BMC Infectious Diseases最新文献

{"title":"Identifying plasma exosome antigens as a potential diagnostic biomarker for tuberculosis disease.","authors":"Yan Jiang, Li Yan, Baoru Zhou, Jianming Hong, Huixing Tan, Xiaonan Li, Yong Wang","doi":"10.1186/s12879-025-10474-9","DOIUrl":"https://doi.org/10.1186/s12879-025-10474-9","url":null,"abstract":"<p><strong>Background: </strong>Exosome is a small extracellular vesicle with a diameter of 30 to 150 nm that is secreted by cells. Mtb and other bacteria can also secrete extracellular vesicles, which carry characteristics and information about the pathogen. Here, we compare the concentration of exosomes and the Mtb antigen in exosomes of tuberculosis patients aiming to evaluate whether exosomes can be used as diagnostic markers of tuberculosis at different stages.</p><p><strong>Methods: </strong>Plasma exosomes were extracted from healthy individuals, the patients with active TB and latent TB, Rehabilitation patients. The concentration and diameter of exosomes from different groups were detected using NTA. The antigen Ag85A, MPT64, CFP-10 of Mtb in exosomes was detected by ELISA. The area under the curve (AUC) was used to model the associations between exosomal Mtb Antigens and tuberculosis.</p><p><strong>Results: </strong>We found that MPT64, Ag85A and CFP-10 levels were significantly higher in active and latent patients than in healthy and recovered patients. And he results shown the AUC for patients with active TB was 0.97 for MPT64, 1.0 for Ag85A, and 0.94 for CFP-10; for patients with latent TB, the AUC was 0.86 for MPT64, 0.98 for Ag85A, and 0.83 for CFP-10.</p><p><strong>Conclusion: </strong>Levels of MPT64, Ag85A and CFP-10 were significantly up-regulated in plasma exosomes from TB patients and latent patients, and the AUC values of all three antigens predicting TB were higher than 0.9. This finding suggests that the three Mtb antigens in plasma exosomes were reliable diagnostic markers for TB.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"65"},"PeriodicalIF":3.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence, incidence estimates, and environmental risk factors for dengue, chikungunya, and Zika infection amongst children living in informal urban settlements in Indonesia and Fiji.","authors":"Joelle I Rosser, John J Openshaw, Audrie Lin, Ruzka R Taruc, Autiko Tela, Nursehang Tamodding, Nurul Pausi Emelia Abdullah, Murni Amiruddin, Esra Buyukcangaz, S Fiona Barker, Amelia Turagabeci, Ansariadi, Karin Leder, Isra Wahid","doi":"10.1186/s12879-024-10315-1","DOIUrl":"10.1186/s12879-024-10315-1","url":null,"abstract":"<p><strong>Background: </strong>The burden of Aedes aegypti-transmitted viruses such as dengue, chikungunya, and Zika are increasing globally, fueled by urbanization and climate change, with some of the highest current rates of transmission in Asia. Local factors in the built environment have the potential to exacerbate or mitigate transmission.</p><p><strong>Methods: </strong>In 24 informal urban settlements in Makassar, Indonesia and Suva, Fiji, we tested children under 5 years old for evidence of prior infection with dengue, chikungunya, and Zika viruses by IgG serology. We used a catalytic model using seroprevalence and mean age to estimate annual incidence of dengue in each country. We also conducted detailed questionnaires to evaluate environmental risk factors for a positive serology result. Dengue risk factors were evaluated for children by univariate and multivariable logistic regression accounting for settlement as a fixed effect. Trash and flooding were additionally evaluated as dengue risk factors at the settlement level by univariate linear regression.</p><p><strong>Results: </strong>In Fiji and Indonesia respectively, 46% and 33% of children under 5 years old were seropositive for dengue, 3% and 3% for chikungunya, and 9% and 2% for Zika. In Indonesia, children living in a household where trash is routinely collected and removed were significantly less likely to be dengue seropositive in both unadjusted and adjusted models [adjusted model: OR 0.3 (95% CI: 0.1-0.8)]. In Indonesia, settlements with a higher proportion of households reporting flooding also had lower dengue rates (slope = 0.44; p-value: <0.05).</p><p><strong>Conclusions: </strong>Household trash collection and community flood management are important targets for interventions to mitigate the increasing risk of Aedes aegypti-transmitted viruses.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"51"},"PeriodicalIF":3.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors of severe pneumonia caused by human bocavirus in children.","authors":"Zhuxia Li, Wenjing Gu, Fengming Zhu, Enze Han, Yongdong Yan, Huiquan Sun, Weidong Xu, Xin Zhang, Li Huang, Shan Gao, Yuqing Wang, Chuangli Hao, Xinxing Zhang","doi":"10.1186/s12879-025-10465-w","DOIUrl":"10.1186/s12879-025-10465-w","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the clinical characteristics of severe pneumonia caused by human bocavirus (HBoV) infection to explore the associated risk factors.</p><p><strong>Methods: </strong>We conducted a retrospective review of data from children hospitalized with HBoV pneumonia. Based on the severity of pneumonia, patients were categorized into severe pneumonia and non-severe pneumonia groups. Clinical manifestations, laboratory examination results, chest imaging and pathogens were analyzed. Logistic regression was employed to identify the risk factors for severe HBoV pneumonia.</p><p><strong>Results: </strong>A total of 334 patients were admitted, with 44 (13.17%) patients diagnosed with severe pneumonia and 290 (86.83%) with non-severe pneumonia. There were no significant differences in age distribution, presence of fever, lung moist rales, pleural effusion and reduced breath sounds between the two groups (all P > 0.05). 57.19% of the HBoV-positive children co-infected with other pathogens and HRV was the most common co-infected pathogens with HBoV. No significant differences were observed in the rate of co-infection between the two groups (χ² = 0.50, p = 0.48). The univariate analysis revealed significant differences between the severe pneumonia group and the non-severe group in terms of gender distribution, presence of underlying chronic diseases, wheezing, premature delivery, lung wheezing rales, pneumothorax, bronchoscopy procedures, length of hospital stay, duration of symptoms prior to admission, neutrophil count, CRP levels, CKMB levels, IgA levels, CD3⁺(%), CD3⁺CD4⁺(%), CD3⁺CD8⁺%, and CD3^-CD19⁺% (all P < 0.05). Multivariate logistic regression analysis identified female gender, wheezing and neutrophil count were independent risk factors and the ratio of CD3⁺CD4⁺ cells was protective factor for severe HBoV pneumonia. The cut-off values of neutrophil count and the ratio of CD3⁺CD4⁺ cells were 6.81 × 10⁹/L and 32.48 respectively.</p><p><strong>Conclusion: </strong>Our study indicated that female gender, wheezing and neutrophil count greater than 6.81 × 10⁹/L were independent risk factors and the ratio of CD3⁺CD4⁺ cells greater than 32.48 was protective factor for severe HBoV pneumonia.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"58"},"PeriodicalIF":3.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of intestinal parasites among diabetic patients in Africa: a systematic review and meta-analysis.","authors":"Marye Nigatie Debash, Getinet Kumie, Assefa Sisay, Solomon Gedfie, Wagaw Abebe, Agenagnew Ashagre, Tadesse Misganaw, Habtu Debash, Melese Abate Reta","doi":"10.1186/s12879-025-10441-4","DOIUrl":"10.1186/s12879-025-10441-4","url":null,"abstract":"<p><strong>Background: </strong>Intestinal parasite infections remain a serious public health concern around the world, particularly in countries with inadequate sanitation. The study aims to ascertain the total magnitude of intestinal parasites in diabetes patients throughout the African countries.</p><p><strong>Objective: </strong>The aim of this systematic review and meta-analysis was to determine the general burden of intestinal parasites among diabetic patients in Africa.</p><p><strong>Methods: </strong>A systematic search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol for studies reporting intestinal parasite infections in patients with diabetes through January 01/2000 to August13/2024. The collected data were analyzed using STATA software version 17. Seven case-control studies and nine cross-sectional studies were included in this study. Heterogeneity across studies was assessed using Cochran's Q statistic and I² statistics. Subgroup analysis was carried out when the I² value exceeded 50%, indicating substantial heterogeneity.</p><p><strong>Results: </strong>In the current systematic review and meta-analysis, the pooled prevalence of intestinal parasites in diabetic patients was 31% (95% CI: 23-38%) with heterogeneity of I² = 95.94%; P < 0.001. The highest prevalence based on geographical area was in region of the Egypt 39% (95% CI: 26-52%), and based on study design was in case control studies 40% (95% CI: 28-52%). Poor hygiene and sanitation(P < 0.001), as well as diabetes mellitus status (P < 0.001), were statistically significant factors associated with patients who have diabetes.</p><p><strong>Conclusion: </strong>Patients with diabetes are a high-risk group for intestinal parasitic infections and should be prioritized for screening. Therefore, it is essential to implement preventative measures for these patients.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"54"},"PeriodicalIF":3.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Xpert MTB/RIF assay in detecting Mycobacterium tuberculosis in samples with different results by smear and culture in a coastal city with high incidence of tuberculosis.","authors":"Gang Feng, Hongyu Jiang, Ying Chen","doi":"10.1186/s12879-025-10446-z","DOIUrl":"10.1186/s12879-025-10446-z","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is a global problem that seriously jeopardizes human health. Among them, the diagnosis and treatment of smear- or culture-negative TB patients is a challenge. The Xpert MTB/RIF (Xpert) assay has been reported to be a novel molecular diagnostic tool for rapidly detecting TB. Still, there is limited data on this assay's performance in subgroups of TB patients. This study aimed to evaluate the diagnostic value of the Xpert method in patients with different smear and culture results and to assess its efficacy for rifampicin resistance (RR) detection.</p><p><strong>Methods: </strong>We retrospectively collected data from 1,721 patients with a clinical diagnosis of tuberculosis. Smear, Xpert, and traditional solid culture methods were used to detect TB infection and explore the detection rate of Xpert in the grouping of results from different smear and culture methods. Information on RR detected by the Xpert method and proportional method of drug sensitivity test (DST) was also recorded and kappa values, sensitivity, and specificity were calculated.</p><p><strong>Results: </strong>We observed that among the three methods, the Xpert method had the highest detection rate of 66.8%, followed by the culture method at 56.0% and the smear method had the lowest at 40.0%. The detection rate of Xpert was 98.3% (642/653) when both smear and culture were positive, 85.1% (296/348) when only one of the two methods, smear and culture, was positive, and 29.4% (212/720) when both smear and culture were negative. The Xpert method and DST showed a high agreement (κ = 0.92) for RR detection. The highest mutation rate was observed for probe E (64.7%), and the least number of probe C mutations occurred (1.5%).</p><p><strong>Conclusion: </strong>The Xpert method has high detection efficiency. It has good diagnostic value in detecting MTB and RR, especially in cases where traditional culture and sputum smear results are negative, and significantly reduces the rate of missed diagnosis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"55"},"PeriodicalIF":3.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert consensus on the benefits of neuraminidase in conventional influenza vaccines: a Delphi study.","authors":"John Youhanna, Joan Puig-Barberà, Matthew S Miller, Deborah Molrine, Monica Hadi, Shweta Bapat, Ike Iheanacho, Sophie Dodman, Tsion Fikre, Paul Swinburn","doi":"10.1186/s12879-024-10277-4","DOIUrl":"10.1186/s12879-024-10277-4","url":null,"abstract":"<p><strong>Background: </strong>Seasonal vaccination is the mainstay of human influenza prevention. Licensed influenza vaccines are regularly updated to account for viral mutations and antigenic drift and are standardised for their haemagglutinin content. However, vaccine effectiveness remains suboptimal. Neuraminidase (NA) evolves more gradually than hemagglutinin and has been demonstrated to provide added clinical benefits. However, NA is not currently a mandated or standardised component of influenza vaccines.</p><p><strong>Methods: </strong>Here, we collated expert opinions on the importance of NA in influenza vaccines in a two-stage Delphi survey. Nine statements about NA were formulated by a steering committee based on a targeted literature review. In the survey's first round, panellists recruited from three continents were requested to report on their agreement with each statement and estimate the strength of evidence for each statement. Panellists were also requested to explain their choice of answer and suggest revisions to the statements. Consensus was considered reached if ≥ 75% of panellists agreed with a statement. If consensus was not reached for a statement, this statement was revised and included in the survey's second round.</p><p><strong>Results: </strong>Nine panellists with a broad range of NA-related expertise, including clinical, research, and public health experience, completed the survey. They agreed that anti-NA responses acquired via natural infection or vaccination are associated with protective immunity independently of haemagglutinin and that NA provided additional advantages including improving disease severity metrics. The experts identified several knowledge gaps concerning heterologous cross-reactivity of vaccine-induced anti-NA antibodies, correlations between anti-NA titres and reduced transmission or infection risks, and differences in anti-NA responses to seasonal influenza vaccines.</p><p><strong>Conclusions: </strong>NA is an important influenza vaccine component and is associated with specific benefits. These benefits would likely be greater if NA content were standardised. Additional research is needed to optimise vaccines for anti-NA effects.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"53"},"PeriodicalIF":3.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study.","authors":"Bibechan Thapa, Prakriti Lamichhane, Trishna Shrestha, Saral Lamichhane, Shreyasi Karki, Sneha Pradhananga, Kabita Hada Batajoo, Prajwal Pudasaini","doi":"10.1186/s12879-025-10486-5","DOIUrl":"https://doi.org/10.1186/s12879-025-10486-5","url":null,"abstract":"<p><strong>Introduction: </strong>Dengue viruses cause either symptomatic infections or asymptomatic seroconversion. Symptomatic dengue has a wide clinical spectrum ranging from self-limiting infection to severe manifestations, mostly characterized by plasma leakage with or without hemorrhage. World Health Organization classification in 2009 classified dengue into dengue without warning signs, dengue with warning signs, and severe dengue. This study aimed to determine patient characteristics and hematological parameters (leukopenia, and thrombocytopenia) in patients with dengue infection in the emergency department of a tertiary center.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 252 patients with dengue confirmed by serological testing against dengue-specific nonstructural protein 1 (NS1) antigen and immunoglobulin M (IgM) by enzyme-linked immunosorbent assay from September to November 2022 who presented in the emergency department of a tertiary hospital in Nepal after ethical approval was obtained. Dengue was categorized according to the World Health Organization 2009 classification. Hematological parameters were recorded by reviewing patients' laboratory records. Data analysis was done using descriptive statistical parameters and a chi-square test.</p><p><strong>Results: </strong>Dengue without warning signs was present in 166 (65.87%) patients, while dengue with warning signs and severe dengue was present in 68 (26.89%) and 18 (7.14%) patients, respectively. Leukopenia (< 4000 cells/mm³⁾ was present among 163 (64.68%) patients. The lowest recorded leukocyte count was 1440. Similarly, thrombocytopenia (< 150000 cells/mm³) was present among 102 patients (40.48%). The lowest recorded platelet count was 26,000 cells/mm³. A significant association was found between the severity of dengue infection and leukopenia (χ² 13.268, p-value 0.001) and thrombocytopenia (χ² 43.924, p value < 0.001).</p><p><strong>Conclusions: </strong>Monitoring of warning signs and clinical parameters is important for identifying the progression of dengue infection to the critical phase. Leukopenia and thrombocytopenia are present among many dengue-infected patients presenting in the emergency department. The severity of the disease will usually only be apparent around defervescence, which often coincides with the onset of the critical phase. Leukopenia and thrombocytopenia could indicate progression to severe disease during emergency department admission.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"56"},"PeriodicalIF":3.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Salmonella and Shigella species and their multidrug resistance patterns among pediatric populations in Ethiopia: a systematic review and meta-analysis.","authors":"Mihret Tilahun, Melaku Ashagrie Belete, Alemu Gedefie, Habtu Debash, Ermiyas Alemayehu, Daniel Gebretsadik Weldehana, Hussein Ebrahim, Ousman Mohammed, Bruktawit Eshetu, Saba Gebremichael Tekele, Zewudu Mulatie, Agumas Shibabaw","doi":"10.1186/s12879-024-10425-w","DOIUrl":"10.1186/s12879-024-10425-w","url":null,"abstract":"<p><strong>Background: </strong>Salmonella and Shigella are major enteric pathogens that cause diarrhea in children worldwide. They are pathogenic microbes that cause significant diarrheal morbidity and mortality in under five children in resource limited countries. Thus, this systemic review and meta-analysis aimed to investigate the prevalence of Salmonella and Shigella species and their multidrug resistance patterns in pediatric populations in Ethiopia.</p><p><strong>Methods: </strong>The articles were searched extensively in the electronic databases and grey literature using entry terms or phrases. Studies meeting the eligibility criteria were extracted in MS Excel and exported for statistical analysis into STATA version 14 software. The overall pooled prevalence of Salmonella and Shigella species was computed using a random-effects model. Heterogeneity was assessed using the Cochrane Q test and I² statistics with corresponding p-values. Publication bias was assessed using a funnel plot and Egger's test. In addition, sensitivity analysis was performed to determine the impact of individual studies on the pooled effect size.</p><p><strong>Result: </strong>Of a total of 742 identified studies, 89 studies were eligible for full-text analysis. Of 89 studies, 21 were included for meta-analysis involving 5318 study participants. These eligible studies reported a total of 593 bacterial isolates. The overall pooled prevalence of Salmonella and Shigella among pediatrics in Ethiopia was 10.70% (95% CI: 8.96-12.45), with substantial heterogeneity (I² = 82.1%, p < 0.001) across the studies. The pooled prevalence of Salmonella and Shigella individually among pediatrics in Ethiopia was 15.43% (95% CI: 10.42-20.72) and 15.83% (95% CI: 11.40-20.40), respectively. Moreover, the overall prevalence of multidrug resistance in Salmonella and Shigella isolates was 81.03% (95% CI: 77.39-84.67) with substantial heterogeneity of I² of 95%, p < 0.0001 between the pooled prevalence of the two species.</p><p><strong>Conclusion: </strong>The pooled prevalence of Salmonella and Shigella and their multidrug resistance were alarmingly high in pediatric. The initial empirical treatment of pediatrics patients remains challenging and results high prevalence of antimicrobial resistance. Thus, appropriate infection prevention and control strategies should be implemented and treatment should be directed based on antimicrobial stewardship protocols.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"52"},"PeriodicalIF":3.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evidence of remdesivir in formerly hospitalized COVID-19 patients: patient-reported and functional outcomes.","authors":"Dorottya Fésü, Enikő Bárczi, Balázs Csoma, Lőrinc Polivka, Márton Boga, Gábor Horváth, János Tamás Varga, Szilvia Sebők, Veronika Müller","doi":"10.1186/s12879-024-10398-w","DOIUrl":"10.1186/s12879-024-10398-w","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID condition (PCC) is characterized by persisting symptoms after the resolution of acute COVID-19. Remdesivir (RDV), a broad-spectrum antiviral drug, has been widely used in patients hospitalized with COVID-19 requiring oxygen therapy. We aimed to evaluate the effects of RDV on PCC by assessing patient-reported and functional outcomes.</p><p><strong>Methods: </strong>We used the data from a single-center registry, including formerly hospitalized post-COVID patients (N = 293). Propensity score matching (PSM) was used (16 criteria, 1:1 ratio) to obtain two comparable groups: those who received standard-of-care (SOC, N = 94) and those treated with RDV in addition to SOC (SOC + RDV, N = 94). Primary outcomes were asymptomatic status and at least 50% symptom score reduction at post-COVID follow-up. Secondary outcomes included results of pulmonary function (PF) tests, 6-minute walk test (6MWT), and quality-of-life (QoL) questionnaires.</p><p><strong>Results: </strong>After PSM, baseline patient characteristics showed no significant differences between the two groups. Most patients were still symptomatic (60% vs. 66%). In the SOC + RDV group, the use of oxygen supplementation (94 vs. 80%, p = 0.005) and steroids (97 vs. 88%, p = 0.027) during infection were higher, while patients presented at their post-COVID visits earlier (median 68 vs. 97 days, p = 0.003). Complete or at least 50% symptom resolution were reported at a significantly earlier stage after infection in the SOC + RDV group compared to the SOC group (multivariable-adjusted HR = 2.28, 95% CI = 1.33-3.92, p = 0.003; and HR = 2.08, 95% CI = 1.43-3.02, p < 0.001; respectively). In the SOC + RDV group, fewer patients experienced sleep disturbances at PCC, and sleep-related questionnaires (Pittsburg Sleep Quality Index, PSQI) results showed significantly better sleep quality (14 vs. 27% and 5.9 vs. 7.7 points, respectively). There were no notable differences in results of PF tests, 6MWT, and other QoL questionnaires.</p><p><strong>Conclusion: </strong>In this propensity score matched cohort, the use of RDV was associated with earlier patient reported symptom resolution during the PCC period, while there were no notable differences in functional outcomes. Our results indicate a possible beneficial effect of RDV in terms of faster symptom resolution after COVID19 infection.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"43"},"PeriodicalIF":3.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics, outcomes, and costs of COVID-19 patients in Thai hospitels: a comparative analysis based on chest X-ray findings.","authors":"Naruemit Sayabovorn, Pochamana Phisalprapa, Weerachai Srivanichakorn, Thanet Chaisathaphol, Chaiwat Washirasaksiri, Tullaya Sitasuwan, Chonticha Auesomwang, Chayanis Kositamongkol, Pongpol Nimitpunya, Teerapat Attachitwatin, Methee Chayakulkeeree, Pakpoom Phoompoung, Cherdchai Nopmaneejumruslers, Tawatchai Taweemonkongsap, Visit Vamvanij, Rungsima Tinmanee","doi":"10.1186/s12879-025-10443-2","DOIUrl":"10.1186/s12879-025-10443-2","url":null,"abstract":"<p><strong>Background: </strong>\"Hospitels\" are hotels that have been specially converted to healthcare facilities. Their utilization emerged as a resource-optimization strategy during the peak of the COVID-19 pandemic in Thailand. This study evaluated the clinical characteristics, outcomes, and admission costs of asymptomatic and mild-to-moderate COVID-19 patients treated in these facilities.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of adult COVID-19 patients who were admitted between July and October 2021 to two hospitels in Bangkok that were affiliated with Siriraj Hospital. Patient demographics, clinical data, vaccination status, treatment modalities, outcomes, and total costs were collected and analyzed via univariable and multivariable statistical methods.</p><p><strong>Results: </strong>Of the 1729 patients, 644 (37.2%) presented with abnormal baseline chest X-rays that could imply to moderate cases. These patients were older (49.2 vs. 42.2 years, P < 0.001), had greater body weights (68.1 vs. 64.7 kg, P < 0.001) and body mass indices (26.3 vs. 24.9 kg/m², P < 0.001), and more frequently presented comorbidities. They demonstrated an increased risk for severe COVID-19 (P < 0.001), lower full vaccination rates (P < 0.001), and higher hospital referral rates (P < 0.001). Symptomatology was largely comparable between patients with normal and abnormal baseline chest X-rays, with significant differences noted only for cough and fatigue. While the admission costs of both groups were similar, the total costs for referred patients were sixfold greater than those for discharged patients (70 545 vs. 12 010 Thai Baht, P < 0.001).</p><p><strong>Conclusions: </strong>Compared with patients with normal baseline chest X-rays, COVID-19 patients with abnormal chest X-rays admitted to hospitels presented higher comorbidity rates, greater severe disease risk, and increased hospital referral rates. Referrals from the hospitels back to Siriraj Hospital substantially escalated the total costs. Vigilant monitoring of patients with initial abnormal chest X-rays in hospitels is crucial for efficient management and resource allocation.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"46"},"PeriodicalIF":3.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}