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Artikel ; Online: Optimizing COVID-19 treatment in immunocompromised patients: early combination therapy with remdesivir, nirmatrelvir/ritonavir and sotrovimab.

Gentile, Ivan / Foggia, Maria / Silvitelli, Maria / Sardanelli, Alessia / Cattaneo, Letizia / Viceconte, Giulio

2023 Band 20, Heft 1, Seite(n) 301

Abstract: Background: Morbidity and mortality are higher in immunocompromised patients affected by COVID-19 than in the general population. Some authors have successfully used antiviral combination, but never in the early phase of the infection.: Methods: We ... ...

Abstract	Background: Morbidity and mortality are higher in immunocompromised patients affected by COVID-19 than in the general population. Some authors have successfully used antiviral combination, but never in the early phase of the infection. Methods: We conducted a retrospective cohort study to determine the efficacy and safety of the combination of two antivirals, with and without a monoclonal antibody (mAb), in both the early (within 10 days of symptoms) and in a later phase (after 10 days) of SARS-CoV-2 infection in immunocompromised patients admitted to our Facility. Results: We treated 11 patients (seven in an early phase and four in a late phase of COVID-19) with 10 days of intravenous remdesivir plus five days of oral nirmatelvir/ritonavir, also combined with sotrovimab in 10/11 cases. Notably, all the "early" patients reached virological clearance at day 30 from the end of the therapy and were alive and well at follow-up, whereas the corresponding numbers in the "late" patients were 50% and 75%. Patients in the "late" group more frequently needed oxygen supplementation (p = 0.015) and steroid therapy (p = 0.045) during admission and reached higher COVID-19 severity (p = 0.017). Discussion: The combination of antiviral and sotrovimab in the early phase of COVID-19 is well tolerated by immunocompromised patients and is associated with 100% of virological clearance. Patients treated later have lower response rates and higher disease severity, but whether therapy plays a causative role in such findings has yet to be determined.
Mesh-Begriff(e)	Humans ; Ritonavir/therapeutic use ; COVID-19 Drug Treatment ; Retrospective Studies ; COVID-19 ; SARS-CoV-2 ; Immunocompromised Host ; Antiviral Agents/therapeutic use
Chemische Substanzen	nirmatrelvir (7R9A5P7H32) ; sotrovimab (1MTK0BPN8V) ; Ritonavir (O3J8G9O825) ; remdesivir (3QKI37EEHE) ; Antiviral Agents
Sprache	Englisch
Erscheinungsdatum	2023-12-15
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2160640-7
ISSN	1743-422X ; 1743-422X
ISSN (online)	1743-422X
ISSN	1743-422X
DOI	10.1186/s12985-023-02269-8
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Casirivimab/imdevimab + remdesivir in hospitalized patients with severe Covid-19: A single centre experience

Moriello, Nicola Schiano / Buonomo, Antonio Riccardo / Scotto, Riccardo / Pinchera, Biagio / Sarno, Marina / Fusco, Ludovica / Viceconte, Giulio / Iuliano, Antonio / Zappulo, Emanuela / Foggia, Maria / Villari, Riccardo / Gentile, Ivan

Heliyon. 2023 Feb., v. 9, no. 2 p.e13126-

2023

Abstract: Since 2020, COVID-19 pandemic has spread worldwide causing a huge number of cases and casualties. Among direct anti SARS-CoV-2 agents available for the treatment of COVID-19, only remdesivir and casirivimab/imdevimab have been approved for severe disease. ...

Abstract	Since 2020, COVID-19 pandemic has spread worldwide causing a huge number of cases and casualties. Among direct anti SARS-CoV-2 agents available for the treatment of COVID-19, only remdesivir and casirivimab/imdevimab have been approved for severe disease. As they act at different levels in blocking viral replication, it is theoretically possible to combine them. In this case series we describe tolerability, safety and effectiveness in a small group of 14 patients of the combination of casirivimab/imdevimab monoclonal antibodies with the polymerase inhibitor remdesivir for the treatment of severe COVID-19. We conducted a retrospective study among consecutive patients admitted to the Infectious Disease ward of the University of Naples (Italy) Hospital for COVID-19 that received the combination of casirivimab/imdevimab and remdesivir for the treatment of severe COVID-19 from the August 1, 2021 to the November 30, 2021. During the study period, 78 patients were admitted for severe COVID-19. Fourteen patients (18%) received the combination casirivimab/imdevimab and remdesivir. They were five males and nine females with a median age of 54 years. Eight patients had significant comorbidities; three patients were in the immediate post-partum period. No adverse drug reaction was observed. All patients except one improved clinical condition and respiratory parameters within seven days following the therapy. All patients were discharged in good conditions.
Schlagwörter	COVID-19 infection ; Severe acute respiratory syndrome coronavirus 2 ; disease severity ; drug toxicity ; hospitals ; postpartum period ; retrospective studies ; therapeutics ; virus replication ; Italy
Sprache	Englisch
Erscheinungsverlauf	2023-02
Erscheinungsort	Elsevier Ltd
Dokumenttyp	Artikel ; Online
Anmerkung	Use and reproduction
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e13126
Datenquelle	NAL Katalog (AGRICOLA)

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Artikel ; Online: Should SARS CoV-2 infection be considered an independent risk factor for Pneumocystis jirovecii pneumonia? Emerging data after two years of pandemic from a single center experience.

Buonomo, Antonio Riccardo / Viceconte, Giulio / Pinchera, Biagio / Scotto, Riccardo / Zappulo, Emanuela / Foggia, Maria / Gentile, Ivan

Reviews on recent clinical trials

2022

Sprache	Englisch
Erscheinungsdatum	2022-05-11
Erscheinungsland	United Arab Emirates
Dokumenttyp	Journal Article
ZDB-ID	2251879-4
ISSN	1876-1038 ; 1574-8871
ISSN (online)	1876-1038
ISSN	1574-8871
DOI	10.2174/1574887117666220511123826
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Casirivimab/imdevimab + remdesivir in hospitalized patients with severe Covid-19: A single centre experience.

Heliyon

2023 Band 9, Heft 2, Seite(n) e13126

Abstract	Since 2020, COVID-19 pandemic has spread worldwide causing a huge number of cases and casualties. Among direct anti SARS-CoV-2 agents available for the treatment of COVID-19, only remdesivir and casirivimab/imdevimab have been approved for severe disease. As they act at different levels in blocking viral replication, it is theoretically possible to combine them. In this case series we describe tolerability, safety and effectiveness in a small group of 14 patients of the combination of casirivimab/imdevimab monoclonal antibodies with the polymerase inhibitor remdesivir for the treatment of severe COVID-19. We conducted a retrospective study among consecutive patients admitted to the Infectious Disease ward of the University of Naples (Italy) Hospital for COVID-19 that received the combination of casirivimab/imdevimab and remdesivir for the treatment of severe COVID-19 from the August 1, 2021 to the November 30, 2021. During the study period, 78 patients were admitted for severe COVID-19. Fourteen patients (18%) received the combination casirivimab/imdevimab and remdesivir. They were five males and nine females with a median age of 54 years. Eight patients had significant comorbidities; three patients were in the immediate post-partum period. No adverse drug reaction was observed. All patients except one improved clinical condition and respiratory parameters within seven days following the therapy. All patients were discharged in good conditions.
Sprache	Englisch
Erscheinungsdatum	2023-01-21
Erscheinungsland	England
Dokumenttyp	Case Reports
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e13126
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Remdesivir Alone or in Combination with Monoclonal Antibodies as an Early Treatment to Prevent Severe COVID-19 in Patients with Mild/Moderate Disease at High Risk of Progression: A Single Centre, Real-Life Study.

Scotto, Riccardo / Buonomo, Antonio Riccardo / Iuliano, Antonio / Foggia, Maria / Sardanelli, Alessia / Villari, Riccardo / Pinchera, Biagio / Gentile, Ivan / Federico Ii Covid-Team

Vaccines

2023 Band 11, Heft 2

Abstract: Early treatment with antivirals against SARS-CoV-2 infection can prevent the onset of severe COVID-19 in fragile and immunocompromised patients. In this real-life, prospective, observational study, we evaluated efficacy and safety of a 3-day early ... ...

Abstract	Early treatment with antivirals against SARS-CoV-2 infection can prevent the onset of severe COVID-19 in fragile and immunocompromised patients. In this real-life, prospective, observational study, we evaluated efficacy and safety of a 3-day early treatment with remdesivir in adult and fragile patients with a diagnosis of SARS-CoV-2 infection who referred to the COVID-19 early treatment service of Infectious Diseases Unit of University of Naples Federico from 10 January 2022 to 31 March 2022. The included patients could be treated with either remdesivir alone or with remdesivir plus a monoclonal antibody with activity against SARS-CoV-2. Among the 62 included patients, we showed low rates of hospitalization (8%), increase in oxygen supplementation (3.2%), ICU admission (1.6%) and death (1.6%). The rate of disease progression was 8% and it was similar in patients treated with remdesivir alone or in combination with monoclonal antibodies (6.7% and 9.4%, respectively;
Sprache	Englisch
Erscheinungsdatum	2023-01-17
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines11020200
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Risk Factors for

Viceconte, Giulio / Buonomo, Antonio Riccardo / D'Agostino, Alessia / Foggia, Maria / Di Fusco, Antonio / Pinchera, Biagio / Scotto, Riccardo / Iacovazzo, Carmine / Fanasca, Luca / Messina, Gaetana / Cacciatore, Francesco / Salvatore, Paola / Gentile, Ivan / On Behalf Of The Federico Ii Covid Team

Journal of fungi (Basel, Switzerland)

2023 Band 9, Heft 8

Abstract: Background: Very few cases of : Methods: A retrospective case-control study was performed. We matched PJP cases with controls with a 1:2 ratio, based on age ± 10 years, solid-organ transplantation (SOT), hematological malignancies, and in the setting ...

Abstract	Background: Very few cases of Methods: A retrospective case-control study was performed. We matched PJP cases with controls with a 1:2 ratio, based on age ± 10 years, solid-organ transplantation (SOT), hematological malignancies, and in the setting of PJP development (ICU vs. non-ICU). A direct immunofluorescence assay on bronchoalveolar lavage fluid was used to diagnose PJP. Results: We enrolled 54 patients. Among 18 cases of PJP, 16 were diagnosed as "proven". Seven of the eighteen cases were immunocompromised, while the other patients had no previous immunological impairment. Patients with PJP had significantly lower median lymphocyte values ( Conclusions: PJP develops in COVID-19 patients regardless of immunosuppressive conditions and the severity of disease, and it is correlated to the corticosteroid dose received.
Sprache	Englisch
Erscheinungsdatum	2023-08-11
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2784229-0
ISSN	2309-608X ; 2309-608X
ISSN (online)	2309-608X
ISSN	2309-608X
DOI	10.3390/jof9080838
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: COVID-19 chest CT and laboratory features of B.1.617.2 (Delta variant) vs B.1.1.7 (Alpha variant) surge: a single center case-control study.

Viceconte, Giulio / Ponsiglione, Andrea / Buonomo, Antonio Riccardo / Camera, Luigi / Scotto, Riccardo / De Giorgi, Marco / Pinto, Lorenzo / Pinchera, Biagio / Villari, Riccardo / Foggia, Maria / Gerundo, Gerardo / Abete, Pasquale / Brunetti, Arturo / Gentile, Ivan

Le infezioni in medicina

2022 Band 30, Heft 4, Seite(n) 555–562

Abstract: Purpose: To assess clinical, laboratory and radiological differences between Delta and Alpha SARS-CoV-2 variants.: Materials and methods: Twenty SARS-CoV-2 patients admitted from 30th of August to 30th of October 2021 (period with estimated highest ... ...

Abstract	Purpose: To assess clinical, laboratory and radiological differences between Delta and Alpha SARS-CoV-2 variants. Materials and methods: Twenty SARS-CoV-2 patients admitted from 30th of August to 30th of October 2021 (period with estimated highest prevalence of Delta variant circulation in Italy) were enrolled. Patients were matched in a 1:1 ratio with same gender and same age +/- 2 years controls admitted from 1st of September 2020 to 30th of January 2021 (predominant circulation of Alpha variant). Chest computed tomography (CT) were retrospectively evaluated. Main clinical parameters, radiological and laboratory findings were compared between two groups. Results: Patients with probable Delta variant had significantly higher CT severity scores, lower PaO2/FiO2 ratio and higher C-reactive protein and lactate dehydrogenase levels at admission. On multivariate analysis, probable Delta variant infection was associated with higher CT severity score. Ground glass opacities and crazy paving patterns were more frequently noticed than consolidation, with the latter being more frequent in Delta cohort, even though not significantly. According to prevalent imaging pattern, the consolidation one was significantly associated with pregnancy ( Conclusions: Patients admitted during predominance of Delta variant circulation had a more severe lung involvement compared to patients in infected when Alpha variant was predominant. Despite imaging pattern seems to be not influenced by viral variant and other clinical variables, the consolidative pattern was observed more frequently in pregnancy.
Sprache	Englisch
Erscheinungsdatum	2022-12-01
Erscheinungsland	Italy
Dokumenttyp	Journal Article
ZDB-ID	2041081-5
ISSN	2532-8689 ; 1124-9390
ISSN (online)	2532-8689
ISSN	1124-9390
DOI	10.53854/liim-3004-10
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 5576: Hefte anzeigen

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Artikel: SARS-CoV-2 in Kidney Transplant Patients: A Real-Life Experience.

Pinchera, Biagio / Spirito, Lorenzo / Ferreri, Lucia / Rocca, Roberto La / Celentano, Giuseppe / Buonomo, Antonio Riccardo / Foggia, Maria / Scotto, Riccardo / Federico, Stefano / Gentile, Ivan / Carrano, Rosa

Frontiers in medicine

2022 Band 9, Seite(n) 864865

Abstract: Background: The COVID-19 pandemic has significantly impacted the management of solid organ transplant recipients and on clinical evolution in post-transplantation. Little is known on the impact of SARS-CoV-2 infection in these patients. The severity and ...

Abstract	Background: The COVID-19 pandemic has significantly impacted the management of solid organ transplant recipients and on clinical evolution in post-transplantation. Little is known on the impact of SARS-CoV-2 infection in these patients. The severity and lethality of this disease in solid organ transplant patients are higher thanin the general population. This study aims to describe clinical characteristics of SARS-CoV-2 infection in solid organ transplant recipients followed in our center. Methods: In this observational study, we enrolled all kidney transplant recipientsattending the A.O.U. Federico II of Naples from March 2020 to January 2021. For each patient we evaluated the epidemiological and clinical characteristics as well as outcome. Results: We enrolled 369 kidney transplant patients (229, male, 62%). Of these, 51 (13.8%) acquired SARS-CoV-2 infection and 29 showed symptomatic disease. Of the 51 patients with the infection, 48 (94.11%) had at least one comorbidity and such comorbidities did not constitute a risk factor for a more severe disease. Hospitalization was necessary for 7 (13.7%) patients. Of these, 2 required low-flow oxygen supplementation, 3 non-invasive/high flow ventilation and 2 invasive ventilation. Finally, 2 patients died. Conclusions: Our study shows a lower mortality and hospitalization rate compared to figures available in the literature (4% vs. 13-30% and 14% vs. 32-100%, respectively). Furthermore, the comorbidities examined (hypertension, dyslipidemia, and diabetes) did not constitute a risk factor for a more severe disease condition in this patient category. Further studies with larger sample size are necessary to confirm these data.
Sprache	Englisch
Erscheinungsdatum	2022-03-28
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.864865
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: mTOR Inhibitor Use Is Associated With a Favorable Outcome of COVID-19 in Patients of Kidney Transplant: Results of a Retrospective Study.

Pinchera, Biagio / Spirito, Lorenzo / Buonomo, Antonio Riccardo / Foggia, Maria / Carrano, Rosa / Salemi, Fabrizio / Schettino, Elisa / Papa, Fortuna / La Rocca, Roberto / Crocetto, Felice / Napolitano, Luigi / Villari, Riccardo / Gentile, Ivan

Frontiers in medicine

2022 Band 9, Seite(n) 852973

Abstract: Introduction: In solid organ transplant recipients, COVID-19 is associated with a poor prognosis because of immunosuppression. Some studies suggest a potential therapeutic role of mammalian Target of Rapamycin (mTOR) inhibitors in SARS-CoV-2 infection. ... ...

Abstract	Introduction: In solid organ transplant recipients, COVID-19 is associated with a poor prognosis because of immunosuppression. Some studies suggest a potential therapeutic role of mammalian Target of Rapamycin (mTOR) inhibitors in SARS-CoV-2 infection. This study aimed to assess the impact of mTOR employment on the evolution and outcome of SARS-CoV-2 infection in solid organ transplant recipients. Methods: We enrolled kidney transplant patients attending the Azienda Ospedaliera Universitaria Federico II in Naples and followed up on these patients from March 2020 to June 2021. We evaluated the risk of acquiring the SARS-CoV-2 infection, the clinical presentation of the disease, and its outcome together with the type of immunosuppressive therapy. Finally, we assessed the impact of mTOR inhibitors on relevant clinical metrics of SARS-CoV-2 infection. Results: We enrolled 371 patients, of whom 56 (15.1%) contracted SARS-CoV-2 infection during the period of the study. There were no differences observed among the different immunosuppressive therapies concerning the risk of acquiring SARS-CoV-2 infection. In contrast, the type of immunosuppressive therapy had a significant impact on the outcome of the disease. In detail, patients who received mTOR inhibitors, as part of their immunosuppressive therapy, compared to other regimens had a lower chance of developing a moderate or severe form of the disease (OR = 0.8, 95, CI: (0.21-0.92), Conclusion: In kidney transplant patients, the use of mTOR inhibitors as part of an immunosuppressive regimen is associated with a better prognosis in the case of COVID-19.
Sprache	Englisch
Erscheinungsdatum	2022-06-21
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.852973
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: A Simple Non-Invasive Score Based on Baseline Parameters Can Predict Outcome in Patients with COVID-19.

Scotto, Riccardo / Lanzardo, Amedeo / Buonomo, Antonio Riccardo / Pinchera, Biagio / Cattaneo, Letizia / Sardanelli, Alessia / Mercinelli, Simona / Viceconte, Giulio / Perrella, Alessandro / Esposito, Vincenzo / Codella, Alessio Vinicio / Maggi, Paolo / Zappulo, Emanuela / Villari, Riccardo / Foggia, Maria / Gentile, Ivan / Federico Ii Covid-Team

Vaccines

2022 Band 10, Heft 12

Abstract: We evaluated the role of CRP and other laboratory parameters in predicting the worsening of clinical conditions during hospitalization, ICU admission, and fatal outcome among patients with COVID-19. Consecutive adult inpatients with SARS-CoV-2 infection ... ...

Abstract	We evaluated the role of CRP and other laboratory parameters in predicting the worsening of clinical conditions during hospitalization, ICU admission, and fatal outcome among patients with COVID-19. Consecutive adult inpatients with SARS-CoV-2 infection and respiratory symptoms treated in three different COVID centres were enrolled, and they were tested for laboratory parameters within 48 h from admission. Three-hundred ninety patients were enrolled. Age, baseline CRP, and LDH were associated with a P/F ratio < 200 during hospitalization. Male gender and CRP > 60 mg/L were shown to be independently associated with ICU admission. Lymphocytes < 1000 cell/μL were associated with the worst P/F ratio. CRP > 60 mg/L predicted exitus. We subsequently devised an 11-points numeric ordinary scoring system based on age, sex, CRP, and LDH at admission (ASCL score). Patients with an ASCL score of 0 or 2 were shown to be protected against a P/F ratio < 200, while patients with an ASCL score of 6 to 8 were shown to be at risk for P/F ratio < 200. Patients with an ASCL score ≥ 7 had a significantly increased probability of death during hospitalization. In conclusion, patients with elevated CRP and LDH and an ASCL score > 6 at admission should be prioritized for careful respiratory function monitoring and early treatment to prevent a progression of the disease.
Sprache	Englisch
Erscheinungsdatum	2022-11-29
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10122043
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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