Pediatric Multisystem Inflammatory Disease, COVID-19 Related

PHILADELPHIA, Oct. 22, 2024 /PRNewswire/ -- Researchers from Children's Hospital of Philadelphia (CHOP) demonstrated how rapid testing of cytokine levels can help distinguish different diseases with similar symptom profiles. Nearly 30% of clinicians changed how they managed disease in children after receiving cytokine level information, showing the potential for this testing to impact clinical practice. The findings were recently published in the Journal of Allergy and Clinical Immunology. Continue Reading Michele P. Lambert, MD, MSTR, Medical Director of the Special Coagulation Laboratory and attending physician in the Division of Hematology at Children's Hospital of Philadelphia During the COVID-19 pandemic, doctors began diagnosing patients with multisystem inflammatory syndrome in children (MIS-C), a condition that occurs weeks after infection and results from inflammation throughout the body. However, the initial symptoms – such as high fever and changes in blood pressure – are very similar to those of an acute, severe COVID-19 infection, so doctors needed to be able to distinguish between the two conditions, since each one requires a very different course of treatment. Distinguishing between MIS-C and COVID-19 is just one example of the value of serum cytokine panels. Cytokines are signaling proteins that regulate inflammation and coordinate immune responses. Researchers and clinical laboratories have worked hard to make sure that cytokine panels can be analyzed more quickly to inform the course of care – with most results returned after 5 to 7 days – yet understanding the value of cytokines in real time, within 24 hours, as biomarkers for different diseases is a relatively new concept. "We wanted to see what clinicians were able to do with this information if it was returned rapidly and whether results would change clinical decision making or muddy the waters and create confusion," said senior study author Michele P. Lambert, MD, Medical Director of the Special Coagulation Laboratory and an attending physician in the Division of Hematology at CHOP. "We wanted to see potential changes included adding additional antimicrobials or an immune suppressant in response to the results in the panel." The study found that the diagnosis was changed or informed in 18.8% of reviewed cases and management of the patient was changed or informed in 29.8% of cases. Even in the remaining 70.2% of cases where patient care did not change, the results provided important information confirming doctors were providing a correct course of treatment. Another key finding in the study was that specific disease states had clear cytokine patterns. For example, higher levels of interferon gamma (IFNg) and lower levels of interleukins 6 and 8 (IL-6 and IL-8) suggested a more robust inflammatory response, such as cytokine storm or familial hemophagocytic lymphohistiocystosis, a rare condition where the immune system attacks one's own body if left untreated. However, a reverse in those levels was more indicative of bacterial or viral sepsis. "The results of a cytokine panel could potentially save lives: supporting antibiotics or immune suppression, but only if we have the results fast enough," Lambert said. "The evolution of our response time and our understanding of the value of these biomarkers demonstrates how important it is for clinicians and clinical laboratories to collaborate to provide the best care possible for patients." Gallo et al, "Serum Cytokine Panels in Pediatric Clinical Practice." J Allergy Clin Immunol. Online September 18, 2024. DOI: 10.1016/j.jaci.2024.08.030 CONTACT: Amanda DiPaolo Bradley, [email protected] SOURCE Children's Hospital of Philadelphia WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

When the COVID-19 pandemic upended clinical trials worldwide, researchers behind the SELECT study of Novo Nordisk's weight-loss drug Wegovy (semaglutide) made a pivotal decision — instead of suspending the trial, they adapted it to capture COVID-19 data as well. That decision has now yielded some surprise insights.A new analysis, presented at the annual European Society of Cardiology (ESC) meeting and simultaneously published in the Journal of the American College of Cardiology, revealed that while Wegovy didn't reduce the incidence of COVID-19 infections, it did appear to lower the rate of COVID-19-related complications and deaths in a high-risk population.In the first eight months of the pandemic, the US Centers for Disease Control and Prevention has estimated that roughly 30% of COVID-19 hospitalisations were among patients who also had obesity.SELECT enrolled just over 17,600 overweight and obese patients with established cardiovascular (CV) disease, but no history of diabetes. Novo reported results last year showing that Wegovy led to a significant 20% risk reduction in major adverse cardiovascular events (MACE) over a period of up to five years versus placebo.The success underscored that Wegovy could offer health advantages beyond weight loss itself, something Novo has been highlighting in its push for insurance companies to cover the treatment. The SELECT study eventually paved the way for a label expansion earlier this year to include reducing the risk of MACE such as heart attacks and strokes, with Medicare agreeing soon after to cover the cost of obesity drugs if they have received FDA approval for an additional "medically accepted indication."Deaths cut by about a thirdThe latest analysis adds more evidence to the blockbuster shot's increasingly long list of benefits. Roughly a quarter of SELECT study participants (n=4258) reported a diagnosis of COVID-19 during the trial, with similar rates in both the Wegovy and placebo groups.Among those who did, 232 patients treated with Wegovy experienced serious COVID-19–related adverse events (2.6%), compared to 277 (3.1%) for placebo. In addition, there were fewer deaths directly linked to COVID-19 in the Wegovy arm versus placebo, with 43 deaths versus 65, respectively, accounting for a 0.66 hazard ratio."Semaglutide's apparent effect size in reducing COVID-19 mortality deserves consideration," said Jeremy Samuel Faust of Mass General Brigham in an accompanying editorial. "If confirmed, the magnitude of the reductions in contemporaneous all-cause and COVID-19–specific mortality among semaglutide recipients compared with placebo closely resembles the synergistic benefits of aspirin and percutaneous coronary interventions for patients with acute ST-segment elevation myocardial infarction."Faust also highlighted the SELECT trial's broader implications. "The present study implies that, in just a short period, semaglutide was adequate to reduce SARS-CoV-2 mortality. This is akin to a vaccine against the indirect effects of a pathogen, except here, we would expect the efficacy to augment over time, rather than wane. Moreover, the benefit could apply to many infections, not just SARS-CoV-2.

TUESDAY, June 25, 2024 -- Current cannabis use may be an independent risk factor for COVID-19 –related complications, according to a study published online June 21 in JAMA Network Open . Nicholas B. Griffith, from the Washington University School of Medicine in St. Louis, and colleagues examined whether cannabis and tobacco use are associated with adverse health outcomes in patients with COVID-19 when accounting for known risk factors. Analysis included 72,501 patients with COVID-19. The researchers found that 13.4 percent of patients had current smoking, and 9.7 percent had current use of cannabis. There was a significant association seen between current tobacco smoking and increased risk of hospitalization (odds ratio [OR], 1.72), intensive care unit (ICU) admission (OR, 1.22), and all-cause mortality (OR, 1.37) in adjusted analysis. Similarly, cannabis use was significantly associated with increased risk of hospitalization (OR, 1.80) and ICU admission (OR, 1.27). However, cannabis use was not associated with all-cause mortality when adjusting for tobacco smoking, vaccination, comorbidity, diagnosis date, and demographic factors. "These findings suggest the need to evaluate the potential impact of cannabis use on COVID-19 outcomes given the growing legalized use of cannabis," the authors write. Several authors disclosed ties the pharmaceutical industry; one author has a patent for "Markers for Addiction." Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.