Comparative outcomes of hemodialysis patients facing pre‐<scp>Omicron</scp> and <scp>Omicron COVID</scp>‐19 epidemics

Beppu, Hiroko; Fukuda, Tatsuya; Otsubo, Naoya; Akihisa, Taro; Kawanishi, Tomoko; Ogawa, Toshie; Abe, Yasutomo; Endo, Mariko; Hanawa, Tomohide; Sugita, Chise; Kikkawa, Yoshiaki; Yamada, Tetsuya; Wakai, Sachiko

doi:10.1111/1744-9987.14067

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Characterized by many mutations compared to its predecessors, Omicron exhibits elevated transmissibility and the ability to evade the immune response [6,7]. However, works indicate a lower severity regarding disease outcomes [5][6][7][8][9].…”

Section: Plos Onementioning

confidence: 99%

“…Notably, 2022 marked the highest peak in reported cases, with a drastic reduction in the Case Fatality Rate (CFR) compared to earlier stages. The emergence of the Omicron variant in early 2022, characterized by high transmissibility and lower severity, also shaped the dynamics of the pandemic [4][5][6][7][8][9]. We also highlight that at the beginning of January 2022, Brazil had 78% and 67% of the population vaccinated against Covid-19 with at least one dose and fully vaccinated, respectively [4].…”

Section: Introductionmentioning

confidence: 97%

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Estimating time-varying epidemiological parameters and underreporting of Covid-19 cases in Brazil using a mathematical model with fuzzy transitions between epidemic periods

Lima,

Tupinambás,

Guimarães

2024

PLoS ONE

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Our study conducts a comprehensive analysis of the Covid-19 pandemic in Brazil, spanning five waves over three years. We employed a novel Susceptible-Infected-Recovered-Dead-Susceptible (SIRDS) model with a fuzzy transition between epidemic periods to estimate time-varying parameters and evaluate case underreporting. The initial basic reproduction number (R0) is identified at 2.44 (95% Confidence Interval (CI): 2.42–2.46), decreasing to 1.00 (95% CI: 0.99–1.01) during the first wave. The model estimates an underreporting factor of 12.9 (95% CI: 12.5–13.2) more infections than officially reported by Brazilian health authorities, with an increasing factor of 5.8 (95% CI: 5.2–6.4), 12.9 (95% CI: 12.5–13.3), and 16.8 (95% CI: 15.8–17.5) in 2020, 2021, and 2022 respectively. Additionally, the Infection Fatality Rate (IFR) is initially 0.88% (95% CI: 0.81%–0.94%) during the initial phase but consistently reduces across subsequent outbreaks, reaching its lowest value of 0.018% (95% CI: 0.011–0.033) in the last outbreak. Regarding the immunity period, the observed uncertainty and low sensitivity indicate that inferring this parameter is particularly challenging. Brazil successfully reduced R0 during the first wave, coinciding with decreased human mobility. Ineffective public health measures during the second wave resulted in the highest mortality rates within the studied period. We attribute lower mortality rates in 2022 to increased vaccination coverage and the lower lethality of the Omicron variant. We demonstrate the model generalization by its application to other countries. Comparative analyses with serological research further validate the accuracy of the model. In forecasting analysis, our model provides reasonable outbreak predictions. In conclusion, our study provides a nuanced understanding of the Covid-19 pandemic in Brazil, employing a novel epidemiological model. The findings contribute to the broader discourse on pandemic dynamics, underreporting, and the effectiveness of health interventions.

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Section: Plos Onementioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Estimating time-varying epidemiological parameters and underreporting of Covid-19 cases in Brazil using a mathematical model with fuzzy transitions between epidemic periods

Lima,

Tupinambás,

Guimarães

2024

PLoS ONE

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Efficacy and safety of early administration of remdesivir in hemodialysis patients with COVID-19: A case report and literature review

Oshiro,

Kinjo,

Aharen

et al. 2024

Medicine

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Rationale: Although the mortality of severe coronavirus disease 2019 (COVID-19) has decreased after the emergence of the Omicron variant, it remains high in patients on hemodialysis (HD). Remdesivir (RDV) is considered as the first line drug for hospitalized COVID-19 patients, however the evidence regarding the usage in HD patients is lacking because clinical trials of RDV have excluded HD patients for safety reasons. Thus, accumulation of knowledge on the regimen, efficacy, and tolerability of RDV in HD patients is important. Patient concerns: A nosocomial COVID-19 cluster was occurred from August 31 to October 12 in 2021 when the Delta variant was predominant. During the cluster, 11 health-care workers and 20 inpatients including 7 HD patients were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diagnoses: The diagnosis of COVID-19 was confirmed by the real-time polymerase chain reaction (PCR) for SARS-CoV-2. Interventions: RDV was initiated within 16 hours after the onset of fever (≥ 37.4°C) or positive PCR result in all HD patients, and continued at 100 mg/day intravenously once daily for either consecutive 5 or 10 days. Outcomes: All patients fully recovered within 2 weeks and did not develop severe COVID-19. Two patients experienced mild liver dysfunction, but it was temporary and remitted spontaneously even continuing RDV treatment. Discontinuation of RDV therapy due to adverse events was not required in any patients. Lessons: Present cases indicated early intervention with RDV may contribute the favorable outcome and daily administration of RDV for up to 10 days was well tolerated even in HD patients. Literature review showed no previous article reported the efficacy and safety of such earlier and longer administration of remdesivir as in the present cases, therefore this report is informative for clinicians to consider the usage of RDV in HD patients.

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Risk of Severe Outcomes From COVID-19 in Immunocompromised People During the Omicron Era: A Systematic Review and Meta-Analysis

Chapman,

Berenbaum,

Curigliano

et al. 2024

Preprint

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Key PointsQuestion:What are the risks of severe outcomes from COVID-19 in people with immunocompromising/immunosuppressive (IC/IS) conditions in the Omicron era?Findings:This systematic review and meta-analysis found increased risk of severe outcomes for people with IC/IS conditions (e.g., autoimmunity, cancer, liver disease, renal disease, transplant) compared with people without the respective conditions.Of all meta-analyzed conditions, transplant recipients had the highest risk of severe COVID-19 outcomes, compared with non-transplant recipients or the general population.Meaning:People with IC/IS conditions remain at increased risk of severe outcomes from COVID-19 during the Omicron era; continued preventative measures and personalized care are crucial.ImportanceThis is the first meta-analysis to investigate the risk of severe outcomes for individuals with immunocompromising/immunosuppressive (IC/IS) conditions specifically in the Omicron era.ObjectiveTo assess the risk of mortality and hospitalization from COVID-19 in people with IC/IS conditions compared with people without IC/IS conditions during the Omicron era.Data SourcesA systematic search of Embase, MEDLINE, PubMed, Europe PMC, Latin American and Caribbean Health Sciences Literature, Cochrane COVID-19 Study Register, and WHO COVID-19 Database was performed to identify studies published between 1 January 2022 and 13 March 2024.Study SelectionInclusion criteria were observational studies that included people (all ages) with at least 1 of the following conditions: IC/IS unspecified groups, transplant (solid organ, stem cells, or bone marrow), any malignancy, autoimmune diseases, any liver diseases, chronic or end-stage kidney disease, and advanced/untreated HIV. In total, 72 studies were included in the review, of which 66 were included in the meta-analysis.Data Extraction and SynthesisData were extracted by one reviewer and verified by a second. Studies were synthesized quantitively (meta-analysis) using random-effect models. PRISMA guidelines were followed.Main Outcomes and MeasuresEvaluated outcomes were risks of death, hospitalization, intensive care unit (ICU) admission, and any combination of these outcomes. Odds ratios, hazard ratios, and rate ratios were extracted; pooled relative risk (RR) and 95% confidence intervals (CI) were calculated.ResultsMinimum numbers of participants per IC/IS condition ranged from 12 634 to 3 287 816. Risks of all outcomes were increased in people with all meta-analyzed IC/IS conditions compared with people without the respective conditions. Of all meta-analyzed IC/IS conditions, transplant recipients had the highest risk of death (RR, 6.78; 95% CI, 4.41-10.43;P<.001), hospitalization (RR, 6.75; 95% CI, 3.41-13.37;P<.001), and combined outcomes (RR, 8.65; 95% CI, 4.01-18.65;P<.001), while participants in the unspecified IC/IS group had the highest risk of ICU admission (RR, 3.38; 95% CI, 2.37-4.83;P<.001) compared with participants without the respective IC/IS conditions or general population.ConclusionsIn the Omicron era, people with IC/IS conditions have a substantially higher risk of death and hospitalization from COVID-19 than people without these conditions.

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Comparative outcomes of hemodialysis patients facing pre‐Omicron and Omicron COVID‐19 epidemics

Cited by 3 publications

References 23 publications

Estimating time-varying epidemiological parameters and underreporting of Covid-19 cases in Brazil using a mathematical model with fuzzy transitions between epidemic periods

Estimating time-varying epidemiological parameters and underreporting of Covid-19 cases in Brazil using a mathematical model with fuzzy transitions between epidemic periods

Efficacy and safety of early administration of remdesivir in hemodialysis patients with COVID-19: A case report and literature review

Risk of Severe Outcomes From COVID-19 in Immunocompromised People During the Omicron Era: A Systematic Review and Meta-Analysis

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