scholarly journals Promising Expectations for Pneumococcal Vaccination during COVID-19

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1507
Author(s):  
Hyobin Im ◽  
Jinhui Ser ◽  
Uk Sim ◽  
Hoonsung Cho
Keyword(s):  
Risk Factor ◽  
Pneumococcal Disease ◽  
Viral Infections ◽  
Secondary Infection ◽  
Pneumococcal Vaccination ◽  
Severe Illness ◽  
Infection Prevalence ◽  
Medical Conditions ◽  
Influenza Pandemics ◽  
Secondary Infections

The emergence of new viral infections has increased over the decades. The novel virus is one such pathogen liable for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, popularly known as coronavirus disease 2019 (COVID-19). Most fatalities during the past century’s influenza pandemics have cooperated with bacterial co/secondary infections. Unfortunately, many reports have claimed that bacterial co-infection is also predominant in COVID-19 patients (COVID-19 associated co/secondary infection prevalence is up to 45.0%). In the COVID-19 pandemic, Streptococcus pneumoniae is the most common coinfecting pathogen. Half of the COVID-19 mortality cases showed co-infection, and pneumonia-related COVID-19 mortality in patients >65 years was 23%. The weakening of immune function caused by COVID-19 remains a high-risk factor for pneumococcal disease. Pneumococcal disease and COVID-19 also have similar risk factors. For example, underlying medical conditions on COVID-19 and pneumococcal diseases increase the risk for severe illness at any age; COVID-19 is now considered a primary risk factor for pneumococcal pneumonia and invasive pneumococcal disease. Thus, pneumococcal vaccination during the COVID-19 pandemic has become more critical than ever. This review presents positive studies of pneumococcal vaccination in patients with COVID-19 and other medical conditions and the correlational effects of pneumococcal disease with COVID-19 to prevent morbidity and mortality from co/secondary infections and superinfections. It also reports the importance and role of pneumococcal vaccination during the current COVID-19 pandemic era to strengthen the global health system.

Abstract 17113: Secondary Infections Are Common in Patients Hospitalized for COVID-19 and Are Associated With Severe Outcomes

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Elizabeth R Anderson ◽  
Tariq Azam ◽  
Husam Shadid ◽  
Michael Pan ◽  
Hanna Berlin ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Viral Infections ◽  
Clinical Laboratory ◽  
Secondary Infection ◽  
Kidney Injury ◽  
Outcome Data ◽  
Hospitalized Patients ◽  
Secondary Infections ◽  
Life Threatening ◽  
The Mean

Background: Secondary infections occur in 10-15% of critically ill sepsis patients. Anecdotal reports suggest secondary infections are common in coronavirus disease 2019 (COVID-19), however data are lacking. We examine the rate of secondary infections in hospitalized patients with COVID-19 and its impact on the cytokine surge and in-hospital outcomes. Methods: The Michigan Medicine Covid-19 Cohort (M2C2) is an ongoing prospective observational study in which detailed clinical, laboratory and outcome data were collected from chart review of consecutive adult patients hospitalized for COVID-19. Patients who were positive for SARS-CoV-2 infection but without respiratory symptoms were not included in this cohort. We define secondary infections as physician-diagnosed and treated bacterial or viral infections secondary to SARS-CoV-2. Results: Of 553 COVID-19 patients hospitalized at Michigan Medicine, 191 (34.5%) developed a secondary infection during hospitalization. The mean age of patients with a secondary infection was 60 years, 61.3% were male compared to 58.8 years, 53.5% male in patients with no secondary infection. Bacterial pneumonia, including ventilator-associated pneumonia, was the most prevalent secondary infection among hospitalized patients (78.5%). Other secondary infections included urosepsis (14.1%), bacteremia (16.8%), and 17.3% of patients developed other types of infections such as shingles and clostridium difficile. 25.8% of patients without secondary infections received antibiotics during their admission compared to 47.1% of patients with secondary infections. Multiple secondary infections (>1) occurred in 43 (8.2%) of patients. Patients with secondary infections were more likely to develop acute kidney injury (78.0% vs. 38.3%, p<0.0001), acute respiratory distress syndrome (78.0% vs. 22.3%, p<0.0001), and death (26.2% vs. 10.2%, p<0.0001) during their hospitalization compared to patients without secondary infections. Conclusions: Secondary infections are common in hospitalized patients with COVID-19 and are associated with life-threatening complications and high mortality. This study suggests that secondary infection prevention may be especially important in COVID-19 patients.

scholarly journals Obesity as a risk factor for dengue shock syndrome in children

2013 ◽  
Vol 53 (4) ◽  
pp. 187 ◽  
Author(s):  
Maria Mahdalena Tri Widiyati ◽  
Ida Safitri Laksanawati ◽  
Endy Paryanto Prawirohartono
Keyword(s):  
Risk Factor ◽  
Viral Infections ◽  
Infection Type ◽  
Secondary Infection ◽  
Univariate Analysis ◽  
Fluid Management ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Control Group ◽  
Case Group

Background Dengue hemorrhagic fever (DHF) leads to highmorbidity and mortality if not be treated properly and promptly.Obesity may play a role in the progression ofDHF to dengue shocksyndrome (DSS) and could be a prognostic factor.Objective To evaluate childhood obesity as a prognostic factorfor DSS.Methods We reviewed medical records of patients with DHFand DSS admitted to Department of Child Health, Dr. SardjitoHospital, Yogyakarta between June 2008 and February 2011.Subjects were aged less than 18 years and fulfilled WHO criteria(1997) for DHF or DSS. The exclusion criteria were the denguefever, a milder form of disease, or other viral infections. Riskfactors for DSS were analyzed by logistic regression analysis.Results Of342 patients who met the inclusion criteria, there were116 DSS patients (33 .9%) as the case group and 226 DHF patients(66.1%) as the control group. Univariate analysis revealed thatrisk factors for DSS were obesity (OR= 1.88; 95%CI 1.01 to3.5 l) ,secondary infection type (OR=0.82; 95%CI 0.41 to 1.63), plasmaleakage with hematocrit increase> 25% (OR=3.42; 95%CI 2.06to 5.65), platelet count < 20,000/μL (OR= l.95; 95%CI 1.20 to3 .16), and inadequate fluid management from prior hospitalization(OR=9.ll; 95% CI 1.13 to 73.66). By multivariate analysis,plasma leakage with hematocrit increase > 25% was associatedwith DSS (OR=2.5 l; 95%CI 1.12 to 5.59), while obesity was notassociated with DSS (OR= l.03; 95%CI 0.32 to3.3 1).Conclusion Obesity is not a risk factor for DSS, while plasmaleakage with hematocrit increase > 25% is associated with DSS.

scholarly journals 2205. Clinical Burden of Pneumococcal Disease in US Adults Aged 65 Years and Above with Chronic or Immunocompromising Conditions

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S752-S752
Author(s):  
Arijita Deb ◽  
Kelly D Johnson ◽  
Wanmei Ou
Keyword(s):  
At Risk ◽  
High Risk ◽  
Pneumococcal Disease ◽  
Medical Condition ◽  
Pneumococcal Vaccination ◽  
The United States ◽  
Healthy Adults ◽  
Medical Conditions ◽  
Increased Risk ◽  
One Year

Abstract Background The presence of chronic and immunocompromising conditions is associated with a disproportionately high risk of developing pneumococcal disease at older ages. The objective of this study was to quantify the risk of all-cause pneumonia (ACP) and invasive pneumococcal disease (IPD) in older US adults aged 65 years and older with underlying medical conditions. Methods A retrospective observational study was conducted using the Humana claims database. The study cohorts were identified at January 1 of each calendar year of observation from 2012 to 2017 and comprised adults aged 65 years and older with continuous enrollment for at least one year before and at least one year after January 1 of each year. For each yearly cohort, medical conditions were identified during the one year before each calendar year and episodes of ACP and IPD were identified during the corresponding 1-year follow-up period from January 1 to December 31. Individuals were stratified into 3 groups: those without any medical conditions of interests (healthy), those with chronic conditions (at-risk) and those with immunocompromising conditions (high-risk). Rate of ACP or IPD was expressed as the number of cases per 100,000 person-years and the rate ratio (RR) was expressed as the rate of pneumococcal disease of patients with medical conditions divided by the rate of pneumococcal disease in healthy adults. Results Of the 10,766,827 adults included in the study, 75% of adults had an underlying medical condition linked to an increased risk of pneumococcal disease. In adults with at-risk conditions, rates of ACP and IPD were 3.1 and 3.6 times the rate in healthy adults, respectively. In adults with high-risk conditions, rates of ACP and IPD were 4.1 and 5 times the rate in healthy adults, respectively. Rate of pneumococcal disease increased substantially with the addition of medical conditions: RR for ACP and IPD increased from 2.1 and 2.2, respectively, in adults with one at-risk conditions to 4.8 and 6.2, respectively, among adults with 2 or more at-risk conditions. Conclusion Despite recommendations of universal pneumococcal vaccination in older adults aged 65 years and above in the United States, the burden of pneumococcal disease remains high, particularly among those with chronic and immunocompromising conditions. Disclosures All authors: No reported disclosures.

scholarly journals Excess Risks And Costs Of Invasive Pneumococcal Disease And Pneumonia Among Us Persons With Underlying Medical Conditions

2013 ◽  
Vol 16 (3) ◽  
pp. A232
Author(s):  
D. Weycker ◽  
R. Farkouh ◽  
D.R. Strutton ◽  
J. Edelsberg ◽  
K. Shea ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Medical Conditions

scholarly journals Coeliac disease and invasive pneumococcal disease: a population-based cohort study

2017 ◽  
Vol 145 (6) ◽  
pp. 1203-1209 ◽  
Author(s):  
A. RÖCKERT TJERNBERG ◽  
J. BONNEDAHL ◽  
M. INGHAMMAR ◽  
A. EGESTEN ◽  
G. KAHLMETER ◽  
...  
Keyword(s):  
Cohort Study ◽  
Coeliac Disease ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Cox Regression ◽  
Statistical Significance ◽  
Pneumococcal Vaccination ◽  
Population Based ◽  
Increased Risk ◽  
Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

scholarly journals Early Impact of 13-Valent Pneumococcal Conjugate Vaccine Use on Invasive Pneumococcal Disease Among Adults With and Without Underlying Medical Conditions—United States

2019 ◽  
Vol 70 (12) ◽  
pp. 2484-2492 ◽  
Author(s):  
Sana S Ahmed ◽  
Tracy Pondo ◽  
Wei Xing ◽  
Lesley McGee ◽  
Monica Farley ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
National Health ◽  
Indirect Effects ◽  
Pneumococcal Disease ◽  
National Health Survey ◽  
Medical Conditions ◽  
In Series ◽  
Interview Survey ◽  
Us Children ◽  
Immunocompetent Adults

Abstract Background The 13-valent pneumococcal vaccine (PCV13) was introduced for US children in 2010 and for immunocompromised adults ≥19 years old in series with the 23-valent polysaccharide vaccine (PPSV23) in 2012. We evaluated PCV13 indirect effects on invasive pneumococcal disease (IPD) among adults with and without PCV13 indications. Methods Using Active Bacterial Core surveillance and the National Health Survey, using Active Bacterial Core surveillance and the National Health Interview Survey, we estimated and compared IPD incidence in 2013–2014 and 2007–2008, by age and serotype group (PCV13, PPSV23-unique, or nonvaccine types [NVTs]), among adults with and without PCV13 indications. Results IPD incidence declined among all adults. Among adults 19–64 years, PCV13-type IPD declined 57% (95% confidence interval [CI], −68% to −43%) in adults with immunocompromising conditions (indication for PCV13 use), 57% (95% CI, −62% to –52%) in immunocompetent adults with chronic medical conditions (CMCs, indications for PPSV23 use alone), and 74% (95% CI, −78% to −70%) in adults with neither vaccine indication. Among adults aged ≥65 years, PCV13-type IPD decreased 68% (95% CI, −76% to −60%) in those with immunocompromising conditions, 68% (95% CI, −72% to −63%) in those with CMCs, and 71% (95% CI, −77% to −64%) in healthy adults. PPSV23-unique types increased in adults 19‒64 years with CMCs, and NVTs did not change among adults with or without PCV13 indications. From 2013 to 2014, non-PCV13 serotypes accounted for 80% of IPD. Conclusions IPD incidence among US adults declined after PCV13 introduction in children. Similar reductions in PCV13-type IPD in those with and without PCV13 indications suggest that observed benefits are largely due to indirect effects from pediatric PCV13 use rather than direct use among adults.

scholarly journals ORAL SECONDARY INFECTION IN STEVENS-JOHNSON SYNDROME PATIENT WITH ORAL INVOLVEMENT: A CASE REPORT

2021 ◽  
Vol 6 (1) ◽  
pp. 79
Author(s):  
Etis Duhita Rahayuningtyas ◽  
Indah Suasani Wahyuni ◽  
Irna Sufiawati
Keyword(s):  
Case Report ◽  
Secondary Infection ◽  
Severity Of Illness ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Oral Manifestation ◽  
Secondary Infections ◽  
Johnson Syndrome ◽  
Oral Involvement

ABSTRACTBackground: Stevens-Johnson syndrome (SSJ) is a hypersensitivity reaction that is often triggered by drugs but this case is rare. These reactions result in uncontrolled keratinocyte damage to the skin and mucosa throughout the body, including the oral mucosa, and are often life-threatening. The use of high doses of corticosteroids is a treatment that is often given but it can trigger secondary infections of fungal and viral in the oral cavity. Purpose: This case report discusses the management of oral manifestations and secondary infections in SSJ patients, and becomes guidance for health professionals. Case: A-42-years-old male patient was consulted from the Department of Dermatology and Venereology (DV) due to oral pain and eating difficulties. The severity-of-illness-score for toxic-epidermal-necrolysis (SCORTEN) was 1. Erosive serosanguinous crusts, tend to bleed were found on the lips. Intraoral clinically presented wide erosive lesions and multiple ulcers, accompanied by a pseudomembranous plaque, and teeth decay. Hematologic examination showed an increase in leukocytes, neutrophil segments, monocytes, SGOT, urea, and creatinine as well as decreased hemoglobin, hematocrit, erythrocytes, MCHC, protein, and albumin. Anti-HSV1 IgG increased almost 6 times than normal values. The patient was diagnosed with SJS with oral involvement, secondary infections of pseudomembranous candidiasis, and herpetic stomatitis. Case Management: Systemic therapy given were intravenous dexamethasone, ranitidine, calcium, and cetirizine, from the DV Department, while hydrocortisone lip ointment, Chlorhexidine digluconate 0.12%, and Nystatin oral suspension for oral problems. The lesions progressed in 24 days. Conclusion: Oral secondary infections may occur in SJS patients due to high-dose corticosteroid therapy.Keywords: Herpetic Stomatitis, Oral Manifestation, Oral Secondary Infection, Pseudomembranous Candidiasis, Stevens-Johnson Syndrome.

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