May 22, 2025

Mpox

Air and Surface Sampling for Clade Ib Monkeypox Virus in United Kingdom Hospitals, 2024 to 2025
To understand if the immediate environment of patients with clade Ib mpox can become contaminated with MPXV, these authors investigated whether this virus could be detected in environmental surface and air samples collected from the seven patients’ rooms or anterooms. Air and environmental sampling was done and they found monkeypox virus (MPXV) clade 1b DNA in 73% of surface samples and 7% of air samples from infected patients' rooms, as well as replication competent or ‘live’ virus in 19% of surface samples that underwent viral isolation. They inoculated 70% confluent monolayers of Vero E6 cells in T25 culture flasks. Flasks were incubated and inspected regularly for signs of cytopathic effect, with time point samples collected to monitor MPXV DNA levels by qPCR.

COVID: Early Inflammatory Phase

The Clinical Impact of Prolonged Steroid Therapy in Severe COVID-19 Patients: A Retrospective Cohort Study with Propensity Score Matching
These are the results of a retrospective, single-center cohort study included adult patients with COVID-19 where they compared clinical outcomes between early steroid withdrawal (EW; ≤10 days) and prolonged steroid tapering (PT; >10 days) in patients with severe COVID-19 requiring oxygen support. They reported: For 28-day mortality PT vs EW (5.9% vs. 10.3%, HR 0.54, 95% CI 0.16-1.84, p = 0.32) 60-day mortality PT vs EW (14.7% vs. 11.8%, HR 1.22, 95% CI 0.48-3.10, p = 0.67) The PT group had significantly longer durations of oxygen support (17.5 vs. 13.0 days, p = 0.001), hospitalization (20.0 vs. 14.0 days, p = 0.001), and ICU stay (5.0 vs. 1.0 days, p = 0.01).

Antibiotic Treatment in Patients Hospitalized for Nonsevere COVID-19
These are the results of a retrospective cohort study that used a target trial emulation design. Participants were adult, immunocompetent patients admitted to general care for COVID-19 from April 2020 to December 2023 at 1,053 U.S.-based acute-care hospitals that contribute data to the Premier Healthcare Database. The cohort included 520,405 patients with COVID-19. A total of 160,482 patients (30.8%) were treated with a CAP antibiotic regimen on day one of admission. The primary outcome was a composite measure of deterioration (vasopressor, high-flow oxygen, noninvasive ventilation, invasive mechanical ventilation, intermediate care, intensive care unit admission) and in-hospital mortality occurring on day two or later. The primary composite outcome was higher in the CAP group (20.8%) compared with the unexposed (no antibiotic) group (18.4%). Patients who received CAP antibiotics had higher odds of poor clinical outcomes (propensity matched–odds ratio [OR], 1.03 [95% CI, 1.01-1.05]; P = .003; inverse probability treatment weighted–OR, 1.03 [95% CI, 1.02-1.05]; P < .001; standardized mortality ratio weighted–OR, 1.10 [95% CI, 1.08-1.12]; P < .001).

COVID: The Late Phase/PASC/Long COVID

Self-reported Health, Neuropsychological Tests and Biomarkers in Fully Recovered COVID-19 Patients vs Patients with Post-COVID Cognitive Symptoms: A Pilot Study
The objective of this pilot study was to compare two groups of laboratory-confirmed post-COVID patients, with and without cognitive symptoms, on measures of cognitive and psychological functioning, self-reported perceptions of functional status and quality of life, and biomarkers of stress, inflammation, and neuroplasticity. Using a case-control design, 17 participants were recruited from a healthcare system in western Michigan, USA in 2022–2024. All participants were aged 25–65 and had a positive polymerase chain reaction (PCR) test confirming previous COVID-19 infection. Ten participants reported cognitive symptoms (Long COVID group) while seven were fully recovered with no residual symptoms (controls). All participants underwent an interview on their self-rated health and quality of life, a battery of neurocognitive tests, and blood draw for biomarker analysis. They found that the Long COVID group scored significantly lower on letter fluency(p < .05). Serum levels of nerve growth factor (NGF), a biomarker of brain plasticity, were significantly lower in the Long COVID group, which was significantly more likely than controls to have serum levels of inflammatory marker (interleukin (IL)-10) values greater than or equal to the median (p = 0.015). Biomarker analyses suggest possible prolonged inflammatory processes in Long COVID patients compared to fully recovered patients. They conclude with “Results of decreased neuroplastic functioning give credence to patients’ reports of post-COVID changes in brain function.”

Vortioxetine for Cognitive Impairment in Major Depressive Disorder During Post-COVID Syndrome: Real-World Evidence
These are the results of a prospective, open-label, comparative effectiveness study in individuals with new-onset major depressive disorder (MDD) as post-COVID syndrome (PCS) outcome. Participants that were eligible were assigned to receive vortioxetine at 10-20 mg/d, escitalopram 10-20 mg/d, or sertraline 50-200 mg/d over eight weeks. The primary and secondary outcomes were changes from baseline to end point in Digital Symbol Substitution Test (DSST) and Montgomery-Asberg Depression Rating Scale (MADRS) or Patient Reported Outcome Measurement Information System Fatigue Short Form 7a (PROMIS 7a), respectively. Data were collected during January 2022 and December 2023.

140 participants. Vortioxetine (n = 70), escitalopram (n = 36), or sertraline (n = 34). Participants assigned to vortioxetine exhibited significant changes in DSST scores from baseline to end point compared to escitalopram or sertraline. Participants in the vortioxetine treatment group reported significantly greater changes in total MADRS scores from baseline to endpoint compared to escitalopram or sertraline. (Vortioxetine, sold under the brand name Trintellix in the U.S. and Brintellix in the EU, is an antidepressant medication of the serotonin modulator and stimulator (SMS) class.)