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Artikel: Is bedside manner or technical expertise more important?

Thomson, Tina

Tennessee nurse

2012 Band 75, Heft 2, Seite(n) 4; discussion 4

Mesh-Begriff(e)	Nursing Staff, Hospital
Sprache	Englisch
Erscheinungsdatum	2012
Erscheinungsland	United States
Dokumenttyp	Comment ; Journal Article
ISSN	1055-3134
ISSN	1055-3134
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Lack of seroresponse to SARS-CoV-2 booster vaccines given early post-transplant in patients primed pre-transplantation.

Gleeson, Sarah / Martin, Paul / Thomson, Tina / Spensley, Katrina J / Goodall, Dawn / Bedi, Rachna / Thind, Amarpreet Kaur / Seneschall, Charlotte / Gan, Jaslyn / McAdoo, Stephen / Lightstone, Liz / Kelleher, Peter / Prendecki, Maria / Willicombe, Michelle

Frontiers in immunology

2023 Band 13, Seite(n) 1083167

Abstract: SARS-CoV-2 vaccines are recommended pre-transplantation, however, waning immunity and evolving variants mandate booster doses. Currently there no data to inform the optimal timing of booster doses post-transplant, in patients primed pre-transplant. We ... ...

Abstract	SARS-CoV-2 vaccines are recommended pre-transplantation, however, waning immunity and evolving variants mandate booster doses. Currently there no data to inform the optimal timing of booster doses post-transplant, in patients primed pre-transplant. We investigated serial serological samples in 204 transplant recipients who received 2 or 3 SARS-CoV-2 vaccines pre-transplant. Spike protein antibody concentrations, [anti-S], were measured on the day of transplantation and following booster doses post-transplant. In infection-naïve patients, post-booster [anti-S] did not change when V3 (1
Mesh-Begriff(e)	Humans ; COVID-19 Vaccines ; SARS-CoV-2 ; COVID-19/prevention & control ; Transplants ; Transplant Recipients ; Antibodies
Chemische Substanzen	COVID-19 Vaccines ; Antibodies
Sprache	Englisch
Erscheinungsdatum	2023-01-16
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.1083167
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Comparison of Vaccine Effectiveness Against the Omicron (B.1.1.529) Variant in Hemodialysis Patients.

Spensley, Katrina J / Gleeson, Sarah / Martin, Paul / Thomson, Tina / Clarke, Candice L / Pickard, Graham / Thomas, David / McAdoo, Stephen P / Randell, Paul / Kelleher, Peter / Bedi, Rachna / Lightstone, Liz / Prendecki, Maria / Willicombe, Michelle

Kidney international reports

2022 Band 7, Heft 6, Seite(n) 1406–1409

Sprache	Englisch
Erscheinungsdatum	2022-04-13
Erscheinungsland	United States
Dokumenttyp	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2022.04.005
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Cohort Study of Outpatient Hemodialysis Management Strategies for COVID-19 in North-West London.

Medjeral-Thomas, Nicholas R / Thomson, Tina / Ashby, Damien / Muthusamy, Anand / Nevin, Margaret / Duncan, Neill / Loucaidou, Marina

Kidney international reports

2020 Band 5, Heft 11, Seite(n) 2055–2065

Abstract: Background: Dialysis patients are at risk of severe coronavirus disease 2019 (COVID-19). We managed COVID-19 hemodialysis outpatients in dedicated satellite dialysis units. This provided rare opportunity to study early disease progress in community- ... ...

Abstract	Background: Dialysis patients are at risk of severe coronavirus disease 2019 (COVID-19). We managed COVID-19 hemodialysis outpatients in dedicated satellite dialysis units. This provided rare opportunity to study early disease progress in community-based patients. We aimed to (i) understand COVID-19 progression, (ii) identify markers of future clinical severity, and (iii) assess associations between dialysis management strategies and COVID-19 clinical outcomes. Methods: We conducted a cohort study of all outpatients managed at a COVID-19 hemodialysis unit. We analyzed data recorded as part of providing COVID-19 clinical care. We analyzed associations between features at diagnosis and the first 3 consecutive hemodialysis sessions in patients who required future hospital admission, and those who had died at 28 days. Results: Isolated outpatient hemodialysis was provided to 106 patients over 8 weeks. No patients received antiviral medication or hydroxychloroquine. Twenty-one patients (20%) were admitted at COVID-19 diagnosis; 29 of 85 patients (34%) were admitted after initial outpatient management; 16 patients (15%) died. By multivariate analysis, nonactive transplant list status, use of institutional transport, and increased white cell count associated with future hospitalization and increased age associated with death. Oxygen saturations progressively decreased over the first 3 dialysis sessions in the cohorts that progressed to future hospital admission or death. Mean ultrafiltration volume of the first 3 hemodialysis sessions was reduced in the same cohorts. Conclusions: Outpatient hemodialysis in patients with COVID-19 is safe for patients and staff. Features at the first 3 dialysis sessions can identify individuals at risk of future hospitalization and death from COVID-19.
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2020-08-25
Erscheinungsland	United States
Dokumenttyp	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2020.08.022
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Immune responses following 3rd and 4th doses of heterologous and homologous COVID-19 vaccines in kidney transplant recipients.

Thomson, Tina / Prendecki, Maria / Gleeson, Sarah / Martin, Paul / Spensley, Katrina / De Aguiar, Rute Cardoso / Sandhu, Bynvant / Seneschall, Charlotte / Gan, Jaslyn / Clarke, Candice L / Lewis, Shanice / Pickard, Graham / Thomas, David / McAdoo, Stephen P / Lightstone, Liz / Cox, Alison / Kelleher, Peter / Willicombe, Michelle

EClinicalMedicine

2022 Band 53, Seite(n) 101642

Abstract: Background: Solid organ transplant recipients have attenuated immune responses to SARS-CoV-2 vaccines. In this study, we report on immune responses to 3rd- (V3) and 4th- (V4) doses of heterologous and homologous vaccines in a kidney transplant ... ...

Abstract	Background: Solid organ transplant recipients have attenuated immune responses to SARS-CoV-2 vaccines. In this study, we report on immune responses to 3rd- (V3) and 4th- (V4) doses of heterologous and homologous vaccines in a kidney transplant population. Methods: We undertook a single centre cohort study of 724 kidney transplant recipients prospectively screened for serological responses following 3 primary doses of a SARS-CoV2 vaccine. 322 patients were sampled post-V4 for anti-spike (anti-S), with 69 undergoing assessment of SARS-CoV-2 T-cell responses. All vaccine doses were received post-transplant, only mRNA vaccines were used for V3 and V4 dosing. All participants had serological testing performed post-V2 and at least once prior to their first dose of vaccine. Findings: 586/724 (80.9%) patients were infection-naïve post-V3; 141/2586 (24.1%) remained seronegative at 31 (21-51) days post-V3. Timing of vaccination in relation to transplantation, OR: 0.28 (0.15-0.54), p=0.0001; immunosuppression burden, OR: 0.22 (0.13-0.37), p<0.0001, and a diagnosis of diabetes, OR: 0.49 (0.32-0.75), p=0.001, remained independent risk factors for non-seroconversion. Seropositive patients post-V3 had greater anti-S if primed with BNT162b2 compared with ChAdOx1, p=0.001.Post-V4, 45/239 (18.8%) infection-naïve patients remained seronegative. De novo seroconversion post-V4 occurred in 15/60 (25.0%) patients. There was no difference in anti-S post-V4 by vaccine combination, p=0.50. T-cell responses were poor, with only 11/54 (20.4%) infection-naive patients having detectable T-cell responses post-V4, with no difference seen by vaccine type. Interpretation: A significant proportion of transplant recipients remain seronegative following 3- and 4- doses of SARS-CoV-2 vaccines, with poor T-cell responses, and are likely to have inadequate protection against infection. As such alternative strategies are required to provide protection to this vulnerable group. Funding: MW/PK received study support from Oxford Immunotec.
Sprache	Englisch
Erscheinungsdatum	2022-09-09
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2022.101642
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Comparison of immunogenicity and clinical effectiveness between BNT162b2 and ChAdOx1 SARS-CoV-2 vaccines in people with end-stage kidney disease receiving haemodialysis: A prospective, observational cohort study.

Martin, Paul / Gleeson, Sarah / Clarke, Candice L / Thomson, Tina / Edwards, Helena / Spensley, Katrina / Mortimer, Paige / McIntyre, Stacey / Cox, Alison / Pickard, Graham / Lightstone, Liz / Thomas, David / McAdoo, Stephen P / Kelleher, Peter / Prendecki, Maria / Willicombe, Michelle

The Lancet regional health. Europe

2022 Band 21, Seite(n) 100478

Abstract: Background: People with end-stage kidney disease, including people on haemodialysis, are susceptible to greater COVID-19 related morbidity and mortality. This study compares the immunogenicity and clinical effectiveness of BNT162B2 versus ChAdOx1 in ... ...

Abstract	Background: People with end-stage kidney disease, including people on haemodialysis, are susceptible to greater COVID-19 related morbidity and mortality. This study compares the immunogenicity and clinical effectiveness of BNT162B2 versus ChAdOx1 in haemodialysis patients. Methods: In this observational cohort study, 1021 patients were followed-up from time of vaccination until December 2021. All patients underwent weekly RT-PCR screening. Patients were assessed for nucleocapsid(anti-NP) and spike(anti-S) antibodies at timepoints after second(V2) and third(V3) vaccinations. 191 patients were investigated for T-cell responses. Vaccine effectiveness (VE) for prevention of infection, hospitalisation and mortality was evaluated using the formula VE=(1-adjustedHR)x100. Findings: 45.7% (467/1021) had evidence of prior infection. There was no difference in the proportion of infection-naïve patients who seroconverted by vaccine type, but median anti-S antibody titres were higher post-BNT162b2 compared with ChAdOx1; 462(152-1171) and 78(20-213) BAU/ml respectively, Interpretation: Serum anti-S concentrations predict risk of breakthrough infection. Anti-S responses vary dependent upon clinical features, infection history and vaccine type. Monitoring of serological responses may enable individualised approaches to vaccine boosters in at risk populations. Funding: National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London.
Sprache	Englisch
Erscheinungsdatum	2022-09-10
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2666-7762
ISSN (online)	2666-7762
DOI	10.1016/j.lanepe.2022.100478
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody lateral flow assay for antibody prevalence studies following vaccination: a diagnostic accuracy study.

Wellcome open research

2022 Band 6, Seite(n) 358

Abstract: Background: ...

Abstract	Background:
Sprache	Englisch
Erscheinungsdatum	2022-05-26
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2398-502X
ISSN	2398-502X
DOI	10.12688/wellcomeopenres.17231.2
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Kidney Transplant Recipients and Omicron: Outcomes, effect of vaccines and the efficacy and safety of novel treatments

Gleeson, Sarah / Martin, Paul / Thomson, Tina / Thind, Amarpreet / Prendecki, Maria / Spensley, Katrina J / Clarke, Candice / Roufosse, Candice / Pickard, Graham / Thomas, David / McAdoo, Stephen P / Lightstone, Liz / Kelleher, Peter / Willicombe, Michelle

medRxiv

Abstract: We aimed to describe the outcomes of Omicron infection in kidney transplant recipients (KTR), compare the efficacy of the community therapeutic interventions and report the safety profile of molnupiravir. From 142 KTRs diagnosed with COVID-19 infection ... ...

Abstract	We aimed to describe the outcomes of Omicron infection in kidney transplant recipients (KTR), compare the efficacy of the community therapeutic interventions and report the safety profile of molnupiravir. From 142 KTRs diagnosed with COVID-19 infection after Omicron had become the dominant variant in the UK, 116 (78.9%) cases were diagnosed in the community; 47 receiving sotrovimab, 21 molnupiravir and 48 no treatment. 10 (20.8%) non-treated patients were hospitalised following infection, which was significantly higher than the sotrovimab group (2.1%), p=0.0048, but not the molnupiravir treated group (14.3%), p=0.47. The only admission following sotrovimab occurred in a patient infected with BA.2. One patient from the molnupiravir and no-treatment groups required ICU support, and both subsequently died, with one other death in the no-treatment group. No patient receiving sotrovimab died. 6/116 (5.2%) patients required dialysis following their diagnosis; 2 (9.5%) patients receiving molnupiravir and 4 (8.3%) no-treatment. This requirement was significantly higher in the molnupiravir group compared with the sotrovimab treated patients, in whom no patient required dialysis, p=0.035. Both molnupiravir treated patients requiring dialysis had features of systemic thrombotic microangiopathy. Post-vaccination serostatus was available in 110 patients. Seropositive patients were less likely to require hospital admission compared with seronegative patients, 6 (7.0%) and 6 (25.0%) respectively, p=0.023. Seropositive patients were also less likely to require dialysis therapy, (p=0.016). In conclusion, sotrovimab treatment in the community was associated with superior patient and transplant outcomes; its clinical efficacy against the BA.2 variant requires a rapid review. The treatment benefit of molnupiravir was not evident, and wider safety reporting in transplant patients is needed.
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2022-05-03
Verlag	Cold Spring Harbor Laboratory Press
Dokumenttyp	Artikel ; Online
DOI	10.1101/2022.05.03.22274524
Datenquelle	COVID19

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Artikel ; Online: Comparison of vaccine effectiveness against the Omicron (B.1.1.529) variant in patients receiving haemodialysis

Spensley, Katrina / Gleeson, Sarah / Martin, Paul / Thomson, Tina / Clarke, Candice L / Pickard, Graham / Thomas, David C / McAdoo, Stephen P / Randell, Paul / Kelleher, Peter / Bedi, Rachna / Lightstone, Liz / Prendecki, Maria / Willicombe, Michelle

medRxiv

Abstract: Background Emerging data suggest a reduction in SARS-CoV-2 vaccine effectiveness against Omicron SARS-CoV-2 infection. There is also evidence to show that Omicron is less pathogenic than previous variants. For clinically vulnerable populations, a less ... ...

Abstract	Background Emerging data suggest a reduction in SARS-CoV-2 vaccine effectiveness against Omicron SARS-CoV-2 infection. There is also evidence to show that Omicron is less pathogenic than previous variants. For clinically vulnerable populations, a less pathogenic variant may still have significant impact on morbidity and mortality. Herein we assess the clinical impact of Omicron infection, and vaccine effectiveness, in an in-centre haemodialysis (IC-HD) population. Methods One thousand, one hundred and twenty-one IC-HD patients were included in the analysis, all patients underwent weekly screening for SARS-CoV-2 infection via RT-PCR testing between 1st December 2021 and 16th January 2022. Screening for infection via weekly RT-PCR testing and 3-monthly serological assessment started prior to the vaccine roll out in 2020. Results Omicron infection was diagnosed in 145/1121 (12.9%) patients over the study period, equating to an infection rate of 3.1 per 1000 patient days. Vaccine effectiveness (VE) against Omicron infection in patients who had received a booster vaccine was 58 (23-75)%, p=0.002; VE was seen in patients who received either ChAdOx1, VE of 47(2-70)%, p=0.034, or BNT162b2, VE of 66 (36-81)%, p=0.0005, as their first two doses. No protection against infection was seen in patients who were partially vaccinated (2-doses), p=0.83. Prior infection was associated with reduced likelihood of Omicron infection, HR 0.69 (0.50-0.96), p=0.0289. Four (2.8%) patients died within 28 days of infection diagnosis, with no excess mortality was seen in patients with infection. Conclusion 3-doses of SARS-CoV-2 vaccines are required in ICHD to provide protection against Omicron infection.
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2022-01-26
Verlag	Cold Spring Harbor Laboratory Press
Dokumenttyp	Artikel ; Online
DOI	10.1101/2022.01.25.22269804
Datenquelle	COVID19

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Artikel: Cohort study of outpatient hemodialysis management strategies for COVID-19 in North-West London

Medjeral-Thomas, Nicholas R / Thomson, Tina / Ashby, Damien / Muthusamy, Anand / Nevin, Margaret / Duncan, Neill / Loucaidou, Marina

Abstract: Background: Dialysis patients are at risk of severe COVID-19. We managed COVID-19 haemodialysis outpatients in dedicated satellite dialysis units. This provided rare opportunity to study early disease progress in community-based patients. We aimed to (1) ...

Abstract	Background: Dialysis patients are at risk of severe COVID-19. We managed COVID-19 haemodialysis outpatients in dedicated satellite dialysis units. This provided rare opportunity to study early disease progress in community-based patients. We aimed to (1) understand COVID-19 progression, (2) identify markers of future clinical severity and (3) assess associations between dialysis management strategies and COVID-19 clinical outcomes. Methods: We conducted a cohort study of all outpatients managed at a COVID-19 haemodialysis unit. We analysed data recorded as part of providing COVID-19 clinical care. We analysed associations between features at diagnosis and the first 3 consecutive haemodialysis sessions in patients who required future hospital admission, and those who had died at 28 days. Results: Isolated outpatient haemodialysis was provided to 106 patients over 8 weeks. No patients received antiviral medication or hydroxychloroquine. 21 patients (20%) were admitted at COVID-19 diagnosis. 29 of 85 patients (34%) were admitted after initial outpatient management. 16 patients (15%) died. By multivariate analysis, non-active transplant list status, use of institutional transport, and increased white cell count associated with future hospitalisation and increased age associated with death. Oxygen saturations progressively decreased over the first 3 dialysis sessions in the cohorts who progressed to future hospital admission or death. Mean ultrafiltration volume of the first three haemodialysis sessions was reduced in the same cohorts. Conclusions: Outpatient haemodialysis in patients with COVID-19 is safe for patients and staff. Features at the first 3 dialysis sessions can identify individuals at risk of future hospitalisation and death from COVID-19.
Schlagwörter	covid19
Verlag	WHO
Dokumenttyp	Artikel
Anmerkung	WHO #Covidence: #728537
Datenquelle	COVID19

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