Infectious Diseases Medicine Research Articles

Use of dalbavancin in infective endocarditis: a case series.

BackgroundInfective endocarditis, typically caused by Gram-positive organisms such as viridans group streptococci and Staphylococcus aureus, is associated with high mortality and morbidity and requires aggressive, prolonged antimicrobial treatment and sometimes surgery. Dalbavancin, a lipoglycopeptide active against Gram-positive pathogens, has a long half-life, which allows IV treatment as one dose or two doses with a prolonged interval, offering personalized treatment for complex psychosocial situations or facilitating early discharge. In the absence of randomized controlled trials in infective endocarditis, current evidence derives from real-world case series involving off-licence use. The Austrian Society for Infectious Disease and Tropical Medicine includes dalbavancin as an option for infective endocarditis.ObjectivesThis retrospective case series reports use of dalbavancin in a small cohort of patients with infective endocarditis treated at Lancashire Cardiac Centre, Blackpool Teaching Hospitals Foundation Trust, UK.ResultsThe pharmacy database included 11 patients in whom dalbavancin was used to address either complex psychosocial circumstances or the need for early discharge. The endocarditis multidisciplinary team selected dalbavancin from available treatment options. Structures affected by infective endocarditis included aortic, mitral and tricuspid valves; aortic composite grafts; implantable cardioverter defibrillator leads; and prosthetic aortic valves. Eight patients underwent surgery; three were managed conservatively with antibiotics. Dalbavancin was curative in all but one patient, whose signs and symptoms of infection improved. No patients developed adverse reactions.ConclusionsDalbavancin is an alternative treatment option at hospital discharge when conventional antibiotics may not be suitable due to complex psychosocial issues or early discharge is required.

Heroin-induced Ulcer Mimicking Pyoderma Gangrenosum

Subcutaneous injections of illicit substances may be performed by some patients citing several advantages by the user, and can present to clinic with ulcers that clinically mimic pyoderma gangrenosum. However, it is vital to recognize heroin-induced ulcers and treat urgently to preserve function. Treatment requires a multidisciplinary approach with general medicine, dermatology, plastic surgery, wound care, infectious disease and addiction medicine. We present a patient with lower extremity ulceration due to subcutaneous injection of heroin which resembled PG.

Ethical issues in genetics and infectious diseases research: An interdisciplinary expert review

Research in genetics and infectious diseases (ID) presents novel configurations of ethical, legal, and social issues (ELSIs) related to the intersection of genetics with public health regulations and the control of transmissible diseases. Such research includes work both in pathogen genetics and on the ways that human genetics affect responses to ID. This paper identifies and systematizes the unique issues at this intersection, based on an interdisciplinary expert review. This paper presents results of a formal issue-spotting exercise among twenty experts in public health, law and genomics, biobanking, genetic epidemiology, ID medicine and public health, philosophy, ethics and ID, ethics and genomics, and law and ID. The focus of the exercise was on the collection, storage, and sharing of genetic information relating to ID. The issue-spotting exercise highlighted the following ELSIs: risks in reporting to government authorities, return of individual research results, and resource allocation - each taking on specific configurations based on the balance between public health and individual privacy/protection. The public health implications of interactions between genomics and ID frame considerations for equity and justice. In the context of the COVID-19 pandemic, these issues are especially pressing.

An Immunosuppression Hidden Malignancy: Case Report of An Unexpected Clostridium Septicum Infection and Its Fatal Consequence

Gastroenterology Medicine & Research An Immunosuppression Hidden Malignancy: Case Report of An Unexpected Clostridium Septicum Infection and Its Fatal Consequence Grade M1*, Welk E1, Sostmann H1, Hammerstein HV1, McAulay CH3 and Bostelmann R2 1Department of Gastroenterology, Infectious Diseases and General Internal Medicine Christian Hospital Quakenbrück, Germany 2Department of Neurosurgery and Spine Surgery, Christian Hospital Quakenbrück, Germany 3Department of Radiology, St. Marienhospital, Vechta, Germany *Corresponding author:Grade M, Department of Gastroenterology, Infectious Diseases and General Internal Medicine Christian Hospital Quakenbrück, Germany Submission: May 14, 2021;Published: May 21, 2021 DOI: 10.31031/GMR.2021.05.000625 ISSN 2637-7632Volume5 Issue5

Left bundle branch block and Wavy triple sign (Yasser’s sign) intertwining COVID-19 Pneumonia with Renal Impairment; defective Sgarbosa criteria for Thrombolytic: A Case Report in Cardiology, Infectious Diseases, Nephrology and Critical Care Medicine

Rationale: Left bundle branch block is a diagnostic utility for ST-segment elevation myocardial infarction equivalent. Consequently, administration of thrombolytic is a pivotal step. Emergent Sgarbosa criteria and their modification are considered helpful guide keys. Wavy triple an electrocardiographic sign (Yasser Sign) is a novel diagnostic sign in hypocalcemia. Interestingly, the presentation of COVID-19 pneumonia with an intertwining left bundle branch block, renal impairment, and hypocalcemia has a risk impact on both morbidity and mortality of COVID-19 patients. Patient concerns: An elderly carpenter male COVID-19 patient was admitted to intensive care unit with COVID-19 pneumonia with interlacing left bundle branch block, renal impairment, and Wavy triple sign (Yasser’s sign). Diagnosis: Left bundle branch block and Wavy triple sign (Yasser’s sign) intertwining COVID-19 pneumonia with renal impairment. Interventions: Arterial blood gases, chest CT scan, electrocardiography, oxygenation, and echocardiography. Outcomes: Gradual dramatic clinical, electrocardiographic, and radiological improvement had happened. Lessons: The triage of the left bundle branch block with the COVID-19 patient is highly significant for both diagnosis of acute myocardial infarction and giving thrombolytic. The combination of left bundle branch block, renal impairment, and hypocalcemia COVID-19 pneumonia signifies the risk in the current case study.

Editorial introductions

Editorial introductions

The scientific biography of Professor V.N. Klimenko (1868‒1941) – bacteriologist, infectious disease and internal medicine specialist

The scientific biography of Professor V.N. Klimenko (1868‒1941) – bacteriologist, infectious disease and internal medicine specialist

709. Multidisciplinary Drug Use Endocarditis Team (DUET): Results From an Academic Center Cohort

BackgroundGuidelines recommend multidisciplinary models for the management of infective endocarditis but have failed to incorporate the unique challenges of treating drug-use associated infective endocarditis (DUA-IE). Given the drug use and overdose epidemic with rising cases of DUA-IE, we created a multidisciplinary Drug Use Endocarditis Team (DUET), which convened monthly case conferences among the specialties involved, including Infectious Diseases, Cardiothoracic Surgery, Cardiology and Addiction Medicine. Objective: To conduct a retrospective cohort study of the patients presented at the DUET conferences from August 2018 to February 2020 to (1) assess clinical and demographic characteristics and (2) describe clinical outcomes.MethodsA retrospective chart review was conducted to analyze 57 patient cases, including descriptive statistical analyses of demographics, clinical characteristics, and outcomes.ResultsAmong our DUET cohort, 43.8% represented isolated right-sided endocarditis, and 84% involved native valve. Methicillin-susceptible Staphylococcus aureus was the most common microorganism isolated. ID was consulted in 94.7% of cases and overall 43.9% completed the planned antimicrobial course. The 7 patients who developed relapse/recurrent IE were initially managed medically, and 5 did not complete the initial antimicrobial course. Formal cardiothoracic surgery consultation was obtained in 57.9% and 24.6% were managed operatively. Of the patients managed operatively, 64.3% completed the antimicrobial course. The rate of antibiotic completion was higher among patients managed operatively but did not reach statistical significance (p=0.08). Formal addiction medicine consultation was obtained in 85.9% of cases, with 63.1% discharged on medications for opioid use disorder (MOUD). The rate of MOUD on discharge was not significantly different between patients managed operatively and non-operatively.Figure 1: Patient Characteristics Figure 2: Infection Characteristics Figure 3: Outcome Analyses ConclusionID is nearly universally involved in the care of patients with DUA-IE, but this patient population requires input from numerous sub-specialties. Multidisciplinary care teams provide a promising framework for DUA-IE to enhance and integrate nuanced decision-making.Disclosures Sarah E. Wakeman, MD, Celero Systems (Advisor or Review Panel member)Optum Labs (Grant/Research Support)UpToDate (Other Financial or Material Support, Author)

Kırım Kongo Kanamalı Ateşi Tanısıyla İzlenen Hastaların Epidemiyolojik ve Biyokimyasal Olarak Değerlendirilmesi

Aim: Crimean-Congo Hemorrhagic Fever (CCHF) is a viral hemorrhagic fever. To evaluate the clinical, epidemiological and laboratory characteristics of patients with CCHF. 
 Methods: This study was performed with adult patients under monitoring with diagnosis of CCHF at the Atatürk University Faculty of Medicine Infectious Diseases Clinic between April 2012 and August 2013. 
 Results: Diagnosis of CCHF was based on presence of Enzyme-linked immunosorbent assay (ELISA) anti-CCFV IgM and/or virus antigen at Refik Saydam Hygiene Center (RSHM) in patient serum and/or real time Polymerase Chain Reaction (PCR). One hundred twenty-one cases were included. Fifty-eight (48.7%) of patients were male and 62(51.2%) female, with a mean age of 50.04 ± 18.22 (16-86) years. Contact with ticks was determined in 62.8% of patients. Length of incubation was 3.9±2.7 days. Five patients (4.1%) died. 
 Conclusion: CCHF which is carried by ticks is a fatal viral infection. The most important factor in protection is the prevention of tick contact. People living in endemic regions must be educated and instructed how to perform daily tick checks. Patients have got high fever, myalgia, headache and tick bite must be asked in history. We believe that early diagnosis and treatment of CCHF cases may significantly reduce morbidity and mortality.

Improving Physical Activity in Adults Admitted to a Hospital With Interventions Developed and Implemented Through Cocreation: Protocol for a Pre-Post Embedded Mixed Methods Study.

BackgroundAdmission to a hospital is often related with hospital-associated disabilities. Improving physical activity during hospitalization is considered effective to counteract hospital-associated disabilities, whereas many studies report on very low physical activity levels. Gradually developing and implementing interventions in cocreation with patients and health care professionals rather than implementing predefined interventions may be more effective in creating sustainable changes in everyday clinical practice. However, no studies have reported on the use of cocreation in the development and implementation of interventions aimed at improving physical activity.ObjectiveThis protocol presents a study that aims to investigate if interventions, which will be developed and implemented in cocreation, improve physical activity among patients in surgery, internal medicine, and cardiology hospital wards. The secondary aims are to investigate effectiveness in terms of the reduction in the time patients spend in bed, the length of hospital stay, and the proportion of patients going home after discharge.MethodsThe Better By Moving study takes place for 12 months at the following five different wards of a university hospital: two gastrointestinal and oncology surgery wards, one internal medicine hematology ward, one internal medicine infectious diseases ward, and one cardiology ward. The step-by-step implementation model of Grol and Wensing is used, and all interventions are developed and implemented in cocreation with health care professionals and patients. Outcome evaluation is performed across the different hospital wards and for each hospital ward individually. The primary outcome is the amount of physical activity in minutes assessed with the Physical Activity Monitor AM400 accelerometer in two individual groups of patients (preimplementation [n=110], and 13 months after the start of the implementation [n=110]). The secondary outcomes are time spent in bed measured using behavioral mapping protocols, and length of stay and discharge destination assessed using organizational data. A process evaluation using semistructured interviews and surveys is adopted to evaluate the implementation, mechanisms of impact, context, and perceived barriers and enablers.ResultsThis study is ongoing. The first participant was enrolled in January 2018. The last outcome evaluation and process evaluation are planned for May and June 2020, respectively. Results are expected in April 2021.ConclusionsThis study will provide information about the effectiveness of developing and implementing interventions in cocreation with regard to improving physical activity in different subgroups of hospitalized patients in a university hospital. By following step-by-step implementation and by performing process evaluation, we will identify the barriers and enablers for implementation and describe the effect of new interventions on improving physical activity among hospitalized patients.Trial RegistrationNetherlands Trial Register NL8480; https://www.trialregister.nl/trial/8480International Registered Report Identifier (IRRID)DERR1-10.2196/19000

Antibiotic Resistance Crisis in Urinary Tract Infections Utis in Egypt

Abstract Introduction/Objective Bacterial adaptation to antibiotics has been very successful. Over the past decade, the increase in antibiotic resistance has generated considerable medical problems. UTIs are one of the most common community-onset infections. The emergence of resistance to all classes of antibiotics in previously susceptible bacterial pathogens is a major challenge to infectious disease medicine. Thus, it is important that we forcefully implement strategies to reduce the rate of appearance and spread of resistant bacteria to allow new drug discovery to catch up with bacterial resistance development. Objectives: Methods The aim of this study is to predict the percentage of urine cultures antibiotic resistance in patients with UTIs in Egypt. Subjects and methods: A total of 200 subjects were enrolled in this study from The Delta region in Egypt; 38% males and 62% females with a median age of 39 years and 35 years respectively. Identification of the isolated organisms was identified by the cultural characters (Morphological characters of the purified bacterial isolates were carried out according to the colony characters, Gram stain reaction and biochemical tests for each organism using a standard semi-automated technique Results 98 cultures (49%) were observed to have resistance to 3- 5 classes of antibiotics including, 98% Cephalosporins, 85% β-lactam inhibitors and 71% fluoroquinolones; 66 females (57 gram -ve stain and 9 gram +ve stain) and 33 males (27gm -ve stain, 6gm +ve stain). 82 cultures (41%) were not resistant to any classes.; 32 males (28 gram -ve stain and 3 gram +ve stain) and 50 females (45 gram -ve stain and 5 gram +ve stain). 19 cultures (9.5%) were observed to be resistant to all antibiotics.; 12 males (11 gram -ve stain and 1 gram +ve stain) and 7 females (2 gram -ve stain and 5 gram +ve stain). Conclusion This study highlights the highest antibiotic resistance associated with urinary tract infection in Egypt as well as the classification of the organisms. The high resistance percentage is due to the overuse of antibiotics by public and inappropriate antibiotic prescribing. Antibiotics are unregulated and available over the counter without a prescription in Egypt which makes it easily accessible. We recommend regulating the use of antibiotics and lunch antimicrobial stewardship programs in Egypt.

Predicting antimicrobial susceptibility from the bacterial genome: A new paradigm for one health resistance monitoring

The laboratory identification of antibacterial resistance is a cornerstone of infectious disease medicine. In vitro antimicrobial susceptibility testing has long been based on the growth response of organisms in pure culture to a defined concentration of antimicrobial agents. By comparing individual isolates to wild-type susceptibility patterns, strains with acquired resistance can be identified. Acquired resistance can also be detected genetically. After many decades of research, the inventory of genes underlying antimicrobial resistance is well known for several pathogenic genera including zoonotic enteric organisms such as Salmonella and Campylobacter and continues to grow substantially for others. With the decline in costs for large scale DNA sequencing, it is now practicable to characterize bacteria using whole genome sequencing, including the carriage of resistance genes in individual microorganisms and those present in complex biological samples. With genomics, we can generate comprehensive, detailed information on the bacterium, the mechanisms of antibiotic resistance, clues to its source, and the nature of mobile DNA elements by which resistance spreads. These developments point to a new paradigm for antimicrobial resistance detection and tracking for both clinical and public health purposes.

Recruitment Strategy for Potential COVID-19 Convalescent Plasma Donors

Recruitment Strategy for Potential COVID-19 Convalescent Plasma Donors

Self-assembled nanogels of luminescent thiolated silver nanoclusters and chitosan as bactericidal agent and bacterial sensor

Multifunctional theranostic agents with the features of good biocompatibility, long-term antibacterial efficacy, and rapid bacterial detection are the desired future medicine for infectious diseases, but which poses huge challenges on the design of such multifunctional nanocomposites in a single entity. Herein, self-assembled nanogels of thiolated silver nanoclusters (Ag NCs) and chitosan was designed and synthesized, which combines the desirable biocompatible, targeting specific, luminescent properties. This nanogel displays an amplified luminescence via strong matrix-ligand coordination between thiolate ligands and chitosan matrix to rigidify the molecular structure on the surface of Ag NCs. Concomitantly, this nanogel exhibits exceptional bactericidal activity, with approximately >10-fold stronger activity compared to its counterpart Ag NCs. Furthermore, a bacterial detection system was developed based on the bacterial binding on the fluorescent nanogels. This work provides a new strategy in designing multifunctional theranostic agents and this new composite Ag NC nanogel holds great promise for practical applications as the theranostic nanomedicines.

Protocol of a population-based prospective COVID-19 cohort study Munich, Germany (KoCo19)

BackgroundDue to the SARS-CoV-2 pandemic, public health interventions have been introduced globally in order to prevent the spread of the virus and avoid the overload of health care systems, especially for the most severely affected patients. Scientific studies to date have focused primarily on describing the clinical course of patients, identifying treatment options and developing vaccines. In Germany, as in many other regions, current tests for SARS-CoV2 are not conducted on a representative basis and in a longitudinal design. Furthermore, knowledge about the immune status of the population is lacking. Nonetheless, these data are needed to understand the dynamics of the pandemic and hence to appropriately design and evaluate interventions. For this purpose, we recently started a prospective population-based cohort in Munich, Germany, with the aim to develop a better understanding of the state and dynamics of the pandemic.MethodsIn 100 out of 755 randomly selected constituencies, 3000 Munich households are identified via random route and offered enrollment into the study. All household members are asked to complete a baseline questionnaire and subjects ≥14 years of age are asked to provide a venous blood sample of ≤3 ml for the determination of SARS-CoV-2 IgG/IgA status. The residual plasma and the blood pellet are preserved for later genetic and molecular biological investigations. For twelve months, each household member is asked to keep a diary of daily symptoms, whereabouts and contacts via WebApp. If symptoms suggestive for COVID-19 are reported, family members, including children < 14 years, are offered a pharyngeal swab taken at the Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, for molecular testing for SARS-CoV-2. In case of severe symptoms, participants will be transferred to a Munich hospital. For one year, the study teams re-visits the households for blood sampling every six weeks.DiscussionWith the planned study we will establish a reliable epidemiological tool to improve the understanding of the spread of SARS-CoV-2 and to better assess the effectiveness of public health measures as well as their socio-economic effects. This will support policy makers in managing the epidemic based on scientific evidence.

Striking Similarities of Multisystem Inflammatory Syndrome in Children and a Myocarditis-Like Syndrome in Adults: Overlapping Manifestations of COVID-19.

Striking Similarities of Multisystem Inflammatory Syndrome in Children and a Myocarditis-Like Syndrome in Adults: Overlapping Manifestations of COVID-19.

Development of Medicines for Infectious Diseases -Malaria

In developed countries, it is said that "threats of infectious diseases are already thought as things of the past". However, as you can see in the case of Ebola hemorrhagic fever that occurred in West Africa, this is a big mistake. Among infectious diseases, only smallpox has been successfully eradicated worldwide. In addition to the three major infectious diseases of HIV/AIDS, tuberculosis, and malaria, there is another group called emerging and reemerging infectious diseases. Recently, neglected tropical diseases (NTDs) have been listed as threats by the WHO, as have drug-resistant bacteria. The spread of these pathogens is increasing due to an increase in global travel. Malaria and more than half of the NTDs are parasitic diseases, such as trypanosomiasis and soil-borne helminthiasis. These are caused by parasites, with eukaryotes similar to their host mammals. In the case of these NTDs, protective immune responses induced by differences between a pathogen and host do not work well, and there is no vaccine against parasites. As for drugs developed to treat these diseases, because the properties of enzymes and target receptors are very similar, and effective drugs simultaneously show efficacy against both the disease and the host, severe side effects often occur. Therefore, the search for targets specifically present in parasites, and screening for drugs that inhibit their physiological functions, is extremely important. Here, as an example of the development of antiparasitic drugs, I will introduce a study on malaria.

No antibody response in acral cutaneous manifestations associated with COVID‐19?

Journal of the European Academy of Dermatology and VenereologyVolume 34, Issue 10 p. e546-e548 Letter To The Editor No antibody response in acral cutaneous manifestations associated with COVID-19? R. Mahieu, Corresponding Author R. Mahieu rafael.mahieu@chu-angers.fr orcid.org/0000-0002-9978-6714 Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, France Université d'Angers, INSERM, CRCINA, Angers, France These authors contributed equally. Correspondence: R. Mahieu. E-mail: rafael.mahieu@chu-angers.frSearch for more papers by this authorL. Tillard, L. Tillard Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, France These authors contributed equally.Search for more papers by this authorH. Le Guillou-Guillemette, H. Le Guillou-Guillemette Virology Department, University Hospital of Angers, HIFIH Laboratory EA 3859, LUNAM, Angers, FranceSearch for more papers by this authorE. Vinatier, E. Vinatier Université d'Angers, INSERM, CRCINA, Angers, France Immunology Department, University Hospital of Angers, Angers, FranceSearch for more papers by this authorP. Jeannin, P. Jeannin Université d'Angers, INSERM, CRCINA, Angers, France Immunology Department, University Hospital of Angers, Angers, FranceSearch for more papers by this authorA. Croué, A. Croué Pathology Department, University Hospital of Angers, Angers, FranceSearch for more papers by this authorY. Le Corre, Y. Le Corre Dermatology Department, LUNAM Université, University Hospital of Angers, Angers, FranceSearch for more papers by this authorY.-M. Vandamme, Y.-M. Vandamme Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, FranceSearch for more papers by this author R. Mahieu, Corresponding Author R. Mahieu rafael.mahieu@chu-angers.fr orcid.org/0000-0002-9978-6714 Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, France Université d'Angers, INSERM, CRCINA, Angers, France These authors contributed equally. Correspondence: R. Mahieu. E-mail: rafael.mahieu@chu-angers.frSearch for more papers by this authorL. Tillard, L. Tillard Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, France These authors contributed equally.Search for more papers by this authorH. Le Guillou-Guillemette, H. Le Guillou-Guillemette Virology Department, University Hospital of Angers, HIFIH Laboratory EA 3859, LUNAM, Angers, FranceSearch for more papers by this authorE. Vinatier, E. Vinatier Université d'Angers, INSERM, CRCINA, Angers, France Immunology Department, University Hospital of Angers, Angers, FranceSearch for more papers by this authorP. Jeannin, P. Jeannin Université d'Angers, INSERM, CRCINA, Angers, France Immunology Department, University Hospital of Angers, Angers, FranceSearch for more papers by this authorA. Croué, A. Croué Pathology Department, University Hospital of Angers, Angers, FranceSearch for more papers by this authorY. Le Corre, Y. Le Corre Dermatology Department, LUNAM Université, University Hospital of Angers, Angers, FranceSearch for more papers by this authorY.-M. Vandamme, Y.-M. Vandamme Infectious Diseases and Tropical Medicine, LUNAM Université, University Hospital of Angers, Angers, FranceSearch for more papers by this author First published: 02 June 2020 https://doi.org/10.1111/jdv.16688Citations: 14 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume34, Issue10October 2020Pages e546-e548 This article also appears in:JEADV COVID-19 articles RelatedInformation

Visual analysis of coronavirus disease 2019 (COVID-19) studies based on bibliometrics

To analyze the development of coronavirus disease 2019(COVID-19), this study systematically retrieved relevant Chinese and English literatures from both CNKI and Web of Science database platforms by bibliometric research method and CiteSpace 5.5.R2 software to obtain information and visualize relevant literatures. A total of 695 Chinese and 446 English literatures were included in this paper. Statistics showed that China had published most of the literatures and established close cooperation with the United States and the United Kingdom. Through the analysis, Tongji Medical College of Huazhong University of Science and Technology and its affiliated hospitals published the largest number of the publications. Moreover, the highly productive journals including Journal of Traditional Chinese Medicine and The Lancet covered eight major fields, such as medicine, medical virology, radiation medicine, infectious disease, and traditional Chinese medicine. Besides, a total of 35 special COVID-19 funds were recently established to subsidize these studies. The key words and themes analysis indicated that protein structure of COVID-19, receptor targets and mechanisms of action, integration of traditional Chinese and Western medicine, screening and development of antiviral drugs from traditional Chinese medicine and Western medicine, vaccine research as well as epidemiological characteristics and prediction are current study hotspots. This study provides a reference for researchers to rapidly master main study directions of COVID-19 and screen out relevant literatures.

Hemophagocytic syndrome in patients infected with the human immunodeficiency virus: A study of 15 consecutive patients.

ABSTRACTObjectivesHemophagocytic syndrome (HPS) is characterized by various clinical and biological data derived from cytokine hyperproduction and cell proliferation. The objectives of this study were to evaluate the epidemiological, etiological, clinical and evolutionary characteristics of patients diagnosed with hemophagocytic syndrome and HIV infection, as well as their comparison with data from the literature.Methods-A retrospective descriptive observational study was performed, including all adult patients with a diagnosis of HPS and HIV infection treated in the Infectious Diseases and Tropical Medicine Unit of the Hospital Universitario Insular, Las Palmas, Gran Canaria from June 1, 1998 to December 31, 2018.ResultsAn analysis of this series of case reports of 15 patients showed a higher percentage of males than females, with a mean age of 42 years. With respect to the diagnostic criteria for HPS, presence of fever, cytopenias and hyperferritinemia were a constant in all patients. Clinical neurological manifestations were frequent and clinical respiratory signs and symptoms absent. HPS was confirmed in some patients who were not severely immune-depressed and had undetectable viral loads. Furthermore, 40% of cases were not receiving ART. The most frequent triggering causes of HPS were viral, especially HHV-8. In addition, two new HPS triggers were identified: Blastocystis dermatitidis and Mycobacterium chelonae.ConclusionAdministration of treatment in HPS is arbitrary. This, together with the high mortality rate and the fact that it is underdiagnosed, indicates the importance of conducting future studies.