bluuebunny/crossref_metadata_2025_split huggingface dataset:
1091. HIV Does Not Increase Risk of Disease Severity in Patients with COVID-19 Infection
Authors: Bangash Salman , Betancourth Adriana , Khan Ayesha , Hsiao Chiu-Bin , Oehler Cassandra , Abalos Charmaine Clarisse D 
Published: December 2022

Abstract

Background
Limited literature on the impact of COVID-19 infection in persons living with HIV infection (PLWHIV) has shown conflicting results, especially on the degree of disease severity and morbidity/mortality risk impact. The advent of vaccinations against COVID-19 infection helped combat this horrific pandemic. However, their efficacy in immunocompromised hosts is understudied. The measurement of anti-spike antibody levels makes them an ideal surrogate to study the efficacy of the immune response conferred after vaccination.

Methods
A quality improvement project was conducted between 03/2020 and 03/2022 at Positive Health Clinic (PHC), a Pittsburgh urban Ryan White-funded HIV clinic, where approximately 930 PLWHIV receive care. PHC patients who tested positive for COVID-19 were followed up for their clinical presentations and outcomes. Goals were to observe longitudinal clinical impact with or without vaccinations; the COVID-19 vaccination acceptance and its serum anti-spike antibody response (AS-Ab); and COVID-19 variants impact on protection by vaccination.

Results
By 02/21, a 70% vaccination rate was achieved for PHC PLWHIV. 136 serum AS-Ab tests were collected at least 28 days after completing the primary vaccination series. Five non-responders were noted (2 renal transplant recipients, 2 with advanced AIDS with uncontrolled HIV, and 1 with liver cirrhosis). Low AS-Ab titers were observed in patients with CD4 &lt; 200 or HIV VL &gt; 200. A total of 109 COVID-19 infections in 105 patients were seen. From 03/20 – 11/21, there were 53 infections noted (45 unvaccinated: 5 with severe disease; 8 vaccinated: 0 severe disease). 58 infections (8 unvaccinated, 2 severe, 50 vaccinated (including four 2nd infections: 0 severe) were observed during 11/221 – 03/22. No mortality was noted. Figure 1.Figure 2.Figure 3Demographics of PHC

Conclusion
This report did not show mortality directly associated with COVID-19 infection in PLWHIV. Moreover, COVID-19 vaccination is known to reduce the risk and severity of COVID-19 infection in the general population, which was consistent across our study. Interestingly, there were very few COVID-19 infections diagnosed in PLWHIV who had low CD4 count and uncontrolled HIV (CD4 &lt; 200 & HIV VL &gt; 500 copies) even after the surge of the Omicron variant.

Disclosures
All Authors: No reported disclosures.
1105. A Matched-Group Comparison of Interventions for COVID-19 During the First and Second Waves of the COVID-19 Pandemic in a County Hospital in Chicago.
Authors: Hernandez Acosta Ruben A , Corpuz Carlos , Gonakoti Sriram , Patel Palak , Chang Hillary , Akaho Elikplim , Skaathun Britt , Hoffman Michael , Rezai Katayoun 
Published: December 2022

Abstract

Background
The COVID-19 pandemic continually challenges the scientific community to develop and evaluate viable treatments. In May 2020, remdesivir became the first medication to receive emergency use authorization for the treatment of COVID-19, while dexamethasone became standard of care for patients requiring supplementary oxygen in late 2020.

Methods
This was a retrospective observational study of hospitalized adult patients with confirmed coronavirus disease 2019 (COVID-19) admitted in the first wave (3/2020-7/2020) and second wave (10/2020-1/2021) at Cook County Hospital. Variables on demographic, clinical data and outcomes were extracted from the EMR. The measured intervention was use of dexamethasone with remdesivir during the second wave; patients were matched by age and diabetic status to patients in the first wave who had received only remdesivir. The primary outcome was mortality; secondary outcomes were ICU admission and intubation. Conditional logistic regression was used to examine associations between use of dexamethasone and each outcome, controlling for glucose levels, use of remdesivir and severity of disease.

Results
621 patients were admitted in the first wave (3/2020-7/2020) versus 355 in the second wave (12/2020-1/2021). Median age was 55 years and 56 years, respectively. Most patients were Hispanic and Black. In the first wave, 296 patients (48%) were admitted with severe COVID-19 (defined as oxygen saturation on room air at or below 94%) versus 163 patients (46%) in the second wave. Logistic regression showed no association between use of dexamethasone and ICU admission, mortality or intubation. Use of remdesivir showed no association with any of the outcomes. Glucose and severe/critical disease were strongly associated with ICU admission (p=0.01 and p=0.003) and mortality (p=0.06 for both).

Conclusion
Despite promising medications, in this study the mortality and disease severity of COVID-19 was very similar to that seen in the first wave. This could be due to patients presenting with more advanced disease and undiagnosed or poorly-controlled comorbidities that may offset the potential benefit of these treatments. Enhancing access to care and decreasing health inequalities may be more worthwhile than finding a “miracle drug”.

Disclosures
All Authors: No reported disclosures.
1106. A Retrospective Assessment of the Effects of Baricitinib and Tocilizumab on COVID-19 Patients requiring High Flow Oxygen
Authors: Tin Kathy , Fernandes Annamarie , Njoroge Alexander , Go Roderick 
Published: December 2022

Abstract

Background
SARS-CoV-2 has been a leading cause of mortality worldwide for over two years. It continues to be a group effort to discover treatment to prevent further deterioration during the disease course. Positive outcomes have been observed in select patients with immune modulator therapy. Although large randomized controlled trials have investigated the use of immunomodulators in COVID-19 therapy, few have compared the differences in safety profiles and clinical outcomes between the different drugs. We studied the differences in outcomes in hospitalized patients with COVID-19 pneumonia treated with baricitinib versus tocilizumab.

Methods
Adult patients admitted to Stony Brook University Hospital between April 2020 and April 2021 with high flow oxygen requirements due to severe COVID-19 pneumonia were retrospectively analyzed. The primary endpoint was the time to reduction of highest oxygen requirement 14 days after immune modulator therapy was administered or hospital discharge, whichever came first. Secondary endpoints include length of hospital stay (LOS), 28-day mortality, and serious adverse events.

Results
132 patients with COVID-19 pneumonia were treated with immune modulators. One patient was excluded from primary and secondary analysis due to having received both tocilizumab and baricitinib. All patients received steroids and remdesivir. 73 received baricitinib and 58 received tocilizumab. Oxygen requirements at the initiation of either baricitnib or tocilizumab had a mean of 5.84±0.6 and 5.9±0.7, respectively using the WHO ordinal scale. The mean time to oxygen down titration in the baricitinib group was similar (5.7±2.6 and 6.07±2.7 days). In continuous variable analysis, patients who received baricitinib had a longer duration of fever (6.0 days vs 3.6 days, p=0.04) and lower serum ferritin (909.9 ng/ml vs. 1331.8 ng/ml, p=0.09). LOS was not similar between the groups (mean 24.4 vs. 25.8, p=0.89). Hospital mortality was not statistically significant between the two groups (32.9% vs. 27.6%, p=0.514).

Conclusion
This study suggests similar outcomes for oxygen requirements, hospital length of stay, and mortality between baricitinib and tocilizumab when given in conjunction with remdesivir and steroids for severe COVID-19 pneumonia.

Disclosures
Kathy Tin, D.O., Merck: Stocks/Bonds|Novavax: Stocks/Bonds|Pfizer: Stocks/Bonds Roderick Go, DO, Aptose Biosciences: Stocks/Bonds|Bristol Meyers Squibb: Stocks/Bonds|Cytodyn Inc.: Stocks/Bonds|Scynexis: Grant/Research Support.
1122. Early Infectious Diseases Consultation and Procalcitonin-Guided Therapy Limits Unnecessary Antibiotic Use in COVID-19
Authors: Kammeyer Joel A , Deutsch Meghan M , Starnes Victoria R , Ibaraki Makoto , Soewarna Victoria , Khalil Basmah , Girdhar Katherine K , Fabian Riaz , Franco Justin H , Staten Stephanie L , Berry Julia T , Setia Abhishiek , Williams Kada K , Asher Rebecca A , Rostad Kylie R , Hollingshead Caitlyn M 
Published: December 2022

Abstract

Background
Antibiotic stewardship has been a central challenge of the COVID-19 pandemic. Empiric antibiotic therapy is offered in 56.6%-74.6% of inpatients with COVID-19, with microbiologically confirmed bacterial pneumonia reported in only 3.5%-16% of cases. Procalcitonin (PCT) as a biomarker for bacterial infection is of interest in improving antibiotic use. PCT-guided antibiotic stewardship initiatives have demonstrated reduction in the use of antibiotics in the COVID-19 pandemic.
An Infectious Diseases (ID) consultation was obtained on most patients at our institution throughout the COVID-19 pandemic. We report a significant reduction in antibiotic use among COVID-19 patients in the setting of near-universal ID consultation in COVID-19 patients.

Methods
We evaluated the records of 1346 patients with COVID-19 from March 2020 – May 2021 at four hospitals with ID consultant availability. We assessed the inclusion of an ID consultant, antibiotic indication, initiation and discontinuation, PCT levels, radiologic images, and changes to therapy decisions. A chi-square test of independence and simple logistic regression were conducted to determine whether an association exists between the PCT level and the decision to discontinue antibiotics.

Results
Of 1346 patients with a confirmed COVID-19 diagnosis, 64.6% (870/1346) received antibiotics on admission. The most common diagnosis associated with initial antibiotic administration was bacterial pneumonia (692/870, 79.5%).  An ID consultation was obtained on 97.8% (677/692) of the patients that received antibiotics for suspected bacterial pneumonia. In 48.1% (326/677) of these patients, antibiotics were discontinued within the first 48 hours of the ID consultation. A statistically significant difference was noted between the PCT level and continuation of antibiotics (Χ2= 67.02, p &lt; .01). The odds of discontinuing antibiotics for the upper (PCT &gt; 0.51) and middle (PCT = 0.26-0.50) groups were 0.22 and 0.37, respectively, when compared to the lower (PCT ≤ 0.25) group.

Conclusion
Early consultation of an ID specialist and evaluation of PCT levels leads to significant reductions in inappropriate antibiotic use. PCT may be a useful adjunct in assisting with the decision to discontinue antibiotics.

Disclosures
All Authors: No reported disclosures.
1126. Effect of Remdesivir on Recovery, Quality of Life, and Long-COVID Symptoms One Year after Hospitalization for COVID-19 Infection: A Randomized Controlled SOLIDARITY Finland Trial
Authors: Nevalainen Olli P O , Horstia Saana , Laakkonen Sanna , Rutanen Jarno , Mustonen Jussi , Kalliala Ilkka , Ansakorpi Hanna , Kreivi Hanna-Riikka , Kuutti Pauliina , Paajanen Juuso , Parkkila Seppo , Paukkeri Erja-Leena , Perola Markus , Pourjamal Negar , Renner Andreas , Rosberg Tuomas , Rutanen Taija , Savolainen Joni , Haukka Jari K , Guyatt Gordon H , Tikkinen Kari A 
Published: December 2022

Abstract

Background
Coronavirus disease 2019 (COVID-19) patients frequently suffer from long-term sequelae, often called “long COVID” or “post COVID-19 condition”. Remdesivir, given in early disease, decreases the risk of hospitalization and potentially mortality. No randomized trials have thus far published long-term follow-up data on any COVID-19 drug treatment. We investigated the effects of remdesivir on a range of patient-important outcomes at one year.

Methods
Between July 2020 and January 2021, an open-label randomized multicenter trial in Finland recruited 208 adult patients from 11 Finnish hospitals. Patients were randomly assigned (1:1 ratio) to standard of care (SoC)with remdesivir (median duration of remdesivir treatment 5 days) or SoC alone. Primary outcomes were self-reported recovery, exertional dyspnea, fatigue, and quality of life at one year. Secondary outcomes were overall mortality and several potential long-COVID symptoms.

Results
At one year, 5 (4.4%) of 114 patients in the remdesivir and 5 (5.3%) of 94 in the SoC group had died (RR 0.82, 95% CI 0.25-2.76; absolute difference: -0.9%, 95% CI -7.9-5.3); 181 (92% of survivors) completed the follow-up. Self-reported recovery (fully or largely) occurred in 85% in remdesivir and in 86% in SoC (RR 0.94, 0.47-1.90; absolute difference: -0.9%, 95% CI -11%-10%). Exertional dyspnea occurred in 5% in remdesivir and 8% in SoC (OR 0.61, 95% CI 0.20-1.85; absolute difference -3.3%, 95% CI -12%-4.4%). We found no convincing difference between remdesivir and SoC groups in quality of life or symptom outcomes (p &gt; 0.05 for all). Of the 21 potential long-COVID symptoms, patients often reported moderate or major bother from fatigue (26%), joint pain (22%), persistent respiratory mucus (21%), and problems with memory (19%) and attention/concentration (18%) (Figure).
Bother from potential long-COVID symptoms at one year from COVID-19 hospitalization between the standard of care and standard of care plus remdesivir groups.

Conclusion
After a one-year follow-up of hospitalized patients (with a very high participation rate), approximately one in four reported substantial bother from fatigue, and one in six reported that they had not recovered well from COVID-19. We found no convincing evidence of a remdesivir effect, but confidence intervals were wide and included possible substantial benefit and substantial harm.

Disclosures
Hanna-Riikka Kreivi, MD, PhD, Pfizer: Advisor/Consultant|Roche: Advisor/Consultant Tuomas Rosberg, MD, PhD, AstraZeneca: Honoraria|Boehringer-Ingelheim: Honoraria|GSK: Honoraria.
1143. Prophylactic and Therapeutic Activity of AZD7442 (Tixagevimab/Cilgavimab) in SARS-CoV-2 Hamster Challenge Models
Authors: Loo Yueh-Ming , Herbert Andrew S , Kuehne Ana I , McTamney Patrick M , Roque Richard , Moreau Alicia M , Bakken Russell , Stefan Christopher P , Koehler Jeffrey W , Delp Korey L , Coyne Susan R , Kane Christopher D , Dye John M , Cai Yingyun , Esser Mark T 
Published: December 2022

Abstract

Background
AZD7442—a combination of 2 human, extended–half-life, SARS-CoV-2–neutralizing monoclonal antibodies (mAbs) (tixagevimab/cilgavimab)—has received US Food and Drug Administration emergency use authorization for COVID-19 prevention in immunocompromised individuals. We evaluated the effect of AZD7442 in prevention and treatment settings in Syrian hamsters challenged with SARS-CoV-2.

Methods
Hamsters received intraperitoneal isotype control mAb (2 mg) or AZD7442 (0.002–2 mg) 1 day before intranasal (IN) SARS-CoV-2 challenge (USA-WA1/2020; 1x105 plaque-forming units) in prevention; OR control mAb (5 mg) or AZD7442 (0.5–5 mg) 1 day after IN SARS-CoV-2 challenge in treatment. The impact of AZD7442 on lung viral RNA and pathology and AZD7442 serum levels was assessed on Days 3 and 7 post infection. Body weight was recorded daily through Day 7.

Results
With AZD7442 prevention, lower lung viral loads were observed compared to controls; at Day 3 post infection, lowest infectious virus titer and viral subgenomic mRNA (sgmRNA) levels were seen with doses ≥0.2 mg AZD7442. Concomitantly, increased serum levels of AZD7442 were observed. By Day 7, infectious virus titer and sgmRNA fell below the level of detection (LOD) at all doses tested. Moreover, AZD7442 at doses ≥0.2 mg protected hamsters from weight loss versus controls. Lung pathology scores (scale: 0 [normal] to 25 [most severe]) were generally dose dependent, with mean scores of &lt; 2 for AZD7442 versus 10 for controls, indicating less SARS-CoV-2–induced inflammation and alveolar damage in hamsters given AZD7442. Lower AZD7442 doses were associated with mean pathology scores similar to controls. With AZD7442 treatment, infectious virus titers were below the LOD at Day 3 post infection and at Day 7 for sgmRNA, for all doses tested. Mean lung pathology score was &lt;2 for AZD7442 versus 12 for controls. AZD7442 doses ≥0.5 mg protected against weight loss relative to controls.

Conclusion
In a SARS-CoV-2 challenge model, AZD7442 administered as prevention or treatment led to significantly lower lung viral loads and improved lung pathology, without weight loss. There was also no evidence that AZD7442 mediated antibody-dependent enhancement of disease or infection.

Disclosures
Yueh-Ming Loo, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Patrick M. McTamney, PhD, AstraZeneca: Employee Richard Roque, B.S., AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Yingyun Cai, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Mark T. Esser, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds.
1144. Rate of Infusion Reactions Among Patients Receiving Casirivimab/Imdevimab in the Home Setting
Authors: Simpson Michelle , Haines Danell 
Published: December 2022

Abstract

Background
Monoclonal antibodies used in the treatment and prevention of COVID 19 infection are an emerging area of infectious disease. Casirivimab/imdevimab received emergency use authorization (EUA) for the prophylaxis and treatment of COVID 19 disease. Infusion reactions may occur with the administration of monoclonal antibodies and can be relieved by slowing or stopping the infusion rate. During the casirivimab/imdevimab EUA, the National Home Infusion Foundation (NHIF) collected data to determine patient outcomes and the incidence of infusion reactions. Infusion rate and premedication protocols were also studied.

Methods
Home infusion companies nationwide were invited to participate in this study by completing a short survey to determine eligibility. The data variables investigated included infusion time, adverse events, and whether standard orders for premedications were used. The data was collected using an Excel® spreadsheet and a follow-up survey verified the relationship between the length of infusion and ADR incidence. The data was imported to IBM SPSS® (Statistical Product and Service Solutions®) for additional analysis.

Results
With this patient sample, the infusion time was either 20, 30, or 50 minutes with most (62.60%) being 20 minutes (Exhibit: Infusion Time). Infusion rates were based on organization protocols, standard prescriber orders, or the clinical needs of the patient. Of the 464 patient cases, 95.26% (n=442) had no reported adverse event. Of the 22 cases with a reported event, the most common symptoms were fever (6) and hypotension (4). Premedications were not routinely included in standard prescribing orders and were based on patient specific situations.

Conclusion
Administration of casirivmab/imdevimab in the home setting showed a low incidence of adverse drug reactions, and the incidence of infusion reactions were not directly related to infusion time or premedication use.

Disclosures
All Authors: No reported disclosures.
Biomarker Development Trial of Satraplatin in Patients with Metastatic Castration-Resistant Prostate Cancer
Authors: Liaw Bobby C , Tsao Che-Kai , Seng Sonia , Jun Tomi , Gong Yixuan , Galsky Matthew D , Oh William K 
Published: December 2022

AbstractBackgroundIn the phase III SPARC trial, satraplatin, an oral platinum analogue, demonstrated anticancer activity in men with metastatic castration-resistant prostate cancer (mCRPC). Repeat biopsies are uncommon in mCRPC, limiting the feasibility of tissue–based biomarkers. This phase II study sought to evaluate the feasibility and utility of blood–based biomarkers to identify platinum–sensitive mCRPC.MethodsPatients with mCRPC who had progressed on docetaxel were enrolled at a single center from 2011 to 2013. Subjects received satraplatin 80 mg/m2 by mouth daily on days 1-5 and prednisone 5 mg PO twice daily, on a 35-day cycle. Serial peripheral blood samples were collected for biomarker assessment.ResultsThirteen docetaxel-refractory mCRPC patients were enrolled, with a median age of 69 years (range 54-77 years) and median PSA of 71.7 ng/mL (range 0.04-3057). Four of 13 patients (31%) responded to satraplatin (defined as a PSA decline of ≥30%). Responders demonstrated improved time to disease progression (206 vs. 35 days, HR 0.26, 95% CI, 0.02-0.24, P = .003). A 6-gene peripheral blood RNA signature and serum tissue inhibitor of metalloproteinase-1 (TIMP-1) levels were assessed as biomarkers, but neither was significantly associated with response to satraplatin.ConclusionIn this small series, one-third of mCRPC patients responded to platinum–based chemotherapy. Peripheral blood biomarker measurement is feasible in mCRPC, though the biomarkers we investigated were not associated with platinum response. Other biomarkers, such as DNA damage repair mutations, should be evaluated.
Nominalism
Authors: Panaccio Claude 
Published: December 2022

Abstract
Chapter 1 proposes a definition of what nominalism is taken to be in this book. On this proposal, “nominalism” is construed as a relational term: a doctrine is said to be nominalist with respect to certain linguistic units. The chapter then enumerates six theses of Ockham that can be so labeled, especially stressing what his position is on universals, relations, and quantities, as well as those relating to syncategorematic terms, abstract terms, and sentences. The last part of the chapter shows why a nominalist program must include (1) a critique of the relevant forms of realism; (2) an ontology; (3) a semantics; and (4) a theory of mind and knowledge.
Semantics
Authors: Panaccio Claude 
Published: December 2022

Abstract
Chapter 4 outlines Ockham’s nominalist semantics. It aims to show how affirmative general statements, relational statements, and quantitative statements can be true, for Ockham, in a world in which only singular substances and qualities exist. The chapter first explains his conception of the signification and reference (or “supposition”) of natural kind terms and his general theory of truth-conditions. The distinctive features of relational terms and relational statements are then explained, with an insistence on Ockham’s notion of “connotation.” The last part of the chapter discusses three semantic ideas that Ockham uses in his analysis of quantitative terms: the idea that entire propositions are sometimes connoted, the idea of pseudo-names and the idea of collective terms.
Conclusion
Authors: Panaccio Claude 
Published: December 2022

Abstract
The Conclusion recalls some of the main theoretical components of Ockham’s nominalism: the rejection of various forms of realism on the basis of certain general principles such as the principle of ontological separability and the Razor principle; a pluralistic ontology that combines essentialism, hylomorphism, and possibilism with the acceptance of an ordered world with no special relational things in it; a semantics which is altogether atomistic, referentialist, mentalist, and externalist; a conception of the human mind as a singular being endowed with innate capacities and related to individual objects of cognition through direct causal connections; and an externalist epistemology that allows for both contingent and necessary knowledge. Ockham’s nominalism comes out in the end as a form of metaphysical realism.
Formation of Regional Clusters
Authors: Dore Poornima , Narayanan K. 
Published: December 2022

AbstractThis Chapter undertakes a cluster analysis to identify possible clusters that evolve across regions over the study period. While it is not possible to discuss all clusters of all regions in detail, the six regions of Maharashtra are illustrated as a case in point to explain the similarities and differences between clusters and regions. The analysis point towards possibilities for a ‘aspirational regions’ perspective in development initiatives.