published: Aug. 27, 2024

Abstract While the acute manifestations of infectious diseases are well known, in some individuals, symptoms can either persist or appear after period. Postviral fatigue syndromes recognized with other viral infections and described coronavirus disease 2019 (COVID-19). We have a growing number individuals that for weeks, months, years. Here, we share evidence regarding abnormalities associated postacute sequelae COVID-19 (PASC) therapeutics. describe physiological biochemical seen reporting PASC. several evidence-based interventions to offer patients. It is expected this understanding mechanisms driving PASC benefits certain therapeutics may not only lead better outcomes those but also potential treating postinfectious sequelae.

Language: Английский

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Interleukin-23 versus Interleukin-17 Inhibitors in Preventing Incidental Psoriatic Arthritis in Patients with Psoriasis: A Real-World Comparison From the TriNetX US Collaborative Network

BioDrugs, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 29, 2025

Psoriatic arthritis (PsA) is a common comorbidity in patients with psoriasis (PsO) that leads to significant disease burden. Biologic therapies targeting the interleukin (IL)-23/IL-17 axis have been widely used for PsO, but their comparative effectiveness preventing PsA remains unclear. The study objective was compare occurrence of developing incidental among PsO treated interleukin-23 inhibitors (IL23is) or interleukin-17 (IL17is). A retrospective cohort conducted using real-world data from TriNetX US Collaborative Network, including 53 healthcare organizations. Adult IL23is IL17is between January 2019 and June 2022 were identified. Cox regression analysis assess risk incidence, hazard ratios (HRs) 95% confidence intervals (CIs) reported. Subgroup analyses performed based on age, sex, ethnicity. Sensitivity included comparisons tumor necrosis factor (TNF) (TNFis) ensure robustness. total 4,580 study, 2,273 receiving 2,307 IL17is. Treatment associated significantly lower incidence compared (HR = 0.60, CI 0.44–0.82, P 0.001). This reduction particularly notable 41- 65-year age group 0.42, 0.27–0.64, < 0.001) females 0.57, 0.38–0.86, 0.007). ethnicity revealed varying outcomes, White showing 0.55, 0.38–0.79, no observed Black African American 1.37, 0.37–5.13, 0.637). comparing TNFis confirmed robustness findings. are patients, specific ethnic groups. These findings suggest may be more suitable at high could inform potential updates treatment guidelines. Further research should focus refining therapeutic strategies by incorporating patient-specific factors such as comorbidities, ethnicity, genetic predispositions, which optimize biologic selection enhance prevention efforts clinical practice.

Language: Английский

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Psoriasis increases the risk of Sjögren’s syndrome: evidence from a propensity score-matched cohort study and transcriptomic analysis

BMC Medicine, Journal Year: 2025, Volume and Issue: 23(1)

Published: Jan. 21, 2025

Despite the well-documented immune dysregulation in both psoriasis and Sjögren's syndrome (SS), specific link between these two autoimmune diseases has not been extensively explored. The present study aims to investigate impact of on risk SS. A retrospective cohort using TriNetX data compared SS development patients with controls propensity score matching, Kaplan–Meier curves, Cox models. Transcriptome were analyzed identify shared differentially expressed genes pathways diseases. total 293,905 an equal number individuals without included. After baseline characteristics groups balanced. During follow-up period, 3339 1937 developed curves indicated a significantly higher developing group non-psoriasis group. Upon adjustment for multiple confounding factors, was 50% than (hazard ratio [HR] 1.50, 95% confidence interval [CI] 1.42–1.58). Subgroup analyses confirmed elevated associated psoriasis. Patients psoriatic arthritis (PsA) those treated biological agents had even Transcriptomic analysis revealed potential pathogenesis involving cellular proliferation, cell recruitment, cytokine secretion, interferon response viral infections. Psoriasis might increase SS, which is augmented by PsA. overlapping immunological mechanisms may underlie co-occurrence

Language: Английский

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Nirmatrelvir-Ritonavir Significantly Reduces Severe COVID-19 Outcomes in Diverse Taiwanese Populations: Comprehensive Evidence from a Large-Scale Longitudinal Cohort Study in Taiwan

Journal of Infection and Public Health, Journal Year: 2025, Volume and Issue: unknown, P. 102760 - 102760

Published: March 1, 2025

Nirmatrelvir-Ritonavir (NR) has proven effective for mild to moderate COVID-19 patients at risk of disease progression. Following its emergency use authorization in Taiwan January 2022, this study aims evaluate impact on severe outcomes across different patient demographics Taiwan. We performed a retrospective analysis database that includes data from three hospitals Northern Patients with 2022 were paired by propensity score matching based NR prescription. Cox proportional hazard regression calculated ratios (HR), adjusting confounding factors. Subgroup determined HRs characteristics. Among 95,096 patients, 3329 the group, and 12,807 non-NR group. users demonstrated significantly better prevention outcomes: intubation (HR=0.296 [95 % CI: 0.187-0.469], p = 0.0482); ICU admission (HR=0.327[0.108-0.991], < 0.001); mortality (HR=0.195 [0.101-0.378], 0.001). revealed lower risks among both sexes, aged 18-65 or ≥ 65 years, BMI 30, diabetes mellitus (DM), cardiovascular (CVD), chronic obstructive pulmonary (COPD). was males, 30. Mortality DM, CVD, COPD. reduces COVID-19, particularly older adults those pre-existing conditions, supporting as an essential treatment high-risk patients.

Language: Английский

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Long‐Term Stroke and Mortality Risk Reduction Associated With Acute‐Phase Paxlovid Use in Mild‐to‐Moderate COVID‐19

Journal of Medical Virology, Journal Year: 2025, Volume and Issue: 97(4)

Published: April 1, 2025

ABSTRACT This retrospective cohort study investigated whether Paxlovid (nirmatrelvir/ritonavir) use during the acute phase of mild‐to‐moderate COVID‐19 reduces risk ischemic or hemorrhagic stroke occurring more than 3 months post‐diagnosis, a condition classified as long COVID. Utilizing TriNetX electronic health records comprising 118 million patients in United States, adults aged 18 years older with confirmed diagnoses from 2022 to 2023 were categorized into (administered within 5 days diagnosis) and non‐Paxlovid groups. Exclusion criteria included prior cerebrovascular disease, mortality months, specific antivirals, severe clinical conditions such ICU admission, intubation, mechanical support, SpO₂ < 90%, respiratory rate > 30/min, sepsis, systemic inflammatory response syndrome, distress syndrome. The index date was initial diagnosis. Propensity score matching 1:1 ratio controlled for confounding factors, (ischemic hemorrhagic) analyzed using Kaplan–Meier survival curves Cox proportional hazards models. Among 181 992 matched pairs, associated significantly reduced (hazard [HR] 0.85; 95% confidence interval [CI]: 0.80–0.89) all‐cause (HR 0.68; CI: 0.63–0.73) COVID period, defined 90 post‐diagnosis. Subgroup analyses demonstrated consistent protective effects across age, sex, BMI, comorbidities hypertension, diabetes, hyperlipidemia, vaccination status. Notably, 0.81; 0.76–0.86) individuals metabolic conditions, including obesity 0.86; 0.78–0.96), exhibited pronounced benefits, observed irrespective These findings highlight that long‐term events mortality, emphasizing its critical role mitigating complications COVID‐19.

Language: Английский

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Clinical Benefits of Sustained Oral Nirmatrelvir/Ritonavir Use for the Outpatient Treatment of COVID-19: Findings from the Taiwanese Health Authority Perspective Using a Decision Tree Modeling Approach

Journal of Market Access & Health Policy, Journal Year: 2024, Volume and Issue: 12(4), P. 326 - 341

Published: Nov. 12, 2024

Despite the observed clinical benefits of nirmatrelvir/ritonavir (NMV/r), it is uncertain whether Taiwan will continue covering NMV/r for high-risk individuals with mild-to-moderate coronavirus disease 2019 (COVID-19). This analysis assessed impact sustained utilization on COVID-19-associated healthcare resource (HCRU) and mortality from Taiwanese health authority perspective (THAP). A decision tree model estimated incremental number events associated over a 30-day period. Model results compared (1) base case using current rates THAP, (2) hypothetical scenario assuming supply not extended in Taiwan. included 80% 0% scenario, respectively. Outcomes hospitalizations involving general ward (GW) stay, intensive care unit (ICU) mechanical ventilation (MV) use, as well bed days, symptom hospitalization deaths. Based epidemiologic data, 150,255 patients COVID-19 were eligible treatment THAP. In HCRU increased by 175% to case, including increases GW, ICU, MV use (differences: 2067; 623; 591, respectively), days (difference: 51,521), 51,714), deaths 480). Findings indicate that THAP reduces burden through reduced incidence COVID-19-related

Language: Английский

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