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Pushparaj K, Kuchi Bhotla H, Arumugam VA, Pappusamy M, Easwaran M, Liu WC, Issara U, Rengasamy KRR, Meyyazhagan A, Balasubramanian B. Mucormycosis (black fungus) ensuing COVID-19 and comorbidity meets - Magnifying global pandemic grieve and catastrophe begins. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 805:150355. [PMID: 34818767 PMCID: PMC8443313 DOI: 10.1016/j.scitotenv.2021.150355] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/25/2021] [Accepted: 09/11/2021] [Indexed: 05/02/2023]
Abstract
Post COVID-19, mucormycosis occurred after the SARS-CoV-2 has rampaged the human population and is a scorching problem among the pandemic globally, particularly among Asian countries. Invasive mucormycosis has been extensively reported from mild to severe COVID-19 survivors. The robust predisposing factor seems to be uncontrolled diabetes mellitus, comorbidity and immunosuppression acquired through steroid therapy. The prime susceptive reason for the increase of mucormycosis cases is elevated iron levels in the serum of the COVID survivors. A panoramic understanding of the infection has been elucidated based on clinical manifestation, genetic and non- genetic mechanisms of steroid drug administration, biochemical pathways and immune modulated receptor associations. This review lime-lights and addresses the "What", "Why", "How" and "When" about the COVID-19 associated mucormycosis (CAM) in a comprehensive manner with a pure intention to bring about awareness to the common public as the cases are inevitably and exponentially increasing in India and global countries as well. The article also unearthed the pathogenesis of mucormycosis and its association with the COVID-19 sequela, the plausible routes of entry, diagnosis and counter remedies to keep the infection at bay. Cohorts of case reports were analysed to spotlight the link between the pandemic COVID-19 and the nightmare-mucormycosis.
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Affiliation(s)
- Karthika Pushparaj
- Department of Zoology, School of Biosciences, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore 641 043, Tamil Nadu, India
| | - Haripriya Kuchi Bhotla
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka 560076, India
| | - Vijaya Anand Arumugam
- Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore 641 046, Tamil Nadu, India
| | - Manikantan Pappusamy
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka 560076, India
| | - Murugesh Easwaran
- International Centre for Genetic Engineering and Biotechnology, New Delhi 110067, India
| | - Wen-Chao Liu
- Department of Animal Science, College of Coastal Agricultural Sciences, Guangdong Ocean University, Zhanjiang 524088, PR China
| | - Utthapon Issara
- Division of Food Science and Technology Management, Faculty of Science and Technology, Rajamangala University of Technology Thanyaburi, Pathum Thani 12110, Thailand
| | - Kannan R R Rengasamy
- Green Biotechnologies Research Centre of Excellence, University of Limpopo, Private Bag X1106, Polokwane, Sovenga 0727, South Africa
| | - Arun Meyyazhagan
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka 560076, India.
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Salazar F, Bignell E, Brown GD, Cook PC, Warris A. Pathogenesis of Respiratory Viral and Fungal Coinfections. Clin Microbiol Rev 2022; 35:e0009421. [PMID: 34788127 PMCID: PMC8597983 DOI: 10.1128/cmr.00094-21] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Individuals suffering from severe viral respiratory tract infections have recently emerged as "at risk" groups for developing invasive fungal infections. Influenza virus is one of the most common causes of acute lower respiratory tract infections worldwide. Fungal infections complicating influenza pneumonia are associated with increased disease severity and mortality, with invasive pulmonary aspergillosis being the most common manifestation. Strikingly, similar observations have been made during the current coronavirus disease 2019 (COVID-19) pandemic. The copathogenesis of respiratory viral and fungal coinfections is complex and involves a dynamic interplay between the host immune defenses and the virulence of the microbes involved that often results in failure to return to homeostasis. In this review, we discuss the main mechanisms underlying susceptibility to invasive fungal disease following respiratory viral infections. A comprehensive understanding of these interactions will aid the development of therapeutic modalities against newly identified targets to prevent and treat these emerging coinfections.
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Affiliation(s)
- Fabián Salazar
- Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom
| | - Elaine Bignell
- Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom
| | - Gordon D. Brown
- Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom
| | - Peter C. Cook
- Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom
| | - Adilia Warris
- Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom
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153
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In Silico Screening of Potential Phytocompounds from Several Herbs against SARS-CoV-2 Indian Delta Variant B.1.617.2 to Inhibit the Spike Glycoprotein Trimer. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020665] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In October 2020, the SARS-CoV-2 B.1.617 lineage was discovered in India. It has since become a prominent variant in several Indian regions and 156 countries, including the United States of America. The lineage B.1.617.2 is termed the delta variant, harboring diverse spike mutations in the N-terminal domain (NTD) and the receptor-binding domain (RBD), which may heighten its immune evasion potentiality and cause it to be more transmissible than other variants. As a result, it has sparked substantial scientific investigation into the development of effective vaccinations and anti-viral drugs. Several efforts have been made to examine ancient medicinal herbs known for their health benefits and immune-boosting action against SARS-CoV-2, including repurposing existing FDA-approved anti-viral drugs. No efficient anti-viral drugs are available against the SARS-CoV-2 Indian delta variant B.1.617.2. In this study, efforts were made to shed light on the potential of 603 phytocompounds from 22 plant species to inhibit the Indian delta variant B.1.617.2. We also compared these compounds with the standard drug ceftriaxone, which was already suggested as a beneficial drug in COVID-19 treatment; these compounds were compared with other FDA-approved drugs: remdesivir, chloroquine, hydroxy-chloroquine, lopinavir, and ritonavir. From the analysis, the identified phytocompounds acteoside (−7.3 kcal/mol) and verbascoside (−7.1 kcal/mol), from the plants Clerodendrum serratum and Houttuynia cordata, evidenced a strong inhibitory effect against the mutated NTD (MT-NTD). In addition, the phytocompounds kanzonol V (−6.8 kcal/mol), progeldanamycin (−6.4 kcal/mol), and rhodoxanthin (−7.5 kcal/mol), from the plant Houttuynia cordata, manifested significant prohibition against RBD. Nevertheless, the standard drug, ceftriaxone, signals less inhibitory effect against MT-NTD and RBD with binding affinities of −6.3 kcal/mol and −6.5 kcal/mol, respectively. In this study, we also emphasized the pharmacological properties of the plants, which contain the screened phytocompounds. Our research could be used as a lead for future drug design to develop anti-viral drugs, as well as for preening the Siddha formulation to control the Indian delta variant B.1.617.2 and other future SARS-CoV-2 variants.
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Sahney A, Wadhawan M, Agarwal N, Berry N, Dadwal V, Vardani A, Kumar A. A Case Series of Amoebic Liver Abscess in Patients With COVID-19 Infection. J Clin Exp Hepatol 2022; 12:1017-1020. [PMID: 34728984 PMCID: PMC8553635 DOI: 10.1016/j.jceh.2021.10.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/24/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Globally, amoebiasis is the second leading cause of death due to parasitic diseases. Amoebic liver abscess (ALA) as an opportunistic infection in recently recovered COVID 19 disease patients has not been reported earlier. METHODS We present here a case series of 13 patients of ALA admitted during the month of May 2021 in BLK hospital, New Delhi, and had recently recovered from COVID 19 disease. RESULTS Out of 13, eight patients had moderate, and one had severe COVID 19 disease. All these patients had received steroids for the management of COVID 19 disease. The remaining 4 (30%) patients had mild disease. The mean age of our patients was 50 years (37-81 years). Out of 13 patients, nine (70%) were male, 5 were diabetic, 2 were hypertensive, and none were alcoholic. The most common presentation was fever (11/13) followed by upper abdomen pain (10/13). The mean time of symptom (fever or pain abdomen) onset from COVID 19 positivity date was 19 days (range 15-23 days). A complication the in form of localized intraperitoneal rupture was common in these patients and was seen in more than 50% (7/13) of patients. All the patients were managed with IV Metronidazole and abscess aspiration. All the patients were discharged, and the mean hospital stay was 6.6 days. CONCLUSION We report here an increase in the incidence of ALA in recently recovered COVID 19 patients and propose that it is most likely due to alteration in the immune state of these patients. It is important for physicians to investigate for liver abscess in patients who present again with fever and/or pain abdomen within 2 weeks of COVID 19 recovery.
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Affiliation(s)
| | | | | | | | | | | | - Ajay Kumar
- Address for correspondence. Ajay Kumar, Chairman, Department Digestive and Liver Diseases, BLK Super Speciality Hospital, India.
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155
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Pakzad R, Malekifar P, Shateri Z, Zandi M, Akhavan Rezayat S, Soleymani M, Karimi MR, Ahmadi SE, Shahbahrami R, Pakzad I, Abdi F, Farahani A, Soltani S, Kesheh MM, Hosseini P. Worldwide prevalence of microbial agents' coinfection among COVID-19 patients: A comprehensive updated systematic review and meta-analysis. J Clin Lab Anal 2022; 36:e24151. [PMID: 34851526 PMCID: PMC8761407 DOI: 10.1002/jcla.24151] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To provide information about pathogens' coinfection prevalence with SARS-CoV-2 could be a real help to save patients' lives. This study aims to evaluate the pathogens' coinfection prevalence among COVID-19 patients. METHOD In order to find all of the relevant articles, we used systematic search approach. Research-based databases including PubMed, Web of Science, Embase, and Scopus, without language restrictions, were searched to identify the relevant bacterial, fungal, and viral coinfections among COVID-19 cases from December 1, 2019, to August 23, 2021. In order to dig deeper, other scientific repositories such as Medrxiv were probed. RESULTS A total of 13,023 studies were found through systematic search. After thorough analysis, only 64 studies with 61,547 patients were included in the study. The most common causative agents of coinfection among COVID-19 patients were bacteria (pooled prevalence: 20.97%; 95% CI: 15.95-26.46; I2 : 99.9%) and less frequent were virus coinfections (pooled prevalence: 12.58%; 95% CI: 7.31-18.96; I2 : 98.7%). The pooled prevalence of fungal coinfections was also 12.60% (95% CI: 7.84-17.36; I2 : 98.3%). Meta-regression analysis showed that the age sample size and WHO geographic region did not influenced heterogeneity. CONCLUSION We identified a high prevalence of pathogenic microorganism coinfection among COVID-19 patients. Because of this rate of coinfection empirical use of antibacterial, antifungal, and antiviral treatment are advisable specifically at the early stage of COVID-19 infection. We also suggest running simultaneously diagnostic tests to identify other microbiological agents' coinfection with SARS-CoV-2.
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Affiliation(s)
- Reza Pakzad
- Department of EpidemiologyFaculty of HealthIlam University Medical SciencesIlamIran
| | - Pooneh Malekifar
- Department of EpidemiologySchool of Public HealthTehran University Medical SciencesTehranIran
| | - Zainab Shateri
- Student research committeeAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Milad Zandi
- Department of VirologySchool of Public HealthTehran University of Medical SciencesTehranIran
- Research Center for Clinical VirologyTehran University of Medical SciencesTehranIran
| | - Sara Akhavan Rezayat
- Department of Management & Health EconomicsSchool of Public HealthTehran University of Medical SciencesTehranIran
| | - Maral Soleymani
- Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Mohammad Reza Karimi
- Research Center for Clinical VirologyTehran University of Medical SciencesTehranIran
| | - Seyed Esmaeil Ahmadi
- Department of Hematology and Blood BankingSchool of Allied MedicineIran University of Medical SciencesTehranIran
| | - Ramin Shahbahrami
- Research Center for Clinical VirologyTehran University of Medical SciencesTehranIran
| | - Iraj Pakzad
- Department of MicrobiologySchool of MedicineIlam University Medical SciencesIlamIran
| | - Fatemeh Abdi
- Non‐communicable Disease Research CenterAlborz University of Medical SciencesKarajIran
| | - Abbas Farahani
- Infectious and Tropical Diseases Research CenterHormozgan Health InstituteHormozgan University of Medical SciencesBandar AbbasIran
| | - Saber Soltani
- Department of VirologySchool of Public HealthTehran University of Medical SciencesTehranIran
- Research Center for Clinical VirologyTehran University of Medical SciencesTehranIran
| | - Mina Mobini Kesheh
- Department of VirologySchool of MedicineIran University of Medical ScienceTehranIran
| | - Parastoo Hosseini
- Department of VirologySchool of Public HealthTehran University of Medical SciencesTehranIran
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Kalam MA, Shano S, Afrose S, Uddin MN, Rahman N, Jalal FA, Akter S, Islam A, Anam MM, Hassan MM. Antibiotics in the Community During the COVID-19 Pandemic: A Qualitative Study to Understand Users' Perspectives of Antibiotic Seeking and Consumption Behaviors in Bangladesh. Patient Prefer Adherence 2022; 16:217-233. [PMID: 35115769 PMCID: PMC8806049 DOI: 10.2147/ppa.s345646] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/12/2022] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic is thought to have led to increased "inappropriate" or "unjustified" seeking and consumption of antibiotics by individuals in the community. However, little reference has been made to antibiotic seeking and using behaviors from the perspectives of users in Bangladesh during this health crisis. PURPOSE This study seeks to document how antibiotic medicines are sought and used during a complex health crisis, and, within different contexts, what are the nuanced reasons why patients may utilize these medicines sub-optimally. METHODS We used an exploratory, qualitative design. Forty semi-structured telephone interviews were conducted with people diagnosed with COVID-19 (n=20), who had symptoms suggestive of COVID-19 (n=20), and who had received care at home in two cities between May and June 2021 in Bangladesh. In this study, an inductive thematic analysis was performed. RESULTS The analysis highlighted the interlinked relationships of antibiotic seeking and consumption behaviors with the diversity of information disseminated during a health crisis. Antibiotic-seeking behaviors are related to previous experience of use, perceived severity of illness, perceived vulnerability, risk of infection, management of an "unknown" illness and anxiety, distrust of expert advice, and intrinsic agency on antimicrobial resistance (AMR). Suboptimal adherence, such as modifying treatment regimes and using medication prescribed for others, were found to be part of care strategies used when proven therapeutics were unavailable to treat COVID-19. Early cessation of therapy was found to be a rational practice to avoid side effects and unknown risks. CONCLUSION Based on the results, we highly recommend the take up of a pandemic specific antimicrobial stewardship (AMS) program in the community. To deliver better outcomes of AMS, incorporating users' perspectives could be a critical strategy. Therefore, a co-produced AMS intervention that is appropriate for a specific cultural context is an essential requirement to reduce the overuse of antibiotics during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Md Abul Kalam
- Bangladesh Country Office, Helen Keller International, Dhaka, 1212, Bangladesh
- Correspondence: Md Abul Kalam, Helen Keller International, Bangladesh Country Office, Dhaka, 1215, Bangladesh, Tel +8801912408148, Email
| | - Shahanaj Shano
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
- EcoHealth Alliance, New York, NY, USA
| | | | - Md Nasir Uddin
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - Nafis Rahman
- Department of Public Health, American International University of Bangladesh, Dhaka, 1212, Bangladesh
| | - Faruk Ahmed Jalal
- Handicap International - Humanity & Inclusion, Dhaka, 1212, Bangladesh
| | - Samira Akter
- Department of Anthropology, Jahangirnagar University, Savar, Dhaka, 1243, Bangladesh
| | - Ariful Islam
- EcoHealth Alliance, New York, NY, USA
- Centre for Integrative Ecology, School of Life and Environmental Science, Deakin University, Geelong Campus, Warrnambool, VIC, 3216, Australia
| | - Md Mujibul Anam
- Department of Anthropology, Jahangirnagar University, Savar, Dhaka, 1243, Bangladesh
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157
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Morovati H, Khodadadi H, Ahmadpour E, Nami S, Mohammadi R, Hosseini H, Behravan M. Global prevalence, mortality, and main risk factors for COVID-19 associated pneumocystosis: A systematic review and meta-analysis. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.359784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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158
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Ghosheh GO, Alamad B, Yang KW, Syed F, Hayat N, Iqbal I, Al Kindi F, Al Junaibi S, Al Safi M, Ali R, Zaher W, Al Harbi M, Shamout FE. Clinical prediction system of complications among patients with COVID-19: A development and validation retrospective multicentre study during first wave of the pandemic. INTELLIGENCE-BASED MEDICINE 2022; 6:100065. [PMID: 35721825 PMCID: PMC9188985 DOI: 10.1016/j.ibmed.2022.100065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/21/2022] [Accepted: 06/01/2022] [Indexed: 12/15/2022]
Abstract
Clinical evidence suggests that some patients diagnosed with coronavirus disease 2019 (COVID-19) experience a variety of complications associated with significant morbidity, especially in severe cases during the initial spread of the pandemic. To support early interventions, we propose a machine learning system that predicts the risk of developing multiple complications. We processed data collected from 3,352 patient encounters admitted to 18 facilities between April 1 and April 30, 2020, in Abu Dhabi (AD), United Arab Emirates. Using data collected during the first 24 h of admission, we trained machine learning models to predict the risk of developing any of three complications after 24 h of admission. The complications include Secondary Bacterial Infection (SBI), Acute Kidney Injury (AKI), and Acute Respiratory Distress Syndrome (ARDS). The hospitals were grouped based on geographical proximity to assess the proposed system's learning generalizability, AD Middle region and AD Western & Eastern regions, A and B, respectively. The overall system includes a data filtering criterion, hyperparameter tuning, and model selection. In test set A, consisting of 587 patient encounters (mean age: 45.5), the system achieved a good area under the receiver operating curve (AUROC) for the prediction of SBI (0.902 AUROC), AKI (0.906 AUROC), and ARDS (0.854 AUROC). Similarly, in test set B, consisting of 225 patient encounters (mean age: 42.7), the system performed well for the prediction of SBI (0.859 AUROC), AKI (0.891 AUROC), and ARDS (0.827 AUROC). The performance results and feature importance analysis highlight the system's generalizability and interpretability. The findings illustrate how machine learning models can achieve a strong performance even when using a limited set of routine input variables. Since our proposed system is data-driven, we believe it can be easily repurposed for different outcomes considering the changes in COVID-19 variants over time.
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159
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Daodu J, Basuli D, Parikh A. A rare case of AIDS co-infected with COVID-19 presenting with disseminated Herpes zoster complicated with CMV and Varicella zoster virus meningoencephalitis. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022326. [PMID: 36533755 PMCID: PMC9828916 DOI: 10.23750/abm.v93i6.13464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023]
Abstract
During the COVID-19 pandemic, numerous co-infections have been reported, with some studies indicating that patients with HIV/AIDS have worse outcomes when co-infected with COVID-19. Here, we present the case of a young adult male who presented with disseminated Varicella and was simultaneously diagnosed with AIDS and COVID-19 virus with several infection-related complications. A 25-year-old African-American male presented to the Emergency Department with vesicular, blistering rashes in multiple dermatomes including his eyelids. The screening test in the ED was positive for COVID-19. Given his high-risk sexual history, he was tested for HIV which returned positive with a CD4 count of zero. He was started on IV antivirals for disseminated varicella with zoster ophthalmicus. The patient was intubated for worsening respiratory failure and required intensive care. During the hospital course, he developed worsening encephalopathy and CSF analysis was positive for CMV and VZV. The patient has a prolonged hospital stay and exhibited evidence of infectious CNS vasculitis and HIV myelopathy. Anti-retroviral therapy was started after the acute period and the patient showed slow but definite clinical improvement. To the best of our knowledge, this is the first case report of a patient with AIDS with COVID-19 and disseminated VZV and with multiple complex infection-related complications.
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Affiliation(s)
- Joseph Daodu
- Brody School of Medicine, Greenville, North Carolina, USA
| | - Debargha Basuli
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Amish Parikh
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina, USA
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Davies-Bolorunduro OF, Fowora MA, Amoo OS, Adeniji E, Osuolale KA, Oladele O, Onuigbo TI, Obi JC, Oraegbu J, Ogundepo O, Ahmed RA, Usman OA, Iyapo BG, Dada AA, Onyia N, Adegbola RA, Audu RA, Salako BL. Evaluation of respiratory tract bacterial co-infections in SARS-CoV-2 patients with mild or asymptomatic infection in Lagos, Nigeria. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:115. [PMID: 35469122 PMCID: PMC9022018 DOI: 10.1186/s42269-022-00811-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/12/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND A common complication of any respiratory disease by a virus could be a secondary bacterial infection, which is known to cause an increase in severity. It is, however, not clear whether the presence of some opportunistic pathogens called pathobionts contributes to the severity of the disease. In COVID-19 patients, undetected bacterial co-infections may be associated with the severity of the disease. Therefore, we investigated the implications of bacterial co-infections in COVID-19 cases. RESULTS This is a cross-sectional study that involved archived specimens collected from nasopharyngeal samples of 150 people for COVID-19 screening in Lagos. DNA extraction from the samples was carried out to determine the presence of five respiratory bacterial pathogens using nested real-time PCR, and data were analysed using the Chi-square test. Of the 150 samples collected, 121 (80.7%) were positive for SARs-CoV-2 infection and 29 were negative. The proportion of patients with bacteria co-infection in COVID-19-negative, asymptomatic, and mild cases were 93.1%, 70.7%, and 67.5%, respectively. There was no statistically significant difference between mild COVID-19 conditions and bacteria co-infection (p = 0.097). There was also no significant difference in the nasal carriage of Staphylococcus aureus, Mycoplasma pneumoniae, and Haemophilus spp. However, there was a statistically significant increase in the carriage of Moraxella catarrhalis and Chlamydophila pneumoniae among COVID-19-negative patients when compared with the positive patients (p value = 0.003 and 0.000 for Moraxella catarrhalis and Chlamydophila pneumoniae, respectively). CONCLUSIONS The current study shows that bacterial co-infection and superinfection with COVID-19 are not associated with mild and asymptomatic COVID-19 cases in our setting. However, given the high prevalence of Staphylococcus aureus and Mycoplasma pneumoniae among the mild COVID-19 cases seen in this study, early diagnosis and treatment of these bacterial co-infections are still encouraged to mitigate the effect on the severity of COVID-19.
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Affiliation(s)
| | - Muinah Adenike Fowora
- Molecular Biology and Biotechnology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Olufemi Samuel Amoo
- Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Esther Adeniji
- Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | - Oluwatobi Oladele
- Molecular Biology and Biotechnology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | | | - Joy Oraegbu
- Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Oluwatobi Ogundepo
- Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | | | | | | | | | | | | | - Rosemary Ajuma Audu
- Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
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Photolon Nanoporous Photoactive Material with Antibacterial Activity and Label-Free Noncontact Method for Free Radical Detection. Int J Mol Sci 2021; 23:ijms23010279. [PMID: 35008705 PMCID: PMC8745701 DOI: 10.3390/ijms23010279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/24/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Abstract
The worldwide increase in bacterial resistance and healthcare-associated bacterial infections pose a serious threat to human health. The antimicrobial photodynamic method reveals the opportunity for a new therapeutic approach that is based on the limited delivery of photosensitizer from the material surface. Nanoporous inorganic–organic composites were obtained by entrapment of photosensitizer Photolon in polysiloxanes that was prepared by the sol–gel method. The material was characterized by its porosity, optical properties (fluorescence and absorbance), and laser-induced antimicrobial activity against Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. The permanent encapsulation of Photolon in the silica coating and the antimicrobial efficiency was confirmed by confocal microscope and digital holotomography. The generation of free radicals from nanoporous surfaces was proved by scanning Kelvin probe microscopy. For the first time, it was confirmed that Kelvin probe microscopy can be a label-free, noncontact alternative to other conventional methods based on fluorescence or chemiluminescence probes, etc. It was confirmed that the proposed photoactive coating enables the antibacterial photodynamic effect based on free radicals released from the surface of the coating. The highest bactericidal efficiency of the proposed coating was 87.16%. This coating can selectively limit the multiplication of bacterial cells, while protecting the environment and reducing the risk of surface contamination.
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162
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Paparoupa M, Aldemyati R, Roggenkamp H, Berinson B, Nörz D, Olearo F, Kluge S, Roedl K, de Heer G, Wichmann D. The prevalence of early- and late-onset bacterial, viral, and fungal respiratory superinfections in invasively ventilated COVID-19 patients. J Med Virol 2021; 94:1920-1925. [PMID: 34951498 PMCID: PMC9015458 DOI: 10.1002/jmv.27548] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/19/2022]
Abstract
The role of respiratory superinfections in patients with coronavirus disease 2019 (COVID‐19) pneumonia remains unclear. We investigated the prevalence of early‐ and late‐onset superinfections in invasively ventilated patients with COVID‐19 pneumonia admitted to our department of intensive care medicine between March 2020 and November 2020. Of the 102 cases, 74 (72.5%) received invasive ventilation and were tested for viral, bacterial, and fungal pathogens on Days 0–7, 8–14, and 15–21 after the initiation of mechanical ventilation. Approximately 45% developed one or more respiratory superinfections. There was a clear correlation between the duration of invasive ventilation and the prevalence of coinfecting pathogens. Male patients with obesity and those suffering from chronic obstructive pulmonary disease and/or diabetes mellitus had a significantly higher probability to develop a respiratory superinfection. The prevalence of viral coinfections was high, with a predominance of the herpes simplex virus (HSV), followed by cytomegalovirus. No respiratory viruses or intracellular bacteria were detected in our cohort. We observed a high coincidence between Aspergillus fumigatus and HSV infection. Gram‐negative bacteria were the most frequent pathogen group. Klebsiella aerogenes was detected early after intubation, while Klebsiella pneumoniae and Pseudomonas aeruginosa were related to a prolonged respiratory weaning. In our cohort, approximately 45% of the invasively ventilated COVID‐19 patients developed a respiratory bacterial, viral, and/or fungal superinfection within 3 weeks after intubation. The most prevalent group of pathogens were Gram‐negative bacteria.
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Affiliation(s)
- Maria Paparoupa
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Razaz Aldemyati
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hannes Roggenkamp
- Department of Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Berinson
- Department of Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominik Nörz
- Department of Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Flaminia Olearo
- Department of Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Kluge
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kevin Roedl
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Geraldine de Heer
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominic Wichmann
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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163
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Abstract
Severe pneumonia is associated with high mortality (short and long term), as well as pulmonary and extrapulmonary complications. Appropriate diagnosis and early initiation of adequate antimicrobial treatment for severe pneumonia are crucial in improving survival among critically ill patients. Identifying the underlying causative pathogen is also critical for antimicrobial stewardship. However, establishing an etiological diagnosis is challenging in most patients, especially in those with chronic underlying disease; those who received previous antibiotic treatment; and those treated with mechanical ventilation. Furthermore, as antimicrobial therapy must be empiric, national and international guidelines recommend initial antimicrobial treatment according to the location's epidemiology; for patients admitted to the intensive care unit, specific recommendations on disease management are available. Adherence to pneumonia guidelines is associated with better outcomes in severe pneumonia. Yet, the continuing and necessary research on severe pneumonia is expansive, inviting different perspectives on host immunological responses, assessment of illness severity, microbial causes, risk factors for multidrug resistant pathogens, diagnostic tests, and therapeutic options.
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Affiliation(s)
- Catia Cillóniz
- Department of pneumology, Hospital Clinic of Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centers in Respiratory Diseases (CIBERES), Barcelona, Spain
| | - Antoni Torres
- Department of pneumology, Hospital Clinic of Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Centers in Respiratory Diseases (CIBERES), Barcelona, Spain
| | - Michael S Niederman
- Weill Cornell Medical College, Department of Pulmonary Critical Care Medicine, New York, NY, USA
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164
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Amin A, Vartanian A, Poladian N, Voloshko A, Yegiazaryan A, Al-Kassir AL, Venketaraman V. Root Causes of Fungal Coinfections in COVID-19 Infected Patients. Infect Dis Rep 2021; 13:1018-1035. [PMID: 34940403 PMCID: PMC8701102 DOI: 10.3390/idr13040093] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 01/09/2023] Open
Abstract
COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has infected over 200 million people, causing over 4 million deaths. COVID-19 infection has been shown to lead to hypoxia, immunosuppression, host iron depletion, hyperglycemia secondary to diabetes mellitus, as well as prolonged hospitalizations. These clinical manifestations provide favorable conditions for opportunistic fungal pathogens to infect hosts with COVID-19. Interventions such as treatment with corticosteroids and mechanical ventilation may further predispose COVID-19 patients to acquiring fungal coinfections. Our literature review found that fungal coinfections in COVID-19 infected patients were most commonly caused by Aspergillus, Candida species, Cryptococcus neoformans, and fungi of the Mucorales order. The distribution of these infections, particularly Mucormycosis, was found to be markedly skewed towards low- and middle-income countries. The purpose of this review is to identify possible explanations for the increase in fungal coinfections seen in COVID-19 infected patients so that physicians and healthcare providers can be conscious of factors that may predispose these patients to fungal coinfections in order to provide more favorable patient outcomes. After identifying risk factors for coinfections, measures should be taken to minimize the dosage and duration of drugs such as corticosteroids, immunosuppressants, and antibiotics.
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Affiliation(s)
- Arman Amin
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766-1854, USA; (A.A.); (N.P.); (A.V.); (A.Y.); (A.L.A.-K.)
| | - Artin Vartanian
- School of Medicine, St. George’s University, St. George’s 999166, Grenada;
| | - Nicole Poladian
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766-1854, USA; (A.A.); (N.P.); (A.V.); (A.Y.); (A.L.A.-K.)
| | - Alexander Voloshko
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766-1854, USA; (A.A.); (N.P.); (A.V.); (A.Y.); (A.L.A.-K.)
| | - Aram Yegiazaryan
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766-1854, USA; (A.A.); (N.P.); (A.V.); (A.Y.); (A.L.A.-K.)
| | - Abdul Latif Al-Kassir
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766-1854, USA; (A.A.); (N.P.); (A.V.); (A.Y.); (A.L.A.-K.)
| | - Vishwanath Venketaraman
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766-1854, USA; (A.A.); (N.P.); (A.V.); (A.Y.); (A.L.A.-K.)
- Correspondence:
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165
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Hesse S, Nuñez H, Salazar JR, Salinas TP, Barrera E, Chong R, Torres S, Cumbrera A, Olivares I, Junco A, Matteo C, González C, Chavarría O, Moreno A, Góndola J, Ábrego L, Díaz Y, Pitti Y, Franco D, Martínez-Montero M, Pascale JM, López-Vergès S, Martínez AA, Armién B. Case Report: First Confirmed Case of Coinfection of SARS-CoV-2 With Choclo orthohantavirus. FRONTIERS IN TROPICAL DISEASES 2021; 2:769330. [PMID: 34851327 PMCID: PMC8594034 DOI: 10.3389/fitd.2021.769330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022] Open
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a major international public health concern. The World Health Organization (WHO) declared the pandemic of coronavirus disease 2019 (COVID-19) on March 11, 2020. In Panama, the first SARS-CoV-2 infection was confirmed on March 9, 2020, and the first fatal case associated to COVID-19 was reported on March 10. This report presents the case of a 44-year-old female who arrived at the hospital with a respiratory failure, five days after the first fatal COVID-19 case, and who was living in a region where hantavirus pulmonary syndrome cases caused by Choclo orthohantavirus (CHOV), are prevalent. Thus, the clinical personnel set a differential diagnosis to determine a respiratory disease caused by the endemic CHOV or the new pandemic SARS-CoV-2. This case investigation describes the first coinfection by SARS-CoV-2 and CHOV worldwide. PCR detected both viruses during early stages of the disease and the genomic sequences were obtained. The presence of antibodies was determined during the patient’s hospitalization. After 23 days at the intensive care unit, the patient survived with no sequelae, and antibodies against CHOV and SARS-CoV-2 were still detectable 12 months after the disease. The detection of the coinfection in this patient highlights the importance, during a pandemic, of complementing the testing and diagnosis of the emergent agent, SARS-CoV-2, with other common endemic respiratory pathogens and other zoonotic pathogens, like CHOV, in regions where they are of public health concern.
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Affiliation(s)
- Susana Hesse
- Intensive Care Unit, Luis "Chicho" Fabrega Hospital, Ministry of Health, Santiago, Panama
| | - Heydy Nuñez
- Department of Epidemiology, National Social Security Fund, Santiago, Panama.,Department of Epidemiology, Ezequiel Abadia Hospital, Soná, Panama
| | - Jacqueline R Salazar
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Tybbysay P Salinas
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Erika Barrera
- Intensive Care Unit, Luis "Chicho" Fabrega Hospital, Ministry of Health, Santiago, Panama
| | - Ricardo Chong
- Regional Department of Epidemiology, Ministry of Health, Santiago, Panama
| | - Saúl Torres
- Department of Epidemiology, Ezequiel Abadia Hospital, Soná, Panama
| | - Amarellys Cumbrera
- Intensive Care Unit, Luis "Chicho" Fabrega Hospital, Ministry of Health, Santiago, Panama
| | - Idiamín Olivares
- Intensive Care Unit, Luis "Chicho" Fabrega Hospital, Ministry of Health, Santiago, Panama
| | - Aimee Junco
- Intensive Care Unit, Luis "Chicho" Fabrega Hospital, Ministry of Health, Santiago, Panama
| | - Christian Matteo
- Intensive Care Unit, Luis "Chicho" Fabrega Hospital, Ministry of Health, Santiago, Panama
| | - Claudia González
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Oris Chavarría
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Ambar Moreno
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Jessica Góndola
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Leyda Ábrego
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute for Health Studies, Panama City, Panama.,National Research System (SNI), National Secretary of Research, Technology and Innovation (SENACYT), Panama City, Panama
| | - Yamilka Díaz
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Yaneth Pitti
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Danilo Franco
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Mabel Martínez-Montero
- Inmunovirology Section, Central Reference Laboratory in Public Health, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Juan Miguel Pascale
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama.,National Research System (SNI), National Secretary of Research, Technology and Innovation (SENACYT), Panama City, Panama
| | - Sandra López-Vergès
- Department of Research in Virology and Biotechnology, Gorgas Memorial Institute for Health Studies, Panama City, Panama.,National Research System (SNI), National Secretary of Research, Technology and Innovation (SENACYT), Panama City, Panama
| | - Alexander A Martínez
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama.,National Research System (SNI), National Secretary of Research, Technology and Innovation (SENACYT), Panama City, Panama
| | - Blas Armién
- Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute for Health Studies, Panama City, Panama.,National Research System (SNI), National Secretary of Research, Technology and Innovation (SENACYT), Panama City, Panama
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166
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Matsuyama T, Yoshinaga SK, Shibue K, Mak TW. Comorbidity-associated glutamine deficiency is a predisposition to severe COVID-19. Cell Death Differ 2021; 28:3199-3213. [PMID: 34663907 PMCID: PMC8522258 DOI: 10.1038/s41418-021-00892-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 vaccinations have greatly reduced COVID-19 cases, but we must continue to develop our understanding of the nature of the disease and its effects on human immunity. Previously, we suggested that a dysregulated STAT3 pathway following SARS-Co-2 infection ultimately leads to PAI-1 activation and cascades of pathologies. The major COVID-19-associated metabolic risks (old age, hypertension, cardiovascular diseases, diabetes, and obesity) share high PAI-1 levels and could predispose certain groups to severe COVID-19 complications. In this review article, we describe the common metabolic profile that is shared between all of these high-risk groups and COVID-19. This profile not only involves high levels of PAI-1 and STAT3 as previously described, but also includes low levels of glutamine and NAD+, coupled with overproduction of hyaluronan (HA). SARS-CoV-2 infection exacerbates this metabolic imbalance and predisposes these patients to the severe pathophysiologies of COVID-19, including the involvement of NETs (neutrophil extracellular traps) and HA overproduction in the lung. While hyperinflammation due to proinflammatory cytokine overproduction has been frequently documented, it is recently recognized that the immune response is markedly suppressed in some cases by the expansion and activity of MDSCs (myeloid-derived suppressor cells) and FoxP3+ Tregs (regulatory T cells). The metabolomics profiles of severe COVID-19 patients and patients with advanced cancer are similar, and in high-risk patients, SARS-CoV-2 infection leads to aberrant STAT3 activation, which promotes a cancer-like metabolism. We propose that glutamine deficiency and overproduced HA is the central metabolic characteristic of COVID-19 and its high-risk groups. We suggest the usage of glutamine supplementation and the repurposing of cancer drugs to prevent the development of severe COVID-19 pneumonia.
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Affiliation(s)
- Toshifumi Matsuyama
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | | | - Kimitaka Shibue
- Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tak W Mak
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, ON, M5G 1L7, Canada
- Department of Immunology, University of Toronto, 101 College Street, Toronto, ON, M5G 1L7, Canada
- Department of Pathology, University of Hong Kong, Hong Kong, Pok Fu Lam, 999077, Hong Kong
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167
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Grinbaum RS, Kiffer CRV. Bacterial infections in COVID-19 patients: a review. Rev Assoc Med Bras (1992) 2021; 67:1863-1868. [PMID: 34909963 DOI: 10.1590/1806-9282.20210812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/28/2021] [Indexed: 01/08/2023] Open
Affiliation(s)
- Renato Satovschi Grinbaum
- Hospital e Maternidade São Luiz São Caetano - São Caetano do Sul (SP), Brazil.,Universidade Cidade de São Paulo - São Paulo (SP), Brazil.,Universidade Municipal de São Caetano do Sul - São Caetano do Sul (SP), Brazil
| | - Carlos Roberto Veiga Kiffer
- Hospital e Maternidade São Luiz São Caetano - São Caetano do Sul (SP), Brazil.,Universidade Federal de São Paulo, Laboratório Especial de Microbiologia Clínica, Escola Paulista de Medicina - São Paulo (SP), Brazil
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168
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Nomah DK, Reyes-Urueña J, Llibre JM, Ambrosioni J, Ganem FS, Miró JM, Casabona J. HIV and SARS-CoV-2 Co-infection: Epidemiological, Clinical Features, and Future Implications for Clinical Care and Public Health for People Living with HIV (PLWH) and HIV Most-at-Risk Groups. Curr HIV/AIDS Rep 2021; 18:518-526. [PMID: 34890019 PMCID: PMC8661831 DOI: 10.1007/s11904-021-00579-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is using the currently available clinical and epidemiological data, to identify key aspects to improve both the clinical management and public health response with regard SARS-CoV-2/HIV co-infection among HIV vulnerable populations and people living with HIV (PLWH). RECENT FINDINGS While at the beginning of the COVID-19 pandemic, the lack of robust information on SARS-CoV-2/HIV coinfection prevented to have a clear picture of the synergies between them, currently available data strongly supports the importance of common structural factors on both the acquisition and clinical impact of these infections and the relevance of age, co-morbidities, and HIV viral load as associated worse prognosis factors among PLWH. Although more information is needed to better understand the biological, clinical, and epidemiological relationship between both infections, in the meanwhile, syndemic approaches to prevent SARS-CoV-2 among HIV higher risk groups and PLWH, targeting these population for SARS-CoV-2 vaccines and protocolizing early identification of HIV + patients with worse COVID-19 prognosis factors, are crucial strategies to decrease the overall impact of SARS-CoV-2 /HIV coinfection.
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Affiliation(s)
- Daniel K Nomah
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Campus de Can Ruti, Josep Carreras Building, Ctra de Can Ruti, Camí de les Escoles, s/n, 08916, Badalona, Catalonia, Spain
- Departament de Pediatria, d'Obstetrícia I Ginecologia I de Medicina Preventiva I de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació Germans Trias I Pujol (IGTP), Badalona, Spain
| | - Juliana Reyes-Urueña
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Campus de Can Ruti, Josep Carreras Building, Ctra de Can Ruti, Camí de les Escoles, s/n, 08916, Badalona, Catalonia, Spain
- Institut d'Investigació Germans Trias I Pujol (IGTP), Badalona, Spain
- CIBER Epidemiologia Y Salud Pública (CIBERESP), Barcelona, Spain
| | - Josep Ma Llibre
- Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Juan Ambrosioni
- Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Fabiana S Ganem
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Campus de Can Ruti, Josep Carreras Building, Ctra de Can Ruti, Camí de les Escoles, s/n, 08916, Badalona, Catalonia, Spain
- Departament de Pediatria, d'Obstetrícia I Ginecologia I de Medicina Preventiva I de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació Germans Trias I Pujol (IGTP), Badalona, Spain
| | - José Ma Miró
- Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Jordi Casabona
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Campus de Can Ruti, Josep Carreras Building, Ctra de Can Ruti, Camí de les Escoles, s/n, 08916, Badalona, Catalonia, Spain.
- Departament de Pediatria, d'Obstetrícia I Ginecologia I de Medicina Preventiva I de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain.
- Institut d'Investigació Germans Trias I Pujol (IGTP), Badalona, Spain.
- CIBER Epidemiologia Y Salud Pública (CIBERESP), Barcelona, Spain.
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169
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Cohen R, Babushkin F, Finn T, Geller K, Alexander H, Datnow C, Uda M, Shapiro M, Paikin S, Lellouche J. High Rates of Bacterial Pulmonary Co-Infections and Superinfections Identified by Multiplex PCR among Critically Ill COVID-19 Patients. Microorganisms 2021; 9:microorganisms9122483. [PMID: 34946086 PMCID: PMC8707776 DOI: 10.3390/microorganisms9122483] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The role of bacterial co-infection and superinfection among critically ill COVID-19 patients remains unclear. The aim of this study was to assess the rates and characteristics of pulmonary infections, and associated outcomes of ventilated patients in our facility. METHODS This was a retrospective study of ventilated COVID-19 patients between March 2020 and March 2021 that underwent BioFire®, FilmArray® Pneumonia Panel, testing. Community-acquired pneumonia (CAP) was defined when identified during the first 72 h of hospitalization, and ventilator-associated pneumonia (VAP) when later. RESULTS 148 FilmArray tests were obtained from 93 patients. With FilmArray, 17% of patients had CAP (16/93) and 68% had VAP (64/93). Patients with VAP were older than those with CAP or those with no infection (68.5 vs. 57-59 years), had longer length of stay and higher mortality (51% vs. 10%). The most commonly identified FilmArray target organisms were H. influenzae, S. pneumoniae, M. catarrhalis and E. cloacae for CAP and P. aeruginosa and S. aureus for VAP. FilmArray tests had high negative predictive values (99.6%) and lower positive predictive values (~60%). CONCLUSIONS We found high rates of both CAP and VAP among the critically ill, caused by the typical and expected organisms for both conditions. VAP diagnosis was associated with poor patient outcomes.
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Affiliation(s)
- Regev Cohen
- Adelson School of Medicine, Ariel University, Ariel 4077625, Israel; (T.F.); (J.L.)
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (F.B.); (K.G.); (H.A.); (C.D.)
- Correspondence: ; Tel.: +972-(9)-8609335
| | - Frida Babushkin
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (F.B.); (K.G.); (H.A.); (C.D.)
| | - Talya Finn
- Adelson School of Medicine, Ariel University, Ariel 4077625, Israel; (T.F.); (J.L.)
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (F.B.); (K.G.); (H.A.); (C.D.)
| | - Keren Geller
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (F.B.); (K.G.); (H.A.); (C.D.)
| | - Hanna Alexander
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (F.B.); (K.G.); (H.A.); (C.D.)
| | - Candice Datnow
- Infectious Diseases Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (F.B.); (K.G.); (H.A.); (C.D.)
| | - Martina Uda
- Intensive Care Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (M.U.); (M.S.)
| | - Maurice Shapiro
- Intensive Care Unit, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel; (M.U.); (M.S.)
| | - Svetlana Paikin
- Clinical Microbiology Laboratory, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel;
| | - Jonathan Lellouche
- Adelson School of Medicine, Ariel University, Ariel 4077625, Israel; (T.F.); (J.L.)
- Clinical Microbiology Laboratory, Sanz Medical Center, Laniado Hospital, Netanya 4244915, Israel;
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170
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Rothe K, Spinner CD, Panning M, Pletz MW, Rohde G, Rupp J, Witzenrath M, Erber J, Eberhardt F, Essig A, Schneider J. Evaluation of a multiplex PCR screening approach to identify community-acquired bacterial co-infections in COVID-19: a multicenter prospective cohort study of the German competence network of community-acquired pneumonia (CAPNETZ). Infection 2021; 49:1299-1306. [PMID: 34687426 PMCID: PMC8536912 DOI: 10.1007/s15010-021-01720-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/12/2021] [Indexed: 01/08/2023]
Abstract
Purpose Thorough knowledge of the nature and frequency of co-infections is essential to optimize treatment strategies and risk assessment in cases of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the multiplex polymerase chain reaction (PCR) screening approach for community-acquired bacterial pathogens (CABPs) at hospital admission, which could facilitate identification of bacterial co-infections in hospitalized COVID-19 patients. Methods Clinical data and biomaterials from 200 hospitalized COVID-19 patients from the observational cohort of the Competence Network for community-acquired pneumonia (CAPNETZ) prospectively recruited between March 17, 2020, and March 12, 2021 in 12 centers in Germany and Switzerland, were included in this study. Nasopharyngeal swab samples were analyzed on hospital admission using multiplex real-time reverse transcription (RT)-PCR for a broad range of CABPs. Results In total of 200 patients Staphylococcus aureus (27.0%), Haemophilus influenzae (13.5%), Streptococcus pneumoniae (5.5%), Moraxella catarrhalis (2.5%), and Legionella pneumophila (1.5%) were the most frequently detected bacterial pathogens. PCR detection of bacterial pathogens correlated with purulent sputum, and showed no correlation with ICU admission, mortality, and inflammation markers. Although patients who received antimicrobial treatment were more often admitted to the ICU and had a higher mortality rate, PCR pathogen detection was not significantly related to antimicrobial treatment. Conclusion General CABP screening using multiplex PCR with nasopharyngeal swabs may not facilitate prediction or identification of bacterial co-infections in the early phase of COVID-19-related hospitalization. Most patients with positive PCR results appear to be colonized rather than infected at that time, questioning the value of routine antibiotic treatment on admission in COVID-19 patients. Supplementary Information The online version contains supplementary material available at 10.1007/s15010-021-01720-8.
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Affiliation(s)
- Kathrin Rothe
- School of Medicine, Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany
| | - Christoph D Spinner
- Department of Internal Medicine II, School of Medicine, University Hospital rechts der isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Marcus Panning
- Faculty of Medicine, Institute of Virology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Mathias W Pletz
- Institute of Infectious Diseases and Infection Control, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- CAPNETZ Stiftung, Hannover, Germany
- CAPNETZ STIFTUNG, Hannover, Germany
| | - Gernot Rohde
- Department of Respiratory Medicine, Medical Clinic I, Goethe University Hospital, Frankfurt, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover, Germany
- CAPNETZ STIFTUNG, Hannover, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
- CAPNETZ STIFTUNG, Hannover, Germany
| | - Martin Witzenrath
- Division of Pulmonary Inflammation, Department of Infectious Diseases and Pulmonary Medicine, Charité, Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- CAPNETZ STIFTUNG, Hannover, Germany
| | - Johanna Erber
- Department of Internal Medicine II, School of Medicine, University Hospital rechts der isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | | | - Andreas Essig
- Department of Medical Microbiology and Hygiene, University of Ulm, Ulm, Germany
| | - Jochen Schneider
- Department of Internal Medicine II, School of Medicine, University Hospital rechts der isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
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171
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COVID-19-Associated Pulmonary Aspergillosis in Patients with Acute Leukemia: A Single-Center Study. J Fungi (Basel) 2021; 7:jof7110890. [PMID: 34829179 PMCID: PMC8625614 DOI: 10.3390/jof7110890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 12/21/2022] Open
Abstract
Patients with coronavirus disease 19 (COVID-19) have increased susceptibility to secondary respiratory infections including invasive pulmonary aspergillosis (IPA). COVID-19-associated pulmonary aspergillosis (CAPA) is difficult to diagnose and can be associated with increased mortality especially in severe immunodeficiency such as hematological malignancies. Our study evaluates IPA in COVID-19 patients defined as COVID-19-CAPA among patients with acute leukemia (AL). A retrospective single-center study analyzed 46 patients with COVID-19 infection and acute leukemia, admitted to the Clinic for Haematology, Clinical Center of Serbia, Belgrade between the 2 April 2020 and 15 May 2021. During hospitalization, all participants were diagnosed with probable IPA according to the previous consensus definitions. Positive serology and galactomannan (GM) detection values in bronchoalveolar lavage (BAL) and serum were used as microbiological criteria. COVID-19 associated probable IPA was found in 22% (9/41) tested patients, where serum GM and IgM anti-Aspergillus antibodies were positive in 12% (5/41) and 10% (4/41) had positive serology for aspergillosis. One patient died while eight recovered during follow-up. Our study showed that COVID-19 might be a risk factor for IPA development in patients with AL. Early diagnosis and prompt treatment are required as reported mortality rates are high.
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172
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Unwin RJ. The 1918 Influenza Pandemic: Back to the Future? Kidney Blood Press Res 2021; 46:639-646. [PMID: 34662882 DOI: 10.1159/000519288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It is just over a century since the 1918 flu pandemic, sometimes referred to as the "mother" of pandemics. This brief retrospective of the 1918 pandemic is taken from the viewpoint of the current SARS-CoV-2/COVID-19 pandemic and is based on a short lecture given during the 2021 Virtual Congress of the ERA-EDTA. SUMMARY This review summarizes and highlights some of the earlier pandemic's salient features, some parallels with today, and some potential learnings, bearing in mind that the flu pandemic occurred over 100 years ago at a time of major turmoil during the climax to WWl, and with limited medical expertise and knowledge, research facilities, or well-structured and resourced healthcare services. While there is little or no information on renal complications at the time, or an effective treatment, some observations in relation to COVID-19 and vaccination are included. Key Messages: Lessons are difficult to draw from 1918 other than the importance and value of non-pharmaceutical measures to limit viral transmission. While the economic impact of the 1918 pandemic was significant, as it is now with COVID-19, subsequent economic analysis has shown that protecting public health and preserving economic activity are not mutually exclusive. Both H1N1 and SARS-CoV-2 viruses are neurotropic and may cause chronically debilitating neurological diseases, including conditions such as encephalitis lethargica (still debated) and myalgic encephalomyelitis (chronic fatigue syndrome), respectively. Although coronavirus and influenza viral infections have some similarities, they are certainly not the same, as we are realising, and future infectious pandemics may still surprise us, but being "forewarned is forearmed."
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Affiliation(s)
- Robert J Unwin
- Department of Renal Medicine, Royal Free Hospital Trust, University College London, London, United Kingdom
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Ermel A, Thyvalikakath TP, Foroud T, Khan B, Srinivasan M. Can Salivary Innate Immune Molecules Provide Clue on Taste Dysfunction in COVID-19? Front Microbiol 2021; 12:727430. [PMID: 34707585 PMCID: PMC8542928 DOI: 10.3389/fmicb.2021.727430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
Emerging concerns following the severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) pandemic are the long-term effects of coronavirus disease (COVID)-19. Dysgeusia in COVID-19 is supported by the abundant expression of the entry receptor, angiotensin-converting enzyme-2 (ACE2), in the oral mucosa. The invading virus perturbs the commensal biofilm and regulates the host responses that permit or suppress viral infection. We correlated the microbial recognition receptors and soluble ACE2 (sACE2) with the SARS-CoV2 measures in the saliva of COVID-19 patients. Data indicate that the toll-like receptor-4, peptidoglycan recognition protein, and sACE2 are elevated in COVID-19 saliva and correlate moderately with the viral load.
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Affiliation(s)
- Aaron Ermel
- Division of Infectious Diseases, Department of Internal Medicine, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
- Indiana University School of Medicine, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
| | - Thankam Paul Thyvalikakath
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
- Indiana University School of Dentistry, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
- Regenstrief Institute, Inc., Indianapolis, IN, United States
| | - Tatiana Foroud
- Indiana University School of Medicine, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
- Department of Medical and Molecular Genetics, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
| | - Babar Khan
- Indiana University School of Medicine, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
- Regenstrief Institute, Inc., Indianapolis, IN, United States
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Mythily Srinivasan
- Department of Oral Pathology, Medicine and Radiology, Indiana University Purdue University at Indianapolis, Indianapolis, IN, United States
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Rise and exacerbation of oral lichen planus in the background of SARS-CoV-2 infection. Med Hypotheses 2021; 156:110681. [PMID: 34601231 PMCID: PMC8478127 DOI: 10.1016/j.mehy.2021.110681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 01/04/2023]
Abstract
Oral Lichen Planus (OLP) is a chronic inflammatory disorder whose exact etiology remains unknown. Inflammatory mediators, cytotoxic CD8+ T cells and mast cells have been hypothesized to mediate the pathogenesis of OLP. COVID-19 pandemic caused by SARS-CoV-2 is marked by cytokine storms in the affected patients. Altered T-cell responses marked by exhaustion of T-cell count with hyperaggressive remaining T-cells and presence of cross-reactive antibodies render infected humans as fertile grounds for development of multisystem disorders. In addition, Vitamin D deficiency in COVID-19 patients can further modify the T cell mediated immunity. Increased circulating cytokines and hyperactive CD8+ T cells can alter the oral immune barriers rendering them susceptible to oral disorders. Due to the widespread immune dysregulation, it is possible that patients of COVID-19 may develop OLP in the aftermath or during recovery. The paper explores the pathogenic mechanism behind development OLP as post-COVID condition on account of their target receptor, T-cell responses, cytokine profile, mucosal immune barriers and nutrition deficiency.
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175
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da Silva Ramos FJ, de Freitas FGR, Machado FR. Sepsis in patients hospitalized with coronavirus disease 2019: how often and how severe? Curr Opin Crit Care 2021; 27:474-479. [PMID: 34292175 PMCID: PMC8452249 DOI: 10.1097/mcc.0000000000000861] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW To discuss why severe COVID-19 should be considered sepsis and how co-infection and secondary infection can aggravate this condition and perpetuate organ dysfunction leading to high mortality rates. RECENT FINDINGS In severe COVID-19, there is both direct viral toxicity and dysregulated host response to infection. Although both coinfection and/or secondary infection are present, the latest is of greater concern mainly in resource-poor settings. Patients with severe COVID-19 present a phenotype of multiorgan dysfunction that leads to death in an unacceptable high percentage of the patients, with wide variability around the world. Similarly to endemic sepsis, the mortality of COVID-19 critically ill patients is higher in low-income and middle-income countries as compared with high-income countries. Disparities, including hospital strain, resources limitations, higher incidence of healthcare-associated infections (HAI), and staffing issues could in part explain this variability. SUMMARY The high mortality rates of critically ill patients with severe COVID-19 disease are not only related to the severity of patient disease but also to modifiable factors, such as the ICU strain, HAI incidence, and organizational aspects. Therefore, HAI prevention and the delivery of best evidence-based care for these patients to avoid additional damage is important. Quality improvement interventions might help in improving outcomes mainly in resource-limited settings.
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176
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Lin N, Verma D, Saini N, Arbi R, Munir M, Jovic M, Turak A. Antiviral nanoparticles for sanitizing surfaces: A roadmap to self-sterilizing against COVID-19. NANO TODAY 2021; 40:101267. [PMID: 34404999 PMCID: PMC8361009 DOI: 10.1016/j.nantod.2021.101267] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/05/2021] [Accepted: 08/08/2021] [Indexed: 05/13/2023]
Abstract
Nanoparticles provide new opportunities in merging therapeutics and new materials, with current research efforts just beginning to scratch the surface of their diverse benefits and potential applications. One such application, the use of inorganic nanoparticles in antiseptic coatings to prevent pathogen transmission and infection, has seen promising developments. Notably, the high reactive surface area to volume ratio and unique chemical properties of metal-based nanoparticles enables their potent inactivation of viruses. Nanoparticles exert their virucidal action through mechanisms including inhibition of virus-cell receptor binding, reactive oxygen species oxidation and destructive displacement bonding with key viral structures. The prevention of viral outbreaks is one of the foremost challenges to medical science today, emphasizing the importance of research efforts to develop nanoparticles for preventative antiviral applications. In this review, the use of nanoparticles to inactivate other viruses, such as influenza, HIV-1, or norovirus, among others, will be discussed to extrapolate broad-spectrum antiviral mechanisms that could also inhibit SARS-CoV-2 pathogenesis. This review analyzes the published literature to highlight the current state of knowledge regarding the efficacy of metal-based nanoparticles and other antiviral materials for biomedical, sterile polymer, and surface coating applications.
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Affiliation(s)
- Neil Lin
- Department of Engineering Physics, McMaster University, Hamilton, Canada
- Faculty of Health Science, McMaster University, Hamilton, Canada
| | - Daksh Verma
- Department of Engineering Physics, McMaster University, Hamilton, Canada
| | - Nikhil Saini
- Department of Engineering Physics, McMaster University, Hamilton, Canada
- W Booth School of Engineering Practice and Technology, McMaster University, Hamilton, Canada
| | - Ramis Arbi
- Department of Engineering Physics, McMaster University, Hamilton, Canada
| | - Muhammad Munir
- Department of Engineering Physics, McMaster University, Hamilton, Canada
| | | | - Ayse Turak
- Department of Engineering Physics, McMaster University, Hamilton, Canada
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Hussain S, Baxi H, Riad A, Klugarová J, Pokorná A, Slezáková S, Líčeník R, Najmi AK, Klugar M. COVID-19-Associated Mucormycosis (CAM): An Updated Evidence Mapping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10340. [PMID: 34639637 PMCID: PMC8508302 DOI: 10.3390/ijerph181910340] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 12/17/2022]
Abstract
Mucormycosis, a serious and rare fungal infection, has recently been reported in COVID-19 patients worldwide. This study aims to map all the emerging evidence on the COVID-19-associated mucormycosis (CAM) with a special focus on clinical presentation, treatment modalities, and patient outcomes. An extensive literature search was performed in MEDLINE (Ovid), Embase (Ovid), Cochrane COVID-19 Study Register, and WHO COVID-19 database till 9 June 2021. The primary outcome was to summarize the clinical presentation, treatment modalities, and patient outcomes of CAM. Data were summarized using descriptive statistics and presented in tabular form. This evidence mapping was based on a total of 167 CAM patients with a mean age of 51 ± 14.62 years, and 56.28% of them were male. Diabetes mellitus (73.65% (n = 123)), hypertension (22.75% (n = 38)), and renal failure (10.77% (n = 18)) were the most common co-morbidities among CAM patients. The most common symptoms observed in CAM patients were facial pain, ptosis, proptosis, visual acuity, and vision loss. Survival was higher in patients who underwent both medical and surgical management (64.96%). Overall mortality among CAM patients was found to be 38.32%. In conclusion, this study found a high incidence of CAM with a high mortality rate. Optimal glycemic control and early identification of mucormycosis should be the priority to reduce the morbidity and mortality related to CAM.
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Affiliation(s)
- Salman Hussain
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (A.R.); (J.K.); (A.P.); (S.S.); (R.L.)
| | - Harveen Baxi
- Independent Researcher, New Delhi 110062, India;
| | - Abanoub Riad
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (A.R.); (J.K.); (A.P.); (S.S.); (R.L.)
- Department of Public Health, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic
| | - Jitka Klugarová
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (A.R.); (J.K.); (A.P.); (S.S.); (R.L.)
| | - Andrea Pokorná
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (A.R.); (J.K.); (A.P.); (S.S.); (R.L.)
- Department of Nursing and Midwifery, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic
| | - Simona Slezáková
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (A.R.); (J.K.); (A.P.); (S.S.); (R.L.)
| | - Radim Líčeník
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (A.R.); (J.K.); (A.P.); (S.S.); (R.L.)
| | - Abul Kalam Najmi
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India;
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 5, 62500 Brno, Czech Republic; (A.R.); (J.K.); (A.P.); (S.S.); (R.L.)
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Allen J, McCambridge MM, Kincaid H, Kalter JA. Incidence of Secondary Hemophagocytic Lymphohistiocytosis in Critically-Ill COVID-19 Patients. Cureus 2021; 13:e16735. [PMID: 34513365 PMCID: PMC8405362 DOI: 10.7759/cureus.16735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 12/15/2022] Open
Abstract
Objective Coronavirus disease 2019 (COVID-19) is associated with diffuse lung injury that can progress to acute respiratory distress syndrome, multisystem-organ failure, and death. The inflammatory storm seen in many COVID-19 patients closely resembles secondary hemophagocytic lymphohistiocytosis (sHLH) which has been described in other virus-associated severe sepsis. We sought to describe the incidence of sHLH in COVID-19 infected patients. Design In this retrospective study, we reviewed the records of critically ill COVID-19 positive patients to determine the incidence of sHLH. An H-score for sHLH diagnosis was determined for each study participant, with a score greater than 169 points needed for diagnosis. Setting A quaternary referral center in suburban Pennsylvania, USA. Patients All study participants had a positive COVID-19 test, and were deemed critically ill defined as receiving invasive mechanical ventilation and/or who expired. Measurements and Main Results Of the 246 records identified, 242 records met inclusion criteria and were reviewed. Eighty five patients were excluded from analysis due to missing H-score data parameters. Overall, 32 of 157 (20.38%, 95% CI:14.38-27.54%) patients met diagnostic criteria for sHLH. The average age was 69.42 years (standard deviation (SD) 14.81). Patients diagnosed with sHLH were more likely to be younger (61.09 years vs 69.38 years, P = 0.0036), male (71.88% vs 52.00%, P = 0.0433), and require mechanical ventilation (96.88% vs 72.80%, P = 0.0035). Conclusions Among critically ill COVID-19 positive patients, the incidence of sHLH is higher than previously reported in patients with non-COVID-19 related sepsis. Clinicians caring for COVID-19 patients should consider this secondary diagnosis and subsequent appropriate treatments, especially in those requiring mechanical ventilation.
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Affiliation(s)
- Jamie Allen
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network Lehigh Valley Campus and University of Southern Florida Morsani College of Medicine, Lehigh Valley, USA
| | - Matthew M McCambridge
- Office of the Chief Medical Officer, Lehigh Valley Health Network Lehigh Valley Campus and University of Southern Florida Morsani College of Medicine, Lehigh Valley, USA
| | - Hope Kincaid
- Network Office of Research and Innovation, Lehigh Valley Health Network Lehigh Valley Campus and University of Southern Florida Morsani College of Medicine, Lehigh Valley, USA
| | - Joshua A Kalter
- Department of Emergency and Hospital Medicine, Lehigh Valley Health Network Lehigh Valley Campus and University of Southern Florida Morsani College of Medicine, Lehigh Valley, USA
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Diwakar J, Samaddar A, Konar SK, Bhat MD, Manuel E, Hb V, Bn N, Parveen A, Hajira SN, Srinivas D, S N. First report of COVID-19-associated rhino-orbito-cerebral mucormycosis in pediatric patients with type 1 diabetes mellitus. J Mycol Med 2021; 31:101203. [PMID: 34517273 PMCID: PMC8418383 DOI: 10.1016/j.mycmed.2021.101203] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a major public health problem worldwide. These patients are at increased risk of developing secondary infections due to a combination of virus- and drug-induced immunosuppression. Recently, several countries have reported an emergence of COVID-19 associated mucormycosis (CAM), particularly among patients with uncontrolled diabetes, with India reporting an alarming increase in rhino-orbito-cerebral mucormycosis (ROCM) in post-COVID cases. Hyperglycemia and diabetic ketoacidosis (DKA) are the major underlying risk factors. So far, case reports and review articles have reported CAM only in adult patients. Here, we describe the first cases of COVID-19-associated ROCM in two pediatric patients with Type 1 diabetes mellitus (DM). Both the cases had asymptomatic infection with SARS-CoV-2 and developed ROCM during the course of treatment of DKA. None of them had exposure to systemic steroids. Imaging findings in both cases revealed involvement of orbit, paranasal sinuses, and brain with cavernous sinus thrombosis. The patients underwent craniotomy with evacuation of abscess. Microbiological and histopathological findings were consistent with the diagnosis of mycormycosis, with fungal culture growing Rhizopus arrhizus. Post-operatively, the patients received liposomal amphotericin B (LAMB) and systemic antibiotics. Retrobulbar injection of LAMB was given in an attempt to halt orbital disease progression. However, it wasn't successful and both of them had to undergo orbital exenteration eventually. ROCM is a rapidly progressive disease and prompt diagnosis with aggressive surgery and timely initiation of antifungal therapy can be life-saving. Physicians should have a high index of suspicion, so as to avoid a delayed diagnosis, particularly in post-COVID patients with uncontrolled diabetes.
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Affiliation(s)
- Jyoti Diwakar
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Arghadip Samaddar
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Subhas Kanti Konar
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Maya Dattatraya Bhat
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Emma Manuel
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Veenakumari Hb
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Nandeesh Bn
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Asmiya Parveen
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sadiya Noor Hajira
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Nagarathna S
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
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Rudramurthy SM, Hoenigl M, Meis JF, Cornely OA, Muthu V, Gangneux JP, Perfect J, Chakrabarti A. ECMM/ISHAM recommendations for clinical management of COVID-19 associated mucormycosis in low- and middle-income countries. Mycoses 2021; 64:1028-1037. [PMID: 34133816 PMCID: PMC8447004 DOI: 10.1111/myc.13335] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 12/11/2022]
Abstract
Reports are increasing on the emergence of COVID-19-associated mucormycosis (CAM) globally, driven particularly by low- and middle-income countries. The recent unprecedented surge of CAM in India has drawn worldwide attention. More than 28,252 mucormycosis cases are counted and India is the first country where mucormycosis has been declared a notifiable disease. However, misconception of management, diagnosing and treating this infection continue to occur. Thus, European Confederation of Medical Mycology (ECMM) and the International Society for Human and Animal Mycology (ISHAM) felt the need to address clinical management of CAM in low- and middle-income countries. This article provides a comprehensive document to help clinicians in managing this infection. Uncontrolled diabetes mellitus and inappropriate (high dose or not indicated) corticosteroid use are the major predisposing factors for this surge. High counts of Mucorales spores in both the indoor and outdoor environments, and the immunosuppressive impact of COVID-19 patients as well as immunotherapy are possible additional factors. Furthermore, a hyperglycaemic state leads to an increased expression of glucose regulated protein (GRP- 78) in endothelial cells that may help the entry of Mucorales into tissues. Rhino-orbital mucormycosis is the most common presentation followed by pulmonary mucormycosis. Recommendations are focused on the early suspicion of the disease and confirmation of diagnosis. Regarding management, glycaemic control, elimination of corticosteroid therapy, extensive surgical debridement and antifungal therapy are the standards for proper care. Due to limited availability of amphotericin B formulations during the present epidemic, alternative antifungal therapies are also discussed.
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Affiliation(s)
- Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Martin Hoenigl
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, California, USA
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Center of Expertise in Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Oliver A Cornely
- Department of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine, University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jean Pierre Gangneux
- CHU Rennes, Inserm, EHESP, Irset (Institut de recherché en santé, environnement et travail) - UMR_S 1085, Université de Rennes, Rennes, France
| | - John Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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181
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Hirschenberger M, Hunszinger V, Sparrer KMJ. Implications of Innate Immunity in Post-Acute Sequelae of Non-Persistent Viral Infections. Cells 2021; 10:2134. [PMID: 34440903 PMCID: PMC8391718 DOI: 10.3390/cells10082134] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
Non-persistent viruses classically cause transient, acute infections triggering immune responses aimed at the elimination of the pathogen. Successful viruses evolved strategies to manipulate and evade these anti-viral defenses. Symptoms during the acute phase are often linked to dysregulated immune responses that disappear once the patient recovers. In some patients, however, symptoms persist or new symptoms emerge beyond the acute phase. Conditions resulting from previous transient infection are termed post-acute sequelae (PAS) and were reported for a wide range of non-persistent viruses such as rota-, influenza- or polioviruses. Here we provide an overview of non-persistent viral pathogens reported to be associated with diverse PAS, among them chronic fatigue, auto-immune disorders, or neurological complications and highlight known mechanistic details. Recently, the emergence of post-acute sequelae of COVID-19 (PASC) or long COVID highlighted the impact of PAS. Notably, PAS of non-persistent infections often resemble symptoms of persistent viral infections, defined by chronic inflammation. Inflammation maintained after the acute phase may be a key driver of PAS of non-persistent viruses. Therefore, we explore current insights into aberrant activation of innate immune signaling pathways in the post-acute phase of non-persistent viruses. Finally, conclusions are drawn and future perspectives for treatment and prevention of PAS are discussed.
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182
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Bacterial Superinfections in Covid-19: Circulating Strains and Outcome. ARS MEDICA TOMITANA 2021. [DOI: 10.2478/arsm-2021-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Abstract
Introduction: The COVID-19 pandemic caused by the new coronavirus has led to enormous pressure on health systems around the world, with an increase in the number of hospitalizations for pneumonia with a higher incidence of healthcare-associated infections (1).
Material and Method: We performed a retrospective analysis of 40 cases hospitalized in the first pandemic wave between March 2020-May 2020, addmited in the Intensive Care Unit of the Clinical Hospital for Infectious Diseases Constanta, including patients with a diagnosis of SARS-CoV-2 infection and Bacterial superinfection. Multiple parameters were analysed: clinical, biological, bacterial culture results, resistance profile of isolated strains, as well as patient’s evolution.
Results and Conclusions: In terms of patient profile, the average age was 62.3 years, with the male sex being the majority represented by a number of 30 cases (75%). All patients had associated comorbidities. The clinical picture presented by the patients was characteristic of severe forms of infection, with respiratory failure.
The observed bio-humoral changes characteristic of bacterial superinfections were found in all patients, leukocytosis with marked neutrophilia, significant biological inflammatory syndrome and positive procalcitonin.
During the period analysed we observed a significant increase in carbapenem-resistant strains. The resistant strains were represented by Klebsiella Pneumoniae found in 35 samples (54%), Acinetobacter Buamanni was isolated in 15 culture samples (23%). The antibiotic regimen used consisted of a combination of 2 or 3 classes of antibiotics depending on the resistance profile, monotherapy is not recommended in infections with multi-resistant germs. All patients required oxygen therapy, the average length of hospital stay was 28 days. Death was recorded in 10 cases (25%).
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183
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Garg M, Prabhakar N, Bhatia H, Dhooria S, Debi U, Muthu V, Maralkunte M, Sehgal I, Agarwal R, Sandhu MS. CT findings in sequel of COVID-19 pneumonia and its complications. BJR Open 2021; 3:20210055. [PMID: 36570781 PMCID: PMC9754056 DOI: 10.1259/bjro.20210055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/19/2021] [Indexed: 12/27/2022] Open
Abstract
A significant number of patients after initial recovery from COVID-19 continue to experience lingering symptoms of the disease that may last for weeks or even months. Lungs being the most commonly affected organ by COVID-19, bear the major brunt of the disease and thus it is imperative to be aware of the evolution of the pulmonary parenchymal changes over time. CT chest is the imaging modality of choice to evaluate post-COVID lungs. Persistent ground-glass opacities, septal thickening, parenchymal bands, crazy-paving, traction bronchiectasis and consolidation constitute the commonly encountered imaging patterns seen on CT in post-COVID-19 lungs. Few vulnerable patients can develop lung fibrosis and show honeycombing on CT. Additionally, many complications like superadded infections (bacterial and fungal), pulmonary thromboembolism and pseudoaneurysm formation are also being reported. In the present pictorial review, we have tried to show the entire CT spectrum of sequelae of COVID-19 pneumonia and commonly associated infections and vascular complications.
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Affiliation(s)
- Mandeep Garg
- Department
of Radiodiagnosis and Imaging, PGIMER,
Chandigarh, India
| | - Nidhi Prabhakar
- Department
of Radiodiagnosis and Imaging, PGIMER,
Chandigarh, India
| | - Harsimran Bhatia
- Department
of Radiodiagnosis and Imaging, PGIMER,
Chandigarh, India
| | | | - Uma Debi
- Department
of Radiodiagnosis and Imaging, PGIMER,
Chandigarh, India
| | | | | | | | - Ritesh Agarwal
- Department
of Pulmonary Medicine, PGIMER,
Chandigarh, India
| | - MS Sandhu
- Department
of Radiodiagnosis and Imaging, PGIMER,
Chandigarh, India
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