International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
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Int. J. Infect. Dis. · Apr 2021
Observational StudyTocilizumab treatment in critically ill patients with COVID-19: A retrospective observational study.
Elevated levels of pro-inflammatory cytokines are observed in severe COVID-19 infections, and cytokine storm is associated with disease severity. Tocilizumab, an interleukin-6 receptor antagonist, is used to treat chimeric antigen receptor T cell-induced cytokine release syndrome and may attenuate the dysregulated immune response in COVID-19. We compared outcomes among tocilizumab-treated and non-tocilizumab-treated critically ill COVID-19 patients. ⋯ Tocilizumab treatment was associated with fewer deaths compared to non-treatment despite predominantly being used in patients with more advanced respiratory disease.
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Int. J. Infect. Dis. · Apr 2021
Comparative StudyEffectiveness of anakinra for tocilizumab-refractory severe COVID-19: A single-centre retrospective comparative study.
A subgroup of patients with SARS-CoV-2 infection was thought to have developed cytokine release syndrome and were treated with tocilizumab; however, a significant percentage of patients evolved. This study aimed to determine the usefulness of anakinra as a rescue treatment for patients with tocilizumab-refractory COVID-19 disease. ⋯ Treatment with anakinra was not useful in improving the prognosis of patients with tocilizumab-refractory severe COVID-19.
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Int. J. Infect. Dis. · Mar 2021
SARS-CoV-2 seroconversion among 4040 Egyptian healthcare workers in 12 resource-limited healthcare facilities: A prospective cohort study.
We examined Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) seroconversion incidence and risk factors 21 days after baseline screening among healthcare workers (HCWs) in a resource-limited setting. ⋯ Most seroconversions were asymptomatic, emphasizing need for regular universal testing. Seropositivity was three-fold that observed at baseline. Cumulative infections increased nationally by a similar rate, suggesting HCW infections reflect community not nosocomial transmission.
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Int. J. Infect. Dis. · Mar 2021
Case ReportsPersistent replication of SARS-CoV-2 in a severely immunocompromised patient treated with several courses of remdesivir.
Microbiological response of SARS-CoV-2 to remdesivir in immunocompromised patients has not been evaluated. We present the case of a severely immunocompromised patient with persistent replication of SARS-CoV-2, who required different courses of remdesivir. Short courses of remdesivir might be insufficient in immunocompromised patients due to prolonged viral clearance.
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Int. J. Infect. Dis. · Mar 2021
Measuring the impact of the COVID-19 outbreak in Ecuador using preliminary estimates of excess mortality, March 17-October 22, 2020.
Ecuador is among the worst-hit countries in the world by the coronavirus disease 2019 (COVID-19) pandemic. In terms of confirmed deaths per million inhabitants, as of October 22, Ecuador ranks fourth in the Americas and ninth worldwide according to data from the World Health Organization. In this report, we estimate excess deaths due to any cause in Ecuador since the start of the lockdown measures on March 17, 2020 until October 22, 2020. ⋯ Our results suggest that the real impact of the pandemic in Ecuador was much worse than that indicated by reports from national institutions. Estimates of excess mortality might provide a better approximation of the true COVID-19 death toll. These estimates might capture not only deaths directly attributable to the COVID-19 pandemic but also deaths from other diseases that resulted from indirect effects of the pandemic.