COVID-19 pandemic waves: Identification and interpretation of global data

Bali Swain, Ranjula; Lin, Xiang; Wallentin, Fan Yang

doi:10.1016/j.heliyon.2024.e25090

Cited by 3 publications

(2 citation statements)

References 33 publications

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Section: Introductionmentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID-19) has emerged as a highly transmissible viral disease [1] given the inherent characteristics of the virus [2,3], the initial absence of specific antibodies in the majority of the population, and the rapid development of several different variants of the original SARS-CoV-2 [4], making the immunization obtained from previous infection or vaccinations less effective in counteracting the spread of the disease. Owing to these characteristics, several pandemic waves have been recorded in different countries, and complete protection from SARS-CoV-2 infection has not been achieved, even with the development of effective vaccines [3]. The magnitude of the pandemic waves, the lack of knowledge about the disease, and the absence of effective therapies capable of treating the more advanced stages of COVID-19 syndrome often made the response by healthcare facilities insufficient, leading to a significant number of hospitalizations and in-hospital deaths during the first and second pandemic waves.…”

Section: Introductionmentioning

confidence: 99%

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Enhancing Precision of Telemonitoring of COVID-19 Patients through Expert System Based on IoT Data Elaboration

Olivelli,

Donati,

Vianello

et al. 2024

Electronics

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The emergence of the highly contagious coronavirus disease has led to multiple pandemic waves, resulting in a significant number of hospitalizations and fatalities. Even outside of hospitals, general practitioners have faced serious challenges, stretching their resources and putting themselves at risk of infection. Telemonitoring systems based on Internet of things technology have emerged as valuable tools for remotely monitoring disease progression, facilitating rapid intervention, and reducing the risk of hospitalization and mortality. They allow for personalized monitoring strategies and tailored treatment plans, which are crucial for improving health outcomes. However, determining the appropriate monitoring intensity remains the responsibility of physicians, which poses challenges and impacts their workload, and thus, can hinder timely responses. To address these challenges, this paper proposes an expert system designed to recommend and adjust the monitoring intensity for COVID-19 patients receiving home treatment based on their medical history, vital signs, and reported symptoms. The system underwent initial validation using real-world cases, demonstrating a favorable performance (F1-score of 0.85). Subsequently, once integrated with an Internet of Things telemonitoring system, a clinical trial will assess the system’s reliability in creating telemonitoring plans comparable with those of medics, evaluate its effectiveness in reducing medic–patient interactions or hospitalizations, and gauge patient satisfaction and safety.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Enhancing Precision of Telemonitoring of COVID-19 Patients through Expert System Based on IoT Data Elaboration

Olivelli,

Donati,

Vianello

et al. 2024

Electronics

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Efficacy of late-onset antiviral treatment in immune-compromised hosts with persistent SARS-CoV-2 infection

Lieber,

Kang,

Sobolik

et al. 2024

Preprint

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The immunocompromised are at high risk of prolonged SARS-CoV-2 infection and progression to severe COVID-19. However, efficacy of late-onset direct-acting antiviral (DAA) therapy with therapeutics in clinical use and experimental drugs to mitigate persistent viral replication is unclear. In this study, we employed an immunocompromised mouse model, which supports prolonged replication of SARS-CoV-2 to explore late-onset treatment options. Tandem immuno-depletion of CD4+ and CD8+ T cells in C57BL/6 mice followed by infection with SARS-CoV-2 variant of concern (VOC) beta B.1.351 resulted in prolonged infection with virus replication for five weeks after inoculation. Early-onset treatment with nirmatrelvir/ritonavir (paxlovid) or molnupiravir was only moderately efficacious, whereas the experimental therapeutic 4'-fluorourdine (4'-FlU, EIDD-2749) significantly reduced virus load in upper and lower respiratory compartments four days post infection (dpi). All antivirals significantly lowered virus burden in a 7-day treatment regimen initiated 14 dpi, but paxlovid-treated animals experienced rebound virus replication in the upper respiratory tract seven days after treatment end. Viral RNA was detectable 28 dpi in paxlovid-treated animals, albeit not in the molnupiravir or 4'-FlU groups, when treatment was initiated 14 dpi and continued for 14 days. Low-level virus replication continued 35 dpi in animals receiving vehicle but had ceased in all treatment groups. These data indicate that late-onset DAA therapy significantly shortens the duration of persistent virus replication in an immunocompromised host, which may have implications for clinical use of antiviral therapeutics to alleviate the risk of progression to severe disease in highly vulnerable patients.

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Efficacy of late-onset antiviral treatment in immunocompromised hosts with persistent SARS-CoV-2 infection

Lieber,

Kang,

Sobolik

et al. 2024

J Virol

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Immunocompromised people are at high risk of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and progression to severe coronavirus disease 2019 (COVID-19). However, the efficacy of late-onset direct-acting antiviral (DAA) therapy with therapeutics in clinical use and experimental drugs to mitigate persistent viral replication is unclear. In this study, we employed an immunocompromised mouse model, which supports prolonged replication of SARS-CoV-2 to explore late-onset treatment options. Tandem immuno-depletion of CD4 + and CD8 + T cells in C57BL/6 mice followed by infection with SARS-CoV-2 variant of concern (VOC) beta B.1.351 resulted in prolonged infection with virus replication for 5 weeks after inoculation. Early-onset treatment with nirmatrelvir/ritonavir (paxlovid) or molnupiravir was only moderately efficacious, whereas the experimental therapeutic 4’-fluorouridine (4’-FlU, EIDD-2749) significantly reduced virus load in the upper and lower respiratory compartments 4 days postinfection (dpi). All antivirals significantly lowered virus burden in a 7-day treatment regimen initiated 14 dpi, but paxlovid-treated animals experienced rebound virus replication in the upper respiratory tract 7 days after treatment end. Viral RNA was detectable 28 dpi in paxlovid-treated animals, albeit not in the molnupiravir or 4’-FlU groups, when treatment was initiated 14 dpi and continued for 14 days. Low-level virus replication continued 35 dpi in animals receiving vehicle but had ceased in all treatment groups. These data indicate that late-onset DAA therapy significantly shortens the duration of persistent virus replication in an immunocompromised host, which may have implications for clinical use of antiviral therapeutics to alleviate the risk of progression to severe disease in highly vulnerable patients. IMPORTANCE Four years after the onset of the global coronavirus disease 2019 (COVID-19) pandemic, the immunocompromised are at greatest risk of developing life-threatening severe disease. However, specific treatment plans for this most vulnerable patient group have not yet been developed. Employing a CD4 + and CD8 + T cell-depleted immunocompromised mouse model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we explored therapeutic options of persistent infections with standard-of-care paxlovid, molnupiravir, and the experimental therapeutic 4’-fluorouridine (4’-FlU). Late-onset treatment initiated 14 days after infection was efficacious, but only 4’-FlU was rapidly sterilizing. No treatment-experienced viral variants with reduced susceptibility to the drugs emerged, albeit virus replication rebounded in animals of the paxlovid group after treatment end. This study supports the use of direct-acting antivirals (DAAs) for late-onset management of persistent SARS-CoV-2 infection in immunocompromised hosts. However, treatment courses likely require to be extended for maximal therapeutic benefit, calling for appropriately powered clinical trials to meet the specific needs of this patient group.

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COVID-19 pandemic waves: Identification and interpretation of global data

Cited by 3 publications

References 33 publications

Enhancing Precision of Telemonitoring of COVID-19 Patients through Expert System Based on IoT Data Elaboration

Enhancing Precision of Telemonitoring of COVID-19 Patients through Expert System Based on IoT Data Elaboration

Efficacy of late-onset antiviral treatment in immune-compromised hosts with persistent SARS-CoV-2 infection

Efficacy of late-onset antiviral treatment in immunocompromised hosts with persistent SARS-CoV-2 infection

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