Respiratory Syndrome Coronavirus Infection Research Articles

Therapeutic and Diagnostic Approaches by using Nanotechnology in SARS-CoV-2 Infections

Severe Acute Respiratory Syndrome Corona Virus-2 infection is a universal threat in recent days, hence early diagnosis and treatment play a pivotal role in controlling the spread thereby preventing them to become endemic. A newer promising approach by Nanotechnology plays an essential role in targeting the specific pathogens for therapeutic and diagnosis of Viral infection. Certain Nano platforms like Microneedle array delivered Virus S1 subunit vaccines, spike protein nanoparticles, Lumazine synthase Nanoparticles, Silver Nanoparticles, Self-Assembling Protein Nanoparticles against Viral therapy are the upcoming applications as a therapeutic approach. Nucleic acid amplification techniques and Surface-enhanced Raman Spectroscopy shows a high specificity with the immunoassay strategy. In recent days, Colloidal Gold – Nanoparticles and silicon nanoparticles have been widely used as a point of care for quick detection of IgG and IgM antibodies obtained from the virus as a diagnostic approach. Additionally, the Nanoparticles serve as a significant improvement in Personal Protective Equipment and protect against exposure to the virus. As a result of repurposing as well as for the development of the drug, apparently, Nanoparticles themselves and their concomitant therapy or their carriers will be advantageous in making a therapeutic and diagnostic approach against Severe Acute Respiratory Syndrome Corona Virus-2 infections.

CTPA imaging findings, beyond pulmonary embolism, in patients with Severe Acute Respiratory Syndrome Corona Virus-2 infection and their relation to clinical outcome - a single center experience.

The aim of our study was to investigate a potential association between the severity of COVID-19 disease and related 28-day mortality, with the presence of mediastinal lymphadenopathy, the extension of lung parenchymal infiltrates, the presence of pulmonary embolism, the density and distribution of mediastinal and subcutaneous fat, the inflammatory markers and the direct and indirect radiological signs of right heart overload and strain. We retrospectively included patients diagnosed with SARS-CoV-2 infection, who were admitted to the Departments of Internal and Respiratory Medicine of Patras University Hospital during the second pandemic wave (February 2021 up to July 2021) and underwent CTPA for routine diagnostic workup. Demographic characteristics, routine laboratory, radiological parameters and 28-day mortality were also recorded. Fifty-three consecutive patients were included. The mean age was 64.47±17.1 years and 64,1% (n=34) were males. Pulmonary embolism (PE) (p=0.019), Right Ventricle-to-Left Ventricle Diameter (RV/LV) Ratio>1 (p<0.01), Reverse Flow in Hepatic Veins (RFHV) (p=0.019), higher density in subcutaneous fat (-99 HU vs. -104HU, p=0.016), increased Lactic Dehydrogenase (LDH), Polymorphonuclear cells (PMN), ferritin, and d-dimer levels (534 vs. 367 U/L, p=0.001, 9220 vs. 5660 Κ/μL, p=001, 956 vs. 360 ng/ml, p=0.005 and 2300 vs. 1040 μg/ml, p=0.003, respectively) were statistically significant related with worse 28-day mortality. Binomial multivariate regression analysis revealed that only RV/LV diameter>1, higher subcutaneous fat density and higher LDH values were independently associated with increased 28-day mortality (OR: 82.9, 95%CI: 1.334-5158, p=0.036, OR: 1.2, 95%CI: 1.016-1.426, p=0.032 and OR:1.016, 95% CI:1.004-1.029, p=0.011, respectively). Subgroup analysis revealed that mediastinal lymph node enlargement (EML) and PE were associated to increased Pulmonary Disease Severity Index (PDSI) score (p=0.042 and p=0.007, respectively), but not to mortality. Our study showed that right heart strain as depicted by a RV/LV diameter>1, higher subcutaneous fat density and higher LDH values are independently associated with an increased 28-day mortality in our SARS-COV2 patient group.

Assocıatıon of serum urıc acıd level wıth dısease severıty and clınıcal outcomes ın COVID-19

Abstract. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is likely to cause uric acid dysregulation, resulting in abnormal serum uric acid concentrations. In this study, we aimed to evaluate the associations between admission serum uric acid levels and demographic, clinical and laboratory features of patients hospitalized with Coronavirus disease 2019 (Covid-19) and to explore the effect of admission serum uric acid values on clinical outcomes.&#x0D; Methods. In this retrospective study, the demographic, clinical and laboratory data of patients with confirmed Covid-19 were collected from the electronic health records of the hospital. The study population was stratified according to the quartiles of serum uric acid; Quartile 1: ≤ 3.5 mg/dl, Quartile 2: 3.6 mg/dl to 6 mg/dl for women and 3.5 mg/dl to 7 mg/dl for men, Quartile 3: ≥ 6 mg/dl for women and ≥ 7 mg/dl for men. The outcomes were the development of acute kidney injury (AKI) and in-hospital mortality.&#x0D; Results. 146 patients were included in the analysis. The median age of patients was 57 (IQR, 49-65) years and 70.5% were male. The overall median serum uric acid level on admission was 4.4 (IQR, 3.5-5.9) mg/dl. Participants in the highest serum uric acid quartile were significantly more hypertensive, and diabetics and showed significantly higher estimated glomerular filtration rate (eGFR) and troponin T levels compared to patients in the lowest serum uric acid quartile. On the other hand; patients in the lowest serum uric acid quartile were admitted with more severe disease than patients with Quartile 2. During follow-up, 19 (13.1%) participants experienced AKI and 15 (10.3%) died. There were significantly positive correlations between AKI and age, hypertension, serum creatinine (SCr), hyperuricemia, C-reactive protein (CRP) and Troponin T (r=0.263, P=0.001; r=0.192, P=0.02; r=0.182, P=0.028; r=0.235, P = 0.004; r=0.219, P=0.008; r=0.236, P=0.004, respectively). A significantly negative correlation was noted between AKI and eGFR (r=-0.189, P=0.023). According to multivariate logistic regression analysis, AKI development was independently associated with CRP and hyperuricemia (OR, 1.009; 95% CI, 1.0082-1.016, P=0.009 and OR, 4.314; 95% CI, 1.190-15.633, P=0.026). The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the concentration of serum admission uric acid was 0.693 (95% CI 0.537–0.849, P=0.006) and the cutoff value was 5.45 mg/dl (sensitivity: 68.4%; specificity: 75.6%).&#x0D; Conclusions. Hyperuricemia and increased CRP were independent risk factors for the development of AKI. Although patients with lower uric acid values developed more severe symptoms, mechanical ventilation and mortality rates were not found to be significantly different among patients with Covid-19 grouped based on admission serum uric values. Following the patients admitted with high uric acid levels closely in terms of renal functions would be helpful for early detection of AKI.

Can diffusion tensor imaging (DTI) outperform standard magnetic resonance imaging (MRI) investigations in post-COVID-19 autoimmune encephalitis?

BackgroundNeurological and psychiatric manifestations related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are widely recognised. Standard magnetic resonance imaging (MRI) investigations are normal in 40–80% of symptomatic patients, eventually delaying appropriate treatment when MRI is unrevealing any structural changes. The aim of this study is to investigate white matter abnormalities during an early stage of post-COVID-19 (coronavirus disease 2019) encephalitis while conventional MRI was normal.MethodsA patient with post-COVID-19 autoimmune encephalitis was investigated by serial MRIs and diffusion tensor imaging (DTI). Ten healthy control individuals (HC) were utilised as a control group for the DTI analysis. Major projection, commissural and association white matter pathways were reconstructed, and multiple diffusion parameters were analysed and then compared to the HC average using a z-test for serial examinations.ResultsEleven days after the onset of neurological symptoms, DTI revealed early white matter changes, compared with HC, when standard MRI was normal. On day 68, DTI showed multiple white matter lesions compared with HC, visible at this time also by the MRI images, indicating inflammatory changes in different association and projection white matter pathways.ConclusionWe confirm a limitation in the sensitivity of conventional MRI at the acute setting of post-COVID-19 autoimmune encephalitis. A complementary DTI investigation could be a valuable diagnostic tool in early therapeutic decisions concerning COVID-19-related neurological symptoms.

Maternal and neonatal outcomes among women with and without severe acute respiratory syndrome corona virus-2 infection: A retrospective analytical study.

BackgroundCorona virus disease (COVID-19) is an infectious disease caused by the novel corona virus known as severe acute respiratory syndrome corona virus 2 (SARS Cov-2). Physiological changes occurring during pregnancy can have a positive or negative effect on the disease progression. The objective of the study was to evaluate the maternal and neonatal outcomes in pregnant women with COVID-19 compared to pregnant women without COVID-19 and to determine its influence on the healthcare system.Material and methodsThis was a retrospective analytical study conducted at a tertiary care hospital in Odisha, India, over 3 months, from 1 September 2020 until 30 November 2020. Results were compared in both groups.ResultsThree hundred and three (303) women delivered, out of whom 92 were COVID-19 positive. Incidence of COVID-19 positivity was 30.3% with 93.47% asymptomatic patients. The majority of the patients were 26–35years of age. Average gestational age at delivery for both groups was 37–40 weeks. COVID-19 positivity was seen more in primigravidas than in multigravidas. Comorbidities such as GDM/type 2 DM, PIH, PROM, APH and jaundice were similar in both groups and statistically non-significant, whereas association of anaemia and hypothyroidism were statistically significant (p<0.05) in the positive group. A single maternal death was reported in the positive group. There was an increase in Caesarean section (p=0.002) with higher incidence of preterm births and lowbirth weights in the positive group. Only 3 babies tested positive for COVID-19, so vertical transmission probability was low. Overall, all babies were healthy and the majority of women were discharged without any complications.ConclusionThere was no significant effect of the infection on maternal and fetal outcomes, but further studies and long-term follow-up is needed to look for any delayed effects on the babies and mothers.

Immunohistochemical Expression of VDR in Myocardium: Postmortem Evaluation of COVID-19 Patients.

Morphological data on heart damage and its mechanisms due to extremely severe course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are limited, as well as data on the correlation of damage and expression of vitamin D receptors (VDRs). In this study, we analyzed a series of myocardial samples obtained during postmortem autopsy of 48 critically ill patients with COVID-19 who died with SARS-CoV-2-associated pneumonia. The purpose of the study was to evaluate immunohistochemical VDR expression in the myocardium. The results showed the only minimal or no immunohistochemical expression of VDR in the nuclei of cardiomyocytes in most cases, along with the persisted strong expression in lymphoid cells. To the best of our knowledge, it is the first study and data provided were regarding myocardial VDR expression in COVID-19 patients. The results are of interest in terms of further study of the effects of ligand-associated VDR activation on the cardiovascular system.

931. Epidemiology and Clinical Outcomes of SARS-CoV-2 Infection Among Pediatric Solid Organ Transplant Recipients: A Single-Center Case Experience

BackgroundThe impact of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among pediatric solid organ transplant (SOT) recipients remains unclear. We sought to characterize the clinical epidemiology and outcomes following SARS-CoV-2 infection among pediatric SOT recipients in Dallas, TX. MethodsRetrospective review of all SOT recipients with laboratory confirmed COVID-19 infection from March 1, 2020 –March 31, 2021. Demographic, clinical, and outcome data were stratified by transplant type and disease severity. Fischer’s exact test and Kruskall-Wallis test were used to evaluate risk factors for more severe disease among hospitalized children.ResultsTwenty-six SOT recipients with a median age of 14 years were included in the study. Fifteen (58%) were female, eighteen (69%) were Hispanic and thirteen (50%) were overweight/obese. Median time post-transplant was 3.6 years (1311 days, interquartile range (IQR) 394-2881). Fourteen patients were liver recipients, seven kidney, three heart, and two multiorgan. The majority of patients (65%) had a known community exposure and presented with fever (50%), cough (38%) and GI symptoms (19%). Half of all cases were hospitalized (n=13), with 2 requiring intensive care unit (ICU) admission, but no patients required positive pressure ventilation. Median hospital stay was 3 days. Five of the thirteen hospitalized patients were categorized as having moderate disease. No patients developed severe disease and there were no deaths. Older children, as well as children with multiple co-morbidities were noted on univariate analysis to be at higher risk for moderate, as compared to mild, disease. ConclusionSARS-CoV-2 infection among pediatric SOT recipients are at increased risk for hospital admission but demonstrate an overall mild /moderate disease course. Larger studies are required to elucidate the risk of morbidity between pediatric SOT recipients and immunocompetent children with SARS-CoV-2.Disclosures Amal Aqul, MD, Albireo pharma Inc. (Consultant)

385. SARS-CoV-2 Infections Among Military Personnel Deployed on the USNS COMFORT to New York City During the COVID-19 Pandemic and One-Year Follow-Up

BackgroundThe USNS COMFORT deployed to New York City to augment the inpatient health care capacity in March 2020. The aim of this study was to determine the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among US Navy personnel upon return from deployment, and to identify incident cases of SARS-CoV-2 infection during 1 year of follow-up.MethodsCrewmembers, the majority of whom were health care workers (HCW), were enrolled following deployment, in May 2020. PCR results from symptomatic crewmembers during deployment, and Day 0 and Day 14 post-deployment screening swabs conducted on all crewmembers, per military order, were abstracted. A questionnaire and serum were collected on Day 14 post-deployment. SARS-CoV-2 infection was defined as a positive SARS-CoV-2 spike glycoprotein immunoglobulin G antibody (IgG) or PCR. COVID-19 related medical encounters, PCR and antibody testing results within 1 year following deployment were abstracted from the Military Health System Data Repository (MDR). There was adequate provision of personal protective equipment (PPE) in the hospital and the COVID-19 vaccine roll-out for HCW began in December 2020. ResultsOf the 1200 crewmembers, 449 were enrolled and completed the questionnaire and screening swabs, and 432 (96.2%) completed the Day 14 blood draw (Table 1). The cumulative prevalence of SARS-CoV-2 infection was 3.01% (13/432; 95% CI, 1.61%–5.09%). One of 17 subjects did not complete the blood draw and was PCR positive on Day 14. 433/449 (96.4%) had a PCR performed during the follow-up period (i.e. after the Day 14 post-deployment visit until Feb 2021), for HCW screening or symptomatic illness (median number of tests: 2 [IQR: 1, 2; range: 1,6]). 25 of 433 (5.8%) were PCR positive (Fig 1). 19 (76.0%) occurred in corpsmen, 23 (92.0%) were symptomatic and none were hospitalized. One asymptomatic re-infection occurred in a crewmember who was PCR negative and IgG positive at Day 14 post-deployment. Table 1. Characteristics of the overall cohort and by SARS-CoV-2 infection Figure 1. Number of PCR tests (bar graph) and positivity rate (red line) by month in 449 USNS COMFORT crewmembers during 1-year follow-up after return from deployment ConclusionThe post-deployment prevalence of SARS-CoV-2 infection was low. A high proportion of HCW underwent PCR testing during 1-year follow-up but a low incidence of infection was observed. This was likely from community transmission as nosocomial transmission was mitigated by adequate PPE and vaccine roll-out. Disclosures All Authors: No reported disclosures

481. SARS-CoV-2 Infection in Hospitalized Children: An Elevated Body Mass Index is a Marker of Increased Risk of Acute Respiratory Failure

BackgroundSeveral risk factors are known to increase the severity of coronavirus disease 2019 (COVID-19) illness in adults, including age and obesity. Specific comorbidities affecting COVID-19 outcomes in children are less well defined. MethodsWe performed a retrospective cohort study of overweight and obese (OW) children compared to underweight and normal weight (NW) children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Children between 2 and 18 years of age who were admitted to Texas Children’s Hospital from April through December of 2020 with a positive SARS-CoV-2 polymerase chain reaction test were included. Asymptomatic patients undergoing surveillance testing for SARS-CoV-2 were excluded. Body mass index (BMI) was calculated using the Centers for Disease Control definition. Demographic and clinical information was obtained from the electronic medical record. Statistical analyses were performed using SAS 9.0. ResultsWe identified 145 total children who met inclusion criteria. Fifty-five (38%) children were NW and 90 (62%) children were OW. Demographics and characteristics are shown (Figure 1). Underlying asthma or chronic lung disease was present in 13 (24%) vs 31 (34%) in the NW and OW groups respectively (P=0.17). OW children were more likely to have pneumonia than NW children [relative risk1.6 (CI 1.40-2.45)]. An elevated BMI was also associated with an increased risk of requiring oxygen [relative risk 1.4 (CI 1.03-1.96)]. The median length of hospitalization was 4 days for NW versus 5 days for OW children (P=0.6). Admission to the Intensive Care Unit (ICU) was similar between the groups (P=0.7). There was no significant difference in treatments administered to children in the two groups, although there was a trend towards increased steroid (29 (53%) vs 59 (67%), P=0.13) and remdesivir (12 (22%) vs 30 (33%), P=0.14) use in the OW children. Four children in each group died. Characteristics of Hospitalized Children with SARS-CoV-2 Infection by Weight Category Abbreviations: ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; MIS-C, multisystem inflammatory syndrome in children; MV, mechanical ventilation; NC, nasal cannula *Denotes statistically significant P-value a. Calculated using chi-square or fisher exact unless otherwise noted. a. Calculated using chi-square or fisher exact unless otherwise noted. A P-value <0.05 was considered significant. b. Calculated using Wilcoxon rank sum test. c. Includes patients with home noninvasive MV (2) or tracheostomy and home MV(4).ConclusionFor children admitted with symptomatic COVID-19, being overweight or obese was significantly associated with having pneumonia and with requiring oxygen. A difference in ICU admission, length of hospitalization, and mortality was not observed. Obesity prevention along with vaccination efforts may prevent COVID-19 related morbidity in this group. Disclosures All Authors: No reported disclosures

VALIDATION OF ANTIBODY RAPID TEST FOR SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 INFECTION IN BETHESDA HOSPITAL YOGYAKARTA

Since March 2020, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection has been around in Indonesia with a case fatality rate was 4.7% on August, 1th 2020. So far, the Real-Time Polymerase Chain Reaction (RT-PCR) method is the gold standard for the SARS-CoV-2 infection diagnosis. This method, however, has some limitations where it has a long turnaround time, complicated operations, and high prices. Hence, the rapid test kits are now readily available to identify the SARS-CoV-2 patients. The purpose of this study is to measure the diagnostic performance, including sensitivity, specificity, positive and negative predictive value, likelihood ratio or LR of antibody rapid test if compared with RT-PCR for the SARS-CoV-2 suspected patients in Bethesda Hospital Yogyakarta. This research was analytical observational research with a cross-sectional design approach, in which data were collected retrospectively. The instruments used in this study included e-medical record (ERM), Laboratory Information System (LIS) data from patients with suspected SARS-CoV-2 infection in Bethesda Hospital Yogyakarta. We collected demographic data of patients, RT-PCR results, antibody rapid test results using Standard Q COVID-19 IgM/IgG Combo. The data were obtained from 50 patients. The results showed that the Rapid test kit has a 100% sensitivity value, 74.4% specificity value, 38.9% positive and 100% negative predictive value, 3906 positive likelihood ratio compared with the RT-PCR results.

Exploring secondary SARS-CoV-2 transmission from asymptomatic cases using contact tracing data

BackgroundIndividuals with asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can propagate the virus unknowingly and thus have been a focus of public health attentions since the early stages of the pandemic. Understanding viral transmissibility among asymptomatic individuals is critical for successful control of coronavirus disease 2019 (COVID-19). The present study aimed to understand SARS-CoV-2 transmissibility among young asymptomatic individuals and to assess whether symptomatology was associated with transmission of symptomatic vs. asymptomatic infections.MethodsWe analyzed one of the first-identified clusters of SARS-CoV-2 infections with multiple chains of transmission that occurred among university students in March 2020 in Kyoto prefecture, Japan, using discrete and two-type branching process models. Assuming that the number of secondary cases resulting from either primary symptomatic or asymptomatic cases independently followed negative binomial distributions, we estimated the relative reproduction numbers of an asymptomatic case compared with a symptomatic case. To explore the potential association between symptomatology and transmission of symptomatic vs. asymptomatic incident infections, we also estimated the proportion of secondary symptomatic cases produced by primary symptomatic and asymptomatic cases.ResultsThe reproduction number for a symptomatic primary case was estimated at 1.14 (95% confidence interval [CI]: 0.61–2.09). The relative reproduction number for asymptomatic cases was estimated at 0.19 (95% CI: 0.03–0.66), indicating that asymptomatic primary cases did not result in sufficient numbers of secondary infections to maintain chains of transmission. There was no apparent tendency for symptomatic primary cases to preferentially produce symptomatic secondary cases.ConclusionsUsing data from a transmission network during the early epidemic in Japan, we successfully estimated the relative transmissibility of asymptomatic cases of SARS-CoV-2 infection at 0.22. These results suggest that contract tracing focusing on symptomatic index cases may be justified given limited testing capacity.

Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Additional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

EFFECTS OF NOVEL CORONAVIRUS DISEASE-19 (COVID-19) ON VITAL ORGANS IN PATIENTS INFECTED WITH SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 (SARS-COV-2)

The world is now facing one of the most devastating public health concern where the 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is spreading all over the world initiating from Wuhan, China, started from December, 2019. The World Health Organization (WHO) already announced the situation as pandemic all over the world. According to the webpage of WHO, this SARS-CoV-2 has been spreading all over the world (223 countries, areas or territories) with 126,890,643 of confirmed cases and 2,778,619 of confirmed deaths(as time of March 30, 2021). Accumulated published documents indicate that the SARS-CoV-2 virus primarily affects the lungs causing hypoxia which is the leading cause of death. There are many reports describing that with the progress of this disease, many other organs (such as heart, kidney, liver, brain) of the affected person start to malfunction. Though SARS-CoV-2 uses the cell surface receptor angiotensin-converting enzyme 2 (ACE-2) expressed by lungs, cardiovascular system, kidneys but it is still not clear except lungs all these other organs are directly affected by this virus or not. Therefore, the aim of this review is to gather information about the affected/damaged organs or tissues and the consequences of this damage in the COVID-19 patients.&#x0D; &#x0D; Peer Review History: &#x0D; Received 11 March 2021; Revised 8 April; Accepted 23 April, Available online 15 May 2021&#x0D; UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. &#x0D; Received file: Reviewer's Comments:&#x0D; Average Peer review marks at initial stage: 6.0/10&#x0D; Average Peer review marks at publication stage: 7.0/10&#x0D; Reviewer(s) detail:&#x0D; Dr. Vanina Doris Edo’o, &#x0D; University of Yaounde I, Yaounde, Cameroun, vanina_edoo@yahoo.com&#x0D; Idoko Alexander,&#x0D; Caritas University, Enugu, Nigeria, idokoalexander1@gmail.com&#x0D; Similar Articles:&#x0D; COVID-19: PHARMACOLOGICAL AND THERAPEUTIC APPROACHES&#x0D; USE OF COLCHICINE TO COUNTERACT THE STRONG HYPERINFLAMMATORY STATE INDUCED BY SARS-COV-2 &#x0D; THE RISKS AND ADVANTAGES OF ANTI-DIABETES THERAPY IN THE POSITIVE COVID-19 PATIENT

Prevalence and significance of mediastinal lymphadenopathy in patients with Severe Acute Respiratory Syndrome Corona Virus-2 infection.

Severe Acute Respiratory Syndrome Corona Virus-2 is the causative factor of Coronavirus Disease 2019. Early in the pandemic, mediastinal lymphadenopathy was not considered to be a significant radiologic finding of the SARS-COV-2 disease. Nevertheless, most recent studies associate mediastinal lymphadenopathy with more severe COVID-19 disease and poorer patient outcomes.

Characteristic Cerebral Venous Thrombosis (CVT) in COVID-19: A Systematic Review

&#x0D; Cerebral venous thrombosis (CVT) is one of the diagnoses reported in coronavirus disease 2019 (COVID-19 patients). Meanwhile, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has the potential to cause endothelial dysfunction, increase thrombin generation and inhibit fibrinolysis. This causes hyper coagulopathy, with the potential to become CVT. Therefore, this study aims to determine the characteristics of CVT cases in COVID-19 patients. This systematic review refers to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) guidelines. The articles were obtained systematically from online databases, Pubmed, Science Direct, as well as Google Scholar, using the search keywords ("COVID 19" OR "SARS-CoV-2 infection" OR "COVID-19 virus disease" OR "2019-nCoV infection" OR "coronavirus disease 2019" OR "coronavirus disease-19" OR "2019- nCoV disease "OR" COVID-19 virus infection") AND" cerebral venous thrombosis " as well as " cerebral venous thrombosis ". After deduplication, eligibility criteria selection and critical assessment on journals, the study reviewed eight patients from four case reports and two case series. According to the characterization, CVT patients with COVID-19 had a mean age of 42.4 years, were mostly male, tended to be cryptogenic, as well as varied neurological symptoms, and increased D-Dimer in most cases. All patients showed CVT features on imaging and were treated using mostly anticoagulants. Five out of the eight patients (50%) died.

RNA-extraction-free diagnostic method to detect SARS-CoV-2: an assessment from two states, India

AbstractWith increasing demand for large numbers of testing during the coronavirus disease 2019 pandemic, alternative protocols were developed with shortened turn-around time. We evaluated the performance of such a protocol wherein 1138 consecutive clinic attendees were enrolled; 584 and 554 respectively from two independent study sites in the cities of Pune and Kolkata. Paired nasopharyngeal and oropharyngeal swabs were tested by using both reference and index methods in a blinded fashion. Prior to conducting real-time polymerase chain reaction, swabs collected in viral transport medium (VTM) were processed for RNA extraction (reference method) and swabs collected in a dry tube without VTM were incubated in Tris–EDTA–proteinase K buffer for 30 min and heat-inactivated at 98 °C for 6 min (index method). Overall sensitivity and specificity of the index method were 78.9% (95% confidence interval (CI) 71–86) and 99% (95% CI 98–99.6), respectively. Agreement between the index and reference method was 96.8% (k= 0.83,s.e.= 0.03). The reference method exhibited an enhanced detection of viral genes (E, N and RNA-dependent RNA polymerase) with lower Ct values compared to the index method. The index method can be used for detecting severe acute respiratory syndrome corona virus-2 infection with an appropriately chosen primer–probe set and heat treatment approach in pressing time; low sensitivity constrains its potential wider use.

SARS-CoV-2 diagnosis: a single-centre experience.

The coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) on the 11th of March 2020. In Romania, there have been 983,217 confirmed cases and 24,386 deaths. We aim to show our experience at the Fundeni Clinical Institute in the diagnosis of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in both patients and health care personnel. Swab samples were collected for extraction of the SARS-CoV-2 RNA from 29380 patients and health care personnel. We have combined three real-time reverse transcription-polymerase chain reaction (RT-PCR) assays for the qualitative detection of SARS-CoV-2. Also, the presence of IgG against SARS-CoV-2 nucleoprotein was analyzed in 1068 patients and clinical staff using the chemiluminescence method. Other 50 people were screened post-vaccination for the presence of SARS-CoV-2 antibodies against the spike (S) protein, using the chemiluminescence method as well. The majority of confirmed cases were in adults, 71.3% of cases being registered in people aged 30-69 years. Most patients diagnosed with SARS-CoV-2 infection (83%) were admitted to the gastroenterology, hematology, and surgery wards. Our study showed that one-third of people developed antibodies against the nucleocapsid of SARS-CoV-2. SARS-CoV-2 IgG seroprevalence does not vary by gender or age. Also, we noticed the presence of antibodies against the SARS-CoV-2 spike protein in all 50 people post-vaccination that were tested two weeks after the second dose. Due to the increasing number of infected patients with SARS-CoV-2, the new coronavirus pandemic involves a sustained testing effort for an accurate virological diagnosis in both direct and indirect diagnosis.

Thromboelastography clot strength profiles and effect of systemic anticoagulation in COVID-19 acute respiratory distress syndrome: a prospective, observational study.

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection may yield a hypercoagulable state with fibrinolysis impairment. We conducted a single-center observational study with the aim of analyzing the coagulation patterns of intensive care unit (ICU) COVID-19 patients with both standard laboratory and viscoelastic tests. The presence of coagulopathy at the onset of the infection and after seven days of systemic anticoagulant therapy was investigated. Forty consecutive SARS-CoV-2 patients, admitted to the ICU of a University hospital in Italy between 29th February and 30th March 2020 were enrolled in the study, providing they fulfilled the acute respiratory distress syndrome criteria. They received full-dose anticoagulation, including Enoxaparin 0.5 mg·kg-1 subcutaneously twice a day, unfractionated Heparin 7500 units subcutaneously three times daily, or low-intensity Heparin infusion. Thromboelastographic (TEG) and laboratory parameters were measured at admission and after seven days. At baseline, patients showed elevated fibrinogen activity [rTEG-Ang 80.5° (78.7 to 81.5); TEG-ACT 78.5 sec (69.2 to 87.9)] and an increase in the maximum amplitude of clot strength [FF-MA 42.2 mm (30.9 to 49.2)]. No alterations in time of the enzymatic phase of coagulation [CKH-K and CKH-R, 1.1 min (0.85 to 1.3) and 6.6 min (5.2 to 7.5), respectively] were observed. Absent lysis of the clot at 30 minutes (LY30) was observed in all the studied population. Standard coagulation parameters were within the physiological range: [INR 1.09 (1.01 to 1.20), aPTT 34.5 sec (29.7 to 42.2), antithrombin 97.5% (89.5 to 115)]. However, plasma fibrinogen [512.5 mg·dl-1 (303.5 to 605)], and D-dimer levels [1752.5 ng·ml-1 (698.5 to 4434.5)], were persistently increased above the reference range. After seven days of full-dose anticoagulation, average TEG parameters were not different from baseline (rTEG-Ang p = 0.13, TEG-ACT p = 0.58, FF-MA p = 0.24, CK-R p = 0.19, CKH-R p = 0.35), and a persistent increase in white blood cell count, platelet count and D-dimer was observed (white blood cell count p < 0.01, neutrophil count p = 0.02, lymphocyte count p < 0.01, platelet count p = 0.13 < 0.01, D-dimer levels p= 0.02). SARS-CoV-2 patients with acute respiratory distress syndrome show elevated fibrinogen activity, high D-dimer levels and maximum amplitude of clot strength. Platelet count, fibrinogen, and standard coagulation tests do not indicate a disseminated intravascular coagulation. At seven days, thromboelastographic abnormalities persist despite full-dose anticoagulation.

Molecular Mechanisms Lead to Sex-Specific COVID-19 Prognosis and Targeted Therapies.

Clinical and epidemiological studies have identified male sex as an important risk factor for COVID-19 clinical outcomes and mortality. This raises the question as to how this risk factor can be addressed in the prognosis, clinical management, and the treatment of patients with Coronavirus disease 2019 (COVID-19). Currently, there are no guidelines or protocols to help alter the course of sex-specific COVID-19 prognosis, especially in severe disease presentations. This is partly due to the lack of research studies characterizing the differences in male vs. female host response to the severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) infection and a lack of a well-rounded understanding of the molecular mechanisms involved. Here, we discuss three distinct but interconnected molecular-level differences in males and females that likely play an essential role in the COVID-19 prognosis. We review interactions of SARS-CoV-2 with host cell angiotensin-converting enzyme 2 (ACE2) in the viral entry between males vs. females and discuss the differential regulation of the renin-angiotensin system (RAS) between the two sexes. Next, we present immune response disparities and how immune function and endocrine regulation may render males increasingly vulnerable to severe COVID-19. We describe the interconnected roles of these three regulatory systems in males and females in response to SARS-CoV-2 infection. Finally, we highlight the clinical implications of these mechanisms to patients with COVID-19 and propose putative targeted therapies that can help reduce COVID-19 severity in those critically ill.

Seroprevalence of SARS-CoV-2 IgG Antibodies in Corsica (France), April and June 2020.

Our aim was to assess the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection after the lockdown in a sample of the Corsican population. Between 16 April and 15 June 2020, 2312 residual sera were collected from patients with a blood analysis conducted in one of the participating laboratories. Residual sera obtained from persons of all ages were tested for the presence of anti-SARS-CoV-2 Immunoglobulin G (IgG) using the EUROIMMUN enzyme immunoassay kit for semiquantitative detection of IgG antibodies against the S1 domain of viral spike protein (ELISA-S). Borderline and positive samples in ELISA-S were also tested with an in-house virus neutralization test (VNT). Prevalence values were adjusted for sex and age. A total of 1973 residual sera samples were included in the study. The overall seroprevalence based on ELISA-S was 5.27% (95% confidence interval (CI), 4.33–6.35) and 5.46% (4.51–6.57) after adjustment. Sex was not associated with IgG detection. However, significant differences were observed between age groups (p-value = 1 E-5). The highest values were observed among 10–19, 30–39, and 40–49 year-old age groups, ranging around 8–10%. The prevalence of neutralizing antibody titers ≥40 was 3% (2.28–3.84). In conclusion, the present study showed a low seroprevalence for COVID-19 in Corsica, a finding that is in accordance with values reported for other French regions in which the impact of the pandemic was low.