Long-term Infectious Complications Research Articles

The Long-term Complications of Covid-19 Infection.

As the Covid-19 pandemic continues into its 4th year, reports of long-term morbidity and mortality are now attracting attention. Recent studies suggest that Covid-19 survivors are at increased risk of common illnesses, such as myocardial infarction, diabetes mellitus and autoimmune disorders. Mortality may also be increased. This article will review the evidence that supports some of these observations and provide an opinion about their validity and their relevance to insured cohorts.

The Long-term Complications of Covid-19 Infection.

As the Covid-19 pandemic continues into its 4th year, reports of long-term morbidity and mortality are now attracting attention. Recent studies suggest that Covid-19 survivors are at increased risk of common illnesses, such as myocardial infarction, diabetes mellitus and autoimmune disorders. Mortality may also be increased. This article will review the evidence that supports some of these observations and provide an opinion about their validity and their relevance to insured cohorts.

#271 The nexus between TMA/TTP, MIS-C, and SLE

Abstract Background and Aims The long-term complications of COVID-19 infection & Multisystem inflammatory syndrome in children (MIS-C) on immune system are still unknown, however there're reports on development of autoimmune disease, highlighting their immune-related nature. MIS-C can induce Thrombotic Microangiopathy (TMA), by inducing endothelial dysfunction, platelet activation, & microthrombi formation, whereas SLE induces TMA/Thrombotic thrombocytopenic purpura (TTP), with ADAMTS13 activity < 10%, or 2ry TMA with ADAMTS13 activity ≥ 10%, where SLE/TTP carries a bad prognosis. Method Our case is one of its kind, where a 12-year- old girl, who was previously infected with SARS-CoV-2, presented with new-onset SLE, associated MIS-C & 2ry TMA/TTP. She presented with convulsions, oliguria, heart failure, impaired kidney function, microangiopathic hemolytic anemia, pancytopenia, highly elevated LDH, & was diagnosed as TMA. Results COVID serology was +ve for IgG, & -ve for IgM, & -ve SARS-CoV-2 PCR, a diagnosis of MIS-C was postulated. Further investigations revealed low C3, C4, +ve ANA, anti-ds DNA & anti-phospholipid Antibodies. Brain imaging showed left cerebellar calcification. Echocardiography showed biventricular dysfunction with EF 30%, where the diagnosis of SLE according to Euler/ACR criteria was confirmed, with 2ry TMA. Emergency hemodialysis, PRBCs transfusion, pulse steroid with total plasma exchange (TPE), were initiated without marked improvement. Rituximab was started on 4th day, but she had generalized convulsion, arrythmia & sudden death occurred. Results of ADAMTS13 activity was < 1%, with +ve autoantibodies, so diagnosis of TMA/TTP was confirmed. Conclusion TMA are a diverse group of disorders that causes microvasculature thrombosis, which is inherited, or acquired 2ry to SLE or COVID-19 infection, where high index of suspicions should be raised for early diagnosis and prompt management, meanwhile COVID-19 infection can induce the development of autoimmune diseases. Herein we raise the question of cause of TMA/TTP, was it 2ry only SLE, or to the previous COVID-19 infection & MIS-C, and if this SLE itself was 2ry also to the previous COVID infection, or all it was by chance?

#3131 Catheter placement by the nephrologist: a safe and effective method for improving access to peritoneal dialysis

Abstract Background and Aims Peritoneal dialysis (PD) is as effective as hemodialysis and provides a better quality of life. However, it remains underused, particularly in our country, for several reasons, especially the unavailability of surgeons with the necessary skills to insert catheters. The aim of our study was to evaluate the impact of catheter placement by the nephrologist on the incidence of peritoneal dialysis patients, compare the success rates and assess the short- and long-term complications between surgical and nephrologist placements. The ultimate goal was to identify and promote the most effective method with the fewest complications. Methods Retrospective study of 69 patients with PD from January 2008 to December 2022. Results 28 received PD catheter placement by nephrologists (group A), while 41 underwent the procedure performed by urologists (group B).The incidence of patients placed on PD has shown a significant increase since the initiation of catheter placement by nephrologists, with a growth rate of over 100% every two years. No significant difference was observed in the incidence of short-term mechanical and infectious complications between the two groups. However, the group B experienced a higher occurrence of long-term mechanical and infectious complications compared to the group A. The waiting time before catheter placement was significantly shorter in group A (5 days vs. 20 days; p < 0.001). The success rate of peritoneal dialysis catheter placement in group A was 92.85%, while it was 97.56% in group B. There was no significant difference in catheter survival at 1 year between the two groups. However, the mean catheter survival was significantly longer in group B (17 months vs. 11 months, p = 0.026). Conclusion The placement of the PD catheter by nephrologists has demonstrated effectiveness and safety. However, it is crucial to investigate and address the factors contributing to the shorter mean catheter survival. By identifying and correcting these factors, we can improve the longevity of catheters and enhance the overall success of PD procedures.

PSA density as a predictor of long-term infectious complications during transurethral resection of the prostate: determining an optimal cut-off value

Introduction. Infectious complications (ICs) after transurethral resection of the prostate (TURP) are significant and potentially life-threatening conditions with an incidence 0.5% – 20.0%. Most publications provide data regarding early infectious complications. At the same time, there are currently no studies aimed at a comprehensive assessment of long-term infectious complications after TURP. The problem of prevention and treatment of ICs is also accompanied by insufficient understanding of the role of undiagnosed inflammation in prostate tissues and the lack of representative laboratory markers.Objective. To assess the prostate-specific antigen density (PSAd) as a predictor of long-term infectious complications after transurethral resection of the prostate and to determine the optimal cut-off value.Materials & methods. This single-center study included 162 patients who underwent mono- and bipolar TURP between 2016 – 2023. Inclusion criteria for the study: prostate volume 30–80 cm3, no history of urinary tract infections (UTIs) at the time of hospitalization and antibiotic treatment at least one month before surgery, possible presence of latent UTIs before surgery, no prostate cancer. Exclusion criteria were failure to meet inclusion criteria. Infectious complications assessed included upper and lower UTIs, as well as epididymitis, orchitis and prostatitis, confirmed by clinical and laboratory data. Prostate-specific antigen (PSA) assessment was performed < 2 days before surgery.Results. The median PSAd value was 0.04 [0.03; 0.08] ng/ml2, the variable was significantly different in non-infection and infection groups (0.04 and 0.08 ng/ml2, respectively, p = 0.009). The area under the curve (AUC) was 0.67 (95% CI [0.546 – 0.791]). The optimal cut-off value of the PSAd in prediction of long-term ICs was > 0.07 ng/ml2, sensitivity / specificity: 58.3% and 76.1%, respectively. The analysis showed more than 4 times higher odds of developing an infectious complication in PSAd > 0.07 ng/ml2 patients: OR 4.3 (95% CI [1.7 – 10.5], p = 0.001).Conclusion. This study demonstrates data that defines a new clinical non-oncological significance of PSAd as a predictor of the development of long-term infectious complications after TURP.

Early Biofilm Formation on the Drain Tip after Total Knee Arthroplasty Is Not Associated with Prosthetic Joint Infection: A Pilot Prospective Case Series Study of a Single Center

Background: Periprosthetic joint infection (PJI) is a devastating complication of arthroplasties that could occur during the surgery. The purpose of this study was to analyze the biofilm formation through microbiological culture tests and scanning electron microscopy (SEM) on the tip of surgical drainage removed 24 h after arthroplasty surgery. Methods: A total of 50 consecutive patients were included in the present prospective observational study. Drains were removed under total aseptic conditions twenty-four hours after surgery. The drain tip was cut in three equal parts of approximately 2–3 cm in length and sent for culture, culture after sonication, and SEM analysis. The degree of biofilm formation was determined using a SEM semi-quantitative scale. Results: From the microbiological analysis, the cultures of four samples were positive. The semi-quantitative SEM analysis showed that no patient had grade 4 of biofilm formation. A total of 8 patients (16%) had grade 3, and 14 patients (28%) had grade 2. Grade 1, scattered cocci with immature biofilm, was contemplated in 16 patients (32%). Finally, 12 patients (24%) had grade 0 with a total absence of bacteria. During the follow-up (up to 36 months), no patient showed short- or long-term infectious complications. Conclusions: Most of the patients who underwent primary total knee arthroplasty (TKA) showed biofilm formation on the tip of surgical drain 24 h after surgery even though none showed a mature biofilm formation (grade 4). Furthermore, 8% of patients were characterized by a positivity of culture analysis. However, none of the patients included in the study showed signs of PJI up to 3 years of follow-up.

Penile cancer: long-term infectious and thromboembolic complications following lymph node dissection – a population-based study (Sweden)

Purpose To assess the long-term risks of infectious and thromboembolic events following inguinal (ILND) and pelvic (PLND) lymph node dissection in men with penile cancer. Material and methods A total of 364 men subjected to ILND with or without PLND for penile cancer between 2000 and 2012 were identified in the Swedish National Penile Cancer Register. Each patient was matched based on age and county of residence with six penile cancer-free men. The Swedish Cancer Register and other population-based registers were used to retrieve information on treatment and hospitalisation for selected infectious and thromboembolic events. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models with multiple imputation. Results The risk of infectious events remained increased for more than five years postoperatively in men with penile cancer compared with matched controls. The palpable nodal disease was the only predictor of these events, with risk increasing with the cN stage. The HR at one, three and five years and six months postoperatively was 8.60 (95% CI 5.16–14.34), 4.02 (95% CI 2.65–6.09) and 1.93 (95% CI 1.11–3.38), respectively. An increased risk of thromboembolic events persisted for three years postoperatively. The HR at one and three years postoperatively was 13.51 (95% CI 6.53–27.93) and 2.12 (95% CI 1.07–4.20). The results correspond well with the over-prescription of anticoagulants observed during this period. An association with bulky disease (cN3) was observed. Conclusions Lymph node dissection for penile cancer is associated with an increased risk of infectious and thromboembolic events. The findings of this population-based study show that the risks of these events remain increased more than five years for infectious and three years for thromboembolic events. Improved awareness of long-term complications following ILND is of importance both among patients and care givers to ensure early detection and treatment.

Post-COVID-19-associated multiorgan complications or "long COVID" with literature review and management strategy discussion: A meta-analysis.

To investigate the post-COVID-19 long-term complications or long COVID of various organ systems in patients after 3 months of the infection, specifically before the Omicron variant, with comparative literature analysis. A systemic literature search and meta-analysis were conducted using multiple electronic databases (PubMed, Scopus, Cochrane library) with predefined search terms to identify eligible articles. Eligible studies reported long-term complications of COVID-19 infection before the Omicron variant infection. Case reports, case series, observational studies with cross-sectional or prospective research design, case-control studies, and experimental studies that reported post-COVID-19 complications were included. The complications reported after 3 months after the recovery from COVID-19 infection were included in the study. The total number of studies available for analysis was 34. The effect size (ES) for neurological complications was 29% with 95% confidence interval (CI): 19%-39%. ES for psychiatric complications was 24% with 95% CI: 7%-41%. ES was 9% for cardiac outcomes, with a 95% CI of 1%-18%. ES was 22%, 95% CI: 5%-39% for the gastrointestinal outcome. ES for musculoskeletal symptoms was 18% with 95% CI: 9%-28%. ES for pulmonary complications was 28% with 95% CI: 18%-37%. ES for dermatological complications was 25%, with a 95% CI of 23%-26%. ES for endocrine outcomes was 8%, with a 95% CI of 8%-9%. ES size for renal outcomes was 3% with a 95% CI of 1%-7%. At the same time, other miscellaneous uncategorized outcomes had ES of 39% with 95% CI of21%-57%. Apart from analyzing COVID-19 systemic complications outcomes, the ES for hospitalization and intensivecare unitadmissions were found to be 4%, 95% CI: 0%-7%, and 11% with 95% CI: 8%-14%. By acquiring the data and statistically analyzing the post-COVID-19 complications during the prevalence of most virulent strains, this study has generated a different way of understanding COVID-19 and its complications for better community health.

MP71-02 ASSESSING THE IMPACT OF HYPOGONADISM ON SURGICAL OUTCOMES FOLLOWING ARTIFICIAL URINARY SPHINCTER PLACEMENT

You have accessJournal of UrologyCME1 Apr 2023MP71-02 ASSESSING THE IMPACT OF HYPOGONADISM ON SURGICAL OUTCOMES FOLLOWING ARTIFICIAL URINARY SPHINCTER PLACEMENT Andrew Gabrielson, Logan Galansky, Una Choi, and Andrew Cohen Andrew GabrielsonAndrew Gabrielson More articles by this author , Logan GalanskyLogan Galansky More articles by this author , Una ChoiUna Choi More articles by this author , and Andrew CohenAndrew Cohen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003339.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Retrospective series suggest a link between hypogonadism and complications following artificial urinary sphincter (AUS) placement. We sought to confirm this finding and evaluate whether testosterone replacement therapy (TRT) in hypogonadal patients prior to AUS placement mitigates this risk. METHODS: A retrospective cohort study was conducted using the TriNetX research network between 2006-2022. We defined 4 groups: 1) Eugonadal patients undergoing AUS, 2) Hypogonadal patients (>1 confirmatory T level <300 ng/dL) with and without TRT, 3) Hypogonadal patients who received TRT prior to AUS, 4) Hypogonadal patients who did not receive TRT prior to AUS. Propensity-score matching was used in comparing baseline differences in comorbidities of the eugonadal and hypogonadal arms. Outcomes included 5-year all-cause revision (cuff erosion, mechanical, infectious), 5-year device complication (mechanical, infectious only), and 90-day surgical site infection (SSI) rate. RESULTS: We included 4,520 eugonadal and 514 hypogonadal patients (19% with TRT, 81% without TRT) undergoing AUS (Table 1). Compared to eugonadal patients, the hypogonadal cohort had a significantly higher 5-year device complication (17% vs 13%, p=0.03) and 90-day SSI rate (2% vs 0.8%, p<0.01), but no difference in 5-year revision rate (26% vs 24%, p=0.21). When comparing hypogonadal patients who received TRT prior to AUS versus hypogonadal patients who did not receive TRT, we found no difference in 5-year revision (32% vs 26%, p=0.19), 5-year device complication (23% vs. 16%, p=0.10), or 90-day SSI (1.1% vs. 1.9%, p=0.48) rates. Hypogonadal patients receiving TRT before AUS were more likely to have pre-existing erectile dysfunction and penile implant surgery, but had similar rates of radical prostatectomy. Post-AUS, only 22 (5.3%) patients in the non-TRT arm received new TRT, suggesting minimal crossover. There was no difference in 5-year revision between eugonadal and hypogonadal patients not receiving TRT. CONCLUSIONS: Pre-existing hypogonadism may impact early SSI rates and long-term mechanical or infectious complications but was not associated with higher rates of all-cause revision likely due to similar rates of cuff erosion. TRT does not appear to impact surgical outcomes among hypogonadal patients undergoing AUS placement. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1013 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Gabrielson More articles by this author Logan Galansky More articles by this author Una Choi More articles by this author Andrew Cohen More articles by this author Expand All Advertisement PDF downloadLoading ...

2116. Long-term (2-year) outcomes and complications of COVID-19 in solid organ transplant (SOT) recipients

Abstract Background The long-term complications of COVID-19 infection in the general population include mortality, re-infection, secondary infection, persistent organ dysfunction, and symptoms of long-COVID. The prevalence of these outcomes and impact on graft function in solid organ transplant (SOT) remain uncertain. We aim to describe these complications in a large series of SOT with COVID-19 with 2 years of long-term follow up. Methods We retrospectively studied all adult (age &amp;gt;18) SOT from a single center hospitalized with SARS-CoV-2 diagnosed by nasopharyngeal swab between 3/10-5/30/2020. Patients with early mortality within 28 days were excluded. Outcomes including mortality, allograft rejection, allograft failure, secondary infections, COVID-19 re-infections, post-COVID complications (oxygen requirement, chronic renal or cardiac dysfunction), and symptoms of long-COVID were analyzed. Re-infections were characterized by severity and likely variant based on local variant predominance. Results 117 SOT recipients were hospitalized with COVID-19 in the study period. 94 survived the first 28 days and were followed for a median of 751 (742-760) days post-infection. 9 (9.57%) died within 1 year of infection and 14 (14.9%) within 2 years. 21 (22.3%) had ≥1 episode of allograft rejection and 21 (22.3%) had allograft failure. 11 (9.4%) were re-infected with COVID-19 at a median of 603 (389-642) days following initial infection, of whom 2 (18.2%) were hospitalized and 0 died. 43 (45.7%) had secondary infections and 18 (19.1%) with multi-drug resistant organisms. 32 (34.0%) developed new chronic kidney disease or end-stage renal disease, 25 (26.6%) had new cardiovascular disease, and 8 (8.51%) had a prolonged oxygen requirement following infection. Of reported long-COVID symptoms, fatigue (26, 27.7%), dyspnea (18, 19.1%), and cough (11, 11.7%) predominated with 25 (26.6%) having &amp;gt;1 symptom. Conclusion In this large cohort of SOT recipients hospitalized during the first wave of the COVID-19 pandemic, long-term 2-year follow-up showed high rates of mortality, allograft rejection, allograft failure, secondary infection, organ dysfunction, and symptoms consistent with long-COVID. Ongoing study of the impact of these complications will be crucial to improving outcomes in SOT recipients. Disclosures Marcus R. Pereira, MD, Hologic: Grant/Research Support|Merck: Grant/Research Support|Moderna: Grant/Research Support|Shire/Takeda: Grant/Research Support|Takeda: Advisor/Consultant|Union Therapeutics: Advisor/Consultant Elizabeth Verna, MD, Salix: Grant/Research Support.

Overall Infectious Complications Related to Belatacept Conversion in Comparison to Tacrolimus in Kidney Transplant Recipients.

Introduction: Belatacept has demonstrated effectiveness for preventing rejection in kidney transplant and has a favorable side effect profile. Studies assessing long-term infectious complications with belatacept compared to tacrolimus are limited. Project Aims: The purpose of this program evaluation was to determine the proportion of patients who developed an infection when converted to belatacept compared to those on tacrolimus. Design: In this retrospective evaluation, kidney transplant recipients receiving belatacept were matched 1:1 to those receiving tacrolimus, based on transplant date, age, induction immunosuppression, and cytomegalovirus risk. Data collection was initiated in tacrolimus patients on the date of belatacept conversion in the belatacept-matched patients. Data were extracted until study conclusion, death, or discontinuation of belatacept. Patients were stratified into 3 groups based on time of conversion posttransplant, which included early, late, and very late conversion. The primary outcome was the proportion of patients with an infection in belatacept compared to tacrolimus. Outcome data were calculated using chi-square, Fisher's exact test, student's t-test or Mann-Whitney U test where appropriate. Results: A total of 328 matched patients were included in the analysis. More patients on belatacept developed an infection compared to tacrolimus (42.7% vs 29.9%, P = 0.02), which was primarily driven by pneumonia (6.1% vs 0.5%; P = 0.01). Higher incidences of infections were identified in those converted within 6 months from transplant. Conclusions: Belatacept was associated with a higher proportion of patients with infections compared to tacrolimus, particularly in those converted within 6 months from time of transplant.

Complications of Autologous Stem Cell Transplantation in Multiple Myeloma: Results from the CALM Study.

Background: The main goal of this post hoc analysis of the Collaboration to Collect Autologous Transplant Outcomes in Lymphoma and Myeloma (CALM) study was to evaluate the rate of short- and long-term infectious and non-infectious complications occurring after ASCT in patients with multiple myeloma (MM). Methods: The analysis included all patients with MM from the CALM study who underwent ≥1 ASCT. The primary endpoint of the analysis was to determine the rate of infectious and non-infectious complications after ASCT and to compare them in three time periods: 0–100 days, 101 days–1 year, and >1 year after the first transplant. Results: The analysis included a total of 3552 patients followed up for a median of 56.7 months (range 0.4–108.1). Complication rates decreased with the time from ASCT with 24.85 cases per 100 patient-years from day 0 to 100 days after the transplant, and <2.31 cases per 100 patient-years from the 101st day. At 100 days after ASC T, 45.7% of patients had complications, with infectious events being twice as frequent as non-infectious complications. Bacterial infections (6.5 cases per 100 patient-years, 95% CI: 6.1–7.0) and gastrointestinal complications (4.7 cases per 100 patient-years, 95% CI: 4.3–5.1) were the most common early events. The pattern of complications changed with time from ASCT. The presence of complications after ASCT was not associated with overall survival. Conclusions: Our data provide a solid basis for comparing ASCT-related complications to those caused by emerging treatments in multiple myeloma, such as CAR T-cell therapy and other immunotherapies.

On the issue of post COVID-19 condition in patients with rheumatic diseases

Actual problems of rheumatology include the possibility of developing a wide range of long-term consequences of COVID-19, so-called post-COVID syndrome (PCS). The results of our own research are presented, during which among 45 patients over 18 years with rheumatic diseases (RD) PCS was detected in 20% cases: 6 of them had ANCAassociated vasculitis (AAV) and one each for rheumatoid arthritis, juvenile arthritis and osteoarthritis. In AAV cases PCS was more severe and varied than in other RD: lung lesions according to computed tomography (up to the damage 75% of the lung parenchyma), skin an d nervous (Guillain–Barré syndrome) lesions, myalgias, arthralgias were present. In most patients PCS ended in recovery, sudden death occurred only in the patient with AAV. The frequency of RD’s relapses in patients with PCS was 9%. Relapses were not noted in AAV, against the background of anti-B cell therapy with rituximab. Our own results and literature data indicate that patients with RD after COVID-19 need careful continuous monitoring to detect long-term complications of coronavirus infection and early diagnosis of relapses of the underlying disease.

Long COVID syndrome and the lung: how long will it last?

The prevalence and duration of the long-term respiratory complications of COVID-19 infection remains to be elucidated. This short commentary reports on recently published studies in patients post-acute COVID-19 infection in terms of symptom prevalence, physiological and radiological sequela and where only symptoms are present despite investigation. Pulmonary function testing, 6-min walk tests, computed tomography chest and more advanced imaging modalities have been incorporated to reveal the underlying pathophysiology that cause such disabling symptoms in patient with post-acute COVID-9 syndrome (PACS). PACS has a serious impact on people’s ability to return to work, affecting the physical, mental, social sphere and with significant healthcare and general economic consequences for them, their families and society.

Antimicrobial Stewardship Using Biomarkers: Accumulating Evidence for the Critically Ill.

This review aims to summarize current progress in the management of critically ill, using biomarkers as guidance for antimicrobial treatment with a focus on antimicrobial stewardship. Accumulated evidence from randomized clinical trials (RCTs) and observational studies in adults for the biomarker-guided antimicrobial treatment of critically ill (mainly sepsis and COVID-19 patients) has been extensively searched and is provided. Procalcitonin (PCT) is the best studied biomarker; in the majority of randomized clinical trials an algorithm of discontinuation of antibiotics with decreasing PCT over serial measurements has been proven safe and effective to reduce length of antimicrobial treatment, antibiotic-associated adverse events and long-term infectious complications like infections by multidrug-resistant organisms and Clostridioides difficile. Other biomarkers, such as C-reactive protein and presepsin, are already being tested as guidance for shorter antimicrobial treatment, but more research is needed. Current evidence suggests that biomarkers, mainly procalcitonin, should be implemented in antimicrobial stewardship programs even in the COVID-19 era, when, although bacterial coinfection rate is low, antimicrobial overconsumption remains high.

Long-Term Complications of COVID-19 Infection in Adolescents and Children.

Purpose of ReviewCompared to adults, post-COVID-19 symptoms are uncommon and have not been thoroughly evaluated in children. This review summarizes the literature in terms of persistent symptoms in children and adolescents after SARS-CoV-2 infection.Recent FindingsChildren were less likely to develop long COVID when compared to adults. Older children (e.g., adolescents) and those who had symptomatic COVID-19 had a higher probability for long COVID.SummaryFamilies and health care providers need to be aware of a new constellation of long COVID symptoms in the pediatric population. More evidence and time are needed to better understand the potential effects of long COVID-19 in children and adolescents. In comparison to adults, children are less likely to have persistent COVID-19 symptoms.

Long-Term Infectious Complications of Kidney Transplantation.

Infections remain a common complication of solid-organ transplantation. Most infections in the first month after transplant are typically health care-associated infections, whereas late infections, beyond 6-12 months, are community-acquired infections. Opportunistic infections most frequently present in the first 12 months post-transplant and can be modulated on prior exposures and use of prophylaxis. In this review, we summarize the current epidemiology of postkidney transplant infections with a focus on key viral (BK polyomavirus, cytomegalovirus, Epstein-Barr virus, and norovirus), bacterial (urinary tract infections and Clostridioides difficile colitis), and fungal infections. Current guidelines for safe living post-transplant are also summarized. Literature supporting prophylaxis and vaccination is also provided.

Long-term complications of COVID-19.

SARS-CoV-2 has rapidly spread across the globe and infected hundreds of millions of people worldwide. As our experience with this virus continues to grow, our understanding of both short-term and long-term complications of infection with SARS-CoV-2 continues to grow as well. Just as there is heterogeneity in the acute infectious phase, there is heterogeneity in the long-term complications seen following COVID-19 illness. The purpose of this review article is to present the current literature with regards to the epidemiology, pathophysiology, and proposed management algorithms for the various long-term sequelae that have been observed in each organ system following infection with SARS-CoV-2. We will also consider future directions, with regards to newer variants of the virus and their potential impact on the long-term complications observed.

Long-term moderate to severe complications of COVID-19 infection since 2019 to date

Abstract Objective: To investigate the long-term complications in patients recovered from coronavirus disease 2019 (COVID-19) infection. Methods: We will perform a meta-analysis and will search multiple electronic databases (PubMed, Scopus, Cochrane library) with predefined search terms to identify eligible articles. Eligible studies should report long-term complications of COVID-19 infection worldwide. Case reports, case series, observational studies with cross-sectional or prospective research design, case-control studies, and experimental studies will be included. Study quality will be evaluated by two reviewers independently using the statistical methodology and categories guided by the Cochrane Collaboration Handbook and PRISMA guidelines. Results: This study will explore and integrate the evidence available on the long-term complications of COVID-19 infection in various organ systems. Conclusion: By acquiring and statistically analyzing the data about these complications, this study will generate an extensive knowledge on the topic for a better management of the post pandemic healthcare related to COVID-19.

Comprehensive and long-term surveys of COVID-19 sequelae in Japan, an ambidirectional multicentre cohort study: study protocol

IntroductionThe rapid spread of COVID-19 posed a global burden. Substantial number of people died of the disease in the acute phase of infection. In addition, a significant proportion of patients...