Search

BackgroundThe rate of seroconversion after COVID-19 vaccination in patients with moderate to severe psoriasis requiring systemic treatment is poorly understood.ObjectivesThe aim of this prospective single-center cohort study performed between May 2020 and October 2021 was to determine the rate of seroconversion after COVID-19 vaccination in patients under active systemic treatment for moderate to severe psoriasis.MethodsInclusion criteria were systemic treatment for moderate to severe psoriasis, known COVID-19 vaccination status, and repetitive anti-SARS-CoV-2-S IgG serum quantification. The primary outcome was the rate of anti-SARS-CoV-2-S IgG seroconversion after complete COVID-19 vaccination.Results77 patients with a median age of 55.9 years undergoing systemic treatment for moderate to severe psoriasis were included. The majority of patients received interleukin- (n=50, 64.9%) or tumor necrosis factor (TNF)-α inhibitors (n=16, 20.8%) as systemic treatment for psoriasis; nine patients (11.7%) were treated with methotrexate (MTX) monotherapy, and one patient each received dimethyl fumarate (1.3%), respectively apremilast (1.3%). All included patients completed COVID-19 vaccination with two doses over the course of the study. Serum testing revealed that 74 patients (96.1%) showed an anti-SARS-CoV-2-S IgG seroconversion. While all patients on IL-17A, -12 or -12/23 inhibitors (n=50) achieved seroconversion, three of 16 patients (18.8%) receiving MTX and/or a TNF-α inhibitor as main anti-psoriatic treatment did not. At follow-up, none of the patients had developed symptomatic COVID-19 or died from COVID-19.ConclusionsAnti-SARS-CoV-2-S IgG seroconversion rates following COVID-19 vaccination in psoriasis patients under systemic treatment were high. An impaired serological response, however, was observed in patients receiving MTX and/or TNF-α inhibitors, in particular infliximab.

Supplemental material, sj-pdf-1-tan-10.1177_1756286421993701 for Observational cohort study of neurological involvement among patients with SARS-CoV-2 infection by Michael Fleischer, Martin Köhrmann, Sebastian Dolff, Fabian Szepanowski, Karsten Schmidt, Frank Herbstreit, Cansu Güngör, Benjamin Stolte, Katharina Marie Steiner, Christine Stadtler, Joachim Riße, Melanie Fiedler, Gerd Meyer zu Hörste, Anne-K. Mausberg, Clemens Kill, Michael Forsting, Ulrich Sure, Ulf Dittmer, Oliver Witzke, Thorsten Brenner, Christoph Kleinschnitz and Mark Stettner in Therapeutic Advances in Neurological Disorders

Supplemental material, sj-pdf-1-tan-10.1177_1756286421993701 for Observational cohort study of neurological involvement among patients with SARS-CoV-2 infection by Michael Fleischer, Martin Köhrmann, Sebastian Dolff, Fabian Szepanowski, Karsten Schmidt, Frank Herbstreit, Cansu Güngör, Benjamin Stolte, Katharina Marie Steiner, Christine Stadtler, Joachim Riße, Melanie Fiedler, Gerd Meyer zu Hörste, Anne-K. Mausberg, Clemens Kill, Michael Forsting, Ulrich Sure, Ulf Dittmer, Oliver Witzke, Thorsten Brenner, Christoph Kleinschnitz and Mark Stettner in Therapeutic Advances in Neurological Disorders

HEV infection appears to be an emerging disease in industrialized countries. The aim of this study was to evaluate the prevalence of HEV infection in pediatric solid organ transplant recipients. One hundred and twenty‐four pediatric recipients of liver (n = 41) or kidney (n = 83) transplants aged between one and 18 yr were screened for anti‐HEV IgG antibodies. Patients were tested for fecal HEV RNA excretion if they showed anti‐HEV seropositivity. As a control group, 108 immunocompetent pediatric patients without liver disease aged between three and 18 yr were screened for anti‐HEV IgG. HEV seroprevalence was 2.4% in renal Tx (2/83), 4.9% in liver Tx patients (2/41), and 3.2% overall (4/124). Three of these four patients were HEV RNA‐negative. In one renal transplant patient, HEV genotype 3 RNA excretion persisted and liver enzymes were elevated, indicating chronic hepatitis. In the control group, eight patients (7.4%) were HEV IgG‐positive without biochemical evidence of hepatitis. The prevalence of HEV infection in pediatric renal or liver transplant recipients is not higher compared with immunocompetent children. Chronic HEV infection with long‐term carriage of the virus may develop in pediatric transplant recipients. Autochthonous HEV infection needs to be considered in uncertain cases of hepatitis in immunosuppressed as well as immunocompetent children.

Item does not contain fulltext HHV type 6 has been reported with enhanced pathogenicity in immunocompromised patients. Herein, we report about a two-yr-old girl who experienced primary HHV 6 infection after liver transplantation. She clinically presented with graft rejection and necrotic hepatitis as well as high fever, pneumonitis with respiratory failure and a rash. Therapy with cidofovir of 5 mg/kg per wk did not show improvement, so that a full pharmacokinetic profile of cidofovir was performed. It demonstrated enhanced body weight normalized clearance of cidofovir and cidofovir dosage was augmented to 12 mg/kg per wk to reach adequate drug exposure. With additional reduction of immunosuppression, the patient dramatically improved and liver function stabilized.