Therapeutic Advances in Infectious Disease最新文献

{"title":"Prediction of mortality in cardio-neurovascular patients with sepsis and septic shock: is NEWS-2 better than qSOFA, SOFA, and qPitt? An observational study.","authors":"Julian Orlando Casallas-Barrera, Darlyng Aireth Zabala-Muñoz, Carol Viviana Aponte-Carrascal, Angie Marcela Ochoa-Ricardo, Edgar Felipe Quintero-Varela, Juan Nicolas Quiñones-Romero, Jenny Paola Garzón-Ruiz, Edwin Silva-Monsalve, Ricardo Buitrago-Bernal","doi":"10.1177/20499361251323207","DOIUrl":"10.1177/20499361251323207","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is one of the leading causes of morbidity and mortality worldwide. Early detection and reliable prediction of sepsis-related mortality are crucial. The prognostic value of National Early Warning Score 2 (NEWS-2) in sepsis patients with cardiovascular and neurovascular diseases is not well elucidated.</p><p><strong>Objectives: </strong>This study aims to evaluate and compare the qSOFA, SOFA, qPitt, and NEWS-2 scores for predicting mortality in sepsis and septic shock patients.</p><p><strong>Design: </strong>An observational retrospective study was conducted involving patients with sepsis or septic shock.</p><p><strong>Methods: </strong>Data were collected between 2023 and 2024. Baseline measures included sociodemographic and clinical characteristics. All subjects were identified from a database of a highly complex healthcare institution focused on the diagnosis and treatment of cardiovascular and neurovascular diseases. The scores qSOFA, SOFA, NEWS-2, and qPitt were collected from medical records and analyzed. A sample size was estimated. The area under the receiver operating characteristic curve (AUROC) analysis was established for each score. A multivariate analysis adjusted for confounding factors through logistic regression was performed.</p><p><strong>Results: </strong>A total of 126 participants were included, with a median age of 72 years (IQR: 59-81), and 76 (60.32%) being men. The overall mortality rate in the population was 19.8%, with 84% of deaths occurring in males. Statistically significant differences in variables such as heart failure, mild liver disease, and atrial fibrillation were observed between the groups (<i>p</i> < 0.05). The NEWS-2 score with a cut-off point of ⩾8 showed a significant association with mortality (<i>p</i> = 0.0001). The AUROC for NEWS-2 was 0.80, compared to a ROC of 0.6960 for qPitt, 0.6776 for SOFA, and 0.5868 for qSOFA (χ² = 16.60, Prob > χ² = 0.0009).</p><p><strong>Conclusion: </strong>NEWS 2 exhibits better performance in predicting mortality among elderly adults with cardiovascular and neurovascular diseases suffering from sepsis or septic shock, compared to the qPitt, SOFA, and qSOFA scores.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251323207"},"PeriodicalIF":3.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostemsavir resistance in clinical context: a narrative review.","authors":"Jonathan M Schapiro, Rolf Kaiser, Mark Krystal, Chris M Parry, Allan R Tenorio, Eugene Stewart, Bruce Gilliam, Margaret Gartland, Andrew Clark, Jose R Castillo-Mancilla","doi":"10.1177/20499361251325103","DOIUrl":"10.1177/20499361251325103","url":null,"abstract":"<p><p>Fostemsavir, a prodrug of the first-in-class gp120-directed attachment inhibitor temsavir, is indicated in combination with other antiretrovirals for the treatment of multidrug-resistant HIV-1 in adults who are heavily treatment-experienced (HTE). Temsavir binds to HIV-1 gp120, close to the CD4 binding site, preventing the initial interaction of HIV-1 with CD4 on the host cell. Amino acid substitutions at four positions in gp120 have been identified as important determinants of viral susceptibility to temsavir (S375H/I/M/N/T/Y, M426L/P, M434I/K, M475I), with a fifth position (T202E) recently described. For most currently circulating group M HIV-1 subtypes, the prevalence of these resistance-associated polymorphisms (RAPs) is low. As with many other antiretrovirals, the impact of RAPs is modified by other changes in the target molecule. Different regions of gp120 interact to modify the temsavir binding pocket, with multiple amino acids playing a role in determining susceptibility. Extensive variability of HIV-1 gp120 means the susceptibility of clinical isolates to temsavir is also highly variable. Importantly, in vitro measurement of the susceptibility of clinical isolates to temsavir does not necessarily capture the range of susceptibilities of the heterogeneous mix of viruses generally present in each isolate. Due to these factors and limited phenotypic clinical data, thus far, no relevant phenotypic cutoff or genotypic algorithms have been derived that reliably predict response to fostemsavir-based therapy in individuals who are HTE; therefore, pre-treatment temsavir resistance testing may be of limited benefit. In the phase III BRIGHTE study, re-suppression after virologic failure was observed in some participants despite treatment-emergent genotypic and/or phenotypic evidence of reduced temsavir susceptibility, and substantial CD4+ T-cell count increases occurred even among participants with HIV-1 RNA ⩾40 copies/mL at Week 240. Clinical management of people who are HTE and experience virologic failure during treatment with fostemsavir-based regimens requires an individualized approach with consideration of potential benefits beyond virologic suppression.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251325103"},"PeriodicalIF":3.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Serine protease inhibitors could be of benefit in the treatment of COVID-19 disease\".","authors":"","doi":"10.1177/20499361241294158","DOIUrl":"https://doi.org/10.1177/20499361241294158","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/20499361211032048.].</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361241294158"},"PeriodicalIF":3.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHO declares Mpox a public health emergency: \"<i>you haven't closed borders with Africa, the epicenter</i>?\"-YouTube reactions highlight geopolitical tensions.","authors":"Ivaan Pitua, Felix Bongomin","doi":"10.1177/20499361251323709","DOIUrl":"https://doi.org/10.1177/20499361251323709","url":null,"abstract":"<p><strong>Background: </strong>Mpox was declared a Public Health Emergency of International Concern by the World Health Organization in August 2024, following an outbreak in Africa. Public engagement on YouTube provides insights into public perceptions during such crises.</p><p><strong>Objectives: </strong>We analyzed public discourse and sentiments related to Mpox, focusing on thematic trends in YouTube comments.</p><p><strong>Design: </strong>A qualitative synthesis employing thematic content analysis of YouTube comments.</p><p><strong>Methods: </strong>The YouTube API retrieved 50 videos each for \"Mpox\" and \"Monkeypox.\" After exclusions, 50 relevant videos remained, and the top 10 by views were analyzed. From 10,567 comments extracted, 2826 were analyzed using Latent Dirichlet Allocation modeling to identify themes.</p><p><strong>Results: </strong>Key themes included geopolitical concerns, disease spread, conspiracy theories, public health measures, and religious interpretations. Comments revealed mixed views on vaccines, lockdowns, and mistrust in authorities.</p><p><strong>Conclusion: </strong>Effective health communication must address scientific, cultural, and geopolitical dimensions while countering misinformation and fostering trust.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251323709"},"PeriodicalIF":3.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Polio: Background and perspective on how international travel can be made safe against polio\".","authors":"","doi":"10.1177/20499361251323437","DOIUrl":"https://doi.org/10.1177/20499361251323437","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/20499361241298857.].</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251323437"},"PeriodicalIF":3.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and antimicrobial resistance patterns of urinary tract infection: insights and strategies from a 5-year serial cross-sectional study in Vietnam.","authors":"Anh Tram Que, Anh Dao Tran, Thi Hong Nhung Trang, Thi Nhu Le Tran, Ngoc-Niem Bui, Chih-Ho Lai","doi":"10.1177/20499361251315346","DOIUrl":"https://doi.org/10.1177/20499361251315346","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infection (UTI) is one of the most common bacterial infections in clinical practice. Given the rapid increase in antimicrobial resistance and the scarcity of new antibiotics, along with the absence of individual antibiogram testing in some countries, there is an urgent need for robust surveillance systems.</p><p><strong>Objective: </strong>This study aimed to provide evidence for the surveillance of resistance, a crucial component in developing national UTI treatment guidelines and guiding empirical therapy decisions.</p><p><strong>Design: </strong>This study utilized a retrospective, serial cross-sectional design.</p><p><strong>Methods: </strong>Antimicrobial surveillance was conducted using data collected from January 1, 2017 to December 31, 2021. A total of 2595 patients with UTIs were recruited for this study. From these patients, 2004 bacterial isolates were identified and subjected to epidemiological and antibiotic resistance analyses.</p><p><strong>Results: </strong><i>Escherichia coli</i> (<i>E. coli</i>, 42.7%), <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>, 11.9%), and <i>Klebsiella pneumoniae</i> (<i>K. pneumoniae</i>, 10.9%) were identified as the predominant causes of UTIs. <i>E. coli</i> isolates demonstrated a high level of sensitivity (80%-90%) to carbapenems (imipenem, ertapenem, and meropenem), aminoglycosides (amikacin), piperacillin/tazobactam, cefoperazone/sulbactam, and fosfomycin. The antibiotic resistance rates of <i>K. pneumoniae</i> strains consistently exceeded 50%, except for amikacin, ertapenem, imipenem, meropenem, and fosfomycin. Notably, all <i>K. pneumoniae</i> strains isolated from patients with UTIs were resistant to ampicillin. During the coronavirus disease pandemic, the <i>E. coli</i> and <i>K. pneumoniae</i> isolates exhibited reduced antibiotic resistance compared to the pre-pandemic period. The resistance rate of <i>P. aeruginosa</i> isolates remained consistently high (60%-70%).</p><p><strong>Conclusion: </strong>Amikacin, ertapenem, imipenem, meropenem, and fosfomycin are promising treatment options for enterobacterial UTIs. However, their efficacy against <i>P. aeruginosa</i> is limited. This study revealed alarmingly high rates of primary etiological pathogen resistance to commonly prescribed empirical therapies for UTIs. These findings provide crucial data for optimizing national guidelines and implementing personalized treatment strategies to enhance the effectiveness of UTI treatments.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251315346"},"PeriodicalIF":3.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Let me hear what you're needing\": exploring how HIV providers conceptualize patient-provider interactions with people with HIV who use drugs using a harm reduction framework.","authors":"Stephanie L Creasy, James E Egan, Sarah Krier, Jessica Townsend, Jessica Ward, Mary Hawk, Emma Sophia Kay","doi":"10.1177/20499361251323721","DOIUrl":"10.1177/20499361251323721","url":null,"abstract":"<p><strong>Background: </strong>In addition to structural interventions such as syringe services and naloxone distribution, harm reduction (HR) is also a <i>relational</i> approach to care encompassing principles such as patient autonomy and pragmatism that can be implemented in healthcare teams to improve outcomes for people with HIV (PWH) who use drugs. Evidence suggests that using a relational HR framework to operationalize care for PWH who use drugs may improve the patient-provider relationship, thus positively impacting HIV outcomes. We previously found that negative attitudes toward people who use drugs are negatively associated with acceptance of HR; however, little is known about how HIV providers conceptualize the patient-provider relationship with PWH who use drugs.</p><p><strong>Objectives: </strong>The aim of this study was to describe the ways healthcare workers (HCWs) characterize interactions with PWH who use drugs and if these characterizations reflect relational HR or missed opportunities to improve the patient-provider relationship.</p><p><strong>Design: </strong>We used a qualitative descriptive design to characterize HCWs' descriptions of their interactions with PWH who use drugs.</p><p><strong>Methods: </strong>We interviewed providers (<i>n</i> = 23) working at three HIV clinics in the United States to assess their interactions with patients. Providers included anyone who had worked at their respective clinic for ⩾1 year and who had face-to-face contact with patients (e.g., front desk staff, nurses, physicians, and social workers). Data were coded thematically via Dedoose.</p><p><strong>Results: </strong>We discovered that HCWs characterize positive patient-provider interactions that both reflect HR principles and may not align with the principles of HR. Examples include when patients appear comfortable with and trusting of their provider, when patients feel heard by their provider, and when providers feel they are responsive to patient needs. However, other HCWs described positive interactions as counter to relational HR.</p><p><strong>Conclusion: </strong>HCW descriptions of positive interactions in line with relational HR in their conceptualization of patient-provider interactions with PWH who use drugs have the potential to guide efforts in increasing the acceptability of HR in HIV care. Given evidence showing HR improves outcomes for those who use substances, findings suggest missed opportunities to incorporate relational HR into the patient-provider relationship in HIV primary care settings.</p><p><strong>Registration: </strong>NCT05404750.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251323721"},"PeriodicalIF":3.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment response of patients with tuberculosis and HIV co-infection: a retrospective analysis of secondary data from Shanghai, China, 2010-2020.","authors":"Chenyu Dong, Renfang Zhang, Shenyang Li, Jun Chen, Yunhe Liu, Xiaoqiong Xia, Gang Liu, Yinzhong Shen, Lei Liu, Liyan Zeng","doi":"10.1177/20499361241308641","DOIUrl":"10.1177/20499361241308641","url":null,"abstract":"<p><strong>Background: </strong>At present, there is a need for more substantial real-world evidence on the factors influencing the effectiveness of tuberculosis (TB) treatment in HIV/TB co-infected patients.</p><p><strong>Objectives: </strong>This retrospective study aims to identify factors affecting TB treatment effectiveness in HIV/TB co-infected patients.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Methods: </strong>We included 461 HIV/TB co-infected patients, deriving 742 samples based on each initial positive TB test period. A total of 7788 valid treatment records corresponding to 17 TB drug compositions and 150 clinical indicators (each > 100 records) were used for analysis. Data mining techniques were employed, including consensus clustering, Fisher's exact test, stratified analysis, multivariate logistic regression analysis, and three modeling approaches (logistic regression, support vector machine, and random forest).</p><p><strong>Results: </strong>The TB treatment effectiveness of CD4⁺ T cell count ⩽ 42 is significantly lower than that of the sample group > 42 (aOR: 1.77, 95% CI: 1.15-2.74, <i>p</i> = 0.010). The TB treatment effectiveness of the \"rifabutin and levofloxacin alone or in combination\" group is significantly higher than that of the \"other first- and second-line anti-TB drugs in combination\" group (aOR: 0.10, 95% CI: 0.01-0.64, <i>p</i> = 0.022). Significant differences exist in factors between TB treatment effective and ineffective groups, including age (aOR: 2.12, 95% CI: 1.10-4.20, <i>p</i> = 0.027), pre-treatment high-density lipoprotein (HDL) cholesterol (aOR: 0.47, 95% CI: 0.25-0.89, <i>p</i> = 0.022), pre-treatment CD8⁺ T cell count (aOR: 0.55, 95% CI: 0.33-0.90, <i>p</i> = 0.019), pre-treatment neutrophil percentage (aOR: 0.68, 95% CI: 0.48-0.96, <i>p</i> = 0.030), rifabutin (aOR: 1.59, 95% CI: 1.09-2.32, <i>p</i> = 0.016), and cycloserine (aOR: 0.21, 95% CI: 0.03-0.77, <i>p</i> = 0.041). The best area under the receiver operating characteristic curve of the test set under three modeling methods is 0.560-0.763. Rate of lymphocyte percentage recovering to normal is significantly higher in the TB treatment-effective group than in the treatment-ineffective group (aOR: 1.83, 95% CI: 1.09-3.10, <i>p</i> = 0.022).</p><p><strong>Conclusion: </strong>CD4⁺ T cell count of 42/μL assists TB treatment effectiveness evaluation. Rifabutin and levofloxacin show more therapeutic benefits. Lymphocyte percentage can serve as an effective TB therapeutic and diagnostic target. Age, pre-treatment factors (HDL cholesterol, CD8⁺ T cell count, and neutrophil percentage), rifabutin, and cycloserine are significantly associated with TB treatment effectiveness. Factors affecting TB treatment effectiveness for HIV/TB co-infected patients need more evidence.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361241308641"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of intercurrent shigellosis and rectal gonorrhea in an acutely unwell febrile returned traveler.","authors":"Charlotte Fuller, Ruchika Bagga, Ezra Bado, Syed Zain Ahmad, Andrea K Boggild","doi":"10.1177/20499361251319659","DOIUrl":"10.1177/20499361251319659","url":null,"abstract":"<p><p>Both acute traveler's diarrhea and sexually transmitted infections are common causes of fever in the returned traveler, with the male sex corresponding to two-fold increased odds of a sexually transmitted infection (STI) diagnosis related to travel. <i>Shigella flexneri</i> is the most common cause of shigellosis in low- and middle-income countries, while within the men who have sex with men (MSM) population, outbreaks of <i>S. flexneri</i> 3a, <i>S. flexneri</i> 2a, and <i>S. sonnei</i> have been reported. We herein present a case of a febrile returned MSM traveler with a predominantly gastrointestinal presentation and proctocolitis whose microbiological work-up confirmed coinfection with <i>S. flexneri</i> and rectal gonorrhea. Based on his travel history and epidemiologic risk factors, it is unclear if food- and waterborne shigellosis versus transmission via sexual contact was the major route of acquisition. This case highlights the broad differential for proctocolitis and the importance of consideration of intercurrent infections.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251319659"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes in immunocompromised adults with COVID-19, based on anti-spike IgG serostatus and monoclonal antibody therapy: a retrospective cohort study in the Omicron period.","authors":"Shilpa Vasishta, Judith Aberg, Gopi Patel, Pooja Anand Gownivaripally, Meenakshi Rana","doi":"10.1177/20499361251320711","DOIUrl":"10.1177/20499361251320711","url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised adults may experience severe COVID-19 outcomes, necessitating a multifaceted treatment approach. Studies from the Delta period showed benefit from monoclonal antibody (mAb) therapy that was most pronounced among anti-spike IgG seronegative individuals. With widespread vaccination and shifting SARS-CoV-2 variants in the Omicron period, clinical predictors of anti-spike IgG seronegativity, and impacts on clinical outcomes, remain incompletely characterized.</p><p><strong>Objectives: </strong>We describe outcomes from a cohort of immunocompromised adults with COVID-19 stratified by anti-spike IgG serostatus and receipt of mAb therapy during the Omicron period to evaluate clinical impact.</p><p><strong>Design: </strong>This was a retrospective study of immunocompromised adults with mild-moderate COVID-19 presenting between December 2021 and October 2022.</p><p><strong>Methods: </strong>Charts were reviewed to assess anti-spike IgG serostatus, receipt of mAb therapy, and 28-day outcomes including conventional oxygen use, high-flow oxygen use, mechanical ventilation, and death.</p><p><strong>Results: </strong>A total of 276 individuals were included, of whom 252 (91%) were partially or fully vaccinated, 190 (69%) were anti-spike IgG seropositive, and 225 (82%) received mAb therapy. A majority were solid organ transplant recipients (169, 61%), with anti-spike IgG seronegatively significantly associated with mycophenolate-based immunosuppression or comorbid chronic kidney disease. Conventional oxygen use among seropositive patients receiving mAb, seronegative patients receiving mAb, seropositive patients not receiving mAb, and seronegative patients not receiving mAb were 2/154 (1%), 5/71 (7%), 6/36 (17%), and 4/15 (27%), respectively. Across the cohort, high-flow oxygen use, mechanical ventilation, and death occurred in 6 (2%), 4 (3%), and 3 (1%) individuals, respectively.</p><p><strong>Conclusion: </strong>Clinical outcomes in a predominantly vaccinated, immunocompromised cohort with mild-moderate COVID-19 during the Omicron period appeared to vary with anti-spike IgG serostatus and receipt of mAb therapy. Observed trends would benefit from prospective studies during future iterations of COVID-19 therapeutics to inform treatment decisions for immunocompromised adults.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251320711"},"PeriodicalIF":3.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}