SARS-CoV2 Infection Research Articles

Latest discoveries related to taste and smell disorders in patients with post-COVID-19 and other neuroviruses – a systematic literature review

Abstract: Introduction: The SARS CoV-2 infection, responsible for COVID-19, has spread worldwide starting with the end of 2019, with major impact in the years 2020 and 2021, especially through the alpha, beta, and delta strains respectively. These strains have also been associated with the development of symptoms of anosmia and ageusia, even after overcoming the acute form of the disease, as part of the post-COVID-19 sequalae that make up the so-called “long-Covid”. [1] The purpose of this systematic literature review was to study these disabling symptoms in the context of long-COVID syndrome. Material and methods: In order to accomplish this review, we used the method Preferred Reporting Items for Systematic Reviews and Meta-Analyses (acronym - PRISMA) to filter and select the articles of interest that appeared in the period 1/01/2021-31/12/2022, in the international medical databases: Elsevier, NCBI/ PubMed,NCBI/ PMC and PEDro (= Physiotherapy Evidence Database classification), as well as ISI Web of Knowledge (Institute for Scientific Information - ex Thomson Reuters - Clarivate Analytics). We used the keywords for the selection: "COVID-19" / "viral neuroinfections" + "smell" /”olphactory” + "taste" /”gustatory”+ "anosmia" + 'ageusia' +'recovery'+'rehabilitation'. Results and discussion: After applying indirect and then direct quantitative and qualitative filtering, 25 articles remained that met the selection criteria (noted in order of relevance in table 1, at the end of the article). We also added a number of freely identified papers, considered relevant to our topic. We studied aspects of the "long-COVID" syndrome, mainly related to neuro-psychiatric symptoms - especially taste and smell disorders (anosmia/ageusia), risk factors, predictors for this status, pathophysiology, their intricate mechanism of action, frequency of symptoms, neuroanatomy imaging correlated with clinical aspects, effect of anosmia and ageusia on quality of life, recovery from such sequelae, favorable/unfavorable prognostic factors in this regard. Conclusions: Smell and taste are more than just simple sensations/perceptions and anosmia/ ageusia does not always recover spontaneously. The category of patients who are left with such permanent qualitative/quantitative alterations requires in-depth study in order to establish standardized and more effective methods of diagnosis, evaluation and treatment and recovery, than those available at the moment. The chosen topic represents a partially studied niche in the current well of knowledge, which will allow us, following the theoretical and practical deepening of the subject, some possible elements of future contribution.

SARS-CoV2 Viral Ct Values Correlation with Some Patients’ Factors and Disease Outcome

Viral load of COVID-19 can be concluded from the cycle threshold (Ct) values measured by RT-PCR test performed on suspected samples. SARS-CoV2 viral load has not been standardized yet to reflect the outcome of COVID-19 infection. This cross-sectional study was performed to detect the frequency of SARS-CoV2 among suspected patients and the correlation of viral RNA load represented by cycle threshold (Ct) values with patients’ clinical presentation (disease severity), comorbidities and demographic data. A total of 520 participants suspected to have SARS-CoV2 infection were enrolled. After filling a questionnaire, a nasopharyngeal swab was collected from each patient and subjected to RT-PCR with the use of specific primers. Ct values of positive cases were obtained. Results revealed that 277 (53.3%) of samples were positive by RT-PCR, of which 160 (57.8 %) were males and 117 (42.2 %) females, with mean Ct value being 27.43. There was no significant correlation of Ct values with different age groups, gender and comorbidities. However, higher Ct values (lower viral RNA load) were recorded in severe and critical patients, which was an interesting result.

Use of nebulized liposomal amphotericin B and posaconazole as antifungal prophylaxis in patients with severe SARS-CoV2 infection in intensive care unit.

COVID-19 associated pulmonary aspergillosis (CAPA) is common and linked with high fatalityrates. To assess the impact on the incidence and outcome of CAPA of an antifungal prophylaxis (AFP) we compared two cohorts of COVID-19 patients admitted to intensive care units (ICU) in Brescia, Italy, from January to August 2021. The study cohort included all mechanically ventilated patients observed between April 2021 and August 2021 with SARS-CoV-2-pneumonia, who received AFP with oral posaconazole (200mg every6h) and nebulized liposomalamphotericin B (50mg every2weeks) from ICU admission to 7days after discharge or, if applicable, until tracheostomy removal. The control cohort included COVID-19 patients admitted to the same ICU between January and March 2021 who did not receive any AFP. Subjects with CAPA at ICU admission were excluded. We included 270 patients, of whom 64 (23.7%) received AFP. In patients in the study group, CAPA-related mortality was significantly reduced (29% vs. 48% p = 0.04), as well as the incidence of CAPA (3.1% vs 12.1%, p = 0.03). Patients who developed CAPA were older (mean of 70-y-old vs 63-y-old, p < 0.001). One subject discontinued posaconazole due to anadverse reaction. Among the 46 patients who received it, only one patient reached an effective plasma concentration of posaconazole. AFP was associated with reduced incidence and mortality from CAPA and was well tolerated in patients with severe COVID-19. Posaconazole concentrations below the efficacy threshold in almost all patients may be attributable to drug interactions and prompt further studies to define its clinical significance.

COVID-19 in pregnant women: description of a possible case of COVID-19-linked HELLP-like syndrome

New evidence suggests that Sars-CoV2 infection during pregnancy may result in complications such as hypertension, nephropathy, thrombocytopenia, and liver damage. A pre-eclampsia-like syndrome has also been proposed in pregnant women with severe SARS-CoV-2 infection, which meets the pre-eclampsia criteria but resolves without delivery, with improvement in respiratory symptoms. 31-year-old, second pregnancy, in Emergency Room for PROM (premature rupture of membranes), has Sars-CoV2 infection and has not been vaccinated. Normal examinations and mild hypertension were present upon admission, but no treatment was administered. Vaginal Leukocytic Delivery 12 hours after admission, newborn Apgar score 9/10, weight 3.250 kg. At 20 hours after delivery, epigastric pain VAS 8-9 for 20 minutes, systolic/diastolic hypertension peak, increase in transaminases, LDH, ALP, Bilirubin, Dimer, platelet and fibrinogen drop. Neurological and respiratory objectivity were negative, and renal indices were within normal limits, so nifedipine 30mgx2/day + methyldopa 500 mgx2/day was started. Abdominal ultrasound revealed a thin perihepatic fluid stratum. A prophilaxis of dexamethasone 12mg twice a day and magnesium sulfate was introduced. At 32 hours after delivery, the laboratory detected an increase in transaminases, LDH, and worsening of thrombocytopenia. The patient is always eupnoic, and the diuresis is adequate. Blood tests improved gradually after 56 hours postpartum. Methyldopa and steroids are escalating. On day 7, discharge with normalized platelet and bilirubin counts and a decreasing trend in transaminases, LDH, and PAL. At the one-week follow-up, liver enzymes and coagulation were completely normal, and blood pressure was well controlled with methyldopa. We conclude that the simultaneous presence of the two diseases could have had a synergistic or opportunistic effect, resulting in severe clinical manifestations via interaction with the Renin-Angiotensin-Aldosterone system.

Cytopathological study of pleural effusion in SARS-CoV2 RTPCR positive subjects during pandemic at tertiary care hospital

Introduction and Aim: Respiratory system is the most common system affected by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Review of literature reveals that pleural effusion were seen in one third of cases with Middle East Respiratory Syndrome(MERS) but were rarely reported in SARS –CoV2.This study aims to study the cytomorphological changes in Pleural effusion seen in SARS CoV-2 positive cases, to correlate the cytological findings with radiological CT COVID-19 Reporting and Data System(CORADS)scorings and to categorize pleural effusion as isolated cause of SARS CoV-2 or aggravation of underlying other etiologies. Materials and Methods: Pleural fluid samples of SARS CoV-2 RT PCR positive cases, obtained from patients of all age groups were included in the study. The samples were predominantly from Covid19 wave 1 (March 2020- February 2021) and few from Covid wave 2(March 2021-April 2021). Biochemical analysis, hematological parameters, cytomorphology and associated comorbidity was recorded, and analysis done. Results: Male predominance was observed. Most common cytological and biochemical finding in pleural fluid analysis was Exudative pleural effusion. Predominant cytological features showed lymphocytic effusion. Radiology showed maximum left sided pleural effusion (42%). CORADS score was 6 in majority of cases and effusion as an isolated cause was seen in few cases. Conclusion: Pleural effusion is a rare finding in SARS COV-2 induced bronchopneumonia. Effusion is seen with a high CORADS score, and they carry a high risk of mortality. This study suggests having SARS CoV-2 infection as a differential diagnostic entity when we find the mentioned morphological and biochemical findings as discussed in the present study.

Identification of Autoantigen Markers for SARS CoV-2 Infection with Machine Learning-based Feature Selection: An Insight into COVID Symptoms

Background and Introduction:: Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection has been shown to trigger autoimmunity, and the phenomenon leads to several chronic human diseases such as Type-1 diabetes, Crohn’s disease, vasculitis, Guillian-Barrė syndrome, etc. The mechanism underlying SARS CoV-2-induced autoimmune response is unknown and is an active area of interest for the researchers. Objective:: The primary objective of this study is to identify the autoantigen markers for the classification of SARS CoV-2 (COVID-19 positive and negative samples) that trigger an immune response leading to autoimmunity using a machine learning approach that provides information to obtain a more accurate diagnosis for COVID-induced diseases. Materials and Methods:: Our study reports the transcriptomic profile of the COVID patient's whole blood samples collected from 0 to 35th day of acute infection as described in the GSE215865 dataset. The binary classification algorithm from the sci-kit learn python library, namely logistic regression and random forest with 10-fold cross-validation, was applied to the processed data, followed by a selection of the 20 best gene features with recursive feature elimination from a set of 10,719 gene features to obtain the classification accuracy of 87%. Results:: The fidgetin, microtubule severing factor (FIGN), SH3 and cysteine-rich domain (STAC), Cadherin-6 (CDH6), docking protein 6 (DOK6), nuclear RNA export factor 3 (NXF3) and maternally expressed 3 (MEG3) are the autoantigens markers identified for classification of COVID-positive and negative samples. Conclusion:: The identified autoantigen markers from transcriptomic datasets using machine learning techniques provide a deeper understanding of COVID-induced diseases and may play an important role as potential diagnostic and drug targets for COVID-19.

In silico approach for the identification of tRNA-derived small non-coding RNAs in SARS-CoV infection.

tsRNAs (tRNA-derived small non-coding RNAs), including tRNA halves (tiRNAs) and tRNA fragments (tRFs), have been implicated in some viral infections, such as respiratory viral infections. However, their involvement in SARS-CoV infection is completely unknown. A comprehensive analysis was performed to determine tsRNA populations in a mouse model of SARS-CoV-infected samples containing the wild-type and attenuated viruses. Data from the Gene Expression Omnibus (GEO) dataset at NCBI (accession ID GSE90624 ) was used for this study. A count matrix was generated for the tRNAs. Differentially expressed tRNAs, followed by tsRNAs derived from each significant tRNAs at different conditions and time points between the two groups WT(SARS-CoV-MA15-WT) vs Mock and ΔE (SARS-CoV-MA15-ΔE) vs Mock were identified. Notably, significantly differentially expressed tRNAs at 2dpi but not at 4dpi. The tsRNAs originating from differentially expressed tRNAs across all the samples belonging to each condition (WT, ΔE, and Mock) were identified. Intriguingly, tRFs (tRNA-derived RNA fragments) exhibited higher levels compared to tiRNAs (tRNA-derived stress-induced RNAs) across all samples associated with WT SARS-CoV strain compared to ΔE and mock-infected samples. This discrepancy suggests a non-random formation of tsRNAs, hinting at a possible involvement of tsRNAs in SARS-CoV viral infection.

The effect of malnutrition on adult Covid-19 patient's ICU admission and mortality in Covid-19 isolation and treatment centers in Ethiopia: A prospective cohort study.

A new coronavirus was first identified in Wuhan, China in December 2019. Since the times of the 1918 influenza pandemic, malnutrition has been known as a risk factor for severity and mortality from viral pneumonia. Similarly, the recently identified SARS-Cov2 infection (COVID-19) and related pneumonia may be closely linked to malnutrition. Therefore, this study will contribute to new knowledge and awareness of the recording and evaluation of each COVID-19 patient's nutritional status by assessing the effect of malnutrition on ICU admission and death of COVID-19 patients in developing countries. We conducted a prospective cohort study in adult COVID-19 patients admitted to selected COVID-19 Isolation and Treatment Centers, Addis Ababa, Ethiopia. Baseline data of the patients were collected using interviewer-administered structured questionnaire and data on the adverse outcomes of follow up were extracted from follow up chart. The main clinical outcomes (ICU admission and death) were captured every week of follow up. We ran a multivariate Cox's regression analysis to determine the relationship between malnutrition at admission and its effect on ICU admission and death. A total of 581 COVID-19 patients were enrolled. From the total of recruited patients, 346 (59.6%) were males and 235 (40.4%) were females. The mean age of the respondents was 55 years (16.45) years. The Cox proportional hazard model controlled for sex, age group, number of co-morbidities, and number of medications found that malnutrition at admission was associated with ICU admission and death. When compared to well-nourished patients, the rate of ICU admission was significantly associated and found to be higher among underweight [(adjusted hazard ratio (AHR) = 10.02, 95% CI: (8.64-12.10)] and overweight [(AHR = 7.7, 95% CI: (6.41-9.62)] patients. The rate of survival probability was significantly associated and was found to be better among well-nourished patients (AHR = 0.06, 95% CI : (0.01-0.44) when compared with malnourished COVID-19 patients. Malnutrition at the time of admission was shown to increase the risk of ICU admission and mortality among COVID-19 patients. Therefore, it is vital to evaluate patients' nutritional condition early in their admission and provide timely intervention to minimize the effects on patients and the healthcare system.

Factors associated with COVID-19 among hospitalized patients with severe acute respiratory infections in Serbia, 2022-2023: A test negative case-control study.

Severe acute respiratory infections (SARI) are estimated to be the cause of death in about 19% of all children younger than 5 years globally. The outbreak of coronaviral disease (COVID-19) caused by SARS-CoV-2, increased considerably the burden of SARI worldwide. We used data from a vaccine effectiveness study to identify the factors associated with SARS CoV-2 infection among hospitalized SARI patients. We recruited SARI patients at 3 hospitals in Serbia from 7 April 2022-1 May 2023. We collected demographic and clinical data from patients using a structured questionnaire, and all SARI patients were tested for SARS-CoV-2 by RT-PCR. We conducted an unmatched test negative case-control study. SARS-CoV-2 infected SARI patients were considered cases, while SARS CoV-2 negative SARI patients were controls. We conducted bivariate and multivariable logistic regression analysis in order to identify variables associated with SARS-CoV-2 infection. We included 110 SARI patients: 74 were cases and 36 controls. We identified 5 factors associated with SARS-CoV-2 positivity, age (OR = 1.04; 95% CI = 1.01-1.07), having received primary COVID-19 vaccine series (OR = 0.28; 95% CI = 0.09-0.88), current smoking (OR = 8.64; 95% CI = 2.43-30.72), previous SARS CoV-2 infection (OR = 3.48; 95% CI = 1.50-8.11) and number of days before seeking medical help (OR = 0.81; 95% CI = 0.64-1.02). In Serbia during a period of Omicron circulation, we found that older age, unvaccinated, hospitalized SARI patients, previously infected with SARS CoV-2 virus and those who smoked, were more likely to be SARS-CoV-2-positive; these patient populations should be prioritized for COVID vaccination.

The Association of Super Infection with SARS-COV2 Virus Infection

The literature on the association of Co-infection and Super infection in patients with SARS-COV2 infection is reviewed in this paper. Co-infection is defined by the Centers for Disease Control and Prevention in the United States as an infection that occurs in the human body when the person is already afflicted with multiple diseases. Super infection is another phrase used by the Centers for Sickness Control and Prevention to describe a disease caused by the same virus but with a different strain each time. Over a lengthy period of time, it has been seen that a patient's viral respiratory infection develops to bacterial infection, which can be fatal. However, the association between the two remains a mystery for the researchers. In the case of COVID-19 viruses, comparable results have been obtained. The extensive spectrum of Co-infections and Super infections in Corona patients has been documented in a number of articles.

Thyroiditis and COVID-19: focus on pediatric age. A narrative review.

In light of the growing concern over the possible link between SARS-CoV2 infection and autoimmune diseases, we conducted a review to investigate the impact of the pandemic outbreak on thyroid diseases. We carried out a narrative review of all pediatric cases described in the literature, mainly focusing on the possible association of COVID-19 with the incidence of autoimmune and post-infective thyroid diseases (namely Hashimoto's Thyroiditis (HT), Grave's Disease (GD) and Sub-Acute Thyroiditis (SAT)). We also felt it was necessary to provide a brief review of Non-thyroidal Illness Syndrome (NTIS) and Multisystem Inflammatory Syndrome in Children (MIS-C) because of their overlap with thyroiditis. There is currently no conclusive evidence linking SARS-CoV-2 infection with an increased incidence of autoimmune thyroiditis (AT) in pediatric age. However, SAT may be a mild complication of SARS-CoV-2 infection, as is the case with other viral infections. SAT typically resolves on its own and does not require treatment. NTIS may be associated with inflammatory complications, such as MIS-C, and admission to intensive care. It may also be considered a prognostic risk factor for severe disease. The hypothesized pathogenetic mechanisms of thyroid damage in COVID-19 include direct damage due to the significant expression of angiotensin-converting enzyme 2 (ACE2) in the thyroid gland, which is a ligand for the virus, and indirect damage due to immune dysregulation, such as the overproduction of IL-6, which is thought to be part of the pathogenesis of thyroiditis. However, due to the limited evidence available, further prospective longitudinal studies are required to clarify the relationship between COVID-19 and thyroid disease in children and adolescents, as well as to investigate any potential long-term consequences.

Clinical characteristics and prognosis of SARS-CoV-2 infection in children with hematological malignancies: A multicenter, retrospective study in China

BackgroundData on SARSCoV-2 infection in children with hematological malignancies (HM) are limited. Here, we describe the clinical features of children with HM after SARS-CoV-2 infection and investigate the potential risk factors for disease severity. MethodsChildren with HM and SARS-CoV-2 infection from five hospitals in five cities in Henan, China from October 2022 to January 2023 were retrospectively included. Clinical information and Coronavirus disease 2019 (COVID-19) vaccination status were collected for further analyses. ResultsA total of 285 children with HM and SARS-CoV-2 infections were included. COVID-19 was asymptomatic in 3.2% of the patients (n = 9), mild in 89.1% (n = 254), moderate in 5.3% (n = 15), severe in 1.8% (n = 5), and critical in 0.7% (n = 2). Fever (92.4%) and cough (56.9%) were the most common symptoms. Most (249, 88.3%) children were managed at home during their COVID-19 illness. Of the 36 children admitted to the hospital, two required intensive care unit care, 11 required supplementary oxygen, and two non-invasive ventilation. A total of 283 (99.3%) children fully recovered and two (0.7%) died due to COVID-19. Significant risk factors for increased severity of infection in multivariable analyses were the presence of comorbidity (OR, 10.4; 95%CI, 2.8–38.7; p < 0.0001), neutropenia (OR, 10.4; 95%CI, 2.6–41.8; p = 0.001), and lymphopenia (OR, 4.2; 95%CI, 1.2–15.4; p = 0.029). A total of 30.9% (88/285) of the children received at least one dose of the inactivated COVID-19 vaccine at COVID-19 diagnosis. Compared with children who received at least one dose of the COVID-19 vaccine, fever was significantly more common in unvaccinated children (79.3% vs. 93.8%, p < 0.001). ConclusionsChildren with HM are not at an increased risk of severe COVID-19 compared to the general pediatric population. However, comorbidities such as lymphopenia and neutropenia may increase the risk of developing moderate or severe/critical disease. Our data may help in management decisions for this vulnerable population.

Risk factors of COVID-19 disease confirmed cases in Solok District

According to West Sumatra corona virus data, Solok Regency has the highest prevalence of positive confirmed cases of COVID-19 in West Sumatra, and one of the areas where the prevalence has increased significantly. Analysis of risk factors for COVID-19 cases in Solok Regency in 2021. We conducted a cross-sectional study analysis of secondary data from March to December 2020 with a mass randomized trial using the polymerase chain reaction (PCR) test in Solok Regency. Descriptive statistical analysis was used with secondary data relevant, and a logistic regression model was used to assess infection risk factors. A total of the 770 participants, 47.4% were women and 66% were aged 50-64 years. A total of 624 participants tested (81.03%) were identified as asymptomatic PCR SARS-CoV infection without symptoms, with 88% of participants with co-morbidities and 66% of participants without travel history. Based on the results obtained a significant relationship between history of comorbidities (p-value=0.00; AOR=0.16; 95% CI=0.08-0.32), clinical symptoms (p-value=0.00; AOR=0.04; 95% CI=0.03-0.08), and travel history (p-value=0.00, AOR=1.80, 95% CI=1.25-2.61). The majority of cases that were confirmed positive for COVID-19 based on the PCR test showed no symptoms, with co-morbidities and travel history. Confirmed positive cases of COVID-19 are associated with co-morbidities, symptoms and travel history.

Lumican, a Multifunctional Cell Instructive Biomarker Proteoglycan Has Novel Roles as a Marker of the Hypercoagulative State of Long Covid Disease.

This study has reviewed the many roles of lumican as a biomarker of tissue pathology in health and disease. Lumican is a structure regulatory proteoglycan of collagen-rich tissues, with cell instructive properties through interactions with a number of cell surface receptors in tissue repair, thereby regulating cell proliferation, differentiation, inflammation and the innate and humoral immune systems to combat infection. The exponential increase in publications in the last decade dealing with lumican testify to its role as a pleiotropic biomarker regulatory protein. Recent findings show lumican has novel roles as a biomarker of the hypercoagulative state that occurs in SARS CoV-2 infections; thus, it may also prove useful in the delineation of the complex tissue changes that characterize COVID-19 disease. Lumican may be useful as a prognostic and diagnostic biomarker of long COVID disease and its sequelae.

MR-Neurography and nerve ultrasound findings in a patient with chronic autoimmune-mediated neuropathy after SARS-CoV2 infection

MR-Neurography and nerve ultrasound findings in a patient with chronic autoimmune-mediated neuropathy after SARS-CoV2 infection

Spontaneous Coronary Artery Dissection and COVID-19: A Review of the Literature.

SARS-CoV-2 is responsible for the global coronavirus disease 2019 (COVID-19) pandemic. While the cardiovascular effects of COVID-19 have been thoroughly described, there are limited published studies in the literature establishing a connection between spontaneous coronary artery dissection (SCAD) and COVID-19. Cardiovascular manifestations include, among others, myocarditis, acute myocardial infraction, and thrombosis. In general, SCAD is an uncommon and underdiagnosed cause of acute myocardial infarction (AMI), particularly in younger women and in patients with underlying fibromuscular dysplasia (FMD). Many patients with SCAD often report significant emotional stress, especially in relation with job loss, during the week preceding their cardiac event. Moreover, the COVID-19 pandemic has led to societal stress and increased unemployment, factors that have been associated with cardiovascular morbidity. SCAD emerges as a rare manifestation of coronary artery disease, which a few recent case reports link to COVID-19. The aim of this article is to summarize the relevant data on the pathophysiology of COVID-19 and SCAD along with a review of the reported cases on acute coronary syndrome (ACS) following SARS-CoV2 infection and, thus, to provide insights about the relationship between COVID-19 and SCAD.

Correlation study of CBC derivatives and biochemical prognostic marker in covid-19 patients

: SARS-CoV2 infection induces inflammatory responses and acute lung injury in human beings. Infection causes certain haematological and biochemical changes in patients. This study aimed analyze the correlation between CBC derivatives and biochemical prognostic marker in COVID-19.: Total 80 individuals selected, 50 COVID-19 positive patients and 30 subjects negative for COVID-19 RT-PCR test. Blood collected was sent to NLR, RDW, assayed in Beckman Coulter DxH 800. Serum CRP estimated by Immuno-turbidimetric method, ferritin by CLIA. Plasma collected estimate for D-DIMER by CLIA. Unpaired T test &amp; Pearson correlation (IBM SPSS 22.0) were used. : Elevated levels of NLR (p value &amp;#60;0.001), RDW (p value &amp;#60;0.001), FERRITIN (p value &amp;#60;0.001), D-D-DIMER (p value &amp;#60;0.001), CRP (p value &amp;#60;0.001) some research parameters like LHD and RSF show significant decrease. In current study the NLR positively correlate to CRP (r value=0.5, p value &amp;#60;0.001), NLR positively correlate to D-DIMER (r value=0.3, p value&amp;#60;0.05), RDW positively correlated to CRP (r value=, 0.3, p value &amp;#60;0.05), RDW negatively correlated to ferritin (r value=-0.439, p value &amp;#60;0.001)LHD negatively correlated ferritin (r value=-0.316, p value=&amp;#60;0.05), MAF negatively correlated to D-dimer (r value=-0.244 &amp;#60;0.05), MSCV positively correlated with CRP (r value=0.336, p value= &amp;#60;0.05).: The cytokine storm produced during covid-19 infection which inturn develop neutrophilia and lymphopenia, CRP production and also cause elevation of procoagulants &amp;D-dimer. RDW and CRP are positively correlated they are elevated during inflammatory conditions.RDW and FERRITIN show negative correlation. Retrospective study have some limitation so future studies will reveal more information.

Elevated levels of cell-free NKG2D-ligands modulate NKG2D surface expression and compromise NK cell function in severe COVID-19 disease.

It is now clear that coronavirus disease 19 (COVID-19) severity is associated with a dysregulated immune response, but the relative contributions of different immune cells is still not fully understood. SARS CoV-2 infection triggers marked changes in NK cell populations, but there are contradictory reports as to whether these effector lymphocytes play a protective or pathogenic role in immunity to SARS-CoV-2. To address this question we have analysed differences in the phenotype and function of NK cells in SARS-CoV-2 infected individuals who developed either very mild, or life-threatening COVID-19 disease. Although NK cells from patients with severe disease appeared more activated and the frequency of adaptive NK cells was increased, they were less potent mediators of ADCC than NK cells from patients with mild disease. Further analysis of peripheral blood NK cells in these patients revealed that a population of NK cells that had lost expression of the activating receptor NKG2D were a feature of patients with severe disease and this correlated with elevated levels of cell free NKG2D ligands, especially ULBP2 and ULBP3 in the plasma of critically ill patients. In vitro, culture in NKG2DL containing patient sera reduced the ADCC function of healthy donor NK cells and this could be blocked by NKG2DL-specific antibodies. These observations of reduced NK function in severe disease are consistent with the hypothesis that defects in immune surveillance by NK cells permit higher levels of viral replication, rather than that aberrant NK cell function contributes to immune system dysregulation and immunopathogenicity.

Exploring the lived experiences and perspectives of individuals with communication and swallowing difficulties associated with Long-COVID

BACKGROUND: Long-COVID occurs in individuals with a history of probable or confirmed SARS CoV-2 infection. Long-COVID can affect individuals who experience both mild and severe acute COVID-19 and can involve and affect multiple body systems. Research thus far acknowledges swallowing and communication difficulties as a characteristic of Long-COVID, however, this research lacks detail and does not address the psychosocial impact of these problems. OBJECTIVES: To establish an understanding of the presence, severity, and trajectory of swallowing and communication difficulties as a symptom of Long-COVID among adults. To investigate the psychosocial impact of these characteristics and explore supports and barriers to recovery. METHODS: The objectives were addressed by utilizing a qualitative research design. Semi-structured interviews were carried out with participants using online Zoom sessions. The interviews were recorded and transcribed and reflexive thematic analysis was used to analyse the data. RESULTS: Seven participants from Ireland, Scotland and Australia were interviewed. Four main themes were identified including dysphagia-related issues, communication-related issues, psychosocial impact of dysphagia and communication disorders, and accessing Long-COVID related healthcare for dysphagia and communication disorders. The presentation of swallowing and communication problems was diverse and had significant psychosocial and mental health consequences. Furthermore, access to healthcare services to effectively treat these issues was challenging. CONCLUSIONS: The lack of recognition of swallowing and communication as a symptom of Long-COVID and its adverse effects is a pertinent issue which warrants further research and updated guidelines for individuals living with Long-COVID and healthcare professionals alike.

Abstract TP203: Effect of SARS-CoV2 Infection on Endovascular Thrombectomy Outcomes - Data From the Florida Stroke Registry

Introduction: The outcomes of endovascular thrombectomy (EVT) in SARS-CoV2 positive patients with acute ischemic stroke (AIS) are not well studied. In the large Florida Stroke Registry we compared in hospital and discharge outcomes of patients with target vessel occlusions treated endovascularly with versus without a SARS-CoV2 positive infection status during their hospitalization. Methods: Data from Get With the Guidelines-Stroke hospitals participating in the Florida Stroke Registry from March 2020 to December 2022 were reviewed. EVT patients with coding for SARS-CoV2 testing during their hospital stay were categorized into SARS-CoV2 positive or negative groups. Associations between SARS-CoV2 status and favorable EVT outcomes of good mRS (0-2) at discharge, discharge to home or to rehabilitation centre, and independent ambulation at discharge were examined using multivariate logistic regression modeling adjusting for demographics, vascular risk factors, and clinical characteristics with generalized estimating equations (GEE). Temporal analyses compared outcomes across the years 2020-2022. Results: A total of 8,778 patients underwent EVT, of these, 193 (2.25%) were SARS-CoV2 positive. The odds of mRS 0-2 and independent ambulation at discharge were OR 0.194 (CI 0.035,1.077) and OR 0.794 (CI 0.168,3.75) in SARS-CoV2 positive relative to negative EVT patients. Outcomes of mRS 0-2 (OR 0.194, CI 0.035,1.077) and ambulation at discharge (OR 0.794, CI 0.168,3.75) were shy of statistical significance. Accounting for baseline differences SARS-CoV2 positive patients were less likely to be discharged home or to a rehabilitation centre (OR 0.671, CI 0.488,0.921) in multivariable analysis with GEE. Temporal analysis of SARS-CoV2 positive patients showed no significant differences across the years studied. Conclusions: In this large muliticentre stroke registry the results suggest that favorable outcomes post thrombectomy may be negatively impacted by SARS-CoV2 infection. Temporal assessment showed similar results across the years studied. These findings provide novel insight from a large database to add to the emerging literature examining outcomes of concurrent SARS-CoV2 infection in the setting of EVT for target vessel occlusion AIS.