Expert Consensus: Main Risk Factors for Poor Prognosis in COVID-19 and the Implications for Targeted Measures against SARS-CoV-2

The clinical evolution of patients infected with the Severe Acute Respiratory Coronavirus type 2 (SARS-CoV-2) depends on the complex interplay between viral and host factors. The evolution to less aggressive but better-transmitted viral variants, and the presence of immune memory responses in a grow...

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Published in:Viruses 2023-06, Vol.15 (7), p.1449
Main Authors: Candel, Francisco Javier, Barreiro, Pablo, Salavert, Miguel, Cabello, Alfonso, Fernández-Ruiz, Mario, Pérez-Segura, Pedro, San Román, Jesús, Berenguer, Juan, Córdoba, Raúl, Delgado, Rafael, España, Pedro Pablo, Gómez-Centurión, Ignacio Alberto, González Del Castillo, Juan María, Heili, Sarah Béatrice, Martínez-Peromingo, Francisco Javier, Menéndez, Rosario, Moreno, Santiago, Pablos, José Luís, Pasquau, Juan, Piñana, José Luis, On Behalf Of The Modus Investigators Adenda
Format: Article
Language:English
Subjects:
Analysis
Antibodies
Antiviral agents
Binding sites
CD20 antigen
CD4 antigen
Chemotherapy
Chronic illnesses
Clinical trials
Comorbidity
Coronaviruses
COVID
COVID-19
COVID-19 vaccines
Disease prevention
Disease transmission
Drugs
Fatalities
HIV
Human immunodeficiency virus
Immunological memory
Immunosuppressive agents
Infections
Infectious diseases
Literature reviews
Malignancy
Medical prognosis
Monoclonal antibodies
Multiple organ dysfunction syndrome
Patients
poor prognosis
Public health
Risk factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Systematic Review
therapy
Vaccination
Viral infections
Virulence
Virulence (Microbiology)
Viruses
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Summary:The clinical evolution of patients infected with the Severe Acute Respiratory Coronavirus type 2 (SARS-CoV-2) depends on the complex interplay between viral and host factors. The evolution to less aggressive but better-transmitted viral variants, and the presence of immune memory responses in a growing number of vaccinated and/or virus-exposed individuals, has caused the pandemic to slowly wane in virulence. However, there are still patients with risk factors or comorbidities that put them at risk of poor outcomes in the event of having the coronavirus infectious disease 2019 (COVID-19). Among the different treatment options for patients with COVID-19, virus-targeted measures include antiviral drugs or monoclonal antibodies that may be provided in the early days of infection. The present expert consensus is based on a review of all the literature published between 1 July 2021 and 15 February 2022 that was carried out to establish the characteristics of patients, in terms of presence of risk factors or comorbidities, that may make them candidates for receiving any of the virus-targeted measures available in order to prevent a fatal outcome, such as severe disease or death. A total of 119 studies were included from the review of the literature and 159 were from the additional independent review carried out by the panelists a posteriori. Conditions found related to strong recommendation of the use of virus-targeted measures in the first days of COVID-19 were age above 80 years, or above 65 years with another risk factor; antineoplastic chemotherapy or active malignancy; HIV infection with CD4+ cell counts < 200/mm ; and treatment with anti-CD20 immunosuppressive drugs. There is also a strong recommendation against using the studied interventions in HIV-infected patients with a CD4+ nadir
ISSN:1999-4915
1999-4915
DOI:10.3390/v15071449