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                <text>SARS-CoV-2 outbreak in immune-mediated inflammatory diseases: the Euro-COVIMID multicentre cross-sectional study.</text>
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                <text>David Saadoun, Matheus Vieira, Mathieu Vautier, Xenofon Baraliakos, Ioana Andreica, José A P da Silva, Marlene Sousa, Mariana Luis, Nikita Khmelinskii, José María Alvaro Gracía, Isabel Castrejon, Juan Carlos Nieto Gonzalez, Carlo Alberto Scirè, Ettore Silvagni, Alessandra Bortoluzzi, Henry Penn, Shahir Hamdulay, Pedro M Machado, Bruno Fautrel, Patrice Cacoub, Matthieu Resche-Rigon, Laure Gossec</text>
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                <text>The COVID-19 pandemic has raised numerous questions among patients with immune-mediated inflammatory diseases regarding potential reciprocal effects of COVID-19 and their underlying disease, and potential effects of immunomodulatory therapy on outcomes related to COVID-19. The seroprevalence of SARS-CoV-2 and factors associated with symptomatic COVID-19 in patients with immune-mediated inflammatory diseases are still unclear. The Euro-COVIMID study aimed to determine the serological and clinical prevalence of COVID-19 among patients with immune-mediated inflammatory diseases, as well as factors associated with COVID-19 occurrence and the impact of the pandemic in its management. In this multicentre cross-sectional study, patients aged 18 years or older with a clinical diagnosis of rheumatoid arthritis, axial spondyloarthritis, systemic lupus erythematosus, Sjögren's syndrome, or giant cell arteritis were recruited from six tertiary referral centres in France, Germany, Italy, Portugal, Spain, and the UK. Demographics, comorbidities, treatments, and recent disease flares, as well as information on COVID-19 symptoms, were collected through a questionnaire completed by participants. SARS-CoV-2 serology was systematically tested. The main outcome was the serological and clinical prevalence of COVID-19. Factors associated with symptomatic COVID-19 were assessed by multivariable logistic regression, and incidence of recent disease flares, changes in treatments for underlying disease, and the reasons for treatment changes were also assessed. This study is registered with ClinicalTrials.gov, NCT04397237. Between June 7 and Dec 8, 2020, 3136 patients with an immune-mediated inflammatory disease answered the questionnaire. 3028 patients (median age 58 years [IQR 46-67]; 2239 [73·9%] women and 789 [26·1%] men) with symptomatic COVID-19, serological data, or both were included in analyses. SARS-CoV-2 antibodies were detected in 166 (5·5% [95% CI 4·7-6·4]) of 3018 patients who had serology tests. Symptomatic COVID-19 occurred in 122 (4·0% [95% CI 3·4-4·8]) of 3028 patients, of whom 24 (19·7%) were admitted to hospital and four (3·3%) died. Factors associated with symptomatic COVID-19 were higher concentrations of C-reactive protein (odds ratio 1·18, 95% CI 1·05-1·33; p=0·0063), and higher numbers of recent disease flares (1·27, 1·02-1·58; p=0·030), whereas use of biological therapy was associated with reduced risk (0·51, 0·32-0·82; p=0·0057). At least one disease flare occurred in 654 (21·6%) of 3028 patients. Over the study period, 519 (20·6%) of 2514 patients had treatment changes, of which 125 (24·1%) were due to the pandemic. This study provides key insights into the epidemiology and risk factors of COVID-19 among patients with immune-mediated inflammatory diseases. Overall, immunosuppressants do not seem to be deleterious in this scenario, and the control of inflammatory activity seems to be key when facing the pandemic. Pfizer, Sanofi, Amgen, Galapagos, and Lilly.</text>
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                <text>10.1016/S2665-9913(21)00112-0</text>
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                <text>The Lancet. Rheumatology</text>
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                <text>SARS-COV-2 PANDEMIC IN THE MEDITERRANEAN AREA: EPIDEMIOLOGY AND PERSPECTIVES</text>
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                <text>Walter Mazzucco</text>
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                <text>In December 2019, a disease caused by a novel Severe Acute Respiratory Syndrome Coronavirus 2  (SARS-CoV-2) was identified in Wuhan, Hubei Province, China. In March 2020, the World Health Organization declared the pandemic due to SARS-CoV-2. At the end of May 2020, SARS-CoV-2 confirmed cases and deaths due to novel Coronavirus disease (COVID-19) were about 6.5 million and 380,000, worldwide. In this commentary the authors argue on the impact of SARS-CoV-2 pandemic in different epidemiological settings within the Mediterranean area, discussing any possible association with higher or lower virus spread according to climatic factors, pollutants, characteristics of general population, and organization of health care services.</text>
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                <text>DOI: 10.3269/1970-5492.2020.15.25</text>
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                <text>Euromediterranean Biomedical Journal</text>
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                <text>Associazione Italiana Giovani Medici</text>
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                <text>Medicine (General)</text>
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                <text>SARS-CoV-2 Pathogenesis: Imbalance in the Renin-Angiotensin System Favors Lung Fibrosis</text>
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                <text>M. Victoria Delpino, Jorge Quarleri</text>
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                <text>fibrosis, ACE2, Ang-(1-7), renin-angiotensin system (RAS), SARS-CoV-2</text>
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                <text>DOI: 10.3389/fcimb.2020.00340</text>
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                <text>Frontiers in Cellular and Infection Microbiology</text>
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                <text>Frontiers Media S.A.</text>
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                <text>Microbiology</text>
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                <text>SARS-CoV-2 persistence and non-protective immunity in infected haematological patients.</text>
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                <text>Karolina Akinosoglou, Foteini Paliogianni, Alexandros Spyridonidis, Argiris Symeonidis, Leonidas G Alexopoulos, Dimitrios Ziazias, Alexandra Kouraklis-Symeonidis, Markos Marangos, Charalambos Gogos</text>
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                <text>immunity, covid-19, SARS-CoV-2, Persistence</text>
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                <text>10.1111/bjh.17212</text>
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                <text>British journal of haematology</text>
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                <text>SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels</text>
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                <text>Harvey W. Kaufman, Justin K. Niles, Martin H. Kroll, Caixia Bi, Michael F. Holick, Sakamuri V. Reddy</text>
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                <text>Until treatment and vaccine for coronavirus disease-2019 (COVID-19) becomes widely available, other methods of reducing infection rates should be explored. This study used a retrospective, observational analysis of deidentified tests performed at a national clinical laboratory to determine if circulating 25-hydroxyvitamin D (25(OH)D) levels are associated with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) positivity rates. Over 190,000 patients from all 50 states with SARS-CoV-2 results performed mid-March through mid-June, 2020 and matching 25(OH)D results from the preceding 12 months were included. Residential zip code data was required to match with US Census data and perform analyses of race/ethnicity proportions and latitude. A total of 191,779 patients were included (median age, 54 years [interquartile range 40.4–64.7]; 68% female. The SARS-CoV-2 positivity rate was 9.3% (95% C.I. 9.2–9.5%) and the mean seasonally adjusted 25(OH)D was 31.7 (SD 11.7). The SARS-CoV-2 positivity rate was higher in the 39,190 patients with “deficient” 25(OH)D values (</text>
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                <text>Epidemiology and Health</text>
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                <text>Wen Zhu, Yongwei Zheng, Mei Yu, Jianhui Wei, Yongguang Zhang, Paytsar Topchyan, Christine Nguyen, Rae Janecke, Lisa Baumann Kreuziger, Gilbert C White, Parameswaran Hari, Richard Aster, Weiguo Cui, Shawn Jobe, Mary Beth Graham, Demin Wang, Renren Wen</text>
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                <text>Severe COVID-19 is associated with unprecedented thromboembolic complications. We found that hospitalized COVID-19 patients develop immunoglobulin Gs (IgGs) that recognize a complex consisting of platelet factor 4 and heparin similar to those developed in heparin-induced thrombocytopenia and thrombosis (HIT), however, independent of heparin exposure. These antibodies activate platelets in the presence of TLR9 stimuli, stimuli that are prominent in COVID-19. Strikingly, 4 out of 42 antibodies cloned from IgG1 + RBD-binding B cells could activate platelets. These antibodies possessed, in the heavy-chain complementarity-determining region 3, an RKH or Y 5 motif that we recently described among platelet-activating antibodies cloned from HIT patients. RKH and Y 5 motifs were prevalent among published RBD-specific antibodies, and 3 out of 6 such antibodies tested could activate platelets. Features of platelet activation by these antibodies resemble those by pathogenic HIT antibodies. B cells with an RKH or Y 5 motif were robustly expanded in COVID-19 patients. Our study demonstrates that SARS-CoV-2 infection drives the development of a subset of RBD-specific antibodies that can activate platelets and have activation properties and structural features similar to those of the pathogenic HIT antibodies.</text>
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                <text>Marc Lütgehetmann, Thomas  Theo Brehm, Susanne Pfefferle, Ronald von Possel, Robin Kobbe, Dominik Nörz, Stefan Schmiedel, Adam Grundhoff, Flaminia Olearo, Petra Emmerich, Alexis Robitaille, Thomas Günther, Platon Braun, Gabriele Andersen, Johannes  K. Knobloch, Marylyn  M. Addo, Ansgar  W. Lohse, Martin Aepfelbacher, Nicole Fischer, Julian Schulze zur Wiesch</text>
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                <text>So far, only a few reports about reinfections with SARS-CoV-2 have been published, and they often lack detailed immunological and virological data. We report about a SARS-CoV-2 reinfection with a genetically distinct SARS-CoV-2 variant in an immunocompetent female healthcare worker that has led to a mild disease course. No obvious viral escape mutations were observed in the second virus variant. The infectious virus was shed from the patient during the second infection episode despite the presence of neutralizing antibodies in her blood. Our data indicate that a moderate immune response after the first infection, but not a viral escape, did allow for reinfection and live virus shedding.</text>
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                <text>healthcare worker, immunity, covid-19, SARS-CoV-2, neutralizing antibodies, Reinfection</text>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>SARS-CoV-2 Renal Impairment in Critical Care: An Observational Study of 42 Cases (Kidney COVID)</text>
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                <text>Francis Bonnet, Franck Verdonk, Antoine-Marie Molina Barragan, Emmanuel Pardo, Pierre Galichon, Nicolas Hantala, Anne-Charlotte Gianinazzi, Lucie Darrivere, Eileen  S. Tsai, Marc Garnier, Fabienne Fieux</text>
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                <text>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to 5% to 16% hospitalization in intensive care units (ICU) and is associated with 23% to 75% of kidney impairments, including acute kidney injury (AKI). The current work aims to precisely characterize the renal impairment associated to SARS-CoV-2 in ICU patients. Forty-two patients consecutively admitted to the ICU of a French university hospital who tested positive for SARS-CoV-2 between 25 March 2020, and 29 April 2020, were included and classified in categories according to their renal function. Complete renal profiles and evolution during ICU stay were fully characterized in 34 patients. Univariate analyses were performed to determine risk factors associated with AKI. In a second step, we conducted a logistic regression model with inverse probability of treatment weighting (IPTW) analyses to assess major comorbidities as predictors of AKI. Thirty-two patients (94.1%) met diagnostic criteria for intrinsic renal injury with a mixed pattern of tubular and glomerular injuries within the first week of ICU admission, which lasted upon discharge. During their ICU stay, 24 patients (57.1%) presented AKI which was associated with increased mortality (p = 0.007), hemodynamic failure (p = 0.022), and more altered clearance at hospital discharge (p = 0.001). AKI occurrence was associated with lower pH (p = 0.024), higher PaCO2 (CO2 partial pressure in the arterial blood) (p = 0.027), PEEP (positive end-expiratory pressure) (p = 0.027), procalcitonin (p = 0.015), and CRP (C-reactive protein) (p = 0.045) on ICU admission. AKI was found to be independently associated with chronic kidney disease (adjusted OR (odd ratio) 5.97 (2.1–19.69), p = 0.00149). Critical SARS-CoV-2 infection is associated with persistent intrinsic renal injury and AKI, which is a risk factor of mortality. Mechanical ventilation settings seem to be a critical factor of kidney impairment.</text>
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                <text>pneumonia, SARS-CoV-2, acute kidney injury, Proteinuria, intrinsic renal injury</text>
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                <text>10.3390/jcm10081571</text>
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                <text>Korean Society of Epidemiology</text>
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                <text>SARS-CoV-2 Risk Management in Clinical Psychiatry: A Few Considerations on How to Deal With an Unrivaled Threat</text>
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                <text>Berthold Langguth, Peter M. Kreuzer, Dagmar Steffling, Rainer Rupprecht, Thomas C. Baghai, Markus Wittmann, Michael Ziereis, Marc Zowe, Helmut Hausner</text>
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                <text>The pandemic spread of the corona virus SARS-CoV-2 has even-handedly shattered national and international health systems and economies almost in an instant. As numbers of infections and COVID-19–related deaths rise from day to day, fears and uncertainties on how to deal with this unknown threat are extremely present both for individuals and societies as a whole. In this manuscript, we aim to exemplarily describe the bullet points concerning (a) the internal risk management, (b) the organizational and structural changes, and (c) the communicational strategies applied in a Psychiatric University Hospital in the Southern part of Germany. The authors are well aware about the fact that almost none of these considerations may be considered as evidence-based at the moment. However, the authors trust that these reflections and experiences may be useful as an orientation for similar risk constellations in other afflicted countries due to the temporal delay of the pandemic course.</text>
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                <text>coronavirus, hospital management, Pandemic, pandemia, clinical psychiatry, SARS-CoV-2</text>
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                <text>DOI: 10.3389/fpsyt.2020.00550</text>
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                <text>Frontiers in Psychiatry</text>
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                <text>Frontiers Media S.A.</text>
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                <text>Peter M. Kreuzer, Thomas C. Baghai, Rainer Rupprecht, Markus Wittmann, Dagmar Steffling, Michael Ziereis, Marc Zowe, Helmut Hausner, Berthold Langguth</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="82392">
                <text>The pandemic spread of the corona virus SARS-CoV-2 has even-handedly shattered national and international health systems and economies almost in an instant. As numbers of infections and COVID-19–related deaths rise from day to day, fears and uncertainties on how to deal with this unknown threat are extremely present both for individuals and societies as a whole. In this manuscript, we aim to exemplarily describe the bullet points concerning (a) the internal risk management, (b) the organizational and structural changes, and (c) the communicational strategies applied in a Psychiatric University Hospital in the Southern part of Germany. The authors are well aware about the fact that almost none of these considerations may be considered as evidence-based at the moment. However, the authors trust that these reflections and experiences may be useful as an orientation for similar risk constellations in other afflicted countries due to the temporal delay of the pandemic course.</text>
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            </elementTextContainer>
          </element>
          <element elementId="40">
            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="82393">
                <text>2020</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="82394">
                <text>coronavirus, Pandemic, SARS-CoV-2, pandemia, Hospital management, clinical psychiatry</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="43">
            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
            <elementTextContainer>
              <elementText elementTextId="82395">
                <text>10.3389/fpsyt.2020.00550</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="82396">
                <text>Epidemiology and Health</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="82397">
                <text>Korean Society of Epidemiology</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="38">
            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
            <elementTextContainer>
              <elementText elementTextId="82398">
                <text>Psychiatry</text>
              </elementText>
            </elementTextContainer>
          </element>
        </elementContainer>
      </elementSet>
    </elementSetContainer>
  </item>
</itemContainer>
