المؤلفون: Myeongji Kim, Ayesha Jalal, Heysu Rubio-Gomez, Romina Bromberg

المصدر: BMC Infectious Diseases, Vol 22, Iss 1, Pp 1-5 (2022)

مصطلحات موضوعية: Herpes simplex virus, Disseminated infection, Multi-organ failure, Acyclovir, Case report, Infectious and parasitic diseases, RC109-216

الوصف: Abstract Background Herpes simplex virus (HSV) rarely causes organ-invasive infection. Diagnosis and treatment for such infections are often delayed, and mortality is high. We present the first reported case of disseminated HSV-1 infection in an adult causing liver failure, myocarditis, and encephalitis in a patient who recovered after receiving parenteral acyclovir treatment. Case presentation A 46-year-old female presented with fever, chills, and malaise after 2 weeks of oral corticosteroid treatment for uveitis. She was diagnosed with disseminated HSV-1 infection with multi-organ involvement causing hepatitis, encephalitis, and myocarditis. Diagnosis was made timely using serum polymerase chain reaction (PCR) for HSV DNA and the patient was given intravenous acyclovir treatment promptly, which led to her survival without significant morbidity. Conclusions Clinicians should have a low threshold for suspecting HSV infection and ordering HSV PCR to decrease morbidity and mortality when there is a high clinical suspicion of systemic HSV infection with multi-organ involvement. Serum PCR for HSV DNA is an excellent modality for an initial diagnostic approach. Further research is warranted to elucidate causality between a course of corticosteroid therapy and systemic HSV-1 infection without major immunosuppressive comorbidities or treatments.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2334Test

الوصول الحر: https://doaj.org/article/17017b1050334570b1692fe1bb54cc60Test

المؤلفون: Jianli Niu, Myeongji Kim, Ayesha T. Jalal, Jessica E. Goldberg, Elsa M. Acevedo Martinez, Nathalie P. Suarez Moscoso, Heysu Rubio-Gomez, Daniel Mayer, Alvaro Visbal, Candice Sareli, Paula A. Eckardt, Aharon E. Sareli

المصدر: Healthcare, Vol 11, Iss 12, p 1703 (2023)

مصطلحات موضوعية: COVID-19, Omicron variant, hospitalizations, incidental COVID-19, in-hospital mortality, intensive care services, Medicine

الوصف: The COVID-19 Omicron variant has imposed a tremendous burden on healthcare services. We characterized the types of the Omicron variant-associated hospitalizations and their associations with clinical outcomes. Consecutive adults hospitalized with COVID-19 during the Omicron variant surge period of 1–14 January 2022, were classified into one of three groups based on their clinical presentations on admission: Group 1—primary COVID-19; Group 2—extrapulmonary manifestations of COVID-19; and Group 3—incidental COVID-19. Of the 500 patients who were hospitalized, 51.4% fell into Group 1, 16.4% into Group 2, and 32.2% into Group 3. The patients in Groups 1 and 2 were older, with higher proportions of comorbidities than patients in Group 3. The Group 1 patients had the highest mortality rate (15.6%), followed by Group 2 (8.5%), and Group 3 (0.6%), with adjusted odds ratios (OR) of 22.65 (95% confidence interval [CI], 2.75–239.46; p = 0.004) and 10.95 (95% CI, 1.02–117.28; p = 0.048), respectively, compared to Group 3. Those in Group 1 showed a greater utilization of intensive care services (15.9%), followed by Group 2 (10.9%), and Group 3 (2.5%), with adjusted ORs of 7.95 (95% CI, 2.52–25.08; p < 0.001) and 5.07 (95% CI, 1.34–19.15; p = 0.017), respectively, compared to Group 3. The patients in Groups 1 and 2 had longer hospitalization stays than the patients in Group 3 (p < 0.001 and p = 0.002, respectively). Older age (≥65 years) was an independent factor associated with longer hospital stays (OR = 1.72, 95% CI, 1.07–2.77). These findings can help hospitals prioritize patient care and service planning for future SARS-CoV-2 variants.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2227-9032/11/12/1703Test; https://doaj.org/toc/2227-9032Test

الوصول الحر: https://doaj.org/article/192310e901dc48e6838e04092f3ee73eTest

المؤلفون: Jose A. Rodriguez, Heysu Rubio-Gomez, Alejandra A. Roa, N. Miller, Paula A. Eckardt

المصدر: IDCases, Vol 20, Iss , Pp e00762- (2020)

مصطلحات موضوعية: SARS-COV-2, Parainfluenza virus, COVID-19, Pneumonia, Coinfection, Infectious and parasitic diseases, RC109-216

الوصف: Coronavirus 2 (SARS-CoV-2) is now considered a pandemic causing Coronavirus disease (COVID-19), multiple fatalities and morbidities which have been associated with it worldwide. We report a severe pneumonia causing acute respiratory distress syndrome due to a coinfection with SARS-COV-2 and Parainfluenza 4 virus in a Hispanic 21 year old male in Florida, USA. The case represents the importance of prompt diagnosis and awareness of the potential co-infection with other respiratory viruses and this novel deadly virus.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2214250920300706Test; https://doaj.org/toc/2214-2509Test

الوصول الحر: https://doaj.org/article/5ad03e36276f42d097c8325f9d0aba7cTest

المؤلفون: Sareli, Jianli Niu, Myeongji Kim, Ayesha T. Jalal, Jessica E. Goldberg, Elsa M. Acevedo Martinez, Nathalie P. Suarez Moscoso, Heysu Rubio-Gomez, Daniel Mayer, Alvaro Visbal, Candice Sareli, Paula A. Eckardt, Aharon E.

المصدر: Healthcare; Volume 11; Issue 12; Pages: 1703

مصطلحات موضوعية: COVID-19, Omicron variant, hospitalizations, incidental COVID-19, in-hospital mortality, intensive care services

الوصف: The COVID-19 Omicron variant has imposed a tremendous burden on healthcare services. We characterized the types of the Omicron variant-associated hospitalizations and their associations with clinical outcomes. Consecutive adults hospitalized with COVID-19 during the Omicron variant surge period of 1–14 January 2022, were classified into one of three groups based on their clinical presentations on admission: Group 1—primary COVID-19; Group 2—extrapulmonary manifestations of COVID-19; and Group 3—incidental COVID-19. Of the 500 patients who were hospitalized, 51.4% fell into Group 1, 16.4% into Group 2, and 32.2% into Group 3. The patients in Groups 1 and 2 were older, with higher proportions of comorbidities than patients in Group 3. The Group 1 patients had the highest mortality rate (15.6%), followed by Group 2 (8.5%), and Group 3 (0.6%), with adjusted odds ratios (OR) of 22.65 (95% confidence interval [CI], 2.75–239.46; p = 0.004) and 10.95 (95% CI, 1.02–117.28; p = 0.048), respectively, compared to Group 3. Those in Group 1 showed a greater utilization of intensive care services (15.9%), followed by Group 2 (10.9%), and Group 3 (2.5%), with adjusted ORs of 7.95 (95% CI, 2.52–25.08; p < 0.001) and 5.07 (95% CI, 1.34–19.15; p = 0.017), respectively, compared to Group 3. The patients in Groups 1 and 2 had longer hospitalization stays than the patients in Group 3 (p < 0.001 and p = 0.002, respectively). Older age (≥65 years) was an independent factor associated with longer hospital stays (OR = 1.72, 95% CI, 1.07–2.77). These findings can help hospitals prioritize patient care and service planning for future SARS-CoV-2 variants.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=multidiscipl::5a0cf3e4c3d84248dc4e6d7340c29065Test

المؤلفون: Jianli Niu, Myeongji Kim, Ayesha T Jalal, Jessica E Goldberg, Elsa M Acevedo Martinez, Nathalie P Suarez Moscoso, Heysu Rubio-Gomez, Daniel Mayer, Alvaro Visbal, Candice Sareli, Paula A Eckardt, Aharon E Sareli

المصدر: Open Forum Infectious Diseases. 9

مصطلحات موضوعية: Infectious Diseases, Oncology

الوصف: Background Patients infected with COVID-19 Omicron variant, may be hospitalized for reasons other than COVID-19 pneumonia. We describe the clinical presentations of hospitalized adult patients with COVID-19 Omicron variant in a large healthcare system in South Florida. Methods Laboratory-confirmed COVID-19 adult patients hospitalized during January 1-14, 2022 were retrospectively reviewed. Clinical presentations were divided into one of three admission groups: COVID-19 pneumonia or respiratory infection (Group 1), severe extrapulmonary manifestations of COVID-19 (Group 2), and completely incidental diagnosis of COVID-19 (Group 3). Risks of in-hospital mortality and intensive care admission were estimated using logistic regression models. Results Among 500 consecutively hospitalized COVID-19 Omicron patients, the median age was 69 (IQR, 53-80) years, and 271 (54.2%) were women. The most common comorbidities were hypertension (326; 65.5%), diabetes (160; 32%), and chronic kidney disease (120; 24%). 260 (52%) patients were fully vaccinated (defined as a patient who received 2-dose vaccines), and 32 (6.4%) were previously infected with COVID-19. 257(51.4%) patients were classified as Group 1, 82 (16.4%) in Group 2, and 161 (32.2%) in Group 3 (Figure 1). Compared to Group 3, patients in Group 1 and Group 2 had a higher risk for ICU admission, with odds ratios (ORs) of 7.45 (95% CI, 2.62-21.23; p< 0.001) and 4.84 (95% CI, 1.44-16.23; p=0.011), and for in-hospital mortality, with ORs of 27.76 (95% CI, 3.78-204.3; p=0.001) and 12.63 (95% CI, 1.49-106.78; p=0.020), respectively (Figure 2). In multivariable-adjusted models, patients in Group 1 remained at higher risk for ICU admission and in-hospital mortality compared to Group 3, while patients in Group 2 remained at a higher risk for ICU admission, but with no difference in in-hospital mortality compared to Group 3 (Figure 2). Figure 1.Clinical characteristics of consecutively hospitalized patients stratified by clinical presentations at admission.Figure 2.Crude (Upper panel) and multivariable-adjusted (Lower panel) odds ratios for ICU admission and in-hospital mortality from logistic regression models. Group 3 represents patients with a completely incidental diagnosis of COVID-19. The variables included in the final multivariable models were age, gender, history of hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease, malignancy, transplantation, HIV, vaccination status, and previous SARS-CoV-2 infection. Conclusion This case series illustrates the clinical presentations of hospitalized adult patients infected with the COVID-19 Omicron variant. Significant differences in in-hospital mortality and ICU admission exist when comparing patients admitted for a COVID-19 related respiratory infection to those admitted with a completely incidental COVID-19 diagnosis. Disclosures All Authors: No reported disclosures.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::37c7667c693584c7662bf5e2b5c4adb5Test
https://doi.org/10.1093/ofid/ofac492.331Test

المؤلفون: Paula A Eckardt, Myeongji Kim, Ayesha T Jalal, Jessica E Goldberg, Elsa M Acevedo Martinez, Nathalie P Suarez Moscoso, Heysu Rubio-Gomez, Daniel Mayer, Alvaro Visbal, Candice Sareli, Jianli Niu, Aharon E Sareli

المصدر: Open Forum Infectious Diseases. 9

مصطلحات موضوعية: Infectious Diseases, Oncology

الوصف: Background The SARS-CoV-2 Omicron variant has been rapidly spreading worldwide. We aimed to characterize Omicron severity by assessing in-hospital deaths and intensive care admissions in a large healthcare system in South Florida during an Omicron predominant surge. Methods Laboratory-confirmed COVID-19 adult patients hospitalized during January 1—14, 2022 were retrospectively reviewed. Risks of in-hospital mortality and intensive care admission were estimated using logistic regression models. Analyses were stratified by age ≥ 65 years and vaccination status, and further adjusted for sex, comorbidities, and history of a previous COVID-19 infection. Results 500 consecutively hospitalized COVID-19 Omicron patients were included. The median age was 69 (IQR, 53-80) years, and 271 (54.2%) were women. The most common comorbidities were hypertension (65.5%), diabetes (32%), and chronic kidney disease (24%). 260 (52%) patients were fully vaccinated (defined as a patient who received 2-dose vaccines), and 32 (6.4%) were previously infected with COVID-19. 252 (50.4%) patients required supplemental oxygen, 54 (10.8%) required intensive care unit (ICU) admission, and 44 (8.8%) patients required mechanical ventilation. At study closeout of March 7, 2022, case fatality rates among patients aged 18–29 years, 30–39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥ 80 years were 0%, 2.2%, 6.4%, 5.3%, 8.0%, 5.7%, and 15.4% respectively (p< 0.001), with the median time from hospital admission to death being 13 days (IQR, 6.5-20.5) (Figure 1). Patients aged ≥ 65 years had 2.6 times higher rates for in-hospital mortality (OR, 2.63; 95% CI, 1.29-5.33; p=0.007) than those aged < 65 years, but were comparable for ICU admission (OR, 0.85; 95% CI, 0.49-1.52; p=0.586). Past vaccination offered no protection against in-hospital mortality (OR, 1.18; 95% CI, 0.64-2.19; p=0.599) or ICU admission (OR, 1.16; 95% CI, 0.66-2.06; p=0.6) (Figure 2). In multivariable-adjusted models, patients aged ≥ 65 years had a higher in-hospital mortality than those aged < 65 years (Figure 2). Figure 1.Left: Distributions of survivors and non-survivors among hospitalized COVID-19 Omicron patients at different age groups; Right: Death curve of non-survivors with COVID-19 omicron in the South Florida area, January 1-14, 2022.Figure 2.Forest plots showing association of age and vaccination status with COVID-19 Omicron patient outcomes. Results were reported as odds ratios (OR,•) with 95% confidence intervals (CIs, horizontal lines), adjusted for sex-, diabetes, hypertension, COPD, chronic kidney disease, coronary heart disease, active malignancy, history of malignancy, history of solid organ transplantation, history of bone marrow transplantation, HIV, and previous SARS-CoV-2 infection. A-B. In-hospital mortality (death); C-D. ICU admission. ICU, intensive care unit. Conclusion This case series provides characteristics and outcomes of hospitalized adult patients with COVID-19 Omicron variant. Past COVID-19 vaccination did not impact ICU admission rate nor in-hospital mortality. Disclosures All Authors: No reported disclosures.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::92253b6c3174d19a58aba12ec34b5692Test
https://doi.org/10.1093/ofid/ofac492.893Test

المؤلفون: Myeongji Kim, Kenneth K. Poon, Nancimae Miller, Heysu Rubio-Gomez

المصدر: The American Journal of Case Reports

مصطلحات موضوعية: COVID-19 Vaccines, SARS-CoV-2, Reinfection, Florida, COVID-19, Humans, Female, Articles, General Medicine, Middle Aged, SARS-CoV-2 Variants, United States

الوصف: Patient: Female, 48-year-old Final Diagnosis: COVID 19 infection Symptoms: Cough • diarrhea • dyspena • fatigue • fever • headache • lightheadedness • nausea • sore throat • vomiting Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Unusual clinical course Background: During the global Coronavirus Disease-2019 (COVID-19) pandemic, the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have identified and monitored variants of concerns (VOCs) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). P.1 (Gamma) variant was initially identified in northern Brazil but has now spread worldwide. This is a report of a 48-year-old female resident of southern Florida with confirmed reinfection with P.1 variant 9 months following the initial infection. This patient was not immunocompromised and was not vaccinated. Case Report: A 48-year-old woman residing in southern Florida presented with symptoms of COVID-19 and tested positive for SARS-CoV-2 with oral swab polymerase chain reaction (PCR) in September 2020. Her symptoms resolved spontaneously after 5 days. Nine months later, the patient again presented with respiratory, digestive, and constitutional symptoms. The nasopharyngeal swab SARS-CoV-2 PCR was positive. At that time, she had not received any vaccinations against SARS-CoV-2. Whole-genome sequencing (WGS) of viral RNA from the patient’s second infection confirmed that the viral strain was P.1 variant containing the E484K spike protein substitution. Conclusions: This report has identified a confirmed case of reinfection with P.1 variant of SARS-CoV-2 outside Brazil. This case supports recent epidemiological findings that indicate this VOC may have increased infectivity and virulence, and highlights the importance of SARS-CoV-2 vaccination for everyone.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7c981908e9daac7ef082d506542bb8ccTest
https://doi.org/10.12659/ajcr.935329Test

المؤلفون: Shahnaz Fatteh, Mariya Fatakhova, Diana C. Andrade, Heysu Rubio-Gomez

المصدر: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. 27(4)

مصطلحات موضوعية: medicine.medical_specialty, Bone marrow transplant, viruses, medicine.medical_treatment, Acyclovir, Antiviral Agents, Drug Hypersensitivity, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Pharmacology (medical), Angioedema, Desensitization (medicine), Aged, Bone Marrow Transplantation, business.industry, virus diseases, Herpes Simplex, Oncology, Desensitization, Immunologic, 030220 oncology & carcinogenesis, Female, business, 030215 immunology

الوصف: Introduction The incidence of acyclovir-induced hypersensitivity is rare. To our knowledge, there are four published case reports of oral acyclovir desensitization in adults. Evidence-based guidelines prompt the use of acyclovir for herpes simplex virus (HSV) prophylaxis and treatment. Literature on the cross-reactivity of structurally similar antiviral agents is conflicting, presenting a clinical challenge when choosing an alternative agent. This is a case of successful acyclovir desensitization in an allogeneic stem cell transplant patient. Case Report A 69-year-old female patient, diagnosed with myelodysplastic/myeloproliferative neoplasm, presented to the hospital for donor mismatch allogeneic bone marrow transplant. The patient reported acyclovir-induced angioedema while receiving treatment for non-complicated herpes zoster (shingles) infection. Management & Outcome: After the acyclovir oral desensitization was conducted in an ICU setting with 1:1 patient-nurse ratio, the patient was successfully started on acyclovir therapy, 800mg by mouth twice daily for HSV prophylaxis with no further complications. Discussion: Oral acyclovir desensitization can provide an option for HSV therapy in patients reporting severe allergy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5b4c02aa86fef27a550d76223c499d4dTest
https://pubmed.ncbi.nlm.nih.gov/32955996Test

المؤلفون: Paula A Eckardt, Heysu Rubio-Gomez, Alejandra A Roa, Jose A Rodriguez, N. Miller

المصدر: IDCases
IDCases, Vol 20, Iss, Pp e00762-(2020)

مصطلحات موضوعية: 0301 basic medicine, Pediatrics, medicine.medical_specialty, viruses, 030106 microbiology, Disease, SARS-COV-2, Infectious and parasitic diseases, RC109-216, medicine.disease_cause, Virus, Article, Parainfluenza virus, 03 medical and health sciences, 0302 clinical medicine, Pandemic, medicine, 030212 general & internal medicine, Young adult, Respiratory system, Coronavirus, business.industry, Coinfection, virus diseases, COVID-19, Pneumonia, medicine.disease, respiratory tract diseases, Infectious Diseases, business

الوصف: Coronavirus 2 (SARS-CoV-2) is now considered a pandemic causing Coronavirus disease (COVID-19), multiple fatalities and morbidities which have been associated with it worldwide. We report a severe pneumonia causing acute respiratory distress syndrome due to a coinfection with SARS-COV-2 and Parainfluenza 4 virus in a Hispanic 21 year old male in Florida, USA. The case represents the importance of prompt diagnosis and awareness of the potential co-infection with other respiratory viruses and this novel deadly virus.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cc5cc44fd912ee972ac5448b83611241Test