SARS-CoV-2 Research Articles

The Effect of Prone Position on Patients with Covid-19: Case Study

Purpose: Evaluation of the prone position in the awake patient with a nasal cannula and diagnosed with Covid-19 in improving oxygen saturation. Methodology: Case study of a patient diagnosed with Sars Cov-2, Covid-19 through a pulmonary Ct with bilateral pneumonia and initial value of C-Reactive protein=38.01mg/l. This patient was treated in outpatient conditions (at home) in the period of October 2020. Result: The standard deviation in terms of oxygen uptake from day one to day eight had significant improvements from SD=94±1.8Sa(O2) to SD=95.7±2.0Sa(O2). Also, nasal cannula oxygen levels had significant reductions from SD=4.1±0.4 liters on day 1 to SD=1.2±0.2 liters. The pvalue results are significant with a value of p=<0.001, so the prone position was better compared to the supin position. Conclusion: The prone position in our patient's case was effective in improving blood oxygen saturation. Received: 2 June 2024 / Accepted: 25 July 2024 / Published: 29 July 2024

Development of multidose thermotolerant formulations of a vector-based Covid-19 vaccine candidate, NDV-HXP-S in different product formats: Stability and preservative efficacy study

Current lead coronavirus vaccines require continuous cold or ultra-cold storage from the manufacturing site to the field to maintain protective efficacy. Since cold chain capacity is limited and complex, logistics planning is crucial to limit vaccine wastage.[1] The restrictive storage concerns also make it difficult to share vaccines between public health departments and neighboring states, leading to increased vaccine wastage.[2] A Newcastle Disease Virus (NDV) vector-based severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) vaccine candidate, NDV-HXP-S, offers a cost-effective alternative which aims to improve global access to SARS CoV-2 vaccines.[3] The NDV-HXP-S vaccine candidate can be mass-produced in chicken eggs and has demonstrated efficacy in preclinical studies, as well as acceptable safety andpotent immunogenicity in clinical studies.[3,4–10] To further advance the NDV-HXP-S vaccine candidate, this manuscript describes work focused on the development of multidose thermotolerant vaccine formulations (i.e., those which would not require continuous extendedrefrigeration), making it convenient to use and store, and simplifying transport and distribution logistics, especially in outbreak settings. Liquid and lyophilized formulations for parenteral administration were rigorously screened for the vaccine formulation’s ability to maintain S-antigen stability after exposure to temperaturestress at 40 °C, 25 °C, and 2 °C to 8 °C storage for six months. Preservative efficacy was evaluated to enable a multidose liquid vaccine format as well as endotoxin testing in lyophilized formulations. Lead liquid vaccine formations were identified that were able to maintain S-antigen content at 2 °C to 8 °C and 25 °C storage for the entire six-month study. Lead lyophilized vaccine formulations were identified which were able to maintain S-antigen content for six months at 2 °C to 8 °C, 25 °C, and 40 °C. Both the liquid and lyophilized formulations identified are improved thermotolerant SARS-CoV-2 vaccine formulations.

Immuno-inflammatory and organ dysfunction markers in severe COVID-19 patients

Infection with the SARS-CoV-2 virus may induce some complications among people who experience mild to moderate respiratory illness and some of them recover without requiring special treatment. Albeit, some individuals become seriously reached risk points and require special medical attention especially older people and people who suffer from chronic diseases. Serum and whole blood samples were collected from confirmed infected persons with SARS CoV-2 by real-time PCR and the control group. All lab. Investigations were performed using Cobas 6000. Significant differences were noted between patients compared to the control group in the Mean ± SD of IL-6 (76.06 ± 7.60 vs 3.61 ± 0.296 pg/ml), Procalcitonin (0.947 ± 0.117 vs 0.061 ± 0.007 ng/ml), CRP (125.3 ± 7.560 vs 4.027 ± 0.251 mg/dl), ALT (154.8 ± 30.47 vs 49.75 ± 2.977 IU/L) and AST (70.83 ± 9.215 vs 27.23 ± 1.767) respectively. While other parameters were also showed significant differences were noted between patients compared to the control group for D-Dimmer, PT, PTT, LDH, Ferritin, WBC, Lymphocyte and Creatinine. The results reached that the effect of SARS CoV-2 and cytokine storm was clear on the body’s organs through vital biomarker investigations that were performed in this study.

Multiscale Materials Engineering via Self-Assembly of Pentapeptide Derivatives from SARS CoV E Protein.

Short peptide-based supramolecular hydrogels hold enormous potential for a wide range of applications. However, the gelation of these systems is very challenging to control. Minor changes in the peptide sequence can significantly influence the self-assembly mechanism and thereby the gelation propensity. The involvement of SARS CoV E protein in the assembly and release of the virus suggests that it may have inherent self-assembling properties that can contribute to the development of hydrogels. Here, three pentapeptide sequences derived from C-terminal of SARS CoV E protein are explored with same amino acid residues but different sequence distributions and discovered a drastic difference in the gelation propensity. By combining spectroscopic and microscopic techniques, the relationship between peptide sequence arrangement and molecular assembly structure are demonstrated, and how these influence the mechanical properties of the hydrogel. The present study expands the variety of secondary structures for generating supramolecular hydrogels by introducing the 310-helix as the primary building block for gelation, facilitated by a water-mediated structural transition into β-sheet conformation. Moreover, these Fmoc-modified pentapeptide hydrogels/supramolecular assemblies with tunable morphology and mechanical properties are suitable for tissue engineering, injectable delivery, and 3D bio-printing applications.

Single nucleotide variants rs7975232 and rs2228570 within vitamin D receptor gene confers protection against severity of COVID-19 infection in Bangladeshi population

Vitamin D insufficiency has been linked to an elevated susceptibility to SARS CoV-2 infection in several studies owing to its immunomodulatory properties. This study aimed to examine the association between vitamin D levels and the genetic variations in the vitamin D receptor (VDR) gene with the severity of COVID-19. A total of 71 COVID-19 patients (Mild = 27, Moderate = 20, Severe = 24) and healthy individuals (n = 22) were recruited in this study. The 25 (OH) vitamin D level was found to be lowest in the severe COVID-19 patients (18.2 ng/mL) compared to other study participants. Initially, Whole Exome Sequencing (WES) of 29 individuals was conducted (patients, n = 22 and controls, n = 7) to identify potential mutational hotspots within the VDR gene. The WES data revealed 2 exonic and 10 intronic variants in the VDR region of the study participants. Further analysis included large number of samples comprising 64 individuals to evaluate the association of 3 SNPs, rs11168266, rs7975232, and rs2228570, with the disease severity employing Sanger sequencing or PCR-RFLP. The genotype T/T [OR (95%CI): 0.32 (0.13–0.79), p = 0.013] and genotype C/C [OR (95%CI): 0.36 (0.15–0.89), p = 0.02] of rs7975232 and rs2228570, respectively were found to be significantly associated with lower risk of COVID-19 severity under recessive model. In conclusion, the genotypes T/T and C/C of ApaI and FokI confer protection against severe COVID-19 in Bangladeshi population, which warrants further validation in a larger sample size.

Records of antibodies in breast milk in postpartum women who have been vaccinated or exposed to COVID-19: A systematic review

Background: Breast milk is a critical element in developing a baby’s immunity through immune transfer. Antibodies are an essential unit of immunity against infection with the SARS-CoV-2 virus. This paper explores antibodies in breast milk in postpartum women who have been vaccinated or exposed to coronavirus disease 2019 (COVID-19). Duration of antibody appearance was studied to determine the adequate time in transferring antibodies by breastfeeding. Methods: Three databases, PubMed, Google Scholar, and ScienceDirect, were used as sources of articles. Inclusion criteria applied in selecting articles were prospective observational study or experimental design study in English, evaluating antibodies in breast milk, and conducted between 2019–2021. Article quality and risk of bias were assessed with Critical Appraisal Skills Programme (CASP). The data found were synthesized in a narrative manner. Results: This systematic review included 20 articles. A total of 306 postpartum women who were infected with COVID-19, 20 postpartum women who had viral symptoms and 495 postpartum women who had been vaccinated were studied. Immunoglobulin A (IgA) and immunoglobulin G (IgG) antibodies were found in the breast milk of infected and vaccinated postpartum women. SARS CoV-2 infection is associated with the presence of IgA dominant, whereas vaccination is related to the presence of IgG dominant. Antibodies persisted from day 10 of onset to 10 months in infected postpartum women and started from three days to six weeks in vaccinated postpartum women. Meta-analysis could not be carried out due to the variety of articles. Conclusions: Antibodies found in breast milk in infected and vaccinated postpartum women have different dominant types. Further research needs to be done regarding the mechanism of antibody transfer in breast milk, longer research duration and studies that directly examine the comparison of antibodies in breast milk in vaccinated and infected postpartum women. Registration: PROSPERO (CRD42022340859, 23 June 2022).

Faktor-Faktor yang Berhubungan dengan Kelengkapan Vaksinasi Covid-19 pada Masyarakat di Wilayah Kerja Puskesmas Kenali Besar Kota Jambi

The Covid-19 pandemic caused by the Sars Cov-2 virus has the effect of triggering mild to severe acute respiratory tract disease with symptoms namely fever, shortness of breath, cough, fatigue, runny nose, sore throat, diarrhea, loss of the ability to smell and taste on the tongue and can cause death. Indonesia is the country with the most new cases and deaths in Southeast Asia as of 24-30 October 2022 with 19,661 new cases or 7.2 new cases per 100,000 population, even though the previous week there were 14,093 cases. This means that the addition occurred as much as 40%. This type of research is quantitative with a cross sectional design. The population of this study was all people aged > 17 years in the working area of the Puskesmas Iknew Besar, totaling 42,796 people with a sample of 172 respondents. The sampling technique used multistage random sampling. Data were collected using questionnaires and observation sheets, then univariate data analysis using the chi-square test. The results of the multivariate analysis show that there is a relationship between the completeness of the Covid-19 vaccination and attitudes, history of Covid-19, history of non-communicable diseases, perception of Covid-19 risk, family support and health information among the community in the working area of the Puskesmas Kenali Besar, Jambi City in 2022.

Post COVID Guillain Barre Syndrome (GBS) in paediatric COVID unit of Dhaka Medical College: A case series

SARS Cov-2 infection presents with mild respiratory illness but has evidence of multisystem involvement in little percentage, though the severity of infection is variable in children. Neurological manifestations may vary from headache, dizziness, olfactory or taste dysfunction to specific syndromes including meningoencephalitis, stroke, and acute transverse myelitis and Guillain- Barre syndrome (GBS). But there is little evidence worldwide about neurological complications of COVID-19 in children. Here we reporting five cases of post COVID-19 GBS with relevant literature review. J Dhaka Med Coll. 2022; 31(2) : 232-236

C-Reactive Protein as an Early Marker of Severity and Outcome in Patients with SARS-CoV-2 Infection

Abstract Background SARS CoV-2 infection is a major cause of morbidity and mortality worldwide. The incidence of SARS CoV-2 infection is rising with millions of people getting infected daily. Mortality rate varies from a country to the other(0.3-6%), most of which are attributed to respiratory failure. Several studies have been performed to identify biomarkers for use in the early identification of patients at risk. Aim of the work This study was done to estimate and evaluate the plasma levels of CRP in patients with SARS CoV-2 and to study the association of CRP levels with severity of disease progression and prognosis of those patients. Patients and Methods This retrospective cohort study was conducted on 100 patients admitted to El-Obour Ain Shams University Specialized Hospital for Isolation during the period between January and October 2020. Results Regarding history patients whom were old or have any of the following comorbid conditons as hypertension, Diabetes mellitus, chronic liver disease and active cancer were statistically more prone to not surviving. Regarding complete blood picture, there was significant decrease in haemoglobin and or increase in total leukocytic count in those who did not survive. Serum Ferritin and D-Dimer were significantly high in those who did not survive. As regard CRP, it was significantly higher in the non-survivor group, Also it correlated with severity as ICU admission and need of respiratory support. Regarding the ROC curve result the best cut-off of CRP to predict mortality was >129mg/l, with Area under the curve = 0.981, Sensitivity = 90.91%, Specificity= 97.75%, positive predictive value = 83.3% and negative predictive value =98.9%. Regarding the ROC curve result the best cut-off of CRP to predict need of respiratory support was >55.3mg/L, with Area under the curve = 0.976, Sensitivity = 100%, Specificity= 86.21%, positive predictive value = 52.0% and negative predictive value =100.0%. Regarding the ROC curve result the best cut-off of CRP to predict need of ICU admission was >55.3mg/L, with Area under the curve = 0.987, Sensitivity = 100.0%, Specificity= 93.75%, positive predictive value = 80.0% and negative predictive value =100.0%. Conclusion Laboratory and clinical medicine groups should actively collaborate and optimize their individual expertise to potentially prove standardized biomarkers assays that will optimize patient care.

Case Report: COVID-19 and Ischemic Stroke in A 16-Year-Old Patient

Introduction: Recent reports show an increasing trend of ischemic stroke at a young age. Diseases associated with ischemic stroke at a young age, namely hereditary hypercoagulable conditions. Case: In this case a 16-year-old boy with clinical complaints of sudden weakness of the right hand and leg, numbness, loss of appetite, nausea and vomiting. Laboratory tests showed results of increased levels of hemoglobin, hematocrit, erythrocyte count, platelet count, leukocyte count and NLR. The neutrophil-to-lymphocyte ratio (NLR), calculated as a simple ratio between the neutrophil and lymphocyte counts measured in peripheral blood. CT scan examination showed acute infarction in the medial left temporal lobe and old infarction in the left frontal lobe (medial gyrus). Thoracic CT Scan examination showed the results of bilateral pneumonia suggestive of viral. The patient encountered COVID-19. The patient experienced cough and shortness of breath and showed abnormal ABG results, namely respiratory alkalosis, decreased oxygen saturation, fever, increased procalcitonin and increased cardiac markers. Discussion: This case report prompts discussions on various aspects of ischemic stroke in young patients, including the role of COVID-19, hypercoagulable states, hematological abnormalities, and diagnostic challenges, with implications for patient management and future research directions. Conclusion: SARS CoV-2 can affect the nervous system through several mechanisms that cause persistent infection, resulting in neurological diseases, including stroke. Young ischemic stroke is usually hypercoagulable and the most common cause is APS. In this patient, polycythemia was occured,that causes blood flow slows and oxygen supply to the brain is reduced. This can cause ischemic stroke.

An Unusual Glomerulopathy with Subepithelial Deposits Having Microspherular Structures Following COVID-19 Vaccine

We report an unusual glomerulopathy with nephrotic syndrome and acute kidney injury almost two weeks after the second injection of SARS CoV-2 vaccine covishield, ChAdOx1-nCoV-19 in a 75-year-old healthy man. Kidney biopsy revealed segmental stage 1 membranous glomerulopathy and collapsing focal segmental glomerulosclerosis pattern with immune complexes on IF. Electron microscopy (EM) revealed aggregates of spherular microparticles along glomerular capillary walls. After starting him on steroids, his kidney functions gradually improved with significantly reduced proteinuria. Our patient seems to be the only reported SARS CoV-2 vaccine-induced early membranous nephropathy showing a collapsing focal segmental glomerulosclerosis pattern and immune complexes on IF with subepithelial deposits consisting of microspherular particles on EM.

Hospitalisations and humoral COVID-19 vaccine response in vaccinated rituximab-treated multiple sclerosis patients

BackgroundPatients with multiple sclerosis (MS) treated with anti-CD20 therapies such as rituximab may have increased risk of severe COVID-19 disease. Vaccination induces protective immunity, but humoral vaccine response is known to be attenuated in rituximab-treated MS-patients-patients, which has indicated a need for real world data on severe morbidity and mortality from COVID-19 after vaccination. MethodsRituximab-treated patients treated at Haukeland University Hospital were identified through the National MS Registry and invited to participate in the study by giving a consent and providing a blood sample 3 weeks or later after ordinary COVID-19- vaccination, i.e. 2 doses given with a standard interval of 3 weeks. Blood samples were analysed with Enzyme-Linked Immunosorbent assay (ELISA) to evaluate humoral vaccine response with screening test against receptor-binding domain (RBD) and confirmatory Spike IgG-specific ELISA. A haemagglutination test (HAT) was performed as a marker of neutralizing antibodies. Patient serum concentration of rituximab were quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS). Registry data from the Norwegian MS registry and information on hospitalization from patient records were collected and linked to laboratory results. Results111 patients were included in the study. A total of 7 (6.3%) were hospitalized due to COVID-19 disease during the observation period. No patient was admitted to ICU and there were no deaths. 34.2% did not have detectable titre of SARS CoV-2 Spike IgG antibodies, 72.1% did not have a detectable titre of SARS CoV-2 RBD antibodies, and 88.2% did not have a detectable HAT titre. There was a correlation between hospitalisation and the absence of SARS CoV-2 Spike IgG antibody titre, and between hospitalisation and MS disease duration, as well as between spike IgG antibody titre and CD19 B-cell count, time since last rituximab infusion, cumulative rituximab treatment time and total IgG level in the patients. ConclusionA substantial proportion of rituximab-treated MS-patients-patients did not have detectable humoral vaccine responses after 2 doses of COVID-19 vaccination. Despite this, the cumulative percentage of patients hospitalized with COVID-19 disease throughout the observation period of 22 months was low, and no patients required ICU treatment. The results support that vaccinated MS-patients treated with rituximab have a protective effect against serious Covid-19 infection.

External Quality Assessment Program for SARS-COV-2 Molecular Detection in Pakistan.

Amid coronavirus disease 2019 (COVID-19) pandemic, accurate detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical for diagnosis management and breaking down transmission chains. We designed a national external quality assessment panel (EQAP) for SARS-CoV-2 molecular detection comprising working laboratories nationwide. A molecular diagnostic EQA panel that consists of five samples for SARS CoV-2 testing was distributed to 141 public and private sector laboratories across country. These samples contain different concentrations of SARS-CoV-2 to evaluate the sensitivity of commercial kits available. Sensitivity among public and private sector laboratories was variable, particularly lower SARS-CoV-2 concentrations significantly increased the risk of false-negative tests, whereas Ct values of accurately tested SARS-CoV-2 specimens increased as concentration decreased. These findings highlighted that performance of used commercial kits was not significantly correlated to various extraction or PCR methods. This study highlights the need for a national external quality assessment panel (EQAP) in the country to improve the quality of the healthcare system while ensuring the accuracy and reliability of results. Furthermore, EQAPs can help laboratories meet accreditation and regulatory requirements. However, continued participation in EQAP is recommended for quality enhancement of laboratories.

Prevalence of non- SARS CoV-2 respiratory virus infection in children during COVID-19 pandemic in Chennai, South India.

Acute respiratory virus infections (ARIs) are a significant cause of morbidity and mortality among children worldwide. Respiratory viral infections in children have been significantly impacted during the COVID-19 pandemic. Variations in the prevalence of respiratory virus infections have been associated with the COVID-19 pandemic, which corresponds to the clinical epidemiology of community-acquired respiratory viruses. The aim of the present study was to investigate the prevalence of acute respiratory viral infection in COVID-19 negative children. The study included 100 SARS-CoV2 negative children with respiratory tract infections. Real-time polymerase chain reaction was used to determine the prevalence of respiratory viruses causing ARI in children. In our study, adenovirus and HRSV-A were predominantly reported in SARS-CoV2 negative children. The results of the study indicated that the incidence of viruses causing acute respiratory tract infections in children changed during the COVID-19 pandemic.

Hyaluronic acid fillers and SARS CoV-2 vaccination. Potential mechanisms associated with delayed inflammatory reactions

Hyaluronic acid fillers and SARS CoV-2 vaccination. Potential mechanisms associated with delayed inflammatory reactions

Expert System for Sars Cov-2 Disease with Comorbidities Using a Combination of Case Based Reasoning and Certainty Factor Methods

<p><em>Virus Sereve Acute Respirator Syndrome Corona Virus 2 (SARS COV-2) is a virus that is also caused by a corona virus which if exposed to this virus will cause a serious infection that has the potential to be life threatening. In various cases, it turns out that infection with the SARS COV-2 virus can have effects on several organs such as the lungs, heart, blood vessels, kidneys and liver. In this regard, some people think that the SARS COV-2 virus is a scary virus that makes people afraid to come to health services so that it has an impact on uncontrolled blood sugar and is prone to complications. To overcome the increase in mortality due to the SARS COV-2 virus with comorbidities with the help of artificial intelligence to build a knowledge-based system in the medical field for diagnosing SARS COV-2 with comorbidities using a combination of Case Based Reasoning and Certainty Factor methods. The Case Based Reasoning method is used as a rule to detect disease symptoms by diagnosing new cases based on old cases. While the Certainty Factor is used to increase the value of confidence and feasibility. The percentage of confidence value given by experts in order to get maximum results.</em></p>

Covid-19 Anosmia And Gustatory Symptoms As A Prognostic Factor

coronavirus pandemic has affected millions of people all across the globe. Along with fever sore throat respiratory difficulty anosmia and ageusia are important symptoms being seen. This study evaluates the prevalence of olfactory and gustatory dysfunction in patients with SARS CoV-2 infection and the severity and duration of altered taste and smell along with time taken for recovery. A total number of 300 patients that had tested positive for COVID 19 in lady hardinge medical college and associated hospitals were assessed for presence and severity of olfactory and gustatory dysfunction.

UNVEILING THE POTENTIAL OF OXADIAZOLE TRIAZINE NUCLEOSIDE DERIVATIVE AS AN INHIBITOR OF SARS COV-2: A COMPUTATIONAL BREAKTHROUGH

SARS-CoV-2 created havoc worldwide in 2019 and was responsible for many deaths. No antiviral drugs have been developed to combat this virus. Oxadiazoles have multiple biological functions, such as anti-inflammatory, anti-tussive, anticancer, analgesic, cough suppressant, anti-oxidant, vasodilator, and more. Many drugs with oxadiazole nuclei have been repurposed to combat COVID-19. To identify a potent oxadiazole derivative against SARS-CoV-2, this article screened 45 substituted oxadiazole triazine nucleoside analogs to counter the three key targets of the SARS-CoV-2 life cycle: spike protein, main proteases, and RNA-dependent RNA-polymerase. The geometry of 45 substituted oxadiazole triazine nucleoside analogs was optimized by density functional theory (DFT) with the B3LYp method. Drug-likeness criteria, ADMET prediction, and docking were carried out for screening. Further analysis of ligand-protein interactions was performed by molecular dynamics simulation at 50 ns. Compounds 1a (-8.5 kcal) and 1m (-8.5 kcal) showed an excellent binding affinity with main proteases (6LU7) and -7.8Kcal, -7.6Kcal, respectively, for RdRp (6M71), while compound 1a and 1m exhibited -8.0 kcal, -8.2 kcal binding affinity respectively for spike protein (6LZG). The MD simulation of the protein-ligand complex with compounds 1a and 1m exhibited good compactness and stability, further validating the docking results. This study proposes these two compounds would be robust inhibitors of SARS CoV-2.

The development and implementation of a proficiency testing program for SARS-CoV-2 using dried tube specimens in resource-limited countries

IntroductionWhen COVID-19 hit the world in 2019, an enhanced focus on diagnostic testing for SARS-CoV-2 was essential for a successful pandemic response. Testing laboratories stretched their capabilities for the new coronavirus by adopting different test methods. The necessity of having external quality assurance (EQA) mechanisms was even more critical due to this rapid expansion. However, there was a lack of experience in providing the necessary SARS-CoV-2 EQA materials, especially in locations with constrained resources.ObjectiveWe aimed to create a PT (Proficiency testing) programme based on the Dried Tube Specimens (DTS) method that would be a practical option for molecular based SARS-CoV-2 EQA in Low- and Middle-Income Countries.MethodsBased on previous ISO/IEC 17043:2010 accreditation experiences and with assistance from the US Centers for Disease Control and Prevention, The Supranational Reference Laboratory of Uganda (adapted the DTS sample preparation method and completed a pilot EQA program between 2020 and 2021. Stability and panel validation testing was conducted on the designed materials before shipping to pilot participants in six African countries. Participants received a panel containing five SARS-CoV-2 DTS samples, transported at ambient conditions. Results submitted by participants were compared to validation results. Participants were graded as satisfactory (≥ 80%) or unsatisfactory (< 80%) and performance reports disseminated.ResultsOur SARS-CoV-2 stability experiments showed that SARS-CoV-2 RNA was stable (-15 to -25 °C, 4 to 8 °C, (18 to 28 °C) room temperature and 35 to 38 °C) as well as DTS panels (4 to 8 °C, 18 to 28 °C, 35 to 38 °C and 45 °C) for a period of 4 weeks. The SARS-CoV-2 DTS panels were successfully piloted in 35 test sites from Zambia, Malawi, Mozambique, Nigeria, and Seychelles. The pilot results of the participants showed good accuracy, with an average of 86% (30/35) concordance with the original SARS CoV-2 expectations.ConclusionThe SARS-CoV-2 DTS PT panel is reliable, stable at ambient temperature, simple to prepare and requires minimal resources.

Candida and Long Covid: Mannan Not from Heaven

The pandemic has supercharged growing awareness of the gut microbiome as a critical determinant of human health. “Long haulers” share microbiomes similar to those seen in myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia, all frequently associated with Candida overgrowth (CO). Candida can synthesize its own IDO, altering tryptophan metabolism (ATM). Zonulin, a circulating protein that increases intestinal and endothelial permeability, has emerged as a central player. Candida hyphal walls express proteins analogous to gliadin/gluten, e.g., celiac disease (CeD), and mannans, e.g., Crohn’s disease (CrD), that may trigger antigliadin and anti-Gq coupled GPCR auto-antibodies linked to their lectin binding domain respectively. Hyphal mannan may induce auto-antibodies to AT1Rs, α1-ARs, mAChRs, and β2-ARs, prominent in LC, and regulate T cell receptors (TCRs) and regulatory B cell function, compromised in not only LC (vitiligo, psoriasis, alopecia) but also SLE, RA, and many other autoimmune diseases. All are Gq coupled GPCRs. The spike protein S on SARS CoV2 can attach to both the ACE2 receptor (required for tryptophan absorption) and Toll-like receptor4 (TLR4) bearing endothelial cells and enterocytes. Spike protein S is persistent in most with LC and, as a ligand for TLR4, can also activate zonulin. S can also activate the NLRP3 inflammasome, as can candidalysin. This inflammasome is directly connected to dementia, cancer, autoimmunity and obesity. Candidalysin causes hypercitrullination, instrumental in creating ACPAs (anti-citrullinated peptide antibodies) linked to LC, MCAS (mast cell activation syndrome), HSD (hypermobility spectrum disorder), and APS (antiphospholipid syndrome). A hypothetical pathophysiologic model is proposed implicating pre-existing CO, aggravated by Covid-19, in not only the genesis of LC but also that of autoimmune disease, dementia, cancer, many chronic diseases, and aging.