Michael X Fu, Peter Simmonds, Monique Andersson, Heli Harvala
Blood transfusion is a vital procedure, where transfusion-transmitted infection of hepatitis B virus (HBV) remains an important issue, especially from blood donors with occult hepatitis B virus infection (OBI). Occult hepatitis B virus infection is a complex entity to detect using surrogate blood biomarkers for intrahepatic viral transcriptional activity, requiring a continually refined battery of tests utilised for screening. This review aims to critically evaluate the latest advances in the current blood biomarkers to guide the identification of OBI donors and discuss novel HBV markers that could be introduced in future diagnostic practice. Challenges in detecting low HBV surface antigen levels, mutants, and complexes necessitate ultrasensitive multivalent dissociation assays, whilst HBV DNA testing requires improved sensitivity but worsens inaccessibility. Anti-core antibody assays defer almost all potentially infectious donations but have low specificity, and titres of anti-surface antibodies that prevent infectivity are poorly defined with suboptimal sensitivity. The challenges associated with these traditional blood HBV markers create an urgent need for alternative biomarkers that would help us better understand the OBI. Emerging viral biomarkers, such as pre-genomic RNA and HBV core-related antigen, immunological HBV biomarkers of T-cell reactivity and cytokine levels, and host biomarkers of microRNA and human leucocyte antigen molecules, present potential advances to gauge intrahepatic activity more accurately. Further studies on these markers may uncover an optimal diagnostic algorithm for OBI using quantification of various novel and traditional blood HBV markers. Addressing critical knowledge gaps identified in this review would decrease the residual risk of transfusion-transmitted HBV infection without compromising the sustainability of blood supplies.
{"title":"Biomarkers of transfusion transmitted occult hepatitis B virus infection: Where are we and what next?","authors":"Michael X Fu, Peter Simmonds, Monique Andersson, Heli Harvala","doi":"10.1002/rmv.2525","DOIUrl":"10.1002/rmv.2525","url":null,"abstract":"<p><p>Blood transfusion is a vital procedure, where transfusion-transmitted infection of hepatitis B virus (HBV) remains an important issue, especially from blood donors with occult hepatitis B virus infection (OBI). Occult hepatitis B virus infection is a complex entity to detect using surrogate blood biomarkers for intrahepatic viral transcriptional activity, requiring a continually refined battery of tests utilised for screening. This review aims to critically evaluate the latest advances in the current blood biomarkers to guide the identification of OBI donors and discuss novel HBV markers that could be introduced in future diagnostic practice. Challenges in detecting low HBV surface antigen levels, mutants, and complexes necessitate ultrasensitive multivalent dissociation assays, whilst HBV DNA testing requires improved sensitivity but worsens inaccessibility. Anti-core antibody assays defer almost all potentially infectious donations but have low specificity, and titres of anti-surface antibodies that prevent infectivity are poorly defined with suboptimal sensitivity. The challenges associated with these traditional blood HBV markers create an urgent need for alternative biomarkers that would help us better understand the OBI. Emerging viral biomarkers, such as pre-genomic RNA and HBV core-related antigen, immunological HBV biomarkers of T-cell reactivity and cytokine levels, and host biomarkers of microRNA and human leucocyte antigen molecules, present potential advances to gauge intrahepatic activity more accurately. Further studies on these markers may uncover an optimal diagnostic algorithm for OBI using quantification of various novel and traditional blood HBV markers. Addressing critical knowledge gaps identified in this review would decrease the residual risk of transfusion-transmitted HBV infection without compromising the sustainability of blood supplies.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed Alissa, Abdullah Alghamdi, Suad A Alghamdi
Mpox, a reemerging zoonotic disease caused by the mpox virus, has garnered increasing attention due to its potential for severe clinical manifestations. While the cutaneous and systemic presentations of mpox have been well-documented, its neurological complications have recently emerged as an area of concern. This review provides a brief overview of the neurological aspects of mpox infection, highlighting the key findings and challenges in understanding and managing these complications. Neurological manifestations in mpox patients range from mild symptoms such as headaches and dizziness to more severe conditions, including encephalitis and seizures. The pathogenesis of neurological involvement is not yet fully elucidated but is thought to involve viral dissemination to the central nervous system. This dissemination may occur through haematogenous or neuronal routes, contributing to the diverse clinical spectrum observed. Early recognition and diagnosis of neurological complications in mpox are crucial for implementing appropriate therapeutic interventions and improving patient outcomes.
{"title":"Overview of reemerging mpox infection with a focus on neurological manifestations.","authors":"Mohammed Alissa, Abdullah Alghamdi, Suad A Alghamdi","doi":"10.1002/rmv.2527","DOIUrl":"10.1002/rmv.2527","url":null,"abstract":"<p><p>Mpox, a reemerging zoonotic disease caused by the mpox virus, has garnered increasing attention due to its potential for severe clinical manifestations. While the cutaneous and systemic presentations of mpox have been well-documented, its neurological complications have recently emerged as an area of concern. This review provides a brief overview of the neurological aspects of mpox infection, highlighting the key findings and challenges in understanding and managing these complications. Neurological manifestations in mpox patients range from mild symptoms such as headaches and dizziness to more severe conditions, including encephalitis and seizures. The pathogenesis of neurological involvement is not yet fully elucidated but is thought to involve viral dissemination to the central nervous system. This dissemination may occur through haematogenous or neuronal routes, contributing to the diverse clinical spectrum observed. Early recognition and diagnosis of neurological complications in mpox are crucial for implementing appropriate therapeutic interventions and improving patient outcomes.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bei Pan, Xiaoman Wang, Honghao Lai, Robin W M Vernooij, Xiyuan Deng, Ning Ma, Dan Li, Jiajie Huang, Weilong Zhao, Jinling Ning, Jianing Liu, Jinhui Tian, Long Ge, Kehu Yang
COVID-19 is not only associated with substantial acute liver and kidney injuries, but also with an elevated risk of post-acute sequelae involving the kidney and liver system. We aimed to investigate whether COVID-19 exposure increases the long-term risk of kidney and liver disease, and what are the magnitudes of these associations. We searched PubMed, Embase, Web of Science, ClinicalTrials.gov, and the Living Overview of the Evidence COVID-19 Repository for cohort studies estimating the association between COVID-19 and kidney and liver outcomes. Random-effects meta-analyses were performed to combine the results of the included studies. We assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. Fifteen cohort studies with more than 32 million participants were included in the systematic review COVID-19 was associated with a 35% greater risk of kidney diseases (10 more per 1000 persons; low certainty evidence) and 54% greater risk of liver disease (3 more per 1000 persons; low certainty evidence). The absolute increases due to COVID-19 for acute kidney injury, chronic kidney disease, and liver test abnormality were 3, 8, and 3 per 1000 persons, respectively. Subgroup analyses found no differences between different type of kidney and liver diseases. The findings provide further evidence for the association between COVID-19 and incident kidney and liver conditions. The absolute magnitude of the effect of COVID-19 on kidney and liver outcomes was, however, relatively small.
{"title":"Risk of kidney and liver diseases after COVID-19 infection: A systematic review and meta-analysis.","authors":"Bei Pan, Xiaoman Wang, Honghao Lai, Robin W M Vernooij, Xiyuan Deng, Ning Ma, Dan Li, Jiajie Huang, Weilong Zhao, Jinling Ning, Jianing Liu, Jinhui Tian, Long Ge, Kehu Yang","doi":"10.1002/rmv.2523","DOIUrl":"10.1002/rmv.2523","url":null,"abstract":"<p><p>COVID-19 is not only associated with substantial acute liver and kidney injuries, but also with an elevated risk of post-acute sequelae involving the kidney and liver system. We aimed to investigate whether COVID-19 exposure increases the long-term risk of kidney and liver disease, and what are the magnitudes of these associations. We searched PubMed, Embase, Web of Science, ClinicalTrials.gov, and the Living Overview of the Evidence COVID-19 Repository for cohort studies estimating the association between COVID-19 and kidney and liver outcomes. Random-effects meta-analyses were performed to combine the results of the included studies. We assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. Fifteen cohort studies with more than 32 million participants were included in the systematic review COVID-19 was associated with a 35% greater risk of kidney diseases (10 more per 1000 persons; low certainty evidence) and 54% greater risk of liver disease (3 more per 1000 persons; low certainty evidence). The absolute increases due to COVID-19 for acute kidney injury, chronic kidney disease, and liver test abnormality were 3, 8, and 3 per 1000 persons, respectively. Subgroup analyses found no differences between different type of kidney and liver diseases. The findings provide further evidence for the association between COVID-19 and incident kidney and liver conditions. The absolute magnitude of the effect of COVID-19 on kidney and liver outcomes was, however, relatively small.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As an indispensable trace element, iron is essential for many biological processes. Increasing evidence has shown that virus infection can perturb iron metabolism and play a role in the occurrence and development of viral infection-related diseases. Ferritin plays a crucial role in maintaining the body's iron homoeostasis. It is an important protein to stabilise the iron balance in cells. Ferritin is a 24-mer hollow iron storage protein composed of two subunits: ferritin heavy chain and ferritin light chain. It was reported that ferritin is not only an intra-cellular iron storage protein, but also a pathogenic mediator that enhances the inflammatory process and stimulates the further inflammatory pathway, which is a key member of the vicious pathogenic cycle to perpetuate. Ferritin exerts immuno-suppressive and pro-inflammatory functions during viral infection. In this review, we describe in detail the basic information of ferritin in the first section, including its structural features, the regulation of ferritin. In the second part, we focus on the role of ferritin in viral infection-related diseases and the molecular mechanisms by which viral infection regulates ferritin. The last section briefly outlines the potential of ferritin in antiviral therapy. Given the importance of iron and viral infection, understanding the role of ferritin during viral infection helps us understand the relationship between iron metabolic dysfunction and viral infection, which provides a new direction for the development of antiviral therapeutic drugs.
{"title":"Ferritin: Significance in viral infections.","authors":"Xia Zhao, Yuntao Zhou, Yong Zhang, Yan Zhang","doi":"10.1002/rmv.2531","DOIUrl":"10.1002/rmv.2531","url":null,"abstract":"<p><p>As an indispensable trace element, iron is essential for many biological processes. Increasing evidence has shown that virus infection can perturb iron metabolism and play a role in the occurrence and development of viral infection-related diseases. Ferritin plays a crucial role in maintaining the body's iron homoeostasis. It is an important protein to stabilise the iron balance in cells. Ferritin is a 24-mer hollow iron storage protein composed of two subunits: ferritin heavy chain and ferritin light chain. It was reported that ferritin is not only an intra-cellular iron storage protein, but also a pathogenic mediator that enhances the inflammatory process and stimulates the further inflammatory pathway, which is a key member of the vicious pathogenic cycle to perpetuate. Ferritin exerts immuno-suppressive and pro-inflammatory functions during viral infection. In this review, we describe in detail the basic information of ferritin in the first section, including its structural features, the regulation of ferritin. In the second part, we focus on the role of ferritin in viral infection-related diseases and the molecular mechanisms by which viral infection regulates ferritin. The last section briefly outlines the potential of ferritin in antiviral therapy. Given the importance of iron and viral infection, understanding the role of ferritin during viral infection helps us understand the relationship between iron metabolic dysfunction and viral infection, which provides a new direction for the development of antiviral therapeutic drugs.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dengue, Zika and chikungunya outbreaks pose a significant public health risk to Pacific Island communities. Differential diagnosis is challenging due to overlapping clinical features and limited availability of laboratory diagnostic facilities. There is also insufficient information regarding the complications of these arboviruses, particularly for Zika and chikungunya. We conducted a systematic review and meta-analysis to calculate pooled prevalence estimates with 95% confidence intervals (CI) for the clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands. Based on pooled prevalence estimates, clinical features that may help to differentiate between the arboviruses include headache, haemorrhage and hepatomegaly in dengue; rash, conjunctivitis and peripheral oedema in Zika; and the combination of fever and arthralgia in chikungunya infections. We estimated that the hospitalisation and mortality rates in dengue were 9.90% (95% CI 7.67-12.37) and 0.23% (95% CI 0.16-0.31), respectively. Severe forms of dengue occurred in 1.92% (95% CI 0.72-3.63) of reported cases and 23.23% (95% CI 13.58-34.53) of hospitalised patients. Complications associated with Zika virus included Guillain-Barré syndrome (GBS), estimated to occur in 14.08 (95% CI 11.71-16.66) per 10,000 reported cases, and congenital brain malformations such as microcephaly, particularly with first trimester maternal infection. For chikungunya, the hospitalisation rate was 2.57% (95% CI 1.30-4.25) and the risk of GBS was estimated at 1.70 (95% CI 1.06-2.48) per 10,000 reported cases. Whilst ongoing research is required, this systematic review enhances existing knowledge on the clinical manifestations of dengue, Zika and chikungunya infections and will assist Pacific Island clinicians during future arbovirus outbreaks.
登革热、寨卡病毒和基孔肯雅病毒的爆发对太平洋岛屿社区的公共卫生构成了重大风险。由于临床特征重叠和实验室诊断设施有限,鉴别诊断具有挑战性。有关这些虫媒病毒(尤其是寨卡和基孔肯雅)并发症的信息也不足。我们进行了一项系统回顾和荟萃分析,以计算太平洋岛屿登革热、寨卡和基孔肯雅临床表现的集合流行率估计值及 95% 的置信区间 (CI)。根据汇总的流行率估计值,有助于区分虫媒病毒的临床特征包括:登革热患者的头痛、出血和肝肿大;寨卡患者的皮疹、结膜炎和外周水肿;以及基孔肯雅病毒感染患者的发热和关节痛。我们估计,登革热的住院率和死亡率分别为 9.90% (95% CI 7.67-12.37) 和 0.23% (95% CI 0.16-0.31)。在报告的登革热病例中,有 1.92%(95% CI 0.72-3.63)的患者出现了严重形式的登革热,在住院患者中,有 23.23%(95% CI 13.58-34.53)的患者出现了严重形式的登革热。与寨卡病毒相关的并发症包括吉兰-巴雷综合征(GBS),估计每 10,000 例报告病例中就有 14.08 例(95% CI 11.71-16.66)发生,以及先天性脑畸形(如小头畸形),尤其是孕前三个月的母体感染。基孔肯雅病的住院率为 2.57%(95% CI 1.30-4.25),每 10,000 例报告病例中发生 GBS 的风险估计为 1.70(95% CI 1.06-2.48)。虽然还需要继续开展研究,但这一系统性综述增进了人们对登革热、寨卡和基孔肯雅感染临床表现的现有了解,并将在未来虫媒病毒爆发时为太平洋岛屿的临床医生提供帮助。
{"title":"Clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands: A systematic review and meta-analysis.","authors":"Sahil Kharwadkar, Nipun Herath","doi":"10.1002/rmv.2521","DOIUrl":"10.1002/rmv.2521","url":null,"abstract":"<p><p>Dengue, Zika and chikungunya outbreaks pose a significant public health risk to Pacific Island communities. Differential diagnosis is challenging due to overlapping clinical features and limited availability of laboratory diagnostic facilities. There is also insufficient information regarding the complications of these arboviruses, particularly for Zika and chikungunya. We conducted a systematic review and meta-analysis to calculate pooled prevalence estimates with 95% confidence intervals (CI) for the clinical manifestations of dengue, Zika and chikungunya in the Pacific Islands. Based on pooled prevalence estimates, clinical features that may help to differentiate between the arboviruses include headache, haemorrhage and hepatomegaly in dengue; rash, conjunctivitis and peripheral oedema in Zika; and the combination of fever and arthralgia in chikungunya infections. We estimated that the hospitalisation and mortality rates in dengue were 9.90% (95% CI 7.67-12.37) and 0.23% (95% CI 0.16-0.31), respectively. Severe forms of dengue occurred in 1.92% (95% CI 0.72-3.63) of reported cases and 23.23% (95% CI 13.58-34.53) of hospitalised patients. Complications associated with Zika virus included Guillain-Barré syndrome (GBS), estimated to occur in 14.08 (95% CI 11.71-16.66) per 10,000 reported cases, and congenital brain malformations such as microcephaly, particularly with first trimester maternal infection. For chikungunya, the hospitalisation rate was 2.57% (95% CI 1.30-4.25) and the risk of GBS was estimated at 1.70 (95% CI 1.06-2.48) per 10,000 reported cases. Whilst ongoing research is required, this systematic review enhances existing knowledge on the clinical manifestations of dengue, Zika and chikungunya infections and will assist Pacific Island clinicians during future arbovirus outbreaks.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chiranjib Chakraborty, Manojit Bhattacharya, Sang-Soo Lee
miRNAs are single-stranded ncRNAs that act as regulators of different human body processes. Several miRNAs have been noted to control the human immune and inflammatory response during severe acute respiratory infection syndrome (SARS-CoV-2) infection. Similarly, many miRNAs were upregulated and downregulated during different respiratory virus infections. Here, an attempt has been made to capture the regulatory role of miRNAs in the human immune and inflammatory response during the infection of SARS-CoV-2 and other respiratory viruses. Firstly, the role of miRNAs has been depicted in the human immune and inflammatory response during the infection of SARS-CoV-2. In this direction, several significant points have been discussed about SARS-CoV-2 infection, such as the role of miRNAs in human innate immune response; miRNAs and its regulation of granulocytes; the role of miRNAs in macrophage activation and polarisation; miRNAs and neutrophil extracellular trap formation; miRNA-related inflammatory response; and miRNAs association in adaptive immunity. Secondly, the miRNAs landscape has been depicted during human respiratory virus infections such as human coronavirus, respiratory syncytial virus, influenza virus, rhinovirus, and human metapneumovirus. The article will provide more understanding of the miRNA-controlled mechanism of the immune and inflammatory response during COVID-19, which will help more therapeutics discoveries to fight against the future pandemic.
{"title":"Regulatory role of miRNAs in the human immune and inflammatory response during the infection of SARS-CoV-2 and other respiratory viruses: A comprehensive review.","authors":"Chiranjib Chakraborty, Manojit Bhattacharya, Sang-Soo Lee","doi":"10.1002/rmv.2526","DOIUrl":"10.1002/rmv.2526","url":null,"abstract":"<p><p>miRNAs are single-stranded ncRNAs that act as regulators of different human body processes. Several miRNAs have been noted to control the human immune and inflammatory response during severe acute respiratory infection syndrome (SARS-CoV-2) infection. Similarly, many miRNAs were upregulated and downregulated during different respiratory virus infections. Here, an attempt has been made to capture the regulatory role of miRNAs in the human immune and inflammatory response during the infection of SARS-CoV-2 and other respiratory viruses. Firstly, the role of miRNAs has been depicted in the human immune and inflammatory response during the infection of SARS-CoV-2. In this direction, several significant points have been discussed about SARS-CoV-2 infection, such as the role of miRNAs in human innate immune response; miRNAs and its regulation of granulocytes; the role of miRNAs in macrophage activation and polarisation; miRNAs and neutrophil extracellular trap formation; miRNA-related inflammatory response; and miRNAs association in adaptive immunity. Secondly, the miRNAs landscape has been depicted during human respiratory virus infections such as human coronavirus, respiratory syncytial virus, influenza virus, rhinovirus, and human metapneumovirus. The article will provide more understanding of the miRNA-controlled mechanism of the immune and inflammatory response during COVID-19, which will help more therapeutics discoveries to fight against the future pandemic.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Walsh, Helen O’Donnell, Mark O’Loughlin, Heather Eames, Jingjing Jiang, Katie M. O’Brien, N. Broderick, Kirsty O'Brien, M. Carrigan, L. Comber, Karen Cardwell, Joan Quigley, Susan M. Smith, Eamon O Murchu, Karina Butler, Brenda Corcoran, Kevin Connolly, P. Harrington, M. Ryan, M. O’Neill
The World Health Organization has stated that the primary goal of immunisation in the COVID‐19 pandemic remains to protect against hospitalisation, severe disease and death. Vaccination is particularly important for those with underlying health conditions given the high risk of severe disease in this population. The aim of this review was to examine the change in efficacy and effectiveness of COVID‐19 vaccination over time in individuals with underlying conditions. A rapid review was undertaken in Cochrane, Embase, Medline, Europe PMC, MedRxiv and Google Scholar from 01/01/2020 to 27/10/2021. A total of 14 unique studies (3 randomised controlled trials and 11 observational studies) were included. Overall, there was limited and inconsistent evidence regarding vaccine efficacy and effectiveness in those with underlying health conditions. However, the evidence suggests potentially faster waning of vaccine effectiveness against infection, severe disease and death in individuals with underlying conditions, particularly for older adults with these conditions, and in those who are immunocompromised. Protection in younger age groups with underlying conditions who are not immunocompromised, may be largely comparable to that observed in the general population, though this is uncertain. Given the significant burden of infection on individuals with underlying conditions, any small decrease in protection is likely to have a substantial impact in this population. Hence, the evidence supports a policy of providing additional doses to those who are immunocompromised, and boosters to all those with underlying health conditions. Further research is required to understand the impact of new variants on vaccine efficacy/effectiveness in this population.
{"title":"Duration of protective immunity following COVID‐19 vaccination of individuals with underlying health conditions: A rapid review","authors":"K. Walsh, Helen O’Donnell, Mark O’Loughlin, Heather Eames, Jingjing Jiang, Katie M. O’Brien, N. Broderick, Kirsty O'Brien, M. Carrigan, L. Comber, Karen Cardwell, Joan Quigley, Susan M. Smith, Eamon O Murchu, Karina Butler, Brenda Corcoran, Kevin Connolly, P. Harrington, M. Ryan, M. O’Neill","doi":"10.1002/rmv.2504","DOIUrl":"https://doi.org/10.1002/rmv.2504","url":null,"abstract":"The World Health Organization has stated that the primary goal of immunisation in the COVID‐19 pandemic remains to protect against hospitalisation, severe disease and death. Vaccination is particularly important for those with underlying health conditions given the high risk of severe disease in this population. The aim of this review was to examine the change in efficacy and effectiveness of COVID‐19 vaccination over time in individuals with underlying conditions. A rapid review was undertaken in Cochrane, Embase, Medline, Europe PMC, MedRxiv and Google Scholar from 01/01/2020 to 27/10/2021. A total of 14 unique studies (3 randomised controlled trials and 11 observational studies) were included. Overall, there was limited and inconsistent evidence regarding vaccine efficacy and effectiveness in those with underlying health conditions. However, the evidence suggests potentially faster waning of vaccine effectiveness against infection, severe disease and death in individuals with underlying conditions, particularly for older adults with these conditions, and in those who are immunocompromised. Protection in younger age groups with underlying conditions who are not immunocompromised, may be largely comparable to that observed in the general population, though this is uncertain. Given the significant burden of infection on individuals with underlying conditions, any small decrease in protection is likely to have a substantial impact in this population. Hence, the evidence supports a policy of providing additional doses to those who are immunocompromised, and boosters to all those with underlying health conditions. Further research is required to understand the impact of new variants on vaccine efficacy/effectiveness in this population.","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139867563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Walsh, Helen O’Donnell, Mark O’Loughlin, Heather Eames, Jingjing Jiang, Katie M. O’Brien, N. Broderick, Kirsty O'Brien, M. Carrigan, L. Comber, Karen Cardwell, Joan Quigley, Susan M. Smith, Eamon O Murchu, Karina Butler, Brenda Corcoran, Kevin Connolly, P. Harrington, M. Ryan, M. O’Neill
The World Health Organization has stated that the primary goal of immunisation in the COVID‐19 pandemic remains to protect against hospitalisation, severe disease and death. Vaccination is particularly important for those with underlying health conditions given the high risk of severe disease in this population. The aim of this review was to examine the change in efficacy and effectiveness of COVID‐19 vaccination over time in individuals with underlying conditions. A rapid review was undertaken in Cochrane, Embase, Medline, Europe PMC, MedRxiv and Google Scholar from 01/01/2020 to 27/10/2021. A total of 14 unique studies (3 randomised controlled trials and 11 observational studies) were included. Overall, there was limited and inconsistent evidence regarding vaccine efficacy and effectiveness in those with underlying health conditions. However, the evidence suggests potentially faster waning of vaccine effectiveness against infection, severe disease and death in individuals with underlying conditions, particularly for older adults with these conditions, and in those who are immunocompromised. Protection in younger age groups with underlying conditions who are not immunocompromised, may be largely comparable to that observed in the general population, though this is uncertain. Given the significant burden of infection on individuals with underlying conditions, any small decrease in protection is likely to have a substantial impact in this population. Hence, the evidence supports a policy of providing additional doses to those who are immunocompromised, and boosters to all those with underlying health conditions. Further research is required to understand the impact of new variants on vaccine efficacy/effectiveness in this population.
{"title":"Duration of protective immunity following COVID‐19 vaccination of individuals with underlying health conditions: A rapid review","authors":"K. Walsh, Helen O’Donnell, Mark O’Loughlin, Heather Eames, Jingjing Jiang, Katie M. O’Brien, N. Broderick, Kirsty O'Brien, M. Carrigan, L. Comber, Karen Cardwell, Joan Quigley, Susan M. Smith, Eamon O Murchu, Karina Butler, Brenda Corcoran, Kevin Connolly, P. Harrington, M. Ryan, M. O’Neill","doi":"10.1002/rmv.2504","DOIUrl":"https://doi.org/10.1002/rmv.2504","url":null,"abstract":"The World Health Organization has stated that the primary goal of immunisation in the COVID‐19 pandemic remains to protect against hospitalisation, severe disease and death. Vaccination is particularly important for those with underlying health conditions given the high risk of severe disease in this population. The aim of this review was to examine the change in efficacy and effectiveness of COVID‐19 vaccination over time in individuals with underlying conditions. A rapid review was undertaken in Cochrane, Embase, Medline, Europe PMC, MedRxiv and Google Scholar from 01/01/2020 to 27/10/2021. A total of 14 unique studies (3 randomised controlled trials and 11 observational studies) were included. Overall, there was limited and inconsistent evidence regarding vaccine efficacy and effectiveness in those with underlying health conditions. However, the evidence suggests potentially faster waning of vaccine effectiveness against infection, severe disease and death in individuals with underlying conditions, particularly for older adults with these conditions, and in those who are immunocompromised. Protection in younger age groups with underlying conditions who are not immunocompromised, may be largely comparable to that observed in the general population, though this is uncertain. Given the significant burden of infection on individuals with underlying conditions, any small decrease in protection is likely to have a substantial impact in this population. Hence, the evidence supports a policy of providing additional doses to those who are immunocompromised, and boosters to all those with underlying health conditions. Further research is required to understand the impact of new variants on vaccine efficacy/effectiveness in this population.","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139807548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed N. Farrag, Ahmed M. Kamel, Iman A. El-Baraky
Despite the advent of direct-acting antiviral agents (DAAs) as a definitive therapy for chronic hepatitis C virus (HCV) infection, the burden of the disease remains globally elevated. The emerging big data on different HCV paradigms fostered the introduction of artificial intelligence/machine learning (AI/ML) applications to help decrease that burden by providing more optimised strategies for early diagnosis and treatment prioritisation. The current review provides descriptive and analytical insight into the recently published AI/ML applications in five medical aspects of HCV infection. In addition, it highlights the opportunities these powerful tools offer in designing national health policies that prioritise HCV patients for the costly DAAs and developing broadly neutralising HCV antibodies. Finally, this paper highlights the challenges encountered in developing and applying these AI/ML models to clinical practice and suggests schemes to overcome some of them. The presented models were primarily evaluated using the Matthews correlation coefficient and the F1-score to make a more reliable inference about their predictive power under imbalanced datasets. Many published AI/ML applications offered great utilities for predicting novel HCV treatments and prioritising patients for DAAs receipt, especially in settings of limited resources and high HCV burden. Some outperformed the classical diagnostic tools, such as third-generation serological tests, alpha-fetoprotein, and ultrasound, in detecting HCV infections and early HCV-associated hepatocellular carcinoma, respectively. However, further statistical and clinical validation of AI/ML models is highly advocated before incorporating these applications into clinical practice.
{"title":"Opportunities and challenges for the application of artificial intelligence paradigms into the management of endemic viral infections: The example of Chronic Hepatitis C Virus","authors":"Ahmed N. Farrag, Ahmed M. Kamel, Iman A. El-Baraky","doi":"10.1002/rmv.2514","DOIUrl":"https://doi.org/10.1002/rmv.2514","url":null,"abstract":"Despite the advent of direct-acting antiviral agents (DAAs) as a definitive therapy for chronic hepatitis C virus (HCV) infection, the burden of the disease remains globally elevated. The emerging big data on different HCV paradigms fostered the introduction of artificial intelligence/machine learning (AI/ML) applications to help decrease that burden by providing more optimised strategies for early diagnosis and treatment prioritisation. The current review provides descriptive and analytical insight into the recently published AI/ML applications in five medical aspects of HCV infection. In addition, it highlights the opportunities these powerful tools offer in designing national health policies that prioritise HCV patients for the costly DAAs and developing broadly neutralising HCV antibodies. Finally, this paper highlights the challenges encountered in developing and applying these AI/ML models to clinical practice and suggests schemes to overcome some of them. The presented models were primarily evaluated using the Matthews correlation coefficient and the F1-score to make a more reliable inference about their predictive power under imbalanced datasets. Many published AI/ML applications offered great utilities for predicting novel HCV treatments and prioritising patients for DAAs receipt, especially in settings of limited resources and high HCV burden. Some outperformed the classical diagnostic tools, such as third-generation serological tests, alpha-fetoprotein, and ultrasound, in detecting HCV infections and early HCV-associated hepatocellular carcinoma, respectively. However, further statistical and clinical validation of AI/ML models is highly advocated before incorporating these applications into clinical practice.","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139663090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mingyao Sun, Mengyuan Yuan, Honghao Lai, Qian Wang, Hengyang Wang, Lina Xing, Jinhui Tian, Zhigang Zhang, Long Ge
Cardiovascular diseases (CVD) are common in long COVID, yet the associated risk remains uncertain. We aimed to quantify the risk of new-onset cardiovascular diseases after COVID-19. We searched PubMed, Embase, and Web of Science from inception up to October 2022. Cohort studies that provided information on the number, proportion, or relative risks (RR) of cardiovascular diseases after COVID-19 were included. Paired reviewers independently screened studies, extracted data, and assessed the risk of bias. We performed random-effects models meta-analyses to calculate RR and corresponding 95% confidence interval (95%CI), and conducted subgroup analyses and meta-regression to explore the potential risk factors. Absolute effects were calculated to facilitate interpretation. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to assess the certainty of evidence. Outcomes of interest were any CVD, major adverse cardiovascular events (MACE), arrhythmias, heart failure, myocarditis, and thrombotic events. Fourteen cohort studies with over 25.37 million participants were included. The results showed a 2.42 times higher risk of any CVD (RR = 2.42, 95% CI: 1.24–4.71; 51 more per 1000), a 95% higher risk of MACE (RR = 1.95, 95% CI: 1.59–2.40; 4 more per 1000), a 61% higher risk of arrhythmias (RR = 1.61, 95% CI: 1.42–1.83; 12 more per 1000), a 71% higher risk of heart failure (RR = 1.71, 95% CI: 1.33–2.21; 2 more per 1000), a 5 times higher risk of myocarditis (RR = 5.06, 95% CI: 3.78–6.77; 4 more per 1000), and a 2.49 times higher risk of thrombotic events (RR = 2.49, 95% CI: 1.22–5.06; 6 more per 1000) associated with COVID-19. Besides, for thrombotic events, a statistically significant subgroup effect was observed in male participants compared to females (Pinteraction = 0.008). The certainty of evidence was high for myocarditis, but low or very low for other outcomes. The results clearly showed varying degrees of elevated new-onset CVD risk in post-COVID-19 individuals. Additionally, our findings suggest that male patients face a higher risk of thrombotic events. However, the differences in pooled results between studies, and the over-precision due to the large sample size of the included studies resulted in high heterogeneity of exceeding 90% in most outcomes, which led to low certainty of evidence.
{"title":"Increased risk of new-onset cardiovascular disease after COVID-19: A systematic review and meta-analysis of 14 cohorts","authors":"Mingyao Sun, Mengyuan Yuan, Honghao Lai, Qian Wang, Hengyang Wang, Lina Xing, Jinhui Tian, Zhigang Zhang, Long Ge","doi":"10.1002/rmv.2518","DOIUrl":"https://doi.org/10.1002/rmv.2518","url":null,"abstract":"Cardiovascular diseases (CVD) are common in long COVID, yet the associated risk remains uncertain. We aimed to quantify the risk of new-onset cardiovascular diseases after COVID-19. We searched PubMed, Embase, and Web of Science from inception up to October 2022. Cohort studies that provided information on the number, proportion, or relative risks (RR) of cardiovascular diseases after COVID-19 were included. Paired reviewers independently screened studies, extracted data, and assessed the risk of bias. We performed random-effects models meta-analyses to calculate RR and corresponding 95% confidence interval (95%CI), and conducted subgroup analyses and meta-regression to explore the potential risk factors. Absolute effects were calculated to facilitate interpretation. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to assess the certainty of evidence. Outcomes of interest were any CVD, major adverse cardiovascular events (MACE), arrhythmias, heart failure, myocarditis, and thrombotic events. Fourteen cohort studies with over 25.37 million participants were included. The results showed a 2.42 times higher risk of any CVD (RR = 2.42, 95% CI: 1.24–4.71; 51 more per 1000), a 95% higher risk of MACE (RR = 1.95, 95% CI: 1.59–2.40; 4 more per 1000), a 61% higher risk of arrhythmias (RR = 1.61, 95% CI: 1.42–1.83; 12 more per 1000), a 71% higher risk of heart failure (RR = 1.71, 95% CI: 1.33–2.21; 2 more per 1000), a 5 times higher risk of myocarditis (RR = 5.06, 95% CI: 3.78–6.77; 4 more per 1000), and a 2.49 times higher risk of thrombotic events (RR = 2.49, 95% CI: 1.22–5.06; 6 more per 1000) associated with COVID-19. Besides, for thrombotic events, a statistically significant subgroup effect was observed in male participants compared to females (<i>P</i><sub><i>interaction</i></sub> = 0.008). The certainty of evidence was high for myocarditis, but low or very low for other outcomes. The results clearly showed varying degrees of elevated new-onset CVD risk in post-COVID-19 individuals. Additionally, our findings suggest that male patients face a higher risk of thrombotic events. However, the differences in pooled results between studies, and the over-precision due to the large sample size of the included studies resulted in high heterogeneity of exceeding 90% in most outcomes, which led to low certainty of evidence.","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":null,"pages":null},"PeriodicalIF":11.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139663013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}