• COVID-19
• Publicationsclose
• Research softwareclose
• Other research productsclose
• Closed Access close
• Other ORP type close

In the post-pandemic COVID-19 period, human activities have returned to normal and COVID-19 cases are usually mild. However, patients with multiple myeloma (MM) present an increased risk for breakthrough infections and severe COVID-19 outcomes, including hospitalization and death. The European Myeloma Network has provided an expert consensus to guide patient management in this era. Vaccination with variant-specific booster vaccines, such as the bivalent vaccine for the ancestral Wuhan strain and the Omicron BA.4/5 strains, is essential as novel strains emerge and become dominant in the community. Boosters should be administered every 6–12 months after the last vaccine shot or documented COVID-19 infection (hybrid immunity). Booster shots seem to overcome the negative effect of anti-CD38 monoclonal antibodies on humoral responses; however, anti-BCMA treatment remains an adverse predictive factor for humoral immune response. Evaluation of the immune response after vaccination may identify a particularly vulnerable subset of patients who may need additional boosters, prophylactic therapies and prevention measures. Pre-exposure prophylaxis with tixagevimab/cilgavimab is not effective against the new dominant variants and thus is no longer recommended. Oral antivirals (nirmatrelvir/ritonavir and molnupiravir) and remdesivir are effective against Omicron subvariants BA.2.12.1, BA.4, BA.5, BQ.1.1 and/or XBB.1.5 and should be administered in MM patients at the time of a positive COVID-19 test or within 5 days post symptoms onset. Convalescent plasma seems to have low value in the post-pandemic era. Prevention measures during SARS-CoV-2 outbreaks, including mask wearing and avoiding crowded places, seem prudent to continue for MM patients.

Supplemental materials for manuscript entitled: Drinking to Cope Mediates the Association Between Dyadic Conflict and Drinking Behavior: A Study of Romantic Couples During the COVID-19 Pandemic

The 500-ns CG-MD simulation trajectory and AA structure towards SARS-CoV-2 virus.

The 500-ns CG-MD simulation trajectory towards SARS-CoV-2 virus.

Abstract:Nirmatrelvir/ritonavir (Paxlovid) consists of a peptidomimetic inhibitor (nirmatrelvir) of the SARS-CoV-2 main protease and a pharmacokinetic enhancer (ritonavir). It is approved for the treatment of mild-to-moderate COVID-19. This combination of nirmatrelvir and ritonavir can mediate significant and complex drug-drug interactions (DDIs), primarily due to the ritonavir component. Indeed, ritonavir inhibits the metabolism of nirmatrelvir through cytochrome P450 3A (CYP3A) leading to higher plasma concentrations and a longer half-life of nirmatrelvir. Coadministration of nirmatrelvir/ritonavir with immunosuppressive drugs (ISDs) is particularly challenging given the major involvement of CYP3A in the metabolism of most of these drugs and their narrow therapeutic ranges. Exposure of ISDs will be drastically increased through the potent ritonavir-mediated inhibition of CYP3A, resulting in an increased risk of adverse drug reactions. Although a decrease in the dosage of ISDs can prevent toxicity, an inappropriate dosage regimen may also result in insufficient exposure and a risk of rejection. Here, we provide some general recommendations for therapeutic drug monitoring of ISDs and dosing recommendations when coadministered with nirmatrelvir/ritonavir. Particularly, tacrolimus should be discontinued, or patients should be given a microdose on day 1, whereas cyclosporine dosage should be reduced to 20% of the initial dosage during the antiviral treatment. Dosages of mammalian target of rapamycin inhibitors (m-TORis) should also be adjusted while dosages of mycophenolic acid and corticosteroids are expected to be less impacted.

This model has been invalidated.

Supplementary Tables of Scientific Paper

Suriname inherited a weak colonial health system after political independence in 1975. In the decades that followed, political and economic developments have had an undeniable influence on the health situation and healthcare in Suriname, as well as on the (feasibility of the implementation of) plans to reform the healthcare system. The Surinamese health outcomes are not only particularly unfavorable compared to the Netherlands, but also compared to other states in the Caribbean region. Some national determinants strongly related to the implementation of effective health measures contribute to this: a low GDP, low control on corruption, sparsely populated areas and high ethnic diversity. The enormous impact of the COVID-19 pandemic in Suriname appears to have been the tipping point for a renewed relationship with the Netherlands. Almost 50 years after political independence, the Surinamese Ministry of Health, with the support of funding and expertise from the Netherlands, is embarking on an ambitious program to restore the health system.

Deliverable report 3.2 describes the findings on the analysis of the Science-Policy-Society (SPS) collaboration system on specific casesthrough a Net-Map analysis. Net-Map is an interview-based mapping tool to visualize implicit knowledge and understand the interplay of complex formal and informal networks, power relations, and actors/stakeholders’ goals; uncover sources of conflicts as well as potentials for cooperation; facilitate knowledge exchange and learning processes; and develop visions and strategies to achieve common goals. The development of the Net-Map analysis tool is described. Due to the Covid-19 pandemic, the interviewbased mapping tool was adapted to fit in an online setting. Online meeting applications such as Microsoft Teams® and MIRO® were implemented to map the stakeholders and their relations in the society-policyscience (SPS) collaboration system in risk analysis of emerging food safety issues and to identify constraints in relations, resources, and capabilities. Food safety scenarios based on gobal challenges were selected based on the in-depth expert interviews (Deliverable 3.1). These were food safety concerns regarding emerging mycotoxins and recycled food contact materials (FCM). Several steps in mycotoxin risk analysis are incomplete due to e.g. lack of occurrence or toxicokinetic/toxicity data, lack of analytical techniques and lack of scientific knowledge. Therefore, this case of emerging mycotoxins was used to perform a Net-Map analysis to identify stakeholders involved in this risk analysis and how they interact. For the FCMs, the focus was put on packaging consisting of recycled paper or cardboard, as they have become increasingly important in the light of sustainability and circular economy. However, food safety challenges are related to these materials, making it a good model case to apply the Net-Map tool on. A Net-Map guidance protocol, including a standardized data reporting format, was distributed among the food safety hub (HUB) leaders. Pilot workshops with FS4EU consortium partners were held, enabling further refinement of the protocol. The final protocol has been made publicly available through the FS4EU website and can be applied in many other contexts. Next, four Net-Map workshops were carried out in the respective home countries of the HUB leaders. In Belgium (West HUB) and Finland (North HUB) the case of FCMs was implemented, while participants of Italy (South HUB) and the Czech Republic (East HUB) worked on the emerging mycotoxins case. First, stakeholders and their main goals in mycotoxin/FCM risk analysis were identified. The next step was to characterise how the stakeholders were linked in the system, followed by an assessment on how influential the stakeholders were. Finally a discussion took place on constraints compromising the risk analysis. The workshops resulted in complex Net-Maps, visualizing how the SPS collaboration system regarding risk analysis of the aforementioned food safety issues is set up in each country. The most prominent stakeholders who take up a central role in the risk analysis process were identified. Many linkages between stakeholders were revealed, going from information sharing (legally required or voluntary), data requesting or communicating to the public. Moreover, in every country, constraints related to these linkages could be identified. These constraints, such as lack of resources or communication issues can be used to define needs for improvements in the current SPS collaboration system. While the initial results are already very interesting to discuss, further validation and verification of the obtained conclusions is needed.

OBJECTIVE: Assessment of the results of the ProtekDuo cannula applied for dedicated right ventricular support with oxygenator in ARDS secondary to COVID-19. METHODS: Systematic literature search in NHS library, Medline (Pubmed) and EMBASE using appropriate keywords as well as PICOS and PRISMA approach. RESULTS: Out of 285 publications found, 5 publications met the search criteria and were included in this review. A total of 194 patients with ARDS secondary to COVID-19 underwent ProtekDuo placement to establish a combination of respiratory [veno-venous extracorporeal membrane oxygenation (V-V ECMO)] and right ventricular support. Patients treated using the ProtekDuo cannula had survival rates between 59% and 89% throughout the five studies, and a significant survival benefit when compared to an invasive ventilation group or compared to dual site V-V ECMO or other double lumen ECMO cannulas. One study focused on extubation and discontinuation of ventilator support, which could be achieved in 100% of ProtekDuo patients. An association for reduced incidence of acute kidney injury (AKI) and use of continuous renal replacement therapy (CRRT) could be shown when the ProtekDuo was used. CONCLUSION: Only limited literature is available for the ProtekDuo in V-P ECMO configuration in the setting of COVID-19 ARDS and should be interpreted with caution. Data on the ProtekDuo is suggestive for lower rates of mortality, AKI and CRRT as compared to other respiratory support modalities.