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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a global health crisis, exacerbating issues like malnutrition due to increased metabolic demands and reduced intake during illness. Malnutrition, a significant risk factor, is linked to worse outcomes in patients with COVID-19, such as increased mortality and extended hospital stays. This retrospective cohort study investigated the relationship between malnutrition and clinical outcomes within 90–180 days using data obtained from the TriNetX database. Patients aged >18 years diagnosed with COVID-19 between 1 January 2022, and 31 March 2024 were enrolled in the study. The propensity score-matching (PSM) method was used to match patients with malnutrition (malnutrition group) and those without malnutrition (control group). The primary composite outcome was the cumulative hazard ratio (HR) for post-COVID-19 condition, all-cause hospitalization, and all-cause mortality between 90 days and 180 days after COVID-19 diagnosis. The secondary outcomes were the individual components of the primary outcomes. Two cohorts, each consisting of 15,004 patients with balanced baseline characteristics, were identified using PSM. During the 90–180-day follow-up period, the malnutrition group exhibited a higher incidence of all-cause hospitalization, mortality, or post-COVID-19 condition (HR = 2.315, 95% confidence interval: 2.170–2.471, p < 0.0001). Compared with patients with COVID-19 without malnutrition, those with malnutrition may be associated with a higher risk of adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

This study investigated the clinical effectiveness of nirmatrelvir plus ritonavir (NMV‐r) on short‐term outcome and the risk of postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection (PASC) among pediatric patients with coronavirus disease 2019 (COVID‐19). This retrospective cohort study used the TriNetX research network to identify pediatric patients between 12 and 18 years with COVID‐19 between January 1, 2022 and August 31, 2023. The propensity score matching (PSM) method was used to match patients receiving NMV‐r (NMV‐r group) with those who did not receive NMV‐r (control group). Two cohorts comprising 633 patients each (NMV‐r and control groups), with balanced baseline characteristics, were identified using the PSM method. During the initial 30 days, the NMV‐r group showed a lower incidence of all‐cause hospitalization, mortality, or ED visits (hazard ratio [HR] = 0.546, 95% confidence interval [CI]: 0.372–0.799, p = 0.002). Additionally, the NMV‐r group had a significantly lower risk of all‐cause hospitalization compared with the control group (HR = 0.463, 95% CI: 0.269–0.798), with no deaths occurring in either group. In the 30–180‐day follow‐up period, the NMV‐r group exhibited a non‐significantly lower incidence of post‐acute sequelae of SARS‐CoV‐2 infection (PASC), encompassing symptoms such as fatigue, cardiopulmonary symptoms, pain, cognitive impairments, headache, dizziness, sleep disorders, anxiety, and depression, compared to the control group. This study underscores the potential effectiveness of NMV‐r in treating high‐risk pediatric patients with COVID‐19, demonstrating significant reductions in short‐term adverse outcomes such as emergency department visits, hospitalization, or mortality within the initial 30‐day period. Additionally, NMV‐r shows promise in potentially preventing the development of PASC. [ABSTRACT FROM AUTHOR]

This study investigated the outcomes of underweight patients with COVID-19 and the effectiveness of antiviral agents in this population. A retrospective cohort study using theTriNetX research network was conducted. Propensity score matching (PSM) was employed to balance the first cohort involving COVID-19 patients with underweight and normal-weight. In the second cohort, underweight patients receiving antiviral agents and untreated individuals were matched using PSM. The primary outcome was a composite of all-cause hospitalization and death during the 7–30-day follow-up period. After PSM, the first cohort including each group of 13,502 patients with balanced baseline characteristics were identified for comparing the outcome of patients with underweight and normal weight. The underweight group had a higher risk of the composite primary outcome than those with normal weight (hazard ratio [HR], 1.251; 95% confidence interval [CI], 1.132–1.382). The second cohort included each 884 underweight patients with and without receiving antivirals.Compared with untreated patients, those receiving antiviral treatment had a lower risk of composite primary outcomes (HR, 0.426; 95% CI, 0.278–0.653). Underweight status may be associated with a higher risk of all-cause hospitalization and death in patients with COVID-19.Among underweight patients, antiviral agents demonstrated clinically beneficial effects. [ABSTRACT FROM AUTHOR]

This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV-r) in treating patients with COVID-19 who have preexisting cardiovascular diseases (CVDs). Patients with underlying CVDs and COVID-19 were included from the TriNetX network. We employed a 1:1 propensity score matching to create two comparable cohorts: patients receiving NMV-r and those not receiving NMV-r. The primary outcome was the composite outcome of all-cause hospitalization or death within 30 days. Propensity score matching yielded two matched cohorts of 10,847 patients each. The composite outcomes of all-cause hospitalization or death within 30 days were 2.2% (239 patients) in the NMV-r cohort and 4.7% (512 patients) in the control cohort, indicating reduced risk in the NMV-r cohort (hazard ratio [HR], 0.475; 95% confidence interval [CI], 0407–0.533). The NMV-r cohort exhibited lower risks of all-cause hospitalization (HR, 0.525; 95% CI, 0.449–0.615) and mortality (HR, 0.113; 95% CI, 0.052–0.246) compared with the control group. A similar trend was observed across most of the subgroups. Our findings indicate that NMV-r to treat COVID-19 could reduce all-cause hospitalization and death in patients with CVDs. [ABSTRACT FROM AUTHOR]

This study investigated the risk of post-COVID-19 conditions in older patients with COVID-19 compared to those with influenza, and how age impacts this relationship. Patients aged ≥65 years with COVID-19 or influenza were identified using the TriNetX network. The risk of post-COVID-19 conditions was compared between survivors of COVID-19 and influenza, followed by a comparison of post-COVID-19 conditions risk between patients aged 65–74 years and those aged over 75 years. Compared with influenza survivors, post-COVID-19 conditions were significantly more prevalent in patients with COVID-19 (hazard ratio [HR], 1.534; 95% confidence interval [CI]: 1.405–1.675). Specifically, COVID-19 survivors have a significantly higher risk of experiencing abnormal breathing (HR, 2.052; 95% CI: 1.757–2.397), fatigue (HR, 1.587; 95% CI: 1.322–1.905), anxiety/depression (HR, 1.587; 95% CI: 1.322–1.905), cognitive symptoms (HR, 1.667; 95% CI: 1.295–2.146) and cough (HR, 1.250; 95% CI: 1.006–1.553) compared with the influenza group. Contrastingly, no significant difference was observed in the risk of any post-COVID-19 condition between COVID-19 survivors aged 65–74 years and those aged over 75 years (HR, 0.994; 95% CI: 0.920–1.073). However, a lower incidence of cognitive symptoms was observed in patients aged 65–74 years compared to those aged ≥75 years (HR, 0.543; 95% CI: 0.445–0.661). In conclusion, compared with influenza, older patients have a higher risk of developing post-COVID-19 conditions after SARS-CoV-2 infection, and those aged over ≥75 years may have an increased risk of developing cognitive symptoms compared to those aged 65–74 years. [ABSTRACT FROM AUTHOR]

The effect of anemia on the post‐acute outcome of patients with severe acute respiratory syndrome coronavirus 2 infection was unclear. This study aimed to investigate the potential association between nutritional deficiency anemia (NDA) status and post‐acute sequelae of patients with SARS‐CoV‐2 infection. This retrospective cohort study included patients with coronavirus disease (COVID‐19) from January 1, 2022 to November 30, 2022 using the TriNetX research network. The patients were grouped into the NDA group comprising patients diagnosed with NDA and the control group comprising patients without NDA, and propensity score matching (PSM) was performed to balance the two groups. The primary outcome was a composite of post‐COVID‐19 condition, all‐cause hospitalization, and all‐cause death. The secondary outcomes were any individual outcomes of the primary composite. The follow‐up period was set at 90–180 days after COVID‐19 diagnosis. Two cohorts comprising 15 446 nonhospitalized patients with COVID‐19 in each group with balanced baseline characteristics were created using PSM. During the follow‐up period, the NDA group demonstrated a higher risk of the composite primary outcome, including post‐COVID‐19 condition, all‐cause hospitalization, or all‐cause death (hazard ratio [HR], 1.896; 95% confidence interval [CI] = 1.757–2.045). Regarding secondary outcomes, the NDA group was associated with worse outcomes, including post‐COVID‐19 condition (HR, 1.992; 95% CI = 1.403–2.828), all‐cause hospitalization (HR, 1.856; 95% CI = 1.714–2.009), and all‐cause death (HR, 3.922; 95% CI = 2.910–5.285) compared to the control group. Among nonhospitalized patients with COVID‐19, NDA was associated with a higher risk of post‐COVID‐19 condition, all‐cause hospitalization, and all‐cause death during the 90–180‐day follow‐up period. [ABSTRACT FROM AUTHOR]

This retrospective cohort study assessed the clinical effectiveness of nirmatrelvirplus ritonavir (NMV-r) in treating COVID-19 in patients with liver cirrhosis(LC). The data of non-hospitalized adult patients with LC who had COVID-19 were selected from the TriNetX platform for the period between 1 March 20201 March 2020, and 31 December 202231 December 2022. Propensity score matching was used to match patients receiving NMV-r (theNMV-r group) with those not receiving NMV-r (the control group). Hazard ratios(HRs) along with 95% confidence intervals (CIs) for the primary outcome – a composite of all-cause hospitalization or mortality during the 30-day follow-up period – were calculated and compared. Two cohorts of 2,369 patients each with balanced baseline characteristics were identified.During the follow-up period, the NMV-r group had a lower risk of all-cause hospitalization or mortality (HR, 0.642;95% CI, 0.503–0.819) than did the control group.NMV-r was also associated with a reduced risk of individual all-cause hospitalization (HR 0.681, 95% CI 0.530–0.876])and all-cause mortality (HR, 0.270; 95% CI,0.129–0.562). This association was consistently observed in the subgroups of age, sex, vaccination status, and LC severity. NMV-r can reduce all-cause hospitalization and mortality among patients with LC who have COVID-19. [ABSTRACT FROM AUTHOR]

This study was aimed at investigating the risk of cytomegalovirus (CMV) disease among coronavirus disease 2019 (COVID‐19) survivors. In this retrospective cohort study, we used the TriNetX research network to identify adults with and without COVID‐19 between January 1, 2022 and December 31, 2022. Propensity score matching was used to match the patients with and without COVID‐19. The primary outcome was the risk of CMV disease during the 90‐day follow‐up period. Two matched cohorts comprising 2 501 634 patients with balanced baseline characteristics were created using propensity score matching. During the follow‐up period, patients with COVID‐19 had a higher risk of CMV disease than those without COVID‐19 (hazard ratio [HR], 2.55; 95% confidence interval: 2.01–3.23). The higher risk of CMV disease in the COVID‐19 cohort compared with that of the non‐COVID‐19 cohort remained unchanged in the subgroup analyses by sex (men: HR, 1.85 [1.38–2.47]; women: HR, 2.31 [1.63–3.27]), age (18–64 years: HR, 2.21 [1.71–2.85]; ≥65 years: HR, 1.97 [1.20–3.25]), obesity (HR, 1.54 [1.04–2.30]), diabetes mellitus (HR, 1.50 [1.08–2.08]), cancer (HR, 3.10 [1.95–4.92]), glucocorticoid use (HR, 3.14 [2.45–4.02]), transplantation (HR, 1.38 [1.08–1.77]), and unvaccinated status (HR, 2.37 [1.82–3.08]). In conclusion, COVID‐19 can increase the risk of CMV disease. Clinicians should be aware of the risk of CMV disease in patients with COVID‐19. [ABSTRACT FROM AUTHOR]

Although a novel oral antiviral agent can improve short‐term COVID‐19 outcomes, its effects on the long‐term outcomes, namely the risk of major adverse cardiovascular events (MACEs), remains unknown. This retrospective cohort study used the TriNetX research network to identify nonhospitalized adult patients with COVID‐19 between March 1, 2020, and January 1, 2022. A propensity score matching method was used to form two matched cohorts with and without receiving nirmatrelvir–ritonavir (NMV‐r) or molnupiravir. The primary outcome was the incidence of MACEs within a 30‐day to 1‐year period following a diagnosis of COVID‐19. Two cohorts of each 80 888 patients with balanced baseline characteristics were formed using propensity score matching. During the follow‐up period, 976 patients in the study group and 1609 patients in the control group developed MACE. Overall, the study group had a significantly lower risk of MACE than the control group (hazard ratio [HR], 0.683; 95% confidence interval: 0.630–0.739). The significantly lower HRs of overall MACEs were consistently observed in most subgroup analyses (age: >41–≤64 years: 0.60 [0.52–0.89]; age: ≥65 years: 0.68 [0.62–0.76]; women: 0.63 [0.57–0.71]; men: 0.62 [0.55–0.70]; vaccinated: 0.74 [0.63–0.88]; unvaccinated: 0.66 [0.60–0.73]; NMV‐r; 0.65 [0.59–0.71]; and molnupiravir: 0.75 [0.61–0.92]). In conclusion, novel oral antiviral agents, namely NMV‐r and molnupiravir, were effective in reducing long‐term MACEs among nonhospitalized patients with COVID‐19, particularly when treated with NMV‐r or in patients aged ≥40 years. These findings suggest the potential role of novel antiviral agents as a preventive measure to reduce further adverse cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

The retrospective cohort was conducted to assess the effect of nirmatrelvir‐ritonavir (NMV‐r) on the long‐term risk of neuropsychiatric sequela following COVID‐19. TriNetX research network was used to identify nonhospitalized adult patients who tested positive for severe acute respiratory syndrome coronavirus 2 infection or were diagnosed with COVID‐19 between March 1, 2020 and July 1, 2022. Further propensity score matching method was used to create two matched cohorts with and without receiving NMV‐r. The primary outcome was the incidence of neuropsychiatric sequela within a 90‐day to 1‐year period following a diagnosis of COVID‐19. After screening 119 494 527 electronic health records, two matched cohorts of each 27 194 patients were identified. During the follow‐up period, the NMV‐r group demonstrated a reduced risk of any neuropsychiatric sequelae compared to the control group (odds ratio [OR], 0.634; 95% confidence interval [CI], 0.604−0.667). In comparison with the control group, the patient treated with NMV‐r exhibited a markedly diminished risk of developing neurocognitive sequela (OR, 0.377; 95% CI, 0.325−0.439) and psychiatric sequela (OR, 0.629; 95% CI, 0.593−0.666). In addition, patients treated with NMV‐r had a significantly reduced risk of developing dementia (OR, 0.365; 95% CI, 0.255−0.522), depression (OR, 0.555; 95% CI, 0.503−0.612), insomnia (OR, 0.582; 95% CI, 0.508−0.668) and anxiety disorder (OR, 0.645 95% CI, 0.600−0.692). Moreover, the beneficial effect of NMV‐r on the neuropsychiatric sequelae was observed across further subgroup analyses. Among nonhospitalized COVID‐19 patients, who at risk of disease progression, the use of NMV‐r is associated with a reduction in the long‐term risk of neuropsychiatric sequela, including dementia, depression, insomnia and anxiety disorder. It may be necessary to re‐evaluate the use of NMV‐r, as a preventive measure to reduce the risk of severe acute disease and post‐acute adverse mental health outcomes. [ABSTRACT FROM AUTHOR]

Despite the acceptance of carotid ultrasound for predicting patients' fluid responsiveness in critical care and anesthesia, its efficacy for predicting hypotension and fluid responsiveness remains unclear in the perioperative setting. Electronic databases were searched from inception to May 2023 to identify observational studies focusing on the use of corrected blood flow time (FTc) and respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak) for assessing the risks of hypotension and fluid responsiveness. Using FTc as a predictive tool (four studies), the analysis yielded a pooled sensitivity of 0.82 (95% confidence interval (CI): 0.72 to 0.89) and specificity of 0.94 (95% CI: 0.88 to 0.97) for the risk of hypotension (area under curve (AUC): 0.95). For fluid responsiveness, the sensitivity and specificity of FTc were 0.79 (95% CI: 0.72 to 0.84) and 0.81 (95% CI: 0.75 to 0.86), respectively (AUC: 0.87). In contrast, the use of ΔVpeak to predict the risk of fluid responsiveness showed a pooled sensitivity of 0.76 (95% CI: 0.63 to 0.85) and specificity of 0.74 (95% CI: 0.66 to 0.8) (AUC: 0.79). The current meta-analysis provides robust evidence supporting the high diagnostic accuracy of FTc in predicting perioperative hypotension and fluid responsiveness, which requires further studies for verification. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the clinical efficacy of a combination of nirmatrelvir and ritonavir (NMV‐r) for treating COVID‐19 in patients with diabetes mellitus (DM). This retrospective cohort study used the TriNetX research network to identify adult diabetic patients with COVID‐19 between January 1, 2020, and December 31, 2022. Propensity score matching was used to match patients who received NMV‐r (NMV‐r group) with those who did not receive NMV‐r (control group). The primary outcome was all‐cause hospitalization or death during the 30‐day follow‐up period. Two cohorts comprising 13 822 patients with balanced baseline characteristics were created using propensity score matching. During the follow‐up period, the NMV‐r group had a lower risk of all‐cause hospitalization or death than the control group (1.4% [n = 193] vs. 3.1% [n = 434]; hazard ratio [HR], 0.497; 95% confidence interval [CI], 0.420–0.589). Compared with the control group, the NMV‐r group also had a lower risk of all‐cause hospitalization (HR, 0.606; 95% CI, 0.508–0.723) and all‐cause mortality (HR, 0.076; 95% CI, 0.033–0.175). This lower risk was consistently observed in almost all subgroup analyses, which examined sex (male: 0.520 [0.401–0.675]; female: 0.586 [0.465–0.739]), age (age 18–64 years: 0.767 [0.601–0.980]; ≥65 years: 0.394 [0.308–0.505]), level of HbA1c (<7.5%: 0.490 [0.401–0.599]; ≥7.5%: 0.655 [0.441–0.972]), unvaccinated (0.466 [0.362–0.599]), type 1 DM (0.453 [0.286–0.718]) and type 2 DM (0.430 [0.361–0.511]). NMV‐r can help reduce the risk of all‐cause hospitalization or death in nonhospitalized patients with DM and COVID‐19. [ABSTRACT FROM AUTHOR]

Several randomized controlled trials and real‐world cohort studies have demonstrated the efficacies of nirmatrelvir plus ritonavir (NMV‐r) and molnupiravir (MOV) in at‐risk patients with COVID‐19; however, the effectiveness of antisevere acute respiratory syndrome‐coronavirus 2 treatments on older patients (≥65 years) remains unclear. This retrospective cohort study aimed to assess the clinical effectiveness of the oral antiviral agents, MOV and NMV‐r, in older patients (≥65 years) infected with severe acute respiratory syndrome‐coronavirus 2. Nonhospitalized older patients with COVID‐19 between January 1, 2022, and December 31, 2022, were recruited from the TriNetX Research Network. Propensity score matching (PSM) was used to match patients who received either NMV‐r or MOV treatment with those who did not receive any oral antiviral agents. Hazard ratios (HRs) for composite all‐cause hospitalization or death during the 30‐day follow‐up period were calculated. PSM revealed two cohorts with 28 824 patients each having balanced baseline characteristics. The antiviral group was associated with significantly lower risk of the primary composite outcome of all‐cause hospitalization or death than the control group (241 vs. 801; HR, 0.307; 95% confidence interval (CI), 0.27–0.36) during the follow‐up period. For the secondary outcome, the antiviral group had a significantly lower risk of all‐cause hospitalization (288 vs. 725; HR, 0.322; 95% CI, 0.28–0.37) and mortality (16 vs. 94; HR, 0.176; 95% CI, 0.10–0.30) than the control group. Moreover, the reduced risk of all‐cause hospitalization or death remained consistent in patients receiving NMV‐r (HR, 0.279; 95% CI, 0.24–0.33) and MOV (HR, 0.279; 95% CI, 0.21–0.38). Our results revealed that NMV‐r and MOV decreased the all‐cause hospitalization and death rates among older patients with COVID‐19, supporting the use of antivirals in this vulnerable population. [ABSTRACT FROM AUTHOR]

This study was conducted to assess the clinical efficacy of probiotics in the treatment of patients with COVID19. PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched for studies from their inception to 8 February 2022. Randomized controlled trials (RCTs) that compared the clinical efficacy of probiotics with usual care or standard care for patients with COVID19 were included. The primary outcome was all-cause mortality. Random-effects model using MantelHaenszel and inverse variance methods were performed to analyze the data Eight RCTs with 900 patients were included. The study group receiving probiotics had a non-significantly lower rate of mortality than the control group had, but this difference was not significant (risk ratio [RR], 0.51; 95% CI, 0.22 to 1.16). However, the study group had significantly lower rates of dyspnea (RR, 0.11; 95% CI, 0.02 to 0.60), fever (RR, 0.37; 95% CI, 0.16 to 0.85) and headache (RR, 0.19; 95% CI, 0.05 to 0.65). Higher complete remission of COVID-19-associated symptoms was observed in the study group than the control group (RR, 1.89; 95% CI, 1.40–2.55). Although probiotics use did not improve clinical outcomes or reduce inflammatory markers, it may relieve COVID-19-associated symptoms. [ABSTRACT FROM AUTHOR]

This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV‐r) in treating patients with coronavirus disease‐2019 (COVID‐19) and substance use disorders (SUDs). This study included two cohorts: the first examined patients with SUDs, with and without a prescription for NMV‐r, while the second compared patients prescribed with NMV‐r, with and without a diagnosis of SUDs. SUDs were defined using ICD‐10 codes, related to SUDs, including alcohol, cannabis, cocaine, opioid, and tobacco use disorders (TUD). Patients with underlying SUDs and COVID‐19 were identified using the TriNetX network. We used 1:1 propensity score matching to create balanced groups. The primary outcome of interest was the composite outcome of all‐cause hospitalization or death within 30 days. Propensity score matching yielded two matched groups of 10 601 patients each. The results showed that the use of NMV‐r was associated with a lower risk of hospitalization or death, 30 days after COVID‐19 diagnosis (hazard ratio (HR), 0.640; 95% confidence interval (CI): 0.543–0.754), as well as a lower risk of all‐cause hospitalization (HR, 0.699; 95% CI: 0.592–0.826) and all‐cause death (HR, 0.084; 95% CI: 0.026–0.273). However, patients with SUDs had a higher risk of hospitalized or death within 30 days of COVID‐19 diagnosis than those without SUDs, even with the use of NMV‐r (HR, 1.783; 95% CI: 1.399–2.271). The study also found that patients with SUDs had a higher prevalence of comorbidities and adverse socioeconomic determinants of health than those without SUDs. Subgroup analysis showed that the benefits of NMV‐r were consistent across most subgroups with different characteristics, including age (patients aged ≥60 years [HR, 0.507; 95% CI: 0.402–0.640]), sex (women [HR, 0.636; 95% CI: 0.517–0.783] and men [HR, 0.480; 95% CI: 0.373–0.618]), vaccine status (vaccinated <2 doses [HR, 0.514; 95% CI: 0.435–0.608]), SUD subtypes (alcohol use disorder [HR, 0.711; 95% CI: 0.511– 0.988], TUD [HR, 0.666; 95% CI: 0.555–0.800]) and Omicron wave (HR, 0.624; 95% CI: 0.536–0.726). Our findings indicate that NMV‐r could reduce all‐cause hospitalization and death in the treatment of COVID‐19 among patients with SUDs and support the use of NMV‐r for treating patients with SUDs and COVID‐19. [ABSTRACT FROM AUTHOR]

The effect of nirmatrelvir plus ritonavir (NMV‐r) on post‐acute COVID‐19 sequelae beyond 3 months of SARS‐CoV‐2 infection remains unknown. This retrospective cohort study utilized data from the TriNetX Research Network. We identified nonhospitalized adult patients with COVID‐19 receiving a diagnosis between January 1 and July 31, 2022. Propensity score matching (PSM) was used to create two matched cohorts: NMV‐r and non‐NMV‐r groups, respectively. We measured the primary outcomes using a composite of all‐cause emergency room (ER) visits or hospitalization and a composite of post‐COVID‐19 symptoms according to the WHO Delphi consensus, which also stated that post COVID‐19 condition occurs usually 3 months from the onset of COVID‐19, during the follow‐up period between 90 days after the index diagnosis of COVID‐19 and the end of follow‐up (180 days). Initially, we identified 12 247 patients that received NMV‐r within 5 days of diagnosis and 465 135 that did not. After PSM, 12 245 patients remained in each group. During the follow‐up period, patients treated with NMV‐r had a lower risk of all‐cause hospitalization and ER visits compared with untreated patients (659 vs. 955; odds ratio [OR], 0.672; 95% confidence interval [CI], 0.607–0.745; p < 0.0001). However, the overall risk of post‐acute COVID‐19 symptoms did not significantly differ between the two groups (2265 vs. 2187; OR, 1.043; 95% CI, 0.978–1.114; p = 0.2021). The reduced risk of all‐cause ER visits or hospitalization in the NMV‐r group and the similarities in the risk of post‐acute COVID‐19 symptoms between the two groups were consistent in the subgroups stratified by sex, age, and vaccination status. Early NMV‐r treatment of nonhospitalized patients with COVID‐19 was associated with reduced risk of hospitalization and ER visits during the period of 90–180 days after diagnosis compared with no NMV‐r treatment; however, post‐acute COVID‐19 symptoms and mortality risk did not differ significantly between the groups. [ABSTRACT FROM AUTHOR]

The long‐term risk of herpes zoster (HZ) after recovery from a SARS‐CoV‐2 infection is unclear. This retrospective cohort study assessed the risk of HZ in patients following a COVID‐19 diagnosis. This retrospective, propensity score‐matched cohort study was based on the multi‐institutional research network TriNetX. The risk of incident HZ in patients with COVID‐19 was compared with that of those not infected with SARS‐CoV‐2 during a 1‐year follow‐up period. Hazard ratios (HRs) and 95% confidence intervals (CIs) of HZ and its subtypes were calculated. This study identified 1 221 343 patients with and without COVID‐19 diagnoses with matched baseline characteristics. During the 1‐year follow‐up period, patients with COVID‐19 had a higher risk of HZ compared with those without COVID‐19 (HR: 1.59; 95% CI: 1.49–1.69). In addition, compared with the control group patients, those with COVID‐19 had a higher risk of HZ ophthalmicus (HR: 1.31; 95% CI: 1.01–1.71), disseminated zoster (HR: 2.80; 95% CI: 1.37–5.74), zoster with other complications (HR: 1.46; 95% CI: 1.18–1.79), and zoster without complications (HR: 1.66; 95% CI: 1.55–1.77). Kaplan–Meier curve analysis (log‐rank p < 0.05) results indicated that the risk of HZ remained significantly higher in patients with COVID‐19 compared with those without COVID‐19. Finally, the higher risk of HZ in the COVID‐19 cohort compared with that in the non‐COVID‐19 cohort remained consistent across subgroup analyses regardless of vaccine status, age, or sex. The risk of HZ within a 12‐month follow‐up period was significantly higher in patients who had recovered from COVID‐19 compared with that in the control group. This result highlights the importance of carefully monitoring HZ in this population and suggests the potential benefit of the HZ vaccine for patients with COVID‐19. [ABSTRACT FROM AUTHOR]

The efficacy of molnupiravir in treating patients with coronavirus disease 2019 (COVID‐19) has been inconsistent across randomized controlled trials (RCTs). Thus, this meta‐analysis was conducted to clarify the literature. A literature search of electronic databases—PubMed, Embase, and Cochrane Library—was performed to identify relevant articles published up to December 31, 2022. Only RCTs that investigated the clinical efficacy and safety of molnupiravir for patients with COVID‐19 were included. The primary outcome was all‐cause mortality at 28–30 days. This pooled analysis of nine RCTs did not reveal a significant difference in all‐cause mortality between molnupiravir and control groups (risk ratio [RR], 0.43; 95% confidence interval [CI], 0.10–1.77) for overall patients. However, the risks of mortality and hospitalization were lower in the molnupiravir group than in the control group (mortality: RR, 0.28; 95% CI, 0.10–0.79; hospitalization: RR, 0.67; 95% CI, 0.45–0.99) among nonhospitalized patients. In addition, molnupiravir use was associated with a borderline higher virological eradication rate relative to the control (RR, 1.05; 95% CI, 1.00–1.11). Finally, no significant difference in adverse event risk was discovered between the groups (RR, 0.98; 95% CI, 0.89–1.08). The findings reveal the clinical benefits of molnupiravir for nonhospitalized patients with COVID‐19. However, molnupiravir may not improve the clinical outcomes of hospitalized patients. These findings support the recommended use of molnupiravir for treating nonhospitalized patients with COVID‐19 but not for hospitalized patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Ophraella communa Lesage is a specific biological control agent of the invasive weed Ambrosia artemisiifolia L. Understanding the molecular mechanism by which O. communa recognizes A. artemisiifolia will help improve its bio-control effect. Odorant-binding proteins (OBPs) play a vital role in insect olfactory perception. In this study, the sequence and expression characteristics of OcomOBP7 were analyzed. We obtained the pure protein of OcomOBP7 by prokaryotic expression and purification, and its binding characteristics were analyzed using a fluorescence competitive binding assay. Finally, we verified the function of OcomOBP7 in vivo using RNAi combined with an electroantennography (EAG) assay. The results showed that the binding ability of OcomOBP7 was broad-spectrum and was involved in the host plant localization of O. communa. The olfactory system plays a key role in various insect behaviors, and odorant-binding proteins participate in the first step of the olfactory process. Ophraella communa Lesage is an oligophagous phytophagous insect that is a specific biological control agent for Ambrosia artemisiifolia L. The leaf beetle must identify and locate A. artemisiifolia through olfaction; however, its odorant-binding protein (OBP) function has not yet been reported. In this study, OcomOBP7 was cloned, and its tissue expression profile and binding ability were analyzed using RT-qPCR and fluorescence binding assays, respectively. Sequence analysis demonstrated that OcomOBP7 belongs to the classical OBP family. The RT-qPCR results showed that OcomOBP7 was specifically expressed in the antennae, indicating that OcomOBP7 may be involved in chemical communication. The fluorescence binding assay showed that OcomOBP7 has an extensive binding ability to alkenes. The electroantennography experiments showed that O. communa antennal response to α-pinene and ocimene decreased significantly after interference because the two odors specifically bound to OcomOBP7. In summary, α-pinene and ocimene are odorant ligands corresponding to OcomOBP7, indicating that OcomOBP7 is involved in the chemical recognition of A. artemisiifolia. Our study lays a theoretical foundation for research into O. communa attractants, which is helpful for the better biological control of A. artemisiifolia by O. communa. [ABSTRACT FROM AUTHOR]

Response to the letter to the editor on "Long-term risk of herpes zoster following COVID-19: A retrospective cohort study of 2 442 686 patients" Furthermore, we are aware that previous studies have demonstrated an increased risk of herpes zoster after COVID-19 vaccination.[[4]] However, our study did not investigate the association between herpes zoster and the COVID-19 vaccine. Third, zoster vaccine is a significant confounding factor, and as a result, our study[2] excluded patients who had received the zoster vaccine. [Extracted from the article]

Molnupiravir versus placebo in unvaccinated and vaccinated patients with early SARSCoV-2 infection in the UK (AGILE CST-2): a randomised, placebo controlled, double-blind, phase 2 trial. Randomized trial of molnupiravir or placebo in patients hospitalized with Covid-19. Huang et al.[1] raised several concerns about our recent meta-analysis.[1] First, he thought that Caraco et al.'s study[2] was the interim analysis of the full MOVe-out study,[3] so it should not include interim and entire studies at the same time. [Extracted from the article]

Background: Ventilator-associated pneumonia (VAP) constitutes a considerable challenge for patients in intensive care units (ICUs) and necessitates the development of effective preventive strategies. This study aimed to evaluate the clinical efficacy of inhaled antibiotics for preventing VAP., Methods: PubMed, Embase, and ClinicalTrials.gov were searched until January 21, 2024. Randomized controlled trials (RCTs) investigating the clinical efficacy of inhaled antibiotics for VAP prevention were included., Results: Seven RCTs, involving 1465 patients, of whom 734 were classified as the study group receiving inhaled antibiotics and 731 as the control group receiving placebo were included in this meta-analysis. Overall, the occurrence of VAP was significantly lower in the study group than in the control group (risk ratio [RR], 0.69; 95% confidence interval [CI], 0.51 to 0.92). However, there were no significant differences in mortality (RR, 0.90; 95% CI, 0.74 to 1.09), length of stay in ICU (mean difference [MD], 0.10 days; 95% CI, -0.91 to 1.1) and hospital (MD, 0.30 days; 95% CI, -1.82 to 2.43), and mechanical ventilation (MV) duration (MD, 0.45 days; 95% CI, -0.45 to 1.35) between groups., Conclusion: Inhaled antibiotics hold promise for mitigating the risk of VAP among critically ill patients. However, their impact on mortality, length of stay in ICU and hospital, and MV duration was not statistically significant., Competing Interests: Declarations competing interests All authors affirm that no conflict of interest exists., (Copyright © 2024. Published by Elsevier Ltd.)

Although the recombinant zoster vaccine (RZV) has demonstrated efficacy in reducing the risk of herpes zoster (HZ) for individuals aged 50 years and older, its effectiveness in patients with chronic obstructive pulmonary disease (COPD) remains uncertain. This study was conducted to assess the effect of RZV on the risk of HZ in COPD patients. A multi-institutional propensity score-matched retrospective cohort study was conducted using the TriNetX Research network, including individuals aged 40 years or older with COPD from January 1, 2018, to December 31, 2022. Patients with a history of HZ or prior zoster vaccination were excluded. The primary outcome was HZ occurrence, with secondary outcomes including severe and nonsevere HZ. After propensity score matching, each 17 431 patients receiving RZV and unvaccinated patients were included. The vaccinated group had a significantly lower risk of HZ compared to the unvaccinated group (HR, 0.62; [95% confidence intervals] 95% CI, 0.51-0.75, p < 0.01). Similar risk reductions were observed for nonsevere HZ (HR, 0.61; 95% CI, 049-0.75, p < 0.01) and severe HZ (HR, 0.53; 95% CI, 0.38-0.73, p < 0.01). Further subgroup analyses demonstrated consistent risk reductions across age (50-59, 60-69, 70-79, and ≥80 years), sex, and comorbidities, except for individual aged 40-49 years. This study confirms the effectiveness of RZV in reducing HZ risk in patients with COPD aged 50 years and older, supporting its administration in this population. However, vaccination rates remain low, highlighting the need for improved vaccination strategies in this high-risk group. Efforts to enhance vaccine uptake are warranted to reduce HZ morbidity., (© 2024 Wiley Periodicals LLC.)

Objectives: This study investigated the clinical effectiveness of molnupiravir for treating non-hospitalized COVID-19 patients with pre-existing psychiatric disorder., Methods: This retrospective cohort study used the TriNetX research network to identify patients with psychiatric disorder who experienced non-hospitalized COVID-19 between 1 January 2022, and 1 May 2023. The propensity score matching (PSM) method was used to match patients receiving molnupiravir (treated group) with those who did not (untreated group). The outcome included short-term outcomes - the composite of all-cause hospitalization or death within 30 days and the risk of post-COVID-19 conditions up to a year after COVID-19 diagnosis., Results: Two groups of 9,421 patients, each with balanced baseline characteristics, were identified using the PSM method. During the 30-day follow-up, treated group was associated with a reduced risk of hospitalization or mortality compared to untreated group (HR, 0.760; 95% CI, 0.665-0.869). Compared to untreated group, treated group also exhibited a decreased risk of experiencing post-COVID-19 conditions, including chest/throat pain (HR, 0.615; 95% CI, 0.543-0.696), abnormal breathing (HR, 0.761; 95% CI, 0.687-0.884), abdominal symptoms (HR, 0.748; 95% CI, 0.674-0.831), fatigue (HR, 0.718; 95% CI, 0.638-0.808), headache (HR, 0.753; 95% CI, 0.665-0.852), cognitive symptoms (HR, 0.769; 95% CI, 0.630-0.940), myalgia (HR, 0.647; 95% CI, 0.530-0.789), cough (HR, 0.867; 95% CI, 0.770-0.978), and palpitation (HR, 0.641; 95% CI, 0.534-0.770) during the 1-year follow-up., Conclusion: Molnupiravir could be associated with lower rates of all-cause hospitalization or death and also lower risk of post-COVID-19 condition among non-hospitalized COVID-19 patients with pre-existing psychiatric disorder., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Liu, Liao, Chang and Lai.)

Objectives: This study assessed the clinical effectiveness of the combination of nirmatrelvir and ritonavir (NMV-r) in treating nonhospitalized patients with COVID-19 who have preexisting psychiatric disorders., Methods: Patients diagnosed with COVID-19 and psychiatric disorders between 1 March 2020, and 1 December 2022, were included using the TriNetX network. The primary outcome was the composite outcome of all-cause emergency department (ED) visits, hospitalization, or death within 30 days., Results: Propensity score matching yielded two cohorts of 20,633 patients each. The composite outcome of all-cause ED visits, hospitalization, or death within 30 days was 3.57% (737 patients) in the NMV-r cohort and 5.69% (1176) in the control cohort, resulting in a reduced risk in the NMV-r cohort (HR: 0.657; 95% confidence interval (CI): 0.599-0.720). The NMV-r cohort exhibited a lower risk of all-cause hospitalization (HR: 0.385; 95% CI: 0.328-0.451) and all-cause death (HR: 0.110; 95% CI: 0.053-0.228) compared with the control group., Conclusion: NMV-r could mitigate the risk of adverse outcomes in nonhospitalized patients with COVID-19 and preexisting psychiatric disorders. However, only a limited number of patients in this population received adequate treatment, thus emphasizing the importance of promoting its appropriate use.

Objectives: This study assessed the effectiveness of the oral antiviral agents nirmatrelvir - ritonavir (NMV-r) and molnupiravir (MOV) for treating mild-to-moderate coronavirus disease 2019 (COVID-19) in patients with COPD., Methods: This retrospective cohort study extracted data from the TriNetX platform and examined 94,984 COVID-19 patients with preexisting COPD from 1 January 2022, to 1 October 2023. Patients receiving NMV-r or MOV (study group) were compared with those not receiving oral antiviral agents (control group) after propensity score matching (PSM)., Results: After PSM, 7,944 patients were classified into the study and control groups. The primary composite outcome of all-cause hospitalization, or death in 30 days was reported in 458 (5.7%) patients in the study group and 566 (7.1%) patients in the control cohort, yielding a hazard ratio [HR] of 0.79 (95% confidence interval [CI]: 0.70-0.89; Table 2). Compared with the control group, the study group had a significantly lower risk of all-cause hospitalization (HR, 0.87; 95% CI: 0.76-0.99) and death (HR: 0.21, 95% CI: 0.13-0.35)., Conclusions: This study revealed that oral antivirals - NMV-r or MOV might improve clinical outcomes in patients with preexisting COPD and COVID-19. However, only a small proportion of preexisting COPD patients with COVID-19 received oral antiviral treatment.