Positive Polymerase Chain Reaction Test Research Articles

Listeria Meningitis as an Indication of Undiagnosed Primary Immune Deficiency, Activated Phosphoinositide 3-Kinase Delta Syndrome: A Case Report.

Listeria monocytogenes is a Gram-positive bacillus that causes severe infections mainly in newborns, pregnant women, immunocompromised individuals, and elderly. In this report, we present a case of immune dysregulation that presented with invasive Listeria infection despite the absence of these risk factors. A previously healthy 5-year-old girl developed L. monocytogenes meningitis, which is unusual given her age and lack of typical risk factors. The patient initially presented with fever, diarrhea and altered mental status, unresponsive to empiric antibiotic treatment. Besides clinical diagnosis of meningitis, laboratory tests revealed pleocytosis and positive polymerase chain reaction test for L. monocytogenes in cerebrospinal fluid. Despite initial improvement, the patient developed proteinuria and hypertension and was later diagnosed with focal class 3 lupus nephritis following a renal biopsy. Given the atypical nature of her L. monocytogenes infection, persistent organomegaly, and lupus nephritis, further immunological evaluation was conducted. Genetic testing revealed a de-novo gain-of-function mutation in the PIK3CD gene, confirming the diagnosis of Activated Phosphoinositide 3-Kinase Delta Syndrome 1 (APDS1), a rare primary immunodeficiency characterized by lymphoproliferation and autoimmunity. The patient was started on immunoglobulin replacement therapy and prophylactic trimethoprim-sulfamethoxazole. No recurrence of severe infection occurred during 2 years of follow-up. This case underscores the importance of considering underlying immune dysregulations in pediatric patients with atypical presentation of Listeria infections.

P-706. Adenovirus Type 21 Outbreak among Haematology and liver transplant patients at a large tertiary care hospital in Singapore

Abstract Background Human adenoviruses (HAdVs) commonly cause acute respiratory illness, with documented outbreaks in military settings. HAdV infections frequently precipitate severe pneumonia amongst immunocompromised patients, with associated mortality risk. We report a HAdV type 21 infection cluster involving immunocompromised patients at a tertiary care hospital. Methods Hospital-onset (HO) adenoviral infection was defined as positive HAdV polymerase chain reaction (PCR) test with corresponding respiratory symptom onset six days after admission. Positive samples were typed in the National Public Health Laboratory by sequencing hexon gene variable regions. Epidemiological investigations were carried out for potential spatiotemporal linkage between these patients for targeted infection prevention interventions. Results Between 1st January to 31st March 2024, 21 HAdV-positive cases were identified, with five categorised as HO HAdV. Four patients (80%) had haematological malignancies and one had received a liver transplant 23 days prior to testing positive for HAdV. The mean age of patients was 58.6 years (SD: ± 9.7), with males comprising 60% of the cohort. The median hospital length of stay (LOS) before HAdV positivity was 21 days (range: 6 – 45). Clinical manifestations included fever, shortness of breath, cough, and acute respiratory failure. All patients required Intensive Care Unit (ICU) admission, with an average ICU LOS of 10 days (SD: ± 9.2). Respiratory samples of three patients were typed as HAdV 21, and three had adenovirus DNAemia. In the identified cluster, the four patients with haematological malignancies shared the same ward, with two overlapping in time but housed in different rooms. The liver transplant patient had overlapping stay in the critical care unit with a patient from the haematology cluster and shared the same mobile chest x-ray machine with two others from the same cluster. All four patients with haematological malignancies experienced same-admission mortality. Conclusion Timely symptom recognition and respiratory multiplex panel testing enabled detection of HAdV infection cluster in immunocompromised patients. Early cluster detection and reinforcement of infection prevention measures at risk locations can mitigate transmission of HAdV infections. Disclosures Moi Lin Ling, FRCPA, Solventum: Honoraria|Solventum: Educational grant for APSIC projects

Long COVID echocardiography, cardiac MRIi, and endomyocardial biopsy findings in previously healthy individuals

Abstract Aims There are many possible causes of myocardial injury in long COVID patients. The aim of the study was to search by endomyocardial biopsy EMB in patients with not previous comorbidities histopathological causes. Material and Methods This is part of a single center registry, 209 patients with chest pain due to long COVID without previous known comorbidities, all patients have had positive COVID polymerase chain reaction (PCR) or rapid antigen test. The median of 32.56 weeks following diagnosis, due to lack of improvement of symptoms with medical treatment, according with clinical, laboratory results, echocardiography, and cardiac magnetic resonance (CMR), the endomyocardial biopsy (EMB) was performed, a total of 16 patients from January 2021 to January 2024 were included. Results Of the 16 patients included,7 (43%) had persistent high-sensitive I troponin (HS-TnT) and 8 (50%) HS-CRP, all patients have low vitamin D level. 5 of them 31% evidenced myocardial injury in CMR, elevated T1 or T2 mappings, anormal extracellular Volume (ECV), or late gadolinium enhancement (LGE). The main findings in histopathology, immunohistochemistry staining, and PCR proof of viral genome. 12 (75%) patients had had diffuse ischemic necrosis with loss of general myocardial architecture, and interstitial edema, early cellular degeneration in the presence of intracytoplasmic lipofuscin 2 patients have lymphocytic myocarditis criteria, from this 2, 1 had immunoperoxidase for SARS-Cov2 (Bio&Sb), where nuclei with uptake evidenced with diaminobenzidine favors virus infection (Sars-Cov2), 1 patient thrombotic microangiopathy and 1 AA amyloidosis. Conclusion Most of patients have diffuse ischemic necrosis instead, inflammatory changes, also it is possible to find AA amyloidosis and thrombotic microangiopathy table 1 and 2

P-1619. Diagnostic Stewardship: Over-testing for Herpes Simplex Virus in Bronchoalveolar Lavage Specimens

Abstract Background HSV-1 is estimated to affect 3.7 billion worldwide (67% prevalence), primarily manifesting as oropharyngeal lesions. Although HSV can be commonly detected by polymerase chain reaction (PCR) in bronchoalveolar lavage (BAL) specimens, true HSV pneumonitis is rare and most positive specimens reflect colonization or asymptomatic reactivation, not active respiratory infection. This study evaluates the appropriateness and frequency that diagnostic HSV-1/2 qualitative DNA PCRs are ordered on BAL specimens at a tertiary medical center and its impact on treatment and patient outcomes. Immune Status of Patients Tested for Opportunistic Infections Methods Patients at a single tertiary medical center who had HSV-1/2 qualitative DNA PCR performed on any specimen in 2022 were identified by lab order. Testing performed on non-BAL specimens were excluded from data collection. De-identified clinical history, risk factors, immune status, concomitant testing, treatment, and outcomes were recorded to secure database for analysis. Immune Status Guiding Treatment in HSV Positive Patients Results HSV-1/2 qualitative DNA PCR testing was performed on BAL specimens from 131 unique patients. Of the 131 patients, 50 (38.2%) were immunosuppressed as defined by active malignancy, pharmacologic immunosuppression, neutropenia, HIV positive thus most testing was performed on immunocompetent patients without risk factors. 16 patients had a positive qualitative PCR (12.2%) of which 6 patients were treated with antiviral therapy (4.6%). 12 patients (9.2%) were tested more than once on different occasions, 4 of which were positive. 1 patient had a documented final diagnosis of HSV pneumonitis treated with acyclovir. Conclusion HSV pneumonitis is a rare manifestation of a common infection that is associated with critical illness, poor outcomes. Many patients will have positive PCR testing of BAL specimens due to inoculation from the upper respiratory tract but this typically does not reflect true infection. Only in the context of significant immunosuppression, compatible clinical presentation can HSV pneumonitis be diagnosed. Excessive ordering of HSV testing leads to unnecessary healthcare expenditure and confounds the clinical picture and decision making. We suggest limiting HSV testing to immunosuppressed patients with the appropriate clinical presentation and use of cytopathology to help confirm diagnosis. Disclosures All Authors: No reported disclosures

Risk Factors Associated with Post-COVID-19 Conditions Among Diabetes Patients in the United Arab Emirates

BackgroundA substantial subset of individuals recovering from the Coronavirus disease 2019 (COVID-19) continues to experience persistent symptoms. Individuals with type 2 diabetes face increased morbidity and mortality following COVID-19 infection. This study aimed to identify risk factors for developing post-COVID-19 conditions among COVID-19 patients with diabetes compared to those without diabetes in the United Arab Emirates.MethodsA retrospective study was conducted on a random sample of 400 patients with confirmed COVID-19 (n = 200/400 patients with diabetes versus n = 200 patients without diabetes). Participants were invited to a telephone interview to assess post-COVID-19 symptoms persisting for at least three months after their initial positive COVID-19 polymerase chain reaction (PCR) test. A total of 167 hospitalized patients participated, including 89 with pre-existing diabetes and 78 without diabetes.ResultsThe prevalence of self-reported post-COVID-19 conditions among participants with diabetes was 34.9%, compared to 14.1% among those without diabetes. Patients with diabetes reported a significant decline in functional status post-COVID-19, with 34.8% experiencing impaired physical activity and 32.6% reporting pain and discomfort, compared to 15.4% and 11.5%, respectively, among participants without diabetes. Older age and female gender were associated with a higher prevalence of post-COVID-19 conditions in the diabetes group.ConclusionPatients with diabetes in this study self-reported a higher frequency and severity of post-COVID-19 conditions compared to those without diabetes. Risk factors predisposing to severe post-COVID-19 conditions included female gender, older age, and comorbidities. Self-reported depression was rare in both groups of this cohort.

Double-blind randomised trial of saline solution for gargling and nasal rinsing in SARS-CoV-2 infection.

Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days. The low-saline solutions contained 2.13 g of salt dissolved in eight ounces of warm water, while the high-saline solution contained six grams of salt dissolved in eight ounces of warm water. Participants gargled and rinsed their nasal passages four times a day for 14 days. Primary outcomes assessed included frequency and duration of SARS-CoV-2 symptoms, while secondary outcomes included hospital or intensive care unit (ICU) admission, need for mechanical ventilatory support, or mortality rates. Exclusion criteria included chronic hypertension or participation in other interventional studies. Fifty-eight individuals were allocated to the low (n = 27) or high (n = 28) saline regimens; with three lost to follow-up. There were no significant differences in primary or secondary outcomes between these groups. Comparatively, during the study period, 9398 individuals with confirmed SARS-CoV-2 infection by positive PCR test were observed as a reference group. Hospitalisation rates in the low-saline (18.5%) and high-saline (21.4%) regimens were significantly lower than in the reference group (58.8%; P < 0.001), while no significant differences were observed in other outcomes among these groups. Low and high saline regimens for gargling and nasal rinsing show similar effectiveness in reducing the frequency and duration of symptoms related to SARS-CoV-2 infection. Both saline regimens are associated with lower hospitalisation rates compared to individuals not using gargling or nasal rinsing in those infected by SARS-CoV-2.

High Prevalence of Unconfirmed Positive HIV Polymerase Chain Reaction Test Results Among African Infants With HIV Exposure in the International Epidemiology Databases to Evaluate AIDS Consortium.

In a large, multiregional cohort of African infants with human immunodeficiency virus (HIV) exposure, 44% of those with a positive HIV polymerase chain reaction test lacked a confirmatory positive test. Efforts are needed to ensure high-fidelity implementation of HIV testing algorithms so that all positive results are confirmed.

Pregnant women admitted to hospital with covid-19 in 10 European countries: individual patient data meta-analysis of population based cohorts in International Obstetric Survey Systems

ObjectivesTo assess the incidence of hospital admissions for covid-19 disease in pregnant women, severity of covid-19 disease, and medical treatment provided to pregnant women with moderate to severe covid-19 during...

P08 Study on the impact of COVID-19 infection in patients with moderate-to-severe plaque psoriasis on biologics: a tertiary centre experience in India

Abstract Introduction As the world faced COVID-19 pandemic, significant concerns were raised regarding its impact on specific patient groups due to paucity of real-world evidence. Individuals with psoriasis undergoing biologic therapy face heightened vulnerability to severe disease. This study aimed to examine the effects of COVID-19 infection on patients with moderate-to-severe plaque psoriasis treated with biologic agents. Materials and Methods Medical records of patients with moderate-to-severe plaque psoriasis undergoing biologic treatment at a tertiary care centre were retrospectively reviewed from March 2021 to June 2021. Patients with confirmed COVID-19 infection, identified through positive polymerase chain reaction tests, were included. Data on patient demographics, disease characteristics, symptoms, and vaccination status were collected and analysed. Results Among 34 infected patients (26 males, 8 females), median age was 50 years (range: 18–70) with a median psoriatic disease duration of 12 years (range: 12–32). Median psoriasis area and severity index (PASI) was 14, with 22.2% of patients having psoriatic arthritis. Comorbidities included overweight (34.4%), obesity (39.2%), dyslipidaemia (24.4%), diabetes mellitus (11.7%), arterial hypertension (7.0%), and coronary artery disease (2.3%). Most patients experienced mild COVID-19 symptoms; 3 required hospitalization due to dyspnoea and hypoxia. At the time of infection, 80% had received at least one dose of mRNA vaccine. Conclusion Our findings suggest that patients receiving biologic therapy for psoriasis did not exhibit a higher risk of severe COVID-19 outcomes. Also, biologic treatment did not appear to impact disease severity adversely indicating potential benefits such as reduced infection risk and milder symptoms. Continuation of biologic therapy in psoriasis patients, even during the pandemic, is essential for effective disease management. Patient education and counselling regarding hesitancy are equally important in such difficult times.

Environmental predictors of SARS-CoV-2 infection incidence in Catalonia (northwestern Mediterranean).

Numerous studies have explored whether and how the spread of the SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19), responds to environmental conditions without reaching consistent answers. Sociodemographic factors, such as variable population density and mobility, as well as the lack of effective epidemiological monitoring, make it difficult to establish robust correlations. Here we carry out a regional cross-correlation study between nine atmospheric variables and an infection index (Ic ) estimated from standardized positive polymerase chain reaction (PCR) test cases. The correlations and associated time-lags are used to build a linear multiple-regression model between weather conditions and the Ic index. Our results show that surface pressure and relative humidity can largely predict COVID-19 outbreaks during periods of relatively minor mobility and meeting restrictions. The occurrence of low-pressure systems, associated with the autumn onset, leads to weather and behavioral changes that intensify the virus transmission. These findings suggest that surface pressure and relative humidity are key environmental factors that may be used to forecast the spread of SARS-CoV-2.

Vaccine effectiveness against mild and severe covid-19 in pregnant individuals and their infants in England: test negative case-control study

ObjectiveTo estimate real world vaccine effectiveness against symptomatic disease and hospital admission with the delta and omicron variants of the SARS-CoV-2 virus in pregnant individuals, and to estimate the protection...

Antibodies to Anaplasma phagocytophilum in Patients with Human Granulocytic Anaplasmosis Confirmed by Both Polymerase Chain Reaction and Culture

Background/AimsSera from patients from a single medical institution in New York State with human granulocytic anaplasmosis established by a positive polymerase chain reaction test (PCR) for Anaplasma phagocytophilum were used to assess the performance of serologic testing. All cases were also confirmed by culture in order to eliminate any false positive PCR samples. MethodsA nested PCR was performed targeting the heat shock operon of A. phagocytophilum. Culture was done using the HL-60 promyelocytic cell line. Serologic testing was performed to detect IgG/A/M using an indirect immunofluorescence assay that incorporated a human isolate of A. phagocytophilum as the source of the antigen. ResultsFrom 1997-2009, 38 human granulocytic anaplasmosis patients were evaluated. On the baseline serum sample 21 (55.3%; 95% CI: 38.3% to 71.4%) had a positive serologic test; 7 samples (33.1%) were positive at a titer of 80-320 and 14 samples (66.7%) at a titer of at least 640. Sixteen (94.1%) of the 17 with a negative baseline test had follow-up testing performed. All 16 tested positive on a convalescent phase serum sample obtained from 6 to 45 days later. ConclusionPCR testing is the most commonly used direct diagnostic test to diagnose human granulocytic anaplasmosis. Our findings demonstrate that only approximately 55% of the PCR and culture positive cases were also seropositive on blood samples obtained at the same time point, indicating that serologic testing performed at the time of presentation has limited sensitivity. However, all of the 16 evaluable seronegative patients developed antibodies to A. phagocytophilum during convalescence.

A prospective analysis of clinical and parasitological outcomes after treatment or a wait-and-see approach of Dientamoeba fragilis infection in an adult general practice population.

Dientamoeba fragilis is a protozoan frequently encountered in stool samples globally. It is debated whether Dientamoeba fragilis carries pathogenic capacities. This study prospectively analyses clinical and parasitological outcomes after treatment or a wait-and-see approach of Dientamoeba fragilis infection in a general practice adult population. In this prospective observational cohort study 113 adult patients with a positive Polymerase Chain Reaction (PCR) test result for D. fragilis (T0) in a primary care setting, were followed-up longitudinally with a control PCR-test and microscopic stool examination at 30 days (T1) and 90 days (T2) after inclusion. Standardized patient-reported questionnaires including treatment details and the adjusted Irritable Bowel Syndrome-Severity Score (IBS-SS) were retrieved at T0, T1 and T2. Parasitology and questionnaires were retrieved from 87 participants at T0 and T1, and 74 at T2. Treated patients(n = 64) more often tested PCR negative at T1 (64.1% vs. 16.4%, p < 0.001) and T2 (67.3% vs. 5.3%, p < 0.001) compared to untreated patients. No difference in decline in IBS-SS was seen comparing the treatment and non-treatment groups at T1 (p = 0.403) or T2 (p = 1.00). A short and long term increased parasitological clearance is shown with treatment of clioquinol or metronidazole compared with no treatment. A clear and significant correlation between parasitological cure and decline of clinical complaints as reported by the participants could not be established.

Noninvasive Early Detection of Systemic Inflammatory Response Syndrome of COVID-19 Inpatients Using a Piezoelectric Respiratory Rates Sensor.

In 2020, 20% of patients with COVID-19 developed severe complications, including life-threatening pneumonia with systemic inflammatory response syndrome (SIRS). We developed a preliminary SIRS monitor that does not require blood sampling, is noninvasive, and can collect data 24 h per day. The proposed monitor comprises a piezoelectric respiratory sensor located beneath the patient's mattress and a fingertip pulse sensor that determines ultra-high accuracy respiratory rate (mode of a 40-min frequency distribution of respiratory rates (M40FD-RR)). We assessed the clinical performance of the M40FD-RR preliminary SIRS monitor in 29 patients (12 female, 17 male, aged 15-90 years) hospitalized at Suwa Central Hospital with COVID-19, which was confirmed by a positive polymerase chain reaction test. SIRS was evaluated by logistic regression analysis using M40FD-RR, heart rate, age, and sex as explanatory variables. We compared the results of 109 examinations of 29 COVID-19 inpatients with SIRS against those determined by the proposed monitor. The proposed monitor achieved 75% sensitivity and 83% negative predictive value, making it a promising candidate for future 24 h noninvasive preliminary SIRS tests.

Neurodevelopment in the First 2 Years of Life Following Prenatal Exposure to Maternal SARS-CoV-2 Infection

The effects of prenatal exposure to SARS-CoV-2 infection on child development throughout the first 2 years of life are unknown. To evaluate whether prenatal exposure to SARS-CoV-2 infection was associated with child neurodevelopmental outcomes during the first 2 years of life. This cohort study used data from the longitudinal, population-based pan-Canadian Pregnancy During the COVID-19 Pandemic cohort, which recruited participants from April 2020 to July 2022. Children were categorized as exposed to prenatal SARS-CoV-2 infection if their birthing parent had a positive polymerase chain reaction test performed by a health authority or as a healthy negative comparison if their birthing parent did not have SARS-CoV-2 antibodies in their postpartum dried blood spot sample. Prenatal SARS-CoV-2 infection. The birthing parent reported on their child's temperament at ages 6 and 24 months, developmental milestones at ages 12 and 24 months, and social-emotional milestones at ages 12 and 24 months. A total of 896 children were included, with 96 children who had been exposed to a prenatal SARS-CoV-2 infection (mean [SD] gestational age at birth, 39.20 [1.50] weeks; 45 [47%] male) and 800 were healthy negative comparisons (mean [SD] gestational age at birth, 39.47 [1.54] weeks; 388 [49%] male). In analyses of covariance adjusted for prepregnancy medical conditions and household socioeconomic status, prenatal exposure to SARS CoV-2 infection was associated with slightly higher regulatory control scores, indicating more regulation, at age 6 months (difference in means, 0.19 [95% CI, 0.02-0.36]; P = .03; ηp2 = 0.01). No significant differences were observed for the other neurodevelopmental outcomes. In mixed models adjusted for the same covariates that aimed to examine change in outcomes over time, prenatal SARS-CoV-2 infection exposure was not associated with developmental change in any neurodevelopmental outcomes between ages 6 and 24 months. In this longitudinal cohort study of multiple aspects of child neurodevelopment between ages 6 and 24 months, negligible associations between prenatal exposure to SARS-CoV-2 infection and child outcomes were observed. Follow-up research is warranted to determine whether these predominantly null effects persist into later childhood.

Tendência temporal dos casos confirmados de COVID-19 em crianças, adolescentes e adultos de São Carlos - SP entre 2020 e 2021: um estudo de série temporal

Introduction: COVID-19 behavior in childhood was different from that of adults and the evaluation of these cases and their trend over time was poorly explored. Also, lethality in the disease in the pediatric population was observed, highlighting the importance of studies in this population. Objective: To analyze the temporal trend in COVID-19-confirmed cases in children and adolescents and compare it to adults in São Carlos. Methods: A time-series study was conducted between February 2020 and March 2021 in São Carlos, SP, Brazil, comparing children and adolescents to adults, both with a positive reverse transcription polymerase chain reaction (RT-PCR) test, in the Epidemiology Surveillance database. Time was split at the 38th epidemiological week (periods 1 and 2). The data were analyzed using a Prais–Winsten generalized linear regression model, considering a p-value &lt; 0.05. The e-SUS database was investigated in the same period, to evaluate clinical cases in children and adolescents’ characteristics. Results: Three thousand and sixteen RT-PCR tests were performed on children and adolescents, and 791 (26.0%) were positive. There was a rising trend of cases, and the comparison between the periods revealed a 2.5-fold increase for children and adolescents and a 3.0-fold increase for adults. Conclusion: There was a rising trend in cases that was comparable between children, adolescents, and adults. This result helps the knowledge about the transmission in children, adolescents, and adults, at the local level. This way, it contributes to the construction of preventive interventions that are necessary and related to public policies.

Role of admission rapid antigen testing (RATs) for COVID-19 on patients transferred from acute hospitals to a postacute rehabilitation setting

Rapid antigen tests (RATs) are suitable for point-of-care testing, require no laboratory time, and give immediate results. However, are RATs useful for detecting asymptomatic COVID-19 infection when compared with polymerase chain reaction (PCR) testing in health care settings? RAT testing was carried out on all new admissions without a history of confirmed COVID-19 infection within 3months of admission. PCR testing was carried out on all patients with a positive RAT for confirmation purposes. The cycle thresholdvalues of COVID-19-detected results on PCR testing were examined to determine the utility of the RATs. A total of 1,403 patients were transferred to the postacute rehabilitation unit from January to December 2023. The results of the study revealed an 85% accuracy of RATs with a 15% rate of false-negative results at the time of admission. All patients who had a positive RAT at the time of admission also had a positive PCR test. This testing algorithm resulted in early detection and prompt isolation of positive cases reducing the likely spread of COVID-19 infection, hospital outbreaks, and bed/ward closures.

Fowl adenovirus 8a isolated from chickens with runting and stunting syndrome induces inclusion body hepatitis and hepatitis-hydropericardium syndrome in chicken embryos.

Fowl adenovirus (FAdV) is the etiological agent of inclusion body hepatitis (IBH) and hepatitis-hydropericardium syndrome (HHS) in poultry. It is also detected in chickens with runting and stunting syndrome (RSS). FAdV has been detected worldwide, and genotypes 8a, 8b, and 11 have been identified in chickens with enteric problems in Brazil. Nevertheless, none of them have been isolated; therefore, these viruses propagate; thus, the viral behavior and pathogenicity are unknown in Brazil. This study aimed to isolate FAdV from the enteric content of chickens affected by RSS. Enteric content samples from chickens affected with RSS and a positive polymerase chain reaction (PCR) test for FAdV were inoculated into specific pathogen-free chicken embryonated eggs (CEEs) through the yolk and chorioallantoic membrane routes on 8 and 10 days of age, respectively and the eggs were incubated for five days for viral isolation. The embryos exhibited dwarfism, beak atrophy, and pale claws. In addition, some embryos displayed edema and gelatin-like characteristics. The liver exhibited hepatomegaly and multiple necrotic foci, resembling the appearance of nutmeg. In addition, the kidneys appeared enlarged and pale. After 8 days of incubation, the hearts of the inoculated embryos showed hydropericardium. Microscopic evaluation revealed the presence of hepatitis, which was characterized by the presence of intranuclear inclusion bodies and cellular necrosis. Viral FAdV particles were observed in kidney cells using electron microscopy. Viral DNA was detected in the embryos in all three passages, and viral gene copies were also measured in some organs, with high FAdV gene copies detected in the spleen and bursa beyond the liver. The molecular characterization of FAdV revealed that the isolated strain belonged to genotype 8a of FAdV. Here, FAdV-8a from chickens infected with RSSs produced IBH/HHS in CEE, and FAdV-8a detected in RSS outbreaks, in addition to producing IBH/HHS in chicken embryos, could be a possible viral agent that causes IBH/HHS in chickens.

Relation Between Monocyte-to-lymphocyte Ratio and Depressive Symptoms in Patients with Non-severe COVID-19 Infection

Background and Aim: Mental health of non-hospitalized patients and those with non-severe infections has attracted lower attention in comparison to other patients. Circulating monocytes are deeply involved in all stages of COVID-19 infection. The present study aimed to investigate the relationship between monocyte-to-lymphocyte ratio (MLR) and depressive symptoms in patients with non-severe COVID-19 infection. Methods: The study included 312 patients with non-severe COVID-19 infection diagnosed on the basis of a positive reverse-transcriptase polymerase chain reaction (RT-PCR) test of nasopharyngeal swabs. Depressive symptoms were assessed using the validated Arabic version of the 7-item Hamilton Depression Rating Scale (HAMD). According to the obtained scores, patients were classified to have mild (10-13), moderate (14-17), or severe depression (&gt;17). Results: The present study included 312 patients with non-severe COVID-19. According to HAMDS, clinically significant depression was diagnosed in 144 patients (46.2 %). They comprised 38 patients (12.2 %) with mild depression, 30 patients (9.6 %) with mild-tomoderate depression and 76 patients (24.4 %) with moderate-to-severe depression. Multivariate logistic regression analysis identified male sex [OR (95% CI): 2.07 (1.27-3.36), p = 0.003], presence of dyspnea [(OR (95 % CI): 1.99 (1.21-3.27), p = 0.007], D dimer levels [OR (95% CI): 2.32 (1.19-4.52), p = 0.013], MLR [OR (95% CI): 0.52 (0.28-0.99), p = 0.046] and abnormal CT findings [OR (95% CI): 1.79 (1.08-2.95), p = 0.023] as significant predictors of depression in the studied patients. Conclusion: Low MLR is related to depressive symptoms in patients with non-severe covid-19 infection. Other predictors include male sex, dyspnea, abnormal CT findings and elevated D-dimer levels.

Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries: an international retrospective cohort study using routinely-collected data

The World Health Organisation (WHO) has identified a range of symptomatic manifestations to aid in the clinical diagnosis of post-COVID conditions, herein referred to as post-acute COVID-19 symptoms. We conducted an international network cohort study to estimate the burden of these symptoms in North American, European, and Asian populations. A federated analysis was conducted including 10 databases from the United Kingdom, Netherlands, Norway, Estonia, Spain, France, South Korea, and the United States, between September 1st 2020 and latest data availability (which varied from December 31st 2021 to February 28th 2023), covering primary and secondary care, nationwide registries, and claims data, all mapped to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). We defined two cohorts for the main analyses: a SARS-CoV-2 infection cohort [positive polymerase chain reaction (PCR) or rapid lateral flow test (LFT) result or clinical COVID-19 diagnosis] and a general population cohort. Individuals with less than 365 days of prior history or 120 days of follow-up were excluded. We estimated incidence rates (IRs) of the 25 WHO-proposed post-acute COVID-19 symptoms, considering symptoms that occurred ≥90 and≤365 days after index date, excluding individualswith the respective symptoms 180 days prior to the index event. Stratified analyses were conducted by ageand sex. Incidence rate ratios (IRRs) were calculated comparing rates in the infected cohort versus the general population. Results from the different databases were combined using random-effects meta-analyses. 3,019,408 individuals were included in the infection cohort. 1,585,160 of them were female and 1,434,248 of them male. 929,351,505 individuals were included in the general population group. 461,195,036 of them were female and 466,022,004 of them male. The 1-year IR of any post-acute COVID-19 symptom in the COVID-19 infection cohort varied significantly across databases, from 4.4 (95% CI 3.8-5.1) per 100 person-years to 103.9 (95% CI 103.2-104.7). The five most common symptoms were joint pain (from 1.6 (95% CI 1.3-1.9) to 14.3 (95% CI 14.1-14.6)), abdominal pain (from 0.3 (95% CI 0.1-0.5) to 9.9 (95% CI 9.7-10.1)), gastrointestinal issues (from 0.6 (95% CI 0.4-0.9) to 13.3 (95% CI 13.1-13.6)), cough (from 0.3 (95% CI 0.2-0.5) to 9.1 (95% CI 8.9-9.3)), and anxiety (from 0.8 (95% CI 0.6-1.2) to 11.4 (95% CI 11.2-11.6)); whereas muscle spasms (from 0.01 (95% CI 0.008-0.2) to 1.7 (95% CI 1.6-1.8)), pins and needles (from 0.05 (95% CI 0.03-0.0.9) to 1.5 (95% CI 1.4-1.6)), memory issues (from 0.03 (95% CI 0.02-0.06) to 0.8 (95% CI 0.7-0.8)), cognitive dysfunction (from 0.007 (95% CI 0.004-0.01) to 0.6 (95% CI 0.4-0.8)), and altered smell and/or taste (from 0.04 (95% CI 0.03-0.04) to 0.7 (95% CI 0.6-0.8)) were least common. Incidence rates of any post-acute COVID-19 symptoms generally increased with age, with certain symptoms peaking in middle-aged adults (anxiety, depressive disorders, headache, altered smell and taste) and others in pre-school children (gastrointestinal issues and cough). Females had higher incidence rates for most symptoms. Based on the random-effects model, the infected cohort had a higher incidence of any post-acute COVID-19 symptom than the general population, with a meta-analytic incidence rate ratio (meta-IRR) of 1.4 (1-2). A similar pattern was seen for all individual symptoms. The highest meta-IRRs were depressive disorder, 2.6 (1.7-3.9); anxiety, 2.3 (1.4-3.8); allergy, 2.1 (1.7-2.8) and sleep disorders, 2.1 (1.5-2.6). The meta-IRR for altered smell and/or taste was 1.9 (1.3-2.8). Post-acute COVID-19 symptoms, as listed by the WHO, were commonly observed following COVID-19 infection. However, even after standardising research methods, there was significant heterogeneity in the incidence rates from different healthcare settings and geographical locations. This is the first international study of the epidemiology of post-acute COVID-19 symptoms using the WHO-listed symptoms. Its findings contibute to understand the epidemiology of this condition from a multinational approach. Limitations of this study include the lack of consensus of the post-acute COVID-19 definition, as well as the difficulty to capture the impact on daily life of the post-acute COVID-19 symptoms in the available datasets. This work has been funded by the European Health Data Evidence Network (EHDEN) through an Evidence Generation Fund Grant and by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre (BRC).