Articles: sars-cov-2.
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COVID-19 is a respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first documented in late 2019, but within months, a worldwide pandemic was declared due to the easily transmissible nature of the virus. Research to date on the immune response to SARS-CoV-2 has focused largely on conventional B and T lymphocytes. ⋯ We discuss the potential use of these cells as therapeutic agents in the COVID-19 setting. Due to the rapidly evolving situation presented by COVID-19, there is an urgent need to understand the pathogenesis of this disease and the mechanisms underlying its immune response. Through this, we may be able to better help those with severe cases and lower the mortality rate by devising more effective vaccines and novel treatment strategies.
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B Acad Nat Med Paris · Apr 2022
[COVID-19 and organ transplantation, lessons from the national census of the Société Francophone de Transplantation].
The Covid-19 pandemic hit the transplant world in March 2020. Teams quickly organized themselves to optimize the management of their immunocompromised patients and to progress in the knowledge of this new disease. To do this, a French Registry was set up, listing all solid organ transplant patients who had developed a SARS Cov2 infection. ⋯ The advent of vaccination has been a great relief, but transplant patients have developed a poorer vaccine response than immunocompetent subjects, keeping them at risk of severe disease after an adapted vaccination schedule. Specific strategies had to be adopted in this particularly fragile population (increased number of vaccine doses, injection of monoclonal antibodies). The collaboration of the French transplantation centers under the impulse of the Société Francophone de Transplantation allowed us to carry out many collaborative projects, which were of great use for the care of the patients.
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The excellent results of Transplantation over the last decades have highlighted new challenges to be solved in the next years. (1) Modify the storage of harvested organs to improve their quality. (2) Modify strategies by taking into account the immunodeficiency in front of news infections like the one with Sars CoV-2. (3) Better understand the mechanisms of chronic rejection, in particular the role of innate immunity. (4) Rethink immunosuppressive strategies to prevent and to treat chronic rejections.
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Review Meta Analysis
Effect of Prone Positioning on Clinical Outcomes of Non-Intubated Subjects with COVID-19: A Comparative Systematic Review and Meta-Analysis.
Awake prone positioning (APP) has been recently proposed as an adjunctive treatment for non-intubated coronavirus disease 2019 (COVID-19) patients requiring oxygen therapy to improve oxygenation and reduce the risk of intubation. However, the magnitude of the effect of APP on clinical outcomes in these patients remains uncertain. We performed a comparative systematic review and meta-analysis to evaluate the effectiveness of APP to improve the clinical outcomes in non-intubated subjects with COVID-19. ⋯ APP has the potential to reduce the in-hospital mortality rate in COVID-19 subjects with hypoxemia without a significant effect on the need for intubation or length of hospital stay. However, there was a significant decrease in the need for intubation on subgroup analysis of RCTs. More large-scale trials with a standardized protocol for prone positioning are needed to better evaluate its effectiveness in this select population.
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There is a lack of knowledge about the real incidence of acute coronary syndrome (ACS) in patients with COVID-19, their clinical characteristics, and their prognoses. ⋯ The incidence of ACS in patients with COVID-19 attending the emergency department was low, around 1.48%, but could be increased in some circumstances. Patients with COVID-19 with ACS had a worse prognosis than control subjects with higher in-hospital mortality.