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  1. Article: A High-Risk Patient With COVID-19 Vaccine Hesitancy Successfully Treated With Monoclonal Antibodies Through Two Major Surges.

    Gurjar, Hitesh / Ghazanfar, Haider / Haider, Asim / Hernandez, Nolberto / Jyala, Abhilasha / Chilimuri, Sridhar

    Cureus

    2022  Volume 14, Issue 2, Page(s) e22721

    Abstract: Vaccine hesitancy remains a significant challenge in managing the current pandemic despite highly effective vaccines in the United States. Monoclonal antibodies (mAb) are an essential addition to coronavirus disease 2019 (COVID-19) treatment, along with ... ...

    Abstract Vaccine hesitancy remains a significant challenge in managing the current pandemic despite highly effective vaccines in the United States. Monoclonal antibodies (mAb) are an essential addition to coronavirus disease 2019 (COVID-19) treatment, along with oral antiviral agents (OAA), for non-hospitalized patients having risk factors for progression to severe COVID-19, especially in unvaccinated people. We present a case of a 74-year-old unvaccinated Hispanic woman with a history of diabetes mellitus, hypertension, coronary artery disease, obesity, and asthma who survived two episodes of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infections in January 2021 and December 2021 with exclusive use of mAb. Our case highlights the importance of using mAbs for treating high-risk patients with SARS-CoV-2 infection, especially in patients with vaccine hesitancy.
    Language English
    Publishing date 2022-02-28
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.22721
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Reversible Systolic Heart Failure in a Patient on Ibrutinib Chemotherapy.

    Khaja, Misbahuddin / Gurjar, Hitesh / Yapor, Laura / Abraham, Minu C / Hernandez, Nolberto / Haider, Asim

    Cureus

    2022  Volume 14, Issue 3, Page(s) e23266

    Abstract: Ibrutinib is an irreversible Bruton tyrosine kinase inhibitor that is approved for the treatment of mantle cell lymphoma, chronic lymphocytic leukemia, small lymphocytic lymphoma, Waldenström macroglobulinemia, marginal zone lymphoma, and mantle cell ... ...

    Abstract Ibrutinib is an irreversible Bruton tyrosine kinase inhibitor that is approved for the treatment of mantle cell lymphoma, chronic lymphocytic leukemia, small lymphocytic lymphoma, Waldenström macroglobulinemia, marginal zone lymphoma, and mantle cell lymphoma. However, it is associated with significant cardiotoxic effects, with hypertension and atrial fibrillation being the most common. We present the case of a 42-year-old female with a medical history significant for lymphoplasmacytic lymphoma who presented with non-arrhythmic, non-ischemic cardiomyopathy after four months of chemotherapy with ibrutinib. In addition, her left ventricular ejection fraction improved markedly within a few days of stopping ibrutinib. We propose that the use of ibrutinib may be associated with reversible non-ischemic cardiomyopathy even in the absence of cardiac arrhythmias. Therefore, clinicians should be cognizant of the signs and symptoms of cardiomyopathy in patients on ibrutinib chemotherapy.
    Language English
    Publishing date 2022-03-17
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.23266
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Outcomes of Monoclonal Antibody Infusion Treatment During Delta (B.1.617.2) and Omicron (B.1.1.529) COVID 19 Variant Surges among Vaccinated and Unvaccinated Patients.

    Ghazanfar, Haider / Haider, Asim / Gurjar, Hitesh / Hernandez, Nolberto / Jyala, Abhilasha / Bhatt, Tanushree / Zeana, Cosmina / Chilimuri, Sridhar

    Health services insights

    2022  Volume 15, Page(s) 11786329221127153

    Abstract: Background: Coronavirus infection of 2019 (COVID-19) is associated with significant morbidity and mortality. Vaccines supplement public health and social measures in preventing severe illness and mortality from COVID-19; however, vaccination rates ... ...

    Abstract Background: Coronavirus infection of 2019 (COVID-19) is associated with significant morbidity and mortality. Vaccines supplement public health and social measures in preventing severe illness and mortality from COVID-19; however, vaccination rates remain inadequate in many regions. It is important to continuously explore the effective treatment due to the insufficient vaccination rate and increasing number of patients infected with virus. The emergence of new variants has led to multiple surges throughout the world requiring changes to treatment protocols.
    Method: We conducted a single-center observational study on all adult patients who received monoclonal antibody (mAb) infusion as a treatment for COVID-19 infection. Based on the predominant variant, patients were either offered Casirivimab (600 mg)/imdevimab (600 mg) or Sotrovimab (500 mg). Forty-six patients were given mAbs; 24 were vaccinated, and the remaining unvaccinated.
    Result: The mean age was 56 years, and the majority (63.04%) of the patients were female. Clinical symptoms of COVID-19 improved within 3 days of infusion in the majority of the patients (70%). None of the patients who received mAb showed progression of disease or required hospitalization at 30 days follow-up. There were no deaths at 30 days follow-up. Monoclonal antibodies are highly effective in reducing hospitalizations and mortality when given within 7 days of symptoms onset in patients with high-risk factors for progression to severe COVID-19 infection. The mean number of days after the onset at which the mAbs were administered to the patient was 4.
    Conclusion: Monoclonal antibodies should be considered in both vaccinated and unvaccinated patients with COVID-19 infection if newer antiviral agents are contraindicated. Our study highlights the effectiveness of monoclonal antibody infusions when given early in the course of COVID-19 infection regardless of vaccination status.
    Language English
    Publishing date 2022-09-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2803340-1
    ISSN 1178-6329
    ISSN 1178-6329
    DOI 10.1177/11786329221127153
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Association between right ventricular dysfunction and in-hospital mortality in surges of SARS-CoV-2 infection attributed to the Alpha, Delta, and Omicron variants.

    Omar, Alaa Mabrouk Salem / Hernandez, Nolberto / Ronderos Botero, Diana Maria / Delacruz, Angel / Doppalapudi, Sai / Itare, Vikram / Shin, Dongmin / Mahasamudram, Jaydeep / Pandey, Neelanjana / Allena, Nishant / Sud, Karan / Chilimuri, Sridhar / Bella, Jonathan N

    International journal of cardiology. Heart & vasculature

    2022  Volume 43, Page(s) 101150

    Abstract: Background: Right ventricular (RV) dysfunction in acute COVID-19 was reported to be associated with poor prognosis: Methods: In a retrospective single-center study, we enrolled 648 consecutive patients hospitalized with COVID-19 [66 (10 %) ... ...

    Abstract Background: Right ventricular (RV) dysfunction in acute COVID-19 was reported to be associated with poor prognosis
    Methods: In a retrospective single-center study, we enrolled 648 consecutive patients hospitalized with COVID-19 [66 (10 %) hospitalized during the alpha variant surge, 433 (67 %) during the delta variant surge, and 149 (23 %), during the omicron variant surge]. Patients were reported from a hospital with an underreported population of mostly African American and Hispanic patients. Patients were followed for a median of 11 days during which in-hospital death occurred in 155 (24 %) patients [Alpha wave: 25 (38 %), Delta Wave: 112 (26 %), Omicron wave: 18 (12 %), p < 0.001].
    Results: RV dysfunction occurred in 210 patients (alpha: 32 %, 26 %, delta: 29 %, and omicron: 49 %, p < 0.001) and was associated with higher mortality across waves, however, independently predicted in-hospital mortality in the Alpha (HR = 5.1, 95 % CI: 2.06-12.5) and Delta surges (HR = 1.6, 95 % CI: 1.11-2.44), but not in the Omicron surge. When only patients with RV dysfunction were compared, the mortality risk was found to decrease significantly from the Alpha (HR = 13.6, 95 % CI: 3.31-56.3) to the delta (HR = 1.93, 95 % CI: 1.25-2.96) and to the Omicron waves (HR = 11, 95 % CI: 0.6-20.8).
    Conclusions: RV dysfunction continues to occur in all strains of the SARS-CoV-2 virus, however, the mortality risk decreased from wave to wave likely due to evolution of better therapeutics, increase rate of vaccination, or viral mutations resulting in decrease virulence.
    Language English
    Publishing date 2022-11-17
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 2818464-6
    ISSN 2352-9067
    ISSN 2352-9067
    DOI 10.1016/j.ijcha.2022.101150
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A 44-Year-Old Hispanic Man with Loss of Taste and Bilateral Facial Weakness Diagnosed with Guillain-Barré Syndrome and Bell's Palsy Associated with SARS-CoV-2 Infection Treated with Intravenous Immunoglobulin.

    Khaja, Misbahuddin / Gomez, Gabriella P Roa / Santana, Yaneidy / Hernandez, Nolberto / Haider, Asim / Lara, Jose Luis Perez / Elkin, Rene

    The American journal of case reports

    2020  Volume 21, Page(s) e927956

    Abstract: BACKGROUND This case report is of a patient who presented with loss of taste and facial weakness and was diagnosed with Guillain-Barre syndrome (GBS) and Bell's palsy, associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ...

    Abstract BACKGROUND This case report is of a patient who presented with loss of taste and facial weakness and was diagnosed with Guillain-Barre syndrome (GBS) and Bell's palsy, associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. GBS is a neurological emergency defined as acute inflammatory demyelinating polyneuropathy. The patient responded to intravenous immunoglobulin (IVIG) treatment. CASE REPORT We present the case of a 44-year-old Hispanic man who came for evaluation of bilateral facial weakness and lack of taste sensation. He had lower motor neuron facial weakness. His head computed tomography and brain magnetic resonance imaging scans did not show any pathological abnormalities. He tested positive for SARS-CoV-2 by a nasopharyngeal swab reverse transcription polymerase chain reaction (RT-PCR) test. Cerebrospinal fluid (CSF) analysis via lumbar puncture revealed elevated protein levels, no leukocytes, and a negative Gram stain. The CSF RT-PCR test for SARS-CoV-2 was negative. PCR tests of the CSF for other viral infections were negative. A diagnosis of GBS was made, and he was treated successfully with IVIG. After the fourth dose of IVIG, the patient was able to close his eyes, frown, show his teeth, and smile. CONCLUSIONS Our case is rare because the patient did not present with lower extremity weakness, but only with bilateral Bell's palsy. Physicians should be aware of GBS because it is a neurological emergency for which COVID-19 can be a risk factor. Early diagnosis and treatment of GBS can prevent neurological disability.
    MeSH term(s) Adult ; Ageusia/diagnosis ; Ageusia/drug therapy ; Ageusia/etiology ; Bell Palsy/diagnosis ; Bell Palsy/etiology ; COVID-19/complications ; COVID-19/drug therapy ; COVID-19/epidemiology ; Diagnosis, Differential ; Guillain-Barre Syndrome/diagnosis ; Guillain-Barre Syndrome/drug therapy ; Guillain-Barre Syndrome/etiology ; Hispanic Americans ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Immunologic Factors/therapeutic use ; Magnetic Resonance Imaging ; Male ; Pandemics ; SARS-CoV-2
    Chemical Substances Immunoglobulins, Intravenous ; Immunologic Factors
    Keywords covid19
    Language English
    Publishing date 2020-10-31
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.927956
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: A 44-Year-Old Hispanic Man with Loss of Taste and Bilateral Facial Weakness Diagnosed with Guillain-Barré Syndrome and Bell's Palsy Associated with SARS-CoV-2 Infection Treated with Intravenous Immunoglobulin

    Khaja, Misbahuddin / Gomez, Gabriella P Roa / Santana, Yaneidy / Hernandez, Nolberto / Haider, Asim / Lara, Jose Luis Perez / Elkin, Rene

    Am J Case Rep

    Abstract: BACKGROUND This case report is of a patient who presented with loss of taste and facial weakness and was diagnosed with Guillain-Barre syndrome (GBS) and Bell's palsy, associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ...

    Abstract BACKGROUND This case report is of a patient who presented with loss of taste and facial weakness and was diagnosed with Guillain-Barre syndrome (GBS) and Bell's palsy, associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. GBS is a neurological emergency defined as acute inflammatory demyelinating polyneuropathy. The patient responded to intravenous immunoglobulin (IVIG) treatment. CASE REPORT We present the case of a 44-year-old Hispanic man who came for evaluation of bilateral facial weakness and lack of taste sensation. He had lower motor neuron facial weakness. His head computed tomography and brain magnetic resonance imaging scans did not show any pathological abnormalities. He tested positive for SARS-CoV-2 by a nasopharyngeal swab reverse transcription polymerase chain reaction (RT-PCR) test. Cerebrospinal fluid (CSF) analysis via lumbar puncture revealed elevated protein levels, no leukocytes, and a negative Gram stain. The CSF RT-PCR test for SARS-CoV-2 was negative. PCR tests of the CSF for other viral infections were negative. A diagnosis of GBS was made, and he was treated successfully with IVIG. After the fourth dose of IVIG, the patient was able to close his eyes, frown, show his teeth, and smile. CONCLUSIONS Our case is rare because the patient did not present with lower extremity weakness, but only with bilateral Bell's palsy. Physicians should be aware of GBS because it is a neurological emergency for which COVID-19 can be a risk factor. Early diagnosis and treatment of GBS can prevent neurological disability.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #895724
    Database COVID19

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