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Article ; Online: Clinical course and outcome among patients with acute pancreatitis and COVID-19.

Kumar, Vivek / Barkoudah, Ebrahim / Souza, Daniel A T / Jin, David X / McNabb-Baltar, Julia

European journal of gastroenterology & hepatology

2021 Volume 33, Issue 5, Page(s) 695–700

Abstract: Background: The data on clinical course and outcome of acute pancreatitis among patients ... pancreatitis is not common among patients with COVID-19. Patients with COVID-19 who had acute pancreatitis ... with COVID 19 and acute pancreatitis.: Methods: This retrospective study was conducted on Research Patient ...

Abstract	Background: The data on clinical course and outcome of acute pancreatitis among patients with coronavirus disease 2019 (COVID-19) are sparse. In this study, we analyzed the clinical profiles of patients with COVID 19 and acute pancreatitis. Methods: This retrospective study was conducted on Research Patient Data Registry data which was pooled from five Mass General Brigham Healthcare Network hospitals. We extracted data on demographics, symptoms, ICU transfer, mechanical ventilation, laboratories' profiles, imaging findings, and patient outcomes. Result: Of 985 screened adult patients, 17 were eligible for the study, 9 (52.9%) were admitted primarily for respiratory failure and developed acute pancreatitis after a median of 22.5 days (13-76 days) from the onset of COVID-19 symptoms. On contrary, eight patients presented with typical symptoms and were diagnosed with acute pancreatitis, the majority with mild severity (62.5%) on admission. Patients who were admitted primarily with severe COVID-19 illness were younger (median age 57 vs. 63 years), females (55.6 vs. 25%), of Hispanic ethnicity (55.6 vs. 25%), and obese (88.9 vs. 37.5%). The median peak lipase, C reactive protein, ferritin, lactate dehydrogenase, D-dimer were higher among patients who developed acute pancreatitis later during hospitalization. Patients who developed acute pancreatitis later also experienced higher episodes of necrotizing pancreatitis (11.1% vs. 0), thromboembolic complications (55.6 vs. 12.5%), and higher mortality (37.5 vs. 12.5%). Conclusion: Acute pancreatitis is not common among patients with COVID-19. Patients with COVID-19 who had acute pancreatitis on admission had more benign course and overall better outcome as compared to the patients who developed acute pancreatitis during hospitalization.
MeSH term(s)	Adult ; African Americans ; Age Distribution ; Aged ; C-Reactive Protein/metabolism ; COVID-19/complications ; COVID-19/metabolism ; COVID-19/physiopathology ; European Continental Ancestry Group ; Female ; Ferritins/metabolism ; Fibrin Fibrinogen Degradation Products/metabolism ; Hispanic Americans ; Hospital Mortality ; Humans ; L-Lactate Dehydrogenase/metabolism ; Length of Stay ; Lipase/metabolism ; Male ; Middle Aged ; Pancreatitis/complications ; Pancreatitis/epidemiology ; Pancreatitis/metabolism ; Pancreatitis/physiopathology ; Pancreatitis, Acute Necrotizing/epidemiology ; Respiratory Distress Syndrome/complications ; Respiratory Distress Syndrome/metabolism ; Respiratory Distress Syndrome/physiopathology ; Retrospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Sex Distribution ; Thromboembolism/epidemiology
Chemical Substances	Fibrin Fibrinogen Degradation Products ; fibrin fragment D ; C-Reactive Protein (9007-41-4) ; Ferritins (9007-73-2) ; L-Lactate Dehydrogenase (EC 1.1.1.27) ; Lipase (EC 3.1.1.3)
Language	English
Publishing date	2021-03-31
Publishing country	England
Document type	Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0000000000002160
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Article ; Online: COVID-19 in pregnancy: A cross-sectional study on clinical features, disease severity, and health outcome.

Amin, Rozhin / Sohrabi, Mohammad-Reza / Zali, Ali-Reza / Hannani, Khatereh

Biomolecules & biomedicine

2024 Volume 24, Issue 3, Page(s) 659–664

Abstract: ... hematological diseases (P < 0.001) was observed in pregnant patients. In conclusion, COVID-19-infected pregnant women ... of COVID-19 in pregnant women and compare them to those of non pregnant women. In this population-based ... were applied. Overall, 79,338 non-pregnant women and 3249 pregnant women diagnosed with COVID-19 were ...

Abstract	Assessing the impact of coronavirus disease 2019 (COVID-19) reveals unique challenges for pregnant women, who experience distinct clinical manifestations and health outcomes compared to their non-pregnant counterparts. We aimed to evaluate the clinical features, disease severity, and health outcomes of COVID-19 in pregnant women and compare them to those of non pregnant women. In this population-based study, we included all women diagnosed with COVID-19 across the province of Tehran during the first two years of the epidemic. Descriptive statistics, the chi-squared test, and the logistic regression model were applied. Overall, 79,338 non-pregnant women and 3249 pregnant women diagnosed with COVID-19 were included. Pregnant women were most commonly in the age group of 25 - 34 years (54%, n = 1758), while the age group of 34-44 had the highest representation among non-pregnant women (56%, n = 44,492). After accounting for age and comorbidities, pregnancy was associated with an increased risk of requiring intensive care (odds ratio [OR] 1.38, confidence interval [CI] 1.223 - 1.564). However, the probability of dying due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was lower in pregnant women compared to non-pregnant women (OR 0.55, CI 0.394-0.793). Cough (41%) and fever (30%) were the most frequent clinical presentations in pregnant women, whereas cough (57%) and muscle ache (38%) were the most common symptoms in non-pregnant women. Furthermore, diarrhea (P < 0.001) and skin lesions (P < 0.001) were reported more frequently by pregnant patients than non-pregnant patients. A significant prevalence of diabetes (P < 0.001), hypertension (P < 0.001), cancers (P < 0.001), and chronic hematological diseases (P < 0.001) was observed in pregnant patients. In conclusion, COVID-19-infected pregnant women exhibit different clinical manifestations and a more severe clinical course but have better health outcomes compared to their non-pregnant counterparts.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Pregnancy ; Female ; Adult ; Cross-Sectional Studies ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/virology ; Iran/epidemiology ; Severity of Illness Index ; SARS-CoV-2 ; Young Adult ; Comorbidity ; Middle Aged
Language	English
Publishing date	2024-05-02
Publishing country	Bosnia and Herzegovina
Document type	Journal Article
ISSN	2831-090X
ISSN (online)	2831-090X
DOI	10.17305/bb.2023.9748
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Article ; Online: Clinical course of COVID-19 among immunocompromised children: a clinical case series.

El Dannan, Huda / Al Hassani, Moza / Ramsi, Musaab

BMJ case reports

2020 Volume 13, Issue 10

Abstract: ... to evaluate the clinical and laboratory characteristics, management and outcomes of COVID-19 in five children ... for immunocompromised patients. Limited studies are available on COVID-19 in immunocompromised children. This case series aimed ... All had a benign course of illness. No changes or delays in their treatment regimens occurred, and none ...

Abstract	Infection with SARS-CoV-2 represents a great source of concern and a new threat for immunocompromised patients. Limited studies are available on COVID-19 in immunocompromised children. This case series aimed to evaluate the clinical and laboratory characteristics, management and outcomes of COVID-19 in five children immunocompromised due to different underlying conditions. All had mild symptoms or were asymptomatic at presentation. All had a benign course of illness. No changes or delays in their treatment regimens occurred, and none experienced a relapse of the original disease, developed severe COVID-19 or died. However, these cases showed a prolonged duration of virus shedding. This report suggests that immunocompromised paediatric patients may not be at a higher risk of developing severe COVID-19. However, further studies are required to elaborate on the pathogenesis of COVID-19 in this vulnerable group.
MeSH term(s)	Age Factors ; COVID-19 ; Child ; Child, Preschool ; Combined Modality Therapy ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Female ; Humans ; Immunocompromised Host/immunology ; Male ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Prognosis ; Risk Assessment ; Sampling Studies ; Severe Acute Respiratory Syndrome/diagnosis ; Severe Acute Respiratory Syndrome/epidemiology ; Severe Acute Respiratory Syndrome/therapy ; Severity of Illness Index ; Sex Factors ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-10-31
Publishing country	England
Document type	Journal Article ; Case Reports
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2020-237804
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Article ; Online: COVID-19 and the clinical course of rheumatic manifestations.

Ahmed, Sakir / Zimba, Olena / Gasparyan, Armen Yuri

Clinical rheumatology

2021 Volume 40, Issue 7, Page(s) 2611–2619

Abstract: ... They may develop novel autoimmune features also. The immune-suppressants used during the acute COVID-19 illness ... them. There is an urgent need to follow-up patients recovering from COVID and monitor autoantibody production ... and inflammatory myositis have been reported after COVID-19. Other reported autoimmune disorders ...

Abstract	The manifestations of COVID-19 have been evolving over time. Various post-COVID-19 syndromes are being recognised. Various viruses have been implicated in the pathogenesis of autoimmune diseases, and we expect a similar outcome with the severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2). The SARS-CoV-2 virus penetrates various tissues and organs and has a predisposition to lead to endotheliitis that may cause vascular manifestations including thrombosis. SARS-CoV-2 has been shown to activate Toll-like receptors and the complement system. It perpetuates NETosis and leads to autoantibody formation. These predispose to systemic autoimmunity. Both reactive arthritis and connective tissue disorders such as lupus and inflammatory myositis have been reported after COVID-19. Other reported autoimmune disorders include haemolytic anaemia, immune thrombocytopenia, cutaneous vasculitis, and Guillain Barré-like acute demyelinating disorders. The multi-system inflammatory syndrome in children and its adult counterpart are another post-COVID-19 entity that presents as an admixture of Kawasaki disease and staphylococcal toxic shock syndrome. Patients with preexisting rheumatic diseases may flare during the SARS-CoV-2 infection. They may develop novel autoimmune features also. The immune-suppressants used during the acute COVID-19 illness may confound the outcomes whereas comorbidities present in patients with rheumatic diseases may mask them. There is an urgent need to follow-up patients recovering from COVID and monitor autoantibody production in the context of rheumatic manifestations. Key Points • COVID-19 is associated with both innate and acquired immune reactions and production of various autoantibodies. • Various immune-mediated manifestations such as arthritis, myositis, haemolytic anaemia, thrombocytopenia, and acute demyelination may develop after COVID-19. • Longitudinal cohort data are warranted to describe, predict, and test prevent various rheumatic manifestations in post-COVID-19 subjects.
MeSH term(s)	Adult ; Autoimmune Diseases ; COVID-19 ; Child ; Humans ; Rheumatic Diseases/complications ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome
Language	English
Publishing date	2021-03-17
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	604755-5
ISSN	1434-9949 ; 0770-3198
ISSN (online)	1434-9949
ISSN	0770-3198
DOI	10.1007/s10067-021-05691-x
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Article ; Online: Lipase elevation on admission predicts worse clinical outcomes in patients with COVID-19.

Kiyak, Mevlut / Düzenli, Tolga

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

2022 Volume 22, Issue 5, Page(s) 665–670

Abstract: ... at the time of admission, on the clinical course and mortality in COVID-19 patients.: Methods ... of chronic pancreatitis. The final study sample consisted of the remaining 3244 COVID-19 patients. Laboratory results ... Conclusion: Elevated lipase activity without acute pancreatitis at the time of admission in COVID-19 ...

Abstract	Background and objectives: Hyperlipasemia is highly prevalent among coronavirus disease 2019 (COVID-19) patients. The aim of this study was to assess the effect of lipase activity, measured at the time of admission, on the clinical course and mortality in COVID-19 patients. Methods: The population of this study comprised 12,139 patients who were hospitalized due to COVID-19 between June 2020 and June 2021 in a pandemic hospital. Of these, 8819 patients were excluded from the study due to missing data, four patients were excluded due to a diagnosis of acute pancreatitis (according to the revised Atlanta criteria), and 72 patients were excluded due to alcohol use or having a history of chronic pancreatitis. The final study sample consisted of the remaining 3244 COVID-19 patients. Laboratory results, intensive care unit (ICU) follow-up periods, the need for mechanical ventilation, and mortality rates were compared between the normal lipase activity and high lipase activity groups. Results: There were 968 (29.8%) patients with high lipase activity at the time of admission. The rate of ICU admission was 36.1% vs. 9.9% (p < 0.001), mechanical ventilation requirement rates were 33.7% vs. 8.3% (p < 0.001), and mortality rates were as 24.6% vs. 6.4% (p < 0.001) in the high lipase activity group compared to the normal lipase activity group. Multivariate regression analysis revealed that high lipase activity was an independent factor in predicting mortality in hospitalized COVID-19 patients (odds ratio [OR]: 3.191, p < 0.001). Conclusion: Elevated lipase activity without acute pancreatitis at the time of admission in COVID-19 patients was determined as an independent predictor of poor prognosis.
MeSH term(s)	Acute Disease ; COVID-19 ; Humans ; Intensive Care Units ; Lipase ; Pancreatitis ; Retrospective Studies ; SARS-CoV-2
Chemical Substances	Lipase (EC 3.1.1.3)
Language	English
Publishing date	2022-04-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2056680-3
ISSN	1424-3911 ; 1424-3903
ISSN (online)	1424-3911
ISSN	1424-3903
DOI	10.1016/j.pan.2022.04.012
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Zs.A 5553: Show issues

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Article: Correlation of Computed Tomography (CT) Severity Score With Laboratory and Clinical Parameters and Outcomes in Coronavirus Disease 2019 (COVID-19).

Pamulapati, Bharath K / Nanjundappa, Ramesh K / Chandrabhatla, Bala S / Roohi, Sumayya U / Palepu, Sushrut

Cureus

2024 Volume 16, Issue 1, Page(s) e52324

Abstract: ... of management at the earliest point possible, and improve the prognostication of COVID-19 patients. ... of disease severity and its possible outcome, which might help in the early identification of patients ... in Hyderabad, Telangana, India, over a period of six months. All RT-PCR-positive COVID-19 patients admitted ...

Abstract	Background: Coronavirus disease 2019 (COVID-19) is a potentially lethal respiratory illness caused by a newly identified coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Given the novelty of the virus, high caseloads, and increasing turnaround time for reverse transcriptase-polymerase chain reaction (RT-PCR) results, accurate information about the clinical course and prognosis of individual patients was largely unknown. This has forced physicians all over the world to brainstorm attempts to come up with reliable indicators like chest high-resolution computed tomography (HRCT) for any changes suggestive of COVID-19; surrogate laboratory parameters such as C-reactive protein (CRP), ferritin, D-dimer, lactate dehydrogenase (LDH), or interleukin-6 (IL-6) for assessing the severity of the disease; and other organ-specific tests to identify the multiorgan involvement in severe-to-critical COVID-19. Chest computed tomography (CT) scans play a significant role in the management of COVID-19 disease and serve as an indicator of disease severity and its possible outcome, which might help in the early identification of patients who might need critical care and earlier prognostication. Methods: A retrospective observational study was conducted at a single center in a level 3 critical care unit (CCU) of a 750-bed teaching hospital in Hyderabad, Telangana, India, over a period of six months. All RT-PCR-positive COVID-19 patients admitted to the CCU with CT chest performed within 24 hours of admission were screened for eligibility for this study. CT severity scoring was based on chest HRCT or CT. Results: Of the 110 patients, a majority (36.36%) were aged between 61 and 70 years. The mean age of our study population was 59.65±11.88 years. Of the 110 patients, the majority were admitted to the hospital for 22-28 days (24.55%), followed by 8-14 days (22.72%), and 21.82% were admitted for one day. Of the 110 patients, a majority were admitted to the CCU for seven days (41.82%), followed by 15-21 days (24.55%); and 19.09% were admitted for 8-14 days. Most of the patients were discharged (65.45%), and we had a 34.55% mortality rate in our study. We found a significant association between chest CT severity score (CTSS) and the age of the patient, duration of hospital stay, and duration of CCU stay using multivariate regression analysis. Conclusion: CTSS could be greatly helpful for the screening and early identification of the disease, especially in those patients awaiting an RT-PCR report or with negative RT-PCR, which would lead to appropriate isolation and treatment measures. Early detection could also help assess the progression of the disease, alter the course of management at the earliest point possible, and improve the prognostication of COVID-19 patients.
Language	English
Publishing date	2024-01-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.52324
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Article ; Online: Course and clinical severity of the SARS-CoV-2 Omicron variant infection in Tianjin, China.

Ren, Yi / Shi, Lixia / Xie, Yi / Wang, Chao / Zhang, Wenxin / Wang, Feifei / Sun, Haibai / Huang, Lijun / Wu, Yuanrong / Xing, Zhiheng / Ren, Wenjuan / Heinrich, Joachim / Wu, Qi / Pei, Zhengcun

Medicine

2023 Volume 102, Issue 38, Page(s) e34669

Abstract: ... moderate, and severe patients, and clinical courses including the interval from positive polymerase chain ... of moderate Covid-19 (8.8% vs 44.3%). On discharge, 45.9% (41.3%, 50.7%) and 42.2% (37.6%, 46.9 ... of the subjects were diagnosed as having experienced mild and moderate Covid-19. The median (interquartile range ...

Abstract	There is limited information describing the course and severity of illness in subjects infected by the severe acute respiratory syndrome coronavirus 2 Omicron variant, especially in children. In this population-based cohort study, subjects with Omicron variant infection during the outbreak between January 8 and February 12, 2022 in Tianjin, China were included (n = 429). The main outcomes were the distribution of asymptomatic, mild, moderate, and severe patients, and clinical courses including the interval from positive polymerase chain reaction (PCR) test to the onset, aggravation or relief of symptoms, and the interval of reversing positive PCR-test into negative, and length of hospital stay. Of the 429 subjects (113 [26.3%] children; 239 [55.7%] female; median age, 36 years [interquartile range 15.0 to 55.0 years]), the proportion (95% CI) of symptomatic subjects on admission was 95.6% (93.2%, 97.2%), including 60.4% (55.7%, 64.9%) mild, 35.0% (30.6%, 39.6%) moderate, and 0.2% (0.0%, 1.3%) severe. Compared with adults, children had lower proportion of moderate Covid-19 (8.8% vs 44.3%). On discharge, 45.9% (41.3%, 50.7%) and 42.2% (37.6%, 46.9%) of the subjects were diagnosed as having experienced mild and moderate Covid-19. The median (interquartile range) length of hospital stay was 14.0 (12.0, 15.0) days. The median interval of reversing positive PCR-test into negative was 12.0 (10.0, 13.0) days. Symptomatic and moderate Covid-19 in Omicron infections was common in adults and children, recovery from Omicron infections took around 2 weeks of time. The severe acute respiratory syndrome coronavirus 2 Omicron infection in this study was not as mild as previously suggested.
MeSH term(s)	Adult ; Child ; Humans ; Female ; Adolescent ; Young Adult ; Middle Aged ; Male ; COVID-19/epidemiology ; Cohort Studies ; SARS-CoV-2 ; China/epidemiology
Language	English
Publishing date	2023-09-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000034669
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Article ; Online: Multi-omic longitudinal study reveals immune correlates of clinical course among hospitalized COVID-19 patients.

Diray-Arce, Joann / Fourati, Slim / Doni Jayavelu, Naresh / Patel, Ravi / Maguire, Cole / Chang, Ana C / Dandekar, Ravi / Qi, Jingjing / Lee, Brian H / van Zalm, Patrick / Schroeder, Andrew / Chen, Ernie / Konstorum, Anna / Brito, Anderson / Gygi, Jeremy P / Kho, Alvin / Chen, Jing / Pawar, Shrikant / Gonzalez-Reiche, Ana Silvia /

Hoch, Annmarie / Milliren, Carly E / Overton, James A / Westendorf, Kerstin / Cairns, Charles B / Rouphael, Nadine / Bosinger, Steven E / Kim-Schulze, Seunghee / Krammer, Florian / Rosen, Lindsey / Grubaugh, Nathan D / van Bakel, Harm / Wilson, Michael / Rajan, Jayant / Steen, Hanno / Eckalbar, Walter / Cotsapas, Chris / Langelier, Charles R / Levy, Ofer / Altman, Matthew C / Maecker, Holden / Montgomery, Ruth R / Haddad, Elias K / Sekaly, Rafick P / Esserman, Denise / Ozonoff, Al / Becker, Patrice M / Augustine, Alison D / Guan, Leying / Peters, Bjoern / Kleinstein, Steven H

Cell reports. Medicine

2023 Volume 4, Issue 6, Page(s) 101079

Abstract: ... that distinguish moderate from severe and fatal COVID-19 disease. Importantly, cellular and molecular states also ... immune responses in relation to heterogeneity in disease course may inform clinical prognosis and opportunities ... The IMPACC cohort, composed of >1,000 hospitalized COVID-19 participants, contains five illness ...

Abstract	The IMPACC cohort, composed of >1,000 hospitalized COVID-19 participants, contains five illness trajectory groups (TGs) during acute infection (first 28 days), ranging from milder (TG1-3) to more severe disease course (TG4) and death (TG5). Here, we report deep immunophenotyping, profiling of >15,000 longitudinal blood and nasal samples from 540 participants of the IMPACC cohort, using 14 distinct assays. These unbiased analyses identify cellular and molecular signatures present within 72 h of hospital admission that distinguish moderate from severe and fatal COVID-19 disease. Importantly, cellular and molecular states also distinguish participants with more severe disease that recover or stabilize within 28 days from those that progress to fatal outcomes (TG4 vs. TG5). Furthermore, our longitudinal design reveals that these biologic states display distinct temporal patterns associated with clinical outcomes. Characterizing host immune responses in relation to heterogeneity in disease course may inform clinical prognosis and opportunities for intervention.
MeSH term(s)	Humans ; COVID-19 ; SARS-CoV-2 ; Longitudinal Studies ; Multiomics ; Disease Progression
Language	English
Publishing date	2023-05-23
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2666-3791
ISSN (online)	2666-3791
DOI	10.1016/j.xcrm.2023.101079
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Article: Clinical Course and Outcome of Cardiovascular Manifestations in Children With Multisystem Inflammatory Syndrome Associated With SARS-CoV-2 Infection in Georgia.

Phirtskhalava, Sofia / Shavgulidze, Elene / Shaikh, Aadil Ashraf Ahmed / Marikar, Farah / Kalatozishvili, Ketevan / Maghradze, Ana / Chkhaidze, Ivane

Cureus

2023 Volume 15, Issue 5, Page(s) e38555

Abstract: ... complications and how treatment affects it. From February 2020 to March 2022, 103 patients with MIS-C were ... IVIG combined with steroids; each patient's illness has resolved without any sequelae, and cardiac ... mainly in terms of post-COVID-19 infection complications already known as multisystem inflammatory ...

Abstract	A SARS-CoV-2 infection is usually characterized by a very mild clinical course in the pediatric population. However, children can be severely affected, and clinical manifestations may differ from adults, mainly in terms of post-COVID-19 infection complications already known as multisystem inflammatory syndrome in children (MIS-C). As the name suggests, this condition involves many systems, including the cardiovascular system, clinical manifestations of which include myocarditis, coronary artery aneurysms, conduction abnormalities, and arrhythmias. This research aims to define the cardiac manifestations caused by multi-inflammatory processes occurring after acute SARS-CoV-2 infection, possibly find a correlation between a certain cardiac abnormality and inflammatory markers, and evaluate the dynamics of cardiovascular complications and how treatment affects it. From February 2020 to March 2022, 103 patients with MIS-C were hospitalized and treated at M.Iashvili Children's Central Hospital, Tbilisi, Georgia. Based on our results, 55% of them had cardiovascular involvement with various manifestations involving coronary artery dilation, valvular insufficiencies, heart rate abnormalities, and pericardial effusion. Our study revealed that only one statistically significant correlation was observed between D-dimer levels and heart rate abnormalities, but there was no correlation between these two values. All of the MIS-C patients reported in our study have received standardized treatment courses with steroids, intravenous immune globulin (IVIG), or IVIG combined with steroids; each patient's illness has resolved without any sequelae, and cardiac manifestations have returned to baseline. Nevertheless, systematic longer-term follow-up is needed to provide clarity on the evolution of medium- and long-term cardiac outcomes in MIS-C.
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.38555
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Article ; Online: Clinical impact of COVID-19 on patients with cancer treated with immune checkpoint inhibition.

Rogiers, Aljosja / Pires da Silva, Ines / Tentori, Chiara / Tondini, Carlo Alberto / Grimes, Joseph M / Trager, Megan H / Nahm, Sharon / Zubiri, Leyre / Manos, Michael / Bowling, Peter / Elkrief, Arielle / Papneja, Neha / Vitale, Maria Grazia / Rose, April A N / Borgers, Jessica S W / Roy, Severine / Mangana, Joanna / Pimentel Muniz, Thiago / Cooksley, Tim /

Lupu, Jeremy / Vaisman, Alon / Saibil, Samuel D / Butler, Marcus O / Menzies, Alexander M / Carlino, Matteo S / Erdmann, Michael / Berking, Carola / Zimmer, Lisa / Schadendorf, Dirk / Pala, Laura / Queirolo, Paola / Posch, Christian / Hauschild, Axel / Dummer, Reinhard / Haanen, John / Blank, Christian U / Robert, Caroline / Sullivan, Ryan J / Ascierto, Paolo Antonio / Miller, Wilson H / Stephen Hodi, F / Suijkerbuijk, Karijn P M / Reynolds, Kerry L / Rahma, Osama E / Lorigan, Paul C / Carvajal, Richard D / Lo, Serigne / Mandala, Mario / Long, Georgina V

Journal for immunotherapy of cancer

2021 Volume 9, Issue 1

Abstract: ... with previously reported rates for hospitalized patients with cancer and was due to COVID-19 in almost half ... of the cases. We identified factors associated with adverse outcomes in ICI-treated patients with COVID-19. ... COVID-19 was the primary cause of death in 8 (7%) patients. Factors independently associated ...

Abstract	Background: Patients with cancer who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to develop severe illness and die compared with those without cancer. The impact of immune checkpoint inhibition (ICI) on the severity of COVID-19 illness is unknown. The aim of this study was to investigate whether ICI confers an additional risk for severe COVID-19 in patients with cancer. Methods: We analyzed data from 110 patients with laboratory-confirmed SARS-CoV-2 while on treatment with ICI without chemotherapy in 19 hospitals in North America, Europe and Australia. The primary objective was to describe the clinical course and to identify factors associated with hospital and intensive care (ICU) admission and mortality. Findings: Thirty-five (32%) patients were admitted to hospital and 18 (16%) died. All patients who died had advanced cancer, and only four were admitted to ICU. COVID-19 was the primary cause of death in 8 (7%) patients. Factors independently associated with an increased risk for hospital admission were ECOG ≥2 (OR 39.25, 95% CI 4.17 to 369.2, p=0.0013), treatment with combination ICI (OR 5.68, 95% CI 1.58 to 20.36, p=0.0273) and presence of COVID-19 symptoms (OR 5.30, 95% CI 1.57 to 17.89, p=0.0073). Seventy-six (73%) patients interrupted ICI due to SARS-CoV-2 infection, 43 (57%) of whom had resumed at data cut-off. Interpretation: COVID-19-related mortality in the ICI-treated population does not appear to be higher than previously published mortality rates for patients with cancer. Inpatient mortality of patients with cancer treated with ICI was high in comparison with previously reported rates for hospitalized patients with cancer and was due to COVID-19 in almost half of the cases. We identified factors associated with adverse outcomes in ICI-treated patients with COVID-19.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; COVID-19/epidemiology ; COVID-19/immunology ; COVID-19/virology ; Cohort Studies ; Female ; Humans ; Immune Checkpoint Inhibitors/adverse effects ; Immune Checkpoint Inhibitors/therapeutic use ; Male ; Middle Aged ; Neoplasms/drug therapy ; Neoplasms/immunology ; Retrospective Studies ; SARS-CoV-2/immunology ; SARS-CoV-2/isolation & purification
Chemical Substances	Immune Checkpoint Inhibitors
Language	English
Publishing date	2021-01-19
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	2719863-7
ISSN	2051-1426 ; 2051-1426
ISSN (online)	2051-1426
ISSN	2051-1426
DOI	10.1136/jitc-2020-001931
Database	MEDical Literature Analysis and Retrieval System OnLINE

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