2022
Real‐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 experienceDematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis
Radcliffe C, Radcliffe AJ, Azar MM, Grant M. Dematiaceous fungal infections in solid organ transplantation: Systematic review and Bayesian meta‐analysis. Transplant Infectious Disease 2022, 24: e13819. PMID: 35253959, DOI: 10.1111/tid.13819.Peer-Reviewed Original ResearchMeSH KeywordsAntifungal AgentsBayes TheoremChildHumansMaleMiddle AgedMycosesOrgan TransplantationTransplant RecipientsConceptsSolid organ transplant recipientsDematiaceous fungal infectionSoft tissue infectionsFungal infectionsInfectious syndromesSystematic reviewEarly post-transplant periodCentral nervous system infectionCommon infectious syndromesPost-transplant periodNervous system infectionOrgan transplant recipientsSolid organ transplantationEnglish-language reportsInfection typeKidney recipientsLiver recipientsPediatric reportsTransplant recipientsPulmonary infectionSystem infectionTissue infectionsWorse prognosisDisseminated infectionMean age
2021
Increased Detection of Mycobacterium tuberculosis Disease Using a Tissue-Based Laboratory-Developed Polymerase Chain Reaction Assay Compared to Standard Diagnostics.
Mackow NA, Abi-Raad R, Kerantzas CA, Hui P, Malinis M, Azar MM. Increased Detection of Mycobacterium tuberculosis Disease Using a Tissue-Based Laboratory-Developed Polymerase Chain Reaction Assay Compared to Standard Diagnostics. American Journal Of Tropical Medicine And Hygiene 2021, 105: 1657-1661. PMID: 34544041, PMCID: PMC8641361, DOI: 10.4269/ajtmh.21-0104.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCulture TechniquesFemaleHumansLungLymph NodesMaleMiddle AgedMycobacterium tuberculosisPleuraReal-Time Polymerase Chain ReactionReference StandardsRetrospective StudiesSensitivity and SpecificitySputumTuberculosisTuberculosis, Lymph NodeTuberculosis, Multidrug-ResistantTuberculosis, PleuralTuberculosis, PulmonaryConceptsComposite reference standardMTB PCRAFB cultureMycobacterium tuberculosisPolymerase chain reactionAcid-fast bacilli smearMycobacterium tuberculosis diseasePositive AFB cultureChain reactionReal-time polymerase chain reactionStandard diagnosticsBacilli smearMTB casesTuberculosis diseaseClinical sensitivityLong turnaround timeXpertClinical performanceReference standardPCRVariable sensitivityTurnaround timeLymphPatientsTuberculosisA 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
Clinicopathologic Features of Tissue Granulomas in Transplant Recipients: A Single Center Study in a Nontuberculosis Endemic Region.
Nussbaum EZ, Patel KK, Assi R, Raad RA, Malinis M, Azar MM. Clinicopathologic Features of Tissue Granulomas in Transplant Recipients: A Single Center Study in a Nontuberculosis Endemic Region. Archives Of Pathology & Laboratory Medicine 2020, 145: 988-999. PMID: 33290524, DOI: 10.5858/arpa.2020-0271-oa.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBartonellaBiopsyCommunicable DiseasesConnecticutCytomegalovirusFemaleGranulomaHematopoietic Stem Cell TransplantationHumansMaleMiddle AgedOrgan TransplantationPrevalenceRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTransplantation, HomologousTreatment OutcomeYoung AdultConceptsEpidemiologic risk factorsPresence of symptomsInfectious etiologyAsymptomatic patientsTransplant recipientsTissue granulomasClinicopathologic featuresRisk factorsAllogeneic hematopoietic stem cell transplant recipientsHematopoietic stem cell transplant recipientsStem cell transplant recipientsYale-New Haven HospitalCommon infectious etiologiesLarge transplant populationCell transplant recipientsSingle-center studyCryptogenic organizing pneumoniaNew Haven HospitalRoutine disease surveillancePaucity of literatureCytomegalovirus hepatitisPosttransplant specimensBiopsy indicationOrganizing pneumoniaTransplant patientsClinical 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 oesophageal mucormycosis managed with medical therapy alone
Ringer M, Pischel L, Azar MM. Diagnosis of oesophageal mucormycosis managed with medical therapy alone. BMJ Case Reports 2020, 13: e236869. PMID: 33093060, PMCID: PMC7583061, DOI: 10.1136/bcr-2020-236869.Peer-Reviewed Original ResearchConceptsIdarubicin/cytarabineLiposomal amphotericin BAcute myeloid leukemiaFebrile neutropeniaInduction chemotherapyPosaconazole therapyClinical characteristicsMedical therapySurgical morbiditySurgical interventionAggressive infectionDevastating manifestationMyeloid leukemiaCT scanInvasive moldsMucormycosisLebanese menAmphotericin BPatientsDiagnosisTherapyReportOdynophagiaNeutropeniaThrombocytopeniaCoronavirus 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 ResearchMeSH KeywordsCohort StudiesCOVID-19HumansMaleMiddle AgedOrgan TransplantationSARS-CoV-2Transplant RecipientsConceptsSOT 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 outcomesDaptomycin perioperative prophylaxis for the prevention of vancomycin‐resistant Enterococcus infection in colonized liver transplant recipients
Sarwar S, Koff A, Malinis M, Azar MM. Daptomycin perioperative prophylaxis for the prevention of vancomycin‐resistant Enterococcus infection in colonized liver transplant recipients. Transplant Infectious Disease 2020, 22: e13280. PMID: 32216015, DOI: 10.1111/tid.13280.Peer-Reviewed Original ResearchConceptsLiver transplant recipientsDays of LTVRE infectionTransplant recipientsPerioperative prophylaxisRisk factorsLT periodVancomycin-resistant enterococcus infectionAntibiotic prophylaxis regimenDays post-LTAcute cellular rejectionPrimary graft failureLiver transplantation recipientsRenal replacement therapyRetrospective chart reviewIntensive care unitMultiple risk factorsVancomycin-resistant EnterococcusCellular rejectionLT morbidityPost-LTPre-LTProphylaxis regimenCause mortalityVRE bacteremiaDiagnosing peritoneal tuberculosis
Koff A, Azar MM. Diagnosing peritoneal tuberculosis. BMJ Case Reports 2020, 13: e233131. PMID: 32033999, PMCID: PMC7035809, DOI: 10.1136/bcr-2019-233131.Peer-Reviewed Original ResearchConceptsPeritoneal tuberculosisEmpiric anti-tuberculous therapyPositive QuantiFERON-TB GoldAnti-tuberculous therapyPresence of ascitesQuantiFERON-TB GoldWorse clinical outcomesLow-incidence regionsAscitic adenosine deaminaseInflammatory ascitesPeritoneal thickeningAbdominal painDecompensated cirrhosisLiver transplantationExtrapulmonary tuberculosisRadiographic responseAntibiotic therapyClinical outcomesTuberculosisIncidence regionDiagnosisMycobacterial testingItalian malesAdenosine deaminaseCirrhosisDisseminated, yet dissembled: Rare infections behind the veil of classical hairy cell leukemia
Shallis RM, Patel TH, Podoltsev NA, Xu ML, Azar MM, Gore SD. Disseminated, yet dissembled: Rare infections behind the veil of classical hairy cell leukemia. Leukemia Research 2020, 90: 106315. PMID: 32036123, DOI: 10.1016/j.leukres.2020.106315.Peer-Reviewed Case Reports and Technical NotesCase 2-2020: A 64-Year-Old Man with Fever and Respiratory Failure
Azar MM, Muse VV, Villalba JA, Turbett SE. Case 2-2020: A 64-Year-Old Man with Fever and Respiratory Failure. New England Journal Of Medicine 2020, 382: 276-285. PMID: 31940703, DOI: 10.1056/nejmcpc1913468.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisBronchoalveolar Lavage FluidCoccidioidomycosisDiagnosis, DifferentialFatal OutcomeFeverGlomerulonephritisHeart FailureHumansLungLung Diseases, FungalMaleMiddle AgedMyocardiumPneumoniaRadiography, ThoracicRespiratory Insufficiency
2019
Allogeneic stem cell transplantation and combination antiretroviral therapy: cautions, complications, and considerations
Shallis RM, Gleeson S, Azar M, Malinis M, Xu ML, Seropian SE, Gowda L, Zeidan AM. Allogeneic stem cell transplantation and combination antiretroviral therapy: cautions, complications, and considerations. Leukemia & Lymphoma 2019, 60: 2584-2587. PMID: 30943051, DOI: 10.1080/10428194.2019.1594221.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2018
Extended-Release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living With HIV With Opioid Use Disorders Transitioning to the Community
Springer SA, Di Paola A, Azar M, Barbour R, Biondi BE, Desabrais M, Lincoln T, Skiest DJ, Altice FL. Extended-Release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living With HIV With Opioid Use Disorders Transitioning to the Community. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2018, 78: 43-53. PMID: 29373393, PMCID: PMC5889326, DOI: 10.1097/qai.0000000000001634.Peer-Reviewed Original ResearchMeSH KeywordsAdultCriminal LawDelayed-Action PreparationsDouble-Blind MethodFemaleFollow-Up StudiesHIV InfectionsHIV-1HumansInjections, IntramuscularMaleMiddle AgedMultivariate AnalysisNaltrexoneNarcotic AntagonistsOpioid-Related DisordersPrisonersProspective StudiesResearch DesignRNA, ViralTime FactorsTreatment OutcomeViral LoadConceptsOpioid use disorderViral suppressionXR-NTXPlacebo groupPrimary outcomeUse disordersXR-NTX groupPlacebo-controlled trialExtended-release naltrexoneStatistical significant differenceRelease naltrexoneMonthly injectionsEligible participantsTreatment groupsJail detaineesHIVMonthsBaselinePlaceboSignificant differencesNaltrexoneJail inmatesDisordersVS levelsOutcomesCentral nervous system histoplasmosis
Wheat J, Myint T, Guo Y, Kemmer P, Hage C, Terry C, Azar MM, Riddell J, Ender P, Chen S, Shehab K, Cleveland K, Esguerra E, Johnson J, Wright P, Douglas V, Vergidis P, Ooi W, Baddley J, Bamberger D, Khairy R, Vikram H, Jenny-Avital E, Sivasubramanian G, Bowlware K, Pahud B, Sarria J, Tsai T, Assi M, Mocherla S, Prakash V, Allen D, Passaretti C, Huprikar S, Anderson A. Central nervous system histoplasmosis. Medicine 2018, 97: e0245. PMID: 29595679, PMCID: PMC5895412, DOI: 10.1097/md.0000000000010245.Peer-Reviewed Original ResearchConceptsCentral nervous system histoplasmosisPercent of patientsCerebrospinal fluidAmphotericin BCentral nervous system involvementSingle-center case seriesNervous system involvementLiposomal amphotericin BCenter case seriesOutcome of treatmentAnti-Histoplasma antibodiesRecognition of infectionPatients 54 yearsCNS histoplasmosisDeoxycholate formulationDisseminated histoplasmosisMost patientsAntigen testingAntibody testingCase seriesImmunodeficiency syndromeHistoplasma antigenHistoplasmosis infectionSystem involvementYear survival
2017
Clinical and epidemiological characterization of histoplasmosis cases in a nonendemic area, Connecticut, United States
Azar MM, Zhang X, Assi R, Hage C, Wheat LJ, Malinis MF. Clinical and epidemiological characterization of histoplasmosis cases in a nonendemic area, Connecticut, United States. Medical Mycology 2017, 56: 896-899. PMID: 29228334, DOI: 10.1093/mmy/myx120.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusHistoplasmosis casesEpidemiology of histoplasmosisNon-endemic areasSymptom onsetAntigen testingMedian timeImmunodeficiency virusActive histoplasmosisNonendemic areasRetrospective analysisEndemic areasEpidemiological characterizationHistoplasmosisNew HavenDaysPatientsEpidemiologyDiagnosisCasesCase 26-2017
Letourneau AR, Price MC, Azar MM. Case 26-2017. New England Journal Of Medicine 2017, 377: 770-778. PMID: 28834480, DOI: 10.1056/nejmcpc1616402.Peer-Reviewed Case Reports and Technical NotesExtended-release naltrexone reduces alcohol consumption among released prisoners with HIV disease as they transition to the community
Springer SA, Di Paola A, Azar MM, Barbour R, Krishnan A, Altice FL. Extended-release naltrexone reduces alcohol consumption among released prisoners with HIV disease as they transition to the community. Drug And Alcohol Dependence 2017, 174: 158-170. PMID: 28334661, PMCID: PMC5407009, DOI: 10.1016/j.drugalcdep.2017.01.026.Peer-Reviewed Original ResearchConceptsHeavy drinking daysAlcohol use disorderFirst heavy drinking dayExtended-release naltrexoneXR-NTXDrinking daysPlacebo groupAlcohol consumptionDrinks/drinking dayPlacebo-controlled trialSerious adverse eventsDrinks/daySignificant differencesMonthly injectionsAdverse eventsHIV diseaseHIV outcomesTreatment armsAlcohol scoresMAIN OUTCOMEAlcohol consumption scoresUse disordersImprovement scoresDrinking outcomesNaltrexone
2016
Integrase strand transferase inhibitors: the preferred antiretroviral regimen in HIV-positive renal transplantation
Azar MM, Malinis MF, Moss J, Formica RN, Villanueva MS. Integrase strand transferase inhibitors: the preferred antiretroviral regimen in HIV-positive renal transplantation. International Journal Of STD & AIDS 2016, 28: 447-458. PMID: 27193421, DOI: 10.1177/0956462416651528.Peer-Reviewed Original ResearchConceptsInhibitor-based regimensRenal transplantationHIV/AIDSAntiretroviral regimenAntiretroviral therapyGraft survivalHIV-positive renal transplant recipientsEnd-stage renal diseaseHIV-positive patientsRenal transplant recipientsChronic kidney diseaseThree-year survivalInhibitor-based therapyNon-nucleoside reverseDrug-drug interactionsTransferase inhibitorsImmunosuppressive medicationsKidney transplantationTransplant recipientsAllograft rejectionGraft failureRenal diseaseCalcineurin inhibitorsClinical outcomesImmunosuppressive drugs