Cases Of COVID-19 Patients Research Articles

Systemic Arterial Hypertension, Diabetes Mellitus and Covid-19: A Retrospective Study in Nineteen Municipalities in Mato Grosso

Objective: To analyze the prevalence and characteristics of COVID-19 cases in patients with systemic arterial hypertension (SAH) and diabetes mellitus (DM) in the southeastern region of Mato Grosso, between March 2020 and March 2022. Method: Epidemiological and analytical study with secondary data from 19 municipalities in the southeastern region of Mato Grosso from 2020 to 2022. The data are in the public domain from the State's COVID-19 indicator panel. The population included all registered cases of COVID-19 in Mato Grosso, as well as in the municipalities of the southeastern region with SAH and DM as comorbidities. Blank/ignored cases were excluded. The descriptive analysis of the data used frequencies and relative frequencies, with the aid of the R software. Research approved by the Research Ethics Committee (Opinion: 4,418,798). Results: Of the 727,952 cases reported in Mato Grosso, 14.40% occurred in the southeast region, with 14.07% having comorbidities. Among these, 54.11% were hypertensive and 28.18% were diabetic. The profile of hypertensive and diabetic cases, respectively, was predominantly female (55.45% and 54.44%), 51 to 60 years old (25.57% and 27.14%), brown (55.79% and 55.61%), had no cardiovascular problems (77.54% and 72.84%), had no neoplasia (83.38% and 83.28%), were not obese (79.97% and 79.70%), had no lung problems (81.55% and 80.85%), recovered cases (88.74% and 86.96%), were not hospitalized (99.94% and 100%) and had laboratory-confirmed cases (95.95% and 95.69%). Research Implications, Originality/Value: This study highlights the importance of understanding the characteristics of patients with comorbidities and COVID-19 to improve prevention, diagnosis and treatment strategies for the disease.

Nutritional status and its relationship with COVID-19 prognosis in hemodialysis patients.

Introduction: among the groups more affected by the COVID-19 pandemic were patients undergoing chronic hemodialysis (HD) treatment due to their comorbidities, advanced age, impaired innate and adaptive immune function, and increased nutritional risk due to their underlying inflammatory state. All of these factors contribute to a higher risk of severe complications and worse outcomes compared to the general population when infected with SARS-CoV-2. Objective: the objective of this study was to describe the nutritional characteristics of and their potential association with the prognosis of COVID-19 in patients undergoing chronic HD treatment. Method: a descriptive, retrospective, observational design. All cases of COVID-19 in patients undergoing chronic treatment at the Hemodialysis Unit of Hospital de Manises, Valencia, Spain, from the start of the pandemic to before vaccination were included. Results: for that, 189 patients were studied, who received chronic HD treatment in the hospital unit, 22 patients were diagnosed with COVID-19 (12 %) in that period. The mean age was 71 years, 10 were women, the Charlson index was 6.59 points, diabetes mellitus 10, vintage HD 51.6 months, 2 patients had previously received a currently non-functioning kidney transplant, 16 had arteriovenous fistula as vascular access, and 6 had central vascular access. The mean dialysis session time was 220.14 minutes and the initial value of the single dose of the Kt/V pool was 1.7. 16 patients had body composition measurement, a strong association (p < 0.05) was identified between mortality and BMI, as well as mortality and FTI. Furthermore, the differences between deceased and surviving groups in the serum levels of various variables related to nutritional status were analyzed, finding significant differences with p < 0.05 in the value of triglycerides and ferritin. Conclusions: higher body mass index and higher body fat content, along with lower baseline levels of triglycerides and ferritin, were significantly associated with higher COVID-19 mortality in patients on chronic hemodialysis. These findings suggest that the initial nutritional status of these patients can significantly influence the prognosis of SARS-CoV-2 infection.

Evaluation of COVID-19 cases treated in the intensive care unit in a coastal city hospital during the pandemic.

SARS-CoV-2 is a novel coronavirus that infects the respiratory tract and was the causing agent of COVID-19, declared a pandemic by the World Health Organization on March 11, 2020. Several studies have been carried out to understand the pathophysiology of the disease, immune reactions, and risk factors that could aggravate the condition and predict the prognosis of patients. Therefore, this study aimed to evaluate the most prevalent laboratory data of hospitalized patients associated with discharge or death. A survey was conducted utilizing the medical records of COVID-19 cases in patients treated in the intensive care unit of the Guilherme Álvaro Hospital in the seaside city of Santos, Brazil. We correlated the most important variables reported in the literature to provide a global comparison of the population affected by the virus in the Santos lowlands.

Proposal and Definition of an Intelligent Decision- Support System Based on Deep Learning Techniques for the Management of Possible COVID-19 Cases in Patients Attending Emergency Departments

Proposal and Definition of an Intelligent Decision- Support System Based on Deep Learning Techniques for the Management of Possible COVID-19 Cases in Patients Attending Emergency Departments

Decoding the Historical TALE: COVID-19 Impact on Hematological Malignancy Patients - Insights from 2020 to 2022

Introduction From the onset of the COVID-19 pandemic, hematological malignancy patients have been at high risk of both contracting SARS-CoV-2 and experiencing its most severe effects, leading to hospitalization and high fatality rates. While the introduction of anti-SARS-CoV-2 vaccines, specific antivirals, and monoclonal antibodies significantly lessened the impact on otherwise healthy individuals, the same cannot always be said for patients with hematological malignancies due to their compromised immune systems. Methods The EPICOVIDEHA registry, part of the EHA-SWG Infections in Hematology, has been actively compiling data on COVID-19 cases in patients with hematological malignancies from the pandemic's onset, spanning diverse geographic locations worldwide. This registry has facilitated the acquisition of comprehensive epidemiological data, enabling a thorough analysis of the evolving patterns in COVID-19 incidence and characteristics during the initial three years of the pandemic. Results As of December 2022, the EPICOVIDEHA registry recorded 8,767 cases of COVID-19 in hematological malignancy patients from 152 centers in 41 countries. Of these cases, 42% were female. Non-Hodgkin's lymphoma accounted for 31% of the cases, followed by multiple myeloma at 17%, chronic lymphocytic leukemia at 13%, and acute myeloid leukemia at 12%, showing consistent proportions over time. Chronic cardiopathy emerged as the most prevalent non-malignant underlying condition, increasing from 32% during the first semester of 2020 to 44% in the second semester of 2022. Critical infections decreased significantly from 19% at the beginning of the pandemic to 4% in the second semester of 2022 (p=0.004). Overall mortality dropped from 29% at the pandemic's onset to 4% after three years (p&amp;lt;0.001). Survival rates for hematological malignancy patients consistently improved with each passing semester (p&amp;lt;0.001). Factors associated with mortality included increased age (HR 1.037, p&amp;lt;0.001), two or more comorbidities (HR 1.244, p&amp;lt;0.001), active malignancy at COVID-19 onset (HR 1.832, p&amp;lt;0.001), pulmonary symptoms (HR 1.299, p=0.003), and hospitalization (HR 12.767, p&amp;lt;0.001), particularly in the intensive care unit (HR 33.684, p&amp;lt;0.001). Conversely, factors linked to increased survival were anti-SARS-CoV-2 vaccination (1-2 doses: HR 0.681, p&amp;lt;0.001; 3+ doses: HR 0.451, p&amp;lt;0.001) and experiencing the COVID-19 episode in 2022 (HR 0.427, p&amp;lt;0.001) (Figure 1A). Initially, COVID-19 was the primary cause of mortality in 70% of the cases, decreasing to 42% by the second semester of 2022 (Figure 1B). Conclusion Our study revealed that patients with hematological malignancies face an elevated vulnerability to severe outcomes, resulting in higher hospitalization and mortality rates over time. However, there was a decline in critical infections and mortality rates during the study period. While factors associated with mortality remained consistent, vaccination and encountering COVID-19 more recently were linked to improved survival. Our findings emphasize the importance of continuous monitoring and targeted interventions to optimize outcomes for this vulnerable group during the pandemic and beyond.

English

This study aimed to evaluate the performance of the PanbioTM Covid-19 Ag Rapid Test (Abbott) in a medical center in Ouagadougou. The PanbioTM COVID-19 Ag test was evaluated from January 26 to March 31, 2021 in symptomatic and asymptomatic patients in the medical Centre of Kossodo. A total of 268 individuals were tested by both SARS-CoV-2 RT-PCR, and antigen RDT. Of these 268 individuals, 52 were positive and 216 were negative for COVID-19 RT-PCR. The performance parameters of the test and its Kappa agreement with the RT-PCR were calculated according to the presence or absence of symptoms in the patients on one hand, and according to the time onset of symptoms on the other hand. The sensitivity of the Panbio&trade; COVID-19 Ag Rapid Test ranged from 29.63% (95% CI: 13.75 to 50.18) among COVID-19 asymptomatic patients, to 87.5% (95% CI: 52.91 to97.76) among symptomatic patients with symptom onset time of 1-5 days. Similarly, the Panbio&trade; COVID-19 Ag Rapid Test specificity was 97.3% (95% CI: 90.58 to 99.67) and 96.4% (95% CI: 91.81 to 98.82) in symptomatic and asymptomatic RT PCR negative patients. The Panbio&trade; COVID-19 Ag Rapid Test shows good performance in detecting COVID-19 cases in patients with a symptom onset time of less than seven (7) days. This performance is even better when the symptom onset is reduced to five (5) days. The results show that the antigen RDT is not suitable for&nbsp;&nbsp; COVID-19 detection among asymptomatic patients. &nbsp; Key words: COVID-19, SARS-CoV-2, diagnosis, antigen test, rapid test, point-of-care.

The burden of a new coronavirus infection in a Children’s multidisciplinary hospital in St. Petersburg 2020–2021

Objective: To describe the burden of COVID-19 in a children’s multidisciplinary hospital for two years of the pandemic, taking into account of age, severity of the disease, the spectrum of underlying conditions and the intensive care need.Methods: An assessment of 6048 cases of COVID-19 in patients under 18 years of age hospitalized from March 26, 2020 to December 31, 2021 was carried out. The diagnosis was confirmed by PCR on an outpatient basis or after hospitalization with the help of diagnostic kits registered in the Russian Federation. The features of the work of a children’s multidisciplinary hospital in new conditions, the dynamics of hospitalization, age characteristics and new coronavirus (CV) infection severity in the pandemic development process are presented. The analysis of the underlying condition’s structure depending on the severity of the disease, as well as the need and volume of therapy in the intensive care unit. The frequency and main characteristics of children’s multisystem inflammatory syndrome (MIS-C) in hospital conditions, long-term PCR positivity and its effect on the duration of inpatient treatment of children have been established.Results: The spread of SARS-COV-2 in St. Petersburg required a radical change in the work of the children’s multidisciplinary hospital. During the two years of the pandemic, four waves of hospitalization of children with new CV were revealed, differing in duration, intensity, and frequency of lung damage, but having no significant differences in the proportion of severe forms of the disease (1.7-2.8% of cases). Intensive therapy was required in 3.6% of cases, of which only 1/3 was due to the severe course of COVID-19 with a lung lesion volume of up to 100%. In 1/3 of cases, patients had risks of developing severe forms and in 1/3 – other pathology. Severe course of new CV was significantly more often accompanied by the need for respiratory support, anticoagulants and anti-inflammatory therapy. Contributing factors of severe forms and unfavorable outcomes were: pathology of the central nervous system, genetic diseases and malformations, obesity, as well as chronic bronchopulmonary pathology. Mortality in the hospital was recorded only among children with severe underlying conditions (0.1% of cases). D-MVS was registered significantly more often in boys (7 out of every 10 patients), accounting for 1.2% of cases of hospitalization of children with new CV over the entire period. Convalescent PCR-positivity in the outcome of COVID-19 was detected in 1/3 of children, significantly more often during the autumnwinter waves of the pandemic and among patients of high school age.Conclusion: New CV is gradually strengthening its position in the structure of acute respiratory pathology in children. Some of SARS-COV-2 infection cases is accompanied by extensive lung damage, as well as severe systemic inflammation independently or in the other infectious diseases structure, induction of the debut of various somatic pathology is not excluded. The presented data confirm the need for increased attention at high risk of adverse respiratory diseases outcomes children. All severe cases of COVID-19 in children require a personalized approach, taking into account the existing background diseases and possible options for the progression of the process. MIS-C should be considered as a systemic inflammatory response syndrome within the framework of an infectious disease of various etiologies, differentiated with Kawasaki disease and the debut of systemic diseases. The long-term PCR-positivity in the outcome of COVID-19 requires further study to address the need and nature of therapy in order to prevent further spread of infection in the population.

COVID-19 in people living with HIV – A case series

People with chronic diseases, old age, obesity, and immunosuppression are more susceptible to infections, including COVID-19. Human immunodeficiency virus (HIV) is widely prevalent in India, yet, the number of COVID cases in people living with HIV is low. We report six cases of COVID-19 in patients with HIV who face various challenges in the intensive care unit. The severity of their COVID infection varies from patient to patient depending on their immune status and treatment with antiretroviral therapy.

Breakthrough COVID-19 cases and hospitalization risk: ASCO COVID-19 registry.

e18807 Background: The ASCO Registry was created to analyze the impact of COVID-19 (COVID) on treatment (Tx) and outcomes of patients (pts) with cancer. Vaccination questions were added in 2021, enabling examination of breakthrough cases – i.e., SARS-CoV-2 infection after vaccination. Methods: The Registry includes pts who test positive for SARS-CoV-2 and have clinically evident cancer receiving Tx or resected cancer on adjuvant Tx &lt;12 months since surgery at the time of the positive test. Practices report data on COVID vaccine type and dates, positive SARS-CoV-2 test date, and subsequent Tx. Breakthrough cases were defined as 1) &gt; 35 days after 1st Pfizer dose, 2) &gt; 42 days after 1st Moderna dose, 3) &gt; 14 days after 1st Janssen dose, or 4) &gt; 42 days after 1st unknown vaccine dose. Data submission cutoff for all practices was February 2, 2022. Summary statistics and exact binomial 95% confidence intervals (CIs) were calculated. Results: This analysis reports on 231 pts with breakthrough cases. Median age is 68 years and 57% of pts are over age 65. Of 73 pts with non-metastatic solid tumors, 19% were hospitalized. Of 74 with metastatic solid tumors, 39% were hospitalized. Of 75 with B-cell malignancies, 32% were hospitalized. Of 9 with other hematologic malignancies, 56% were hospitalized. While the fraction of patients in the ASCO registry with breakthrough cases who were hospitalized remained fairly constant throughout 2021 (approximately 40%), those with breakthrough cases occurring in the last month of 2021 and early 2022 had a lower hospitalization rate (approximately 20%), which is consistent with less severe cases of COVID-19 in patients infected with the omicron variant (the predominant variant in the US in Dec 2021- Jan 2022) (Table). The majority of breakthrough cases occurred more than 6 months after initial vaccination (71%) and the median time to breakthrough infection from initial vaccination was 7.3 months (IQR: 5.6 – 9.9). The Registry continues to accrue cases and additional vaccine data; analysis will be updated with most current vaccination data for possible Annual Meeting presentation. Conclusions: Hospitalizations among patients with cancer and breakthrough COVID in the ASCO Registry occur at a high rate, particularly among patients with advanced cancers and hematologic malignancies. This decrease in recent months is likely due to increased incidence of the Omicron variant that resulted in milder COVID symptoms among those infected. A majority of SARS-CoV-2 infections occurring six months or more after vaccination suggests waning vaccine efficacy over time that could be impacted by additional doses.[Table: see text]

Emergency Operation in Dr Wahidin Sudirohusodo and Hasanuddin University Hospital during the COVID-19 Pandemic

Introduction : In December 2019, the world was shocked by a respiratory infectious disease caused by the novel coronavirus which was later referred to as COVID-19. This virus is transmitted from human to human very quickly through droplets, aerosols, and direct contact with COVID-19 patients. One of the health services suspected of playing a role in the spread of this virus is surgery. Surgical procedures involve much medical personnel and direct contact withpatients causes surgery to be considered. In addition, surgery is also prone to causing nosocomial infections becausegenerally postoperative patients have an increased inflammatory process and decreased immune response. In contrast toelective surgery, emergency surgery has a higher risk of postoperative morbidity and mortality than elective surgerybecause of the limited time to prepare and assess the patient. To find out the number of reactive and positive cases of COVID-19 after emergency surgery at our institution.&#x0D; Method : The type of research conducted is descriptive where this study uses secondary data in the form of medical records of postoperative emergency patients who meet the inclusion and exclusion criteria.&#x0D; Results : A total of 741 medical records were obtained, with 691 of them being COVID-19 negative and 50 being COVID-19 positive.&#x0D; Conclusion: We found 93.3% negative post-operative COVID-19 cases and 6.7% positive post-operative COVID-19 cases in patients underwent emergency surgery procedures.

Acute Kidney Injury Associated With Remdesivir: A Comprehensive Pharmacovigilance Analysis of COVID-19 Reports in FAERS.

Acute kidney injury (AKI) is a common complication among patients with the novel coronavirus (COVID-19). COVID-19 along with AKI usually resulted in a poor prognosis for those affected. Remdesivir is a novel antiviral drug that was urgently approved for the treatment of COVID-19. In the current study, safety data of remdesivir were limited. We gathered information on COVID-19 cases in patients with adverse events that were reported to the U.S. Food and Drug Administration (US FDA) Adverse Event Reporting System (FAERS) database. We employed the reporting odds ratio (ROR) method to perform disproportionality analysis. Finally, we identified 12,869 COVID-19 cases. A total of 3,991 of these cases reported remdesivir as a primary suspected drug, while 8,878 cases were treated with other drugs. More AKI events occurred in cases of male patients and those above the age of 65 years. We detected a significant association between remdesivir and AKI: ROR = 2.81, 95% CI (2.48, 3.18). The association was stronger after the propensity score matching ROR = 3.85, 95% CI (3.11, 4.78). The mean time to AKI event onset was 4.91 ± 7.25 days in COVID-19 cases with remdesivir therapy. The fatality proportion was 36.45% in AKI cases with remdesivir treatment. This pharmacovigilance study identified a significant association between AKI events and remdesivir treatment in COVID-19 patients by mining FAERS real-world big data. Although causality was not confirmed, the association between remdesivir and AKI should not be ignored, especially in the older, male COVID-19 inpatients.

MS and COVID-19 challenge: asymptomatic COVID-19 infection during treatment with cladribine.

BackgroundThe use of disease-modifying therapies (DMTs) in people with multiple sclerosis (pwMS) may affect COVID-19 infection outcomes due to DMTs’ immunomodulatory and immunosuppressive effects on immune response. The yet unknown issues are both the early response to the infection, as well as the post-infection development of immunity against the virus under these treatments due to their interaction with the immune system.MethodsWe report two asymptomatic cases of COVID-19 in patients with relapsing–remitting multiple sclerosis (RRMS) shortly after starting cladribine therapy, both developed anti-SARS-CoV-2 antibody response.ResultsPatients with MS who are under newly initiated treatment with cladribine tablets may experience an asymptomatic COVID-19 infection and they may develop immunity against SARS-CoV-2.ConclusionThese observations raise the probability that DMTs with immunosuppressive effects, such as cladribine, may be considered as a treatment option for selected MS patients with high disease activity during the COVID-19 pandemic.

Low vitamin D levels and increased neutrophil in patients admitted at ICU with COVID-19.

Background & aimsSystemic inflammation has been reported as a new predictor for COVID-19 outcomes. Thus, we hypothesized that ICU patients infected by COVID-19 had lower blood vitamin D levels and increased systemic inflammation. Therefore, this is the first Brazilian study to evaluate the vitamin D concentrations and NLR as a systemic inflammation in patients infected by COVID-19 admitted in ICU.MethodsThis cross-sectional study selected twenty-six patients from COVID-19 Data Sharing/FAPESP, Brazil. Twenty-five patients were enrolled from a single hospital and those with blood vitamin D and neutrophil and lymphocyte data were included and had all available data analyzed. Patients were divided in two groups: low vitamin D concentration when ≤20 ng/mL (low Vit D group, n = 8, 5M/3F, 62.7 ± 8.4 years old), and normal vitamin D when > 20 ng/mL (normal Vit D group, n = 17, 9M/8F, 74 ± 8.2 years old). Serum 25-hydroxy-vitamin D, C reactive protein (CRP), and count of neutrophils and lymphocytes concentrations were collected from COVID-19 Data Sharing/FAPESP. Statistical analyses were performed using the Prism version 5.0 and Student T test was applied to verify any difference between the groups.ResultsLow vitamin D group had 15.5 ± 3.3 ng/mL of 25OH Vit D concentrations and normal vitamin D group had 35.9 ± 8.8 ng/mL. Although no difference between groups for CRP concentrations (low Vit D: 4.5 ± 3.3 vs. normal Vit D: 4.2 ± 4.0 mg/dL, p = 0.45), we found higher neutrophil count and NLR values in the low Vit D group when compared to normal Vit D group (low Vit D: 6049.8 ± 3719.7 vs. normal Vit D: 3741.8 ± 1704.1 ng/mL, p = 0.02) and (low Vit D: 9.0 ± 8.6 vs. normal Vit D: 4.2 ± 4.0 ng/mL, p = 0.03), respectively.ConclusionThis data sharing-derived cases of COVID-19 in patients admitted at ICU showed that patients infected by COVID-19 had lower serum 25-hydroxy vitamin D and enhanced systemic inflammation when assessed by NLR values.

The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals.

Nosocomial transmission of SARS-CoV-2 is a key concern, and evaluating the effect of testing and infection prevention and control strategies is essential for guiding policy in this area. Using a within-hospital SEIR transition model of SARS-CoV-2 in a typical English hospital, we estimate that between 9 March 2020 and 17 July 2020 approximately 20% of infections in inpatients, and 73% of infections in healthcare workers (HCWs) were due to nosocomial transmission. Model results suggest that placing suspected COVID-19 patients in single rooms or bays has the potential to reduce hospital-acquired infections in patients by up to 35%. Periodic testing of HCWs has a smaller effect on the number of hospital-acquired COVID-19 cases in patients, but reduces infection in HCWs by as much as 37% and results in only a small proportion of staff absences (approx. 0.3% per day). This is considerably less than the 20–25% of staff that have been reported to be absent from work owing to suspected COVID-19 and self-isolation. Model-based evaluations of interventions, informed by data collected so far, can help to inform policy as the pandemic progresses and help prevent transmission in the vulnerable hospital population.This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.

Inflammatory Bowel Disease (IBD) and immunosuppression do not worsen the prognosis of COVID-19. Results from the ENEIDA Project of GETECCU

BackgroundThe exhaustive registry of COVID-19 cases in patients with IBD is a unique opportunity to learn how to deal with this infection, especially in reference to the management of immunosuppressive treatment, isolation measures or if the disease is more severe in IBD patients due to immunosuppression. With these premises, the aims of this study were to know the incidence and characteristics of COVID-19 in the ENEIDA cohort during the first wave of the pandemic; the outcomes among those under immunosuppressants/biologics for IBD; the risk factors for contracting the infection and poor outcomes; and the impact of the infection after three-month follow-up.MethodsProspective observational cohort study of all IBD patients with COVID-19 included in the ENEIDA registry (with 60.512 patients in that period) between March and July 2020, with at least 3 months of follow-up. Any patient with a confirmed (by PCR or SARS-CoV-2 serology) or probable (suggestive clinical picture) infection was considered as a case.ResultsA total of 484 patients with COVID-19 from 63 centres were included: 247 Crohn’s disease, 223 ulcerative colitis and 14 unclassified colitis; median age 52 years (IQR: 42–61), 48% women and 44% ≥1 comorbidity. Diagnosis was made by PCR: 63% and serology: 35%. The most frequent symptoms: fever (69%), followed by cough (63%) and asthenia (38%). During lockdown 78% followed strict isolation. 35% required hospital admission (ICU: 2.7%) and 12% fulfilled criteria for SIRS upon admission. 16 patients died from COVID-19 (mortality:3.3%). 12% stop IBD medication during COVID-19. At 3 months, taken into account all included cases, 76% were in remission of IBD. Male gender (OR 1.56; 95%CI:1–2.4, p=0.05), ≥40 years of age (OR 2.55; 95% CI:1.4–4.8; p=0.004), Charlson score ≥1 (OR 2.1; 95% CI:1.3–3.5; p=0.004), and systemic steroids <3 months before infection (OR 1.8; 95%CI:1–1.6; p= 0.032), were risk factors for hospitalisation due to COVID-19, while occupation considered of risk was actually protective (OR 0.58; 95%CI:0.3–0.99; p=0.046). A Charlson score ≥ 1 (OR 5.5; 95%CI:1.5–20.3; p=0.001) and the use of aminosalicylates at COVID-19 diagnosis (OR 4.6;95%CI:1.2–17; p=0.023) were associated with ICU admission. Age ≥60 years (OR 6.5; 95%CI:1.7–25.5; p=0.007) was the only risk factor for COVID-19 related death.ConclusionIBD does not seem to worsen the prognosis of COVID-19, even when immunosuppressants and biological drugs are used. Age and comorbidity are the most important prognostic factors for more severe COVID-19 in IBD patients. The use of aminosalicylates and the risk of a worse outcome deserves a deeper analysis.Funded by the Carlos III Health Institute (COV20 / 00227).

The course and outcomes of COVID-19 in patients with ANCA-associated systemic vasculitis, receiving biological therapy (Rituximab, Mepolizumab): The results of the first 8 months of the pandemic

Objective. Currently, the issues of the effect of anti-B cell therapy or inhibitor of interleukin 5 on the risk of COVID-19 infecting and outcomes in patients with ANCA-associated vasculitis (AAV) has not been completely studied. We present an analysis of the COVID-19 course and outcomes in AAV patients treated with rituximab or mepolizumab from one rheumatology center registry. Methods. From November 11 to November 15, 2020, a cross-sectional study was conducted using telephone and online surveys, and information was collected from all 128 AAV patients treated with rituximab in V.A. Nasonova Research Institute of Rheumatology. Patients mean age was 51 (20–81) years, 61.7% were women. Granulomatosis with polyangiitis (GPA) was diagnosed in 58 patients, microscopic polyangiitis (MPA) – in 38, eosinophilic granulomatosis with polyangiitis (EGPA) – in 24 (including 54.2% of ANCA-negative cases), and AAV with uncertain nosological affiliation – in 8 patients. Due to the disease activity or a high risk of AAV recurrence during the pandemic rituximab was prescribed in 60/126 (47.6%) patients, and mepolizumab – in 6 cases. Results. In the spring of the pandemic (until May 2020), the incidence of COVID-19 in AAV patients treated with rituximab was 4.3%, the disease course was relatively favorable. All patients recovered. At month 3–6, antibodies to SARS-CoV-2 IgG persisted in only 1 out of 4 patients. Since September 2020, the incidence has increased 3-fold, with a more severe course of COVID-19. In total, in the period until November 11, 2020, COVID-19 was diagnosed in 17.2% (22/128); the mean age of patients was 55 (25–81) years; 54.5% were women. 21/22 patients were on rituximab therapy, 2 patients had mepolizumab therapy (including 1 case after previous rituximab therapy). COVID-19 incidence was lower in patients with GPA (15.5%) vs MPA and EGPA (21.1% and 20.8% respectively). The mortality rate was 13.6%, including 2 patients with MPA and 1 patient with GPA. When analyzing the 5-year survival rate according to the registry of AAV patients treated with rituximab, prognosis worsening was noted; in 2020 there were 3 deaths due to COVID-19, in the previous 5 years – only 2 deaths. Discussion. Taking into account the fact the mechanisms of AAV and severe COVID-19 are largely synergistic (primarily in the context of microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome as manifestation of the acute inflammatory syndrome), the activity of AAV can potentially contribute to the disease onset and a severe course of COVID-19. Given the previously published information on the use of rituximab during the COVID-19 pandemic for various diseases, it seems that B cell depletion, without reducing the risk of infection, may have a protective effect with regard to the risk of severe/catastrophic COVID-19, which, however, can be insufficient in AAV patients. Further analysis of COVID-19 cases in patients with AAV and other immuno-inflammatory rheumatic diseases is exceptionally important.

Implications of COVID-19 for patients with pre-existing digestive diseases: an update

Implications of COVID-19 for patients with pre-existing digestive diseases: an update

The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals. (Special Issue: Modelling that shaped the early COVID-19 pandemic response in the UK.)

Nosocomial transmission of SARS-CoV-2 is a key concern, and evaluating the effect of testing and infection prevention and control strategies is essential for guiding policy in this area. Using a within-hospital SEIR transition model of SARS-CoV-2 in a typical English hospital, we estimate that between 9 March 2020 and 17 July 2020 approximately 20% of infections in inpatients, and 73% of infections in healthcare workers (HCWs) were due to nosocomial transmission. Model results suggest that placing suspected COVID-19 patients in single rooms or bays has the potential to reduce hospital-acquired infections in patients by up to 35%. Periodic testing of HCWs has a smaller effect on the number of hospital-acquired COVID-19 cases in patients, but reduces infection in HCWs by as much as 37% and results in only a small proportion of staff absences (approx. 0.3% per day). This is considerably less than the 20-25% of staff that have been reported to be absent from work owing to suspected COVID-19 and self-isolation. Model-based evaluations of interventions, informed by data collected so far, can help to inform policy as the pandemic progresses and help prevent transmission in the vulnerable hospital population.

Risk and Outcomes of COVID-19 Patients with Asthma: A Meta-Analysis

Objective: The outbreak of SARS-CoV-2 disease (COVID-19) emerged in 2019, and ultimately spread worldwide, being defined as a pandemic by the World Health Organization on March 11, 2020. The respiratory disease related to COVID-19 can range from being asymptomatic to presenting as devastating ARDS and death. The elderly and individuals with comorbidities and immunocompromised states are at a higher risk. Asthma is an inflammatory spasm of the airways with ACE2 overexpression at the alveolar level. ACE2 and TMPRSS2 expression mediate SARS-CoV-2 infection of host lung cells and hence might increase disease susceptibility in asthmatics. Materials and Methods: A literature review was done by searching the databases of Pubmed, WHO, clinicaltrials.gov, and Google Scholar, using the keywords of -COVID-19, SARS-CoV-2, coronavirus, asthma, and their combinations, following the timeline of December 2019 to August 10, 2020. We included patients with asthma diagnosed with COVID-19 while excluding non-COVID-19 patients, pregnant patients, and patients with other diseases or comorbidities. Primary outcomes included mortality and ICU admissions of both groups. Based on the available data, we conducted a meta-analysis via RevMan 5.4 using a random-effects model and 95% confidence intervals. Results: Patients with and without asthma were compared for risk outcomes of mortality. For the 755 COVID-19 patients with asthma and 4969 non-asthmatic COVID-19 patients, we found that the risk of mortality would increase by 9% in the asthmatic group (RR=1.09, CI= 0.58 to 2.03, I2=72%). There was an increased proportion of ICU admissions among the asthmatic group (RR=1.39, CI = 0.80 to 2.42). There was high heterogeneity among the studies (I² = 79%). Medications such as corticosteroids improve the mortality and ICU admission rates. Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma has been lower than those of the nonasthmatic group. COVID-19 patients with asthma were at increased risk of mortality and ICU admission due to underlying factors or predisposition. Finally, corticosteroids are considered safe and may confer protection against the severity of COVID-19 infection.

Disproportionate impact of COVID-19 disease among racial and ethnic minorities in the U.S. cancer population as seen in CancerLinQ Discovery data.

84 Background: Patients with cancer may face difficult care decisions during the COVID-19 outbreak in the US. Understanding COVID-19 risk factors may help patients and oncologists identify high-risk patients and plan for the best cancer treatment in a timely fashion. This analysis provides an assessment of racial and ethnic risk factors for COVID-19 disease within the CancerLinQ (CLQ) Discovery database. Methods: CLQ is a health technology platform developed by ASCO, which collects and aggregates longitudinal electronic health record (EHR) data from oncology practices throughout the United States. Patients with a diagnosis of a malignant neoplasm and at least two encounters in the past year at a reporting CLQ practice were defined as the underlying cancer patient population at risk for SARS-CoV-2 infection. COVID-19 cases were identified via a positive RT-PCR test for SARS-CoV-2 RNA and/or an ICD-10 code for coronavirus (e.g., B97.29, U07.1, or U07.2). Relative risks and 95% CI were calculated using SAS. Results: We identified 232,428 patients with cancer. From 1/1/2020-4/30/2020, we identified 223 COVID-19 cases in patients with cancer. Of these, 203 had a positive RT-PCR, 26 had an ICD-10 diagnosis code for SARS-CoV-2, and 6 had both. SARS-CoV-2 cases were identified from 19 of the 35 CLQ practices (52.8%) reporting data during the study period. Compared to white patients, African Americans were approximately 2 times more likely to have COVID-19 disease (RR = 1.95; 95% CI = 1.40-2.71), and Hispanics were more than 4 times more likely (RR = 4.65; 95% CI = 3.36-6.43). Patients with hematologic cancers were 1.5 times as likely to be diagnosed with COVID-19 (RR = 1.53; 95% CI = 1.09-2.16) compared to patients with solid tumors. At the time of this abstract, 10 patients (4.5%) died. Conclusions: These results are based on data from a sample of CLQ practices and represent an initial analysis of COVID-19 in the CLQ population. The elevated risk for COVID-19 among African Americans and Hispanics with cancer is noteworthy, particularly since these patients often suffer poorer cancer outcomes. The elevated risk among patients with hematologic cancers is also worth noting because these patients often have compromised immune systems and are already susceptible to many other types of infection. Because the US is in the midst of an active outbreak, we are continuing to analyze new cases and additional risk factors, such as geographical location, anti-cancer treatments, and other cancer variables (e.g. stage).