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001-es BibID:	BIBFORM108005
035-os BibID:	(cikkazonosító)349 (Scopus)85148850132 (WoS)000938286900001
Első szerző:	Kardos Zsófia
Cím:	Tocilizumab in Combination with Corticosteroids in COVID-19 Pneumonia : a Single-centre Retrospective Controlled Study / Zsófia Kardos, Miklós Szabó, Zsuzsanna Baráth, Ágnes Miksi, Csaba Oláh, Ádám Kozma, József A. Gergely, Eszter Csánky, Zoltán Szekanecz
Dátum:	2023
ISSN:	2227-9059
Megjegyzések:	Abstract: Introduction: Interleukin 6 receptor inhibition by tocilizumab (TCZ) has been effectively used worldwide for the treatment of multisystem inflammatory syndrome (MIS) associated with COVID-19. In this single centre study, we compared the outcome of COVID-19 pneumonia in TCZ treated vs. untreated (control) patients. We wished to compare TCZ administration in the general ward vs. in the intensive care unit (ICU). We also studied the role of a consulting rheumatologist in the management of severe COVID-19 pneumonia. Patients and methods: In our patients, COVID 19 pneumonia was confirmed by SARS-CoV-2 PCR, chest X-ray, and CT. We compared patients selected for TCZ treatment with TCZ-untreated age- and sex-matched controls. All patients received corticosteroids. In the TCZ-treated group, patients received one or two doses of TCZ 8 mg/kg IV in combination with corticosteroids. We recorded age, sex, symptom duration, oxygen saturation (SaO2), partial arterial oxygen pressure (PaO2), total white blood cell (WBC), absolute neutrophil, absolute lymphocyte and platelet counts, CRP, ferritin, IL-6, LDH, procalcitonin (PCT), and D-di mer. The primary outcome parameters were the need for ICU, ventilation, death, and time of hos pitalisation. Results: Altogether, 104 patients, 52 TCZ-treated and 52 TCZ-untreated, were included in this study. At baseline, the TCZ-treated patient group indeed had more pronounced COVID-19- related MIS compared to controls. Consultation with a rheumatologist was performed in 60% vs. 40% of cases. Nineteen patients (37%) received one, while 33 (63%) received two TCZ doses. TCZ was administered to 28 patients (54%) in the general ward and to 24 (46%) in the ICU. TCZ treatment was found to be safe in our COVID-19 pneumonia patients. TCZ treatment favourably influenced MIS biomarkers, and was associated with better clinical outcomes compared to controls. Patients receiving TCZ treatment in combination with corticosteroids already in the general ward exerted much better outcomes than those treated in the ICU. Consultation with a rheumatologist also im proved outcome. Conclusions: We successfully used TCZ in combination with corticosteroids in Hungarian COVID-19 pneumonia patients. We pointed out the importance of early treatment al ready in the general ward, and the involvement of a rheumatologist in making treatment decisions.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk COVID-19 IL-6 receptor tocilizumab pneumonia efficacy
Megjelenés:	Biomedicines. - 11 : 2 (2023), p. 1-15. -
További szerzők:	Szabó Miklós (1980-) (tüdőgyógyász) Baráth Zsuzsa Miksi Ágnes Oláh Csaba (1972-) (idegsebész) Kozma Ádám Gergely József A. Csánky Eszter (1959-) (tüdőgyógyász, klinikai immunológus, allergológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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001-es BibID:	BIBFORM111799
035-os BibID:	(cikkazonosító)1125530 (Scopus)85161006926 (WoS)000997781200001
Első szerző:	Szabó Miklós (tüdőgyógyász)
Cím:	The importance of chest CT severity score and lung CT patterns in risk assessment in COVID-19-associated pneumonia: a comparative study / Szabó Miklós, Kardos Zsófia, Kostyál László, Tamáska Péter, Oláh Csaba, Csánky Eszter, Szekanecz Zoltán
Dátum:	2023
ISSN:	2296-858X
Megjegyzések:	Introduction: Chest computed tomography (CT) is suitable to assess morphological changes in the lungs. Chest CT scoring systems (CCTS) have been developed and use in order to quantify the severity of pulmonary involvement in COVID-19. CCTS has also been correlated with clinical outcomes. Here we wished to use a validated, relatively simple CTSS to assess chest CT patterns and to correlate CTSS with clinical outcomes in COVID-19. Patients and methods: Altogether 227 COVID-19 cases underwent chest CT scanning using a 128 multi-detector CT scanner (SOMATOM Go Top, Siemens Healthineers, Germany). Specific pathological features, such as ground-glass opacity (GGO), crazy-paving pattern, consolidation, fibrosis, subpleural lines, pleural effusion, lymphadenopathy and pulmonary embolism were evaluated. CTSS developed by Pan et al. (CTSS-Pan) was applied. CTSS and specific pathologies were correlated with demographic, clinical and laboratory data, A-DROP scores, as well as outcome measures. We compared CTSS-Pan to two other CT scoring systems. Results: The mean CTSS-Pan in the 227 COVID-19 patients was 14.6???6.7. The need for ICU admission (p <?0.001) and death (p <?0.001) were significantly associated with higher CTSS. With respect to chest CT patterns, crazy-paving pattern was significantly associated with ICU admission. Subpleural lines exerted significant inverse associations with ICU admission and ventilation. Lymphadenopathy was associated with all three outcome parameters. Pulmonary embolism led to ICU admission. In the ROC analysis, CTSS>18.5 significantly predicted admission to ICU (p =?0.026) and CTSS>19.5 was the cutoff for increased mortality (p <?0.001). CTSS-Pan and the two other CTSS systems exerted similar performance. With respect to clinical outcomes, CTSS-Pan might have the best performance. Conclusion: CTSS may be suitable to assess severity and prognosis of COVID-19-associated pneumonia. CTSS and specific chest CT patterns may predict the need for ventilation, as well as mortality in COVID-19. This can help the physician to guide treatment strategies in COVID-19, as well as other pulmonary infections.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Frontiers in Medicine. - 10 (2023), p. 1-9. -
További szerzők:	Kardos Zsófia Kostyál László (1974-) (radiológus) Tamáska Péter Oláh Csaba Csánky Eszter (1959-) (tüdőgyógyász, klinikai immunológus, allergológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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001-es BibID:	BIBFORM103048
035-os BibID:	(cikkazonosító)920016 (WoS)000836963000001 (Scopus)85135457642
Első szerző:	Szabó Miklós (tüdőgyógyász)
Cím:	Severity and prognostic factors of SARS-CoV-2-induced pneumonia : the value of clinical and laboratory biomarkers and the A-DROP score / Miklós Szabó, Zsófia Kardos, Csaba Oláh, Péter Tamáska, Katalin Hodosi, Eszter Csánky, Zoltán Szekanecz
Dátum:	2022
ISSN:	2296-858X
Megjegyzések:	IntroductionNumerous clinical and laboratory scores that include C-reactive protein (CRP), D-dimer, ferritin, lactate dehydrogenase (LDH), interleukin 6 (IL-6), procalcitonin (PCT), blood urea nitrogen (BUN), creatinine levels and oxygenation (PaO2 and SaO(2)) have been used for the prognosis of COVID-19. In addition, composite scores have been developed for the assessment of general state and risk in community-acquired pneumonia (CAP) that may be applied for COVID-19 as well. In this study, we assessed severity and potential prognostic risk factors for unfavorable outcome among hospitalized COVID-19 patients. We also applied the A-DROP general scoring system used in CAP to COVID-19. Patients and methodsAltogether 233 patients admitted to our center with COVID-19 were included in the study. Clinical status, several laboratory biomarkers described above, indicators of oxygenation were determined at hospital admission. We also applied the A-DROP composite scoring system that includes Age (>= 70 years in males and >= 75 years in females), Dehydration (BUN >= 7.5 mmol/l), Respiratory failure (SaO(2) <= 90% or PaO2 <= 60 mmHg), Orientation disturbance (confusion) and low blood Pressure (systolic BP <= 90 mmHg) to COVID-19. ResultsAt the time of admission, most patients had elevated CRP, LDH, ferritin, D-dimer, and IL-6 levels indicating multisystemic inflammatory syndrome (MIS). Altogether 49 patients (21.2%) required admission to ICU, 46 (19.7%) needed ventilation and 40 patients (17.2%) died. In the binary analysis, admission to ICU, the need for ventilation and death were all significantly associated with the duration of hospitalization, history of hypertension or obesity, confusion/dizziness, as well as higher absolute leukocyte and neutrophil and lower lymphocyte counts, elevated CRP, PCT, LDH, ferritin, IL-6, BUN, and creatinine levels, low PaO2 and SaO(2) and higher A-DROP score at the time of admission (p < 0.05). ConclusionNumerous laboratory biomarkers in addition to obesity, dizziness at the time of admission and the history of hypertension may predict the need for ICU admission and ventilation, as well as mortality in COVID-19. Moreover, A-DROP may be a suitable scoring system for the assessment of general health and disease outcome in COVID-19.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk COVID-19 tocilizumab (IL-6 inhibitor) prognosis pneumonia outcome A-DROP score
Megjelenés:	Frontiers in Medicine. - 9 (2022), p. 1-8. -
További szerzők:	Kardos Zsófia Oláh Csaba Tamáska Péter Hódosi Katalin Csánky Eszter (1959-) (tüdőgyógyász, klinikai immunológus, allergológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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001-es BibID:	BIBFORM100812
035-os BibID:	(cikkazonosító)839374 (WoS)000784285000001 (Scopus)85127370507
Első szerző:	Szabó Miklós (tüdőgyógyász)
Cím:	Introduction of a Capillary Gel Electrophoresis-Based Workflow for Biotherapeutics Characterization : size, Charge, and N-Glycosylation Variant Analysis of Bamlanivimab, an Anti-SARS-CoV-2 Product / Szabo Miklos, Sarkozy Daniel, Szigeti Marton, Farsang Robert, Kardos Zsofia, Kozma Adam, Csanky Eszter, Chung Doo Soo, Szekanecz Zoltan, Guttman Andras
Dátum:	2022
ISSN:	2296-4185
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk capillary electrophoresis bamlanivimab anti-SARS-CoV-2 product characterization N-glycans
Megjelenés:	Frontiers in Bioengineering and Biotechnology. - 10 (2022), p. 1-9. -
További szerzők:	Sárközy Dániel (1993-) (PhD hallgató) Szigeti Márton (1986-) (környezetmérnök) Farsang Róbert Kardos Zsófia Kozma Ádám Csánky Eszter (1959-) (tüdőgyógyász, klinikai immunológus, allergológus) Chung, Doo Soo Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Guttman András (1954-) (vegyészmérnök)
Pályázati támogatás:	BIONANO_GINOP-2.3.2-15-2016-00017 GINOP NN 127062 NKFIH
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