Long term side effects of monoclonal antibodies for covid

B cell-targeting strategies such as rituximab are widely used in B cell hematologic malignancies, rheumatologic and musculoskeletal diseases and a variety of autoimmune disorders. The purpose of this paper is to illustrate how exposure to anti-CD20 treatment profoundly affects B cell functions involved in anti-SARS-CoV-2 immunity and significantly impacts on the clinical and serological course ...Oct 3, 2020 · Regeneron's treatment, called REGN-COV2, is a combination or "cocktail" of two antibodies: infection-fighting proteins that were developed to bind to the part of the new coronavirus that it uses ... Monoclonal antibodies have been identified as a potential therapy to prevent COVID-19 disease progression in patients at risk for severe disease. Most antibodies made by the human body are polyclonal, meaning that they are derived from multiple B lymphocyte lineages and have slightly different specificities for target antigens. Monoclonal ...Possible side effects of molnupiravir include diarrhea, dizziness, and nausea. 3. Is molnupiravir similar to Tamiflu? Yes, this new pill is similar—in function, ease of use, and availability—to Tamiflu, the antiviral medication that is used to prevent serious symptoms of flu.Monoclonal antibodies, such as casirivimab and imdevimab, may be associated with worse clinical outcomes when administered to hospitalized patients with COVID-19 requiring high flow oxygen or ... Nov 3, 2021 · Although antibody response is a central component of vaccine efficacy, memory B cells may also be important for long-term protection and the ability to respond to emerging variant strains. In SARS-CoV-2 naive subjects, MBCs specific for full-length spike protein and RBD, as well as an optimal neutralizing antibody response are efficiently ... Future reports from this project will look at other aspects of immune system function in response to the COVID-19 vaccine, how the vaccine works in variants of concern, more information on specific diseases and therapies, vaccine side effects, and impact on disease activity. Get Free Coronavirus Support for Chronic Illness PatientsFig. 1: Neutralizing monoclonal antibodies: identification, selection and production. The neutralizing monoclonal antibodies (mAbs) given emergency use authorization for treatment of COVID-19 were ...Benefits of antiviral therapy. For people at high risk of getting very sick from COVID-19, antiviral therapy, given early, can greatly reduce the chance of getting COVID-19 and prevent the disease from becoming severe. It also reduces the chance of needing to be in the hospital. The treatment can also shorten how long COVID-19 symptoms last. The recommendations for COVID-19 treatments and the use of monoclonal antibodies changes often to meet the demand of up-and-coming variants. For the most up-to-date information, the FDA offers a ...Future reports from this project will look at other aspects of immune system function in response to the COVID-19 vaccine, how the vaccine works in variants of concern, more information on specific diseases and therapies, vaccine side effects, and impact on disease activity. Get Free Coronavirus Support for Chronic Illness Patientsmonoclonal antibodies. Monoclonal antibody treatment with bamlanivimab or with casirivimab and imdevimab are for people who have tested positive for COVID-19 and have mild to moderate symptoms that started no more than 10 days ago. This treatment is designed to be used prior to someone becoming ill enough with COVID-19 to require hospitalization.Apr 1, 2022 · Side effects include: Data from an ongoing trial in outpatients with mild to moderate COVID-19 (NCT04545060; COMET-ICE) indicate most common treatment-emergent adverse events in those treated with sotrovimab were mild or moderate (grade 1 or 2) rash (2%) and diarrhea (1%). No other treatment-emergent adverse events reported more frequently in ... While these results are exciting, scientists are still learning about monoclonal antibody therapy for COVID-19 and how it affects people long-term. There’s some concern that treatment may make it harder to fight off a future COVID-19 infection or reduce the effectiveness of a future COVID-19 vaccine.Neurological symptoms or mental health conditions, including difficulty thinking or concentrating, headache, sleep problems, dizziness when you stand, pins-and-needles feeling, loss of smell or taste, and depression or anxiety Joint or muscle pain Heart symptoms or conditions, including chest pain and fast or pounding heartbeatTell your doctor or nurse right away if you have any side effects during or after your infusion. Keep in mind that only a limited number of people have taken COVID-19 monoclonal antibody treatment – scientists are still learning about its side effects and risks. Serious and unexpected side effects may occur. What if I am pregnant or breast ...nausea, vomiting, or diarrhea low blood pressure rash anaphylaxis Always talk with a healthcare professional about the possible side effects of the medications you’re taking, especially...Sep 28, 2021 · The mechanisms behind the production of such autoantibodies aren’t yet clear. Widespread and long-term inflammation during severe COVID-19 may cause the immune system to produce antibodies to pieces of the virus it wouldn’t normally recognize. Some of those pieces might resemble human proteins enough to trigger the production of autoantibodies. Oct 13, 2021 · Additional COVID treatments are the antiviral drug remdesivir, which is also used only in people sick enough to be hospitalized, and monoclonal antibodies, which can help mild or moderate cases. Monoclonal antibodies can also be used to help prevent infection in people who have been exposed to the virus and are at high risk of hospitalization ... Monoclonal antibodies are “laboratory-produced molecules that act as substitute antibodies that can restore, enhance, or mimic the immune system’s attack on cells,” according to the U.S. Food and Drug Administration ( FDA ). In this case, these antibodies replicate your body’s immune response to COVID-19, blocking or neutralizing the ...Nov 30, 2022 · The side effects of receiving any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the injection site. These are not all the possible side effects. Not many people have received bebtelovimab. Serious and unexpected side effects may happen. Oct 26, 2021 · Quick Overview. Monoclonal antibody therapy is approved for emergency use authorization (EUA) by the FDA for high-risk patients who have tested positive for COVID-19 and patients who have been exposed to COVID-19. Monoclonal antibody therapy is free. You don’t need insurance, but some facilities may ask you to cover an administration fee. Although the therapeutic monoclonal antibodies hold great promise for treating various diseases, they have certain side effects. One of the complications of monoclonal antibody therapy is the ...Tell your doctor or nurse right away if you have any side effects during or after your infusion. Keep in mind that only a limited number of people have taken COVID-19 monoclonal antibody treatment – scientists are still learning about its side effects and risks. Serious and unexpected side effects may occur. What if I am pregnant or breast ... Feb 3, 2023 · Multiorgan effects of COVID-19 include clinical manifestations pertaining to the cardiovascular, pulmonary, renal, and neuropsychiatric organ systems, although the duration of these multiorgan system effects is unclear. Long-term "effects of COVID-19 treatment or hospitalization" are similar to other severe infections. Adults 65 and older make up about 75 percent of the roughly 900,000 U.S. deaths caused by the coronavirus since the start of the pandemic, federal data show. In addition to age, which is a risk factor for severe COVID-19, about 80 percent of adults 65 and older have at least one chronic health condition that can worsen a coronavirus ...Nov 30, 2022 · The side effects of receiving any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the injection site. These are not all the possible side effects. Not many people have received bebtelovimab. Serious and unexpected side effects may happen. The most common side effects of taking Paxlovid include impaired sense of taste (for example, a metallic taste in the mouth) and diarrhea. Liver problems have occurred in patients receiving ritonavir.The mechanisms behind the production of such autoantibodies aren’t yet clear. Widespread and long-term inflammation during severe COVID-19 may cause the immune system to produce antibodies to pieces of the virus it wouldn’t normally recognize. Some of those pieces might resemble human proteins enough to trigger the production of autoantibodies.Antibodies are proteins made by the immune system to clear infections. For viruses, like the COVID-19 virus, these proteins are critical to stop the infection. “The problem is that our immune system takes two to three weeks to make good antibodies,” Overton said. “Monoclonal antibodies are supplemental antibodies that can be administered ...Oct 13, 2021 · Additional COVID treatments are the antiviral drug remdesivir, which is also used only in people sick enough to be hospitalized, and monoclonal antibodies, which can help mild or moderate cases. Monoclonal antibodies can also be used to help prevent infection in people who have been exposed to the virus and are at high risk of hospitalization ... Bamlanivimab 700 Mg/20 Ml (35 Mg/Ml) Intravenous Solution (EUA) Antiviral Monoclonal Antibodies - SARS-Cov-2 Coronavirus - Uses, Side Effects, and More Generic Name(S): bamlanivimab Nov 24, 2021 · This is especially true with the emergence of new viral variants and the rare vaccine side effects like allergic reactions, heart inflammation ( myocarditis) and blood-clotting ( thrombosis). The spike protein mediates the coronavirus entry into host cells. Critical questions about the infection itself also remain. Monoclonal antibodies, such as casirivimab and imdevimab, may be associated with worse clinical outcomes when administered to hospitalized patients with COVID-19 requiring high flow oxygen or ... Monoclonal antibodies, designed to mimic the body’s natural immune response, are available as treatment for COVID-19 for patients at high risk of progression to severe disease. There are several approved treatments for coronavirus disease 2019 (COVID-19) in hospitalized patients but few for patients who are not sick enough to be hospitalized.Some people who have been infected with the virus that causes COVID-19 can experience long-term effects from their infection, known as Long COVID or Post-COVID Conditions (PCC). Long COVID is broadly defined as signs, symptoms, and conditions that continue or develop after acute COVID-19 infection. This definition of Long COVID was developed by ...Jul 21, 2023 · Convalescent plasma (kon-vuh-LES-unt PLAZ-muh) therapy uses blood from people who've recovered from an illness to help others get better. When the body clears out a virus, a person's blood has immune system proteins called antibodies. To get convalescent plasma, people donate blood after recovery. The blood is processed to remove blood cells ... "These responses may also explain why such long-term effects can occur long after the viral infection has passed." As for COVID-19 vaccines, the primary antigen used is the SARS-CoV-2 spike protein.Jan 17, 2021 · The U.S. government recently advised those with COVID-19 and at risk for serious complications to ask their health care provider about one of the monoclonal antibody therapies authorized by the U ... Tell your doctor or nurse right away if you have any side effects during or after your infusion. Keep in mind that only a limited number of people have taken COVID-19 monoclonal antibody treatment – scientists are still learning about its side effects and risks. Serious and unexpected side effects may occur. What if I am pregnant or breast ...Oct 26, 2021 · Quick Overview. Monoclonal antibody therapy is approved for emergency use authorization (EUA) by the FDA for high-risk patients who have tested positive for COVID-19 and patients who have been exposed to COVID-19. Monoclonal antibody therapy is free. You don’t need insurance, but some facilities may ask you to cover an administration fee. Apr 1, 2022 · Side effects include: Data from an ongoing trial in outpatients with mild to moderate COVID-19 (NCT04545060; COMET-ICE) indicate most common treatment-emergent adverse events in those treated with sotrovimab were mild or moderate (grade 1 or 2) rash (2%) and diarrhea (1%). No other treatment-emergent adverse events reported more frequently in ... Nov 25, 2021 · "These responses may also explain why such long-term effects can occur long after the viral infection has passed." As for COVID-19 vaccines, the primary antigen used is the SARS-CoV-2 spike protein. Key Points. Covid-19 antibody drugs from Regeneron and Eli Lilly should no longer be used because they don’t work against the omicron variant that now accounts for nearly all U.S. infections, U ...These neutralizing monoclonal antibodies, which were originally identified and isolated from B cells and plasma of donors who have recovered from COVID-19, inhibit the interaction of the spike protein of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) with the human ACE-2 receptors, thereby preventing viral attachment, cell entry ...The president’s unique treatment may have prevented his body from making the antibodies necessary for long-term protection. The monoclonal antibodies he received were produced by the drug ...Bamlanivimab and etesevimab are monoclonal antibodies. Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens, such as viruses ...The recommendations for COVID-19 treatments and the use of monoclonal antibodies changes often to meet the demand of up-and-coming variants. For the most up-to-date information, the FDA offers a ...Convalescent plasma (kon-vuh-LES-unt PLAZ-muh) therapy uses blood from people who've recovered from an illness to help others get better. When the body clears out a virus, a person's blood has immune system proteins called antibodies. To get convalescent plasma, people donate blood after recovery. The blood is processed to remove blood cells ...Tell your doctor or nurse right away if you have any side effects during or after your infusion. Keep in mind that only a limited number of people have taken COVID-19 monoclonal antibody treatment – scientists are still learning about its side effects and risks. Serious and unexpected side effects may occur. What if I am pregnant or breast ... Link Between Blood Cancers and Coronavirus. Blood cancers affect your body’s infection-fighting white blood cells. Multiple myeloma is a cancer of white blood cells called plasma cells. That ...Monoclonal antibody therapy Currently, there are no monoclonal antibodies authorized for use in the United States. As of January 26, 2023, Evusheld is no longer authorized by the FDA for emergency use in the United States, as it is not expected to be effective against more than 90% of the COVID-19 variants currently circulating in the United ...The president’s unique treatment may have prevented his body from making the antibodies necessary for long-term protection. The monoclonal antibodies he received were produced by the drug ...While these results are exciting, scientists are still learning about monoclonal antibody therapy for COVID-19 and how it affects people long-term. There’s some concern that treatment may make it harder to fight off a future COVID-19 infection or reduce the effectiveness of a future COVID-19 vaccine.Jan 5, 2022 · Possible side effects of molnupiravir include diarrhea, dizziness, and nausea. 3. Is molnupiravir similar to Tamiflu? Yes, this new pill is similar—in function, ease of use, and availability—to Tamiflu, the antiviral medication that is used to prevent serious symptoms of flu. Taking Paxlovid when not indicated may put a patient at risk for side effects, possible drug-drug interactions, health care costs, and does not treat an underlying condition if it is not COVID-19. How are antibodies made? Antibodies are proteins made by your body's immune system that fight off infections, including infections caused by viruses.Not a lot of people have been given COVID-19 monoclonal antibody therapy. Serious and unexpected side effects may happen. COVID-19 monoclonal antibody therapy is still being studied, so it is possible that all of the risks are not known at this time. Q: How do I report side effects (or medical issues) with infusion therapies?The side effects of receiving any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the injection site. These are not all the possible side effects. Not many people have received bebtelovimab. Serious and unexpected side effects may happen.Anti-SARS-CoV-2 monoclonal antibodies. The SARS-CoV-2 virus’s spike glycoprotein, which sits on its surface, functions to facilitate the virus’s entry into the body’s cells. Some SARS-CoV-2 ...Sep 5, 2023 · an altered or impaired sense of taste. diarrhea. increased blood pressure. muscle aches. abdominal pain. nausea. feeling generally unwell. Since Paxlovid is cleared by the kidneys, dose adjustments may be required for patients with mild-to-moderate kidney disease, explains Dr. Topal. Most monoclonal antibodies don’t last very long in the bloodstream. That’s why they’re only used after a person has been infected. But one type of monoclonal antibody, called Evusheld ...COVID-19 Monoclonal Antibody Therapeutics webpage and . NIH COVID-19 Treatment Guidelines Treatment Page for the most up-to-date information on this topic. Healthcare systems in the U.S. and abroad have been increasingly administering monoclonal antibodies to treat COVID-19 positive patients.Multiorgan effects of COVID-19. Effects of COVID-19 treatment/hospitalization. The typical clinical symptoms in "long covid" are tiredness, dyspnea, fatigue, brain fogginess, autonomic dysfunction, headache, persistent loss of smell or taste, cough, depression, low-grade fevers, palpitations, dizziness, muscle pain, and joint pains.Jun 28, 2018 · The novel class of monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) are a valuable addition to our preventives for migraine. However, there are significant conceivable long-term adverse effects that need to be considered as these new products gain approval and enter the market. We will have a better feel for the ... Sep 7, 2021 · Monoclonal antibodies are “laboratory-produced molecules that act as substitute antibodies that can restore, enhance, or mimic the immune system’s attack on cells,” according to the U.S. Food and Drug Administration ( FDA ). In this case, these antibodies replicate your body’s immune response to COVID-19, blocking or neutralizing the ... Monoclonal antibody therapy. Each antibody binds only one specific antigen. Monoclonal antibody therapy is a form of immunotherapy that uses monoclonal antibodies (mAbs) to bind monospecifically to certain cells or proteins. The objective is that this treatment will stimulate the patient's immune system to attack those cells.COVID-19 Monoclonal Antibody Therapeutics webpage and . NIH COVID-19 Treatment Guidelines Treatment Page for the most up-to-date information on this topic. Healthcare systems in the U.S. and abroad have been increasingly administering monoclonal antibodies to treat COVID-19 positive patients.Regeneron's treatment, called REGN-COV2, is a combination or "cocktail" of two antibodies: infection-fighting proteins that were developed to bind to the part of the new coronavirus that it uses ...Remdesivir has demonstrated in vitro and in vivo activity against SARS-CoV-2. 1. Intravenous remdesivir is approved by the Food and Drug Administration (FDA) for the treatment of COVID-19 in adults and pediatric patients aged ≥28 days and weighing ≥3 kg. In nonhospitalized patients with mild to moderate COVID-19 who are at high risk of ...Aug 9, 2023 · Others have side effects that affect their ability to do daily activities. Side effects generally go away in a few days. Even if you don’t experience any side effects, your body is building protection against the virus that causes COVID-19. Adverse events (serious health problems) are rare but can cause long-term health problems. They usually ... The recommendations for COVID-19 treatments and the use of monoclonal antibodies changes often to meet the demand of up-and-coming variants. For the most up-to-date information, the FDA offers a ...One possible side effect of monoclonal antibody therapy is an allergic reaction. Allergic reactions can happen during and after infusion with monoclonal antibody therapy. Tell your health care provider right away if you get any of the following signs and symptoms of allergic reactions: fever, chills, nausea, headache, shortness of breath, low ...Monoclonal antibody treatment is a neutralizing antibody medicine – meaning, it contains man-made antibodies that are like the antibodies of patients who have recovered from COVID-19. These antibodies may help reduce the amount of COVID-19 virus in your body, which could give your body more time to learn how to make its own antibodies. [2] Monoclonal antibodies have been identified as a potential therapy to prevent COVID-19 disease progression in patients at risk for severe disease. Most antibodies made by the human body are polyclonal, meaning that they are derived from multiple B lymphocyte lineages and have slightly different specificities for target antigens.Nov 9, 2021 · A single dose of REGEN-COV, a combination monoclonal antibody therapy, reduced the risk of COVID-19 by 81.6% several months after a single dose. UNC School of Medicine’s Myron Cohen, MD, leads monoclonal antibody research efforts as part of the NIH-sponsored COVID Prevention Network. Mar 18, 2021 · Scientists developing new treatments for those with COVID-19 symptoms are turning to the same biomedicine that is playing an increasingly important role in treating cancer: monoclonal antibodies. While vaccines may eventually reduce the number of COVID-19 infections, therapies are needed to treat those who still get sick from the virus. Wear a Mask mask. If you become infected with COVID-19, there are treatment options that may help reduce how sick you become. The U.S. Food and Drug Administration has authorized and approved treatments that have already been taken by millions of people, reducing their risk of severe COVID-19 symptoms and keeping many of them out of the hospital.The U.S. government recently advised those with COVID-19 and at risk for serious complications to ask their health care provider about one of the monoclonal antibody therapies authorized by the U ...FDA News Release Coronavirus (COVID-19) Update: FDA Authorizes New Long-Acting Monoclonal Antibodies for Pre-exposure Prevention of COVID-19 in Certain Individuals For Immediate Release:...The most common side effects of taking Paxlovid include impaired sense of taste (for example, a metallic taste in the mouth) and diarrhea. Liver problems have occurred in patients receiving ritonavir.All of these COVID-19 vaccines are still fairly new, so possible long-term side effects are still being studied, and it’s possible that the guidance about the different vaccines might change. If you have concerns about getting one of these COVID-19 vaccines, it’s important to talk with your doctor.Constitutional symptoms (skin ulcers, purpura, arthralgia, weakness, paraesthesia and fever) disappeared or improved. No acute or delayed side effects were observed. Conclusions: Rituximab appears to be a safe and effective therapeutic option in symptomatic patients with HCV-associated MC glomerulonephritis and signs of systemic vasculitis. The key to figuring out whether COVID-19 leads to long-lasting antibody protection, Ellebedy realized, lies in the bone marrow. To find out whether those who have recovered from mild cases of COVID-19 harbor long-lived plasma cells that produce antibodies specifically targeted to SARS-CoV-2, the virus that causes COVID-19, Ellebedy teamed up ...Bamlanivimab 700 Mg/20 Ml (35 Mg/Ml) Intravenous Solution (EUA) Antiviral Monoclonal Antibodies - SARS-Cov-2 Coronavirus - Uses, Side Effects, and More Generic Name(S): bamlanivimab FDA News Release Coronavirus (COVID-19) Update: FDA Authorizes New Long-Acting Monoclonal Antibodies for Pre-exposure Prevention of COVID-19 in Certain Individuals For Immediate Release:...Sep 21, 2022 · Monoclonal antibodies act like your body’s own antibodies to help stop the symptoms of COVID-19. They can prevent hospitalization and reduce the severity of your illness. An antibody is a ... Possible side effects of molnupiravir include diarrhea, dizziness, and nausea. 3. Is molnupiravir similar to Tamiflu? Yes, this new pill is similar—in function, ease of use, and availability—to Tamiflu, the antiviral medication that is used to prevent serious symptoms of flu.All of these COVID-19 vaccines are still fairly new, so possible long-term side effects are still being studied, and it’s possible that the guidance about the different vaccines might change. If you have concerns about getting one of these COVID-19 vaccines, it’s important to talk with your doctor.Jun 23, 2022 · Most monoclonal antibodies don’t last very long in the bloodstream. That’s why they’re only used after a person has been infected. But one type of monoclonal antibody, called Evusheld ... Jul 20, 2023 · Researchers are also studying proteins created in a lab called monoclonal antibodies. They can help the immune system clear out viruses. The monoclonal antibody, vilobelimab, is authorized by the FDA for those who are on mechanical ventilation or extracorporeal membrane oxygenation, called ECMO. Drugs being studied that have uncertain ... progression of COVID-19. The side effects of getting any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the infusion site. These are not all the possible side effects of monoclonal antibody treatment. Not a lot of people have been given monoclonal antibody treatment.Nov 25, 2021 · "These responses may also explain why such long-term effects can occur long after the viral infection has passed." As for COVID-19 vaccines, the primary antigen used is the SARS-CoV-2 spike protein. The study thoroughly analyzes the possible pathways in which the experimental mRNA vaccines from Pfizer and Moderna could be causing serious adverse effects in vaccinated individuals. “Both are delivered through muscle injection, and both require deep-freeze storage to keep the RNA from breaking down,” Seneff and Nigh stated.Jul 21, 2023 · Convalescent plasma (kon-vuh-LES-unt PLAZ-muh) therapy uses blood from people who've recovered from an illness to help others get better. When the body clears out a virus, a person's blood has immune system proteins called antibodies. To get convalescent plasma, people donate blood after recovery. The blood is processed to remove blood cells ... Oct 14, 2020 · The president’s unique treatment may have prevented his body from making the antibodies necessary for long-term protection. The monoclonal antibodies he received were produced by the drug ... Aug 11, 2021 · The study explained how one notable vaccine side effect called antibody-dependent enhancement (ADE) is brought on by the spike proteins produced in the human body via the mRNA injection. “The mRNA vaccines ultimately deliver the highly antigenic spike protein to antigen-presenting cells. Remdesivir has demonstrated in vitro and in vivo activity against SARS-CoV-2. 1. Intravenous remdesivir is approved by the Food and Drug Administration (FDA) for the treatment of COVID-19 in adults and pediatric patients aged ≥28 days and weighing ≥3 kg. In nonhospitalized patients with mild to moderate COVID-19 who are at high risk of ...Most monoclonal antibodies don’t last very long in the bloodstream. That’s why they’re only used after a person has been infected. But one type of monoclonal antibody, called Evusheld ...Clinical Data Last Updated: March 6, 2023 Monoclonal antibodies (mAbs) that target the SARS-CoV-2 spike protein have been shown to have clinical benefits in treating SARS-CoV-2 infection. However, laboratory studies have found that the activity of anti-SARS-CoV-2 mAbs against specific variants and subvariants can vary dramatically.Benefits of antiviral therapy. For people at high risk of getting very sick from COVID-19, antiviral therapy, given early, can greatly reduce the chance of getting COVID-19 and prevent the disease from becoming severe. It also reduces the chance of needing to be in the hospital. The treatment can also shorten how long COVID-19 symptoms last. | Cdshmuks (article) | Mkirfa.