Journal of Infection and Public Health最新文献

{"title":"Unlocking antiviral potentials of traditional plants: A multi-method computational study against human metapneumovirus (HMPV)","authors":"Amit Dubey ,&nbsp;Manish Kumar ,&nbsp;Aisha Tufail ,&nbsp;Vivek Dhar Dwivedi ,&nbsp;Andrea Ragusa","doi":"10.1016/j.jiph.2025.102885","DOIUrl":"10.1016/j.jiph.2025.102885","url":null,"abstract":"<div><h3>Background</h3><div>Human metapneumovirus (HMPV) is a major cause of respiratory infections, especially in vulnerable populations. The absence of targeted antiviral therapies necessitates the exploration of novel drug candidates. Traditional medicinal plants offer a reservoir of bioactive compounds with potential antiviral properties. This study employs a multi-method computational approach to assess the antiviral potential of phytochemicals against HMPV.</div></div><div><h3>Methods</h3><div>A comprehensive <em>in silico</em> framework was employed, including virtual screening, molecular docking, molecular dynamics (MD) simulations, density functional theory (DFT) calculations, pharmacophore modeling, and Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) profiling. Key bioactive compounds were evaluated for their binding affinity, stability, and pharmacokinetic properties.</div></div><div><h3>Results</h3><div>Among the analyzed phytochemicals, Glycyrrhizin exhibited the highest binding affinity (-65.4 kcal/mol) with strong hydrogen bonding and remarkable dynamic stability (RMSD 1.3 Å). Withaferin A (-63.7 kcal/mol) also demonstrated high pharmacokinetic potential. DFT analyses confirmed their favorable electronic properties, and ADMET profiling validated their drug-like characteristics. These findings highlight the promise of natural compounds as potential HMPV inhibitors.</div></div><div><h3>Conclusions</h3><div>This study underscores the potential of traditional phytochemicals in antiviral drug discovery. The integration of computational techniques accelerates lead identification and optimization. Further <em>in vitro</em> and <em>in vivo</em> validations are essential to confirm these findings and facilitate clinical translation.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102885"},"PeriodicalIF":4.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discovery of anti-methicillin-resistant Staphylococcus aureus inhibitors by targeting thymidylate kinase (TMPK) via multi-step virtual screening, molecular simulations, and free energy calculations","authors":"Talal Alshammari ,&nbsp;Abdulrahman Alshammari ,&nbsp;Metab Alharbi ,&nbsp;Abdullah F. Alasmari ,&nbsp;Abdullah S. Alhamed ,&nbsp;Norah A. Albekairi ,&nbsp;Alanoud Talal Aljasham ,&nbsp;Amal F. Alshammary","doi":"10.1016/j.jiph.2025.102884","DOIUrl":"10.1016/j.jiph.2025.102884","url":null,"abstract":"<div><h3>Background</h3><div>Antibiotic resistance, mainly caused by methicillin-resistant <em>Staphylococcus aureus</em> (MRSA), is a globally growing concern and a significant health issue in regard to infectious diseases. This issue will require a novel and comprehensive strategy to overcome the resistance to MRSA.</div></div><div><h3>Methods</h3><div>Therefore, the current study advances TMPK-targeted drug discovery by screening a vast chemical space using virtual screening with detailed dynamics and binding energy evaluations. In contrast to the previous efforts, our study focuses on the pharmacological exploitation of TMPK's conserved and druggable active site in MRSA, which lacks homologs in humans and remains understated in antimicrobial pipelines. We screened traditional Chinese medicine and African natural compound databases, as well as the InterBioScreen, dark chemical matter, and Maybridge databases, using a three-step virtual screening strategy.</div></div><div><h3>Results</h3><div>From these databases, we identified 16 compounds as the most potent based on their docking and redocking scores and interaction profiles with the key residues. Of these, the top eight hits were re-validated using the induced-fit docking method, which confirmed the validity of these hits’ interaction and inhibitory potential against TMPK. Thereafter, using molecular simulations, 500 ns each, we determined that these compounds exhibited stable dynamic profiles, minimal residual fluctuation, and well-folded conformations during the simulation. Furthermore, using the binding free energy calculations, including both the MMGBSA and MMPBSA methods, the top hits were ranked based on the strongest binding energy, which provides compelling evidence for the stability, specificity, and high binding affinity of these compounds towards TMPK. PCA (Principal Component Analysis) and FEL (Free Energy Landscape) analyses revealed the conformational behavior of these complexes. Furthermore, ADMET analysis confirmed the safety of these molecules.</div></div><div><h3>Conclusions</h3><div>This study identified potential therapeutic hits using computational and theoretical approaches; however, experimental validation through <em>in vitro</em> enzymatic assays and MRSA culture-based inhibition studies is essential to confirm their therapeutic potencies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102884"},"PeriodicalIF":4.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic antifungal effect of naturally-derived antimicrobials with penetration enhancer against Candida albicans biofilm at 5 °C and 22 °C","authors":"Byung Soo Ko,&nbsp;Seon Gyeong Park,&nbsp;Min Suk Rhee","doi":"10.1016/j.jiph.2025.102882","DOIUrl":"10.1016/j.jiph.2025.102882","url":null,"abstract":"<div><h3>Background</h3><div>Biofilms of fungi such as <em>Candida albicans</em> (<em>C. albicans</em>) can survive even at cold temperatures and are generally difficult to eradicate with well-known antimicrobials. The aim of this study was to develop a novel synergistic technique against <em>C. albicans</em> biofilms using low concentrations of propylene glycol (PG), as a penetration enhancer. It helps naturally-derived antimicrobials [caprylic acid (CA) and carvacrol (CAR)] permeate <em>C. albicans</em> biofilms and cell membranes within short times even in cold environments.</div></div><div><h3>Methods</h3><div><em>C. albicans</em> biofilms formed on stainless steel coupons were treated with antifungal complexes (PG, CA and CAR at 0.6–1.2 mM) for 1 or 5 min at 5 and 22°C. PG was selected as the highest fungicidal efficacy, as well as its odourless, colourless nature and excellent solubility compared to other penetration enhancers (isopropyl citrate, laurocapram). To visualize cell damage by antifungal complex, treated biofilms at 5°C and 22°C were examined using the confocal microscopy and field emission scanning electron microscopy.</div></div><div><h3>Results</h3><div>Each substance (PG, CA, CAR), when applied alone to <em>C. albicans</em> biofilms for 5 min, showed less than 0.50 log reduction at both 5 and 22°C. <em>C. albicans</em> biofilm was completely eradicated by PG + CA + CAR (all 1.2 mM) after 5 min at 5 and 22°C (&gt; 6.20 log reduction), but treatment mixtures without PG were incompletely eliminated after 1 min at 5°C (1.75 log reduction) and 22°C (3.75 log reduction). Based on the visualization of biofilms, PG + CA + CAR (all 1.2 mM) resulted in remarkable membrane disruption and cell detachment from stainless steel coupons in contrast to the other treatment conditions.</div></div><div><h3>Conclusion</h3><div>This study indicates that trace amounts of developed antifungal complex could be an effective way to inactivate fungal biofilms on the surfaces of the medical and healthcare field even at cold temperatures.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102882"},"PeriodicalIF":4.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights into the evolutionary origin of Francisella tularensis subsp. holarctica","authors":"Wen Wang ,&nbsp;Rui Zhang ,&nbsp;Guodong Yang ,&nbsp;Yanhua Wang","doi":"10.1016/j.jiph.2025.102878","DOIUrl":"10.1016/j.jiph.2025.102878","url":null,"abstract":"<div><h3>Background</h3><div>As a global expansion of <em>Francisella tularensis</em> subsp. <em>holarctica</em> in the northern hemisphere, its origin has been of great interest. Based on the phylogenetic analysis of the whole genome sequences (WGS) available in public databases, estimating temporal signal in accordance with random permutations of sampling dates, and searching the powerful SNPs within the B.16 clade, we intend to explore the historical origin of this subspecies and routes of dispersal across its regional distribution.</div></div><div><h3>Methods</h3><div>We constructed a phylogenetic tree for the four main clades based on 395 WGSs, including six B.16 strains. SNP analysis was performed to identify genetic signatures, while BactDating was employed to estimate the temporal divergence of the most recent common ancestor (MRCA). Data from comparisons of the six WGSs belonging to B.16 were used to screen putative SNPs, and generate new subclades for assigning B.16 strains from China. CanSNPer was used to assign the established canSNP nomenclature.</div></div><div><h3>Results</h3><div>A time-calibrated phylogeny estimated the MRCA of the four major clades at 2276 BCE (95 % CI: 3145–1446 BCE), with B.16 diverging approximately 1002 years earlier than B.4, B.12, and B.6. Within B.16, we identified one novel canonical single-nucleotide polymorphism, which assign Chinese strains (410108, 410109, and 410111) to the terminal clade named B.316. We depicted the distribution of B.4, B.6, B.12, and B.16 in 32 countries across five continents, including detailed distributions in subordinate regions of Russia/USSR, and the distribution of B.4, B.11, B.16, and B.20 related to China in other countries worldwide.</div></div><div><h3>Conclusions</h3><div>Given that Asia, specifically China, harbors the distribution of four major genetic clades including the earliest diverging B.16, we hypothesize that subsp. <em>holarctica</em> likely have originated in Asia/China and subsequently spread worldwide. These findings enhance our understanding of the pathogen’s evolutionary history and provide a framework for refining disease surveillance strategies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102878"},"PeriodicalIF":4.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural and clinical risk factors of infective endocarditis – A nationwide case-control study in South Korea","authors":"Hee Jeong Lee ,&nbsp;William D. Kim ,&nbsp;Kyung Eun Ha ,&nbsp;Hyun-Jung Lee ,&nbsp;Dae-Young Kim ,&nbsp;Kyu-Yong Ko ,&nbsp;Jiwon Seo ,&nbsp;Hasung Kim ,&nbsp;Chi Young Shim ,&nbsp;Geu-Ru Hong ,&nbsp;Jong-Won Ha ,&nbsp;Ji-won Hwang ,&nbsp;Iksung Cho","doi":"10.1016/j.jiph.2025.102876","DOIUrl":"10.1016/j.jiph.2025.102876","url":null,"abstract":"<div><h3>Background</h3><div>Infective endocarditis (IE) causes high mortality and morbidity, posing a significant burden on healthcare systems. Although the incidence of IE is rising globally, its risk factors, particularly procedure-related risks, remain unclear. This study aimed to investigate the clinical and procedural risk factors associated with IE using nationwide data from South Korea.</div></div><div><h3>Methods</h3><div>We analyzed data from the Korean National Health Insurance Service between 2003 and 2018. A total of 8487 patients with IE and 33,535 matched controls based on age, sex, and the Charlson Comorbidity Index were included. Procedural risk factors were categorized as dental, gastrointestinal, respiratory, and genitourinary, with analysis periods of 90 and 60 days for dental and other procedures, respectively. Logistic regression models were used to evaluate the associations, with statistical significance set at <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Traditional risk factors including dialysis, immunosuppression, congenital heart disease, and valvular disease were significantly associated with IE. Additionally, invasive procedures, such as intravenous catheter insertion (odds ratio [OR], 18.94) and respiratory (OR, 4.05), gastrointestinal (OR, 3.09), and genitourinary procedures (OR, 3.97), were strongly associated with an increased risk of IE (all <em>P</em> &lt; 0.001). Dental procedures without antibiotic prophylaxis were also associated with a higher risk of IE (OR, 1.19; <em>P</em> = 0.001), whereas those with prophylaxis were not (OR, 1.07; <em>P</em> = 0.256).</div></div><div><h3>Conclusions</h3><div>Both clinical factors and procedural interventions significantly contributed to the risk of IE. Our findings support the need for expanded preventive strategies, particularly considering nondental invasive procedures and high-risk patient groups.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102876"},"PeriodicalIF":4.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and locations of falls among older pilgrims during Hajj: Implications for targeted prevention","authors":"Walid A. Alkeridy ,&nbsp;Khulud K. Alharbi ,&nbsp;Shahad M. Sofi ,&nbsp;Bashaier D. Alosaimi ,&nbsp;Abrar M. Aljohani ,&nbsp;Basmah A. Rafie ,&nbsp;Bashaier A. Fairaq ,&nbsp;Gehan K. Mubaraki ,&nbsp;Nawal A. Sindi ,&nbsp;Maha M. Almarwani","doi":"10.1016/j.jiph.2025.102874","DOIUrl":"10.1016/j.jiph.2025.102874","url":null,"abstract":"<div><div>Falls are a major cause of morbidity and mortality among older adults, with risks heightened during physically demanding mass gatherings such as the Islamic Hajj. However, research addressing fall-related risks during Hajj remains limited. This study aimed to determine the prevalence, risk factors, and common locations of falls among older pilgrims. A cross-sectional survey was conducted during the 2024 Hajj among pilgrims aged ≥60 years. Data were collected through structured interviews using standardized questionnaires on demographics, medical history, fall occurrence, locations, and injuries. Logistic regression was used to identify independent predictors. Among 777 participants (median age 68.0 years; 60.2 % male), 39 (5.0 %) reported falls. Most occurred at high-density sites, especially Mena (46.2 %), followed by the Grand Mosque and Arafat (each 17.9 %). Falls occurred during the throwing of Jamarat, in bathrooms, and on stairs. Non-Saudi nationality (OR = 2.53, <em>p</em> = 0.010) and asthma (OR = 3.78, <em>p</em> = 0.005) were identified as independent predictors. Injuries occurred in 28.2 % of fallers, and 23.1 % required emergency care. Targeted interventions are essential, including pre-travel assessments, multilingual educational programs, improved infrastructure, and designated walking paths. Future studies should explore the feasibility of real-time surveillance systems to enhance fall detection and safety during Hajj.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102874"},"PeriodicalIF":4.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in mortality due to respiratory diseases around the COVID-19 pandemic: A multi-national comparative study","authors":"Jang Ho Lee ,&nbsp;Jeong Hwan Ko ,&nbsp;Hyunjung Park ,&nbsp;Namkug Kim ,&nbsp;Sei Won Lee","doi":"10.1016/j.jiph.2025.102877","DOIUrl":"10.1016/j.jiph.2025.102877","url":null,"abstract":"<div><h3>Background</h3><div>Various preventive measures in the coronavirus disease-2019 (COVID-19) pandemic could disrupt the transmission of respiratory pathogens and affect the epidemiology of other respiratory diseases. The aim was to compare mortality due to respiratory diseases before and during the COVID-19 pandemic in the United States and South Korea.</div></div><div><h3>Methods</h3><div>Mortality due to respiratory diseases was investigated between December 2017 and December 2021 using two nationwide datasets from the United States and South Korea. Respiratory diseases were categorized into pneumonia, influenza, chronic lower respiratory diseases, and upper respiratory infections, defined by ICD-10 codes. The terms ‘before the COVID-19 pandemic’ and ‘during the COVID-19 pandemic’ refer to the intervals from December 2017 to February 2020 and from March 2020 to December 2021, respectively.</div></div><div><h3>Results</h3><div>Mortality due to respiratory diseases decreased during the COVID-19 pandemic in the United States and South Korea, except for upper respiratory infection. Although a sharp increase in mortality was noted in the winter compared with other seasons before the COVID-19 pandemic, the winter mortality peaks for pneumonia, influenza, and chronic lower respiratory diseases were reduced during the COVID-19 pandemic. In the United States, winter mortality due to pneumonia declined from 17,167 deaths in 2017–2018 to 11,745 deaths in 2020–2021. Similarly, influenza mortality decreased from 9676 to 165 deaths, and deaths from chronic lower respiratory diseases declined from 47,905 to 36,674. South Korea showed a trend comparable to that of the United States. These changes were not observed in upper respiratory infections. Trend of annual mortality for each respiratory disease was significantly different before and during the COVID-19 pandemic, except for influenza in the under-70 age group and upper respiratory infections in all age groups.</div></div><div><h3>Conclusions</h3><div>The COVID-19 pandemic affected the epidemiology of respiratory diseases. The findings suggest that various preventive measures in the COVID-19 pandemic might have contributed to changes in their epidemiology.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102877"},"PeriodicalIF":4.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza vaccination coverages in Italy from 1999/00 to 2023/24: A joinpoint regression analysis","authors":"Andrea Zaino ,&nbsp;Michele Bonacquisti ,&nbsp;Luigi Russo ,&nbsp;Tiziana Sabetta ,&nbsp;Alessandro Solipaca ,&nbsp;Walter Ricciardi ,&nbsp;Stefania Boccia ,&nbsp;Leonardo Villani","doi":"10.1016/j.jiph.2025.102875","DOIUrl":"10.1016/j.jiph.2025.102875","url":null,"abstract":"<div><h3>Background</h3><div>Influenza is a contagious respiratory viral infection with significant health and economic impacts, causing millions of cases and hundreds of thousands of deaths annually worldwide. In Italy, annual epidemics affect approximately 8 % of the population. Vaccination remains the most effective prevention strategy, yet coverage in Italy is low and consistently below the WHO-recommended threshold of 75 % in elderly. This study aims to analyze trends in influenza vaccination coverage in Italy from 1999/2000 to 2023/2024 through joinpoint regression analysis.</div></div><div><h3>Methods</h3><div>Data on influenza vaccination coverage were obtained from the Italian Ministry of Health, covering the general population and specific age groups. The analysis included data from the 1999/2000 season to the 2023/2024 season. Joinpoint regression was used to identify significant changes in coverage trends over time, calculating Annual Percentage Change (APC) and Average Annual Percent Change (AAPC).</div></div><div><h3>Results</h3><div>Coverages vary between and within age groups over the study period. The pediatric population showed the lowest values, never exceeding 10 % except for the COVID-19 pandemic years. Similar trends, albeit with higher coverage, were observed in the adult population. In the elderly population, the WHO target of 75 % was never reached, obtaining the highest value of 68.3 % in 2005/2006. Trends show increasing AAPC coverages for all groups except 15–17 years. During the pandemic, increases in coverages are observed in all age groups, but these decline towards pre-pandemic values during the following seasons.</div></div><div><h3>Conclusions</h3><div>Our study shows that vaccination coverage in Italy falls below target thresholds, particularly in high-risk age groups, with a significant decreasing trend observed in the years following the pandemic across almost all age groups. Despite the proven efficacy and safety of the vaccine, hesitancy has gained momentum in Italy, resulting in persistently low coverage rates. Our findings highlight the need for a multifaceted approach, including expanding free vaccination programs, implementing school-based initiatives, strengthening healthcare worker engagement, and enhancing public awareness campaigns. A coordinated national effort, led by the Ministry of Health, is essential to achieving higher coverage rates and reducing the burden of influenza.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102875"},"PeriodicalIF":4.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the escalating burden of dengue in the Americas amid global challenges","authors":"José Cherem,&nbsp;Joziana Muniz de Paiva Barçante","doi":"10.1016/j.jiph.2025.102879","DOIUrl":"10.1016/j.jiph.2025.102879","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102879"},"PeriodicalIF":4.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of tocilizumab in COVID-19: A systematic evaluation of adverse effects and therapeutic outcomes","authors":"Othman AlOmeir ,&nbsp;Ahmad H. Alhowail ,&nbsp;Syed Imam Rabbani ,&nbsp;Syed Mohammed Basheeruddin Asdaq ,&nbsp;Rafiulla Gilkaramenthi ,&nbsp;Abida Khan ,&nbsp;Mohd Imran ,&nbsp;Tafadzwa Dzinamarira","doi":"10.1016/j.jiph.2025.102873","DOIUrl":"10.1016/j.jiph.2025.102873","url":null,"abstract":"<div><h3>Background</h3><div>While COVID-19 has transitioned from a pandemic to an endemic state, the management of its persistent complications continues to present substantial clinical challenges. Tocilizumab, an interleukin-6 receptor antagonist endorsed by the World Health Organization (WHO) for severe COVID-19 management, remains a critical therapeutic intervention. This systematic evaluation provides a comprehensive assessment of tocilizumab's safety and efficacy profile to inform clinical decision-making.</div></div><div><h3>Methods</h3><div>The study involved exhaustive search across multiple databases (PubMed, SCOPUS, WoS, BIOSIS) utilizing MeSH terms and Boolean operators to identify relevant studies. Methodological worthiness was rigorously evaluated utilizing the Risk of Bias 2 (RoB 2) tool. The statistical analysis of the findings incorporated one-way ANOVA, Mann-Whitney U tests, and Pearson's correlation coefficient (r) with 95 % confidence intervals to quantify adverse effects and therapeutic outcomes.</div></div><div><h3>Results</h3><div>The analysis of nine studies encompassing diverse demographic populations (ages ≥2 years, both sexes) established a clear safety profile for tocilizumab. The treatment demonstrated a statistically important association (P &lt; 0.05) with mild adverse effects (nausea, diarrhea, headache, fatigue; r = 0.62, 95 % CI = 0.59–0.71) and moderate adverse effects (tremors, urinary difficulties, mood changes; r = 0.54, 95 % CI = 0.47–0.60). More concerning were the severe adverse effects, including hepatobiliary dysfunction and hypersensitivity reactions (r = 0.36, 95 % CI = 0.32–0.41), with rare but critical instances of acute liver failure (r = 0.18, 95 % CI = 0.15–0.22). Notably, despite this safety profile, tocilizumab exhibited significant therapeutic efficacy (P &lt; 0.01) in ameliorating COVID-19 symptoms, particularly in cases complicated by cytokine storm syndrome.</div></div><div><h3>Conclusion</h3><div>This study confirms tocilizumab's position as a valuable therapeutic agent for COVID-19 complications while highlighting the necessity for judicious patient selection and vigilant monitoring due to its potential for significant adverse effects. The findings underscore the importance of pre-treatment screening, adherence to contraindications, and ongoing pharmacovigilance to optimize risk-benefit ratios.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102873"},"PeriodicalIF":4.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}