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Clinical Presentation, Treatment and Vaccination in COVID-19

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 13755

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Prof. Dr. Dorota Zarębska-Michaluk

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Guest Editor

Department of Infectious Diseases, Jan Kochanowski University, 25-369 Kielce, Poland
Interests: COVID-19; infectious diseases; viral hepatitis

Prof. Dr. Robert Flisiak

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Guest Editor

Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
Interests: infectious diseases; viral hepatitis; liver; COVID-19
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Dear Colleagues,

Nearly two years have passed since the World Health Organization announced the pandemic of COVID-19. At the beginning, only supportive care was available; however, the rapid spread of COVID-19 around the world sparked a need for an antiviral agent active against SARS-CoV-2. Initially, the search for an effective therapy focused on drug repurposing and new ways of using approved agents with proven activity against other viruses. New antiviral drugs were then discovered following clinical trials, and are now available. During these two years, the spectrum of anti-inflammatory and immunosuppressive drugs used in the cytokine storm stage has also broadened. Despite growing knowledge of SARS-CoV-2 and experience in treating COVID-19, vaccines that became available at the end of 2020 are hugely important in the fight against the pandemic. However, new therapeutic possibilities and available prophylaxis influence the disease and its future. The clinical presentation of COVID-19 and prognosis also change with the appearance of new variants of the virus.

In this Special Issue, we would like to invite you to submit a wide variety of papers, including original research, short communications, reviews, and viewpoints, which will broaden the understanding of the topic of clinical diagnosis, treatment, and vaccination against COVID-19.

Prof. Dr. Dorota Zarębska-Michaluk
Prof. Dr. Robert Flisiak
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
COVID-19 (coronavirus disease 2019)
clinical presentation of COVID-19
treatment of COVID-19
vaccination against COVID-19
management of COVID-19
variants of SARS-CoV-2

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Published Papers (6 papers)

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Research

11 pages, 275 KiB

Open AccessArticle

The Effect of Reduced Oxygen Saturation on Retinal Microvascularization in COVID-19 Patients with Bilateral Pneumonia Based on Optical Coherence Tomography Study

by Magdalena Kal, Mateusz Winiarczyk, Jerzy Mackiewicz, Dominik Odrobina, Elżbieta Cieśla, Bernadetta Płatkowska-Adamska, Michał Biskup, Paweł Pabjan and Dorota Zarębska-Michaluk

J. Pers. Med. 2022, 12(11), 1824; https://doi.org/10.3390/jpm12111824 - 2 Nov 2022

Cited by 5 | Viewed by 1672

Abstract

The aim of the study was to evaluate changes in the retinal thickness and microvasculature based on optical coherence tomography (OCT) depending on baseline oxygen saturation (SpO2) in patients hospitalized due to COVID-19 bilateral pneumonia. The prospective study was carried out among 62 patients with COVID-19 pneumonia who underwent ophthalmic examination after hospital discharge. They were divided into three groups depending on the oxygen saturation (SpO2) on admission: ≤90% (group 1), >90% and ≤95% (group 2), and >95% (group 3). The following parameters were assessed in the ophthalmological examination and correlated with the baseline SpO2: ganglion cell layer (GCL), the retinal nerve fiber layer (RNFL) in the macular area, RNFL in the peripapillary area, the foveal avascular zone (FAZ) in superficial capillary plexus (SCP) and deep capillary plexus (DCP), vessel density (VD) in SCP, in DCP, and in the choriocapillaris plexus (CC). Baseline saturation ≤90% in COVID-19 patients caused a decrease of VD in some areas of SCP and DCP and an increase in FAZ area in SCP and DCP. In the group of patients with SpO2 ≤ 90% statistically significant thinning of the retina in the inner superior ring (ISR) (p = 0.029), the inner temporal ring (ITR) (p = 0.34), the outer superior ring (OSR) (p = 0.012), and the outer temporal ring (OTR) (p= 0.004)] was observed. The statistically significant thickening of RNFL optic disc and thinning of RNFL retina in some macular areas in patients with SpO2 ≤ 90% were reported. The size of FAZ area in SCP and vessel density were significantly greater in some areas of SCP, DCP, and CC in patients with SpO2 ≤ 90% (p = 0.025). Baseline oxygen saturation ≤90% has been found to influence the ocular parameters of OCT in COVID-19 patients. We noticed a widened FAZ zone in SCP and increased VD in some regions of the retina and choroid as a response to systemic hypoxia. Full article

(This article belongs to the Special Issue Clinical Presentation, Treatment and Vaccination in COVID-19)

11 pages, 2238 KiB

Open AccessArticle

The Caliber of Segmental and Subsegmental Vessels in COVID-19 Pneumonia Is Enlarged: A Distinctive Feature in Comparison with Other Forms of Inflammatory and Thromboembolic Diseases

by Maria-Chiara Ambrosetti, Giulia Battocchio, Stefania Montemezzi, Filippo Cattazzo, Tissjana Bejko, Evelina Tacconelli, Pietro Minuz, Ernesto Crisafulli, Cristiano Fava and Giancarlo Mansueto

J. Pers. Med. 2022, 12(9), 1465; https://doi.org/10.3390/jpm12091465 - 7 Sep 2022

Viewed by 1488

Abstract

Background: The purpose of this study was to compare COVID-19 patients’ vessel caliber with that of normal lungs and lungs affected by other inflammatory and thromboembolic processes. Methods: between March and April 2020, 42 patients affected by COVID-19 pneumonia (COV-P) underwent CT scans of the lungs at Verona University Hospital for clinical indications. The lung images of four different groups of patients were compared (normal lung (NL), distal thromboembolism (DTE), and bacterial and fungal pneumonia (Bact-P, Fung-P)) by a radiologist with four years of experience. Results: The COV-P patients’ segmental and subsegmental vessels, evaluated as the ratio with the corresponding bronchial branch (V/B ratio), were larger, with respect to the NL the DTE groups, in the apparently healthy parenchyma, a result confirmed in the zones of opacification with respect to the Bact-P and Fung-P groups. Conclusions: This was the first study to show, by comparative analysis, that COVID-19 patients’ segmental and subsegmental vessel calibers are significantly enlarged. This is a distinctive feature of COVID-19 pneumonia, suggesting its distinct pathophysiology as compared to other inflammatory and thromboembolic diseases and alerting radiologists to consider it when evaluating the CT scans of suspected patients. Full article

(This article belongs to the Special Issue Clinical Presentation, Treatment and Vaccination in COVID-19)

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11 pages, 882 KiB

Open AccessArticle

Lack of Difference in Tocilizumab Efficacy in the Treatment of Severe COVID-19 Caused by Different SARS-CoV-2 Variants

by Oleksandr Oliynyk, Wojciech Barg, Yanina Oliynyk, Serhij Dubrov, Vitaliy Gurianov and Marta Rorat

J. Pers. Med. 2022, 12(7), 1103; https://doi.org/10.3390/jpm12071103 - 4 Jul 2022

Cited by 8 | Viewed by 1804

Abstract

Tocilizumab (TOC) is presumed to be an effective and safe treatment for severe COVID-19, but its usefulness has not been yet investigated for different SARS-CoV-2 variants. This study aimed to evaluate the influence of TOC on mortality in patients with severe COVID-19 caused by Delta and non-Delta SARS-CoV-2 variants. In a retrospective analysis, we compared the medical records of 78 and 224 patients with severe COVID-19 due to Delta and non-Delta variants, respectively. A total of 30 patients with Delta and 84 with non-Delta variants were treated with TOC in addition to standard therapy. There were no statistically significant differences in mortality rate when comparing Delta vs. non-Delta patients nor when comparing those treated with TOC vs. not treated with TOC in both variants. Using a logistic regression model, in the examined population as a whole, we found an increased (p < 0.05) risk of death as leukocyte and erythrocyte counts decreased and as procalcitonin increased. Increased procalcitonin was significant for mortality in the Delta group, while decreased IL-6, leukocytes, and platelets and increased fibrinogen and procalcitonin were significant in the non-Delta group. Tocilizumab efficacy in severe COVID-19 does not differ between Delta or non-Delta virus variants. The Delta variant of SARS-CoV-2 does not increase mortality when compared to other virus strains. Full article

(This article belongs to the Special Issue Clinical Presentation, Treatment and Vaccination in COVID-19)

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14 pages, 1153 KiB

Open AccessArticle

EASIX, Modified EASIX and Simplified EASIX as an Early Predictor for Intensive Care Unit Admission and Mortality in Severe COVID-19 Patients

by Aleksander Zińczuk, Marta Rorat, Krzysztof Simon and Tomasz Jurek

J. Pers. Med. 2022, 12(7), 1022; https://doi.org/10.3390/jpm12071022 - 21 Jun 2022

Cited by 6 | Viewed by 2742

Abstract

COVID-19 receives a lot of attention due to its threat to global public health. Research is ongoing to find universal methods to assess the baseline health status of a patient to determine prognosis and management strategies. This study aims to assess the predictive potential of the EASIX (Endothelial Activation and Stress Index) and two of its modifications (mEASIX and sEASIX) in terms of the need for admission to the ICU (intensive care unit), the use of IMV (invasive mechanical ventilation) and death due to COVID-19. The medical data of 370 severely ill patients hospitalised in the COVID-19 departments of the Regional Specialist Hospital in Wroclaw (Poland), including the ICU, were analysed retrospectively. The mortality rate in the group studied was 65.7% (243 cases). In the case of all three indices, EASIX, mEASIX and sEASIX, there was a statistically significant correlation between the need for admission to the ICU (p = 0.026, p = 0.019, p = 0.001, respectively) and the risk of death (p < 0.001). In terms of the risk of death, the high values of the assessed indices (EASIX ≥ 2.36, mEASIX ≥ 704.03, sEASIX ≥ 3.81) were characterised by low sensitivity (≤40%), high specificity (approximately 90%) and low NPV (negative predictive value) (approximately 40%) with high PPV (positive predictive value) (approximately 80%). Due to the ease of implementation and the low cost of performing basic laboratory tests, the above-mentioned indices can be used as an additional, but not universal tool for the initial assessment of the health condition of patients admitted to the hospital. Full article

(This article belongs to the Special Issue Clinical Presentation, Treatment and Vaccination in COVID-19)

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13 pages, 328 KiB

Open AccessArticle

Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels

by Rasmieh Al-Amer, Malakeh Z. Malak, Hala Mohammad Ramadan Burqan, Elena Stănculescu, Sylivia Nalubega, Abdulmajeed A. Alkhamees, Amin Omar Hendawy and Amira Mohammed Ali

J. Pers. Med. 2022, 12(6), 912; https://doi.org/10.3390/jpm12060912 - 31 May 2022

Cited by 8 | Viewed by 2453

Abstract

Although vaccination has been adopted by the WHO to limit worldwide transmission of COVID-19, people’s worries about COVID-19 vaccines may suppress their desire for vaccination despite vaccine availability. This study aimed to investigate anxiety and stress symptoms among 250 Jordanians (mean age = 43.18 ± 6.34 years, 72% females) who received their first vaccine dose. The respondents completed the anxiety and stress subscales of the Depression Anxiety and Stress scale 21 (DASS-21) before and after vaccination. The respondents expressed more moderate–severe levels of stress before than after vaccination (20.8% and 13.2%, respectively). Meanwhile, 37.2% and 45.2% of the respondents expressed moderate–severe anxiety before and after vaccination, respectively. Wilcoxon signed-rank test revealed that the drop in the level of stress from before- (median (IQR) = 5 (1–8)) to after vaccination (median (IQR) = 3 (1–7)) was statistically significant (z = −3.81, p = 0.001, r = 0.17) while the increase in anxiety was not. Anxiety significantly dropped postvaccination among individuals experiencing mild to severe anxiety before vaccination. Similarly, stress and anxiety significantly increased among individuals expressing normal anxiety before vaccination (z = −3.57 and −8.24, p values = 0.001, r = 0.16 and 0.37, respectively). Age positively correlated with postvaccination anxiety among respondents with mild prevaccination anxiety, and it negatively correlated with the prevaccination level of stress in the normal-anxiety group. Gender, marital status, respondents’ level of education, and history of COVID-19 infection had no significant correlation with anxiety or stress at either point of measurement. Overcoming their hesitancy to receive COVID-19 vaccines, individuals with normal levels of anxiety experienced a rise in their distress symptoms following immunization. On the contrary, vaccination seemed to desensitize anxious individuals. Policymakers need to formulate a population-specific plan to increase vaccine preparedness and promote psychological well-being over all during the pandemic. Full article

(This article belongs to the Special Issue Clinical Presentation, Treatment and Vaccination in COVID-19)

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14 pages, 1732 KiB

Open AccessArticle

Impaired Humoral Immunity with Concomitant Preserved T Cell Reactivity in IBD Patients on Treatment with Infliximab 6 Month after Vaccination with the SARS-CoV-2 mRNA Vaccine BNT162b2: A Pilot Study

by Richard Vollenberg, Phil-Robin Tepasse, Eva Lorentzen and Tobias Max Nowacki

J. Pers. Med. 2022, 12(5), 694; https://doi.org/10.3390/jpm12050694 - 26 Apr 2022

Cited by 7 | Viewed by 2704

Abstract

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has been caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The most important approach to prevent severe disease progression and to contain the pandemic is the use of COVID-19 vaccines. The aim of this study was to investigate the humoral and cellular response in immunosuppressed patients with inflammatory bowel disease (IBD) on treatment with anti-TNF (infliximab, adalimumab) and anti-α4ß7-Integrin (vedolizumab) 6 months after mRNA vaccination against SARS-CoV-2 compared to healthy subjects. Methods: In this prospective study, 20 IBD patients and 9 healthy controls were included 6 months after the second BNT162b2 vaccination. In addition to quantitative determination of IgG antibody levels against the SARS-CoV-2 receptor-binding domain (RBD) of the spike protein subunit S1, a SARS-CoV-2 surrogate neutralization test (sVNT) was used to assess potential neutralization capacity. SARS-CoV-2-specific T-cell responses were measured using an interferon-γ (IFN-γ) release assay (IGRA; Euroimmun Medical Laboratory Diagnostics, Lübeck, Germany). Results: S-IgG could still be detected in the majority of IBD patients 6 months after second vaccination. Compared to healthy controls, IBD patients treated with anti-TNF agents showed both lower neutralizing activity in sVNT (percent inhibition of ACE2 receptor binding by RBD protein) and lower IgG-S (AU/mL) antibody levels (AB) (sVNT: 79% vs. 2%, p < 0. 001; AB: 1018 AU/mL vs. 141 AU/mL, p = 0.025). In contrast, patients on therapy with vedolizumab showed no impairment in humoral immune response (sVNT, S-IgG) compared with healthy controls. Specific T-cellular reactivity was detected in 73% of IBD patients and in 67% of healthy controls independent of immunosuppressive therapy (anti-TNF., vedolizumab) (p = 0.189). Conclusion: Six months after BNT162b2 vaccination, this study found significantly decreased antibody levels in patients under anti-TNF therapy. IBD patients under anti-TNF and vedolizumab therapy had no impairment of T-cellular reactivity compared to healthy controls at this time point. Further studies with larger collectives for confirmation should follow. Full article

(This article belongs to the Special Issue Clinical Presentation, Treatment and Vaccination in COVID-19)

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