Article
Nutrition & Dietetics
Rebecca Liu, Mary Paz, Layla Siraj, Taylor Boyd, Silvia Salamone, Thuy-Lan Vo Lite, Krystle M. Leung, Josue D. Chirinos, Helen H. Shang, Matthew J. Townsend, Junsung Rho, Peiyun Ni, Kushi Ranganath, April D. Violante, Zezhou Zhao, Casey Silvernale, Imama Ahmad, Nira A. Krasnow, Erica S. Barnett, Mukesh Harisinghani, Braden Kuo, Katharine E. Black, Kyle Staller
Summary: This study characterizes the prevalence, clinical manifestations, and outcomes of feeding intolerance in critically ill patients with COVID-19. Feeding intolerance developed in 56% of the patients and was associated with poor outcomes.
CLINICAL NUTRITION
(2022)
Article
Immunology
Muhammad Z. Mushtaq, Saad B. Z. Mahmood, Aysha Almas, Syed Ather Wasti, Syed Ahsan Ali
Summary: This study examined the response of tocilizumab in COVID-19 patients by analyzing clinical parameters and inflammatory markers. The results showed that tocilizumab can decrease the need for mechanical ventilation and improve inflammatory markers and neutrophil to lymphocyte ratio. However, it is associated with adverse events including bacterial and fungal infections.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2022)
Article
Critical Care Medicine
Giacomo Grasselli, Vittorio Scaravilli, Davide Mangioni, Luigia Scudeller, Laura Alagna, Michele Bartoletti, Giacomo Bellani, Emanuela Biagioni, Paolo Bonfanti, Nicola Bottino, Irene Coloretti, Salvatore Lucio Cutuli, Gennaro De Pascale, Daniela Ferlicca, Gabriele Fior, Andrea Forastieri, Marco Franzetti, Massimiliano Greco, Amedeo Guzzardella, Sara Linguadoca, Marianna Meschiari, Antonio Messina, Gianpaola Monti, Paola Morelli, Antonio Muscatello, Simone Redaelli, Flavia Stefanini, Tommaso Tonetti, Massimo Antonelli, Maurizio Cecconi, Giuseppe Foti, Roberto Fumagalli, Massimo Girardis, Marco Ranieri, Pierluigi Viale, Mario Raviglione, Antonio Pesenti, Andrea Gori, Alessandra Bandera
Summary: Critically ill patients with COVID-19 are at high risk for hospital-acquired infections (HAIs), especially ventilator-associated pneumonia (VAP) and bloodstream infections (BSIs) caused by multidrug-resistant organisms. HAIs prolong mechanical ventilation and hospitalization, and those complicated by septic shock nearly double mortality rate.
Review
Immunology
Hamid Nasrollahi, Atefe Ghamar Talepoor, Zahra Saleh, Mahsa Eshkevar Vakili, Paria Heydarinezhad, Narges Karami, Maryam Noroozi, Seppo Meri, Kurosh Kalantar
Summary: The COVID-19 pandemic caused by SARS-CoV-2 has had devastating effects on global health and the economy. The immune system plays a critical role in controlling the infection, but dysregulated inflammatory responses and imbalanced immune function can contribute to tissue damage and disease pathogenesis. Important mechanisms in severe COVID-19 include excessive production of inflammatory cytokines, impaired antiviral response, overactivation of immune cells, decreased frequencies of certain immune cell populations, complement activation, lymphopenia, and dysregulation of B lymphocyte function. Manipulating the immune system has been explored as a therapeutic approach. This review discusses the role of immunity in COVID-19 development and progression, focusing on molecular and cellular aspects of the immune system in mild versus severe forms of the disease. Immune-based therapeutic approaches are also being investigated.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Immunology
Paolo Gaibani, Federica D'Amico, Michele Bartoletti, Donatella Lombardo, Simone Rampelli, Giacomo Fornaro, Simona Coladonato, Antonio Siniscalchi, Maria Carla Re, Pierluigi Viale, Patrizia Brigidi, Silvia Turroni, Maddalena Giannella
Summary: The gut microbiota (GM) of COVID-19 patients showed severe dysbiosis, reduced diversity, loss of health-associated microorganisms, and enrichment of potential pathogens, particularly Enterococcus.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2021)
Article
Multidisciplinary Sciences
Douglas D. Fraser, Maitray A. Patel, Logan R. Van Nynatten, Claudio Martin, Shannon L. Seney, Michael R. Miller, Mark Daley, Marat Slessarev, Gediminas Cepinskas, Ganeem K. Juneja, Vanessa Sabourin, Alison Fox-Robichaud, Calvin H. Yeh, Paul Y. Kim, Sigrun Badryna, Susanne Oehler, Markus Miholits, Brian Webb
Summary: Naturally infected critically ill COVID-19 patients develop adaptive immunity to variants of SARS-CoV-2, with stronger antibody responses observed for the alpha variant compared to other variants. Patients diagnosed with cancer or chronic obstructive pulmonary disease have lower levels of neutralizing antibodies.
Article
Immunology
Fabian Heinrich, Michael F. Nentwich, Eric Bibiza-Freiwald, Dominik Noerz, Kevin Roedl, Martin Christner, Armin Hoffmann, Flaminia Olearo, Stefan Kluge, Martin Aepfelbacher, Dominic Wichmann, Marc Lutgehetmann, Susanne Pfefferle
Summary: The study found that in critically ill COVID-19 patients, blood SARS-CoV-2 RNA load can serve as a prognostic factor, with significantly higher levels in non-survivors upon ICU admission and a higher probability of blood RNA clearance failure. Blood RNA load represents an important independent predictor of outcome for critically ill COVID-19 patients, with a higher impact on survival compared to respiratory tract SARS-CoV-2 RNA loads.
OPEN FORUM INFECTIOUS DISEASES
(2021)
Article
Virology
Beatriz Olea, Eliseo Albert, Ignacio Torres, Roberto Gozalbo-Rovira, Nieves Carbonell, Jose Ferreres, Sandrine Poujois, Rosa Costa, Javier Colomina, Jesus Rodriguez, Maria L. Blasco, David Navarro
Summary: The study found that detection of SARS-CoV-2 N-antigenemia is relatively common in critically ill COVID-19 patients, and is associated with increased serum levels of inflammation and tissue-damage markers. Further investigation is needed to determine if this virological parameter can serve as a biomarker for poor clinical outcomes.
JOURNAL OF MEDICAL VIROLOGY
(2022)
Article
Infectious Diseases
Yonghao Xu, Manshu Li, Liang Zhou, Dongdong Liu, Weiqun He, Weibo Liang, Qingwen Sun, Huadong Sun, Yimin Li, Xiaoqing Liu
Summary: This study found that all 19 critically ill COVID-19 patients in ICU survived through 28 days of observation, with some patients being discharged from the hospital. No side effects of ribavirin were observed in these patients, and it may benefit COVID-19 patients through increasing virus clearance.
INFECTION AND DRUG RESISTANCE
(2021)
Review
Microbiology
Francesca Raffaelli, Eloisa Sofia Tanzarella, Gennaro De Pascale, Mario Tumbarello
Summary: Patients with COVID-19 in the ICU often develop respiratory fungal infections, including CAPA, CAPM, and PCP. Multiple risk factors promote these infections, such as epithelial damage, mechanical ventilation, and immunosuppression. Differentiating between colonization and infection in COVID-19 patients is challenging, and reliable diagnostic approaches are limited. Although several antifungal drugs are available, the development of more effective and less toxic drugs is needed.
Article
Critical Care Medicine
Mailis Maes, Ellen Higginson, Joana Pereira-Dias, Martin D. Curran, Surendra Parmar, Fahad Khokhar, Delphine Cuchet-Lourenco, Janine Lux, Sapna Sharma-Hajela, Benjamin Ravenhill, Islam Hamed, Laura Heales, Razeen Mahroof, Amelia Solderholm, Sally Forrest, Sushmita Sridhar, Nicholas M. Brown, Stephen Baker, Vilas Navapurkar, Gordon Dougan, Josefin Bartholdson Scott, Andrew Conway Morris
Summary: This study found that COVID-19 patients were more likely to develop VAP, with 3 cases of invasive aspergillosis identified among them and herpesvirade activation being more frequent. The causative organisms of secondary pneumonia observed were similar between COVID-19 and non-COVID-19 patients, suggesting a link to pulmonary dysbiosis caused by COVID-19.
Article
Immunology
Jana L. Jacobs, Asma Naqvi, Faraaz A. Shah, Valerie F. Boltz, Mary F. Kearney, Bryan J. McVerry, Prabir Ray, Caitlin Schaefer, Meghan Fitzpatrick, Barbara Methe, Janet S. Lee, Alison Morris, John W. Mellors, Georgios D. Kitsios, William Bain
Summary: Lower respiratory tract (LRT) and plasma viral RNA (vRNA) levels are strongly correlated in mechanically ventilated COVID-19 patients. Delayed LRT vRNA clearance is observed in nonsurvivors. Plasma vRNA may serve as a practical surrogate for LRT vRNA, especially early in critical illness.
JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Infectious Diseases
Michael Neuberger, Achim Jungbluth, Michael Irlbeck, Florian Streitparth, Maria Burian, Thomas Kirchner, Jens Werner, Martina Rudelius, Thomas Knoesel
Summary: This study describes the rare condition of severe duodenitis in COVID-19 patients, which can cause significant bleeding and/or gastrointestinal dysmotility, and provides a description of its clinical and histopathological characteristics. The results suggest that approximately 8% of critically ill COVID-19 patients may develop severe duodenitis, potentially associated with direct infection of the duodenal enterocytes by SARS-CoV-2, and the clinical consequences of severe bleeding and/or upper gastrointestinal dysmotility may be underestimated.
Article
Medicine, General & Internal
Daniele Roberto Giacobbe, Laura Labate, Stefania Tutino, Federico Baldi, Chiara Russo, Chiara Robba, Lorenzo Ball, Silvia Dettori, Anna Marchese, Chiara Dentone, Laura Magnasco, Francesca Crea, Edward Willison, Federica Briano, Denise Battaglini, Nicolo Patroniti, Iole Brunetti, Paolo Pelosi, Matteo Bassetti
Summary: The cumulative incidence of enterococcal bloodstream infection is high in critically ill patients with COVID-19, with a potential 30-day mortality rate exceeding 40%. The severity of acute clinical conditions, influenced by both viral pneumonia and enterococcal bloodstream infection, may play a crucial role in determining patient outcomes.
ANNALS OF MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Ankita Garg, Benjamin Seeliger, Anselm A. Derda, Ke Xiao, Anika Gietz, Kristian Scherf, Kristina Sonnenschein, Isabell Pink, Marius M. Hoeper, Tobias Welte, Johann Bauersachs, Sascha David, Christian Bar, Thomas Thum
Summary: Elevated levels of cardiovascular and inflammatory microRNAs were observed in critically ill COVID-19 patients, suggesting a specific response and cardiac involvement of COVID-19. MiR profiles showed potential for differentiating between severe COVID-19 and Influenza-ARDS patients.
EUROPEAN JOURNAL OF HEART FAILURE
(2021)
Review
Pharmacology & Pharmacy
Wasim S. El Nekidy, Hazem Elrefaei, Terrence J. Lee St. John, Nizar M. Attallah, Farah Kablaoui, Ahmad Nusair, Bartlomiej Piechowski-Jozwiak, Janise Phillips, Islam M. Ghazi
Summary: The approved dosing of ertapenem in patients with chronic kidney disease stage 5 utilizing dialysis may lead to neurotoxicity in some cases, with risk factors including male sex, dementia, and concomitant use of certain drugs. Alternative dosing strategies may need further investigation for efficacy and safety.
ANNALS OF PHARMACOTHERAPY
(2021)
Article
Oncology
Benjamin J. Ereshefsky, Diaa Alrahmany, Wasim S. El Nekidy, Laura Pontiggia, Islam M. Ghazi
Summary: In the treatment of CDI, low-dose oral vancomycin showed equivalent outcomes compared to high-dose vancomycin, with no significant differences in secondary outcomes such as 90-day readmission/recurrence or 30-day all-cause mortality.
JOURNAL OF CHEMOTHERAPY
(2021)
Article
Pharmacology & Pharmacy
Wasim S. El Nekidy, Abdullah Shatnawei, Manal M. Abdelsalam, Mariam Hassan, Ruba Z. Dajani, Nouran Salem, Terrence J. Lee St John, Nadeem Rahman, Fadi Hamed, Jihad Mallat
Summary: This study investigated the incidence of hypertriglyceridemia (HTG) in patients infected with SARS-CoV-2 and the risk factors associated with it, finding an association between HTG and the use of propofol and favipiravir. HTG may reflect the high inflammatory state in these patients, but there was no relationship observed between lipase and TG levels over time.
ANNALS OF PHARMACOTHERAPY
(2022)
Article
Urology & Nephrology
Wasim S. El Nekidy, Raymond Cha, Islam M. Ghazi
Summary: This review discussed the relevant studies on the use of vancomycin to treat methicillin-resistant Staphylococcus aureus infections in patients with chronic kidney disease stage 5 utilizing hemodialysis. Administering vancomycin during the last hour of dialysis and using a standard maintenance dose can simplify dosing and reduce the risk of errors.
CLINICAL NEPHROLOGY
(2022)
Review
Pharmacology & Pharmacy
Bartlomiej Piechowski-Jozwiak, Emna Abidi, Wasim S. El Nekidy, Julien Bogousslavsky
Summary: Desmoteplase is a potentially superior thrombolytic agent for the treatment of ischemic stroke, with high fibrin specificity and promising outcomes in patients with significant stenosis or occlusion of proximal vessels. However, adverse reactions have been observed in some clinical trials. Nevertheless, recent research data suggest that it is well-tolerated, with a safety profile comparable to placebo.
EUROPEAN JOURNAL OF DRUG METABOLISM AND PHARMACOKINETICS
(2022)
Article
Pharmacology & Pharmacy
Wasim S. El Nekidy, Manal M. Abdelsalam, Ahmad R. Nusair, Rania El Lababidi, Ruba Z. Dajani, Terrence J. Lee St John, Islam M. Ghazi
Summary: This study found that cefoxitin demonstrated a similar microbiologic cure rate compared to ertapenem for the treatment of urinary tract infections, but was not as effective in clinical cure. The 90-day recurrence rate was significantly lower in the cefoxitin group compared to the ertapenem group. In many clinical settings, cefoxitin can be used as a carbapenem-sparing agent as an alternative to ertapenem.
Review
Pharmacology & Pharmacy
Emna Abidi, Wasim S. El Nekidy, Eman Alefishat, Nadeem Rahman, Georg A. Petroianu, Rania El-Lababidi, Jihad Mallat
Summary: Elevated IL-6 levels play a key role in COVID-19 immune impairment, with tocilizumab being investigated as a potential treatment by targeting IL-6 receptor antagonism. While early observational studies show benefits, subsequent randomized trials have produced conflicting results regarding tocilizumab's efficacy as a standard therapy for COVID-19 pneumonia.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Urology & Nephrology
Wasim S. El Nekidy, Jihad Mallat, Ahmad R. Nusair, Ayah H. Eshbair, Nizar Attallah, Mohamad Mooty, Muriel Ghosn, Islam M. Ghazi
Summary: This study investigated the impact of different antimicrobials on clinical and microbiologic outcomes in hemodialysis (HD) dependent patients with urinary tract infection (UTI). The findings showed a high rate of clinical and microbiologic cure in both oliguric and anuric patients, with low recurrence and mortality rates. It suggests that treatment recommendations for UTI should take into account clinical and microbiologic outcomes as well as achievable urinary concentration.
HEMODIALYSIS INTERNATIONAL
(2022)
Review
Medicine, General & Internal
Emna Abidi, Wasim S. El Nekidy, Bassam Atallah, Khaled Al Zaman, Praveen Ghisulal, Rania El Lababidi, Yosef Manla, Ihab Ahmed, Ziad Sadik, Ahmed Taha, Mohamed Askalany, Antoine Cherfan, Mohamed Helal, Saad Sultan, Umar Khan, Vivek Kakar, Jihad Mallat
Summary: There is an increasing use of ECMO support in critically ill adults, which raises the need for understanding the complex changes in drugs' pharmacokinetics (PK) and pharmacodynamics (PD). Managing pharmacotherapy for critically ill patients on ECMO is challenging, and predicting PK and PD alterations is crucial for optimal therapeutic plans. Despite the resurgence in ECMO use, especially in the COVID-19 era, there is limited data on its effect on commonly used drugs and their management for optimal outcomes. This review aims to provide key information on evidence-based PK alterations and monitoring of drugs used in an ECMO setting.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Urology & Nephrology
Katie E. Cardone, Rebecca Maxson, Katherine H. Cho, Joseph M. Davis, Wasim S. El Nekidy, Sandra L. Kane-Gill, Anusha McNamara, Lori Wazny, Lana Wong, Marisa Battistella
Summary: Patients with kidney disease could benefit from clinical pharmacy services. The advancing American Kidney Health executive order provides opportunities for comprehensive medication management. Practice standards for pharmacists caring for patients with kidney disease have been developed to promote standardization of services.
Article
Infectious Diseases
Joanna Saleh, Wasim S. El Nekidy, Rania El Lababidi
Summary: This study investigated the appropriateness of antibiotic use and prescribing habits at hospital discharge. The findings showed that the most challenging issue with antibiotic regimens at discharge was the inappropriate duration of therapy. Further research is needed to identify effective interventions that can be implemented in all settings, including resource-limited ones.
JAC-ANTIMICROBIAL RESISTANCE
(2022)
Article
Infectious Diseases
Laila Rkieh, Wasim S. El Nekidy, Leen Oyoun Alsoud, Adnan Alatoom, Rania El Lababidi, Mohamad Mooty, Ahmad R. Nusair
Summary: This study reports the use of caspofungin for the treatment of candiduria, including C. auris. Despite the low urinary concentration of echinocandins, most patients achieved mycological and clinical cure after using caspofungin.
