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Open Access April 10, 2025

Impact of Vaccination on Severe Outcomes in COVID-19 Reinfections and Breakthrough Infections

Abstract COVID-19 vaccines have demonstrated efficacy in reducing the prevalence of serious illnesses. The relative risk of hospitalization and mortality for patients who get breakthrough infections after immunization versus those who develop reinfections after a prior spontaneous infection is examined in this correspondence. Based on a study on U.S. Veterans who were not vaccinated and experienced [...] Read more.
COVID-19 vaccines have demonstrated efficacy in reducing the prevalence of serious illnesses. The relative risk of hospitalization and mortality for patients who get breakthrough infections after immunization versus those who develop reinfections after a prior spontaneous infection is examined in this correspondence. Based on a study on U.S. Veterans who were not vaccinated and experienced reinfections had a much higher risk of experiencing severe illness outcomes compared to those who had received immunizations and experienced breakthrough infections, even if the rates of reinfection and breakthrough infection were similar. Our findings highlight the value of immunization in reducing severe COVID-19 outcomes, even in the presence of reinfections.
Correspondence
Open Access January 10, 2025

Clinical characteristics of COVID-19 patients who received ventilator management during the omicron variant period in a tertiary hospital in Japan

Abstract Background: Severe COVID-19 patients who received ventilator management were not very rare even when the omicron variant became dominant, but the clinical characteristics of these patients are still unclear. Methods: The clinical characteristics of severe COVID-19 patients requiring ventilator management were retrospectively investigated from January 2023 to December 2023. [...] Read more.
Background: Severe COVID-19 patients who received ventilator management were not very rare even when the omicron variant became dominant, but the clinical characteristics of these patients are still unclear. Methods: The clinical characteristics of severe COVID-19 patients requiring ventilator management were retrospectively investigated from January 2023 to December 2023. Results: Severe COVID-19 patients who received ventilator management accounted for 11 of 275 (4.2%) patients during the omicron variant period. Their mean age was 70.7 (51-85) years, and males were predominant. Ten of eleven (91.7%) patients were managed in the emergency department and had underlying diseases, including chronic lung/heart/kidney diseases and neurological diseases. However, only 4 of 11 (36.4%) had a clear history of vaccination. The patients showed a positive SARS-CoV-2 antigen titer of 3305.7 (12.9-20912). All 11 patients were treated with remdesivir and dexamethasone, and 5 (45.5%) also received sotrovimab. Pathogenic bacteria were isolated from 7 of 11 (63.6%) patients, and all 11 patients were treated with antibiotics. Only 3 of 11 (27.3%) patients were managed using extracorporeal membrane oxygenation (ECMO), but 9 of 11(81.8%) patients survived. Conclusions: These data suggest that severe COVID-19 patients who required ventilator management were less-vaccinated, elderly patients with underlying disease. These patients were treated successfully using antiviral agents, steroids, neutralizing antibodies, and antibiotics, with a few also treated using ECMO in the omicron era.
Commentary
Open Access November 20, 2023

Ensitrelvir improved SARS-CoV-2 viral titers of COVID-19 patients refractory to remdesivir

Abstract Background: The titers of SARS-COV-2 antigens are frequently used as markers of viral activity and threshold for release from quarantine and treatment. COVID-19 patients were treated with several antiviral agents, including remdesivir (RDV) and ensitrelvir (ESV), which is a novel anti-SARS-CoV-2 agent recently suggested to have strong antiviral activity. Cases: We present the cases [...] Read more.
Background: The titers of SARS-COV-2 antigens are frequently used as markers of viral activity and threshold for release from quarantine and treatment. COVID-19 patients were treated with several antiviral agents, including remdesivir (RDV) and ensitrelvir (ESV), which is a novel anti-SARS-CoV-2 agent recently suggested to have strong antiviral activity. Cases: We present the cases of two patients whose SARS-CoV-2 antigens were successfully decreased by oral administration of ESV after they could not be decreased by RDV drip infusion. Case 1 was a 74-year-old man who was admitted with SARS-CoV-2 infection and had been infected by the virus a month earlier and relapsed twice. He had been treated with rituximab for diffuse B cell lymphoma and not received vaccination for SARS-CoV-2. RDV was administered intravenously two weeks earlier and again 4 days earlier, but it failed to control the infection, and he was transferred to our hospital (day 1). Intravenous RDV was restarted on day 1, but viral antigens remained high until day 5. The RDV was then switched to oral ESV, and viral antigen titers were successfully decreased on days 8, 10, and 12. Case 2 was an 81-year-old man who was admitted with SARS-CoV-2 infection on day 0. He had heart failure and diabetes mellitus, and had not received vaccination for SARS-CoV-2. Intravenous RDV was started on day 1, but viral antigens were still high until day 8. He was then switched from RDV to oral ESV, and viral antigen titers were successfully decreased on day 11. Conclusions: These cases suggest that ESV might be more effective than RDV for reducing viral activity, and it is easy to administer orally.
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Case Series
Open Access October 16, 2023

Clinical Characteristics and Imaging Findings of Adult COVID-19 and Influenza-related Pulmonary Complications due to Methicillin-susceptible Staphylococcus aureus

Abstract The pulmonary characteristics of Staphylococcus aureus (S. aureus) co-infection with respiratory viruses, such as SARS-CoV-2 and influenza virus, are still unclear. Case series: Two patients with methicillin-susceptible S. aureus [...] Read more.
The pulmonary characteristics of Staphylococcus aureus (S. aureus) co-infection with respiratory viruses, such as SARS-CoV-2 and influenza virus, are still unclear. Case series: Two patients with methicillin-susceptible S. aureus (MSSA) infection in the lungs co-infected with either SARS-CoV-2 or influenza virus are reported. Case 1 was a 66-year-old woman who was admitted with SARS-CoV-2 infection. Her chest X-ray and computed tomography (CT) showed multiple cavity formations with infiltration shadows, and MSSA was detected from her sputum and blood, suggesting COVID-19-related bacterial pneumonia and pulmonary embolism. No catheters had been used, but she had skin eruptions and a history of SARS-CoV-2 vaccination. Ampicillin/sulbactam (ABPC/SBT) was administered, and she finally improved. Case 2 was an 87-year-old man with a history of atopic dermatitis who was admitted with moderate pneumonia, and influenza virus co-infection was found. He showed multiple cavitary shadows, and MSSA was isolated from both his sputum and blood. He was diagnosed with influenza-related bacterial pulmonary embolism. No catheters had been used, but he had a history of influenza vaccination. He was also treated by ABPC/SBT and finally improved. Conclusions: These cases suggest that MSSA showed affinity to the lungs when co-infected with either SARS-CoV-2 or influenza virus, and it presented as septic emboli without catheter use. We should consider MSSA infection when patients have SARS-CoV-2 or influenza virus co-infection, and multiple cavity formation and skin disorders are seen, even though they were vaccinated and no catheters were used.
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Case Series
Open Access September 04, 2023

Management of Severe Acute Respiratory Syndrome-Corona Virus-2 infection in the Principality of Monaco

Abstract Background: This work is a report of the present situation and management of Corona Virus (CoV) infection in the Principality of Monaco. Methods: To comply with the practices adopted by the World Health Organization (WHO) and neighboring Countries in this area, residents infected by CoV are the object of this health report. The Prince’s Government also communicates the data relating to [...] Read more.
Background: This work is a report of the present situation and management of Corona Virus (CoV) infection in the Principality of Monaco. Methods: To comply with the practices adopted by the World Health Organization (WHO) and neighboring Countries in this area, residents infected by CoV are the object of this health report. The Prince’s Government also communicates the data relating to screening. These are stopped at Sunday January 1st included. Results: The results of this survey point out how this infection is still active in Monaco, although not at the emergency levels of 2020. Conclusions: These results call for not leaving prevention measures, both primary (vaccine) and secondary (personal protective equipment [PPE], social distancing, etc.) adopted until now and which gave so good results.
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Case Series
Open Access July 28, 2023

Should not we vaccinate the public against seasonal influenza all over the year in COVID-19 era?

Abstract The pandemic of the SARS-CoV2 (COVID-19) that was declared by the World Health Organization (WHO) on 11 March 2020 is still ongoing. One of the early recommendations from CDC and other international agencies is the seasonal influenza vaccination to decrease the effects and burden of COVID-19 pandemic. This review suggests that during COVID-19 pandemic vaccination against seasonal influenza should [...] Read more.
The pandemic of the SARS-CoV2 (COVID-19) that was declared by the World Health Organization (WHO) on 11 March 2020 is still ongoing. One of the early recommendations from CDC and other international agencies is the seasonal influenza vaccination to decrease the effects and burden of COVID-19 pandemic. This review suggests that during COVID-19 pandemic vaccination against seasonal influenza should be conducted all over the year, even for young age groups, because of several reasons. First, the complications of seasonal influenza, especially pneumonia, could increase the burden on the saturated healthcare systems worldwide. Second, the resemblance of symptoms and signs of both seasonal influenza and COVID-19 will difficult diagnosing and isolation of COVID-19 patients. Third, it has been postulated that there is a cross immunity between seasonal influenza and COVID-19.
Mini Review
Open Access November 29, 2022

The Application of Machine Learning in the Corona Era, With an Emphasis on Economic Concepts and Sustainable Development Goals

Abstract The aim of this article is to examine the impacts of Coronavirus Disease -19 (Covid-19) vaccines on economic condition and sustainable development goals. In other words, we are going to study the economic condition during Covid19. We have studied the economic costs of pandemic, benefits in terms of gross domestic product (GDP), public finances and employment, investment on vaccines around the [...] Read more.
The aim of this article is to examine the impacts of Coronavirus Disease -19 (Covid-19) vaccines on economic condition and sustainable development goals. In other words, we are going to study the economic condition during Covid19. We have studied the economic costs of pandemic, benefits in terms of gross domestic product (GDP), public finances and employment, investment on vaccines around the world, progress and totally the economic impacts of vaccines and the impacts of emerging markets (EM) on achieving sustainable development goals (SDGs), including no poverty, good health and well-being, zero hunger, reduced inequality etc. The importance of emerging economies in reducing the harmful effects of the Corona has also been noted. We have tried to do experimental results and forecast daily new death cases from Feb-2020 to Aug-2021 in Iran using Artificial Neural Network (ANN) and Beetle Antennae Search (BAS) algorithm as a case study with econometric models and regression analysis. The findings show that Covid19 has had devastating economic and health effects on the world, and the vaccine can be very helpful in eliminating these effects specially in long-term. We observed that there is inequality in the distribution of Corona vaccines in rich countries compared to poor which EM can decrease the gap between them. The results show that both models (i.e., Artificial intelligence (AI) and econometric models) almost have the same results but AI optimization models can robust the model and prediction. The main contribution of this article is that we have surveyed the impacts of vaccination from socio-economic viewpoint not just report some facts and truth. We have surveyed the impacts of vaccines on sustainable development goals and the role of EM in achieving SDGs. In addition to using the theoretical framework, we have also used quantitative and empirical results that have rarely been seen in other articles.
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Article
Open Access February 18, 2025

Late-Onset Rabies: A Case Report Highlighting the Importance of Prompt Medical Attention

Abstract Rabies is a virus present in more than 150 nations and territories worldwide, but it can be prevented through vaccination. Each year, tens of thousands of people die from rabies, primarily in Asia and Africa, with children under the age of 15 representing 40% of these fatalities. Up to 99% of rabies transmissions to humans occur through dog bites, making dogs the leading cause of rabies-related [...] Read more.
Rabies is a virus present in more than 150 nations and territories worldwide, but it can be prevented through vaccination. Each year, tens of thousands of people die from rabies, primarily in Asia and Africa, with children under the age of 15 representing 40% of these fatalities. Up to 99% of rabies transmissions to humans occur through dog bites, making dogs the leading cause of rabies-related deaths in humans. We present a fatal case of rabies after a 5-month exposure incident. The patient, a 55-year-old Nigerian missionary from Enugu state, Nigeria presented with restlessness, hydrophobia, occasional barking gestures, abdominal discomfort and agitation. His condition was said to have progressively worsened as patients was unable to eat and drink fluids for days. His wife reported that the patient had experienced a bite from a stray dog on his right arm 5 months before presentation, for which no antirabies prophylaxis was given. The patient died on the second day of admission to the hospital (within 7 days of symptom onset).
Case Report
Open Access October 02, 2022

Thoughts on Pneumococcal Vaccination for the Adult Individuals with Autoimmune Diseases

Abstract Streptococcus pneumoniae [...] Read more.
Streptococcus pneumoniae is an important pathogenic bacteria causing pneumonia and invasive pneumococcal diseases, and the vaccination for pneumococcal vaccination is recommended in patients with RA and other autoimmune disorders. Compared with the immunocompetent individuals, frequency and the mortality rate were higher in the RA patients. The effect of pneumococcal vaccination may not be weakened in people using corticosteroid and biological disease-modifying anti-rheumatic drug (DMARD) currently being used, but mild to relatively inhibition of immunogenicity was suggested in patients using either methotrexate or rituximab. Administration of 13-valent pneumococcal conjugate vaccine (PCV13), rather than 23-valent Pneumococcal polysaccharide vaccine (PPSV23) may be desirable in preventing pneumonia in people with autoimmune disease and sequential administration of PCV13 in people aged ≤64 years and PPSV23 from age ≥65 years may be useful for preventing pneumonia in people with autoimmune disease according to the insurance system. In addition, PCV15 and PCV 20 will be available soon and expected for more clinical efficiency rather than current PCV13 and PPSV23.
Mini Review
Open Access March 26, 2022

Healthcare Workers Should Receive Seasonal Influenza Vaccine during COVID-19 Pandemic?

Abstract It is known that seasonal influenza virus vaccination is important to be taken every year among healthcare workers (HCWs) to avoid transmission of influenza virus and its complications inside the workplace. The reason behind the importance of vaccination is that HCWs are at high risk to be infected with influenza virus. Among the studies addressing the rates of influenza vaccine status among HCWs, [...] Read more.
It is known that seasonal influenza virus vaccination is important to be taken every year among healthcare workers (HCWs) to avoid transmission of influenza virus and its complications inside the workplace. The reason behind the importance of vaccination is that HCWs are at high risk to be infected with influenza virus. Among the studies addressing the rates of influenza vaccine status among HCWs, a study was conducted in three Middle East countries where the vaccination rates were 24.7%, 67.2%, and 46.4% in United Arab Emirates, Kuwait, and Oman, respectively. Now, after the pandemic of COVID-19 there are beliefs that vaccination with influenza virus could decrease the deaths from COVID-19. A recent retrospective cohort study to detect the effect of seasonal influenza vaccine on the deaths among COVID-19 patients showed that the individuals who didn’t take the influenza vaccine in the last year before being infected with COVID-19 had a higher risk of being hospitalized when compared with patients who took the vaccine. In conclusion, seasonal influenza vaccine could have an important role in the prevention of COVID-19. Seasonal influenza vaccine coverage should be improved among HCWs. New tailored health education programs to improve the attitudes and beliefs of HCWs towards seasonal influenza vaccine during the era of COVID-19 are strongly and urgently needed.
Mini Review
Open Access December 09, 2021

The Quasi-paranoid Empathy of Healthcare Staff in a Generalized Covid-phobic Context in West Cameroon's Hospital Institutions

Abstract The present study raises the problem of empathy of caregivers vis-à-vis patients in a covid/post-covid context. It is based on the observation that health workers are increasingly invaded by excessive fear and persistence of COVID-19 contamination. This induces avoidance, a certain suspicion, persecution and indifference/coldness towards patients, and plunges them into a strong insidious emotional [...] Read more.
The present study raises the problem of empathy of caregivers vis-à-vis patients in a covid/post-covid context. It is based on the observation that health workers are increasingly invaded by excessive fear and persistence of COVID-19 contamination. This induces avoidance, a certain suspicion, persecution and indifference/coldness towards patients, and plunges them into a strong insidious emotional deficiency. These attitudes, which are significantly close to paranoid and phobic access, seem to gradually dominate therapeutic interactions within hospitals. Freudian and Rogerian psychoanalysis advocates empathetic/benevolent listening, positive consideration and unconditional acceptance of the patient as ethical and deontological indispensable principles for any therapeutic evolution. Thus, it is predicted that within hospitals, the current non empathetic attitudes of care towards patients have their origin in a generalized covid-phobic atmosphere that develops a quasi-dominant paranoia in caregivers. Using a subscale of caregiver's Covid-phobic quasi-paranoia, and the one of caregiver's empathy in a covid/post-covid context, the data were collected from 126 participants including 55 nursing assistants, 61 state-certified nurses and 10 doctors, chosen at random from the staff of three (03) health facilities in the city of Bafoussam, MIFI department, West Cameroon region, including one (01) public district medical center (CMA) and two (02) private hospitals (clinics). After analysis, the results obtained sufficiently demonstrate that within the health institutions of West Cameroon, the higher the professional level of the caregiver, the more the severity of his quasi-paranoid covid-phobic accesses is significant, and the less he expresses an authentic empathy towards the patients who arrive at the hospital. This implies that in this period of health crisis, caregivers must reinvest in a real function of providers of affectivity and relay of empathy at the bedside of the patient both in hospital and outpatient. Thus, a real systematical vaccination operation may insure their total immunity and better reduce their quasi-paranoid empathy in this generalized Covid-phobic context.
Article
Open Access November 10, 2021

A Note on Excess Mortality Attributable to COVID-19 in the United States

Abstract Background: Annual influenza outbreaks constitute a major public health concern in the United States. But this health burden appears dwarfed by the impact of COVID-19. Our aim is to quantify the excess mortality attributable to COVID-19, compared to previous influenza seasons. Methods: We retrospectively compare weekly mortality figures attributable to influenza and pneumonia in the [...] Read more.
Background: Annual influenza outbreaks constitute a major public health concern in the United States. But this health burden appears dwarfed by the impact of COVID-19. Our aim is to quantify the excess mortality attributable to COVID-19, compared to previous influenza seasons. Methods: We retrospectively compare weekly mortality figures attributable to influenza and pneumonia in the United States from 2013 to 2019 with corresponding figures attributable to influenza, pneumonia, and COVID-19 from 2019 to 2021. We utilize a difference in differences regression methodology to estimate excess mortality observed in 2019-21 compared to 2013-2019. Results: Mortality patterns attributable to influenza, pneumonia, and COVID-19 differ significantly from the 2013-19 experience. Notably, distinct, aperiodic mortality waves occur in the 2019-2021 window, and mortality is well in excess of what is observed in typical influenza seasons. Conclusions: The COVID-19 pandemic has led to considerable excess mortality in the United States, and has strained public health resources. One might expect that the mortality waves observed during the pandemic will be damped by increasing levels of vaccination, and prior infections.
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Brief Report
Open Access August 15, 2021

Prevention is always better than Cure: Immunity Boosting to Fight Infections

Abstract Since the first outbreak of SARS-CoV2, Severe Acute Respiratory Syndrome Coronavirus-2 in Wuhan, China in the December 2019, the world continues to be in state of fear, uncertainty, tension and anxiety till date and this state might continue because of emerging mutants. The vaccination drive all over the world is continuing, still the new variants are cause of concern, with the aim to prevent the [...] Read more.
Since the first outbreak of SARS-CoV2, Severe Acute Respiratory Syndrome Coronavirus-2 in Wuhan, China in the December 2019, the world continues to be in state of fear, uncertainty, tension and anxiety till date and this state might continue because of emerging mutants. The vaccination drive all over the world is continuing, still the new variants are cause of concern, with the aim to prevent the spread of the virus, focus should be on techniques and processes which helps in strengthening our defense mechanism, the immune system. It has becoming clear from several studies that the immune system is greatly impacted by the COVID-19 infection through several inflammatory reactions. The role of balanced diet full of nutrients cannot be overlooked in controlling infectious diseases. A balanced diet which should include plant foods, vitamins and micronutrients and this review wants to emphasize on the preventive role played by the plant foods, vitamins and minerals in COVID-19 infections, to reduce the mortality rate as well as the morbidity in patients who are infected.
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