Reverse Transcriptase-polymerase Chain Reaction Test Research Articles

Contact patterns between index patients and their close contacts and assessing risk for COVID-19 transmission during different exposure time windows: a large retrospective observational study of 450 770 close contacts in Shanghai

IntroductionTo characterise age-mixing patterns among index cases and contacts of COVID-19, and explore when patients are most infectious during the disease process.MethodsThis study examined all initial 90 885 confirmed index...

Association between pancreatic lipase levels and coronavirus disease 2019

Aims: Elevated pancreatic enzyme can be observed in the course of coronavirus disease-2019 (COVID-19) due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Here, we aimed to determine the frequency of lipase elevation in the course of COVID-19 and examine its effect on disease outcomes. 
 Methods: Of 42742 patients with the positivity of SARS-CoV-2 reverse transcriptase-polymerase chain reaction test (RT-PCR), 3167 undergoing lipase tests were included. The relationship between patients’ clinical features, development of acute pancreatitis (AP), and mortality rates was investigated. 
 Results: Higher lipase levels than normal limits were found in 399 (12.6%) patients. Lipase levels were three times higher than the normal limit in 119 (3.8%) patients; compared to the rest of the patients, patients’ age (62.8±17.9 vs 52.1±17.9 years, p

Prognostic Factors for Mortality in Adults Hospitalized With COVID-19 Infection in the Americas.

Many reports on COVID-19have highlighted an association between patient characteristics upon admission for COVID-19 and how they affect variable progressions of the disease severity and, ultimately mortality. In this cohort, we analyzed data from patients in the Americas who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, and were hospitalized. We retrieved data from identified studies selected from full-text screening to identify relevant patient demographics: age, gender, race, duration of hospital stay, and comorbidities. Data were assessed for consistency, missing values, presence of outliers, and implausible values were documented. Our analysis was performed by calculating the case fatality rates for data reported by the original authors within the studies. The primary outcome was mortality. Participants in the review were COVID-19 inpatients diagnosed through reverse-transcriptase polymerase chain reaction tests (RT-PCR) and above the age of 45 years in the North and South American continents. The study included 12,895 patients who were hospitalized with the COVID-19 infection, and an overall 14.4% in-hospital case-fatality rate was demonstrated. The prognostic factor with the most significant association for increased risk of in-hospital mortality in the elderly was having a high viral load of the COVID-19 virus with a case-fatality rate of 41.4%. In addition, being of Caucasian ethnicity and having the comorbidity of chronic obstructive pulmonary disease (COPD) were also associated with higher rates of mortality among elderly hospitalized patients with case-fatality rates of 40.8% and 35.7% respectively. Prognostic factors for COVID-19 mortality were determined by having a high viral load of the infection, being of Caucasian ethnicity, and having underlying pulmonary comorbidities such as COPD. In the future research should be undertaken to determine the underlying mechanisms behind these effects.

Diagnostic performance of the WHO definition of probable dengue within the first 5 days of symptoms on Reunion Island.

The relevance of the World Health Organization (WHO) criteria for defining probable dengue had not yet been evaluated in the context of dengue endemicity on Reunion Island. The objective of this retrospective diagnostic study was to evaluate the diagnostic performance of the 2009 WHO definition of probable dengue and to propose an improvement thereof. From the medical database, we retrieved the data of subjects admitted to the emergency department of the University Hospital of Reunion Island in 2019 with suspected dengue fever (DF) within a maximum of 5 days post symptom onset, and whose diagnosis was confirmed by a Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). The intrinsic characteristics of probable dengue definitions were reported in terms of sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), using RT-PCR as the gold standard. Of the 1,181 subjects who exhibited a positive RT-PCR, 652 (55%) were classified as probable dengue. The WHO definition of probable dengue yielded a sensitivity of 64% (95%CI 60-67%), a specificity of 57% (95%CI 52-61%), a LR+ of 1.49 (95%CI 1.33-1.67), and a LR- of 0.63 (95%CI 0.56-0.72). The sensitivity and LR- for diagnosing and ruling out probable dengue could be improved by the addition of lymphopenia on admission (74% [95%CI: 71-78%] and 0.54 [95%CI: 0.46-0.63] respectively), at the cost of slight reductions of specificity and LR+ (48% [95%CI: 44-53%] and 1.42 [95%CI: 1.29-1.57], respectively). In the absence of, or when rapid diagnostic testing is unreliable, the use of the improved 2009 WHO definition of probable dengue could facilitate the identification of subjects who require further RT-PCR testing, which should encourage the development of patient management, while also optimizing the count and quarantine of cases, and guiding disease control.

The Triglycerides and Glucose Index Is an Independent Risk Factor for Acute Respiratory Distress Syndrome in Patients with COVID-19.

Introduction: Although it has been observed that the triglycerides and glucose (TyG) index, a biomarker of insulin resistance, is associated with severity and morbidity by COVID-19, evidence is still scarce. Therefore, the objective of this study was to determine whether the TyG index is associated with both the degree of severity and mortality by acute respiratory distress syndrome (ARDS) in patients with COVID-19. Methods: Men and women aged 20 years or more with diagnosis of COVID-19 were included in a case-control study. Exclusion criteria were pregnancy, cancer, autoimmune diseases, autoimmune treatment, and incomplete data. Patients with severe COVID-19 ARDS were allocated into the case group, and those with mild or moderate COVID-19 ARDS in the control group. COVID-19 was defined by a positive reverse transcriptase-polymerase chain reaction test for SARS-CoV-2, and ARDS was defined according to the Berlin criteria. Results: A total of 206 patients were included and allocated into the case (n = 103) and control (n = 103) groups. The logistic regression analysis adjusted by age, sex, and body mass index showed that the TyG index is significantly associated with moderate [odds ratio (OR) = 6.0; 95% confidence interval (CI): 1.1-30.6] and severe (OR = 9.5; 95% CI: 2.4-37.5) COVID-19 ARDS, and death (OR = 10.1; 95% CI: 2.2-46.5). Conclusion: The results of our study show a significant and independent association of the TyG index with ARDS and mortality in patients with COVID-19.

Multimodal approach for early prediction of COVID-19 disease using convolutional neural network

<p><span>The latest human coronavirus is COVID-19. Chest radiography imaging is essential for screening, early detection, and monitoring COVID-19 infections since the virus resides in the lungs. Classical real time reverse transcriptase polymerase chain reaction (RT-PCR) data and chest X-ray pictures will become more important for COVID-19 identification as the pandemic spreads due to their affordability, wide availability, and infection control benefits, which reduce cross-contamination. This work presents multi-modal hybrid automated approaches to classify COVID-19 illness into three clinical categories: normal, pathogenic, and COVID-19 utilising RT-PCR test data and online chest X-ray datasets. The RT-PCR and chest X-ray image datasets were processed using supervised machine learning and convolutional neural networks (CNN). Together, these measures help us separate COVID-19 patients, those with similar symptoms, and healthy persons. The author improved detection times and classification accuracy with extra tree classifier’s feature selection and openCV’s image sharpening. The proposed approaches were tested using a research dataset. The proposed methods allowed reliable COVID-19 disease categorization for clinical decision-making, with random forest (RF) classifier global precision values of 91.58% on the RT-PCR dataset and CNN model accuracy of 95.46% on improved sharpened images.</span></p>

Diagnostic Performance of Saliva Samples in Asymtomatic COVID-19 Infected Patients in Kakamega Kenya

The pandemic coronavirus SARS‐CoV‐2 in the world has caused a large infected population suffering from COVID‐19. To curb the spreading of the virus, WHO urgently demanded an extension of screening and testing; thus, a rapid and simple diagnostic method is needed which is non-invasive. Use of self-collected saliva can minimize healthcare worker exposure and expand testing capabilities for symptomatic and asymptomatic patients. The main aim of this study was to document the ability of patients to self-collect sufficient saliva specimens for SARS-CoV-2 in the quantitative detection by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in asymptomatic patients by themselves under observation by a healthcare provider. The researcher recorded whether the patients were confident and the suitability of the specimen for laboratory testing that would inform clinical decision making. Seventy-one patients aged from 13 years and above were included between December 2020 and July, 2021. Saliva samples and Nasopharyngeal samples were taken from each patient. Quantitative PCR was performed to detect SARS-CoV-2 viral load in the nasopharyngeal samples and qualitative Reverse Transcriptase Loop-mediated isothermal amplification (RT-LAMP) was used to detect the presence of the virus in saliva samples. Results of saliva vs. nasopharyngeal samples testing using the two different methods were compared. Statistical analyses were performed. Out of the 350 samples tested, 314 samples were found to be Covid 19 positive. Result of the test was validated by the RT-PCR test. This showed that only 314 samples were tested both by saliva rapid test and PCR test while the rest 36 samples were not tested using RT-PCR method but were tested using saliva test. Thus, the salivary test based on pure oral saliva samples easily obtained by noninvasive techniques using RT-LAMP has the same agreement with the nasopharyngeal technique using RT-PCR one in asymptomatic COVID-19 patients.

Correlation of Measurable Body Fat and Muscle Composition Parameters and Visceral Adipose Tissue on Computed Tomography with COVID-19 Severity

Background/Aims: Obesity increases the risk of having COVID-19. To evaluate the relationship between body fat, muscle composition, and visceral adipose tissue on computed tomography (CT) with COVID-19 outcome. Materials and Methods: 149 patients were included who had chest CT and a positive reverse transcriptase-polymerase chain reaction test. We measured the epicardial adipose tissue thickness (EAT) and liver density (LD), thoracic subcutaneous adipose tissue /pectoralis major (TSAT/PMJ), abdominal subcutaneous adipose tissue /psoas major muscle (ASAT/PSM), abdominal subcutaneous adipose tissue/erector spina muscle (ASAT/ESM) thickness ratios from thorax CT. Lymphocyte, platelet, neutrophil count, lymphocyte/neutrophil ratio, and CRP were recorded. Results: The mean EAT was high in the patients with a poor clinical course (in severe patients: 7.06±2.39 mm, in critical patients: 7.89±2.08 mm). The mean EAT of the ICU group was 7.70±2.14 mm, it was 8.50±2.10 mm in the deceased patients. TSAT/PMJ was lower in deceased patients (0.90±0.36, p=0.038). ASAT/PSM and ASAT/ESM were also higher in the moderate group (2,27±1,60 and 0,51±0,25) (p=0.003. and p=0.019) than mild one (1.59±1.80, and 0.40±0.26). There was no difference in terms of DM, malignancy, or gender. Conclusion: EAT was high in ICU-admitted and deceased patients and can be used as a predictor of poor prognosis.

COVID-stasis of Pregnancy: An Increased Prevalence of COVID-19 in Patients with Cholestasis.

To evaluate the relationship between intrahepatic cholestasis of pregnancy (ICP) and coronavirus disease 2019 (COVID-19). We performed a retrospective cohort study of pregnant women undergoing induction of labor (IOL) at a single institution between May 2020 to January 2021. Primary exposure was diagnosis of intrahepatic cholestasis of pregnancy (ICP). The primary outcome was the prevalence of COVID-19 as determined by reverse-transcriptase polymerase chain reaction testing on nasopharyngeal swabs for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) on routine admission testing. Secondary outcomes were abnormal laboratory values and adverse fetal outcomes. Logistic regression with log link analysis was performed comparing patients undergoing IOL for ICP compared with IOL for all other indications. The moderating effect of ethnicity was assessed by the interaction between ethnicity and ICP in a logistic regression model. The Wilcoxon rank-sum test and Fisher's exact test were performed for the secondary outcome analyses. Over the course of the study, 596 patients underwent IOL: 24 for ICP and 572 for other indications. The overall prevalence of COVID-19 positivity in the cohort was 5.5% (33 of 596). Those with ICP were more likely to test positive for COVID-19 compared with those with other IOL indications (29.2 vs. 4.5%, RR = 6.4, 95% CI: 2.8-12.5, p < 0.001). All patients with ICP who tested positive for COVID-19 were Hispanic. To analyze the moderating effect of ethnicity, the results of the logistic model found the interaction between ethnicity and ICP to not be significant (p = 0.991). In patients with ICP, the median AST (aspartate aminotransferase) was higher than those with COVID-19 (p = 0.0182). There were no adverse fetal outcomes in the ICP group. In this single-site retrospective cohort study, we demonstrated an increased prevalence of COVID-19 in those with ICP in general and among Hispanic patients specifically. Despite this difference, there was no increased risk of adverse fetal outcomes. · There is an increased prevalence of COVID-19 among Hispanic patients with ICP.. · The median AST of COVID-19-positive patients was significantly higher than COVID-19-negative patients.. · There was no increased risk of adverse fetal outcomes in with COVID-19 and ICP..

What is the relevancy of a surveillance of mumps without a systematic laboratory confirmation in highly immunized populations? Epidemiology of suspected and biologically confirmed mumps cases seen in general practice in France between 2014 and 2020

BackgroundIn France, mumps surveillance is conducted in primary care by the Sentinelles network, the National Reference Centre for Measles, Mumps and Rubella and Santé publique France. AimThe objective of this study was to estimate the incidence of suspected mumps in general practice, the proportion of laboratory confirmed cases and the factors associated with a virological confirmation. MethodsGeneral practitioners (GPs) participating in the Sentinelles network should report all patients with suspected mumps according to a clinical definition in case of parotitis and a serological definition in case of clinical expression without parotitis. All suspected mumps cases reported between January 2014 and December 2020 were included. A sample of these cases were tested by real time reverse transcriptase polymerase chain reaction (RT-PCR) for mumps biological confirmation. ResultsA total of 252 individuals with suspected mumps were included in the study. The average annual incidence rate of suspected mumps in general practice in France between 2014 and 2020 was estimated at 11 cases per 100,000 population [CI95%: 6–17]. A mumps confirmation RT-PCR test was performed on 146 cases amongst which 17 (11.5 %) were positive. Age (between 20 and 29 years old), the presence of a clinical complication and an exposure to a suspected mumps case within the 21 days prior the current episode were associated with a mumps biological confirmation. ConclusionIf these results confirm the circulation of mumps virus in France, they highlight the limits of a surveillance without a systematic laboratory confirmation in highly immunized populations.

Radiographic patterns and severity scoring of COVID-19 pneumonia in children: a retrospective study

BackgroundChest radiography (CXR) is an adjunct tool in treatment planning and monitoring of the disease course of COVID-19 pneumonia. The purpose of the study was to describe the radiographic patterns and severity scores of abnormal CXR findings in children diagnosed with COVID-19 pneumonia.MethodsThis retrospective study included children with confirmed COVID-19 by reverse transcriptase-polymerase chain reaction test who underwent CXR at the arrival. The CXR findings were reviewed, and modified radiographic scoring was assessed.ResultsThe number of abnormal CXR findings was 106 of 976 (10.9%). Ground-glass opacity (GGO) was commonly found in children aged > 9 years (19/26, 73.1%), whereas peribronchial thickening was predominantly found in children aged < 5 years (25/54, 46.3%). Overall, the most common radiographic finding was peribronchial thickening (54/106, 51%). The lower lung zone (56/106, 52.8%) was the most common affected area, and there was neither peripheral nor perihilar predominance (84/106, 79.2%). Regarding the severity of COVID-19 pneumonia based on abnormal CXR findings, 81 of 106 cases (76.4%) had mild lung abnormalities. Moderate and severe lung abnormalities were found in 21 (19.8%) and 4 (3.8%) cases, respectively. While there were no significant differences in the radiographic severity scores among the various pediatric age groups, there were significant disparities in severity scores in the initial CXR and medical treatments.ConclusionsThis study clarified the age distribution of radiographic features across the pediatric population. GGO was commonly found in children aged > 9 years, whereas peribronchial thickening was predominant in children aged < 5 years. The lower lung zone was the most common affected area, and the high severity lung scores required more medical treatments and oxygen support.

Effects of SARS-COV-2 infection on outcomes in patients hospitalized for acute cardiac conditions. A prospective, multicenter cohort study (Swiss Cardiovascular SARS-CoV-2 Consortium).

Although the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) causing coronavirus disease 2019 (COVID-19) primarily affects the respiratory system, the disease entity has been associated with cardiovascular complications. This study sought to assess the effect of concomitant SARS-COV-2 infection on clinical outcomes of patients hospitalized primarily for acute cardiac conditions on cardiology wards in Switzerland. In this prospective, observational study conducted in 5 Swiss cardiology centers during the COVID-19 pandemic, patients hospitalized due to acute cardiac conditions underwent a reverse-transcriptase polymerase chain reaction test at the time of admission and were categorized as SARS-COV-2 positive (cases) or negative (controls). Patients hospitalized on cardiology wards underwent treatment for the principal acute cardiac condition according to local practice. Clinical outcomes were recorded in-hospital, at 30 days, and after 1 year and compared between cases and controls. To adjust for imbalanced baseline characteristics, a subgroup of patients derived by propensity matching was analyzed. Between March 2020 and February 2022, 538 patients were enrolled including 122 cases and 416 controls. Mean age was 68.0 ± 14.7 years, and 75% were men. Compared with controls, SARS-COV-2-positive patients more commonly presented with acute heart failure (35% vs. 17%) or major arrhythmia (31% vs. 9%), but less commonly with acute coronary syndrome (26% vs. 53%) or severe aortic stenosis (4% vs. 18%). Mortality was significantly higher in cases vs. controls in-hospital (16% vs. 1%), at 30 days (19.0% vs. 2.2%), and at 1 year (28.7% vs. 7.6%: p < 0.001 for all); this was driven primarily (up to 30 days) and exclusively (at one-year follow-up) by higher non-cardiovascular mortality, and was accompanied by a greater incidence of worsening renal function in cases vs. controls. These findings were maintained in a propensity-matched subgroup of 186 patients (93 cases and 93 controls) with balanced clinical presentation and baseline characteristics. In this observational study of patients hospitalized for acute cardiac conditions, SARS-COV-2 infection at index hospitalization was associated with markedly higher all-cause and non-cardiovascular mortality throughout one-year follow-up. These findings highlight the need for effective, multifaceted management of both cardiac and non-cardiac morbidities and prolonged surveillance in patients with acute cardiac conditions complicated by SARS-COV-2 infection.

Delay in Time to Oncologic Therapies for Patients with Positive COVID-19 Test

For several cancers, delays between diagnosis and initiation of treatment has important clinical implications, often affecting trial eligibility, treatment intention, and oncologic outcomes. The coronavirus disease-19 (COVID-19) pandemic placed an extraordinary strain on the United States healthcare system, and its effect on oncologic patterns of care has yet to be established. We hypothesize that patients who received a new cancer diagnosis and subsequently tested positive for COVID-19 had delayed oncologic treatment compared to those who did not test positive for COVID-19. The National Cancer Database (NCDB) was queried to identify patients who were diagnosed and treated for any of 10 common malignancies from 2019-2020. Included disease sites were head and neck, esophagus, rectum, anus, lung, breast, cervix, uterus, prostate, and primary brain. Those who tested positive for COVID-19 between time of diagnosis and first oncologic treatment (including surgery, radiation, or systemic therapy) were compared to those who did not test positive for COVID-19. COVID-19 positivity was assessed using a new variable in the NCDB, "SARSCOV2_POS," which captures whether patients received a positive COVID-19 test via reverse transcriptase-polymerase chain reaction testing in inpatient, outpatient, or emergency room settings in 2020. Duration in days from cancer diagnosis to time to first treatment (TTFT) was analyzed using two-sample t-tests, with significance level of p<0.05. A total of 1,503,127 patients were identified for analysis. Of these, 7,340 (0.5%) tested positive for COVID-19 between diagnosis and start of treatment. Initial treatment was most commonly surgery (55.3%), followed by systemic therapy (17.4%) and radiation (12.7%). Overall, median TTFT was 55 days [interquartile range (IQR) 31-91] for the COVID-19 group versus 34 days (IQR 15-56) for the non-COVID-19 group (p <0.01). Subgroup analysis of the 10 individual sites of disease revealed statistically significant delays in each, with greatest absolute difference in median TTFT in prostate (31.5 days; 95.5 versus 64.0) and greatest relative difference in brain (>700%, 28.5 versus 4.0). In the first year of the pandemic, patients who tested positive for COVID-19 between oncologic diagnosis and initial management experienced significant delays in initiation of cancer-directed therapy compared to those who did not test positive for COVID-19, with median increase in TTFT of 21 days. Additional follow-up is needed to evaluate the clinical impact of these delays, as well as change in patterns of care in later years of the pandemic.

Comparative and Prospective Study on the Efficacy of RT-PCR and Rapid Antigen Test in Symptomatic COVID-19 Patients at Tertiary Care Hospital

The COVID-19 pandemic has primarily been controlled by testing for SARS-CoV-2 infections. Despite vaccines, testing will remain crucial for surveillance and screening, allowing for the detection of new variants in a timely manner and to isolate the infected people to lower the danger of the disease spreading further. The research study attempts to found out the efficiency of Reverse-transcriptase polymerase chain reaction (RT-PCR) and Rapid antigen tests in symptomatic COVID-19 patients at tertiary care hospitals. The research was performed on 1000 patients, both In-patients and Out-patients, who presented with COVID-19 symptoms. SARS-COV-2 nucleocapsid protein antigen was detected qualitatively with rapid antigen test in human nasal specimens through the immuno-chromatographic assay. The rapid test results were compared with a molecular test RT-PCR in which FAM, HEX, and ROX were the indicator dyes for the RdRp gene, E gene, and the internal control (RNAse P), respectively. Nearly 322 cases were positive with both RT-PCR and rapid antigen test methods. Fifty-nine samples yielded negative results with the rapid antigen test and positive with PCR. Three samples were negative with RT-PCR and positive with the rapid antigen test. The findings from our study show that the common symptoms are fever 92.2% and cough 74.1% in the reported test population. But in confirmed cases of RT-PCR showed cough at 74.1% was more prevalent, followed by fever at 41.3%. Rapid antigen test showed a overall sensitivity and specificity of 85.3% and 99.5%. According to World Health Organization, rapid antigen detection tests meet the minimum performance requirements of ≥80% sensitivity and ≥97% specificity. Hence, the present study meets this criterion and may perhaps be a probable tool for point-of-care in hospital settings.

Computed tomography findings in COVID-19 and atypical pneumonia: a comparative study.

Computed tomography (CT) has an important role in the rapid diagnosis, treatment, and management of lower respiratory tract infections. This study aimed to explore different imaging characteristics between Coronavirus disease 2019 (COVID-19) and atypical pneumonia (non-COVID-19) on chest CT of patients admitted to the emergency department. CT features of 120 patients with positive Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase-polymerase chain reaction (RT-PCR) and 83 patients with negative SARS-CoV-2 by RT-PCR but positive respiratory tract sample test results for other respiratory pathogens were retrospectively evaluated, findings were recorded and compared between the two groups. Compared to non-COVID-19, COVID-19 patients were more likely to have a peripheral (60.5% vs. 23.8%, p < 0.001) and bilateral distribution (72.3% vs. 41.3%, p < 0.001), patchy consolidations (45% vs. 28.9%, p = 0.021), ground glass opacity (GGO) (94.2% vs. 83.1%, p = 0.011), crazy paving patterns (55% vs. 31.3%, p < 0.001); but less likely to have centrilobular nodules (15% vs. 62.7%, p < 0.001), pleural effusion (3.3% vs. 10.8%, p = 0.032), multifocal consolidations (7.5% vs. 21.7%, p = 0.003), and random distribution (1.7% vs. 46.3%, p < 0.001). There were significant differences between the CT patterns of patients with COVID-19 and other atypical pneumonia. The presence of patchy consolidations, GGO, crazy paving patterns with typical peripheral, bilateral distribution, and absence of centrilobular nodules, pleural effusion, and multifocal consolidations may help to differentiate COVID-19 from atypical pneumonia.

Covid-19’lu Pediatrik Vakalardaki Toraks Tomografisi Bulgularının Yaşlara Göre Dağılımı , Thoracic computed tomography findings of pediatric COVID-19 cases according to age groups

Objective: In this study, we aimed to evaluate thoracic computed tomography (CT) findings of pediatric patients with novel coronavirus disease 2019 (COVID-19) pneumonia according to age groups. Methods: A total of 105 patients aged between 0 and 18 years who were admitted to our clinic between April 2020 and September 2020 were retrospectively analyzed. The definitive diagnosis was established by reverse transcriptase-polymerase chain reaction (RT-PCR) testing of the combined nasopharyngeal/oropharyngeal swabs. The patients were divided into three groups according to age: 0-6, 6-12, and 12-18 years. Thoracic CT findings at the time of initial admission were evaluated. Results: Of the patients, 51 had RT-PCR positivity for COVID-19, while 54 had RT-PCR negativity. Of the RT-PCR-positive patients, 30 (58.8%) had normal CT, while lung involvement was observed in 21 patients (41.2%). The most common thoracic CT findings were bilateral lung involvement (27.5%), lower lobe involvement (31.4%), nodular involvement (31.4%), and ground-glass opacity (37.3%). In the 6-12 age group, middle lobe involvement was significantly more frequent (p=0.041). The rate of consolidation significantly decreased with the increasing age (p=0.045). Conclusion: The most common CT findings were bilateral, peripheral lower lobe involvement in pediatric COVID-19 cases. Consolidation was the most frequent lesion in the 0-6 age group, which can be attributed to the high incidence of bacterial co-infection. In the 12-18 age group, the distribution, morphology, and opacity of the lesions were comparable with those seen in adults. The lesions presented with nodular and ground-glass opacity patterns in the 6-12 and 12-18 age groups.

Antibody Response against Severe Acute Respiratory Syndrome Coronavirus 2 Messenger Ribonucleic Acid Vaccines in Infected Individuals: A Systematic Review.

Individuals with a history of coronavirus disease 2019 (COVID-19) exhibit memory immunity acquired during natural infection. However, a decline in immunity after infection renders these individuals vulnerable to re-infection, in addition to a higher risk of infection with new variants. This systematic review examined related studies to elucidate the antibody response in these infected individuals after messenger ribonucleic acid (mRNA) vaccination. Hence, the focus of this review was to ascertain differences in the concentration of binding and neutralising antibodies of previously infected individuals in comparison to those of infection-naïve individuals after administration of two doses of mRNA vaccination through available case-control and cohort studies. Positive reverse transcriptase-polymerase chain reaction (RT-PCR) test or detectable anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies at the baseline in included studies showed categorisation of infected and uninfected individuals. This review utilised three online databases: PubMed, Scopus and Cochrane with the following keywords: (COVID-19 OR 'Coronavirus Disease 2019' OR SARS-CoV-2) AND Immun* AND (Pfizer OR BioNTech OR BNT162b2 OR Comirnaty OR Moderna OR mRNA-1273) from January 2019 to July 2021. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) 2020 guidelines and assessment based on the Crowe Critical Appraisal Tool (CCAT), we included 13 related qualified papers of observational studies discerning the binding and neutralising antibody concentrations of infected and uninfected individuals after administration of mRNA vaccines, such as the BNT162b2 and mRNA-1273 vaccine. The mRNA vaccines induced robust binding and neutralising antibody responses in both groups. However, infected individuals showed induction of higher antibody responses in a shorter time compared to uninfected individuals. Hence, a single dose of mRNA vaccination for infected individuals may be sufficient to reach the same level of antibody concentration as that observed in uninfected individuals after receiving two doses of vaccination.

ROLE OF CT CHEST IN EVALUATION OF PULMONARY MANIFESTATIONS OF COVID-19 RECOVERED CASES

Objective: Pulmonary manifestations may be seen in a number of coronavirus disease 2019 (COVID-19)-recovered the evidence on post-COVID pulmonary sequelae is still limited. Herein, we aim to assess the role of computed tomography (CT) chest in the evaluation of pulmonary manifestations of COVID-19 recovered cases. Methods: We conducted a hospital-based study in the Department of Radiodiagnosis at Government Medical College and Rajindra Hospital Patiala. It included 182 reverse transcriptase-polymerase chain reaction (RT-PCR)-proven COVID-19 patients after they recovered from the disease with at least one negative RT-PCR test and/or clinical recovery. Clinical data and CT findings in the recovery phase were summarized, and the relationship of different clinical parameters with CT severity scores was analyzed. Results: The mean (±standard deviation [SD]) age of patients was 50.2±14.7 years, and 62.6% of them were males. The mean (±SD) symptomatic-scan interval was 33.05±22.27 days. Pulmonary abnormalities were found in the majority of the cases in the recovery phase, that is, 176 patients accounting for 96.7%, while six patients had normal scans. Bilateral involvement was seen in 169 out of 176 patients. Common CT patterns observed were ground glass opacities (90.34%), reticular pattern (81.82%), interlobular septal thickening (70.45%), linear opacities (90.34% cases), fibrous stripes (78.41% cases), and consolidation (36.93%). The mean (±SD) CT severity score of our study subjects was 16.10±7.95. Patients were also categorized into four groups according to symptomatic scan interval &lt;1 month, 1–2 month, 2–3 month, and &gt;3 months. We found that residual changes were more severe in patients with shorter symptomatic scan interval. Conclusion: COVID-19 patients demonstrate persistent pulmonary abnormalities even after clinical recovery. Hence, follow-up in patients with moderate and severe disease is strongly recommended.

Radiological characteristics of coronavirus patients.

The present study aimed to evaluate the radiological findings of coronavirus patients who had positive computed tomography of the lung following real-time reverse transcriptase-polymerase chain reaction testing. The data of 1727 patients who had reverse-transcriptase-polymerase chain reaction (RT-PCR) testing between May 2020 and August 2021 and had thoracic computed tomography (CT) on Days 7th to 8th were analyzed retrospectively. The Radiological Society of North America's recommended reporting system was used to categorize CT findings. Of the 1727 patients who underwent RT-PCR testing, there were 1417 patients with positive CT results. Of these 1417 patients, 679 (47.9%) were female. When patients with high blood values were evaluated, the number of CT-positive patients was significantly higher than CT-negative patients (P < .05). The number of patients with low lymphocyte and albumin values was significantly higher (P < .05). In 75.7% of those who had positive CT results, the PCR result was positive. Thoracic CT is a critical diagnostic tool in Coronavirus Disease 2019 patients with RT-PCR negative. It also depicts the progression of lung involvement in RT-PCR-positive patients. Performing it late in the disease's progression may increase the risk of contracting the disease.

Performance of Rapid Antigen Tests to Detect Symptomatic and Asymptomatic SARS-CoV-2 Infection : A Prospective Cohort Study.

The performance of rapid antigen tests (Ag-RDTs) for screening asymptomatic and symptomatic persons for SARS-CoV-2 is not well established. To evaluate the performance of Ag-RDTs for detection of SARS-CoV-2 among symptomatic and asymptomatic participants. This prospective cohort study enrolled participants between October 2021 and January 2022. Participants completed Ag-RDTs and reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2 every 48 hours for 15 days. Participants were enrolled digitally throughout the mainland United States. They self-collected anterior nasal swabs for Ag-RDTs and RT-PCR testing. Nasal swabs for RT-PCR were shipped to a central laboratory, whereas Ag-RDTs were done at home. Of 7361 participants in the study, 5353 who were asymptomatic and negative for SARS-CoV-2 on study day 1 were eligible. In total, 154 participants had at least 1 positive RT-PCR result. The sensitivity of Ag-RDTs was measured on the basis of testing once (same-day), twice (after 48 hours), and thrice (after a total of 96 hours). The analysis was repeated for different days past index PCR positivity (DPIPPs) to approximate real-world scenarios where testing initiation may not always coincide with DPIPP 0. Results were stratified by symptom status. Among 154 participants who tested positive for SARS-CoV-2, 97 were asymptomatic and 57 had symptoms at infection onset. Serial testing with Ag-RDTs twice 48 hours apart resulted in an aggregated sensitivity of 93.4% (95% CI, 90.4% to 95.9%) among symptomatic participants on DPIPPs 0 to 6. When singleton positive results were excluded, the aggregated sensitivity on DPIPPs 0 to 6 for 2-time serial testing among asymptomatic participants was lower at 62.7% (CI, 57.0% to 70.5%), but it improved to 79.0% (CI, 70.1% to 87.4%) with testing 3 times at 48-hour intervals. Participants tested every 48 hours; therefore, these data cannot support conclusions about serial testing intervals shorter than 48 hours. The performance of Ag-RDTs was optimized when asymptomatic participants tested 3 times at 48-hour intervals and when symptomatic participants tested 2 times separated by 48 hours. National Institutes of Health RADx Tech program.