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2.
PNAS Nexus ; 3(7): pgae245, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39015547

RESUMEN

The emergence of large language models (LLMs) has sparked considerable interest in their potential application in psychological research, mainly as a model of the human psyche or as a general text-analysis tool. However, the trend of using LLMs without sufficient attention to their limitations and risks, which we rhetorically refer to as "GPTology", can be detrimental given the easy access to models such as ChatGPT. Beyond existing general guidelines, we investigate the current limitations, ethical implications, and potential of LLMs specifically for psychological research, and show their concrete impact in various empirical studies. Our results highlight the importance of recognizing global psychological diversity, cautioning against treating LLMs (especially in zero-shot settings) as universal solutions for text analysis, and developing transparent, open methods to address LLMs' opaque nature for reliable, reproducible, and robust inference from AI-generated data. Acknowledging LLMs' utility for task automation, such as text annotation, or to expand our understanding of human psychology, we argue for diversifying human samples and expanding psychology's methodological toolbox to promote an inclusive, generalizable science, countering homogenization, and over-reliance on LLMs.

3.
Sci Total Environ ; 939: 173581, 2024 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-38810750

RESUMEN

Black carbon (BC) is a component of fine particulate matter (PM2.5) that is a key contributor to adverse human health effects and climate forcing. To date, BC mass concentrations and possible sources in Kazakhstan have not been studied. Thus, understanding the temporal variations of BC for a large developing region with a complex climate is useful. In this study, measurements of fine particulate BC mass concentrations in Astana were made from June 2020 to October 2021 by measuring light absorption of PM2.5 on filters. The mean BC concentration was 2.56 ± 1.29 µg m-3 with maximum and minimum monthly mean BC concentrations being 4.56 ± 2.03 µg m-3 and 1.12 ± 0.42 µg m-3 in January 2021 and June 2020, respectively. Temporal analyses of BC, SO2, PM10, NOx, CO, meteorological and atmospheric stability parameters were performed. Aggregated pollutant 'episodic loadings' during the heating and non-heating periods were identified. Their relationships with blocking anticyclones and cyclones were investigated by examining the reversal of meridional gradients at 500 hPa geopotential height (GPH) maps and identifying Omega (Ω) and Rex blocking types. Astana has some of the highest BC concentrations of cities worldwide. Seasonal BC source location identification using Conditional Bivariate Probability Function (CBPF) analysis implicated combined heat and power (CHP) plant emissions as the major BC source in Astana. Significant increases in BC concentrations were observed during the cold season due to numerous sources, generally poorer atmospheric dispersion and blocking events. The Concentration Weighted Trajectory (CWT) analysis results showed that the distribution of the 75th percentile of BC during episodic periods actively controlled by blockings exceeding than the entire measurement period, which may reflect cross-border transport and adjacent countries.

4.
Sci Rep ; 14(1): 10399, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38710723

RESUMEN

Emissions of ultrafine particles (UFPs; diameter < 100 nm) are strongly associated with traffic-related emissions and are a growing global concern in urban environments. The aim of this study was to investigate the variations of particle number concentration (PNC) with a diameter > 10 nm at nine stations and understand the major sources of UFPs (primary vs. secondary) in Tehran megacity. The study was carried out in Tehran in 2020. NOx and PNC were reported from a total of nine urban site locations in Tehran and BC concentrations were examined at two monitoring stations. Data from all stations showed diurnal changes with peak morning and evening rush hours. The hourly PNC was correlated with NOx. PNCs in Tehran were higher compared to those of many cities reported in the literature. The highest concentrations were at District 19 station (traffic) and the lowest was at Punak station (residential) such that the average PNC varied from 8.4 × 103 to 5.7 × 104 cm-3. In Ray and Sharif stations, the average contributions of primary and secondary sources of PNC were 67 and 33%, respectively. Overall, we conclude that a decrease in primary emission leads to a decrease in the total concentration of aerosols, despite an increase in the formation of new particles by photo nucleation.

6.
Antibiotics (Basel) ; 13(4)2024 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-38666996

RESUMEN

Antimicrobial resistance is a global healthcare threat with significant clinical and economic consequences peaking at secondary and tertiary care hospitals where multidrug-resistant Gram-negative bacteria (MDR GNB) lead to poor outcomes. A prospective study was conducted between January and December 2019 for all invasive bloodstream infections (BSIs) secondary to MDR GNB in Qatar identified during routine microbiological service to examine their clinical, microbiological, and genomic characteristics. Out of 3238 episodes of GNB BSIs, the prevalence of MDR GNB was 13% (429/3238). The predominant MDR pathogens were Escherichia coli (62.7%), Klebsiella pneumoniae (20.4%), Salmonella species (6.6%), and Pseudomonas aeruginosa (5.3%), while out of 245 clinically evaluated patients, the majority were adult males, with the elderly constituting almost one-third of the cohort and with highest observed risk for prolonged hospital stays. The risk factors identified included multiple comorbidities, recent healthcare contact, previous antimicrobial therapy, and admission to critical care. The in-hospital mortality rate was recorded at 25.7%, associated with multiple comorbidities, admission to critical care, and the acquisition of MDR Pseudomonas aeruginosa. Resistant pathogens demonstrated high levels of antimicrobial resistance but noticeable susceptibility to amikacin and carbapenems. Genomic analysis revealed that Escherichia coli ST131 and Salmonella enterica ST1 were the predominant clones not observed with other pathogens.

7.
Infection ; 52(3): 1125-1141, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38388854
8.
Clin Microbiol Infect ; 30(4): 492-498, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37858867

RESUMEN

OBJECTIVES: To evaluate the safety and efficacy of switching from intravenous (IV) to oral antimicrobial therapy in patients with Enterobacterales bacteraemia, after completion of 3-5 days of microbiologically active IV therapy. METHODS: A multicentre, open-label, randomized trial of adults with monomicrobial Enterobacterales bacteraemia caused by a strain susceptible to ≥1 oral beta-lactam, quinolone, or trimethoprim/sulfamethoxazole. Inclusion criteria included completion of 3-5 days of microbiologically active IV therapy, being afebrile and haemodynamically stable for ≥48 hours, and absence of an uncontrolled source of infection. Pregnancy, endocarditis, and neurological infections were exclusion criteria. Randomization, stratified by urinary source of bacteraemia, was to continue IV (IV Group) or to switch to oral therapy (Oral Group). Agents and duration of therapy were determined by the treating physicians. The primary endpoint was treatment failure, defined as death, need for additional antimicrobial therapy, microbiological relapse, or infection-related re-admission within 90 days. Non-inferiority threshold was set at 10% in the 95% CI for the difference in the proportion with treatment failure between the Oral and IV Groups in the modified intention-to-treat population. The protocol was registered at ClinicalTrials.gov (NCT04146922). RESULTS: In the modified intention-to-treat population, treatment failure occurred in 21 of 82 (25.6%) in the IV Group, and 18 of 83 (21.7%) in the Oral Group (risk difference -3.7%, 95% CI -16.6% to 9.2%). The proportions of subjects with any adverse events (AE), serious AE, or AE leading to treatment discontinuation were comparable. DISCUSSION: In patients with Enterobacterales bacteraemia, oral switch, after initial IV antimicrobial therapy, clinical stability, and source control, is non-inferior to continuing IV therapy.


Asunto(s)
Bacteriemia , Quinolonas , Adulto , Humanos , Antibacterianos/efectos adversos , Bacteriemia/tratamiento farmacológico , Bacteriemia/microbiología , Insuficiencia del Tratamiento , Administración Intravenosa , Resultado del Tratamiento
9.
J Infect Public Health ; 17(1): 152-162, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38029491

RESUMEN

BACKGROUND: The use of ill-suited antibiotics is a significant risk factor behind the increase in the mortality, morbidity, and economic burden for patients who are under treatment for hematological malignancy (HM) and bloodstream infections (BSI). Such unfitting treatment choices intensify the evolution of resistant variants which is a public health concern due to possible healthcare-associated infection spread to the general population. Hence, this study aims to evaluate antibiograms of patients with BSI and risk factors associated with septicemia. METHODS: A total of 1166 febrile neutropenia episodes (FNE) among 513 patients with HM from the National Center for Cancer Care and Research (NCCCR), Qatar, during 2009-2019 were used for this study. The socio-demographic, clinical, microbial, and anti-microbial data retrieved from the patient's health records were used. RESULTS: We analyzed the sensitivity of gram-negative and gram-positive bacilli reported in HM-FN-BSI patients. Out of the total 512 microorganisms isolated, 416 (81%) were gram-negative bacteria (GNB), 76 (15%) were gram-positive bacteria (GPB) and 20 (4%) were fungi. Furthermore, in 416 GNB, 298 (71.6%) were Enterobacteriaceae sp. among which 121 (41%) were ESBL (Extended Spectrum Beta-Lactamase) resistant to Cephalosporine third generation and Piperacillin-Tazobactam, 54 (18%) were Carbapenem-resistant or multidrug-resistant organism (MDRO). It's noteworthy that the predominant infectious agents in our hospital include E. coli, Klebsiella species, and P. aeruginosa. Throughout the study period, the mortality rate due to BSI was 23%. Risk factors that show a significant correlation with death are age, disease status, mono or polymicrobial BSI and septic shock. CONCLUSION: Decision pertaining to the usage of antimicrobials for HM-FN-BSI patients is a critical task that relies on the latest pattern of prevalence, treatment resistance, and clinical outcomes. Analysis of the antibiogram of HM-FN-BSI patients in Qatar calls for a reconsideration of currently followed empirical antibiotic therapy towards better infection control and antimicrobial stewardship.


Asunto(s)
Bacteriemia , Neutropenia Febril , Neoplasias Hematológicas , Sepsis , Humanos , Escherichia coli , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Bacteriemia/microbiología , Bacterias Gramnegativas , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Neoplasias Hematológicas/complicaciones , Neoplasias Hematológicas/microbiología , Neoplasias Hematológicas/terapia , Sepsis/tratamiento farmacológico , Sepsis/epidemiología , Sepsis/complicaciones , Fiebre/tratamiento farmacológico , Pseudomonas aeruginosa , Klebsiella , Estudios Retrospectivos , Neutropenia Febril/tratamiento farmacológico , Neutropenia Febril/epidemiología , Neutropenia Febril/microbiología
10.
Leuk Lymphoma ; 65(2): 199-208, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37966980

RESUMEN

Since the beginning of the COVID-19 pandemic, there has been an overall improvement in patient mortality. However, haematological malignancy patients continue to experience significant impacts from COVID-19, including high rates of hospitalization, intensive care unit (ICU) admissions, and mortality. In comparison to other haematological malignancy patients, individuals with chronic myeloid leukemia (CML) generally have better prognosis. This study, conducted using a large haematological malignancy patient database (EPICOVIDEHA), demonstrated that the majority of CML patients experienced mild infections. The decline in severe and critical infections over the years can largely be attributed to the widespread administration of vaccinations and the positive response they elicited. Notably, the mortality rate among CML patients was low and exhibited a downward trend in subsequent years. Importantly, our analysis provided confirmation of the effectiveness of vaccinations in CML patients.


Asunto(s)
COVID-19 , Neoplasias Hematológicas , Leucemia Mielógena Crónica BCR-ABL Positiva , Humanos , Pandemias , Leucemia Mielógena Crónica BCR-ABL Positiva/epidemiología , Hospitalización
11.
Qatar Med J ; 2023(3): 15, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37565045

RESUMEN

BACKGROUND: Bronchial asthma affects about 20% of Qatar's population. The impact of asthma on COVID-19 outcomes is controversial. The aim of this study was to explore the impact of asthma on COVID-19 outcomes and the predictors of COVID-19-related morbidity and mortality in a cohort of asthma patients infected by COVID-19. METHODS: This is a retrospective cohort study of adult patients with asthma infected with COVID-19, who were recruited from Hamad Medical Corporation (HMC), the main healthcare system in Qatar. Patients were matched to a control group of non-asthmatic COVID-19 patients (1:2) based on sex, age, and other comorbidities. RESULTS: Between March and August 2020, 616 patients with asthma met the inclusion criteria. The need for hospitalization among patients with asthma was independently associated with older age (adjusted odds ratio [aOR] for 10 years, 1.32; 95% confidence interval [CI], 1.13-1.54; p = 0.001) and hypertension (aOR, 2.4; 95% CI, 1.43-3.93; p = 0.001) but not with the use of inhaled corticosteroids (ICS), long-acting beta2 agonists, montelukast, or tiotropium. Patients with asthma required less hospitalization for COVID-19 than non-asthmatic patients (28.2% vs. 37.3%, respectively; aOR, 0.59; 95% CI, 0.77-0.90; p < 0.001). However, admission to the intensive care unit (ICU) was comparable between both groups (3.3% vs. 2.2%; aOR, 1.64; 95% CI, 0.78-3.43; p = 0.193). No difference in mortality rate was observed between the two groups. CONCLUSIONS: In Qatar, adult patients with asthma do not appear to be at higher risk of COVID-19-related hospitalization or ICU admission compared to the general adult COVID-19-infected population. Older age and hypertension were the only significant predictors of COVID-19-related hospitalization among patients with asthma. Further larger studies are required to confirm such an association.

12.
Perspect Psychol Sci ; : 17456916231180099, 2023 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-37462616

RESUMEN

Technological innovations have become a key driver of societal advancements. Nowhere is this more evident than in the field of machine learning (ML), which has developed algorithmic models that shape our decisions, behaviors, and outcomes. These tools have widespread use, in part, because they can synthesize massive amounts of data to make seemingly objective recommendations. Yet, in the past few years, the ML community has been drawing attention to the need for caution when interpreting and using these models. This is because these models are created by humans, from data generated by humans, whose psychology allows for various biases that impact how the models are developed, trained, tested, and interpreted. As psychologists, we thus face a fork in the road: Down the first path, we can continue to use these models without examining and addressing these critical flaws and rely on computer scientists to try to mitigate them. Down the second path, we can turn our expertise in bias toward this growing field, collaborating with computer scientists to reduce the models' deleterious outcomes. This article serves to light the way down the second path by identifying how extant psychological research can help examine and curtail bias in ML models.

13.
Antimicrob Agents Chemother ; 67(7): e0003023, 2023 07 18.
Artículo en Inglés | MEDLINE | ID: mdl-37310284

RESUMEN

The emergence of carbapenem-resistant, hypervirulent Klebsiella pneumoniae is a new threat to health care. We studied the molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae isolates in Qatar using whole-genome sequence data. We also characterized the prevalence and genetic basis of hypervirulent phenotypes and established the virulence potential using a Galleria mellonella model. Of 100 Klebsiella isolates studied, NDM and OXA-48 were the most common carbapenemases. Core genome single-nucleotide polymorphism (SNP) analysis indicated the presence of diverse sequence types and clonal lineages; isolates belonging to Klebsiella quasipneumoniae subsp. quasipneumoniae sequence type 196 (ST196) and ST1416 may be disseminated among several health care centers. Ten K. pneumoniae isolates carried rmpA and/or truncated rmpA2, and 2 isolates belonged to KL2, indicating low prevalence of classical hypervirulent isolates. Isolates carrying both carbapenem resistance and hypervirulence genes were confined mainly to ST231 and ST383 isolates. One ST383 isolate was further investigated by MinION sequencing, and the assembled genome indicated that blaNDM was located on an IncHI1B-type plasmid (pFQ61_ST383_NDM-5) which coharbored several virulence factors, including the regulator of the mucoid phenotype (rmpA), the regulator of mucoid phenotype 2 (rmpA2), and aerobactin (iucABCD and iutA), likely resulting from recombination events. Comparative genomics indicated that this hybrid plasmid may be present in two additional Qatari ST383 isolates. Carbapenem-resistant, hypervirulent K. pneumoniae ST383 isolates pose an emerging threat to global health due to their simultaneous hypervirulence and multidrug resistance.


Asunto(s)
Infecciones por Klebsiella , Klebsiella pneumoniae , Humanos , Carbapenémicos/farmacología , Qatar/epidemiología , Infecciones por Klebsiella/tratamiento farmacológico , Infecciones por Klebsiella/epidemiología , Klebsiella , beta-Lactamasas/genética , Plásmidos/genética , Genómica , Antibacterianos/farmacología
14.
Sci Rep ; 13(1): 5967, 2023 04 12.
Artículo en Inglés | MEDLINE | ID: mdl-37045974

RESUMEN

Given its centrality in scholarly and popular discourse, morality should be expected to figure prominently in everyday talk. We test this expectation by examining the frequency of moral content in three contexts, using three methods: (a) Participants' subjective frequency estimates (N = 581); (b) Human content analysis of unobtrusively recorded in-person interactions (N = 542 participants; n = 50,961 observations); and (c) Computational content analysis of Facebook posts (N = 3822 participants; n = 111,886 observations). In their self-reports, participants estimated that 21.5% of their interactions touched on morality (Study 1), but objectively, only 4.7% of recorded conversational samples (Study 2) and 2.2% of Facebook posts (Study 3) contained moral content. Collectively, these findings suggest that morality may be far less prominent in everyday life than scholarly and popular discourse, and laypeople, presume.


Asunto(s)
Comunicación , Principios Morales , Humanos , Red Social , Autoinforme
15.
Front Immunol ; 14: 1061255, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36817441

RESUMEN

Introduction: The BNT162b2 mRNA-based vaccine has shown high efficacy in preventing COVID-19 infection but there are limited data on the types and persistence of the humoral and T cell responses to such a vaccine. Methods: Here, we dissect the vaccine-induced humoral and cellular responses in a cohort of six healthy recipients of two doses of this vaccine. Results and discussion: Overall, there was heterogeneity in the spike-specific humoral and cellular responses among vaccinated individuals. Interestingly, we demonstrated that anti-spike antibody levels detected by a novel simple automated assay (Jess) were strongly correlated (r=0.863, P<0.0001) with neutralizing activity; thus, providing a potential surrogate for neutralizing cell-based assays. The spike-specific T cell response was measured with a newly modified T-spot assay in which the high-homology peptide-sequences cross-reactive with other coronaviruses were removed. This response was induced in 4/6 participants after the first dose, and all six participants after the second dose, and remained detectable in 4/6 participants five months post-vaccination. We have also shown for the first time, that BNT162b2 vaccine enhanced T cell responses also against known human common viruses. In addition, we demonstrated the efficacy of a rapid ex-vivo T cell expansion protocol for spike-specific T cell expansion to be potentially used for adoptive-cell therapy in severe COVID-19, immunocompromised individuals, and other high-risk groups. There was a 9 to 13.7-fold increase in the number of expanded T cells with a significant increase of anti-spike specific response showing higher frequencies of both activation and cytotoxic markers. Interestingly, effector memory T cells were dominant in all four participants' CD8+ expanded memory T cells; CD4+ T cells were dominated by effector memory in 2/4 participants and by central memory in the remaining two participants. Moreover, we found that high frequencies of CD4+ terminally differentiated memory T cells were associated with a greater reduction of spike-specific activated CD4+ T cells. Finally, we showed that participants who had a CD4+ central memory T cell dominance expressed a high CD69 activation marker in the CD4+ activated T cells.


Asunto(s)
COVID-19 , Inmunoterapia Adoptiva , Humanos , Vacuna BNT162 , Linfocitos T CD4-Positivos , Proyectos Piloto , Linfocitos T/inmunología , Memoria Inmunológica
16.
Haematologica ; 108(1): 22-33, 2023 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-35545919

RESUMEN

Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.


Asunto(s)
COVID-19 , Hematología , Leucemia Mieloide Aguda , Humanos , Adulto , Estudios de Seguimiento , Prueba de COVID-19 , Leucemia Mieloide Aguda/terapia , Leucemia Mieloide Aguda/tratamiento farmacológico
17.
Cancers (Basel) ; 14(22)2022 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-36428621

RESUMEN

Background: The outcome of patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 is unknown and there are no specific treatment guidelines. Methods: We describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022. Results: Acute leukaemia and lymphoma were the most frequent HM (35.8% and 35.1%, respectively). Overall, 343 (76.2%) patients received treatment for HM, which was delayed for longer than one month since diagnosis in 57 (16.6%). An overall response rate was observed in 140 (40.8%) patients after the first line of treatment. After a median follow-up of 35 days, overall mortality was 177/450 (39.3%); 30-day mortality was significantly higher in patients not receiving HM treatment (42.1%) than in those receiving treatment (27.4%, p = 0.004), either before and/or after COVID-19, or compared to patients receiving HM treatment at least after COVID-19 (15.2%, p < 0.001). Age, severe/critical COVID-19, ≥2 comorbidities, and lack of HM treatment were independent risk factors for mortality, whereas a lymphocyte count >500/mcl at COVID-19 onset was protective. Conclusions: HM treatment should be delivered as soon as possible for patients with simultaneous diagnosis of COVID-19 and HM requiring immediate therapy.

18.
J Fungi (Basel) ; 8(11)2022 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-36354913

RESUMEN

AIM: This rapid systematic review aimed to collect the evidence published over the last decade on the effect of empirical antifungal therapy and its early initiation on survival rates. METHODS: A systematic search was conducted in PubMed, Cochrane, Medline, Scopus, and Embase, in addition to a hand search and experts' suggestions. RESULTS: Fourteen cohort studies and two randomized clinical trials reporting the survival outcome of empirical antifungal therapy were included in this review. Two studies reported the association between early empirical antifungal therapy (EAFT) and survival rates in a hematological cancer setting, and fourteen studies reported the outcome in patients in intensive care units (ICU). Six studies reported that appropriate EAFT decreases hospital mortality significantly; ten studies could not demonstrate a statistically significant association with mortality rates. DISCUSSION: The inconsistency of the results in the literature can be attributed to the studies' small sample size and their heterogeneity. Many patients who may potentially benefit from such strategies were excluded from these studies. CONCLUSION: While EAFT is practiced in many settings, current evidence is conflicting, and high-quality studies are needed to demonstrate the true value of this approach. Meanwhile, insights from experts in the field can help guide clinicians to initiate EAFT when indicated.

19.
Front Oncol ; 12: 992137, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36276116

RESUMEN

Patients with lymphoproliferative diseases (LPD) are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we describe and analyze the outcome of 366 adult patients with chronic lymphocytic leukemia (CLL) or non-Hodgkin Lymphoma (NHL) treated with targeted drugs and laboratory-confirmed COVID-19 diagnosed between February 2020 and January 2022. Median follow-up was 70.5 days (IQR 0-609). Most used targeted drugs were Bruton-kinase inhibitors (BKIs) (N= 201, 55%), anti-CD20 other than rituximab (N=61, 16%), BCL2 inhibitors (N=33, 9%) and lenalidomide (N=28, 8%).Only 16.2% of the patients were vaccinated with 2 or more doses of vaccine at the onset of COVID-19. Mortality was 24% (89/366) on day 30 and 36%(134/366) on the last day of follow-up. Age >75 years (p<0.001, HR 1.036), active malignancy (p<0.001, HR 2.215), severe COVID-19 (p=0.017, HR 2.270) and admission to ICU (p<0.001, HR 5.751) were risk factors for mortality at last day of follow up. There was no difference in OS rates in NHL vs CLL patients (p=0.306), nor in patients treated with or without BKIs (p=0.151). Mortality in ICU was 66% (CLL 61%, NHL 76%). Overall mortality rate decreased according to vaccination status, being 39% in unvaccinated patients, 32% and 26% in those having received one or two doses, respectively, and 20% in patients with a booster dose (p=0.245). Overall mortality rate dropped from 41% during the first semester of 2020 to 25% at the last semester of 2021. These results show increased severity and mortality from COVID-19 in LPDs patients treated with targeted drugs.

20.
Int J Infect Dis ; 124: 96-103, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36218031

RESUMEN

OBJECTIVES: To estimate the real-world effectiveness of sotrovimab against severe, critical, or fatal COVID-19 in Qatar at a time in which most SARS-CoV-2 incidences occurred due to the BA.2 Omicron subvariant. METHODS: We conducted a matched case-control study among all individuals eligible for sotrovimab treatment per United States Food and Drug Administration guidelines in the resident population of Qatar. The odds of progression to severe forms of COVID-19 were compared in cases (treatment group) versus controls (eligible patients who opted not to receive the treatment). Subgroup analyses were conducted. RESULTS: A total of 3364 individuals were eligible for sotrovimab treatment during the study period, of whom 519 individuals received the treatment, whereas the remaining 2845 constituted the controls. The adjusted odds ratio of disease progression to severe, critical, or fatal COVID-19 comparing the treatment group to the control group was 2.67 (95% confidence interval 0.60-11.91). In the analysis including only the subgroup of patients at higher risk of severe forms of COVID-19, the adjusted odds ratio was 0.65 (95% confidence interval 0.17-2.48). CONCLUSION: There was no evidence for a protective effect of sotrovimab in reducing COVID-19 severity in a setting dominated by the BA.2 subvariant.


Asunto(s)
Tratamiento Farmacológico de COVID-19 , SARS-CoV-2 , Humanos , Anticuerpos Neutralizantes/uso terapéutico , Estudios de Casos y Controles , Qatar/epidemiología
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