Coronavirus Disease 2019 Infection Research Articles

The Effect of COVID-19 and COVID-19 Vaccination on Assisted Human Reproduction Outcomes: A Systematic Review and Meta-Analysis.

The most discussed infectious disease is coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Many research endeavors have focused on the effects of the virus on reproductive organs, as these have also been shown to carry the receptors to which the virus attaches. The results of assisted reproductive technology (ART) have been significantly affected by the pandemic, with some in vitro fertilization (IVF) centers being closed due to the risk of further spread of the disease. According to World Health Organization statistics, 17.5% of adults worldwide suffered from fertility problems in 2023; in other words, one in six people in the world have reproductive health problems. As infertility is a growing problem in the modern world and new developments in assisted reproduction are always a topic of profound interest, it is important to understand the impact of SARS-CoV-2 on reproductive health. This systematic review aimed to examine studies describing patients undergoing ART procedures with a COVID-19-positive history and to shed light on the recent evidence on the safety of COVID-19 vaccination in the ART context. A meta-analysis was conducted to confirm the results of the systematic review. The results showed a significant difference in clinical pregnancy rates between the vaccinated and unvaccinated groups and an increased miscarriage rate in those with a COVID-19-positive history. However, no significant difference in clinical pregnancy and birth rates was found in participants with a previous COVID-19 infection. The results show that further studies and research are needed, even though the spread and impact of the virus have decreased. Evidence-based information for individuals and couples undergoing infertility treatment is vital to enable informed decision-making.

Cytokine release syndrome following COVID-19 infection during treatment with nivolumab for cancer of esophagogastric junction carcinoma: a case report and review

BackgroundCytokine release syndrome (CRS) is an acute systemic inflammatory syndrome characterized by fever and multiple organ failure, which is triggered by immunotherapy or certain infections. Immune checkpoint inhibitors rarely cause immune-related adverse event- cytokine release syndrome (irAE-CRS). This article presents a case report of irAE-CRS triggered by coronavirus disease 2019 (COVID-19).Case presentationA 60-year-old man with type 2 diabetes received nivolumab treatment for esophagogastric junction carcinoma and experienced two immune-related adverse events: hypothyroidism and skin disorder. Eleven days before his visit to our hospital, he had a fever and was diagnosed with COVID-19. Five days before his visit, he developed a fever again, along with general malaise, water soluble diarrhea, and myalgia of the extremities. On admission, the patient was in a state of multiple organ failure, and although the source of infection was unknown, a tentative diagnosis of septic shock was made. The patient's condition was unstable despite systemic management with antimicrobial agents, high-dose vasopressors, and intravenous fluids. We suspected CRS due to irAE (irAE-CRS) based on his history of nivolumab use. Steroid pulse therapy (methylprednisolone 1 g/day) was started, and the patient temporarily recovered. However, his respiratory condition worsened; consequently, he was placed on a ventilator and tocilizumab was added to the treatment. His muscle strength recovered to the point where he could live at home, and was subsequently discharged.ConclusionIn patients previously treated with immune checkpoint inhibitors, irAE-CRS should be considered as a differential diagnosis when multiple organ damage is observed in addition to inflammatory findings. It is recommended to start treatment with steroids; if the disease is refractory, other immunosuppressive therapies such as tocilizumab should be introduced as early as possible.

Sperm quality and sexual function after the first COVID-19 infection during the omicron surge: an observational study in southwest China.

As the Omicron variant became the dominant coronavirus disease 2019 (COVID-19) strain and the threat to human health decreased, the impact of COVID-19 on male reproductive health and semen quality may have changed. In this prospective observational study, we aimed to investigate the changes in semen quality and sexual function before and after the Omicron variant infection by self-controlled study and to explore the influence of Omicron variant infection on male reproductive health. We recruited 373 participants who provided semen samples before their first COVID-19 infection. During the subsequent follow-up, only 154 participants provided the second semen samples, 11 of whom were not infected with COVID-19. Sperm quality was assessed approximately 45 and 90 days after COVID-19, as well as before infection. Semen parameters, including total sperm count, total forward sperm, progressive motility, and sperm concentration, significantly declined 45 days after COVID-19 infection. At 90 days after infection, the total sperm count, total forward sperm, and sperm concentration gradually increased to pre-infection levels. Participants who experienced fever showed worse semen quality in terms of total forward sperm, sperm concentration, and sperm progressive rate. However, this phenomenon was not observed in the other group infected with COVID-19 without fever or not infected. In addition, 49 (34.3%) of 143 persons confirmed that the COVID-19 infection resulted in changes in sexual function, with an increase in premature ejaculation diagnostic tool (PEDT) scores. The results of our self-controlled study indicate that COVID-19 is associated with impaired semen quality early after disease onset. After 1-2 spermatogenesis cycles, the semen quality gradually recovers from the infection. These findings are beneficial for better understanding the COVID-19-associated sequelae, which are fundamental for semen collection during assisted reproduction.

COVID-19 Diagnosis, Oral Anticoagulation, and Stroke Risk in Patients with Atrial Fibrillation.

Coronavirus disease 2019 (COVID-19) has been associated with an increased risk of stroke. It remains unclear whether the risk of stroke associated with a diagnosis of COVID-19 differed with oral anticoagulation (OAC) use. The aim of this study was to evaluate the association between COVID-19 infection, OAC use, and stroke in patients with atrial fibrillation (AF). A retrospective cohort study was conducted in individuals with established AF using data from Optum's deidentified Clinformatics® Data Mart Database. Cox proportional hazard models with time-dependent variables were employed to assess the association between possession of OAC, COVID-19 diagnosis in both inpatient and outpatient setting, and time to ischemic stroke. A total of 561,758 individuals aged 77 ± 10 were included in the study, with a mean follow up time of 1.3 years. OAC use was associated with a reduced stroke risk [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.82-0.88]. COVID-19 infection was associated with an increased risk of stroke (HR 2.11, 95% CI 1.87-2.38); this increased risk was particularly pronounced for patients diagnosed with an inpatient diagnosis of COVID-19 (HR 3.95, 95% CI 3.33-4.68). There was no significant interaction between OAC use and COVID-19 diagnosis (p value = 0.96). As a result, the relative increase in stroke risk associated with COVID-19 did not differ between patients on OAC (HR 2.12; 95% CI 1.71-2.62) and those not on OAC (HR 2.11; 95% CI 1.83-2.43). In a nationwide sample of patients with established AF, we found the relative increase in stroke risk associated with COVID-19 was independent of OAC use.

Impact on the nervous system of long COVID-19 infection in children.

The coronavirus disease 2019 (COVID-19) pandemic has had a profound global impact, raising concerns about its long-term effects, particularly neurological complications. While studies have highlighted such complications in adults, there is a paucity of research focusing on children. To examine the medium- to long-term neurological and cognitive symptoms in 18 year old children and below with positive versus negative COVID-19 antigens and to identify the probable risk factors to promote specific health actions. An observational study was carried out to determine neurological symptoms in the medium and long terms after COVID 19. A random sample of 124 children, both symptomatic or asymptomatic, tested positive or negative for COVID-19 through swab tests. Neurological symptoms were assessed between 6 to 12 months and 2 years after the infection. Acute symptoms, including headache, anosmia, ageusia, and myalgia, were observed in more than 20% of the children, but they generally resolved within 6 to 12 months. Persistent functional difficulties, such as in studying, paying attention, and socializing, were reported in 3% of the cases. Behavioral symptoms at baseline were noted in 7.8% of children, but they were remitted in most cases, except for those with prior involvement. These findings underscore the need for continued monitoring of children following COVID-19 infection and the importance of tailored health interventions.

COVID-19 and diabetes research: Where are we now and what does the future hold? A bibliometric visualization analysis

Background & objectiveThe extensive spread of Coronavirus disease 2019 (COVID-19) worldwide has caused a dramatic negative impact on many individuals' health. This study aims to systematically and comprehensively analyze the current status and possible future directions of diabetes mellitus (DM) and COVID-19 research. MethodsWe obtained publications about COVID-19 and DM from the Web of Science Core Collection (WoSCC) using the search terms "COVID-19″ and similar terms combined with "DM" and similar terms, with a date range of January 2020 to May 2024. And we used CiteSpace V 6.3.R2 to perform the bibliometric visualization analysis. ResultsThe search enrolled 6266 publications. The USA is a country with the most publications; Harvard University was the most productive institution in this field. The highest-ranked journal was the PLOS ONE, and the most cited journal was Lancet. The 20 most cited journals have all been cited 28754 times, accounting for 28 % of the total cites; the range of those journals was 790–3197. Publications on COVID-19 and DM research exhibited a distinct trajectory, shifting from an initial emphasis on understanding the impact of diabetes on COVID-19 infection and its associated pathophysiological mechanisms to a focus on analyzing the differential responses of diverse patient populations. Subsequently, research has progressed to examine the effects of medications and vaccines, as well as the long-term consequences of COVID-19 in diabetic individuals. Throughout this research endeavor, the exploration of diverse therapeutic interventions, their efficacy, and ultimate outcomes have consistently remained a paramount focus. And " metabolic syndrome," " long COVID," and " gestational diabetes" are still likely to be the hotspots and frontiers of research in the future. ConclusionsThis bibliometric analysis related to DM in COVID-19 illuminates the current research situation and developmental trends, supporting researchers in the exploration of prospective directions for research.

Male sexual disorder in coronavirus disease 2019 pandemic

Background At the end of 2019, a new coronavirus infection disease, named COVID-19, emerged in China. In this context, couples’ sexual lives could have been significantly altered. Fear of the COVID-19 pandemic implications affects their lives, or the lives of friends and relatives might produce feelings of anxiety and panic. Sometimes, these feelings can degenerate into further negative psychological reactions, including adjustment disorder and depression. Aim To find the relation between COVID-19 pandemic and occurrence of male sexual disorders. Patients and methods In this retrospective study 300 cases with past history of COVID-19 virus infection were included in this study. They were recruited from the Dermatology Outpatient Clinic of Al-Azhar University (Assiut) Hospital. Results There was a statistically significant difference between the prepandemic and postpandemic erectile dysfunction scores (P=0.043). There was a statistically significant difference between prepandemic and postpandemic scores according to premature ejaculation (P=0.022). There was a significant difference among erectile dysfunction and both depression degree (χ 2=90.706, P<0.001) and anxiety degree (χ 2=263.652, P<0.001) likewise, it has been found that there was a significant difference among premature ejaculation and both depression degree (χ 2=109.542, P<0.001) and anxiety degree (χ 2=165.382, P<0.001). Conclusion Significant difference between prepandemic and postpandemic scores according to erectile dysfunction and premature ejaculation. Among erectile dysfunction and both depression degree and anxiety degree likewise, it has been found that there was a significant difference among premature ejaculation and both depression degree and anxiety degree.

Cardiovascular Complications in Respiratory Viral Infections with a Focus on COVID-19

Patients with respiratory viral infections have altered immune responses, which may predispose them to cardiovascular complications. In the face of the pandemic of a new kind of severe acute respiratory syndrome (SARS), coronavirus disease 2019 (COVID-19), there is a resurgence of interest in the early diagnosis, prevention, and treatment of patients who are at risk. COVID-19 often manifests as viral pneumonia, although extrapulmonary manifestations are also common. Acute cardiac damage associated with elevated highsensitivity troponin levels crucially contributes to mortality in severe COVID-19. The present review clinically compares cardiovascular complications between COVID-19 and other respiratory infections caused by singlestranded RNA viruses, namely influenza, SARS, and Middle East respiratory syndrome (MERS). Estimating the death rate from RVIs has been a subject of intense research, but the mortality from cardiovascular complications in these infections is less understood and calls for further research.

A clinical study of rhino-orbital-cerebral mucormycosis during the COVID-19 pandemic in western Maharashtra.

The aim of the study was to describe the epidemiology and study the risk factors, clinical presentation, management, and outcome of rhino-orbital-cerebral mucormycosis (ROCM) in terms of mortality, exenteration, eye salvage, and vision salvage. This retrospective, observational study was carried out over a period of two months. A detailed history was noted, and an ophthalmological examination was done. The diagnosis was done by Potassium hydroxide (KOH) mount and fungal culture. Magnetic resonance imaging (MRI) of the orbit, brain, and paranasal sinuses were performed. Medical (intravenous amphotericin B, posaconazole), surgical (retrobulbar amphotericin B injection, exenteration, Functional Endoscopic Sinus Surgery (FESS)), or combined management was evaluated, and clinical outcomes was noted. The mean age of patients was 54.2 years and the male-to-female ratio was 1.77/1. The most common underlying risk factor for ROCM was uncontrolled diabetes mellitus (70%), followed by the use of corticosteroids for the management of coronavirus disease 2019 (COVID-19) infection in 68% of patients. The most common clinical presentation was diminution of vision followed by eschar, ptosis, and proptosis. Medical and FESS were done in all patients; exenteration was done in 12% of patients. Sixty-six percent of patients were alive with regression of ROCM, 20% of patients were alive with residual, 8% of patients were alive with the progression of ROCM, and 6% of patients had expired. Among the ones who are alive, the ocular outcome was orbital exenteration in 12.76%, the eye was salvaged in 25.53 and vision salvage was achieved in 61.70%. ROCM affects older males. Immunosuppression due to COVID-19 infection, diabetes mellitus, and corticosteroid use in the management of COVID-19 are the main risk factors for the development of ROCM. Antifungal therapy along with surgical debridement decreases mortality.

Factors Associated with Mortality in Patients with Coronavirus Disease (COVID-19) in Babol, North of Iran.

The spectrum of the clinical features of coronavirus disease 2019 (COVID-19) spans from asymptomatic or mild disease to severe respiratory failure, while different factors are related to its mortality rate. This research aimed to determine the clinical and laboratory characteristics and the associated factors of mortality in patients with COVID-19. Data were collected from hospitalized patients (May to June 2020), and COVID-19 was confirmed in patients by real-time polymerase chain reaction (PCR). The patient group was classified into survivor and deceased groups. The chi-square and the independent t-test with Statistical Package for the Social Sciences (SPSS) software program, version 18, were used for analysis. Mean age, hemoglobin, serum C-reactive protein (CRP), alkaline phosphatase (ALP), white blood cells, and level of procalcitonin in non-survivors were significantly higher than in survivors. Serum tumour necrosis factor-alpha (TNF-a) had a significant relationship with Ddimer (p = 0.0006). The risk of mortality in patients with serum CRP ≥ 100 mg/dl was significantly higher than those with CRP < 100 mg/dl (odds ratio (OR) = 4.8 (95% CI, 1.33-12.44, p = 0.01). COVID-19 has different clinical features and can be an asymptomatic, mild, or severe disease. Thus, findings about the disease and the consequent outcomes differ in patients. Further studies are needed to evaluate the clinical features and consequences of COVID-19 infection.

P190 POST-COVID INFECTION AS AN INDEPENDENT PREDICTOR OF DIASTOLIC HYPERTENSION IN AFRICAN POPULATION: SUDAN MMM 2022

Introduction: Several clinical studies reported a mutual relationship between coronavirus disease 2019 (COVID-19) and high blood pressure (BP) readings. It was established that hypertension is associated with increased COVID-19 severity, morbidity, and mortality; however, its effect on the future blood pressure reading and development of hypertension is not apparent. Methods: This is a cross-sectional analytic study based on MMM 2022, Sudan data. The targeted population was &gt;18 years old. Blood pressure was measured on 3 consecutive measures. Participants who had a history of hypertension were excluded. Systolic hypertension was defined if systolic blood pressure (SBP) ≥ 140 mmHg, and diastolic hypertension was defined if diastolic blood pressure (DBP) ≥ 90 mmHg. Continuous data was presented in mean and standard deviation, and categorical data was presented in frequency and percentages. Logistic regression models (unadjusted and adjusted) were used to predict high blood pressure readings. Results: A total of 14,402, (42.92%) were male and the mean age was (35.1±14.7 years) patients were included in this study. The prevalence of associated medical conditions, diabetes, heart attack, heart failure, arrhythmia, and stroke were 6.3%, 1.12%, 1.5%, 0.8%, 4.8%, and 1.1% respectively. The mean SBP was (118.88±17.42) mmHg, and the mean DBP was (78.89±11.0) mmHg. Furthermore, the COVID-19 infection affected (4.48%) of this study population. They were older (36.8±12.2 vs. 35.0±14.8, p=0.003), more frequently males (56.1% vs. 42.3%, p &lt;0.001), and diabetic (8.8% vs. 6.2%, p=0.006). The incidence of systolic hypertension and diastolic hypertension, in the population, was (10.98%) and (14.57%) respectively. The post-COVID patients had a significantly higher mean DBP (80.0±10.7 vs. 78.8±11.0, p=0.008) but not the SBP. Using unadjusted and adjusted logistic regression, the odd ratio is significant for predicting high DBP post-COVID infection (table 1). Conclusions: Post-COVID infection carries a huge burden on healthy individuals. After adjusting for the possible confounders, post-COVID-19 infection was an independent predictor of diastolic hypertension in the African population.

Is it possible to predict persistent acute kidney injury in critically ill patients with COVID-19 infection?

Critically ill patients with coronavirus disease 2019 (COVID-19) often face a heightened risk of morbidity and mortality, particularly due to complications such as acute kidney injury (AKI). While the persistent acute kidney injury risk index (PARI) has shown promise in predicting the risk of persistent AKI (pAKI) in non-COVID patients, its effectiveness in critically ill COVID-19 patients remains to be explored. We aimed to evaluate the predictive power of the PARI in identifying pAKI and its prognostic significance in terms of clinical outcomes. This was a single-center retrospective study of patients with COVID-19 admitted at our 36-bed tertiary intensive care unit between April and December 2020. There were 152 patients who fulfilled our inclusion criteria. Fifty seven (37.5%) had developed AKI and 16 (10.25%) had developed pAKI. Vasopressor, mechanical ventilation and renal replacement therapy (RRT) requirement, sequential organ failure assessment (SOFA), and PARI were significantly higher in patients who developed pAKI than those who did not. The PARI were significantly higher in patients with short-term mortality compared to survivors. The area under the receiver operating characteristic (ROC) curve (AUC) of the PARI score for predicting pAKI was 0.66 (95% CI: 0.53-0.79), whereas short-term mortality was 0.733 (95% CI, 0.65-0.81). The PARI score was evaluated as simple, useful, and reliable in predicting pAKI in severe cases with COVID-19; and therefore, pAKI and its related RRT complications can be prevented with protective interventions. Further comprehensive studies are warranted to deepen our understanding of this relationship.

Long-term effect of corticosteroid treatment during acute COVID-19 infection on pulmonary function test results.

The outbreak of the novel coronavirus 19 has led to unprecedented clinical challenges globally. Various therapeutic and pharmacologic interventions have been proposed, yet evidence of their long-term efficacy remains limited. Corticosteroids (CS) have shown efficacy in the sub-acute phase of the pandemic. This study aims to evaluate the long-term effects on pulmonary function tests (PFTs) in patients treated with CS during acute coronavirus disease 2019 (COVID-19) infection. A retrospective study was conducted from February 2020 to March 2021. Clinical and demographic data were extracted from electronic medical records of patients attending the post-COVID outpatient clinic at the Pulmonary Institute of Soroka University Medical Center. A multivariate linear mixed effects model was employed to obtain adjusted estimates for the impact over time. The study included 405 patients, of whom 155 (38.3%) received CS treatment. Approximately 60% completed two or more follow-up visits. PFTs [forced expiratory volume in the first second (FEV1), forced vital capacity (FVC)] returned to baseline more rapidly (0.9% and 0.85% per month, respectively) in patients treated with CS. This accelerated recovery was observed across all patients, including those with a body mass index (BMI) above 30 kg/m2 and those with known chronic lung disease. Systemic CS treatment during acute COVID-19 infection was associated with a faster recovery of PFTs during long-term follow-up, even among subgroups at higher risk of long-term pulmonary damage.

Impact of Diabetes on COVID-19 Susceptibility: A Nationwide Propensity Score Matching Study.

Prior research has highlighted poor clinical outcomes in coronavirus disease 2019 (COVID-19)-infected patients with diabetes; however, susceptibility to COVID-19 infection in patients with diabetes has not been extensively studied. Participants aged ≥30 years who underwent COVID-19 testing from December 2019 to April 2020 were analyzed using the National Health Insurance Service data in South Korea. In a cohort comprising 29,433 1:1 propensity score-matched participants, COVID-19 positivity was significantly higher in participants with diabetes than in those without diabetes (512 [3.5%] vs. 395 [2.7%], P<0.001). Logistic regression analysis indicated that diabetes significantly increased the risk of COVID-19 test positivity (odds ratio, 1.307; 95% confidence interval, 1.144 to 1.493; P<0.001). Patients with diabetes exhibited heightened COVID-19 infection rates compared to individuals without diabetes, and diabetes increased the susceptibility to COVID-19, reinforcing the need for heightened preventive measures, particularly considering the poor clinical outcomes in this group.

Association between ursodeoxycholic acid use and COVID-19 in individuals with chronic liver disease: a nationwide case-control study in South Korea

BackgroundConflicting evidence exists regarding the effects of ursodeoxycholic acid (UDCA) on coronavirus disease 2019 (COVID-19). This study investigates the association between UDCA administration and COVID-19 infection and its related outcomes in individuals with chronic liver disease (CLD).MethodsA customized COVID-19 research database (n = 3,485,376) was created by integrating data from the National Health Insurance Service (NHIS) and the Korea Disease Control and Prevention Agency’s COVID-19 databases. The study focused on patients diagnosed with COVID-19 in 2021, using the NHIS data from 365 days before diagnosis. To create comparable groups with and without UDCA administration before COVID-19, we used propensity score matching. The primary endpoint was the first confirmed positive result for severe acute respiratory syndrome coronavirus-2. In addition, we identified severe COVID-19-related outcomes. Subgroup analysis were conducted based on the dose of UDCA exposure.ResultsData from 74,074 individuals with CLD was analyzed. The participants’ average age was 57.5 years, and 52.1% (19,277) of those in each group were male. Those with prior UDCA exposure had a significantly lower risk of COVID-19 infection (adjusted OR: 0.80, 95% CI [0.76–0.85]) compared to the non-UDCA group. Additionally, the UDCA group had a lower risk of severe COVID-19 outcomes (adjusted OR: 0.67, 95% CI [0.46–0.98]). Subgroup analyses indicated that there was a decrease in COVID-19 infection and its related outcomes with increasing UDCA exposure dose.ConclusionsOur large observational study highlights the potential use of readily available UDCA as an adjunctive therapy for COVID-19 in individuals with CLD.

Role of ACE2 and TMPRSS2 polymorphisms in clinical severity and outcomes of COVID-19 in Egypt.

The clinical presentations of coronavirus disease 2019 (COVID-19) exhibit significant variation, ranging from asymptomatic cases to mortality resulting from severe pneumonia. Host genetics can partially explain this variation. This study evaluated possible associations between severity and outcome of COVID-19 and single nucleotide polymorphism (SNP) rs2285666 in the ACE2 gene and SNP rs2070788 in the TMPRSS2 gene. The study included a sample of 100 consecutive adult patients admitted to the COVID-19 Isolation and Intensive Care Units of the Zagazig University Hospitals, Zagazig, Egypt from July 2021 to November 2021. For rs2285666, polymerase chain reaction-restriction fragment length polymorphism was carried out. For rs2070788, real-time polymerase chain reaction was performed. For rs2285666, the GA genotype was the most frequent among female patients (39% [16/41]) and the A genotype was more prevalent among male patients (54.2% [32/59]). For rs2070788, the AA genotype was the most frequent among all patients (46% [46/100]). No rs2285666 or rs2070788 genotypes or allele frequencies had significant associations with either severity or outcomes of patients. This study found no significant associations of COVID-19 severity or outcomes of patients with genotypes or allele frequencies of the rs2285666 SNP in the ACE2 gene or the rs2070788 SNP of the TMPRSS2 gene. The search for other genetic associations with COVID-19 infection is still required. The study reveals that host genetics explain the variation observed in the disease. Specific genetic variants can confer either increased susceptibility or resistance to the disease.

Long-term cytokine profile in multisystem inflammatory disease among children

BackgroundMultisystem inflammatory disease in children (MIS-C) is a post-infectious condition following coronavirus disease-19 infection. Long-term follow-up data suggests that initial clinical severity does not necessarily correlate with long-term outcomes. The long-term immunological response in children with MIS-C remains poorly understood. We analyzed cytokine profiles at diagnosis and during follow-up, in pediatric patients with MIS-C, exploring correlations among cytokine expressions and standard biochemical and hormonal test results. MethodsTwenty-five MIS-C patients (mean 9.4 ± 3.9) with complete test results at diagnosis and at 6- and 12-months follow-up were included in the study. Selected cytokines, such as IL-9, eotaxin, IP-10, MIP-1β, RANTES, MCP-1(MCAF), TNF-α, PDGF-B, IL-4, and MIP-1α, were included in the analysis. ResultsIP-10, MCP-1 (MCAF), and MIP-1α levels normalized or nearly normalized at 6–12 months, the remaining cytokines, including IL-9, eotaxin, MIP-1β, RANTES, TNF-α, PDGF-B, IL-4, remained higher in MIS-C than in controls at our last follow-up time. At 6 months post-diagnosis, a mild negative correlation between triglycerides and HOMA-IR with MCP-1 (MCAF), IL-4, and Eotaxin was noted. At the 12-month follow-up we found a mild positive correlation of cortisol and ACTH levels with PDGF-B, MIP-1α, and TNF-α. Conversely, a negative correlation between these cytokines with fasting glucose and HOMA-IR was observed. ConclusionsOur study findings highlight a notable cytokine-mediated inflammatory response in pediatric patients with MIS-C, characterized by sustained elevated levels over a 12-month monitoring period compared to the control group. We have identified various interrelationships among different cytokines, as well as correlations between heightened cytokine levels and metabolic and hormonal patterns. The pronounced inflammatory response underscores its involvement in acute organ damage, while its persistence suggests potential implications for long-term metabolic disorders.

Impact of HLA Alleles on COVID-19 Severity in Kidney Transplant Recipients: A Single-Center Study.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, particularly affecting vulnerable populations, such as organ transplant recipients. Human leukocyte antigens (HLAs) play a critical role in immune response regulation, and understanding their association with COVID-19 can provide insights into disease susceptibility and severity. This study aims to explore the association between HLA allele variability and COVID-19 susceptibility and severity among kidney transplant recipients. Methods In 2023, we conducted a study on 73 kidney transplant recipients who tested positive for COVID-19 via polymerase chain reaction. This study included assessments of clinical status, immunosuppressive drug levels, HLA allele frequencies, and donor-recipient tissue compatibility. Molecular analyses were performed using sequence-specific oligonucleotide typing, and statistical analysis was conducted using IBM SPSS Statistics, version 20.0 (IBM Corp., Armonk, NY). Results Among the participants, 31 were hospitalized and 42 were treated as outpatients. Significant differences were observed in HLA allele distributions, particularly the HLA-A*11 allele, which was more prevalent in outpatient-treated patients, suggesting a potential protective effect. No significant age differences were observed between hospitalized and outpatient groups. Serum tacrolimus levels were notably higher in outpatients. Statistical analyses revealed significant associations between certain HLA groups and the severity of COVID-19 infection. Conclusions This study highlights the importance of HLA allele compatibility in influencing the clinical outcomes of COVID-19 in kidney transplant recipients. The findings suggest that specific HLA alleles may reduce susceptibility or moderate the severity of COVID-19, indicating a need for broader genetic studies across diverse populations to validate these observations and improve management strategies for transplant recipients during pandemics.

Metabolic health is more strongly associated with the severity and mortality of coronavirus disease 2019 than obesity

BackgroundObesity has been suggested to be associated with the coronavirus disease 2019 (COVID-19); however, it is unclear whether obesity or metabolic abnormalities accompanied by obesity have a stronger association with COVID-19 risk.MethodsThis study used the Korea Disease Control and Prevention Agency database, which includes information about the COVID-19 diagnosis and mortality dates of the entire Korean population between October 2020 and December 2021 (for diagnosis) or March 2022 (for mortality). A total of 24,310,283 adults were included and classified into four metabolic obesity phenotypes: (1) metabolically healthy and normal weight (MHNW), (2) metabolically unhealthy and normal weight (MUNW), (3) metabolically healthy and obese (MHO), and (4) metabolically unhealthy and obese (MUO). COVID-19 mortality and severity were compared according to metabolic obesity phenotypes in the total population and in each age group (20–<50 years, 50–<70 years, and ≥ 70 years). Additionally, major adverse cardiovascular events (MACE) after COVID-19 infection were compared according to metabolic obesity phenotypes.ResultsA total of 3, 956, 807 participants (16.3%) were diagnosed with COVID-19 during the study period. Among them, metabolically unhealthy subjects had higher mortality rates than metabolically healthy subjects (0.81% for MUNW, 0.40% for MUO, 0.23% for MHNW, and 0.19% for MHO). The rates of severe hospitalized disease were also higher in metabolically unhealthy subjects than in healthy subjects (0.59% for MUNW, 0.55% for MUO, 0.19% for MHNW, and 0.31% for MHO). In the subgroup analyses by age, similar trends were observed in subjects aged 20–50 and 50–70 years, respectively. Additionally, the incidence of total MACE was increased in metabolically unhealthy individuals.ConclusionsThe study shows that metabolic health is more strongly associated with COVID-19 mortality and severity than obesity, particularly in adults aged < 70 years.

Post-acute sequelae of SARS-CoV-2 mimic: An important neurological condition

Background and objectivesIn 2024, the sequalae of the acute phase of coronavirus disease-19 (COVID-19) infection, which include neurological symptoms and are commonly referred to as long COVID or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC), continue to be a substantial health concern; however, similar symptoms are observed in individuals with no previous COVID-19 infection. MethodsThis was a single-center, retrospective, descriptive case series study. Data were obtained from patients who visited our outpatient clinic specializing in PASC between June 1, 2021, and May 31, 2023. We compared antibody test results between patients with confirmed acute phase infection and those without. We compared differences in demographic and clinical characteristics between patients with positive results during the acute phase of COVID-19 infection and positive anti-SARS-CoV-2 antibody tests (true-PASC), and those with neither (PASC-mimic). ResultsOf 437 patients diagnosed with PASC according to World Health Organization criteria, 222 underwent COVID-19 antibody tests. Of these, 193 patients (86.9%) had a history of confirmed acute phase infection, whereas 29 (13.1%) did not. Of the former, 186 patients (96.4%) were seropositive for anti-nucleotide SARS-CoV-2 antibodies (true-PASC), whereas 19 of the latter tested seronegative for anti-nucleotide SARS-CoV-2 antibodies (PASC-mimic). There were no significant differences in symptom characteristics between true-PASC and PASC-mimic participants. ConclusionsIt was difficult to identify any clinical features to aid in diagnosing PASC without confirmation of acute COVID-19 infection. The findings indicate the existence of a “PASC-mimic” condition that should be acknowledged and excluded in future PASC-related research studies.