The role of Interleukin 6 inhibitors in therapy of severe COVID-19.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although demographic and clinical parameters such as sex, age, comorbidities, genetic background and various biomarkers have been identified as risk factors, there is an unmet need to predict the risk and onset of severe inflammatory disease leading to poor clinical outcomes. In addition, very few mechanistic biomarkers are available to inform targeted treatment of severe (auto)-inflammatory conditions associated with COVID-19. Calprotectin, also known as S100A8/S100A9, MRP8/14 (Myeloid-Related Protein) or L1, is a heterodimer involved in neutrophil-related inflammatory processes. In COVID-19 patients, calprotectin levels were reported to be associated with poor clinical outcomes such as significantly reduced survival time, especially in patients with severe pulmonary disease. AREAS COVERED: Pubmed was searched using the following keywords: Calprotectin + COVID19, S100A8/A9 + COVID19, S100A8 + COVID-19, S100A9 + COVID-19, MRP8/14 + COVID19; L1 + COVID-19 between May 2020 and 8 March 2021. The results summarized in this review provide supporting evidence and propose future directions that define calprotectin as an important biomarker in COVID-19. EXPERT OPINION: Calprotectin represents a promising serological biomarker for the risk assessment of COVID-19 patients.

https://www.tandfonline.com/doi/pdf/10.1080/1744666X.2021.1905526

Circulating Calprotectin as a Biomarker of COVID-19 Severity.

Lenzilumab in hospitalised patients with COVID-19 pneumonia (LIVE-AIR): a phase 3, randomised, placebo-controlled trial

http://www.thelancet.com/article/S221326002100494X/pdf

The emergence of a new acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), the cause of the 2019-nCOV disease (COVID-19), has caused a pandemic and a global health crisis. Rapid human-to-human transmission, even from asymptomatic individuals, has led to the quick spread of the virus worldwide, causing a wide range of clinical manifestations from cold-like symptoms to severe pneumonia, acute respiratory distress syndrome (ARDS), multiorgan injury, and even death. Therefore, using rapid and accurate diagnostic methods to identify the virus and subsequently select appropriate and effective treatments can help improvement of patients and control the pandemic. So far, various treatment regimens along with prophylactic vaccines have been developed to manage COVID-19-infected patients. Among these, antibody-based therapies, including neutralizing antibodies (against different parts of the virus), polyclonal and monoclonal antibodies, plasma therapy, and high-dose intravenous immunoglobulin (IVIG) have shown promising outcomes in accelerating and improving the treatment process of patients, avoiding the viral spreading widely, and managing the pandemic. In the current review paper, different types and applications of therapeutic antibodies in the COVID-19 treatment are comprehensively discussed.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/jcb.30017

Recent advances in antibody-based immunotherapy strategies for COVID-19.

Background: Coronavirus disease 2019 (COVID-19) is a novel disease associated with a cytokine-mediated, severe, acute respiratory syndrome. Tocilizumab and lenzilumab are recombinant monoclonal antibodies against IL-6 and granulocyte macrophage colony-stimulating factor, respectively, and have been proposed as a potential treatment for acute, hypoxic respiratory failure associated with COVID-19. Results & methodology: We present the case of a 68-year-old man with COVID-19 who was initially treated with hydroxychloroquine and lenzilumab, but continued to develop hypoxemia, requiring an increase in respiratory support with an associated rise in serum inflammatory markers. He was subsequently treated with tocilizumab with marked clinical improvement and a decrease in acute phase reactants within 48 h. Discussion & conclusion: This case demonstrates the effective use of tocilizumab in the treatment of COVID-19 and suggests the superiority of tocilizumab over lenzilumab in the management of this cytokine-mediated syndrome.

/pdf/case-report-use-of-lenzilumab-and-tocilizumab-for-the-13ukrgblwd.pdf

Case report: use of lenzilumab and tocilizumab for the treatment of coronavirus disease 2019.

Outcomes in hospitalized kidney transplant patients with a penicillin allergy label in the United States, 2005-2014.

Although uncommon, Brucella infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and constitutional symptoms that were ongoing for 11 months. He was diagnosed with neurobrucellosis. The patient was treated successfully with intravenous ceftriaxone, oral doxycycline and oral rifampin therapy. He had persistent neurological sequelae after completing treatment. This case illustrates the high index of suspicion needed to diagnose neurobrucellosis in a non-endemic country because initial symptoms can be subtle. The disease can be treated successfully, but long-lasting neurological sequelae are common.

Neurobrucellosis associated with feral swine hunting in the southern United States.

This research evaluates the accuracy of two methods of authorship prediction: syntactical analysis and n-gram, and explores its potential usage. The proposed algorithm measures n-gram, and counts adjectives, adverbs, verbs, nouns, punctuation, and sentence length from the training data, and normalizes each metric. The proposed algorithm compares the metrics of training samples to testing samples and predicts authorship based on the correlation they share for each metric. The severity of correlation between the testing and training data produces significant weight in the decision-making process. For example, if analysis of one metric approximates 100% positive correlation, the weight in the decision is assigned a maximum value for that metric. Conversely, a 100% negative correlation receives the minimum value. This new method of authorship validation holds promise for future innovation in fraud protection, the study of historical documents, and maintaining integrity within academia.

Jared Nelson

Papers

Case report: use of lenzilumab and tocilizumab for the treatment of coronavirus disease 2019.

Outcomes in hospitalized kidney transplant patients with a penicillin allergy label in the United States, 2005-2014.

Neurobrucellosis associated with feral swine hunting in the southern United States.

Authorship Verification via Linear Correlation Methods of n-gram and Syntax Metrics