A Detailed Overview of SARS-CoV-2 Omicron: Its Sub-Variants, Mutations and Pathophysiology, Clinical Characteristics, Immunological Landscape, Immune Escape, and Therapies

Viruses, Год журнала: 2023, Номер 15(1), С. 167 - 167

Опубликована: Янв. 5, 2023

The COVID-19 pandemic has created significant concern for everyone. Recent data from many worldwide reports suggest that most infections are caused by the Omicron variant and its sub-lineages, dominating all previously emerged variants. numerous mutations in Omicron’s viral genome sub-lineages attribute it a larger amount of fitness, owing to alteration transmission pathophysiology virus. With rapid change structure, sub-variants, namely BA.1, BA.2, BA.3, BA.4, BA.5, dominate community with an ability escape neutralization efficiency induced prior vaccination or infections. Similarly, several recombinant sub-variants Omicron, XBB, XBD, XBF, etc., have emerged, which better understanding. This review mainly entails changes due having higher number mutations. binding affinity, cellular entry, disease severity, infection rates, importantly, immune evading potential them discussed this review. A comparative analysis Delta other variants evolved before gives readers in-depth understanding landscape infection. Furthermore, discusses range abilities possessed approved antiviral therapeutic molecules neutralizing antibodies functional against sub-variants. evolution is causing infections, but broader aspect their not been explored. Thus, scientific should adopt elucidative approach obtain clear idea about recently including variants, so effective vaccines drugs can be achieved. This, turn, will lead drop cases and, finally, end pandemic.

Язык: Английский

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Neutralizing Monoclonal Antibody Use and COVID-19 Infection Outcomes

JAMA Network Open, Год журнала: 2023, Номер 6(4), С. e239694 - e239694

Опубликована: Апрель 24, 2023

Importance Evidence on the effectiveness and safety of COVID-19 therapies across a diverse population with varied risk factors is needed to inform clinical practice. Objective To assess neutralizing monoclonal antibodies (nMAbs) for treatment their association adverse outcomes. Design, Setting, Participants This retrospective cohort study included 167 183 patients from consortium 4 health care systems based in California, Minnesota, Texas, Utah. The nonhospitalized 12 years older positive laboratory test collected between November 9, 2020, January 31, 2022, who met at least 1 emergency use authorization criterion poor outcome. Exposure Four nMAb products (bamlanivimab, bamlanivimab-etesevimab, casirivimab-imdevimab, sotrovimab) administered outpatient setting. Main Outcomes Measures Clinical SARS-CoV-2 genomic sequence data propensity-adjusted marginal structural models were used nMAbs outcomes: all-cause department (ED) visits, hospitalization, death, composite hospitalization or death within 14 days 30 index date (defined as first referral). Patient dates categorized into variant epochs: pre-Delta (November June 30, 2021), Delta (July Omicron BA.1 (December (January 2022). Results Among patients, mean (SD) age was 47.0 (18.5) years; 95 669 (57.2%) female birth, 139 379 (83.4%) White, 138 900 (83.1%) non-Hispanic. A total 25 241 received nMAbs. Treatment associated lower odds ED visits (odds ratio [OR], 0.76; 95% CI, 0.68-0.85), (OR, 0.52; 0.45-0.59), 0.14; 0.10-0.20). reduced stronger unvaccinated (14-day hospitalization: OR, 0.51; 0.44-0.59), associations immunocompromised (hospitalization days: 0.31 [95% 0.24-0.41]; 0.13 0.06-0.27]). strength increased incrementally among greater probability outcomes; example, ORs 0.58 (95% 0.48-0.72) those third (moderate) stratum 0.41 0.32-0.53) fifth (highest) stratum. hospitalizations strongest during epoch 0.37; 0.31-0.43) but not 1.29; 0.68-2.47). These findings corroborated subset viral data. significant mortality benefit all epochs (pre-Delta: 0.16 0.08-0.33]; Delta: 0.14 0.09-0.22]; BA.1: 0.10 0.03-0.35]; 0.02-0.93]). Potential drug events identified 38 treated (0.2%). Conclusions Relevance In this study, safe reductions although it epoch. suggest that targeted stratification strategies may help optimize future decisions.

Язык: Английский

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Efficacy of pre-exposure prophylaxis to prevent SARS-CoV-2 infection after lung transplantation: a two center cohort study during the omicron era

Infection, Год журнала: 2023, Номер 51(5), С. 1481 - 1489

Опубликована: Март 16, 2023

Lung transplant (LTx) recipients are at risk for poor outcomes from coronavirus disease 2019 (COVID-19). The aim of the study was to assess outcome patients receiving pre-exposure prophylaxis (PrEP) with tixagevimab and cilgavimab after LTx.All LTx outpatient visits February 28th October 31st, 2022 two German centers were included. Baseline characteristics recorded followed until November 30rd, 2022. Infections SARS-CoV-2, severity, COVID-19-associated death compared between without PrEP.In total, 1438 included in analysis, 419 (29%) received PrEP. Patients PrEP older earlier transplantation, had lower glomerular filtration rates, levels SARS-CoV-2-S antibodies. In 535 (37%) developed SARS-CoV-2 infection during a follow-up median 209 days. Fewer infections occurred period (31% vs. 40%, p = 0.004). Breakthrough 77 (19%). 37 (8%) severe or critical. No difference severity COVID-19 observed There 15 deaths (n 1 PrEP). Compared matched controls, there non-significant towards moderate critical (p 0.184).The number Despite being higher worse associated mortality similar

Язык: Английский

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Outcomes of targeted treatment in immunocompromised patients with asymptomatic or mild COVID-19: a retrospective study

Scientific Reports, Год журнала: 2023, Номер 13(1)

Опубликована: Сен. 16, 2023

The aim of this study was to describe the outcomes targeted COVID-19 treatments in immunocompromised patients with asymptomatic or mild during period expansion different Omicron subvariants France. A retrospective monocentric observational performed. All aged 18 more, SARS-CoV-2 infection COVID-19, and who had received a treatment sotrovimab, tixagevimab/cilgavimab, nirmatrelvir/ritonavir remdesivir at Bordeaux University Hospital from 1st January 2022 31st December were eligible. primary interest defined as composite either (i) progression moderate (WHO-Clinical Progression Scale 4 5) severe (WHO-CPS ≥ 6), (ii) occurrence COVID-19-related death. secondary components outcome. Outcomes collected until day 30 after administration discharge for still hospitalised relation 30. 223 COVID-19: 114 50 49 nirmatrelvir/ritonavir, 10 remdesivir. Among treated patients, (4.5%) progressed disease: three (1.3%) 7 (3.1%) disease. them, (1.8%) died COVID-19. More than 95% by therapies era did not progress

Язык: Английский

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Oral antivirals for COVID-19 among patients with cancer

Supportive Care in Cancer, Год журнала: 2024, Номер 32(8)

Опубликована: Июль 9, 2024

Язык: Английский

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How I treat: Coronavirus disease 2019 in leukemic patients and hematopoietic cell transplant recipients

Transplant Infectious Disease, Год журнала: 2024, Номер 26(4)

Опубликована: Июль 5, 2024

Among immunocompromised hosts, leukemia patients, and hematopoietic cell transplant recipients are particularly vulnerable, facing challenges in balancing coronavirus disease 2019 (COVID-19) management with their underlying conditions. In this How I Treat article, we discuss how approach severe acute respiratory syndrome 2 infections daily clinical practice, considering the existing body of literature for topics where available data not sufficient to provide adequate guidance, our opinion based on expertise experience. Diagnostic approaches include nasopharyngeal swabs polymerase chain reaction testing chest computed tomography scans symptomatic patients at risk progression. Preventive measures involve strict infection control protocols prioritizing vaccination both families. Decisions regarding chemotherapy or transplantation COVID-19 require careful consideration factors such as severity treatment urgency. Treatment early initiation antiviral therapy, nirmatrelvir/ritonavir remdesivir. For cases prolonged viral shedding, distinguishing between viable non-viable viruses remains challenging but is crucial determining contagiousness guiding decisions. Overall, individualized immune status, presentation, kinetics essential effectively managing patients.

Язык: Английский

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Monoclonal Antibodies in Prevention and Early Treatment of COVID-19 in Lung Transplant Recipients: A Systematic Review and Perspective on the Role of Monoclonal Antibodies in the Future

Transplant International, Год журнала: 2025, Номер 38

Опубликована: Фев. 10, 2025

Coronavirus disease 2019 (COVID-19) has significantly impacted lung transplant recipients (LTR), who remain vulnerable to severe COVID-19 despite vaccination, prompting the use of monoclonal antibodies (mAbs) as a treatment option. This systematic review summarizes clinical efficacy mAbs against in adult LTR and provides perspective on role for infectious diseases future. A search PubMed/MEDLINE, Embase Cochrane was conducted studies reporting outcomes or solid organ (SOTR) including with drug-specific outcomes. Twelve were included. Pre-exposure prophylaxis reduced breakthrough infection LTR. Early correlated incidence outcomes, although statistical significance varied among studies. Overall, observational have demonstrated potential benefit LTR, both early treatment, well importance administration. Moreover, mAb therapy appeared safe could be viable option other pathogens, route that warrants further investigation. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382133 , identifier CRD42022382133.

Язык: Английский

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Clinical outcomes in immunocompromised adults with COVID-19, based on anti-spike IgG serostatus and monoclonal antibody therapy: a retrospective cohort study in the Omicron period

Therapeutic Advances in Infectious Disease, Год журнала: 2025, Номер 12

Опубликована: Янв. 1, 2025

Background: Immunocompromised adults may experience severe COVID-19 outcomes, necessitating a multifaceted treatment approach. Studies from the Delta period showed benefit monoclonal antibody (mAb) therapy that was most pronounced among anti-spike IgG seronegative individuals. With widespread vaccination and shifting SARS-CoV-2 variants in Omicron period, clinical predictors of seronegativity, impacts on remain incompletely characterized. Objectives: We describe outcomes cohort immunocompromised with stratified by serostatus receipt mAb during to evaluate impact. Design: This retrospective study mild-moderate presenting between December 2021 October 2022. Methods: Charts were reviewed assess serostatus, therapy, 28-day including conventional oxygen use, high-flow mechanical ventilation, death. Results: A total 276 individuals included, whom 252 (91%) partially or fully vaccinated, 190 (69%) seropositive, 225 (82%) received therapy. majority solid organ transplant recipients (169, 61%), seronegatively significantly associated mycophenolate-based immunosuppression comorbid chronic kidney disease. Conventional use seropositive patients receiving mAb, not 2/154 (1%), 5/71 (7%), 6/36 (17%), 4/15 (27%), respectively. Across cohort, death occurred 6 (2%), 4 (3%), 3 (1%) individuals, Conclusion: Clinical predominantly mild–moderate appeared vary Observed trends would prospective studies future iterations therapeutics inform decisions for adults.

Язык: Английский

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Navigating Coronavirus Disease 2019 in Immunocompromised Populations

Infectious Disease Clinics of North America, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Язык: Английский

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Burden of COVID-19 in immunocompromised patients in Germany: a retrospective, observational Study on Health Insurance Data from 2021 to 2022

Infection, Год журнала: 2025, Номер unknown

Опубликована: Апрель 11, 2025

Abstract Purpose Patients with COVID-19 and immunocompromising conditions are threatened higher morbidity, mortality a greater economic burden than immunocompetent persons due to an inadequate immune response infection vaccination. Health outcomes in 2021 2022, period during which vaccines became available gradually, were investigated. Methods This retrospective observational study was based on statutory health insurance (SHI) claims data of approximately 2.7 million insurees each extrapolated the overall German SHI population. An immunocompromised group defined via several risk factors. COVID-19-related compared without factors (immunocompetent group). Results In both years, COVID-19-associated hospitalizations significantly elevated (33.11% vs 7.88% 2021, 19.25% 2.21% 2022), as ICU admission (9.17% 1.75% 3.94% 0.32%), (9.70% 1.62% 3.42% 0.30%), average costs for (17,966 € 12,769 16,640 10,853 €). Hospitalization/intensive care unit (ICU) rates associated decreased from 2022 groups, but more prominently group. Consequently, gap between groups increased. Conclusion From remained substantially group, despite availability authorized treatments.

Язык: Английский

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