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  1. Article ; Online: Clinical Significance of Indeterminate QuantiFERON-TB Gold Plus Assay Results in Hospitalized COVID-19 Patients with Severe Hyperinflammatory Syndrome

    Xavier Solanich / Miguel Fernández-Huerta / Celeste Basaez / Arnau Antolí / Gemma Rocamora-Blanch / Xavier Corbella / Miguel Santin / Fernando Alcaide

    Journal of Clinical Medicine, Vol 10, Iss 5, p

    2021  Volume 918

    Abstract: Performance of the QuantiFERON-TB Gold Plus (QFT-Plus) assay could be affected by conditions of immune dysregulation. Little is known about the reliability of QTF-Plus in COVID-19 patients. Our aim was to determine the prevalence and the factors related ... ...

    Abstract Performance of the QuantiFERON-TB Gold Plus (QFT-Plus) assay could be affected by conditions of immune dysregulation. Little is known about the reliability of QTF-Plus in COVID-19 patients. Our aim was to determine the prevalence and the factors related to an indeterminate QFT-Plus test in COVID-19 hospitalized patients, and to analyze its relationship with in-hospital mortality. A retrospective analysis of all hospitalized COVID-19 patients on whom a QTF-Plus assay was performed in a tertiary care public hospital during the first epidemic wave in Spain (March–April 2020). Out of a total of 96 patients included, 34 (35.4%) had an indeterminate result, in all cases due to a lack of response in the mitogen control. Factors related to COVID-19 severity, such as higher lactate dehydrogenase (LDH) (odds ratio [OR] 1.005 [95% confidence interval [CI] 1.002–1.008]) and previous administration of corticosteroids (OR 4.477 [95% CI 1.397–14.345]), were independent predictors for indeterminate QFT-Plus assay. Furthermore, indeterminate results were more frequent among COVID-19 patients who died during hospitalization (29.1% vs. 64.7%; p = 0.005). We conclude that QFT-Plus assay yielded an unexpected, high prevalence of indeterminate results in severe COVID-19 patients. Factors related to worse COVID-19 outcome, such as LDH, as well as corticosteroid use before the QFT-Plus assay, seem to be predictors for an indeterminate result. The role of an indeterminate QFT-Plus result in predicting COVID-19 severity and mortality should be evaluated.
    Keywords QuantiFERON-TB Gold Plus ; indeterminate ; COVID-19 ; SARS-CoV-2 ; corticosteroids ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2021-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Multiple Drug Regimen-Refractory Rosai–Dorfman–Destombes Disease Mimicking Relapsing Polychondritis Successfully Treated with Cobimetinib

    Kima López-Aldabe / Francesc Escrihuela-Vidal / Manel Tuells-Morales / Clàudia Llobera-Ris / Andrea Bauer-Alonso / Montserrat Cortes-Romera / Laura Gràcia-Sànchez / Marian Tormo-Ratera / Xavier Juanola Roura / Rosa Maria Penin-Mosquera / Xavier Corbella / Xavier Solanich

    European Journal of Case Reports in Internal Medicine (2022)

    2022  

    Abstract: Rosai-Dorfman-Destombes disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a rare non-Langerhans cell histiocytosis of unknown cause. The disease often manifests as bilateral painless cervical lymphadenopathy associated with systemic ... ...

    Abstract Rosai-Dorfman-Destombes disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a rare non-Langerhans cell histiocytosis of unknown cause. The disease often manifests as bilateral painless cervical lymphadenopathy associated with systemic symptoms such as fever and weight loss. Extranodal disease is also frequent and can involve any organ, mostly skin, nasal cavity, bone, and retro-orbital tissue. Swelling of cartilaginous tissues such as ear helix or laryngeal structures may mimic the entity known as relapsing polychondritis. Although spontaneous remission is the most expected evolution, some cases require systemic treatment with prednisone, methotrexate or cytotoxic agents, with variable success rates. In this respect, since somatic variants in genes involved in the mitogen-activated protein kinase (MAPK) pathway have been observed to play a pathogenic role in RDD, the use of therapies targeting these pathogenic variants seems to be a reasonable strategy. Here we present a case of RDD with extensive extranodal involvement that showed a rapid and complete response to the MEK inhibitor cobimetinib
    Keywords rosai–dorfman–destombes disease ; rosai–dorfman disease ; relapsing polychondritis ; mapk/erk pathway ; cobimetinib ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Methylprednisolone Pulses Plus Tacrolimus in Addition to Standard of Care vs. Standard of Care Alone in Patients With Severe COVID-19. A Randomized Controlled Trial

    Xavier Solanich / Arnau Antolí / Gemma Rocamora-Blanch / Núria Padullés / Marta Fanlo-Maresma / Adriana Iriarte / Francesca Mitjavila / Olga Capdevila / Antoni Riera-Mestre / Jordi Bas / Vanesa Vicens-Zygmunt / Jordi Niubó / Nahum Calvo / Santiago Bolivar / Raúl Rigo-Bonnin / Anna Mensa-Vilaró / Laura Arregui / Cristian Tebe / Sebastià Videla /
    Pilar Hereu / Xavier Corbella

    Frontiers in Medicine, Vol

    2021  Volume 8

    Abstract: Introduction: Severe lung injury is triggered by both the SARS-CoV-2 infection and the subsequent host-immune response in some COVID-19 patients.Methods: We conducted a randomized, single-center, open-label, phase II trial with the aim to evaluate the ... ...

    Abstract Introduction: Severe lung injury is triggered by both the SARS-CoV-2 infection and the subsequent host-immune response in some COVID-19 patients.Methods: We conducted a randomized, single-center, open-label, phase II trial with the aim to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus plus standard of care (SoC) vs. SoC alone, in hospitalized patients with severe COVID-19. The primary outcome was time to clinical stability within 56 days after randomization.Results: From April 1 to May 2, 2020, 55 patients were prospectively included for subsequent randomization; 27 were assigned to the experimental group and 28 to the control group. The experimental treatment was not associated with a difference in time to clinical stability (hazard ratio 0.73 [95% CI 0.39–1.37]) nor most secondary outcomes. Median methylprednisolone cumulative doses were significantly lower (360 mg [IQR 360–842] vs. 870 mg [IQR 364–1451]; p = 0.007), and administered for a shorter time (median of 4.00 days [3.00–17.5] vs. 18.5 days [3.00–53.2]; p = 0.011) in the experimental group than in the control group. Although not statistically significant, those receiving the experimental therapy showed a numerically lower all-cause mortality than those receiving SoC, especially at day 10 [2 (7.41%) vs. 5 (17.9%); OR 0.39 (95% CI 0.05–2.1); p = 0.282]. The total number of non-serious adverse events was 42 in each the two groups. Those receiving experimental treatment had a numerically higher rate of non-serious infectious adverse events [16 (38%) vs. 10 (24%)] and serious infectious adverse events [7 (35%) vs. 3 (23%)] than those receiving SoC.Conclusions: The combined use of methylprednisolone pulses plus tacrolimus, in addition to the SoC, did not significantly improve the time to clinical stability or other secondary outcomes compared with the SoC alone in severe COVID-19. Although not statistically significant, patients receiving the experimental therapy had numerically lower all-cause mortality than those receiving ...
    Keywords COVID-19 ; SARS-CoV-2 ; methylprednisolone ; tacrolimus ; inflammation ; lung injury ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2021-06-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Beneficial effect of corticosteroids in preventing mortality in patients receiving tocilizumab to treat severe COVID-19 illness

    Manuel Rubio-Rivas / Mar Ronda / Ariadna Padulles / Francesca Mitjavila / Antoni Riera-Mestre / Carlos García-Forero / Adriana Iriarte / Jose M. Mora / Nuria Padulles / Monica Gonzalez / Xavier Solanich / Merce Gasa / Guillermo Suarez-Cuartin / Joan Sabater / Xose L. Perez-Fernandez / Eugenia Santacana / Elisabet Leiva / Albert Ariza-Sole / Paolo D. Dallaglio /
    Maria Quero / Antonio Soriano / Alberto Pasqualetto / Maylin Koo / Virginia Esteve / Arnau Antoli / Rafael Moreno-Gonzalez / Sergi Yun / Pau Cerda / Mariona Llaberia / Francesc Formiga / Marta Fanlo / Abelardo Montero / David Chivite / Olga Capdevila / Ferran Bolao / Xavier Pinto / Josep Llop / Antoni Sabate / Jordi Guardiola / Josep M. Cruzado / Josep Comin-Colet / Salud Santos / Ramon Jodar / Xavier Corbella

    International Journal of Infectious Diseases, Vol 101, Iss , Pp 290-

    2020  Volume 297

    Abstract: Objectives: To assess the characteristics and risk factors for mortality in patients with severe coronavirus disease-2019 (COVID-19) treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). Methods: From March 17 to April 7, ... ...

    Abstract Objectives: To assess the characteristics and risk factors for mortality in patients with severe coronavirus disease-2019 (COVID-19) treated with tocilizumab (TCZ), alone or in combination with corticosteroids (CS). Methods: From March 17 to April 7, 2020, a real-world observational retrospective analysis of consecutive hospitalized adult patients receiving TCZ to treat severe COVID-19 was conducted at our 750-bed university hospital. The main outcome was all-cause in-hospital mortality. Results: A total of 1,092 patients with COVID-19 were admitted during the study period. Of them, 186 (17%) were treated with TCZ, of which 129 (87.8%) in combination with CS. Of the total 186 patients, 155 (83.3 %) patients were receiving noninvasive ventilation when TCZ was initiated. Mean time from symptoms onset and hospital admission to TCZ use was 12 (±4.3) and 4.3 days (±3.4), respectively. Overall, 147 (79%) survived and 39 (21%) died. By multivariate analysis, mortality was associated with older age (HR = 1.09, p < 0.001), chronic heart failure (HR = 4.4, p = 0.003), and chronic liver disease (HR = 4.69, p = 0.004). The use of CS, in combination with TCZ, was identified as a protective factor against mortality (HR = 0.26, p < 0.001) in such severe COVID-19 patients receiving TCZ. No serious superinfections were observed after a 30-day follow-up. Conclusions: In patients with severe COVID-19 receiving TCZ due to systemic host-immune inflammatory response syndrome, the use of CS in addition to TCZ therapy, showed a beneficial effect in preventing in-hospital mortality.
    Keywords COVID-19 ; Tocilizumab ; Corticosteroids ; Systemic inflammation ; Mortality ; Infectious and parasitic diseases ; RC109-216 ; covid19
    Language English
    Publishing date 2020-12-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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