A survey of patients previously hospitalized for 

showed a majority were still suffering from symptoms including fatigue and changes to livelihood due to affected breathing, 6 months after their discharge.

American Academy of Allergy, Asthma & Immunology (AAAAI) 2021 Virtual Sessions

 this week, depict a small-scale perspective of necessary follow-up care for habitual symptoms that more affected COVID-19 patients may face.

The research conducted by a team of Oklahoma State University Center for Health Sciences investigators also show fluctuation in the prevalence of respiratory COVID-19 symptoms well beyond the presumed recovery phase of a patient.

Led by Ben Rossavik, DO, of the Department of Pediatrics, investigators conducted a six-month discharge survey of patients treated for RT-PCR-confirmed COVID-19 at a local tertiary center from March - August 2020.

In an accumulation of 42 patient responses, Rossavik and colleagues observed significant prevalence of fatigue (52.4%), changes in daily activities due to breathing (52.4%), shortness of breath (47.6%), change in taste and smell (42.9%) and increased much production (38.1%).

More than one-fourth of all surveyed patients reported continued issues with rhinorrhea, nasal congestion, and cough, as well.

 regarding the findings, Rossavik discussed some of the more surprising symptoms being reported by patients a half-year following their COVID-19 discharge—including multiple instances of hair loss.

Rossavik also shared perspectives collected from survey respondents, including frequent failures of memory on their COVID-19 treatment in the hospital, and experiences in physical therapy and rehabilitation.

“A lot of times, the way our model is run, people go there for a period of time, then they’re done and they go home,” Rossavik said. “But then they still complain about this inability to just walk around their house.”

The concept of COVID-19 “long-haulers” needing even bettered follow-up care and comprehensive rehabilitative services is evidenced by such feedback.

The study, “A Survey of Respiratory Symptoms Reported in Patients Following Hospitalization with COVID-19 Infection,” was presented at AAAAI 2021.

Videos

A nNew survey results depict unexpected burdens in long-haul patients, as well as continued issues following rehabilitatio provides insight into long-term COVID-19 symptoms and complications unresolved from rehabilitation.n.

Breathing Difficulty Still Common in Hospitalized COVID-19 Patients After 6 Months

Biologic therapy benralizumab (Fasenra) is associated with possible elimination or maximal reduction of oral corticosteroid (OCS) use in dependent patients with 

The findings from the PONENTE Trial, presented at the 

 this weekend, evidence the AstraZeneca biologic’s benefit for reducing maintenance therapy needs in patients with severe asthma, regardless of baseline parameters including eosinophil counts.

Presented by study author Andrew Menzies-Gow, BSc, MBBS, PhD, deputy medical director at the Royal Brompton & Harefield Hospitals in the UK, the PONENTE data showed benralizumab’s influence on OCS dose reduction among 598 participants to receive at least 1 dose of the monoclonal antibody.

Mean patient age was 53.3 years old, with a majority being female (64%) and White (80.6%). A majority of patients were taking ≥5 mg OCS daily (67.7%) at baseline; 84.4% had suffered an exacerbation in the prior 12 months. Eosinophil levels at baseline varied from <150 (20.8%), ≥150 to <300 (43.7%), to ≥300 cells/mcL (35.5%).

Investigators administered benralizumab throughout the induction and OCS-reduction phases of the trial, by 30 mg subcutaneous injection every 4 weeks for 3 dosages, then every 8 weeks thereafter.

At study’s end, 62.2% (95% CI, 58.18–66.11) of patients had eliminated OCS use.Another 80.6% (95% CI, 77.20–83.70) eliminated use or reduced the daily dosage to ≤5 mg if instances of adrenal insufficiency prevented further reduction.

Another 91.3% (95% CI, 88.75–93.44) of patients achieved a daily ≤5 mg OCS dosage, regardless of the cause for stopping the reduction.

 during AAAAI 2021, Menzies-Gow discussed his team’s findings and their indication for benralizumab’s benefit for lessened OCS dependency in severe asthma.

“If you looked across the globe, depending on where you are, somewhere between 20% and 50% of severe asthmatics are stuck on OCS, so this is a big clinical problem,” he explained.

The study, “Elimination of Oral Corticosteroids (OCS) with Benralizumab Treatment in OCS-Dependent Asthmatics Using a Rapid, Personalized Algorithm: The PONENTE Trial,” was presented at AAAAI 2021.

An interview with a study author on new interpretations of biologic asthma benefit.

PONENTE: Benralizumab Reduces Oral Corticosteroid Use in Severe Asthmatics

 this week showed pooled controlled and open-label data from phase 3 trials indicate sustained benefit and safety of oral peanut immunotherapy for the reduction of 

The data, which collected up to 3.5 years of outcomes associated with Aimmune Therapeutics’ AR101 (PALFORZIA), showed the first peanut allergen powder regulated as a food immunotherapy by the US Food and Drug Administration (FDA) was feasible as a 300 mg dose for a majority (83%) of phase 3 patients.

The assessment of patients aged 4-17 years old also showed 74% of the 150 participants to discontinue treatment due to adverse events had done so in the first 6 months. At trial’s end, two-thirds (66.9%) of patients reached 1 year of immunotherapy; 38% reached 2 years; and 8.3% reached 3 years.

 during AAAAI 2021, lead study author Thomas Casale, MD, professor of medicine at the University of South Florida, broke down the study’s details, and provided outlooks for extended observation.

As PALFORZIA becomes more widely prescribed, investigators are interested in reaching trial marks of four-, even five-year outcomes.

“Do people have sustained unresponsiveness, where we could stop the trial for a period of time, and they would be fine?” Casale prosed.

Casale also discussed the influence of COVID-19 on the need for bettered food allergy protection—the pandemic’s effect could come in various factors associated with anaphylaxis risks.

“If you’re on a fixed income and you’ve lost your job, try to get food from a food bank that are guaranteed to not have the allergens that you’re allergic to. It’s much harder,” Casale said. “And if you do have an allergic reaction, you’re much less likely to go to the emergency department out of fear of getting COVID-19.

An additional observed benefit from the three-plus year data: Casale and colleagues found the adverse events reported by patient families were largely expected, minor in severity, and easily managed by trained and informed clinicians and parents overseeing administration.

“That provides a degree of comfort,” Casale explained. “That’s way different than sending your child to a birthday party, they eat a cookie they didn’t know has peanuts. Now when they have an allergic reaction, nobody is there that recognizes it, nobody is there with epinephrine, no one knows what to do.”

A discussion on continued research into the first regulated treatment for pediatric peanut allergy.

PALFORZIA at 3 Years: New Data Show Sustained Peanut Immunotherapy Benefit, Safety

The Risks of Switching Psoriasis Biologics During COVID-19

Involuntary Biologic Switches: Long-Term Impact

Maintaining Biologic Adherence

Outcomes Linked to Psoriasis Biologic Switches

The Current Challenges of Psoriasis Prescribing

Managing Psoriasis Biologics During COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has been a perfect storm of factors that could increase the risk of 

Many across the globe have been forced to give up their exercise regimen at gyms or sports leagues, lapsing on their exercise programs. Also there likely has been an increase in unhealthy eating, with a likelihood of snacking throughout the day and takeout food for meals.

Add those factors to an increase in stress and there might be a lasting impact of the global cardiovascular health.

, Waqar Khan, MD, MPH, Founder and President of Lone Star Heart and Vascular Center, explained what some of the treatment gaps are in coronary heart disease and how the COVID-19 pandemic may have impacted cardiovascular health.

Khan recently published a new book called 

 featuring real-life patient stories and evidence-based data to give a snapshot on the state of coronary heart disease.

Khan said most of the treatment gaps are in diagnosis, as well as finding a way to treat heart disease without needing to perform major bypasses and surgeries. He said there has been a push for more treatments that reduce these procedures and he expects even more in the future.

Unhealthy lifestyles during the pandemic may increase the risk of cardiovascular disease. 

Waqar Khan, MD: Coronary Heart Disease During COVID-19

 and leg ulcers face unique challenges, namely the stigma and taboo that may arise from having such presentations.

In addition to the lack of treatments for these symptoms, individuals may experience increasingly worsened quality of life and discomfort. They may even feel less inclined to tell their providers and caretakers about these symptoms.

, Caterina Minniti, MD, Albert Einstein College of Medicine, talked about the various challenges faced by these patients and their providers.

In particular, she indicated that—perhaps due to stigma and/or lack of comprehensive knowledge—there has been a long history of an absence of language to discuss this specific type of clinical presentation.

She underscored the need to incorporate meaningful discussions about sickle-cell related leg ulcers between clinicians and their patients.

“If we don’t have the language to communicate this, then we are really very behind in trying to solve the problem,” Minniti said.

She further encouraged clinicians to ask their patients directly about leg ulcers—if they have it and the severity of it.

“Look at the ankle and see if you can find signs of scars and old ulcers,” she said. “Because that is a bad prognostic sign for our patients.”

Providers should then ensure proper referral and a nutritional diet among these patients.

Due to taboo or stigma, patients may not openly discuss their leg ulcers with their providers.

Caterina Minniti, MD: Challenges Associated with Sickle-Cell Related Leg Ulcers

Currently, there are no approved treatments for leg ulcers, one of one several presentations associated with 

 of the HOPE trial, led by Caterina Minniti, MD, Albert Einstein College of Medicine, noted improvements or resolutions in leg ulcers among patients receiving voxelotor. 

These improvements were reported as early as 24 weeks into treatment, most notably in the treatment group receiving the highest dosing (1500 mg).

“Now, you might think that 24 weeks is a long time because it’s six months,” Minniti told 

 in a recent interview. “But in reality, leg ulcers in patients with sickle cell disease lasts a very long time.”

There was a less notable effect of treatment on patient leg ulcers among those who received a lower dosage (900 mg).

Nevertheless, Minniti expressed optimism about the implications for these findings

“We were really excited,” she said. “Anything that may hasten the healing is extremely beneficial.”

She also acknowledged next steps for her and her team, which include conducting a prospective, randomized trial to evaluate, in greater depth, leg ulcer outcomes and healing among patients. 

This study will enroll 80 patients and randomize them 1:1 to voxelotor 1500 mg or placebo.

Furthermore, Minniti noted, they hope to carry out trials and collect data in countries where leg ulcers are even more prevalent and where the need is greater.

An expert discusses findings that showed voxelotor (Oxbryta) improved leg ulcers in patients with sickle cell disease.

Caterina Minniti, MD: Leg Ulcers in Sickle Cell Patients

There are very few people who haven’t been personally impacted by 

 (CHD), whether it is them personally or a loved one.

However, treating the disease that results in 17 million deaths annually can be difficult and identifying who might be at risk in the future is crucial in driving that number down.

Waqar Khan, MD, MPH, Founder and President of Lone Star Heart and Vascular Center is hoping to shed some light on this condition with his new book, 

In the book, Khan uses real-life patient stories and new evidence-based data to tell the entire tale of what doctors should do to treat these patients and what people and family members should be on the lookout for.

Khan explores how CHD impacts the individual and what some risk factors and root causes are. He also looks at the different types of heart attacks and how their warning signs differ.

 and how he plans to update the information in the future should new guidelines or more data come out.

Dr. Khan discusses some of the risk factors associated with CHD. 

Waqar Khan, MD, MPH: The Importance of Coronary Heart Disease Awareness

In an era of quickly evolving guidelines and available agents to respond to post-

, clinicians could benefit from an overarching review of topline therapies and the means to tailored care through antithrombotics.

Fatima Rodriguez, MD, MPH, and Robert A. Harrington, MD, of the Stanford Cardiovascular Institute, recently penned such a 

In their review of the rapidly progressing classes of antithrombotic therapies—and the large-scale trials which dictate the utility of such drugs—Rodriguez and Harrington aimed to provide a more comprehensive guidance to navigating antiplatelets, anticoagulants, relevant research interpretations, and individualized treatment decisions.

Additionally, they provided perspective on what recommendations cannot be currently evidenced—namely, where gaps in research still persist, and what benefit would be served from filling them.

above, Rodriguez provides a review of her and Harrington’s work, and shared her thoughts on future antithrombotic guidance in post-ACS.

A Stanford Cardiovascular Institute expert details a recent review into managing a growing field of agents.

Acute Coronary Syndrome Management with Antithrombotics

In the final part of their interview with 

, Dongngan Truong, MD, University of Utah Health and Intermountain Primary Children’s Hospital, and Jane Newburger, MD, Boston Children’s Hospital, spoke on the importance for primary care providers to recognize multisystem inflammatory syndrome in children (MIS-C) and related symptoms.

“One of the most important things about MIS-C is recognition,” said Truong. “Obviously, given the overlap of symptoms of MIS-C with other things, the differential or what doctors think about might be causing symptoms has to be broad.”

Nevertheless, she encouraged providers to be cognizant of the possibly, especially in children who have previous been diagnosed with 

She underscored the important role of close follow-up, utilizing the right labs during the diagnosis process, and understanding when to seek referral to a center that can offer proper treatment and care.

“For a busy pediatric practice with kids who are sick and have fever, this can be a needle in a haystack,” Newburger acknowledged. “But it really makes a difference to get somebody to care quickly.”

Part of the recognition process, of course, is staying informed with the definitions of MIS-C, which include knowing the symptoms and presentations typically associated with the condition.

will hopefully tell, the long-term outcomes of the newly discovered syndrome and at-risk subpopulations will become better understood.

Two pediatric cardiologists stress that recognizing symptoms of MIS-C is essential for primary care providers.