scholarly journals CMV seropositivity is a potential novel risk factor for severe COVID-19 in non-geriatric patients

2021 ◽  
Author(s):  
Simone Weber ◽  
Victoria Kehl ◽  
Johanna Erber ◽  
Karolin I. Wagner ◽  
Ana-Marija Jetzlsperger ◽  
...  
Keyword(s):  
Risk Factor ◽  
Geriatric Patients ◽  
Prediction Models ◽  
Severe Disease ◽  
Cross Reactivity ◽  
German Population ◽  
Mild Disease ◽  
High Prevalence ◽  
The Relationship ◽  
Cmv Status

Background: COVID-19 has so far affected more than 250 million individuals worldwide, causing more than 5 million deaths. Several risk factors for severe disease have been identified, most of which coincide with advanced age. In younger individuals, severe COVID-19 often occurs in the absence of obvious comorbidities. Guided by the finding of cytomegalovirus (CMV)-specific T cells with some cross-reactivity to SARS-CoV-2 in a COVID-19 intensive care unit (ICU) patient, we decided to investigate whether CMV seropositivity is associated with severe or critical COVID-19. Methods: National German COVID-19 bio-sample and data banks were used to retrospectively analyze the CMV serostatus of patients who experienced mild (n=101), moderate (n=130) or severe to critical (n=80) disease by CMV IgG serology. We then investigated the relationship between disease severity and CMV serostatus via statistical models. Results: Non-geriatric patients (< 70 years) with severe COVID-19 were found to have a very high prevalence of CMV-seropositivity, while CMV status distribution in individuals with mild disease was similar to the prevalence in the German population; interestingly, this was not detectable in older patients. Prediction models support the hypothesis that the CMV serostatus might be a strong biomarker in identifying younger individuals with a higher risk of developing severe COVID-19. Conclusions: We identified CMV-seropositivity as a potential novel risk factor for severe COVID-19 in non-geriatric individuals in the studied cohorts. More mechanistic analyses as well as confirmation of similar findings in cohorts representing the currently most relevant SARS-CoV-2 variants should be performed shortly.

scholarly journals SARS-CoV-2-Laden Respiratory Aerosol Deposition in the Lung Alveolar-Interstitial Region Is a Potential Risk Factor for Severe Disease: A Modeling Study

2021 ◽  
Vol 11 (5) ◽  
pp. 431
Author(s):  
Sabine Hofer ◽  
Norbert Hofstätter ◽  
Albert Duschl ◽  
Martin Himly
Keyword(s):  
Risk Factor ◽  
Particle Deposition ◽  
Early Stage ◽  
Severe Disease ◽  
Ambient Air ◽  
Aerosol Deposition ◽  
Pulmonary Involvement ◽  
Mild Disease ◽  
Disease Initiation

COVID-19, predominantly a mild disease, is associated with more severe clinical manifestation upon pulmonary involvement. Virion-laden aerosols and droplets target different anatomical sites for deposition. Compared to droplets, aerosols more readily advance into the peripheral lung. We performed in silico modeling to confirm the secondary pulmonary lobules as the primary site of disease initiation. By taking different anatomical aerosol origins into consideration and reflecting aerosols from exhalation maneuvers breathing and vocalization, the physicochemical properties of generated respiratory aerosol particles were defined upon conversion to droplet nuclei by evaporation at ambient air. To provide detailed, spatially-resolved information on particle deposition in the thoracic region of the lung, a top-down refinement approach was employed. Our study presents evidence for hot spots of aerosol deposition in lung generations beyond the terminal bronchiole, with a maximum in the secondary pulmonary lobules and a high preference to the lower lobes of both lungs. In vivo, initial chest CT anomalies, the ground glass opacities, resulting from partial alveolar filling and interstitial thickening in the secondary pulmonary lobules, are likewise localized in these lung generations, with the highest frequency in both lower lobes and in the early stage of disease. Hence, our results suggest a disease initiation right there upon inhalation of virion-laden respiratory aerosols, linking the aerosol transmission route to pathogenesis associated with higher disease burden and identifying aerosol transmission as a new independent risk factor for developing a pulmonary phase with a severe outcome.

scholarly journals Low Levels of Vitamin D Are Associated With Markers of Immuno-Inflammatory Response and Clinical Outcome in Covid-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A278-A278
Author(s):  
Luigi di Filippo ◽  
Agnese Allora ◽  
Mauro Doga ◽  
Patrizia Rovere Querini ◽  
Massimo Locatelli ◽  
...  
Keyword(s):  
Vitamin D ◽  
Inflammatory Response ◽  
Disease Severity ◽  
Severe Disease ◽  
University Hospital ◽  
Reactive Protein ◽  
Vitamin D Levels ◽  
High Flow Oxygen ◽  
High Prevalence ◽  
The Relationship

Abstract High prevalence of vitamin D (VD) deficiency in COVID-19 patients was reported by several studies. Since VD is a key regulating factor of both innate and adaptive immunity, it was hypothesized that VD deficiency may predispose to SARS-CoV-2 infection and lower levels of VD could be related to increased COVID-19 severity and worse outcome risks. However, to date, only few studies partially investigated the relationship between VD and inflammatory and immune response and clinical features of COVID-19 patients. The aim of this study is to evaluate the influence of vitamin D levels on COVID-19 inflammatory activity, clinical pattern and disease severity. Patients admitted to San Raffaele University Hospital for COVID-19 from February 2020 were enrolled in this study. We excluded patients with comorbidities and therapies influencing VD metabolism. 25OH-Vitamin D levels were evaluated at admission in hospital and VD insufficiency and deficiency were defined as VD level below 30 ng/mL and 20 ng/mL, respectively. A total of 88 patients were included in the study. Median (IQR) VD levels were 16.3 (11.2–23.9) ng/mL. VD insufficiency and deficiency were found in 88.6% and in 68.2% of patients, respectively. Linear regression analyses showed a positive correlation between VD levels and PaO2/FiO2 ratio (p=0.019; r=0.254), and negative correlations between VD levels and Neutrophil/Lymphocyte (N/L) ratio (p=0.04; r=-0.19), C-reactive protein (CRP) levels (p=0.047; r=-0.18) and Interleukin 6 (IL-6) levels (p=0.04; r=-0.22). Lower VD levels were found in patients affected by severe disease (needs for high-flow oxygen therapy and/or noninvasive mechanical ventilation, admitted to ICU and/or dead) than non-severe patients (13.4 ng/mL [10.37–19.15] vs 18.45 ng/mL [15.15–24.95]; p=0.007). Moreover, patients with VD deficiency had higher levels of CRP, LDH, IL-6, IFN-gamma (p=0.04, p=0.01, p=0.002, p=0.04; respectively), lower PaO2/FiO2 and higher N/L ratios (p=0.008, p=0.004; respectively), and higher rate of severe disease (65% vs 39%, p=0.02), as compared to VD non-deficient ones. In conclusion, low VD levels are widely found in hospitalized COVID-19 and may lead to increased disease severity through an excessive immune-inflammatory response. Our data suggest that reaching adequate vitamin D levels in risky population may contribute to prevention of COVID-19 occurrence and severity.

scholarly journals High Prevalence of Antineutrophil Cytoplasmic Antibody Positivity in Childhood Onset Graves’ Disease Treated with Propylthiouracil

2000 ◽  
Vol 85 (11) ◽  
pp. 4270-4273
Author(s):  
Hirokazu Sato ◽  
Motoshi Hattori ◽  
Mikiya Fujieda ◽  
Shigetaka Sugihara ◽  
Hiroaki Inomata ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Cross Reactivity ◽  
Graves Disease ◽  
Childhood Onset ◽  
First Line ◽  
High Prevalence ◽  
Antibody Positivity ◽  
Antithyroglobulin Antibodies ◽  
The Relationship

Propylthiouracil (PTU)-induced antineutrophil cytoplasmic antibody (ANCA)-related vasculitis and nephritis were recently reported in about 30 patients with hyperthyroidism. The objective of this study was to clarify the prevalence of ANCA and the relationship between ANCA and thyroid antibodies in children with Graves’ disease. Titers of myeloperoxidase (MPO)-ANCA in sera of 51 patients with childhood onset Graves’ disease (16 before treatment, 25 and 10 treated with PTU and methimazole, respectively) were measured by enzyme-linked immunosolvent assay. Antithyroglobulin antibodies (TGAbs) and antithyroperoxidase antibodies (TPOAbs) were also measured by RIA in 25 PTU-treated patients. No patients had clinical manifestations of vasculitis and nephritis. MPO-ANCA was positive in 6.7% of patients before treatment and in 64.0% of those treated with PTU and in none of those treated with methimazole. MPO-ANCA had a significantly positive correlation with TGAbs (P &lt; 0.05) and no significant correlation with TPOAbs. These findings show the high prevalence of the MPO-ANCA positivity in PTU-treated childhood onset Graves’ disease, suggesting that PTU may not be preferred as the first line for the treatment of children with Graves’ disease. The significant correlation between MPO-ANCA and TGAbs indicates that the severity of Graves’ disease may be a factor responsible for the MPO-ANCA positivity. The cross-reactivity between MPO-ANCA and TPOAbs may not play a role in the high prevalence of MPO-ANCA in the patients exposed to PTU.

scholarly journals Depression as a risk factor for Alzheimer's disease: evidence and role of Nursing

2019 ◽  
Vol 18 (3) ◽  
pp. 612-642 ◽  
Author(s):  
Rebeca Montoiro Rodriguez ◽  
Alba Elena Martínez Santos ◽  
Raquel Rodríguez-González
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Risk Factor ◽  
Field Methods ◽  
High Prevalence ◽  
Role Of Nursing ◽  
Diverse Data ◽  
The Relationship ◽  
Progressive Disorder

Introducción: La depresión y la demencia son dos patologías con una alta prevalencia a nivel mundial y multitud de rasgos en común. La demencia es un trastorno de carácter progresivo, siendo la Enfermedad de Alzheimer (EA) el tipo más común. Por su parte, la depresión representa la principal causa mundial de discapacidad. El objetivo de esta revisión es analizar la depresión como factor de riesgo para la EA resaltando, además, el papel de enfermería a nivel preventivo.Métodos: Se realizó una búsqueda bibliográfica sistemática en diversas fuentes de información. Es necesario destacar Pubmed como la principal base de datos a partir de la cual se obtuvieron la mayoría de artículos.Resultados y discusión: Existen principalmente tres hipótesis acerca de la relación depresión-demencia: depresión como factor de riesgo, depresión como pródromo, o depresión y demencia patologías independientes. Son múltiples los aspectos que deben valorarse en cada caso, agregándose así mayor complejidad a las investigaciones. A nivel neurobiológico también está probada la presencia de mecanismos patológicos comunes. Se destaca la prevención como punto clave en el abordaje de estos trastornos, donde enfermería desempeña un importante papel en la detección precoz y la educación para salud.Conclusiones: La depresión como factor de riesgo para la EA ha sido corroborada en numerosos estudios. Pese a ello, sigue sin existir acuerdo definitivo y, por lo tanto, resulta crucial continuar investigando y profundizando en el binomio depresión-demencia Introduction: Depression and dementia are two diseases with a high prevalence worldwide and many features in common. Dementia is a progressive disorder being Alzheimer's Disease the most frequent type. On the other hand, depression represents the first worldwide cause of disability. The objective of this review is to analyze depression as a risk factor in the development of Alzheimer's Disease and to highlight the role of nurses regarding prevention in this field. Methods: A bibliographic systematic search in diverse data bases was done. It is necessary to highlight PubMed as the main data base from which the majority of articles included were obtained.Results and discussion: There are mainly three hypotheses about the relationship between depression and dementia: depression as a risk factor, depression as a prodrome or depression and dementia as two independent pathologies. Moreover, there are a lot of aspects that must be taken into account in each case adding more complexity to the investigations. At the neurobiological level there is also evidence of common pathological mechanisms for both diseases. In addition, prevention has to be emphasized as a key point in the treatment of these disorders and nurses play a crucial role in early diagnosis and health education.Conclusions: Depression as a risk factor to Alzheimer's Disease has been demonstrated in many studies. However, there is not a conclusive agreement and, therefore, it is crucial to continue investigating the relation between depression and dementia.

scholarly journals Human Memory B Cells Producing Potent Cross-Neutralizing Antibodies against Human Parechovirus: Implications for Prevalence, Treatment, and Diagnosis

2015 ◽  
Vol 89 (15) ◽  
pp. 7457-7464 ◽  
Author(s):  
B. M. Westerhuis ◽  
K. S. M. Benschop ◽  
G. Koen ◽  
Y. B. Claassen ◽  
K. Wagner ◽  
...  
Keyword(s):  
Risk Factor ◽  
Neutralizing Antibodies ◽  
Therapeutic Option ◽  
Antiviral Treatment ◽  
Severe Disease ◽  
Human Memory ◽  
Cross Reactivity ◽  
Human Mabs ◽  
Content Type ◽  
Life Threatening

ABSTRACTThe familyPicornaviridaeis a large and diverse group of positive-sense RNA viruses, including human enteroviruses (EVs) and human parechoviruses (HPeVs). The human immune response against EVs and HPeVs is thought to be mainly humoral, and an insufficient neutralizing antibody (Ab) response during infection is a risk factor and can ultimately be life threatening. The accessibility of different antigenic sites and observed cross-reactivity make HPeVs a good target for development of therapeutic human monoclonal antibodies (MAbs). In this study, we generated two different human MAbs specific for HPeV by screening culture supernatants of Ab-producing human B cell cultures for direct neutralization of HPeV1. Both MAbs showed HPeV1-specific neutralization as well as neutralization of HPeV2. One antibody, AM18, cross-neutralized HPeV4, -5, and -6 and coxsackievirus A9 (CV-A9). VP1 capsid protein-specific assays confirmed that AM18 bound VP1 of HPeV1, -2, and -4 with high affinity (11.5 pM). In contrast, the HPeV1-specific MAb AM28, which neutralized HPeV1 even more efficiently than did AM18, showed no cross-reactivity with HPeV3 to -6 or other EVs and did not bind any of the capsid proteins, suggesting that AM28 is specific for a conformation-dependent, nonlinear epitope on the virus. The discovery of MAbs that are cross-reactive between HPeVs may help development of HPeV treatment options with antibodies and vaccine design based on epitopes recognized by these antibodies.IMPORTANCEHPeV infections are widespread among young children and adults, causing a broad range of disease. Infections can be severe and life threatening, while no antiviral treatment is available. Given that the absence of neutralizing Abs is a risk factor for severe disease in infants, treatment of picornavirus infections with MAbs would be a therapeutic option. To study antibody neutralization of HPeV in more detail, we generated two different HPeV1-specific human MAbs. Both MAbs show HPeV1-specific neutralization and cross-neutralized HPeV2. One MAb also cross-neutralized other HPeVs. Surprisingly, this MAb also neutralized CV-A9. These MAbs provide a unique tool for further research and for the diagnosis (antigen detection) and possible treatment of HPeV infections.

scholarly journals Dirofilaria immitis Could Be a Risk Factor for the Development of Allergic Diseases in Humans

Animals ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 1847
Author(s):  
José Alberto Montoya-Alonso ◽  
Rodrigo Morchón ◽  
Jorge Isidoro Matos ◽  
Yaiza Falcón-Cordón ◽  
Noelia Costa-Rodriguez ◽  
...  
Keyword(s):  
Risk Factor ◽  
Canary Islands ◽  
Dirofilaria Immitis ◽  
Allergic Diseases ◽  
Specific Ige ◽  
Zoonotic Infection ◽  
Total Ige ◽  
High Prevalence ◽  
Heartworm Infection ◽  
The Relationship

The Canary Islands are hyperendemic for canine heartworm and the risk of zoonotic infection is high. Additionally, there is evidence of development of allergies due to nematode infections in animals and humans. Since the population of the Canary Islands presents high prevalence of allergic comorbidities, and previous studies have shown a possible relationship between allergies and seropositivity to heartworm, the aim was to evaluate whether exposure to heartworm may contribute to the development of allergies in the human population. First, an epidemiological study was conducted on 248 owners of dogs with/without heartworm infection in the Canary Islands. Secondly, a serological analysis of the presence of total IgE and specific IgE against heartworm was conducted in 66 samples of inhabitants of the Canary Islands. The survey showed that allergic owners had heartworm-positive dogs more frequently (p < 0.01). Of the analyzed human samples, 43.9% were seropositive to heartworm and Wolbachia. Total IgE concentrations were increased in 34.5% seropositive samples and 8.1% seronegative samples. Specific IgE against heartworm was only found in human seropositive samples (17.2%). Contact with heartworm may be a risk factor for the development of allergic diseases, although further studies to elucidate the relationship between heartworm and allergies should be carried out.

scholarly journals Obesity and Depression: Its Prevalence and Influence as a Prognostic Factor: A Systematic Review

2020 ◽  
Vol 17 (8) ◽  
pp. 715-724
Author(s):  
Beatriz Villagrasa Blasco ◽  
Jesús García-Jiménez ◽  
Isabel Bodoano ◽  
Luis Gutiérrez-Rojas
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Current Data ◽  
Cross Sectional ◽  
Atypical Depression ◽  
African American Adolescent ◽  
Pubmed Database ◽  
High Prevalence ◽  
African American Adolescent Males ◽  
The Relationship

Objective Depression and obesity are two conditions with great impact over global health. This is mainly due to their high prevalence and the morbidity and mortality associated to both. The main aim of the present systematic review is to study the association between obesity and depression and the prognostic implications derived from it.Methods A literature review was performed in the PUBMED database. 18 articles were found (9 cross-sectional studies, 6 longitudinal studies and 3 clinical trials), which were reviewed by critical reading after which a summary of the main conclusions was written.Results These selected articles confirmed that there is indeed a link between depression and obesity, although there are doubts as to the significance of this relationship. Depression is a risk factor for obesity, especially atypical depression and in African-American adolescent males. Obesity is a risk factor for depression, especially in women and for recurrent depressive disorder. The comorbidity between obesity and depression is a risk factor for a bad prognosis illness.Conclusion The relationship between both disorders has been analysed in scientific literature, obtaining significant associations but also contradictory results. The most current data demonstrates that there is a relationship between both entities, although there is no unanimity when it comes to establishing the meaning of this association.

scholarly journals Prospective characterisation of SARS-CoV-2 infections among children presenting to tertiary paediatric hospitals across Australia in 2020: a national cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054510
Author(s):  
Danielle Wurzel ◽  
Alissa McMinn ◽  
Monsurul Hoq ◽  
Christopher C Blyth ◽  
David Burgner ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Severe Disease ◽  
Surveillance Network ◽  
Health Service Provision ◽  
Mild Disease ◽  
Multicentre Cohort Study ◽  
High Prevalence ◽  
National Cohort ◽  
Community Transmission

ObjectiveTo present Australia-wide data on paediatric COVID-19 and multisystem inflammatory syndromes to inform health service provision and vaccination prioritisation.DesignProspective, multicentre cohort study.SettingEight tertiary paediatric hospitals across six Australian states and territories in an established research surveillance network—Paediatric Active Enhanced Disease (PAEDS).ParticipantsAll children aged <19 years with SARS-CoV-2 infection including COVID-19, Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) and Kawasaki-like disease TS infection (KD-TS) treated at a PAEDS site from 24 March 2020 to 31 December 2020.InterventionLaboratory-confirmed SARS-CoV-2 infection.Main outcomeIncidence of severe disease among children with COVID-19, PIMS-TS and KD-TS. We also compared KD epidemiology before and during the COVID-19 pandemic.ResultsAmong 386 children with SARS-CoV-2 infection, 381 (98.7%) had COVID-19 (median 6.3 years (IQR 2.1–12.8),53.3% male) and 5 (1.3%) had multisystem inflammatory syndromes (PIMS-TS, n=4; KD-TS, n=1) (median 7.9 years (IQR 7.8–9.8)). Most children with COVID-19 (n=278; 73%) were Australian-born from jurisdictions with highest community transmission. Comorbidities were present in 72 (18.9%); cardiac and respiratory comorbidities were most common (n=32/72;44%). 37 (9.7%) children with COVID-19 were hospitalised, and two (0.5%) required intensive care. Postinfective inflammatory syndromes (PIMS-TS/KD-TS) were uncommon (n=5; 1.3%), all were hospitalised and three (3/5; 60%) required intensive care management. All children recovered and there were no deaths. KD incidence remained stable during the pandemic compared with prepandemic.ConclusionsMost children with COVID-19 had mild disease. Severe disease was less frequent than reported in high prevalence settings. Preventative strategies, such as vaccination, including children and adolescents, could reduce both the acute and postinfective manifestations of the disease.

Presence and Persistence of Sleep-Related Symptoms and Suicidal Ideation in Psychiatric Inpatients

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Michael R. Nadorff ◽  
Thomas E. Ellis ◽  
Jon G. Allen ◽  
E. Samuel Winer ◽  
Steve Herrera
Keyword(s):  
Risk Factor ◽  
Suicidal Ideation ◽  
Inpatient Treatment ◽  
Improve Method ◽  
Sleep Problems ◽  
Psychiatric Inpatients ◽  
Poor Sleep ◽  
Treatment Termination ◽  
Suicidal Patients ◽  
The Relationship

Background: Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. Aims: To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. Method: The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Results: Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. Conclusion: These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

2012 ◽  
Vol 32 (S 01) ◽  
pp. S39-S42 ◽  
Author(s):  
S. Kocher ◽  
G. Asmelash ◽  
V. Makki ◽  
S. Müller ◽  
S. Krekeler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Frequent Change ◽  
Patient Age ◽  
Treatment Regimens ◽  
Patient Âgé ◽  
The Relationship ◽  
Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

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