2022
Antiviral Treatment of Coronavirus Disease-2019 Pneumonia
Radcliffe C, Malinis M, Azar M. Antiviral Treatment of Coronavirus Disease-2019 Pneumonia. Clinics In Chest Medicine 2022, 44: 279-297. PMID: 37085220, PMCID: PMC9701636, DOI: 10.1016/j.ccm.2022.11.008.Peer-Reviewed Original ResearchConceptsAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionSyndrome coronavirus 2 infectionCoronavirus diseaseCoronavirus 2 infectionDirect acting antiviralsAdditional clinical trialsReal-world studyCOVID-19Acting antiviralsAntiviral treatmentTherapeutic optionsAvailable therapiesClinical trialsDisease progressionInpatient treatmentHigh riskEarly pandemicMonoclonal antibodiesDiseaseTreatmentMorbidityPandemicPneumoniaOutpatientsEvaluating clinical effectiveness of SARS‐CoV‐2 vaccine in solid organ transplant recipients: A propensity score matched analysis
Tucker M, Azar MM, Cohen E, Gan G, Deng Y, Palacios C, Malinis M. Evaluating clinical effectiveness of SARS‐CoV‐2 vaccine in solid organ transplant recipients: A propensity score matched analysis. Transplant Infectious Disease 2022, 24: e13876. PMID: 35684932, PMCID: PMC9348300, DOI: 10.1111/tid.13876.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsSARS-CoV-2 infectionOrgan transplant recipientsCritical COVID-19Clinical effectivenessTransplant recipientsVaccine eraVaccinated solid organ transplant recipientsCOVID-19Propensity score-matched cohortSARS-CoV-2 vaccinationSevere coronavirus disease 2019Cause-specific Cox regression modelsCOVID-19-related mortalitySARS-CoV-2 vaccinesSARS-CoV-2 infection ratesCurrent vaccine recommendationsKey preventative strategiesPrimary vaccine seriesRetrospective cohort studyDoses of mRNACox regression modelCoronavirus disease 2019Poisson regression modelsVaccine seriesReal‐world experience with available, outpatient COVID‐19 therapies in solid organ transplant recipients during the omicron surge
Radcliffe C, Palacios CF, Azar MM, Cohen E, Malinis M. Real‐world experience with available, outpatient COVID‐19 therapies in solid organ transplant recipients during the omicron surge. American Journal Of Transplantation 2022, 22: 2458-2463. PMID: 35583664, PMCID: PMC9348251, DOI: 10.1111/ajt.17098.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOral antiviral agentsOrgan transplant recipientsOutpatient therapyTransplant recipientsAntiviral agentsCOVID-19-related morbidityMonoclonal antibodiesKidney transplant recipientsRate of hospitalizationCOVID-19 therapyReal-world effectivenessSARS-CoV-2 pandemicCOVID-19 diagnosisModerate diseaseRetrospective reviewMean ageOutpatient settingClinical trialsSubstantial burdenTherapyCoronavirus diseaseMean timeHealthcare systemReal-world experienceLaboratory Diagnosis for SARS-CoV-2 Infection
Christensen BB, Azar MM, Turbett SE. Laboratory Diagnosis for SARS-CoV-2 Infection. Infectious Disease Clinics Of North America 2022, 36: 327-347. PMID: 35636903, PMCID: PMC9141924, DOI: 10.1016/j.idc.2022.02.002.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionClinical syndromeMolecular testingPatient's clinical syndromeReverse transcriptase-polymerase chain reactionOptimal diagnostic testCOVID-19 infectionSymptom onsetAcute infectionAntigen testingSerologic testingAcute diagnosisPolymerase chain reactionLaboratory diagnosisDiagnostic testsInfectionChain reactionDiagnosisSyndromeTestingClinical effectiveness of additional primary SARS‐CoV‐2 vaccine doses for solid organ transplant recipients
Radcliffe C, Azar MM, Cohen E, Tucker M, Grubaugh ND, Malinis M. Clinical effectiveness of additional primary SARS‐CoV‐2 vaccine doses for solid organ transplant recipients. Clinical Transplantation 2022, 36: e14601. PMID: 35064939, DOI: 10.1111/ctr.14601.Commentaries, Editorials and LettersAn outbreak of SARS‐CoV‐2 on a transplant unit in the early vaccination era
Roberts SC, Palacios C, Grubaugh ND, Alpert T, Ott IM, Breban MI, Initiative Y, Martinello RA, Smith C, Davis MW, Mcmanus D, Tirmizi S, Topal JE, Azar MM, Malinis M. An outbreak of SARS‐CoV‐2 on a transplant unit in the early vaccination era. Transplant Infectious Disease 2022, 24: e13782. PMID: 34969164, DOI: 10.1111/tid.13782.Peer-Reviewed Original ResearchConceptsSARS-CoV-2Infection prevention practicesSARS-CoV-2 outbreakTransplant unitCOVID-19-associated morbiditySolid organ transplant recipientsSARS-CoV-2 vaccinationPrevention practicesHospital day 18Potential index casesOrgan transplant recipientsInfection prevention behaviorsMonoclonal antibody therapyCOVID-19SARS-CoV-2 clustersHospital staff membersWhole-genome sequencingAsymptomatic patientsTransplant recipientsPositive patientsAtypical presentationImmunocompromised patientsAntibody therapyVaccination eraDisease progression
2021
Longitudinal Immune Profiling of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Solid Organ Transplant Recipient
Klein J, Brito AF, Trubin P, Lu P, Wong P, Alpert T, Peña-Hernández MA, Haynes W, Kamath K, Liu F, Vogels CBF, Fauver JR, Lucas C, Oh J, Mao T, Silva J, Wyllie AL, Muenker MC, Casanovas-Massana A, Moore AJ, Petrone ME, Kalinich CC, Dela Cruz C, Farhadian S, Ring A, Shon J, Ko AI, Grubaugh ND, Israelow B, Iwasaki A, Azar MM, Team F. Longitudinal Immune Profiling of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Solid Organ Transplant Recipient. The Journal Of Infectious Diseases 2021, 225: 374-384. PMID: 34718647, PMCID: PMC8807168, DOI: 10.1093/infdis/jiab553.Peer-Reviewed Original ResearchConceptsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfectionLongitudinal immune profilingTransplant recipientsImmune profilingPrimary SARS-CoV-2 infectionCD4 T cell poolMale renal transplant recipientSolid organ transplant recipientsSARS-CoV-2 reinfectionSARS-CoV-2 antibodiesSARS-CoV-2 infectionWhole viral genome sequencingRenal transplant recipientsImmune escape mutationsOrgan transplant recipientsT cell poolTime of reinfectionCoronavirus disease 2019Lower neutralization titersHumoral memory responsesViral genome sequencingInitial diagnosisImmunologic deficiencyHumoral responseImmunologic investigationsChanging trends in mortality among solid organ transplant recipients hospitalized for COVID‐19 during the course of the pandemic
Heldman MR, Kates OS, Safa K, Kotton CN, Georgia SJ, Steinbrink JM, Alexander BD, Hemmersbach‐Miller M, Blumberg EA, Multani A, Haydel B, La Hoz RM, Moni L, Condor Y, Flores S, Munoz CG, Guitierrez J, Diaz EI, Diaz D, Vianna R, Guerra G, Loebe M, Rakita RM, Malinis M, Azar MM, Hemmige V, McCort ME, Chaudhry ZS, Singh PP, Kramer K, Velioglu A, Yabu JM, Morillis JA, Mehta SA, Tanna SD, Ison MG, Derenge AC, van Duin D, Maximin A, Gilbert C, Goldman JD, Lease ED, Fisher CE, Limaye AP, Team T. Changing trends in mortality among solid organ transplant recipients hospitalized for COVID‐19 during the course of the pandemic. American Journal Of Transplantation 2021, 22: 279-288. PMID: 34514710, PMCID: PMC8653312, DOI: 10.1111/ajt.16840.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOrgan transplant recipientsTransplant recipientsCOVID-19IL-6/ILComorbidity-adjusted mortalityUse of corticosteroidsUse of hydroxychloroquineMultivariable logistic regressionBaseline comorbiditiesMulticenter registryImproved survivalReceptor inhibitorsGeneral populationMortality trendsMortalityLogistic regressionFurther studiesLater periodRecipientsCorticosteroidsComorbiditiesHydroxychloroquinePandemicPatientsResponse to “SARS‐CoV‐2 vaccine effectiveness trumps immunogenicity in solid organ transplant recipients”
Malinis M, Cohen E, Azar MM. Response to “SARS‐CoV‐2 vaccine effectiveness trumps immunogenicity in solid organ transplant recipients”. American Journal Of Transplantation 2021, 21: 4106-4107. PMID: 34328268, PMCID: PMC8441690, DOI: 10.1111/ajt.16770.Commentaries, Editorials and LettersCOVID‐19 in hospitalized lung and non‐lung solid organ transplant recipients: A comparative analysis from a multicenter study
Heldman MR, Kates OS, Safa K, Kotton CN, Georgia SJ, Steinbrink JM, Alexander BD, Hemmersbach‐Miller M, Blumberg EA, Crespo MM, Multani A, Lewis AV, Beaird O, Haydel B, La Hoz RM, Moni L, Condor Y, Flores S, Munoz CG, Guitierrez J, Diaz EI, Diaz D, Vianna R, Guerra G, Loebe M, Rakita RM, Malinis M, Azar MM, Hemmige V, McCort ME, Chaudhry ZS, Singh P, Hughes K, Velioglu A, Yabu JM, Morillis JA, Mehta SA, Tanna SD, Ison MG, Tomic R, Derenge A, van Duin D, Maximin A, Gilbert C, Goldman JD, Sehgal S, Weisshaar D, Girgis RE, Nelson J, Lease ED, Limaye AP, Fisher CE, Team T. COVID‐19 in hospitalized lung and non‐lung solid organ transplant recipients: A comparative analysis from a multicenter study. American Journal Of Transplantation 2021, 21: 2774-2784. PMID: 34008917, PMCID: PMC9215359, DOI: 10.1111/ajt.16692.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsLung transplant recipientsOrgan transplant recipientsTransplant recipientsRisk factorsAllograft dysfunctionAdult solid organ transplant recipientsCOVID-19High mortalityChronic lung allograft dysfunctionOnly independent risk factorMultivariable logistic regression modelChronic allograft dysfunctionComorbidity-adjusted mortalityLung allograft dysfunctionMulticenter cohort studyIndependent risk factorCoronavirus disease 2019Logistic regression modelsLung transplantCohort studyHeart failureMulticenter studyDisease 2019MortalityEffectiveness of SARS‐CoV‐2 vaccination in fully vaccinated solid organ transplant recipients
Malinis M, Cohen E, Azar MM. Effectiveness of SARS‐CoV‐2 vaccination in fully vaccinated solid organ transplant recipients. American Journal Of Transplantation 2021, 21: 2916-2918. PMID: 34101990, PMCID: PMC8222879, DOI: 10.1111/ajt.16713.Peer-Reviewed Original ResearchA retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients
Ringer M, Azmy V, Kaman K, Tang D, Cheung H, Azar MM, Price C, Malinis M. A retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients. Transplant Infectious Disease 2021, 23: e13556. PMID: 33378571, PMCID: PMC7883059, DOI: 10.1111/tid.13556.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedCase-Control StudiesCohort StudiesComorbidityCOVID-19COVID-19 Drug TreatmentCytokine Release SyndromeFemaleGlucocorticoidsGraft RejectionHeart TransplantationHospitalizationHumansImmunologic FactorsImmunosuppressive AgentsInterleukin-10Interleukin-6Kidney TransplantationLiver TransplantationMaleMiddle AgedReceptors, Interleukin-2Retrospective StudiesSARS-CoV-2Severity of Illness IndexTreatment OutcomeYoung AdultConceptsCytokine release syndromeBody mass indexNon-SOT patientsSOT groupSOT patientsRelease syndromeInterleukin-6COVID-19-related cytokine release syndromeSoluble interleukin-2 receptor levelsControl groupInterleukin-2 receptor levelsSolid organ transplant patientsSolid organ transplant recipientsImpact of immunomodulationInterleukin-10 levelsOrgan transplant recipientsOrgan transplant patientsCritical care needsMulti-center studyCoronavirus disease 2019COVID-19Interleukin levelsIndex hospitalizationTransplant patientsTransplant recipients
2020
Healthcare resource use among solid organ transplant recipients hospitalized with COVID‐19
Heldman MR, Kates OS, Haydel BM, Florman SS, Rana MM, Chaudhry ZS, Ramesh MS, Safa K, Kotton CN, Blumberg EA, Besharatian BD, Tanna SD, Ison MG, Malinis M, Azar MM, Rakita RM, Morillas JA, Majeed A, Sait AS, Spaggiari M, Hemmige V, Mehta SA, Neumann H, Badami A, Jeng A, Goldman JD, Lala A, Hemmersbach‐Miller M, McCort ME, Bajrovic V, Ortiz‐Bautista C, Friedman‐Moraco R, Sehgal S, Lease ED, Limaye AP, Fisher CE. Healthcare resource use among solid organ transplant recipients hospitalized with COVID‐19. Clinical Transplantation 2020, 35: e14174. PMID: 33349940, PMCID: PMC7883125, DOI: 10.1111/ctr.14174.Peer-Reviewed Original ResearchClinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients
Gaston DC, Malinis M, Osborn R, Peaper DR, Landry M, Juthani-Mehta M, Azar MM. Clinical implications of SARS-CoV-2 cycle threshold values in solid organ transplant recipients. American Journal Of Transplantation 2020, 21: 1304-1311. PMID: 33043603, PMCID: PMC7675520, DOI: 10.1111/ajt.16357.Peer-Reviewed Original ResearchConceptsSolid organ transplant recipientsOrgan transplant recipientsClinical implicationsCycle threshold valuesSOT patientsTransplant recipientsSymptom onsetYale New Haven Health SystemUpper respiratory tract samplesSARS-CoV-2 viral RNASARS-CoV-2 viral dynamicsAdult SOT recipientsRetrospective chart reviewRespiratory tract samplesSARS-CoV-2 cycle threshold valuesInfection prevention measuresCOVID-19 severityViral RNAHigher clinical acuityPrimary diagnostic testRT-PCR assaysSOT recipientsChart reviewViral loadAdmission severityDiagnosis of SARS-CoV-2 infection in the setting of the cytokine release syndrome
Azar MM, Shin JJ, Kang I, Landry M. Diagnosis of SARS-CoV-2 infection in the setting of the cytokine release syndrome. Expert Review Of Molecular Diagnostics 2020, 20: 1087-1097. PMID: 32990479, DOI: 10.1080/14737159.2020.1830760.Peer-Reviewed Original ResearchConceptsSARS-CoV-2Immune profileCOVID-19SARS-CoV-2 infectionCytokine release syndromeAdaptive immune cellsMultiple inflammatory cytokinesSARS-CoV-2 RNAFalse-negative resultsRelease syndromeInfectious complicationsIL-10Laboratory markersD-dimerInflammatory moleculesIP-10IL-6Inflammatory cytokinesMCP-1Acute diagnosisIL-2Immune cellsClinical severityTherapeutic benefitPathogenic contributionCoronavirus Disease 2019 in Solid Organ Transplant: A Multicenter Cohort Study
Kates OS, Haydel BM, Florman SS, Rana MM, Chaudhry ZS, Ramesh MS, Safa K, Kotton CN, Blumberg EA, Besharatian BD, Tanna SD, Ison MG, Malinis M, Azar MM, Rakita RM, Morilla JA, Majeed A, Sait AS, Spaggiari M, Hemmige V, Mehta SA, Neumann H, Badami A, Goldman JD, Lala A, Hemmersbach-Miller M, McCort ME, Bajrovic V, Ortiz-Bautista C, Friedman-Moraco R, Sehgal S, Lease ED, Fisher CE, Limaye AP, Arya A, Jeng A, Kuo A, Luk A, Puing A, Rossi A, Brueckner A, Multani A, Keller B, Derringer D, Florescu D, Dominguez E, Sandoval E, Bilgili E, Hashim F, Silveira F, Haidar G, Joharji H, Murad H, Gani I, el-amm J, Kahwaji J, Popoola J, Yabu J, Hughes K, Saharia K, Gajurel K, Bowman L, Veroux M, Morales M, Fung M, Theodoropoulos N, de la Cruz O, Kapoor R, La Hoz R, Allam S, Vora S, McCarty T, Anderson-Haag T, Malhotra U, Kelly U, Bhandaram V, Bennett W, Lominadze Z. Coronavirus Disease 2019 in Solid Organ Transplant: A Multicenter Cohort Study. Clinical Infectious Diseases 2020, 73: e4090-e4099. PMID: 32766815, PMCID: PMC7454362, DOI: 10.1093/cid/ciaa1097.Peer-Reviewed Original ResearchConceptsSOT recipientsUnderlying comorbiditiesCohort studyLaboratory-confirmed COVID-19Solid organ transplant recipientsMulti-center cohort studyCOVID-19Multicenter cohort studyOrgan transplant recipientsPredictors of mortalitySolid organ transplantsMultivariable logistic regressionKidney/pancreasCoronavirus disease 2019 (COVID-19) pandemicElectronic case report formCase report formsDisease 2019 pandemicImmunosuppression intensityStandardized intakePrimary endpointTransplant recipientsHospitalized patientsMedian ageTransplant centersClinical featuresTocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019 Survival and Clinical Outcomes
Price CC, Altice FL, Shyr Y, Koff A, Pischel L, Goshua G, Azar MM, Mcmanus D, Chen SC, Gleeson SE, Britto CJ, Azmy V, Kaman K, Gaston DC, Davis M, Burrello T, Harris Z, Villanueva MS, Aoun-Barakat L, Kang I, Seropian S, Chupp G, Bucala R, Kaminski N, Lee AI, LoRusso PM, Topal JE, Dela Cruz C, Malinis M. Tocilizumab Treatment for Cytokine Release Syndrome in Hospitalized Patients With Coronavirus Disease 2019 Survival and Clinical Outcomes. CHEST Journal 2020, 158: 1397-1408. PMID: 32553536, PMCID: PMC7831876, DOI: 10.1016/j.chest.2020.06.006.Peer-Reviewed Original ResearchConceptsCytokine release syndromeTocilizumab-treated patientsSevere diseaseRelease syndromeTocilizumab treatmentInflammatory biomarkersNonsevere diseaseSoluble IL-2 receptor levelsHigh-sensitivity C-reactive proteinIL-2 receptor levelsConsecutive COVID-19 patientsIL-6 receptor antagonistMechanical ventilation outcomesC-reactive proteinCOVID-19 patientsHigher admission levelsRace/ethnicityMV daysVentilation outcomesAdverse eventsChart reviewClinical responseMedian ageWhite patientsClinical outcomesMolecular Testing for Acute Respiratory Tract Infections: Clinical and Diagnostic Recommendations From the IDSA’s Diagnostics Committee
Hanson KE, Azar MM, Banerjee R, Chou A, Colgrove RC, Ginocchio CC, Hayden MK, Holodiny M, Jain S, Koo S, Levy J, Timbrook TT, Caliendo AM. Molecular Testing for Acute Respiratory Tract Infections: Clinical and Diagnostic Recommendations From the IDSA’s Diagnostics Committee. Clinical Infectious Diseases 2020, 71: 2744-2751. PMID: 32369578, PMCID: PMC7454374, DOI: 10.1093/cid/ciaa508.Peer-Reviewed Original ResearchMeSH KeywordsCOVID-19HumansMolecular Diagnostic TechniquesRespiratory Tract InfectionsSARS-CoV-2VirusesConceptsRespiratory tract infectionsAcute respiratory tract infectionsTract infectionsDiagnostics CommitteeSpecific nucleic acid amplification testsBacterial respiratory tract infectionsNucleic acid amplification testsRoutine clinical practiceDiagnostic reference standardNew molecular testsGlobal health responseClinical signsRespiratory medicineAmplification testsClinical practiceMolecular testingClinical judgmentAvailable assaysHealth responseDiagnostic recommendationsNovel coronavirus pandemicMolecular testsReference standardInfectionMolecular diagnostics