The Lancet

BackgroundThere is a large inter-individual variation in CD34+ cell yield after G-CSF mobilisation and collection from peripheral blood in healthy allogenic haematopoietic stem cell donors. Donor characteristics including gender and age, baseline and pre-collection blood results, mobilisation factors and collection factors have been associated with CD34+ cell concentration in the blood after G-CSF mobilisation and/or CD34+ cell yield after collection. Since the literature reporting these associa...

Dexamethasone has been shown to reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment would be rolled out in the UK and globally, as well as its cost-effectiveness of implementing this intervention. We estimate that, for the UK, approximately 12,000 [4,250 - 27,000] lives could be saved by January 2021. Assuming that dexamethasone has a similar e...

BackgroundPost-mortem studies can provide important information for understanding new diseases and small autopsy case series have already reported different findings in COVID-19 patients. MethodsWe evaluated whether some specific post-mortem features are observed in these patients and if these changes are related to the presence of the virus in different organs. Complete macroscopic and microscopic autopsies were performed on different organs in 17 COVID-19 non-survivors. Presence of SARS-CoV-2...

BackgroundMolnupiravir and nirmatrelvir-ritonavir (Paxlovid) are oral antivirals that have been proposed as treatments for patients admitted to hospital with COVID-19. MethodsIn this randomised, controlled, open-label, adaptive platform trial, several potential treatments for patients hospitalised with COVID-19 pneumonia were evaluated. Molnupiravir and nirmatrelvir-ritonavir were assessed in separate comparisons in RECOVERY, both of which are reported here. Eligible and consenting adults could...

SARS-CoV-2 has rapidly spread across the United States, causing extensive morbidity and mortality, though the histopathologic basis of severe disease cases has yet to be studied in detail. Over the past century, autopsy has contributed significantly to our understanding of numerous disease processes, but for several reasons, autopsy reports following deaths related to SARS- CoV-2 have thus far been limited across the globe. We report on the relevant cardiopulmonary findings in the first series o...

BACKGROUNDRegular blood donation is associated with an increased risk of iron deficiency (ID; ferritin <15 {micro}g/L). Oral iron supplementation is known to shorten iron store recovery time and could serve as a more effective alternative to extended donation intervals. We aimed to determine the optimal ferritin-guided iron supplementation protocol in terms of donor health, side-effects, donor return, and treatment adherence. METHODSIn this prospective randomized placebo-controlled trial donors...

The hypothesis for this study was that RBC mechanical fragility (MF) could be an aggregate in vitro property predictive of transfused RBC performance in vivo. Various MF values were obtained via MF profiling, based on several variations of testing parameters, using both a "legacy" approach (with a commercial, cam-based vertical bead mill and a spectrophotometer) and a more proprietary approach (with a custom-developed, electromagnetic horizontal bead mill combined with proprietary optics and ana...

Background and hypothesisAtypical haemolytic uraemic syndrome (aHUS) is a rare condition caused by compliment dysregulation. Eculizumab is an effective treatment for patients with aHUS, yet a lifelong treatment strategy is costly for health services and is of uncertain additional benefit to patients. This economic evaluation was conducted as part of stopping eculizumab treatment safely in aHUS (SETS aHUS) trial and assessed the cost-effectiveness of a lifelong delivery of eculizumab strategy com...

BackgroundAtypical haemolytic uremic syndrome (aHUS) is a rare life-threatening disease. Lifelong treatment with intravenous eculizumab every two/three weeks was recommended but evidence is emerging that patients can stop eculizumab and restart should they relapse. However, little is known about the opinions and needs of aHUS patients on withdrawal. ObjectiveWe aimed to understand the factors that impact on decisions to withdraw from treatment. MethodsWe analysed in-depth telephone interviews ...

ObjectiveTo determine if Tocilizumab treatment in patients hospitalized with laboratory confirmed SARS-CoV-2 infection and subsequent COVID-19 disease provides short-term survival benefit. DesignCase-control, observational study that includes an observation period from arrival to discharge or inpatient death. Both Cox proportional hazards and average treatment effects models were used to determine survival and treatment benefits. SettingThree Cone Health acute care hospitals including one COVI...

IntroductionStem cell transplant (SCT) is a potential cure for haematological malignancies whose outcomes are predicted to be poor on chemotherapy alone and cases difficult to treat using standard of care treatment. There is growing evidence to show that not all patients who would benefit from SCT, receive it due to inequities in the treatment pathway. The role of socioeconomic deprivation on inequities in the SCT setting is unclear due to conflicting findings. We aim to synthesis the UK evidenc...

BackgroundSARS-CoV-2 is the cause of an ongoing pandemic with a projected 100,000 to 240,000 U.S. deaths. To date, documentation of histopathologic features in fatal cases of COVID-19 has been limited due to small sample size and incomplete organ sampling. MethodsPost-mortem examinations were performed on 12 fatal COVID-19 cases in Washington State during February-March 2020. Clinical and laboratory data were reviewed. Tissue examination of all major organs was performed by light microscopy and...

ImportanceRecent reports have highlighted an intense influenza activity related to the circulation of the influenza A(H3N2) subclade k variant. There is no data available on the impact of the emergence of H3N2 subclade k on the severity of the 2025-2026 epidemic or on the clinical phenotype of patients requiring admission to the intensive care unit (ICU). ObjectiveTo compare the clinical presentation, hospital mortality and virological characteristics of patients with laboratory-confirmed influ...

BackgroundAspirin has been proposed as a treatment for COVID-19 on the basis of its antithrombotic properties. MethodsIn this randomised, controlled, open-label platform trial, several possible treatments were compared with usual care in patients hospitalised with COVID-19. Eligible and consenting adults were randomly allocated in a 1:1 ratio to either usual standard of care plus 150mg aspirin once daily until discharge or usual standard of care alone using web-based simple (unstratified) rando...

BackgroundMyocarditis is a recognized complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Emerging studies further suggest an associated risk of myocarditis following administration of messenger RNA (mRNA) COVID-19 vaccinations. coronavirus disease 2019 (COVID-19) vaccinations. We investigated the incidence of myocarditis throughout the COVID-19 pandemic across a large healthcare system in the Washington, DC, metropolitan area. MethodsThis retrospective analy...

This report describes the ocular manifestations in a cohort of patients with Clade I mpox evaluated in the Democratic Republic of the Congo (DRC) from 2007 to 2011, as well as the clinical course of a pediatric patient with mpox associated with ocular disease. Among 216 patients, ocular manifestations were observed in 8.3% of the patients, including conjunctivitis, eyelid lesions, eyelid swelling, eye pain, orbital swelling, keratitis, and corneal staphyloma. These findings highlight the broad s...

AimsIntravenous (IV) iron is the recommended treatment for patients with iron deficiency anemia (IDA) who are unresponsive to oral iron treatment or require rapid iron replenishment. Ferric derisomaltose (FDI) and ferric carboxymaltose (FCM) are high-dose, rapid infusion, IV iron formulations that have recently been compared in three head-to-head randomized controlled trials (RCTs), which showed significantly higher incidence of hypophosphatemia after administration of FCM than FDI. The present ...

BACKGROUNDThe interleukin-6 receptor antagonist tocilizumab improves outcomes in critically ill patients with coronavirus disease 2019 (COVID-19). However, the effectiveness of other immune modulating agents is unclear. METHODSWe evaluated four immunomodulatory agents in an ongoing international, multifactorial, adaptive platform trial. Adult participants with COVID-19 were randomized to receive tocilizumab, sarilumab, anakinra, or standard care (control). In addition, a small group (n=21) of p...

BackgroundColchicine, an anti-inflammatory drug, was used early in the COVID-19 pandemic for its ability to modulate the inflammatory response. However, its clinical efficacy in hospitalized patients, particularly when used alongside corticosteroids, remains unclear. This systematic review and meta-analysis assessed colchicines efficacy in hospitalized COVID-19 patients. MethodsWe searched PubMed, Web of Science, and EMBASE databases for randomized controlled trials (RCTs) evaluating colchicine...

BackgroundCoronavirus disease 2019 (COVID-19) had a significant impact on the National Health Service in the United Kingdom (UK), with over 33 000 cases reported in London by July 6, 2020. Detailed hospital-level information on patient characteristics, outcomes and capacity strain are currently scarce but would guide clinical decision-making and inform prioritisation and planning. MethodsWe aimed to determine factors associated with hospital mortality and describe hospital and ICU strain by con...