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This study aims to evaluate the effectiveness of anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines in preventing the post‐acute sequelae of SARS‐CoV‐2 infection (PASC), commonly known as long COVID, and reducing all‐cause mortality among older patients. A retrospective cohort study was conducted using the TriNetX database. The study cohort consisted of older patients (age ≥ 65 years) with their first COVID‐19 illness between January 1, 2022, and May 31, 2024. Participants were divided into vaccinated and unvaccinated groups based on their vaccination status. Propensity score matching (PSM) was used to balance baseline characteristics. Cox regression models and log‐rank tests were applied to estimate the hazard ratio (HR) for PASC and all‐cause mortality during 30–180 days of follow‐up. The study included 189 059 geriatric patients who contracted SARS‐CoV‐2, with 5615 vaccinated and 183 444 unvaccinated. After PSM, each group contained 5615 patients. Vaccinated patients exhibited a significantly lower incidence of PASC symptoms (HR = 0.852, 95% CI: 0.778–0.933, p = 0.0005), particularly anxiety and depression, with a HR of 0.710 (95% CI: 0.575–0.878, p = 0.0015). Vaccination was also significantly associated with reduced all‐cause mortality (HR = 0.231, 95% CI: 0.136–0.394, p < 0.0001). The findings highlight the effectiveness of COVID‐19 vaccination in mitigating the development of PASC and decreasing mortality among older patients. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) represents a significant burden on older adults (aged ≥ 50 years) globally and can lead to acute respiratory tract infections with substantial morbidity and mortality. However, there is a significant gap in knowledge regarding RSV infection in older adults, particularly in the Asia‐Pacific region. This knowledge gap underscores the need for targeted and comprehensive studies to fully understand the nuanced epidemiology of RSV in ageing populations. This review synthesises data from various countries, emphasising the impact of RSV on older populations in the Asia‐Pacific region. The overall proportions of RSV‐related ARIs among older patients ranged from 0.2% to 5.6%. Among older adult patients with CAP, RSV accounted for 1.1%–10.3% of cases. However, it is crucial to note that the diversity in reported percentages highlights the influence of factors such as geographic location, health care settings and diagnostic practices. The most common symptoms observed in older adults with RSV infection were cough, sputum production and fever, followed by dyspnoea, sore throat and rhinorrhoea. Most of the old adults with RSV infection had underlying diseases, and RSV can cause significant morbidity and mortality in old adults. Treatment of RSV infections predominantly involve supportive care, with aerosolised ribavirin reserved for severe cases, especially immunocompromised patients. Emerging antiviral agents, including fusion and nucleoprotein inhibitors, offer promising avenues for future therapeutics. The recent approval of the bivalent RSV prefusion F protein‐based vaccine for individuals aged 60 and older represents a milestone in preventive strategies. In conclusion, RSV infection remains a significant threat to older adults in the Asia‐Pacific region, necessitating ongoing research and surveillance efforts. The recent vaccine approval marks a positive milestone, but further studies are crucial for refining prevention and treatment approaches. [ABSTRACT FROM AUTHOR]

Although the recombinant zoster vaccine (RZV) has demonstrated efficacy in reducing the risk of herpes zoster (HZ) for individuals aged 50 years and older, its effectiveness in patients with chronic obstructive pulmonary disease (COPD) remains uncertain. This study was conducted to assess the effect of RZV on the risk of HZ in COPD patients. A multi‐institutional propensity score‐matched retrospective cohort study was conducted using the TriNetX Research network, including individuals aged 40 years or older with COPD from January 1, 2018, to December 31, 2022. Patients with a history of HZ or prior zoster vaccination were excluded. The primary outcome was HZ occurrence, with secondary outcomes including severe and nonsevere HZ. After propensity score matching, each 17 431 patients receiving RZV and unvaccinated patients were included. The vaccinated group had a significantly lower risk of HZ compared to the unvaccinated group (HR, 0.62; [95% confidence intervals] 95% CI, 0.51–0.75, p < 0.01). Similar risk reductions were observed for nonsevere HZ (HR, 0.61; 95% CI, 049–0.75, p < 0.01) and severe HZ (HR, 0.53; 95% CI, 0.38–0.73, p < 0.01). Further subgroup analyses demonstrated consistent risk reductions across age (50–59, 60–69, 70–79, and ≥80 years), sex, and comorbidities, except for individual aged 40–49 years. This study confirms the effectiveness of RZV in reducing HZ risk in patients with COPD aged 50 years and older, supporting its administration in this population. However, vaccination rates remain low, highlighting the need for improved vaccination strategies in this high‐risk group. Efforts to enhance vaccine uptake are warranted to reduce HZ morbidity. [ABSTRACT FROM AUTHOR]

This study investigated the clinical effectiveness of nirmatrelvir plus ritonavir (NMV‐r) on short‐term outcome and the risk of postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection (PASC) among pediatric patients with coronavirus disease 2019 (COVID‐19). This retrospective cohort study used the TriNetX research network to identify pediatric patients between 12 and 18 years with COVID‐19 between January 1, 2022 and August 31, 2023. The propensity score matching (PSM) method was used to match patients receiving NMV‐r (NMV‐r group) with those who did not receive NMV‐r (control group). Two cohorts comprising 633 patients each (NMV‐r and control groups), with balanced baseline characteristics, were identified using the PSM method. During the initial 30 days, the NMV‐r group showed a lower incidence of all‐cause hospitalization, mortality, or ED visits (hazard ratio [HR] = 0.546, 95% confidence interval [CI]: 0.372–0.799, p = 0.002). Additionally, the NMV‐r group had a significantly lower risk of all‐cause hospitalization compared with the control group (HR = 0.463, 95% CI: 0.269–0.798), with no deaths occurring in either group. In the 30–180‐day follow‐up period, the NMV‐r group exhibited a non‐significantly lower incidence of post‐acute sequelae of SARS‐CoV‐2 infection (PASC), encompassing symptoms such as fatigue, cardiopulmonary symptoms, pain, cognitive impairments, headache, dizziness, sleep disorders, anxiety, and depression, compared to the control group. This study underscores the potential effectiveness of NMV‐r in treating high‐risk pediatric patients with COVID‐19, demonstrating significant reductions in short‐term adverse outcomes such as emergency department visits, hospitalization, or mortality within the initial 30‐day period. Additionally, NMV‐r shows promise in potentially preventing the development of PASC. [ABSTRACT FROM AUTHOR]

The article in Liver International discusses the impact of different metabolic syndrome traits on micro- and macrovascular outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). The study found that hepatic steatosis combined with insulin resistance had the highest risk of microvascular disease, while hepatic steatosis combined with hypertension had the highest risk of macrovascular disease. The authors raised concerns about the heterogeneity within the definitions of insulin resistance and hypertension traits, suggesting a more detailed classification based on medication types and disease severity is needed for accurate risk assessment and personalized prevention strategies. [Extracted from the article]

This study was aimed at investigating the risk of cytomegalovirus (CMV) disease among coronavirus disease 2019 (COVID‐19) survivors. In this retrospective cohort study, we used the TriNetX research network to identify adults with and without COVID‐19 between January 1, 2022 and December 31, 2022. Propensity score matching was used to match the patients with and without COVID‐19. The primary outcome was the risk of CMV disease during the 90‐day follow‐up period. Two matched cohorts comprising 2 501 634 patients with balanced baseline characteristics were created using propensity score matching. During the follow‐up period, patients with COVID‐19 had a higher risk of CMV disease than those without COVID‐19 (hazard ratio [HR], 2.55; 95% confidence interval: 2.01–3.23). The higher risk of CMV disease in the COVID‐19 cohort compared with that of the non‐COVID‐19 cohort remained unchanged in the subgroup analyses by sex (men: HR, 1.85 [1.38–2.47]; women: HR, 2.31 [1.63–3.27]), age (18–64 years: HR, 2.21 [1.71–2.85]; ≥65 years: HR, 1.97 [1.20–3.25]), obesity (HR, 1.54 [1.04–2.30]), diabetes mellitus (HR, 1.50 [1.08–2.08]), cancer (HR, 3.10 [1.95–4.92]), glucocorticoid use (HR, 3.14 [2.45–4.02]), transplantation (HR, 1.38 [1.08–1.77]), and unvaccinated status (HR, 2.37 [1.82–3.08]). In conclusion, COVID‐19 can increase the risk of CMV disease. Clinicians should be aware of the risk of CMV disease in patients with COVID‐19. [ABSTRACT FROM AUTHOR]

Although a novel oral antiviral agent can improve short‐term COVID‐19 outcomes, its effects on the long‐term outcomes, namely the risk of major adverse cardiovascular events (MACEs), remains unknown. This retrospective cohort study used the TriNetX research network to identify nonhospitalized adult patients with COVID‐19 between March 1, 2020, and January 1, 2022. A propensity score matching method was used to form two matched cohorts with and without receiving nirmatrelvir–ritonavir (NMV‐r) or molnupiravir. The primary outcome was the incidence of MACEs within a 30‐day to 1‐year period following a diagnosis of COVID‐19. Two cohorts of each 80 888 patients with balanced baseline characteristics were formed using propensity score matching. During the follow‐up period, 976 patients in the study group and 1609 patients in the control group developed MACE. Overall, the study group had a significantly lower risk of MACE than the control group (hazard ratio [HR], 0.683; 95% confidence interval: 0.630–0.739). The significantly lower HRs of overall MACEs were consistently observed in most subgroup analyses (age: >41–≤64 years: 0.60 [0.52–0.89]; age: ≥65 years: 0.68 [0.62–0.76]; women: 0.63 [0.57–0.71]; men: 0.62 [0.55–0.70]; vaccinated: 0.74 [0.63–0.88]; unvaccinated: 0.66 [0.60–0.73]; NMV‐r; 0.65 [0.59–0.71]; and molnupiravir: 0.75 [0.61–0.92]). In conclusion, novel oral antiviral agents, namely NMV‐r and molnupiravir, were effective in reducing long‐term MACEs among nonhospitalized patients with COVID‐19, particularly when treated with NMV‐r or in patients aged ≥40 years. These findings suggest the potential role of novel antiviral agents as a preventive measure to reduce further adverse cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

The retrospective cohort was conducted to assess the effect of nirmatrelvir‐ritonavir (NMV‐r) on the long‐term risk of neuropsychiatric sequela following COVID‐19. TriNetX research network was used to identify nonhospitalized adult patients who tested positive for severe acute respiratory syndrome coronavirus 2 infection or were diagnosed with COVID‐19 between March 1, 2020 and July 1, 2022. Further propensity score matching method was used to create two matched cohorts with and without receiving NMV‐r. The primary outcome was the incidence of neuropsychiatric sequela within a 90‐day to 1‐year period following a diagnosis of COVID‐19. After screening 119 494 527 electronic health records, two matched cohorts of each 27 194 patients were identified. During the follow‐up period, the NMV‐r group demonstrated a reduced risk of any neuropsychiatric sequelae compared to the control group (odds ratio [OR], 0.634; 95% confidence interval [CI], 0.604−0.667). In comparison with the control group, the patient treated with NMV‐r exhibited a markedly diminished risk of developing neurocognitive sequela (OR, 0.377; 95% CI, 0.325−0.439) and psychiatric sequela (OR, 0.629; 95% CI, 0.593−0.666). In addition, patients treated with NMV‐r had a significantly reduced risk of developing dementia (OR, 0.365; 95% CI, 0.255−0.522), depression (OR, 0.555; 95% CI, 0.503−0.612), insomnia (OR, 0.582; 95% CI, 0.508−0.668) and anxiety disorder (OR, 0.645 95% CI, 0.600−0.692). Moreover, the beneficial effect of NMV‐r on the neuropsychiatric sequelae was observed across further subgroup analyses. Among nonhospitalized COVID‐19 patients, who at risk of disease progression, the use of NMV‐r is associated with a reduction in the long‐term risk of neuropsychiatric sequela, including dementia, depression, insomnia and anxiety disorder. It may be necessary to re‐evaluate the use of NMV‐r, as a preventive measure to reduce the risk of severe acute disease and post‐acute adverse mental health outcomes. [ABSTRACT FROM AUTHOR]

Several randomized controlled trials and real‐world cohort studies have demonstrated the efficacies of nirmatrelvir plus ritonavir (NMV‐r) and molnupiravir (MOV) in at‐risk patients with COVID‐19; however, the effectiveness of antisevere acute respiratory syndrome‐coronavirus 2 treatments on older patients (≥65 years) remains unclear. This retrospective cohort study aimed to assess the clinical effectiveness of the oral antiviral agents, MOV and NMV‐r, in older patients (≥65 years) infected with severe acute respiratory syndrome‐coronavirus 2. Nonhospitalized older patients with COVID‐19 between January 1, 2022, and December 31, 2022, were recruited from the TriNetX Research Network. Propensity score matching (PSM) was used to match patients who received either NMV‐r or MOV treatment with those who did not receive any oral antiviral agents. Hazard ratios (HRs) for composite all‐cause hospitalization or death during the 30‐day follow‐up period were calculated. PSM revealed two cohorts with 28 824 patients each having balanced baseline characteristics. The antiviral group was associated with significantly lower risk of the primary composite outcome of all‐cause hospitalization or death than the control group (241 vs. 801; HR, 0.307; 95% confidence interval (CI), 0.27–0.36) during the follow‐up period. For the secondary outcome, the antiviral group had a significantly lower risk of all‐cause hospitalization (288 vs. 725; HR, 0.322; 95% CI, 0.28–0.37) and mortality (16 vs. 94; HR, 0.176; 95% CI, 0.10–0.30) than the control group. Moreover, the reduced risk of all‐cause hospitalization or death remained consistent in patients receiving NMV‐r (HR, 0.279; 95% CI, 0.24–0.33) and MOV (HR, 0.279; 95% CI, 0.21–0.38). Our results revealed that NMV‐r and MOV decreased the all‐cause hospitalization and death rates among older patients with COVID‐19, supporting the use of antivirals in this vulnerable population. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the clinical efficacy of a combination of nirmatrelvir and ritonavir (NMV‐r) for treating COVID‐19 in patients with diabetes mellitus (DM). This retrospective cohort study used the TriNetX research network to identify adult diabetic patients with COVID‐19 between January 1, 2020, and December 31, 2022. Propensity score matching was used to match patients who received NMV‐r (NMV‐r group) with those who did not receive NMV‐r (control group). The primary outcome was all‐cause hospitalization or death during the 30‐day follow‐up period. Two cohorts comprising 13 822 patients with balanced baseline characteristics were created using propensity score matching. During the follow‐up period, the NMV‐r group had a lower risk of all‐cause hospitalization or death than the control group (1.4% [n = 193] vs. 3.1% [n = 434]; hazard ratio [HR], 0.497; 95% confidence interval [CI], 0.420–0.589). Compared with the control group, the NMV‐r group also had a lower risk of all‐cause hospitalization (HR, 0.606; 95% CI, 0.508–0.723) and all‐cause mortality (HR, 0.076; 95% CI, 0.033–0.175). This lower risk was consistently observed in almost all subgroup analyses, which examined sex (male: 0.520 [0.401–0.675]; female: 0.586 [0.465–0.739]), age (age 18–64 years: 0.767 [0.601–0.980]; ≥65 years: 0.394 [0.308–0.505]), level of HbA1c (<7.5%: 0.490 [0.401–0.599]; ≥7.5%: 0.655 [0.441–0.972]), unvaccinated (0.466 [0.362–0.599]), type 1 DM (0.453 [0.286–0.718]) and type 2 DM (0.430 [0.361–0.511]). NMV‐r can help reduce the risk of all‐cause hospitalization or death in nonhospitalized patients with DM and COVID‐19. [ABSTRACT FROM AUTHOR]

This study assessed the clinical efficacy of nirmatrelvir plus ritonavir (NMV‐r) in treating patients with coronavirus disease‐2019 (COVID‐19) and substance use disorders (SUDs). This study included two cohorts: the first examined patients with SUDs, with and without a prescription for NMV‐r, while the second compared patients prescribed with NMV‐r, with and without a diagnosis of SUDs. SUDs were defined using ICD‐10 codes, related to SUDs, including alcohol, cannabis, cocaine, opioid, and tobacco use disorders (TUD). Patients with underlying SUDs and COVID‐19 were identified using the TriNetX network. We used 1:1 propensity score matching to create balanced groups. The primary outcome of interest was the composite outcome of all‐cause hospitalization or death within 30 days. Propensity score matching yielded two matched groups of 10 601 patients each. The results showed that the use of NMV‐r was associated with a lower risk of hospitalization or death, 30 days after COVID‐19 diagnosis (hazard ratio (HR), 0.640; 95% confidence interval (CI): 0.543–0.754), as well as a lower risk of all‐cause hospitalization (HR, 0.699; 95% CI: 0.592–0.826) and all‐cause death (HR, 0.084; 95% CI: 0.026–0.273). However, patients with SUDs had a higher risk of hospitalized or death within 30 days of COVID‐19 diagnosis than those without SUDs, even with the use of NMV‐r (HR, 1.783; 95% CI: 1.399–2.271). The study also found that patients with SUDs had a higher prevalence of comorbidities and adverse socioeconomic determinants of health than those without SUDs. Subgroup analysis showed that the benefits of NMV‐r were consistent across most subgroups with different characteristics, including age (patients aged ≥60 years [HR, 0.507; 95% CI: 0.402–0.640]), sex (women [HR, 0.636; 95% CI: 0.517–0.783] and men [HR, 0.480; 95% CI: 0.373–0.618]), vaccine status (vaccinated <2 doses [HR, 0.514; 95% CI: 0.435–0.608]), SUD subtypes (alcohol use disorder [HR, 0.711; 95% CI: 0.511– 0.988], TUD [HR, 0.666; 95% CI: 0.555–0.800]) and Omicron wave (HR, 0.624; 95% CI: 0.536–0.726). Our findings indicate that NMV‐r could reduce all‐cause hospitalization and death in the treatment of COVID‐19 among patients with SUDs and support the use of NMV‐r for treating patients with SUDs and COVID‐19. [ABSTRACT FROM AUTHOR]

The effect of nirmatrelvir plus ritonavir (NMV‐r) on post‐acute COVID‐19 sequelae beyond 3 months of SARS‐CoV‐2 infection remains unknown. This retrospective cohort study utilized data from the TriNetX Research Network. We identified nonhospitalized adult patients with COVID‐19 receiving a diagnosis between January 1 and July 31, 2022. Propensity score matching (PSM) was used to create two matched cohorts: NMV‐r and non‐NMV‐r groups, respectively. We measured the primary outcomes using a composite of all‐cause emergency room (ER) visits or hospitalization and a composite of post‐COVID‐19 symptoms according to the WHO Delphi consensus, which also stated that post COVID‐19 condition occurs usually 3 months from the onset of COVID‐19, during the follow‐up period between 90 days after the index diagnosis of COVID‐19 and the end of follow‐up (180 days). Initially, we identified 12 247 patients that received NMV‐r within 5 days of diagnosis and 465 135 that did not. After PSM, 12 245 patients remained in each group. During the follow‐up period, patients treated with NMV‐r had a lower risk of all‐cause hospitalization and ER visits compared with untreated patients (659 vs. 955; odds ratio [OR], 0.672; 95% confidence interval [CI], 0.607–0.745; p < 0.0001). However, the overall risk of post‐acute COVID‐19 symptoms did not significantly differ between the two groups (2265 vs. 2187; OR, 1.043; 95% CI, 0.978–1.114; p = 0.2021). The reduced risk of all‐cause ER visits or hospitalization in the NMV‐r group and the similarities in the risk of post‐acute COVID‐19 symptoms between the two groups were consistent in the subgroups stratified by sex, age, and vaccination status. Early NMV‐r treatment of nonhospitalized patients with COVID‐19 was associated with reduced risk of hospitalization and ER visits during the period of 90–180 days after diagnosis compared with no NMV‐r treatment; however, post‐acute COVID‐19 symptoms and mortality risk did not differ significantly between the groups. [ABSTRACT FROM AUTHOR]

The long‐term risk of herpes zoster (HZ) after recovery from a SARS‐CoV‐2 infection is unclear. This retrospective cohort study assessed the risk of HZ in patients following a COVID‐19 diagnosis. This retrospective, propensity score‐matched cohort study was based on the multi‐institutional research network TriNetX. The risk of incident HZ in patients with COVID‐19 was compared with that of those not infected with SARS‐CoV‐2 during a 1‐year follow‐up period. Hazard ratios (HRs) and 95% confidence intervals (CIs) of HZ and its subtypes were calculated. This study identified 1 221 343 patients with and without COVID‐19 diagnoses with matched baseline characteristics. During the 1‐year follow‐up period, patients with COVID‐19 had a higher risk of HZ compared with those without COVID‐19 (HR: 1.59; 95% CI: 1.49–1.69). In addition, compared with the control group patients, those with COVID‐19 had a higher risk of HZ ophthalmicus (HR: 1.31; 95% CI: 1.01–1.71), disseminated zoster (HR: 2.80; 95% CI: 1.37–5.74), zoster with other complications (HR: 1.46; 95% CI: 1.18–1.79), and zoster without complications (HR: 1.66; 95% CI: 1.55–1.77). Kaplan–Meier curve analysis (log‐rank p < 0.05) results indicated that the risk of HZ remained significantly higher in patients with COVID‐19 compared with those without COVID‐19. Finally, the higher risk of HZ in the COVID‐19 cohort compared with that in the non‐COVID‐19 cohort remained consistent across subgroup analyses regardless of vaccine status, age, or sex. The risk of HZ within a 12‐month follow‐up period was significantly higher in patients who had recovered from COVID‐19 compared with that in the control group. This result highlights the importance of carefully monitoring HZ in this population and suggests the potential benefit of the HZ vaccine for patients with COVID‐19. [ABSTRACT FROM AUTHOR]

The efficacy of molnupiravir in treating patients with coronavirus disease 2019 (COVID‐19) has been inconsistent across randomized controlled trials (RCTs). Thus, this meta‐analysis was conducted to clarify the literature. A literature search of electronic databases—PubMed, Embase, and Cochrane Library—was performed to identify relevant articles published up to December 31, 2022. Only RCTs that investigated the clinical efficacy and safety of molnupiravir for patients with COVID‐19 were included. The primary outcome was all‐cause mortality at 28–30 days. This pooled analysis of nine RCTs did not reveal a significant difference in all‐cause mortality between molnupiravir and control groups (risk ratio [RR], 0.43; 95% confidence interval [CI], 0.10–1.77) for overall patients. However, the risks of mortality and hospitalization were lower in the molnupiravir group than in the control group (mortality: RR, 0.28; 95% CI, 0.10–0.79; hospitalization: RR, 0.67; 95% CI, 0.45–0.99) among nonhospitalized patients. In addition, molnupiravir use was associated with a borderline higher virological eradication rate relative to the control (RR, 1.05; 95% CI, 1.00–1.11). Finally, no significant difference in adverse event risk was discovered between the groups (RR, 0.98; 95% CI, 0.89–1.08). The findings reveal the clinical benefits of molnupiravir for nonhospitalized patients with COVID‐19. However, molnupiravir may not improve the clinical outcomes of hospitalized patients. These findings support the recommended use of molnupiravir for treating nonhospitalized patients with COVID‐19 but not for hospitalized patients. [ABSTRACT FROM AUTHOR]

Nirmatrelvir/ritonavir (NMV‐r) is an effective anti‐SARS‐CoV‐2 agent and has been recommended in the treatment of nonhospitalized patients with COVID‐19. In rare occasions, some patients experience virologic and symptomatic rebound after initial resolution, which we call COVID‐19 rebound after NMV‐r. Although COVID rebound can also occur after molnupiravir treatment or even no antiviral treatment, we have more serious concern about the rebound after NMV‐r, which remains the most effective antiviral. Due to a lack of information about its frequency, mechanism, outcomes, and management, we conducted this review to provide comprehensive and updated information to address these questions. Based on the limited evidence, the incidence of COVID‐19 rebound after NMV‐r was less than 2%, and most cases developed 5–15 days after initiating NMV‐r treatment. Almost all reported cases had mild symptoms, and the clinical condition gradually subsided without additional treatment. Overall, the clinical outcome was favorable, and only a small number of patients required emergency department visits or hospitalization. Regarding virologic rebound, culturable SARS‐CoV‐2 with possible transmission was observed, so re‐isolation may be needed. [ABSTRACT FROM AUTHOR]

Following the rapidly increasing number of multisystem inflammatory syndromes in children (MIS‐C), a similar clinical scenario has been observed in adult patients. Although its prevalence is low and probably related to underdiagnosis, its development can be associated with high mortality. Multisystem inflammatory syndrome in adults (MIS‐A) can develop following both asymptomatic and symptomatic severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and in previously healthy people. Like MIS‐C, MIS‐A is a multisystem disease that can involve the cardiovascular, respiratory, gastrointestinal, dermatologic, hematologic, and neurologic systems. In addition to the clinical manifestations, the diagnosis of MIS‐A requires laboratory evidence of inflammation and SARS‐CoV‐2 infection. The appropriate treatment for MIS‐A remains unclear; anti‐inflammatory agents, including intravenous immunoglobulin and corticosteroids, are commonly used. However, there are still many unknowns regarding MIS‐A. Further studies are needed to determine the true prevalence, pathogenesis, and effective treatment for MIS‐A. [ABSTRACT FROM AUTHOR]

To assess the clinical efficacy and safety of neutralizing monoclonal antibodies (mABs) for outpatients with coronavirus disease 2019 (COVID‐19). PubMed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (ICTRP) databases were searched from inception to July 19, 2021. Only randomized controlled trials (RCTs) that assessed the clinical efficacy and safety of neutralizing mABs in the treatment of COVID‐19 outpatients were included. The Cochrane risk‐of‐bias tool was used to assess the quality of the included RCTs. The primary outcome was the risk of COVID‐19‐related hospitalization or emergency department (ED) visits. The secondary outcomes were the risk of death and adverse events (AEs). Five articles were included, in which 3309 patients received neutralizing mAB and 2397 patients received a placebo. A significantly lower rate of hospitalization or ED visits was observed among patients who received neutralizing mABs than those who received a placebo (1.7% vs. 6.5%, odds ratios (OR): 0.26; 95% confidence interval (CI): 0.19–0.36; I2 = 0%). In addition, the rate of hospitalization was significantly lower in the patients who received neutralizing mABs than in the control group (OR: 0.24; 95% CI: 0.17−0.34; I2 = 0%). The mortality rate was also significantly lower in the patients who received neutralizing mABs than in the control group (OR: 0.16; 95% CI: 0.05−0.58; I2 = 3%). Neutralizing mABs were associated with a similar risk of any AE (OR: 0.81; 95% CI: 0.64–1.01; I2 = 52%) and a lower risk of serious AEs (OR: 0.37; 97% CI: 0.19–0.72; I2 = 45%) compared with a placebo. Neutralizing mABs can help reduce the risk of hospitalization or ED visits in COVID‐19 outpatients. For these patients, neutralizing mABs are safe and not associated with a higher risk of AEs than a placebo. Highlights: Neutralizing monoclonal antibodies (mABs) decreased risk of hospitalization or emergence department visits in coronavirus disease 2019 (COVID‐19) outpatients. Neutralizing mABs reduced mortality in COVID‐19 outpatients. Neutralizing mABs had no increased risk of any adverse events (AEs) and lower risk of serious AEs. [ABSTRACT FROM AUTHOR]

This study investigated the effect of melatonin on clinical outcomes in patients with coronavirus disease 2019 (COVID‐19). We searched PubMed, the Web of Science, the Cochrane Library, Ovid MEDLINE, and Clinicaltrials.gov for randomized controlled trials (RCTs) published before September 11, 2021. Only RCTs that compared the clinical efficacy of melatonin with a placebo in the treatment of patients with COVID‐19 were included. The primary outcome measure was the clinical recovery rate. We included three RCTs in this meta‐analysis. Melatonin 3 mg three times daily was administered in one RCT, and 3 or 6 mg daily before bedtime in the other two trials. Treatment duration was 14 days in two RCTs and 7 days in one trial. The clinical recovery rates were 94.2% (81/86) and 82.4% (70/85) in the melatonin and control groups, respectively. Overall, patients receiving melatonin had a higher clinical recovery rate than did the controls (odds ratio [OR]: 3.67; 95% CI: 1.21−11.12; I2 = 0%, p = 0.02). The risk of intensive care unit admission was numerically lower in the melatonin group than in the control group (8.3% [6/72] vs. 17.6% [12/68], OR: 0.45; 95% CI: 0.16−1.25; I2 = 0%, p = 0.13), and the risk of mortality was numerically lower in the melatonin group than in the control group (1.4% [1/72] vs. 4.4% [3/68], OR: 0.32; 95% CI: 0.03−3.18; I2 = 0%, p = 0.33). In conclusion, melatonin may help improve the clinical outcomes of patients with COVID‐19. Highlight: This study investigated the effect of melatonin on clinical outcomes in patients with coronavirus disease 2019.Patients receiving melatonin had a higher clinical recovery rate than did the controls (odds ratio: 3.67; 95% CI: 1.21−11.12; I2 = 0%, p = 0.02).The risk of intensive care unit admission was only insignificantly lower in the melatonin group than in the control group.The risk of mortality was insignificantly lower in the melatonin group than in the control group. [ABSTRACT FROM AUTHOR]

A study published in the Journal of Medical Virology examined the risk factors for COVID-19 pneumonia in Chinese patients with pre-existing interstitial lung disease (ILD). The study found that being male and using corticosteroids were associated with a higher risk of COVID-19 pneumonia, while vaccination was associated with a reduced risk. However, the study had some limitations, including the exclusion of well-known risk factors for COVID-19 progression and a lack of clear definition for the severity of COVID-19 pneumonia. The authors also suggested considering the use of antiviral medications in ILD patients with mild-to-moderate COVID-19. Overall, the study provides valuable insights but needs further refinement to enhance our understanding of COVID-19 outcomes in ILD patients. [Extracted from the article]

Response to the letter to the editor on "Long-term risk of herpes zoster following COVID-19: A retrospective cohort study of 2 442 686 patients" Furthermore, we are aware that previous studies have demonstrated an increased risk of herpes zoster after COVID-19 vaccination.[[4]] However, our study did not investigate the association between herpes zoster and the COVID-19 vaccine. Third, zoster vaccine is a significant confounding factor, and as a result, our study[2] excluded patients who had received the zoster vaccine. [Extracted from the article]

Molnupiravir versus placebo in unvaccinated and vaccinated patients with early SARSCoV-2 infection in the UK (AGILE CST-2): a randomised, placebo controlled, double-blind, phase 2 trial. Randomized trial of molnupiravir or placebo in patients hospitalized with Covid-19. Huang et al.[1] raised several concerns about our recent meta-analysis.[1] First, he thought that Caraco et al.'s study[2] was the interim analysis of the full MOVe-out study,[3] so it should not include interim and entire studies at the same time. [Extracted from the article]

Keywords: antiviral agents; disease control; SARS coronavirus; toxicity; virus classification EN antiviral agents disease control SARS coronavirus toxicity virus classification 1910 1912 3 02/19/21 20210401 NES 210401 DATA AVAILABILITY STATEMENT Data are available from the included original studies. ALT, alanine transaminase; AST, aspartate transaminase; CI, confidence interval gl In conclusion, the drug effect was comparable in both groups, so it might be a tolerable drug in the treatment of coronavirus infection. Antiviral agents, disease control, SARS coronavirus, toxicity, virus classification. [Extracted from the article]

LINKED CONTENT: This article is linked to Hadi et al papers. To view these articles, visit https://doi.org/10.1111/apt.16730 [ABSTRACT FROM AUTHOR]

Aim The present retrospective study was carried out to investigate the epidemiological characteristics and the prognostic factors of candidemia among elderly patients. Methods From 2009 to 2012, elderly patients with candidemia were identified at the Chi Mei medical center, a 900-bed regional hospital in southern Taiwan, and their medical records retrospectively reviewed. Results During the 4-year period, a total of 175 episodes of candidemia among elderly patients were identified. The patients ranged in age from 65 to 98 years (mean 76.4 years) and the mean (±standard deviation) Charlson Comorbidity Index score was 7.6 (±2.7). Cancer was the most common underlying disease ( n = 127, 72.6%), followed by diabetes mellitus ( n = 69, 39.4%). Candida albicans ( n = 96, 54.9%) was the most common pathogen, followed by C. tropicalis ( n = 39, 22.3%), C. parapsilosis ( n = 24, 13.7%) , C. glabrata ( n = 22, 12.6%), C. guilliermondii ( n = 2, 1.1%) and Candida species ( n = 3, 1.7%). The ratio of C. albicans causing candidemia was significantly higher in young-old than old-old patients (64.1% vs 47.4%, P = 0.027). The overall in-hospital mortality was 50.3%. Multivariate analysis showed that the in-hospital mortality was only significantly associated with jaundice ( P = 0.004), no use of antifungal agent ( P = 0.021) and intensive care unit admission ( P < 0.001). Conclusions Candidemia can develop in elderly patients, especially patients with cancer or other risk factors. C. albicans is the most common Candida species causing candidemia among elderly patients, followed by C. tropicalis. The mortality of candidemia among elderly patients remains high. Geriatr Gerontol Int 2015; 15: 688-693. [ABSTRACT FROM AUTHOR]

Dengue is a reportable disease in Taiwan, so all clinicians should report dengue cases to Taiwan's Centers for Disease Control (CDC). To investigate the effect of COVID-19 preventive measures on dengue, we compare the case number of dengue in Taiwan before and after the COVID-19 outbreak. We read with great interest the recent issue,1 which raised the concern about the cocirculation of dengue during the coronavirus disease-2019 (COVID-19) pandemic. [Extracted from the article]

OBJECTIVES: To evaluate the diagnostic performance of procalcitonin (PCT) in elderly patients with bacterial infection in the emergency department (ED). DESIGN: Prospective. SETTING: ED of a tertiary care hospital. PARTICIPANTS: Elderly patients with systemic inflammatory response syndrome (SIRS) enrolled from September 2004 through August 2005. MEASUREMENTS: A serum sample for the measurement of PCT, two sets of blood cultures, and other cultures of relevant specimens from infection sites were collected in the ED. Two independent experts blinded to the PCT results classified the patients into bacterial infection and nonbacterial infection groups. RESULTS: Of the 262 patients with SIRS enrolled, 204 were classified as having bacterial infection and 48 as having bacteremia. PCT levels were significantly higher in patients with bacteremia than in those without. The area under the receiver operating characteristic curve for identification of bacteremia according to PCT was 0.817 for the old-old group (≥75), significantly higher than 0.639 for the young-old group (65–74); P=.02). The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of PCT for bacteremia in patients aged 75 and older were 96.0%, 68.3%, 33.8%, and 98.8%, respectively, with a PCT cutoff value of 0.38 ng/mL. CONCLUSION: PCT is sensitive for diagnosing bacteremia in elderly patients with SIRS at ED admission but is helpful in excluding bacteremia only in those aged 75 and older. PCT is not an independent predictor of local infections in these patients. [ABSTRACT FROM AUTHOR]

The article "Addressing Confounders in GLP-1RA Effects on ALD Outcomes" published in Liver International discusses a study on the impact of glucagon-like peptide-1 receptor agonist (GLP-1RA) on adverse liver outcomes in patients with alcohol-associated liver disease (ALD) and type 2 diabetes (T2D). The study found that GLP-1RA users had a lower likelihood of hepatic decompensation compared to non-GLP-1RA individuals. However, the study highlighted the need to address confounding factors such as ALD severity, BMI measurements, and racial and ethnic factors in future research to ensure more reliable comparisons between treatment groups. The authors suggest employing active comparator designs and including detailed clinical parameters to establish more robust evidence for the role of GLP-1RA in managing patients with ALD and T2D. [Extracted from the article]

The article focuses on a study related to use of ceftaroline for treating older patients with community-acquired pneumonia. Topics include the randomized controlled trials showing that ceftaroline being non-inferior to ceftriaxone in terms of clinical efficacy, the safety profile in the treatment of community acquired pneumonia in both adult and pediatric patients, and the clinical evaluation population defining as modified intention-to-treat population.

A letter to the editor is presented concerning a study into catheter removal in older patients with catheter-related bloodstream infection (CRBSI) caused by methicillin-resistant Staphylococcus aureus (MRSA).

A letter to the editor is presented concerning patient outcomes and the emergence of rifampicin-resistant bacteremia during a combination treatment of rifampicin and glycopeptide in elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) infections.

The article presents a study to determine the appropriateness of parenteral nutrition (PN) in older people with malnutrition. It discusses categorization of appropriateness of PN use into, appropriate and unavoidable during the need for nutritional support, appropriate but avoidable when functional gastrointestinal tract had had not been accessed and inappropriate when PN is prescribed even diagnostic or nutritional criteria have not achieved. It suggest for careful evaluation PN indication.

A letter to the editor is presented which is concerned with the case study of a 67 year old female patient taking warfarin and moxifloxacin who developed an abdominal wall hematoma and hemoperitoneum.

The article discusses research which examined prevalence of healthcare-associated listerioris among elderly patients. The study was conducted at Chi Mei Medical Center in southern Taiwan. It outlines clinical characteristics of 11 patients involved in the study, noting details on their underlying conditions, initial presentation and site of isolates. It is concluded that mortality of elderly patients with listeriosis remains high, particularly in immuno-compromised individuals.

A letter to the editor is presented regarding the case study of a 67-year-old woman diagnosed with uric acid crystalluria-associated pink urine.

A letter to the editor is presented regarding the association between thyroid function and metabolic syndrome in older people.

A letter to the editor is presented regarding a study of nonbacteremic pneumococcal pneumonia in hospitalized patients in Taiwan after the introduction of pneumococcal vaccines.

Background and Aims: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promise in reducing alcohol consumption, but their impact on clinical outcomes in patients with alcohol use disorder (AUD) remains unclear. We investigated the association between GLP-1RAs and the development and progression of alcohol-related liver disease (ArLD) in patients with AUD., Methods: Using the TriNetX Research Network, we conducted two retrospective cohort studies comparing GLP-1RAs versus dipeptidyl peptidase-4 inhibitors (DPP-4is) in patients with type 2 diabetes. The first cohort included patients with AUD but without ArLD (n = 7132 after propensity score matching), while the second comprised patients with established ArLD (n = 1896 after matching). Primary outcomes were incident ArLD in the AUD cohort and hepatic decompensation in the ArLD cohort., Results: In the AUD cohort (median follow-up: 63.2 months), GLP-1RA users showed significantly lower risks of developing ArLD compared to DPP-4i users (incidence rate: 6.0 vs. 8.7 per 1000 person-years; HR: 0.62, 95% CI: 0.44-0.87, p = 0.006). GLP-1RAs were also associated with reduced risks of all-cause mortality (HR: 0.53, p < 0.001). In the ArLD cohort (median follow-up: 28.2 months), GLP-1RA users demonstrated lower risks of hepatic decompensation (incidence rate: 39.5 vs. 51.4 per 1000 person-years; HR: 0.66, 95% CI: 0.51-0.85, p = 0.001) and all-cause mortality (HR: 0.53, p < 0.001) compared to DPP-4i users., Conclusions: GLP-1RAs were associated with reduced risks of developing and progressing ArLD in patients with AUD, suggesting potential therapeutic benefits in this population., (© 2025 John Wiley & Sons Ltd.)