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Harada N, Shibano I, Izuta Y, Kizawa Y, Shiragami H, Tsumura A, Ohji G, Mugitani A. Infectious mononucleosis due to Epstein-Barr virus reactivation in an immunocompromised 60-year-old patient with COVID-19. J Infect Chemother 2024; 30:1182-1185. [PMID: 38570136 DOI: 10.1016/j.jiac.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/20/2024] [Accepted: 03/30/2024] [Indexed: 04/05/2024]
Abstract
Epstein-Barr virus (EBV) reactivation in COVID-19 patients has been reported, but studies on its clinical significance are lacking. We herein report the occurrence of infectious mononucleosis (IM) due to EBV reactivation in a 60-year-old man with rheumatoid arthritis being treated with methotrexate and tocilizumab. The patient presented with a fever and tested positive for COVID-19. Laboratory findings revealed an increased atypical lymphocyte count, decreased platelet count, and elevated liver enzyme levels. Flow cytometry showed predominant expansion of reactive T cells. EBV reactivation was confirmed using real-time polymerase chain reaction. The patient was treated with remdesivir, and clinical improvement was observed after 10 days of treatment. Follow-up showed a gradual decrease in the EBV-DNA load with no recurrence of atypical lymphocytes. These findings suggest that COVID-19 in immunocompromised patients may lead to unexpected EBV reactivation and IM, even for patients outside the age at which IM is likely to occur.
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Affiliation(s)
| | - Ikumi Shibano
- Department of Hematology, Fuchu Hospital, Osaka, Japan
| | - Yuto Izuta
- Department of Hematology, Fuchu Hospital, Osaka, Japan
| | - Yusuke Kizawa
- Department of Hematology, Fuchu Hospital, Osaka, Japan
| | | | - Akiko Tsumura
- Department of Infectious Diseases, Fuchu Hospital, Osaka, Japan
| | - Goh Ohji
- Division of Infectious Disease Therapeutics, Department of Infectious Disease, Kobe University Graduate School of Medicine, Japan
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Blake E, Stringham E, Sloan-Aagard C. Concurrent disease burden from multiple infectious diseases and the influence of social determinants in the contiguous United States. PLoS One 2024; 19:e0293431. [PMID: 39231143 PMCID: PMC11373817 DOI: 10.1371/journal.pone.0293431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/12/2023] [Indexed: 09/06/2024] Open
Abstract
Social determinants of health are known to underly excessive burden from infectious diseases. However, it is unclear if social determinants are strong enough drivers to cause repeated infectious disease clusters in the same location. When infectious diseases are known to co-occur, such as in the co-occurrence of HIV and TB, it is also unknown how much social determinants of health can shift or intensify the co-occurrence. We collected available data on COVID-19, HIV, influenza, and TB by county in the United States from 2019-2022. We applied the Kulldorff scan statistic to examine the relative risk of each disease by year depending on the data available. Additional analyses using the percent of the county that is below the US poverty level as a covariate were conducted to examine how much clustering is associated with poverty levels. There were three counties identified at the centers of clusters in both the adjusted and unadjusted analysis. In the poverty-adjusted analysis, we found a general shift of infectious disease burden from urban to rural clusters.
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Affiliation(s)
- Emma Blake
- Department of Public Health, Brigham Young University, Provo, UT, United States of America
| | - Este Stringham
- Department of Public Health, Brigham Young University, Provo, UT, United States of America
| | - Chantel Sloan-Aagard
- Department of Public Health, Brigham Young University, Provo, UT, United States of America
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3
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Asfaram S, Iranpour S, Molaei S, Abdollahzadeh H, Faraji F, Aminizadeh S. Sero-prevalence of Toxoplasma gondii before and during the COVID-19 pandemic in Northwestern Iran. BMC Infect Dis 2024; 24:834. [PMID: 39152395 PMCID: PMC11328482 DOI: 10.1186/s12879-024-09724-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Toxoplasma gondii (T. gondii) is a ubiquitous protozoan parasite on our planet that causes toxoplasmosis. This study evaluated the seroprevalence and related risk factors for T. gondii infection in a population referred to healthcare centers in Meshkin-Shahr, Northwest Iran. METHODS A total of 400 blood samples were randomly collected from the general population and assessed using the anti-Toxoplasma antibodies, Immunoglobulin G and M (IgG and IgM) Enzyme-linked immunosorbent assay (ELISA) Kits in two steps before and during the coronavirus disease 2019 (COVID-19) pandemic, 2019-2020. The results were analyzed through logistic regression via SPSS 26 software. RESULTS Before the COVID-19 pandemic, anti-toxoplasma antibodies were detected in 39% of individuals (IgG: 38%, IgM: 0.5%, and IgG-IgM: 0.5%). Among the eleven risk factors evaluated, contact with soil and people awareness were significantly associated with T. gondii infection (p < 0.05). However, factors such as females, 20-39 age groups, junior high schools, housewives, rural areas, raw meat or vegetable consumption, vegetable or fruits washed by water, not detergent, and cat owners did not show a significant relationship with seropositivity (p > 0.05). After the outbreak of the COVID-19 pandemic, the overall seroprevalence for anti-T. gondii antibody increased to 49.7% (IgG: 47.7%, IgM: 0.5%, and IgG and IgM: 1.5%). Among these patients, 26% were positive for COVID-19. Additionally, before the COVID-19 pandemic, 40 samples were negative for anti-T. gondii antibodies but later became positive. The crude and adjusted models suggested that toxoplasmosis may be a possible risk factor for increased susceptibility to COVID-19, with an odds ratio (OR) of 1.28 (95% confidence interval (CI), 0.82-1.99; P < 0.05). Conversely, a non-significant protective effect against latent toxoplasmosis was observed in COVID-19-positive individuals (OR = 0.99; 95% CI, 0.51-1.92; P > 0.05), and COVID-19 positivity did not increase the levels of anti-T. gondii IgG antibodies. CONCLUSIONS The general population in this region had a moderate seroprevalence of T. gondii. The increased number of COVID-19-positive patients with latent toxoplasmosis highlights the need to pay attention to the early diagnosis and proper treatment of toxoplasmosis in these patients and implement preventive programs in these areas for future possible viral infections.
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Affiliation(s)
- Shabnam Asfaram
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sohrab Iranpour
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Soheila Molaei
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Hamed Abdollahzadeh
- Ardabil Health Center Laboratory, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Fatemeh Faraji
- Meshkin-Shahr Health Center Laboratory, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Selva Aminizadeh
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Cuevas-Sierra A, Chero-Sandoval L, Higuera-Gómez A, Vargas JA, Martínez-Urbistondo M, Castejón R, Martínez JA. Modulatory role of Faecalibacterium on insulin resistance and coagulation in patients with post-viral long haulers depending on adiposity. iScience 2024; 27:110450. [PMID: 39081294 PMCID: PMC11284562 DOI: 10.1016/j.isci.2024.110450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/05/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Patients with Post-viral long hauler encompass lasting symptoms and comorbid complexities, often exacerbated in individuals with excessive body weight. The aim was to study gut microbiota in 130 patients with post-viral long hauler stratified by body mass index (BMI) and the relationship between inflammation and microbiota. Significant higher values were found for anthropometric variables and markers of glucose and dyslipidemia in individuals with higher BMI, as well as elevated levels of C-reactive protein, fibrinogen, IL-6, uric acid, and D-dimer. An interactive association showed an interplay between Faecalibacterium, D-dimer levels, and insulin resistance. This investigation showed that anthropometric, biochemical, and inflammatory variables were impaired in patients with post-viral long haulers with higher BMI. In addition, gut microbiota differences were found between groups and a modification effect on Faecalibacterium abundance regarding insulin resistance and D-dimer. These findings suggest that considering adiposity and gut microbiota structure and composition may improve personalized clinical interventions in patients with chronic inflammation.
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Affiliation(s)
- Amanda Cuevas-Sierra
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
| | - Lourdes Chero-Sandoval
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
- Department of Endocrinology and Nutrition of the University Clinical Hospital, University of Valladolid, 47002 Valladolid, Spain
| | - Andrea Higuera-Gómez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
| | - J. Antonio Vargas
- Internal Medicine Service of Puerta de Hierro Majadahonda University Hospital, 2822 Madrid, Spain
| | | | - Raquel Castejón
- Internal Medicine Service of Puerta de Hierro Majadahonda University Hospital, 2822 Madrid, Spain
| | - J. Alfredo Martínez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049 Madrid, Spain
- Centro de Medicina y Endocrinología, Universidad de Valladolid, Valladolid, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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Abdoli A, Mazaherifar S, Solhjoo K, Zargar MF, Jahromi HP, Taghipour A, Darayesh M, Badri M, Pirestani M, Falahi S, Kenarkoohi A. Effect of Rodent Control Program on Incidence of Zoonotic Cutaneous Leishmaniasis, Iran. Emerg Infect Dis 2024; 30:1447-1449. [PMID: 38916636 PMCID: PMC11210642 DOI: 10.3201/eid3007.231404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
We report the effect of a rodent control program on the incidence of zoonotic cutaneous leishmaniasis in an endemic region of Iran. A 1-year interruption in rodent control led to 2 years of increased incidence of zoonotic cutaneous leishmaniasis. Restarting rodent control led to a decline of zoonotic cutaneous leishmaniasis.
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Rezaeian S, Rahmanian F, Rajabpour Z, Taghipour A, Mofazzal Jahromi MA, Rahmanian A, Shakeri H, Kalani N, Jahromi MJ, Abdoli A. Case report: Varicella zoster virus encephalitis following COVID-19 vaccination in an immunocompetent individual. Heliyon 2024; 10:e28703. [PMID: 38596010 PMCID: PMC11002061 DOI: 10.1016/j.heliyon.2024.e28703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
The varicella zoster virus (VZV) is a latent viral infection and its reactivation has been reported following different conditions such as immunosuppression. This study presents a confirmed case of VZV encephalitis following the first dose administration of the Sinopharm COVID-19 vaccine. A 63-year-old immunocompetent woman who developed VZV encephalitis after first dose administration of Sinopharm COVID-19 vaccine. A final diagnosis of VZV encephalitis was made based on positive CSF PCR results for VZV infection. Treatment was administered with acyclovir and she returned to normal life without any neurological sequelae. In this report, VZV reactivation and VZV encephalitis have been observed after COVID-19 vaccination; however, the results of this report should be considered with some caution, and continued post-vaccine surveillance of adverse events is recommended to explore whether any causal association with VZV reactivation is biologically plausible in this context, or if it is just a coincidence.
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Affiliation(s)
- Sanaz Rezaeian
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Rahmanian
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Internal Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Zohre Rajabpour
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mirza Ali Mofazzal Jahromi
- Department of Immunology, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Advanced Medical Sciences & Technologies, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Abdolvahab Rahmanian
- Department of Internal Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Heshmatollah Shakeri
- Department of Infectious Disease, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Navid Kalani
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
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Hamdy DA, Eid RA, Abdel-Tawab H, El-Badry MA, Abdallah AM, El Wahab WMA. Impact of latent toxoplasmosis on pneumonic and non-pneumonic COVID-19 patients with estimation of relevant oxidative stress biomarkers. Folia Parasitol (Praha) 2024; 71:2024.008. [PMID: 38628099 DOI: 10.14411/fp.2024.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/16/2024] [Indexed: 04/19/2024]
Abstract
Susceptibility to COVID-19, the most devastating global pandemic, appears to vary widely across different population groups. Exposure to toxoplasmosis has been proposed as a theory to explain the diversity of these populations. The aim of the present study was to investigate the possible association between latent toxoplasmosis and COVID-19 and its probable correlation with markers of oxidative stress, C-reactive protein (CRP) and ferritin. In a case-control study, blood samples were collected from 91 confirmed (48 non-pneumonic; NP, and 43 pneumonic; P) COVID-19 patients and 45 healthy controls. All participants were tested for IgG anti-Toxoplasma gondii antibodies and oxidative stress markers (nitric oxide [NO], superoxide dismutase [SOD] and reduced glutathione [GSH]), and CRP and serum ferritin levels were determined. In COVID-19 patients, IgG anti-T. gondii antibodies were found in 54% compared to 7% in the control group, with the difference being statistically significant (P ˂ 0.001). However, no significant correlation was found between the severity of COVID-19 and latent T. gondii infection. Latent toxoplasmosis had a strong influence on the risk of COVID-19. NO and SOD levels were significantly increased in COVID-19 patients, while GSH levels decreased significantly in them compared to control subjects (P ˂ 0.001 for both values). CRP and ferritin levels were also significantly elevated in P COVID-19 patients infected with toxoplasmosis. This is the first study to look at the importance of oxidative stress indicators in co-infection between COVID-19 and T. gondii. The high prevalence of latent toxoplasmosis in COVID-19 suggests that T. gondii infection can be considered a strong indicator of the high risk of COVID-19.
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Affiliation(s)
- Doaa A Hamdy
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Ragaey A Eid
- Department of Gastroenterology, Hepatology and infectious diseases (Tropical Medicine Department), College of Medicine, Beni-Suef University, Beni-Suef,Egypt
| | - Heba Abdel-Tawab
- Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed A El-Badry
- Research Institute of Medical Entomology, General Organisation for Teaching Hospitals and Institutes (GOTHI), Giza, Egypt
| | - Abdelrahman M Abdallah
- Department of Chest Diseases, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Wegdan M Abd El Wahab
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Valente-Acosta B, Moreno-Sánchez F, Neme-Yunes Y, López-Rueda S, Hoyo-Ulloa I, Garcia-Gutierrez M. Concomitant Cytomegalovirus Viraemia in Multisystem Inflammatory Syndrome in Adults (MIS-A) following COVID-19. Case Rep Infect Dis 2024; 2024:8852063. [PMID: 38590710 PMCID: PMC11001470 DOI: 10.1155/2024/8852063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
Multisystem inflammatory syndrome in adults (MIS-A) is recognised as an infrequent complication of coronavirus disease 2019 (COVID-19). This syndrome occurs following COVID-19 infection in some individuals and is characterised by inflammation of multiple organ systems, such as the heart, liver, bowel, and lymph nodes. Cytomegalovirus (CMV) viraemia is associated primarily with immunosuppression. In COVID-19 patients, it has been reported in severe and critical cases. We present a case of an adult patient diagnosed with MIS-A and concomitant CMV viraemia.
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Affiliation(s)
- Benjamin Valente-Acosta
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Francisco Moreno-Sánchez
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Yvette Neme-Yunes
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Sara López-Rueda
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Irma Hoyo-Ulloa
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
| | - Mónica Garcia-Gutierrez
- The American British Cowdray Medical Center, Sur 136 116, Alvaro Obregon, Mexico City 01120, Mexico
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9
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Ruan W, Xu J, Yang F, Wu X, Ying K. Tropheryma whipplei infection in the lung of a patient with long COVID: a case report. BMC Infect Dis 2024; 24:292. [PMID: 38448808 PMCID: PMC10916207 DOI: 10.1186/s12879-024-09183-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/27/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Immune dysregulation in individuals with long COVID has been detected. Differential diagnosis of diffuse infiltration on chest CT in long COVID is challenging. CASE PRESENTATION A 62-year-old man presented with a 10-month history of dyspnea after COVID-19 infection. Dyspnea became worse in the one month preceding presentation. The chest CT showed multifocal, subpleural, bilateral opacities due to long-COVID, and infiltration around the bronchovascular bundle in the bilateral lower lung field. The pathology for the transbronchial cryobiopsy (TBCB) first reported chronic inflammation (mainly interstitial pneumonia). The patient had positive results on tests for the antibody, RO-52+, EJ+. The presumptive diagnosis of connective tissue disease-interstitial lung disease was made. Prednisone and cyclophosphamide were given. At follow-up one month later, the chest CT showed new diffuse ground-glass infiltration. The previous TBCB specimen was re-evaluated. Foamy macrophages were found in the alveolar air space. Periodic acid-Schiff (PAS) staining was performed. Numerous intracytoplasmic organisms were detected, with morphologic features consistent with those of Tropheryma whipplei. The patient recovered after intravenous ceftriaxone and oral trimethoprim-sulfamethoxazole. The final diagnosis was lung T. whipplei infection and long COVID-19. CONCLUSION This is the first case report of Tropheryma whipplei infection in the lung of a patient with long COVID-19. T. whipplei should be considered as a potential pathogen for diffuse lung infiltration in the post-COVID-19 era.
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Affiliation(s)
- Wenjing Ruan
- Regional Medical Center for the National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, China.
| | - Jing Xu
- Department of Pathology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fan Yang
- Regional Medical Center for the National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, China
| | - Xiaohong Wu
- Regional Medical Center for the National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, China
| | - Kejing Ying
- Regional Medical Center for the National Institute of Respiratory Disease, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, China
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Cognialli RCR, Fratucci GF, Carneiro BH, Antonio KL, Voidaleski MF, Favarello LM, Vicente VA, Queiroz-Telles F. Case report: First case of fungemia caused by Papiliotrema laurentii in a patient with SARS-CoV-2 infection. Rev Soc Bras Med Trop 2024; 57:e008002023. [PMID: 38324809 PMCID: PMC10852462 DOI: 10.1590/0037-8682-0480-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/14/2023] [Indexed: 02/09/2024] Open
Abstract
Previously considered saprobe and non-pathogenic, the fungus Papiliotrema laurentii (formerly known as Cryptococcus laurentii), is rarely associated with human infection. Nevertheless, there has been an increase in reported infections by non-neoformans cryptococci. After a literature search on the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PMC (PubMed Central) databases, we conclude that this is the first case report of fungemia and probable meningitis caused by Papiliotrema laurentii in a previously immunocompetent host with associated COVID-19.
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Affiliation(s)
| | | | | | | | - Morgana Ferreira Voidaleski
- Universidade Federal do Paraná, Programa de Pós-Graduação em Microbiologia, Parasitologia e Patologia, Curitiba, PR, Brasil
| | | | | | - Flávio Queiroz-Telles
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Saúde Coletiva, Curitiba, PR, Brasil
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Basavaraju RM, Shetty S, Pugazhendhi P, Aradya A. Prosthodontic rehabilitation of patients with a unilateral subtotal maxillectomy using a customised subperiosteal zygomatic implant: a post-COVID-19 mucormycosis. BMJ Case Rep 2024; 17:e258338. [PMID: 38199654 PMCID: PMC10806840 DOI: 10.1136/bcr-2023-258338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Restoring the maxillary resection defect involving the alveolar process, the hard and soft palate and the paranasal sinuses in terms of phonetics, mastication and deglutition is more challenging, especially with young patients with aesthetic concerns.This case report describes the prosthodontic rehabilitation of a young patient with a unilateral subtotal maxillectomy due to post-COVID-19 mucormycosis. A patient-specific subperiosteal implant was planned to rehabilitate the patient's bony defect. Using postsurgical CT, a customised subperiosteal titanium framework was fabricated by the direct metal laser sintering method using grade IV titanium alloy. The fabricated framework was implanted over the patient's zygomatic anatomic contour. Three months later, the patient-specific implant was unveiled to the oral cavity, an open-tray impression was made and the fixed implant prosthesis was fabricated.This case report opens a new realm of rehabilitation for severely compromised maxillary bony defects and impaired oral functioning with no other viable conventional reconstruction options.
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Affiliation(s)
- Ravi Marballi Basavaraju
- Prosthodontics and Crown & Bridge, JSS Dental college and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Sujeeth Shetty
- Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - Prakash Pugazhendhi
- Prosthodontics and Crown & Bridge, JSS Dental college and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Anupama Aradya
- Prosthodontics and Crown & Bridge, JSS Dental college and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Choi UW, Ai X, Li H, Hao Y, Yao X, Guan Y. Immunosuppressive therapy and COVID-19 infection in patients with NMOSD. Immun Inflamm Dis 2024; 12:e1128. [PMID: 38270296 PMCID: PMC10790678 DOI: 10.1002/iid3.1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION To evaluate whether treated with immunosuppressants in neuromyelitis optica spectrum disorder (NMOSD) shows an effect on the severity and outcomes of COVID-19 Omicron variant. METHODS This is a substudy of a single-center clinical trial involving human umbilical cord mesenchymal stem cells (hUC-MSCs) in NMOSD patients. NMOSD patients with hUC-MSCs treatment, NMOSD patients without hUC-MSCs treatment, and matched healthy controls (HC) were included. Demographic information, NMOSD-related clinical features, comorbidities, use of disease-modifying therapy, COVID-19 vaccination status, COVID-19 clinical features, COVID-19 clinical outcomes, and NMOSD-related disease activity were obtained through online questionnaires or phone calls. RESULTS The majority of NMOSD patients received long-term treatment with mycophenolate mofetil (68.8%) or azathioprine (22.9%), and 50% received oral glucocorticoid. During the epidemic, 97.4% of NMOSD patients infected with COVID-19 had asymptomatic or mild forms, with only two patients (2.6%) requiring hospitalization. None of these patients required tracheal intubation or admission to the intensive care unit. Clinical symptoms were found to be more prevalent in HC groups. Additionally, the HC groups had higher fever-recorded temperatures. NMOSD patients who received hUC-MSCs treatment had shorter disease duration than patients who did not receive hUC-MSCs treatment. DISCUSSION Immunosuppressant-treated patients with NMOSD have a similar risk of COVID-19 infection as the general population, but the disease duration is shorter and the clinical symptoms are less severe. Among our NMOSD patients who received hUC-MSCs treatment, COVID-19 outcomes were favorable, with no increased risk of severe COVID-19. Prospective studies on immunotherapies are needed to help determine best treatment practices.
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Affiliation(s)
- Un Wai Choi
- Department of Neurology, Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Xiwen Ai
- Department of Neurology, Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Hongyan Li
- Department of Neurology, Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yong Hao
- Department of Neurology, Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Xiaoying Yao
- Department of Neurology, Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yangtai Guan
- Department of Neurology, Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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Escalante EJ, Rodríguez JG, Salas JDC, Castañeda Z, Conde MLM. Clinical Course, Nosocomial, and Opportunistic Infections Among Kidney Transplant Recipients with COVID-19: A Retrospective Single Center Study. Transplant Proc 2023; 55:1829-1842. [PMID: 37302863 PMCID: PMC10201330 DOI: 10.1016/j.transproceed.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/16/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND We report the results of an observational study, analyzing the clinical course of kidney transplant patients hospitalized for COVID-19 and comparing it with a control to determine if outcomes, nosocomial, and opportunistic infections were different between groups. METHODS An observational, retrospective, case-control, single-center study, including a group of kidney transplant adults diagnosed with COVID-19, from March 2020 to April 2022. Transplant patients hospitalized for COVID-19 comprised the cases. The control group consisted of non-transplanted adults, without immunosuppressive treatment, hospitalized for COVID-19, and matched by age, sex, and month at diagnosis of COVID-19. Study variables were collected, including demographic/clinical, epidemiologic, clinical/biological at diagnosis, evolutive, and outcome variables. RESULTS Fifty-eight kidney transplant recipients were included. Thirty required hospital admission. Ninety controls were included. Transplant recipients had a higher frequency of intensive care unit (ICU) admission, ventilatory support, and death. The relative risk for death was 2.45. When adjusted by baseline estimated glomerular filtration rate (eGFR) and comorbidity, only the risk for opportunistic infection remained high. Variables independently associated with death were dyslipidemia, eGFR at admission, MULBSTA score, and ventilatory support. Pneumonia by Klebsiella oxytoca was the most frequent nosocomial infection. Pulmonary aspergillosis was the most frequent opportunistic infection overall. Pneumocystosis and cytomegalovirus colitis were more frequent among transplant patients. The relative risk for opportunistic infection in this group was 1.88. Baseline eGFR, serum interleukin 6 level, and coinfection were independently associated with it. CONCLUSIONS Evolutive course of COVID-19 requiring hospitalization in renal transplant recipients was primarily determined by comorbidity and baseline kidney function. At equal comorbidity and renal function, there were no differences in mortality, ICU admission, nosocomial infection, and hospital stay. However, the risk for opportunistic infection remained high.
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Affiliation(s)
- Elias Jatem Escalante
- Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lleida, Catalonia, Spain.
| | | | | | - Zaira Castañeda
- Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lleida, Catalonia, Spain
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14
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Rajagopal J, Konaka Gautamdas S, Sivakumar G, Ramaraju K. A Case Series on Post-COVID Tuberculosis: An Underrated Duo of COVID-19 and Tuberculosis. Cureus 2023; 15:e48013. [PMID: 38034214 PMCID: PMC10687378 DOI: 10.7759/cureus.48013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
In India, tuberculosis (TB) has the second highest disease burden following diabetes mellitus. During the COVID-19 pandemic, there was a surge of several opportunistic infections. In this case series, we report five patients, including three adults and two adolescents, who have developed various forms of TB disease after symptomatic COVID-19 pneumonia. The average time for development of post-COVID TB was 48 days. Adolescent patients have developed disseminated TB, which can be due to COVID-19-induced immunological injury or its treatment-related immune suppression. All the adult patients had high CT severity scores (CTSS) and required the administration of intravenous steroids during their COVID-19 pneumonia. Various presentations of TB were secondary spontaneous pneumothorax, miliary TB, consolidation, and nodular infiltrates. One patient had a drug-induced liver injury, which complicated the treatment of that patient. Factors that may contribute to the development of post-COVID TB are diabetes mellitus, increased severity of COVID-19 pneumonia manifested by CTSS, and administration of intravenous steroids. Bidirectional screening of TB had to be done when patients present with symptoms of COVID-19 pneumonia.
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Affiliation(s)
- Jayakumar Rajagopal
- Respiratory Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, IND
| | | | - Gayathri Sivakumar
- Respiratory Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, IND
| | - Karthikeyan Ramaraju
- Respiratory Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, IND
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15
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Gozukucuk R, Kilic HH. The relationship between CMV reactivation, anti-cytokine treatment and mortality in critical COVID-19 patients. Pak J Med Sci 2023; 39:1286-1290. [PMID: 37680795 PMCID: PMC10480725 DOI: 10.12669/pjms.39.5.7301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/16/2023] [Accepted: 06/18/2023] [Indexed: 09/09/2023] Open
Abstract
Objective To examine the use of anti-cytokine treatment in critical COVID-19 patients and their association with the frequency of CMV cases, viral load level, and mortality in these patients. Methods This is a retrospective study. A total of 170 critical and/or intensive care patients with COVID-19 admitted to Hisar Hospital Intercontinental from March 15, 2020, to December 31, 2021 were divided into the use of anti-cytokine treatment group and the no anti-cytokine treatment group. Furthermore, the relationship between CMV reactivation, mortality and anti-cytokine treatment in patients was also examined. Results A total of 170 critical COVID-19 patients were included in the study, three of them were excluded. One hundred sixty seven were included in the study of which 38 (22.7%) were found to be CMV DNA positive. As an anti-cytokine treatment, it was observed that tocilizumab was used in 53 patients, anakinra was used in 27 patients, and no anti-cytokine treatment was used in 77 patients. CMV positivity in patients treated with anti-cytokines (31.11%) was found to be significantly higher than in patients who were not treated with it (16.88%) (p:0.033). Furthermore, it was determined that anti-cytokine treatment significantly decreased mortality (p: 0.003) and that there was no significant relationship between CMV reactivation and mortality (p: 0.399). Conclusion Even though CMV reactivation was high in critical COVID-19 patients who received anti-cytokine treatment, decrease in mortality were observed with early diagnosis and effective treatment. Therefore, CMV infection should be considered in patients receiving immunosuppressive treatment.Clinical Trial Registration: HisarIH-101/NCT05419206.
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Affiliation(s)
- Ramazan Gozukucuk
- Ramazan Gozukucuk, Department of Infectious Disease and Clinical Microbiology, Faculty of Dentist, Istanbul Galata University, Evliya Çelebi, Meşrutiyet Cd. No:62, Beyoglu, Istanbul, 34430 Turkey. Hisar Hospital Intercontinental,Saray Mah. Siteyolu Cad.No:7, Umraniye, Istanbul, 34768 Turkey
| | - Hasan Huseyin Kilic
- Hasan Huseyin Kilic, Department of Anesthesiology and Reanimation, Istanbul Dogus Universty Dudullu Yerleşkesi Dudullu Osb Mah. Nato Yolu Cad. 265/ 1 Ümraniye, Istanbul 34775 Turkey. Hisar Hospital Intercontinental,Saray Mah. Siteyolu Cad.No:7, Umraniye, Istanbul, 34768 Turkey
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16
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Zulfiqar S, Gasser RB, Ghodsian S, Almukhtar M, Holland C, Rostami A. Strongyloides coinfection in COVID-19 patients treated with corticosteroids: A systematic review. Rev Med Virol 2023; 33:e2469. [PMID: 37353858 DOI: 10.1002/rmv.2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/25/2023]
Abstract
The COVID-19 pandemic linked to the virus SARS-CoV-2, which began in China, affected ∼765 million people as of 30 April 2023. The widespread use of corticosteroids for the symptomatic treatment of COVID-19 could lead to the reactivation of infections of opportunistic pathogens, including Strongyloides. We sought to determine the clinical symptoms and demographic characteristics of SARS-CoV-2-Strongyloides co-infection, particularly in patients with severe disease and being treated with immunosuppressive drugs. To do this, we undertook a systematic review of the literature, and searched public accessible scientific databases-the Web of Science, Scopus, PubMed/Medline and Embase -for eligible studies (1 December 2019 to 30 August 2022). The review protocol is registered in PROSPERO (CRD42022377062). Descriptive statistical analyses were used to present the clinical and laboratory parameters of the co-infection; for this, we calculated prevalence using the following formula: positive cases/total number of cases × 100. Of a total of 593 studies identified, 17 studies reporting 26 co-infected patients met the criteria for inclusion in this review. The median age of these patients was 55.14 years. Most of cases (53.8%) were treated with dexamethasone, followed by methylprednisolone (26.9%). Eighteen of 26 patients were immigrants living in European countries or the USA; most of these immigrants originated from Latin America (58%) and South-East Asia (11%). The commonest symptoms of co-infection were abdominal pain (50%), fever (46.1%), dyspnoea (30.7%) and cough (30.7%), and frequently reported laboratory findings were high absolute eosinophil count (38.4%), high white blood cell count (30.7%), high C-reactive protein (23.0%) and high neutrophil count (19.2%). Two of the 26 patients (7.7%) had fatal outcomes. Most of the SARS-CoV-2-Strongyloides coinfected cases were immigrants living in developed countries, emphasising the need for clinicians in these countries to be aware of clinical and laboratory parameters associated with such co-infections, as well as the key importance of rapid and accurate diagnostic tests for timely and effective diagnosis and patient management.
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Affiliation(s)
- Sana Zulfiqar
- School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Robin B Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, Victoria, Australia
| | - Sahar Ghodsian
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mustafa Almukhtar
- Takhar Family Medicine and Urgent Care, Sacramento, California, United States
| | - Celia Holland
- Department of Zoology, School of Natural Sciences, Trinity College Dublin, the University of Dublin, College Green Dublin, Ireland
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Krivosikova L, Kuracinova T, Martanovic P, Hyblova M, Kaluzay J, Uhrinova A, Janega P, Babal P. Long COVID Complicated by Fatal Cytomegalovirus and Aspergillus Infection of the Lungs: An Autopsy Case Report. Viruses 2023; 15:1810. [PMID: 37766216 PMCID: PMC10535245 DOI: 10.3390/v15091810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
After the acute phase of COVID-19, some patients develop long COVID. This term is used for a variety of conditions with a complex, yet not fully elucidated etiology, likely including the prolonged persistence of the virus in the organism and progression to lung fibrosis. We present a unique autopsy case of a patient with severe COVID-19 with prolonged viral persistence who developed interstitial lung fibrosis complicated by a fatal combination of cytomegalovirus and Aspergillus infection. SARS-CoV-2 virus was detected at autopsy in the lungs more than two months after the acute infection, although tests from the nasopharynx were negative. Immune dysregulation after COVID-19 and the administration of corticoid therapy created favorable conditions for the cytomegalovirus and Aspergillus infection that were uncovered at autopsy. These pathogens may represent a risk for opportunistic infections, complicating not only the acute coronavirus infection but also long COVID, as was documented in the presented case.
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Affiliation(s)
- Lucia Krivosikova
- Institute of Pathological Anatomy, Faculty of Medicine, Comenius University in Bratislava, 814 99 Bratislava, Slovakia; (L.K.); (T.K.); (P.J.)
| | - Tereza Kuracinova
- Institute of Pathological Anatomy, Faculty of Medicine, Comenius University in Bratislava, 814 99 Bratislava, Slovakia; (L.K.); (T.K.); (P.J.)
| | - Peter Martanovic
- Health Care Surveillance Authority, 829 24 Bratislava, Slovakia;
| | | | - Jozef Kaluzay
- 4th Department of Internal Medicine, Comenius University in Bratislava, 814 99 Bratislava, Slovakia;
| | | | - Pavol Janega
- Institute of Pathological Anatomy, Faculty of Medicine, Comenius University in Bratislava, 814 99 Bratislava, Slovakia; (L.K.); (T.K.); (P.J.)
- Centre of Experimental Medicine, Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, 813 71 Bratislava, Slovakia
| | - Pavel Babal
- Institute of Pathological Anatomy, Faculty of Medicine, Comenius University in Bratislava, 814 99 Bratislava, Slovakia; (L.K.); (T.K.); (P.J.)
- Medirex Group Academy, n.p.o., 949 05 Nitra, Slovakia;
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18
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Viceconte G, Buonomo AR, D’Agostino A, Foggia M, Di Fusco A, Pinchera B, Scotto R, Iacovazzo C, Fanasca L, Messina G, Cacciatore F, Salvatore P, Gentile I. Risk Factors for Pneumocystis jirovecii Pneumonia in Non-HIV Patients Hospitalized for COVID-19: A Case-Control Study. J Fungi (Basel) 2023; 9:838. [PMID: 37623609 PMCID: PMC10455879 DOI: 10.3390/jof9080838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/30/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Very few cases of Pneumocystis jirovecii pneumonia (PJP) have been reported in COVID-19 so far, and mostly in patients with concomitant HIV infection or in solid-organ transplant recipients. Despite COVID-19 being associated with lymphopenia and the use of steroids, there are no studies specifically aimed at investigating the risk factors for PJP in COVID-19. METHODS A retrospective case-control study was performed. We matched PJP cases with controls with a 1:2 ratio, based on age ± 10 years, solid-organ transplantation (SOT), hematological malignancies, and in the setting of PJP development (ICU vs. non-ICU). A direct immunofluorescence assay on bronchoalveolar lavage fluid was used to diagnose PJP. RESULTS We enrolled 54 patients. Among 18 cases of PJP, 16 were diagnosed as "proven". Seven of the eighteen cases were immunocompromised, while the other patients had no previous immunological impairment. Patients with PJP had significantly lower median lymphocyte values (p = 0.033), longer COVID-19 duration (p = 0.014), a higher dose of steroid received (p = 0.026), higher CRP values (p = 0.005), and a lower SARS-CoV-2 vaccination rate than the controls (p = 0.029). Cumulative steroid dose is the independent risk factor for PJP development (OR = 1.004, 95%CI = 1-1.008, p = 0.042). CONCLUSIONS PJP develops in COVID-19 patients regardless of immunosuppressive conditions and the severity of disease, and it is correlated to the corticosteroid dose received.
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Affiliation(s)
- Giulio Viceconte
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Antonio Riccardo Buonomo
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Alessia D’Agostino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Maria Foggia
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Antonio Di Fusco
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Biagio Pinchera
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Riccardo Scotto
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
| | - Carmine Iacovazzo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy;
| | - Luca Fanasca
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, 8031 Naples, Italy; (L.F.); (P.S.)
| | - Gaetana Messina
- Thoracic Surgery Unit, University of Campania “Luigi Vanvitelli”, Via Sergio Pansini n.5, 8031 Naples, Italy;
| | - Francesco Cacciatore
- Department of Translational Medical Sciences, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy;
| | - Paola Salvatore
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, 8031 Naples, Italy; (L.F.); (P.S.)
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Via Sergio Pansini n.5, 8031 Naples, Italy; (A.R.B.); (A.D.); (M.F.); (A.D.F.); (B.P.); (R.S.); (I.G.)
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19
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Shams M, Rashidi A, Mohamadi J, Moradi M, Pakzad R, Naserifar R, Abdi J, Ghelichi F, Bozorgomid A, Maspi N, Kenarkoohi A, Mohammadi Y, Abdoli A, Falahi S. Real-time impact of COVID-19 pandemic on cutaneous leishmaniasis case finding and strategic planning, preventive interventions, control and epidemiology in a region with a high burden of cutaneous leishmaniasis and COVID-19: A cross-sectional descriptive study based on registry data in Ilam-Iran. Health Sci Rep 2023; 6:e1489. [PMID: 37599657 PMCID: PMC10432587 DOI: 10.1002/hsr2.1489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/17/2023] [Accepted: 07/31/2023] [Indexed: 08/22/2023] Open
Abstract
Background and Aims Cutaneous leishmaniasis (CL) is a severe parasitic disease affecting people, mostly in underdeveloped nations. As a zoonotic infection yearly incidence of CL depends on several parameters such as demographic, epidemiological, and environmental factors as well as prevention and control measures. The sudden outbreak of pandemics such as SARS-Corona-Virus-2 pandemic, can probably affect the incidence or reporting of other diseases, especially infectious diseases, in various ways such as pressure on health systems, providing sanitary services and its components, lockdowns and changes in people's living habits. Aim This study aimed to evaluate the COVID-19 impact on the incidence and other epidemiological aspects as well as control measures of CL in Ilam Province-Iran. Methods Required data was extracted from the CL registration system in Ilam from 2014 to 2021 to demonstrate the trend of CL incidence before and after COVID-19 pandemic. Results Based on our results, a declining pattern of CL incidence was observed, accompanied by the advent and intensification of the viral pandemic in Iran and Ilam province. Although, this decreasing pattern was not integral in all areas, and even increase in CL detection was emphasized in some regions. Conclusion It may be inferred that the COVID-19 pandemic may disrupt treatment programs of CL cases, rodent nest destruction, and fighting vector insects.
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Affiliation(s)
- Morteza Shams
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
| | - Ayoub Rashidi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
- Public Health Staff, Infectious Diseases Control UnitIlam University of Medical SciencesIlamIran
| | - Jasem Mohamadi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
- Department of Pediatrics, School of Medicine, Emam Khomeini HospitalIlam University of Medical sciencesIlamIran
| | - Mohamad Moradi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
- Department of Pediatrics, School of Medicine, Emam Khomeini HospitalIlam University of Medical sciencesIlamIran
| | - Reza Pakzad
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
| | - Razi Naserifar
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
| | - Jahangir Abdi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
| | - Fariba Ghelichi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
| | - Arezoo Bozorgomid
- Infectious Diseases Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Nahid Maspi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
| | - Azra Kenarkoohi
- Department of Microbiology, Faculty of MedicineIlam University of Medical SciencesIlamIran
| | | | - Amir Abdoli
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
| | - Shahab Falahi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
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Carneiro VCDS, Moreira ODC, Coelho WLDCNP, Rio BC, Sarmento DJDS, Salvio AL, Alves-Leon SV, de Paula VS, Leon LAA. miRNAs in Neurological Manifestation in Patients Co-Infected with SARS-CoV-2 and Herpesvírus 6 (HHV-6). Int J Mol Sci 2023; 24:11201. [PMID: 37446381 PMCID: PMC10342854 DOI: 10.3390/ijms241311201] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 07/15/2023] Open
Abstract
Human herpesviruses (HHVs) can establish latency and be reactivated, also are neurotropic viruses that can trigger neurological disorders. HHV-6 is a herpesvirus that is associated with neurological disorders. Studies have reported the detection of HHV-6 in patients with COVID-19 and neurological manifestations. However, specific diagnoses of the neurological disorders caused by these viruses tend to be invasive or difficult to interpret. This study aimed to establish a relationship between miRNA and neurological manifestations in patients co-infected with COVID-19 and HHV-6 and evaluate miRNAs as potential biomarkers. Serum samples from COVID-19 patients in the three cohorts were analyzed. miRNA analysis by real-time polymerase chain reaction (qPCR) revealed miRNAs associated with neuroinflammation were highly expressed in patients with neurological disorders and HHV-6 detection. When compared with the group of patients without detection of HHVs DNA and without neurological alterations, the group with detection of HHV-6 DNA and neurological alteration, displayed significant differences in the expression of mir-21, mir-146a, miR-155 and miR-let-7b (p < 0.01). Our results reinforce the involvement of miRNAs in neurological disorders and provide insights into their use as biomarkers for neurological disorders triggered by HHV-6. Furthermore, understanding the expression of miRNAs may contribute to therapeutic strategies.
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Affiliation(s)
- Vanessa Cristine de Souza Carneiro
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil (L.A.A.L.)
| | - Otacilio da Cruz Moreira
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil
- Real Time PCR Platform RPT09A, Fiocruz, Rio de Janeiro 21040-360, Brazil
| | | | - Beatriz Chan Rio
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil (L.A.A.L.)
| | | | - Andreza Lemos Salvio
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro 22290-240, Brazil
| | - Soniza Vieira Alves-Leon
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro 22290-240, Brazil
- Department of Neurology, Reference and Research Center for Multiple Sclerosis and Other Central Nervous System Idiopathic Demyelinating Inflammatory Diseases, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro 21941-617, Brazil
| | - Vanessa Salete de Paula
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil
| | - Luciane Almeida Amado Leon
- Laboratory of Technological Development in Virology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil (L.A.A.L.)
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Arunachalam M, Natarajan R, Krishnamurthi M, Gopalakrishnan RK. Clinical and radiographic assessment of periodontal status among patients with post-COVID mucormycosis: A cross-sectional study. J Indian Soc Periodontol 2023; 27:381-385. [PMID: 37593554 PMCID: PMC10431227 DOI: 10.4103/jisp.jisp_429_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 01/26/2023] [Accepted: 03/05/2023] [Indexed: 08/19/2023] Open
Abstract
Background An escalation in cases of rhinomaxillary mucormycosis among post-COVID patients is being reported. However, there is limited information about periodontal features in mucormycosis cases. This study explored the periodontal signs and symptoms among post-COVID mucormycosis individuals. Materials and Methods This cross-sectional study was carried out with a total of 25 post-COVID mucormycosis patients attending tertiary care public teaching hospital. Clinical and radiographic assessments were done. Results An elevation in mean probing pocket depth (PPD) up to 6.21 ± 2.7 mm was noted. Nearly 16%-40% of patients had Miller's Grade III mobility in the affected site. Forty-four per cent had localized single or multiple abscess, 40% had palatal swelling, 32% had necrosis of soft tissue and bone exposure, and 52% had maxillary dentoalveolar segmental mobility in the affected site. Radiographic examination revealed varying stages of interdental bone loss. Conclusion The present study observed an increase in mobility and mean PPD which did not commiserate with interdental bone loss in the affected maxillary region.
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Affiliation(s)
- Muthukumaraswamy Arunachalam
- Departments of Periodontics and Implant Dentistry, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Rajakumari Natarajan
- Departments of Periodontics and Implant Dentistry, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Malathi Krishnamurthi
- Departments of Periodontics and Implant Dentistry, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Ramesh Kumar Gopalakrishnan
- Department of Public Health Dentistry, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
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Nelson MC, Manos CK, Flanagan E, Prahalad S. COVID-19 after rituximab therapy in cSLE patients. Ther Adv Vaccines Immunother 2023; 11:25151355231181242. [PMID: 37362155 PMCID: PMC10285438 DOI: 10.1177/25151355231181242] [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: 02/17/2023] [Accepted: 05/18/2023] [Indexed: 06/28/2023] Open
Abstract
Childhood-onset systemic lupus erythematosus (cSLE) is an autoimmune disease associated with significant morbidity and mortality. Rituximab is a B-cell depleting therapy utilized in the treatment of SLE. In adults, rituximab has been associated with increased risk of adverse outcomes in patients who develop coronavirus disease 2019 (COVID-19). We aimed to assess the impact of prior rituximab treatment on clinical outcomes from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in children with SLE. To describe the impact of rituximab on outcomes from SARS-CoV-2 infection, we conducted a retrospective study of pediatric SLE patients in our center diagnosed with COVID-19 who had previously received rituximab between February 2019 and October 2022. Patients' clinical characteristics, disease activity, and outcomes were assessed. Of the eight subjects assessed, five required hospitalizations for COVID-19, four required ICU admission, and two were seen in the emergency department for their symptoms. One patient ultimately expired from her illness. The median time between rituximab administration and COVID-19 diagnosis was 3 months. We assessed the clinical outcomes, including the need of ICU admission and fatal outcome, of COVID-19 in our cSLE patient population after rituximab administration. Approximately 60% of our patients required hospitalization for their illness, and seven out of eight patients required healthcare utilization to include hospitalization and/or emergency department visits.
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Affiliation(s)
| | - Cynthia K. Manos
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USAChildren’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Elaine Flanagan
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USAChildren’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Sampath Prahalad
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USAChildren’s Healthcare of Atlanta, Atlanta, GA, USADepartment of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
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23
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Kang JS. Changing Trends in the Incidence and Clinical Features of Pneumocystis jirovecii Pneumonia in Non-HIV Patients before and during the COVID-19 Era and Risk Factors for Mortality between 2016 and 2022. Life (Basel) 2023; 13:1335. [PMID: 37374118 DOI: 10.3390/life13061335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Fungal superinfections have been reported in patients with coronavirus disease 2019 (COVID-19). We analyzed the incidence and clinical characteristics of Pneumocystis jirovecii pneumonia (PCP) in non-human immunodeficiency virus patients at a tertiary hospital between 2016 and 2022 to evaluate the impact of the COVID-19 pandemic on PCP. The study period was divided into pre-COVID-19 and COVID-19 eras based on the pandemic declaration by the World Health Organization. Among the 113 patients included, the incidence of PCP in the COVID-19 era (37/1000 patient-years) was significantly higher than that in the pre-COVID-19 era (13.1/1000 patient-years) (p < 0.001). Co-infection with invasive pulmonary aspergillosis (IPA) also increased (2.4% vs. 18.3%, p = 0.013). Independent risk factors for PCP-related mortality were previous glucocorticoid use, hypoxemia, acute kidney injury, and IPA co-infection. Risk factors for IPA in patients with PCP included previous use of tyrosine kinase inhibitors, COVID-19 infection within 30 days, leukopenia, and intensive care unit admission. In the COVID-19 era, 12 (16.9%) patients with PCP had a history of COVID-19 infection within 90 days; however, infection was not associated with mortality. Active evaluation of patients with suspected PCP and assessment of IPA co-infection risk may help improve the outcomes of patients with PCP.
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Affiliation(s)
- Jin Suk Kang
- Division of Infectious Diseases, Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, 75, Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
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24
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Munir A, Dahhan H, Huda Z, Lone NA. Concomitant Pulmonary Aspergillosis Following Severe COVID-19. Cureus 2023; 15:e41112. [PMID: 37519517 PMCID: PMC10386872 DOI: 10.7759/cureus.41112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
This case report discusses an atypical complication of COVID-19 pneumonia in a 68-year-old male patient, distinguished by the development of cavitary lung disease and a subsequent incidence of invasive pulmonary aspergillosis (IPA). This adverse development transpired following a prolonged hospitalization and an extensive course of corticosteroid therapy post-COVID-19 pneumonia. This case accentuates the importance of vigilance in observing patients with severe COVID-19 pneumonia for potential opportunistic infections, particularly given the inherent risks associated with prolonged corticosteroid therapy. Prompt diagnosis and initiation of treatment are key to enhancing patient outcomes in such presentations.
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Affiliation(s)
- Ahmad Munir
- Radiology, Peconic Bay Medical Center, Riverhead, USA
| | - Hadi Dahhan
- Radiology, Plainview Hospital, Plainview, USA
| | - Zoha Huda
- Radiology, Peconic Bay Medical Center, Riverhead, USA
| | - Nazir A Lone
- Critical Care, Peconic Bay Medical Center, Riverhead, USA
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25
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Irfan A, Faisal S, Zahoor AF, Noreen R, Al-Hussain SA, Tuzun B, Javaid R, Elhenawy AA, Zaki MEA, Ahmad S, Abdellattif MH. In Silico Development of Novel Benzofuran-1,3,4-Oxadiazoles as Lead Inhibitors of M. tuberculosis Polyketide Synthase 13. Pharmaceuticals (Basel) 2023; 16:829. [PMID: 37375776 DOI: 10.3390/ph16060829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
Benzofuran and 1,3,4-oxadiazole are privileged and versatile heterocyclic pharmacophores which display a broad spectrum of biological and pharmacological therapeutic potential against a wide variety of diseases. This article reports in silico CADD (computer-aided drug design) and molecular hybridization approaches for the evaluation of the chemotherapeutic efficacy of 16 S-linked N-phenyl acetamide moiety containing benzofuran-1,3,4-oxadiazole scaffolds BF1-BF16. This virtual screening was carried out to discover and assess the chemotherapeutic efficacy of BF1-BF16 structural motifs as Mycobacterium tuberculosis polyketide synthase 13 (Mtb Pks13) enzyme inhibitors. The CADD study results revealed that the benzofuran clubbed oxadiazole derivatives BF3, BF4, and BF8 showed excellent and remarkably significant binding energies against the Mtb Pks13 enzyme comparable with the standard benzofuran-based TAM-16 inhibitor. The best binding affinity scores were displayed by 1,3,4-oxadiazoles-based benzofuran scaffolds BF3 (-14.23 kcal/mol), BF4 (-14.82 kcal/mol), and BF8 (-14.11 kcal/mol), in comparison to the binding affinity score of the standard reference TAM-16 drug (-14.61 kcal/mol). 2,5-Dimethoxy moiety-based bromobenzofuran-oxadiazole derivative BF4 demonstrated the highest binding affinity score amongst the screened compounds, and was higher than the reference Pks13 inhibitor TAM-16 drug. The bindings of these three leads BF3, BF4, and BF8 were further confirmed by the MM-PBSA investigations in which they also exhibited strong bindings with the Pks13 of Mtb. Moreover, the stability analysis of these benzofuran-1,3,4-oxadiazoles in the active sites of the Pks13 enzyme was achieved through molecular dynamic (MD) simulations at 250 ns virtual simulation time, which indicated that these three in silico predicted bio-potent benzofuran tethered oxadiazole molecules BF3, BF4, and BF8 demonstrated stability with the active site of the Pks13 enzyme.
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Affiliation(s)
- Ali Irfan
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Shah Faisal
- Department of Chemistry, Islamia College University Peshawar, Peshawar 25120, Pakistan
| | - Ameer Fawad Zahoor
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Razia Noreen
- Department of Biochemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Sami A Al-Hussain
- Department of Chemistry, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13623, Saudi Arabia
| | - Burak Tuzun
- Plant and Animal Production Department, Technical Sciences Vocational School of Sivas, Sivas Cumhuriyet University, Sivas 58140, Turkey
| | - Rakshanda Javaid
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Ahmed A Elhenawy
- Chemistry Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt
- Chemistry Department, Faculty of Science and Art, AlBaha University, Mukhwah, Al Bahah 65731, Saudi Arabia
| | - Magdi E A Zaki
- Department of Chemistry, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13623, Saudi Arabia
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University, Peshawar 25000, Pakistan
| | - Magda H Abdellattif
- Department of Chemistry, College of Science, Taif University, Taif 21944, Saudi Arabia
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26
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Kim JY, Oh S, Yoon M, Yong TS. Importance of Balanced Attention Toward Coronavirus Disease 2019 and Neglected Tropical Diseases. Yonsei Med J 2023; 64:351-358. [PMID: 37226561 DOI: 10.3349/ymj.2022.0656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 05/26/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has been spreading since 2019, causing a worldwide pandemic. Amid the COVID-19 pandemic, tuberculosis, AIDS, and malaria have adversely affected the quality of life of patients and killed millions of people. In addition, COVID-19 continues to impede the delivery of health services, including those for the control of neglected tropical diseases (NTDs). Furthermore, NTDs have been reported as possible co-pathogens among patients infected with COVID-19. However, studies regarding parasitic co-infection among these patients have been limited. This review aimed to explore and describe the cases and reports of parasitic infections in the backdrop of COVID-19 to provide comprehensive knowledge regarding this aspect. We reviewed seven cases of patients who had parasitic co-infection and tested positive for COVID-19, and summarized the literature on the importance of controlling parasitic diseases. In addition, we identified recommendations for the control of parasitic diseases under possible difficulties, such as declining funding for parasitic diseases in 2020. This review highlights the growing burden of NTDs under COVID-19 that may be caused by the deficiency of healthcare infrastructure and human resources as the main reasons. Clinicians should remain vigilant for possible co-infections with parasites in COVID-19 patients, while policymakers are urged to reinforce a balanced and long-term health strategy that addresses both NTDs and COVID-19.
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Affiliation(s)
- Ju Yeong Kim
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul, Korea
| | - Singeun Oh
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul, Korea
| | - Moonsoo Yoon
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul, Korea
| | - Tai-Soon Yong
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul, Korea.
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27
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Kim JYH, Ragusa M, Tortosa F, Torres A, Gresh L, Méndez-Rico JA, Alvarez-Moreno CA, Lisboa TC, Valderrama-Beltrán SL, Aldighieri S, Reveiz L. Viral reactivations and co-infections in COVID-19 patients: a systematic review. BMC Infect Dis 2023; 23:259. [PMID: 37101275 PMCID: PMC10131452 DOI: 10.1186/s12879-023-08117-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Viral reactivations and co-infections have been reported among COVID-19 patients. However, studies on the clinical outcomes of different viral reactivations and co-infections are currently in limit. Thus, the primary purpose of this review is to perform an overarching investigation on the cases of latent virus reactivation and co-infection in COVID-19 patients to build collective evidence contributing to improving patient health. The aim of the study was to conduct a literature review to compare the patient characteristics and outcomes of reactivations and co-infections of different viruses. METHODS Our population of interest included confirmed COVID-19 patients who were diagnosed with a viral infection either concurrently or following their COVID-19 diagnosis. We extracted the relevant literature through a systematic search using the key terms in the online databases including the EMBASE, MEDLINE, Latin American Caribbean Health Sciences Literature (LILACS), from inception onwards up to June 2022. The authors independently extracted data from eligible studies and assessed the risk of bias using the Consensus-based Clinical Case Reporting (CARE) guidelines and the Newcastle-Ottawa Scale (NOS). Main patient characteristics, frequency of each manifestation, and diagnostic criteria used in studies were summarized in tables. RESULTS In total, 53 articles were included in this review. We identified 40 reactivation studies, 8 coinfection studies, and 5 studies where concomitant infection in COVID-19 patients was not distinguished as either reactivation or coinfection. Data were extracted for 12 viruses including IAV, IBV, EBV, CMV, VZV, HHV-1, HHV-2, HHV-6, HHV-7, HHV-8, HBV, and Parvovirus B19. EBV, HHV-1, and CMV were most frequently observed within the reactivation cohort, whereas IAV and EBV within the coinfection cohort. In both reactivation and coinfection groups, patients reported cardiovascular disease, diabetes, and immunosuppression as comorbidities, acute kidney injury as complication, and lymphopenia and elevated D-dimer and CRP levels from blood tests. Common pharmaceutical interventions in two groups included steroids and antivirals. CONCLUSION Overall, these findings expand our knowledge on the characteristics of COVID-19 patients with viral reactivations and co-infections. Our experience with current review indicates a need for further investigations on virus reactivation and coinfection among COVID-19 patients.
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Affiliation(s)
- Jenny Yeon Hee Kim
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
| | - Martin Ragusa
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Fernando Tortosa
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Ana Torres
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
| | - Lionel Gresh
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | - Jairo Andres Méndez-Rico
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | | | - Thiago Costa Lisboa
- Critical Care Department, Hospital de Clinicas de Porto Alegre, PPG Ciencias Pneumologicas, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Sandra Liliana Valderrama-Beltrán
- Ph.D. Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
- Internal Medicine Department, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sylvain Aldighieri
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
- Department of Health Emergencies, Pan American Health Organization, Washington, DC USA
| | - Ludovic Reveiz
- Knowledge Translation Program, Evidence and Intelligence for Action in Health Department, Pan American Health Organization, Washington, DC USA
- Incident Management System for the COVID-19 Response, Pan American Health Organization, Washington, DC USA
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28
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Hawsawi NM, Hamad AM, Rashid SN, Alshehri F, Sharaf M, Zakai SA, Al Yousef SA, Ali AM, Abou-Elnour A, Alkhudhayri A, Elrefaei NG, Elkelish A. Biogenic silver nanoparticles eradicate of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) isolated from the sputum of COVID-19 patients. Front Microbiol 2023; 14:1142646. [PMID: 37143540 PMCID: PMC10153441 DOI: 10.3389/fmicb.2023.1142646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
In recent investigations, secondary bacterial infections were found to be strongly related to mortality in COVID-19 patients. In addition, Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA) bacteria played an important role in the series of bacterial infections that accompany infection in COVID-19. The objective of the present study was to investigate the ability of biosynthesized silver nanoparticles from strawberries (Fragaria ananassa L.) leaf extract without a chemical catalyst to inhibit Gram-negative P. aeruginosa and Gram-positive Staph aureus isolated from COVID-19 patient’s sputum. A wide range of measurements was performed on the synthesized AgNPs, including UV–vis, SEM, TEM, EDX, DLS, ζ -potential, XRD, and FTIR. UV-Visible spectral showed the absorbance at the wavelength 398 nm with an increase in the color intensity of the mixture after 8 h passed at the time of preparation confirming the high stability of the FA-AgNPs in the dark at room temperature. SEM and TEM measurements confirmed AgNPs with size ranges of ∼40-∼50 nm, whereas the DLS study confirmed their average hydrodynamic size as ∼53 nm. Furthermore, Ag NPs. EDX analysis showed the presence of the following elements: oxygen (40.46%), and silver (59.54%). Biosynthesized FA-AgNPs (ζ = −17.5 ± 3.1 mV) showed concentration-dependent antimicrobial activity for 48 h in both pathogenic strains. MTT tests showed concentration-dependent and line-specific effects of FA-AgNPs on cancer MCF-7 and normal liver WRL-68 cell cultures. According to the results, synthetic FA-AgNPs obtained through an environmentally friendly biological process are inexpensive and may inhibit the growth of bacteria isolated from COVID-19 patients.
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29
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Banerjee A, Das M, Verma P, Chatterjee A, Ramalingam K, Srivastava KC. COVID-19 and Mucormycosis of Orofacial Region: A Scoping Review. Cureus 2023; 15:e37984. [PMID: 37223184 PMCID: PMC10202344 DOI: 10.7759/cureus.37984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2023] [Indexed: 05/25/2023] Open
Abstract
During the second wave of coronavirus disease, or COVID-19, infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in the year 2021 around the globe, there is a surge in the number of cases of mucormycosis or "Black Fungus" that is directly/indirectly associated with COVID-19. In this review article, mucormycosis of the orofacial region has gained importance from the maximum published literature (45 articles) from various databases like PubMed, Google Scholar, Scopus, Web of Science, and Embase. Rhino-orbital cerebral mucormycosis (ROCM) is a fatal condition associated with COVID-19 among categories of mucormycosis such as pulmonary, oral, gastrointestinal, cutaneous, and disseminated. ROCM targets the maxillary sinus, also involving teeth of the maxilla, orbits, and ethmoidal sinus. These are of particular interest to dentists and oral pathologists for proper diagnosis and identification. Co-morbid conditions, especially diabetes mellitus type II, have to be monitored carefully in COVID-19 patients as they have a higher risk of developing mucormycosis. In this review article, various presentations of COVID-19-linked mucormycosis are mentioned having particular emphasis on pathogenesis, signs and symptoms, clinical presentation, various diagnostic modalities including histopathology, radiology like CT and MRI, serology, tissue culture, various laboratory investigations, treatment protocols, management with prognosis, and so on. Any suspected case of mucormycosis needs quick detection and treatment since it progresses quickly due to the destructive course of infection. Long-term follow-up along with proper care is a must to detect any kind of recurrence.
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Affiliation(s)
- Abhisek Banerjee
- Oral and Maxillofacial Pathology, Awadh Dental College and Hospital, Jamshedpur, IND
| | - Moumalini Das
- Oral and Maxillofacial Pathology, Awadh Dental College and Hospital, Jamshedpur, IND
| | - Pooja Verma
- Oral and Maxillofacial Pathology, Awadh Dental College and Hospital, Jamshedpur, IND
| | - Abhishek Chatterjee
- Dentistry, Rampurhat Government Medical College and Hospital, Rampurhat, IND
| | - Karthikeyan Ramalingam
- Oral pathology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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30
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Kazachinskaia EI, Zibareva LN, Filonenko ES, Ivanova AV, Gadzhieva MM, Bekshokov KK, Kononova YV, Chepurnov AA, Shestopalov AМ. Investigation of the inhibitory activity of extracts, fractions and secondary metabolites of <i>Silene</i> spp. (<i>Caryophyllaceae</i>) and <i>Serratula cupuliformis</i> (<i>Asteraceae</i>) on the replication of SARS-CoV-2 coronavirus. SOUTH OF RUSSIA: ECOLOGY, DEVELOPMENT 2023. [DOI: 10.18470/1992-1098-2023-1-62-81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Aim. In vitro analysis of the inhibitory activity of extracts, fractions and secondary metabolites of plants of the genus Silene [Caryophylaceae] and Serratula cupuliformis [Asteraceae) on the replication of SARS-CoV-2.Material and Methods. Silene spp. and Serratula cupuliformis of the Siberian Botanical Garden of National Research Tomsk State University were used. Ethanol extracts and butanol fractions of Silene spp. were prepared. The flavonoid shaftoside and the ecdysteroid 20-hydroxyecdysone from Lychnis chalcedonica were isolated. Analysis of BAS was carried out by the HPLC method. In vitro analysis of the inhibitory activity of extracts on SARS-CoV-2 replication was performed in Vero cell culture by direct inactivation [neutralization) of virions. Comparison samples were dry ethanol extracts of chaga [Inonotus obliquus, Basidiomycota), spices of cloves [Syzygium aromaticum, Myrtaceae) and root of licorice [Glycyrrhiza glabra L., Fabaceae).Results. The inhibitory activity of ethanol extracts and butanol fractions of Silene spp., as well as individual compounds [shaftozide and 20-E) was revealed in the range of 50% effective concentrations [EC50) when dissolved in water from 339.85±83.92 pg/ml to 1.59±0.39 pg/ml and when dissolved in DMSO from 119.34±26.34 pg/ml to 2.22±0.57 pg/ml, respectively. The butanol fraction of Serratula cupuliformis was active with EC50=21.74±4.80 and 27.42±6.05 pg/mL. These results for some samples of Silene spp. and Serratula cupuliformis are comparable to the EC50 values of the comparators.Conclusion. The results obtained suggest the presence of biologically active substances in the herbal preparations studied that act destructively on virions of SARS-CoV-2 and affect one of the main stages of its "life" cycle - on the attachment to receptors of sensitive cells.
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Affiliation(s)
- E. I. Kazachinskaia
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences; Vector State Research Centre of Virology and Biotechnology
| | | | | | - A. V. Ivanova
- Vector State Research Centre of Virology and Biotechnology
| | | | - K. K. Bekshokov
- I.M. Sechenov First Moscow State Medical University, Russian Ministry of Health
| | - Yu. V. Kononova
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences
| | - A. A. Chepurnov
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences; Dagestan State University
| | - A. М. Shestopalov
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences; Dagestan State University
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31
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Guchhait P, Chaudhuri BN, Das S. Bloodstream Infections with Opportunistic Pathogens in COVID-19 Era: A Real Challenge Necessitates Stringent Infection Control. J Lab Physicians 2023; 15:131-138. [PMID: 37064967 PMCID: PMC10104717 DOI: 10.1055/s-0043-1764476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 01/03/2023] [Indexed: 04/18/2023] Open
Abstract
Background : Bloodstream infections (BSI) due to opportunistic microbes in the coronavirus disease 2019 (COVID-19) pandemic lead to high morbidity and mortality among hospitalized patients. Thus, it is vital to find out the risk factors of BSI and to learn the ways to mitigate it. Aim : The aim of this study was to evaluate important risk factors of BSI due to opportunistic pathogens and to assess the role of the rigid infection control program to deal with this issue. Methods : A prospective, cross-sectional study was performed for 6 months on 150 patients admitted in both COVID-19 and non-COVID-19 intensive care units of our hospital. BSI was confirmed by the BACTEC and Vitek 2 compact system. Prospective surveillance and environmental sampling were carried out for source tracking along with rigorous infection control measures and the outcome was analyzed. Findings : Burkholderia cepacia, Elizabethkingia meningoseptica, Candida auris, vancomycin-resistant Enterococcus , and Achromobacter xylosoxidans were the common opportunistic pathogens isolated from a single or paired blood sample(s) in our study. Key risk factors were prolonged intensive care unit stay, central venous access, mechanical ventilation, immune-compromised condition, and use of biologics. Reverse osmosis water and used normal saline bottles were the common environmental source of infection. Following the implementation of precise infection control measures, there was a sharp decline in BSI cases, which was not attributed to the downfall of COVID-19 cases. Conclusion : Combined prospective surveillance and environmental sampling helped to find out the sources and implementation of an intensive and insistent infection control program that are needed to control opportunistic pathogens mediated BSI.
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Affiliation(s)
- Partha Guchhait
- Department of Microbiology, Peerless Hospitex Hospital and Research Center Ltd., Kolkata, West Bengal, India
| | - Bhaskar Narayan Chaudhuri
- Department of Microbiology, Peerless Hospitex Hospital and Research Center Ltd., Kolkata, West Bengal, India
- Address for correspondence Bhaskar Narayan Chaudhuri, MD Department of Microbiology, Peerless Hospitex Hospital and Research Center Ltd.Kolkata-700094, West BengalIndia
| | - Satadal Das
- Department of Microbiology, Peerless Hospitex Hospital and Research Center Ltd., Kolkata, West Bengal, India
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32
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Yeom J, Wolk R, Griffin L, Freedman PD, Reich RF. Atypical herpetic ulcerations in COVID-19 positive patients: A report of three cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:268-271. [PMID: 36229369 PMCID: PMC9335396 DOI: 10.1016/j.oooo.2022.07.015] [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: 09/22/2021] [Revised: 04/08/2022] [Accepted: 07/23/2022] [Indexed: 11/17/2022]
Abstract
Since the global COVID-19 pandemic, numerous reports have been made regarding oral lesions seen in COVID-19 patients. It remains unclear whether or not these are true manifestations of COVID-19. Here we present 3 patients who were hospitalized for COVID-19 and who developed atypical herpetic ulcerations during their treatment with remdesivir (Veklury) and steroids. In healthy patients, recurrent infection by herpes simplex virus (HSV) presents as lesions only on the lips and the attached oral mucosa. Atypical herpetic ulcerations are seen in immunocompromised patients. They present as large, stellate shaped ulcerations with raised borders and may involve movable mucosa. The 3 cases presented in this report resembled the atypical herpetic ulcerations typically seen in patients with immunosuppression. Through our report, we aimed to introduce the possibility of atypical herpetic ulcers in patients being treated for COVID-19, to allow for their timely diagnosis and to raise awareness of the underlying immunocompromised state.
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Affiliation(s)
- Joonsung Yeom
- Section of Oral & Maxillofacial Pathology, New York-Presbyterian Queens, Flushing, NY, USA.
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Andrade MCR, Lemos BRP, Silva LM, Pecotte JK. Eliminating Potential Effects of Other Infections During Selection of Nonhuman Primates for COVID-19 Research. Comp Med 2023; 73:45-57. [PMID: 36744555 PMCID: PMC9948906 DOI: 10.30802/aalas-cm-21-000086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The study of nonhuman primates (NHP) can provide significant insights into our understanding numerous infectious agents. The etiological agent of COVID-19, SARS-CoV-2 virus, first emerged in 2019 and has so far been responsible for the deaths of over 4 million people globally. In the frenzied search to understand its pathogenesis and immunology and to find measures for prevention and control of this pandemic disease, NHP, particularly macaques, are the preferred model because they manifest similar clinical signs and immunologic features as humans. However, possible latent, subclinical, and opportunistic infections not previously detected in animals participating in a study may obscure experimental results and confound data interpretations in testing treatments and vaccine studies for COVID-19. Certain pathophysiologic changes that occur with SARS-CoV-2 virus infection are similar to those of simian pathogens. The current review discusses numerous coinfections of COVID-19 with other diseases and describes possible outcomes and mechanisms in COVID-19 studies of NHP that have coinfections. Due to the urgency triggered by the pandemic, screening that is more rigorous than usual is necessary to limit background noise and maximize the reliability of data from NHP COVID-19 studies. Screening for influenza virus, selected respiratory bacteria, and regional endemic pathogens such as vector-borne agents, together with the animal's individual exposure history, should be the main considerations in selecting a NHP for a COVID-19 study. In addition, because NHP are susceptible to the SARS-CoV-2 virus, management and surveillance measures should be established to prevent transmission to healthy animals from infected colony animals and husbandry staff. This review presents compiled data on the use of NHP in COVID-19 studies, emphasizing the need to create the most reliable NHP model for those studies by extensive screening for other pathogens.
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Key Words
- absl, animal biosafety level
- ace-2, angiotensin-converting enzyme
- ards, acute respiratory distress syndrome
- cnprc, california national primate research center
- e, envelope
- esr, erythrocyte sedimentation rate
- hav, hepatitis a virus
- hbv, hepatitis b virus
- hgf hepatocyte growth factor
- htlv, human t-cell lymphotropic virus
- ifn, interferon
- il, interleukin
- ip, inducible protein
- m, matrix
- mcp, monocyte chemotactic proteins
- mcsf, macrophage colony-stimulating factor
- mip, macrophage inflammatory protein
- n, nucleocapsid
- nsp, non-structural proteins
- rdrp, rna-dependent rna polymerase
- s, spike
- sars-cov-2, severe acute respiratory syndrome-coronavirus-2
- sfv, simian foamy virus
- sop, standard operating procedures
- srv/d, simian retrovirus type d
- stlv, simian t-lymphotropic virus
- tb, tuberculosis
- tgf, transforming growth factor
- tmprss2 transmembrane serine protease 2
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Affiliation(s)
- Marcia C R Andrade
- Institute of Science and Technology on Biomodels, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;,
| | - Bárbara R P Lemos
- Institute of Science and Technology on Biomodels, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Larissa M Silva
- Institute of Science and Technology on Biomodels, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; University of Grande Rio, Duque de Caxias, Brazil
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Hinojosa V, Cesena De la Fuente S, Hussaini N, Varon J. Gastric Aspergillosis in a COVID-19 Patient. Cureus 2023; 15:e34897. [PMID: 36925984 PMCID: PMC10013252 DOI: 10.7759/cureus.34897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2023] [Indexed: 03/18/2023] Open
Abstract
The SARS-CoV-2 virus, which causes Coronavirus-19 infection (COVID-19), frequently elicits the development of depressed immunity, therefore, opportunistic infections. Opportunistic organisms are commonly present in the human body without causing critical illness. However, they can also lead to pathologic illness when a person is immunocompromised. Aspergillosis is among the many opportunistic infections. Even though this infection primarily involves the respiratory system and is less likely to be found in the gastrointestinal tract, we report a case of a COVID-19 individual that developed massive gastrointestinal bleeding whose condition deteriorated, and the pathological examination revealed gastric aspergillosis. Although not common, gastric aspergillosis should be considered while treating patients with COVID-19 who present gastrointestinal symptoms.
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Affiliation(s)
| | | | | | - Joseph Varon
- Critical Care Medicine, United Memorial Medical Center, Houston, USA
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Bazmjoo A, Bagherzadeh MA, Raoofi R, Taghipour A, Mazaherifar S, Sotoodeh H, Ostadi Z, Shadmand E, Jahromi MAM, Abdoli A. Toxoplasma gondii, HBV, and HCV co-infection and their correlation with CD4 cells among Iranian HIV-positive patients. Immun Inflamm Dis 2023; 11:e794. [PMID: 36840494 PMCID: PMC9947625 DOI: 10.1002/iid3.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION Human immunodeficiency virus (HIV/AIDS) infected patients have a higher risk of opportunistic infections (OIs) depending on their immunological status, especially CD4 + cell count. Toxoplasma gondii, hepatitis C virus (HCV), and hepatitis B virus (HBV) are important OIs among Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) patients. However, little is known about co-infection of these pathogens among HIV-infected individuals and their correlation with the patient's CD4 + cell count. Hence, this study aimed to investigate the serological and molecular status of T. gondii infection among HIV-infected individuals who had co-infection with HBV and HCV infections. METHODS A total of 100 HIV/AIDS patients in two cities in the southwest of Iran was tested for T. gondii Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies as well as DNA detection by polymerase chain reaction (PCR) targeting the RE gene. HBV and HCV were detected by hepatitis B surface antigen (HBsAg) test, hepatitis C antibody (HCV Ab) test, and Real-Time PCR. The number of CD4 + cell counts was determined by Flow cytometry. RESULTS Anti-T. gondii IgG was positive in 22% of the patients, but anti-T. gondii IgM and PCR were negative in all samples. HBV and HCV were positive in 8% and 33% of the patients, respectively. Co-infections were as followed: HIV + HCV (16%), HIV + HCV + T. gondii (11%), HIV + T. gondii (5%), HIV + HBV (1%), HIV + HBV + T. gondii (1%), HIV + HBV + HCV (1%), and HIV + HBV + HCV + T. gondii (5%). A significant decline in CD4 + cell counts was found in such co-infection groups (HIV + T. gondii, HIV + HCV + T. gondii, and HIV + HBV + HCV + T. gondii) compared with the HIV mono-infection group. CONCLUSIONS Our study showed that co-infections of T. gondii, HCV, and HBV were common among HIV-infected patients and co-infections had a negative correlation with CD4 + cell counts of the patients.
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Affiliation(s)
- Ahmadreza Bazmjoo
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Student Research CommitteeJahrom University of Medical SciencesJahromIran
| | - Mohammad Aref Bagherzadeh
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Student Research CommitteeJahrom University of Medical SciencesJahromIran
| | - Rahim Raoofi
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of Infectious DiseasesJahrom University of Medical SciencesJahromIran
| | - Ali Taghipour
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | - Samaneh Mazaherifar
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | | | - Zahra Ostadi
- Department of Disease ControlFasa University of Medical SciencesFasaIran
| | - Enayat Shadmand
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | - Mirza A. M. Jahromi
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of ImmunologyJahrom University of Medical SciencesJahromIran
- Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran
| | - Amir Abdoli
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
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Singh S, Barbarino A, Youssef EG, Coleman D, Gebremariam T, Ibrahim AS. Protective Efficacy of Anti-Hyr1p Monoclonal Antibody against Systemic Candidiasis Due to Multi-Drug-Resistant Candida auris. J Fungi (Basel) 2023; 9:103. [PMID: 36675924 PMCID: PMC9860579 DOI: 10.3390/jof9010103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Candida auris is a multi-drug-resistant fungal pathogen that can survive outside the host and can easily spread and colonize the healthcare environment, medical devices, and human skin. C. auris causes serious life-threatening infections (up to 60% mortality) in immunosuppressed patients staying in such contaminated healthcare facilities. Some isolates of C. auris are resistant to virtually all clinically available antifungal drugs. Therefore, alternative therapeutic approaches are urgently needed. Using in silico protein modeling and analysis, we identified a highly immunogenic and surface-exposed epitope that is conserved between C. albicans hyphal-regulated protein (Cal-Hyr1p) and Hyr1p/Iff-like proteins in C. auris (Cau-HILp). We generated monoclonal antibodies (MAb) against this Cal-Hyr1p epitope, which recognized several clinical isolates of C. auris representing all four clades. An anti-Hyr1p MAb prevented biofilm formation and enhanced opsonophagocytic killing of C. auris by macrophages. When tested for in vivo efficacy, anti-Hyr1p MAb protected 55% of mice against lethal systemic C. auris infection and showed significantly less fungal burden. Our study is highly clinically relevant and provides an effective alternative therapeutic option to treat infections due to MDR C. auris.
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Affiliation(s)
- Shakti Singh
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Ashley Barbarino
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
| | - Eman G. Youssef
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
| | - Declan Coleman
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
- Biology Department, Pomona College, Pomona, CA 91711, USA
| | - Teclegiorgis Gebremariam
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
| | - Ashraf S. Ibrahim
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
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Mazaherifar S, Solhjoo K, Rasti S, Heidarnejadi SM, Abdoli A. Patterns of cutaneous leishmaniasis during the COVID-19 pandemic in four endemic regions of Iran. Trans R Soc Trop Med Hyg 2023; 117:38-44. [PMID: 36068660 DOI: 10.1093/trstmh/trac081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/16/2022] [Accepted: 08/04/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Both zoonotic cutaneous leishmaniasis (ZCL) and anthroponotic cutaneous leishmaniasis are endemic in different regions of Iran. It is important to know the type of cutaneous leishmaniasis (CL) for prevention strategies. On the other hand, Iran is one of the countries that was severely affected by the coronavirus 2019 (COVID-19) pandemic. However, little is known about the causative agents of CL during the COVID-19 pandemic in Iran. METHODS In this study, a total of 181 samples were isolated from patients with CL lesions in four different endemic cities of Iran (Jahrom, Juyom, Kashan and Shoushtar) during the COVID-19 pandemic (the summer and autumn of 2021). The nested-PCR targeting kinetoplast DNA (kDNA) minicircles was applied for species identification of the parasite and the internal transcribed spacer-1 (ITS-1) gene was applied for sequencing and phylogenetic analysis. RESULTS Molecular detection of kDNA minicircles revealed that all isolates from the four cities were Leishmania major, indicating the ZCL pattern. Ten isolates were sequenced by the ITS-1 gene and deposited in GenBank [accession numbers: OL627363-72]. Sequencing and phylogenetic analysis displayed a high similarity rate of the isolates with sequences from other parts of Iran and Iraq. Over half of the patients (53.59%) had a single lesion, while 17.12, 14.92, 2.21 and 12.16% of cases had two, three, four and more than four lesions, respectively. About half of the patients (50.27%) had lesions on their hands, while the rest had lesions on multiple locations (19.34%), legs (16.58%), face (9.94%), ears (1.66%) and waist (2.21%). CONCLUSIONS This study revealed the occurrence of ZCL during the COVID-19 pandemic in four endemic regions of Iran. Strategies for prevention and control of the disease should be considered to mitigate the occurrence of ZCL.
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Affiliation(s)
- Samaneh Mazaherifar
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
| | - Kavous Solhjoo
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
| | - Sima Rasti
- Department of Parasitology and Mycology and Infectious Diseases Research Center, Faculty of Medicine, Kashan University of Medical Sciences, Kashan 8115187159, I.R.Iran
| | | | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
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Ng TK, Chan W, Wang KWC. Psychometric properties of the traditional Chinese version of the COVID Stress Scales in Hong Kong. Front Public Health 2023; 11:1149221. [PMID: 37033053 PMCID: PMC10080101 DOI: 10.3389/fpubh.2023.1149221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The COVID Stress Scales (CSS) assess six domains of COVID-19-related stress, including (a) COVID danger, (b) COVID socioeconomic consequences, (c) COVID xenophobia, (d) COVID contamination, (e) COVID traumatic stress symptoms, and (f) COVID compulsive checking. Although the CSS have been validated in various cultural contexts, their psychometric properties in Hong Kong have not been examined. This study endeavors to validate the traditional Chinese version of the 36-item CSS (CSS-36) and the 18-item CSS (CSS-18) in Hong Kong. Method Participants were 521 Hong Kong undergraduate students (61% female) aged from 18 to 26 years (M = 20.65, SD = 1.56). An online questionnaire was used for data collection. Results The results of confirmatory factor analyses supported a six-factor structure for both the CSS-36 and the CSS-18. Multiple-group confirmatory factor analyses established the gender invariance of the six-factor model for both the CSS-36 and the CSS-18. The CSS-36 and the CSS-18 exhibited good internal consistency reliability and concurrent validity with fear of COVID-19 and negative emotional states. Discussion The findings offer evidence for the psychometric properties of the traditional Chinese version of the CSS-36 and the CSS-18 in the Hong Kong context.
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Affiliation(s)
- Ting Kin Ng
- Department of Psychology, Lingnan University, Tuen Mun, Hong Kong SAR, China
- *Correspondence: Ting Kin Ng
| | - Wai Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Kitty Wan Ching Wang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Geraili A, Badirzadeh A, Sadeghi M, Mousavi SM, Mousavi P, Shahmoradi Z, Hosseini SM, Hejazi SH, Rafiei-Sefiddashti R. Toxoplasmosis and symptoms severity in patients with COVID-19 in referral centers in Northern Iran. J Parasit Dis 2022; 47:185-191. [PMID: 36532601 PMCID: PMC9741704 DOI: 10.1007/s12639-022-01556-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Toxoplasmosis has been categorized as one of the long-lasting protozoan parasitic infections. It affects almost one-third of the world's population. In recent years, several documented studies have elucidated that infected individuals have a remarkably higher incidence of distinct health problems and show various adverse effects. In the PCR-positive COVID-19 patients in Gonbad-e-Kavus, Kalaleh, and Minoodasht counties in the northern part of Iran from June 2021 to December 2021, we sought to investigate any potential relationships between the severity of COVID-19 symptoms and acute and latent toxoplasmosis caused by Toxoplasma gondii (T. gondii). Whole blood samples of 161 COVID-19 patients with positive PCR. The samples were centrifuged to separate serum and screened for two important antibodies against T. gondii (IgM and IgG) by using ELISA kits for human anti-T. gondii IgM and IgG. Anti-T. gondii IgM and IgG antibodies were detected in 8/161 (5.0%) and 42/161 (26.1%) COVID-19 patients, respectively. No significant relationships were found between Toxoplasma IgM and IgG results with clinical signs, age, sex, contact with animals, comorbidities, and also the mortality rate of people with COVID-19. These findings showed that acute and latent toxoplasmosis infections are common among patients with COVID-19; however, no significant associations were found between toxoplasma infections and the symptoms of COVID-19. Therefore, toxoplasmosis is not considered a risk factor for COVID-19.
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Affiliation(s)
- Ali Geraili
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Badirzadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Sadeghi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mahmoud Mousavi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Mousavi
- Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycolog, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zabihollah Shahmoradi
- Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycolog, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Dermatology, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed-Mohsen Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Hossein Hejazi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycolog, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Raheleh Rafiei-Sefiddashti
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Mofazzal Jahromi MA, Sefidfard M, Taghipour A, Roustazadeh A, Matin S, Mir H, Badri M, Bahrami F, Abdoli A. Latent infections, coronavirus disease 2019 and psychiatric disorders: The friend of my enemy. CLINICAL AND TRANSLATIONAL DISCOVERY 2022; 2:e141. [PMID: 36712173 PMCID: PMC9875118 DOI: 10.1002/ctd2.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
Recent reports revealed an increased rate of hospitalization and mortality of coronavirus disease 2019 (COVID-19) among patients with psychiatric disorders. On the other hand, there is a link between latent infections, including Toxoplasma gondii, herpes simplex virus type 1 (HSV-1) and cytomegalovirus (CMV) with psychiatric disorders. We individually assessed data regarding 1) the mortality rate of COVID-19 among individuals with psychiatric disorders; 2) the association of latent infections in COVID-19 patients and 3) the association between latent infections and psychiatric disorders. We developed the hypothesis that latent infection could increase the risk of severe COVID-19 among patients with psychiatric disorders. Cumulative evidence proposed that infection with toxoplasmosis, CMV and HSV-1 could increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-Co-V2) infections among patients with psychiatric disorders probably by induction of hyperinflammatory conditions. These infections are also associated with hyperinflammation and T cell exhaustion, which has also been observed in both schizophrenia and COVID-19. This hypothesis provides new insights into the role of latent infections in increasing the mortality rates of COVID-19 among individuals with psychiatric disorders. Strategies for screening, early diagnosis and treatment of these infections could be recommended for COVID-19 patients with a background of psychiatric disorders.
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Affiliation(s)
- Mirza Ali Mofazzal Jahromi
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of ImmunologySchool of MedicineJahrom University of Medical SciencesJahromIran
- Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran
| | - Mina Sefidfard
- Department of PsychiatryJahrom University of Medical SciencesJahromIran
- Research Center for Noncommunicable DiseasesJahrom University of Medical SciencesJahromIran
| | - Ali Taghipour
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | - Abazar Roustazadeh
- Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran
- Department of Biochemistry and NutritionJahrom University of Medical SciencesJahromIran
| | | | - Hamed Mir
- Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran
- Department of Biochemistry and NutritionJahrom University of Medical SciencesJahromIran
| | - Milad Badri
- Medical Microbiology Research CenterQazvin University of Medical SciencesQazvinIran
| | - Fares Bahrami
- Kurdistan University of Medical SciencesKurdistanIran
| | - Amir Abdoli
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran
- Research Center for Noncommunicable DiseasesJahrom University of Medical SciencesJahromIran
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Falahi S, Sayyadi H, Kenarkoohi A. Immunogenicity of COVID-19 mRNA vaccines in hemodialysis patients: Systematic review and meta-analysis. Health Sci Rep 2022; 5:e874. [PMID: 36210877 PMCID: PMC9528953 DOI: 10.1002/hsr2.874] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022] Open
Abstract
Background and Aims Vaccine response is a concern in hemodialysis patients. Given that hemodialysis patients were not included in clinical trials, we aimed to synthesize the available evidence on the immunogenicity of coronavirus disease 2019 (COVID-19) mRNA vaccines in hemodialysis patients. Methods We searched Scopus, PubMed, Sciencedirect, and finally google scholar databases for studies on COVID-19 mRNA-vaccines immunogenicity in hemodialysis patients up to December 1, 2021. Eligible articles measured antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike or Receptor-Binding Domain Antibody (S/RBD) postimmunization with COVID-19 mRNA vaccines. The immunogenicity of the vaccine was evaluated using seroconversion rates measured between 21 and 30 days after the first immunization and between 14 and 36 days post the second dose. We included studies including participants without a history of COVID-19 before vaccination. Healthy controls or health-care workers served as the control groups. After selecting eligible articles, the data were finally extracted from included articles. We used a random effects model to estimate the pooled seroconversion rate after COVID-19 mRNA vaccine administration. We assessed the heterogeneity between studies with the I 2 statistical index. Result We selected 39 eligible citations comprising 806 cases and 336 controls for the first dose and 6314 cases and 927 controls for the second dose for statistical analysis. After the first dose of mRNA vaccines, the seroconversion rate was 36% (95% confidence interval [CI]: 0.24-0.47) and 68% (95% CI: 0.45-0.91) in hemodialysis patients and the control group, respectively. While seroconversion rate after the second dose of mRNA vaccines was 86% (95% CI: 0.81-0.91) and 100% (95% CI: 1.00-1.00) in hemodialysis patients and the control group, respectively. Conclusion Although the immune response of hemodialysis patients to the second dose of the SARS-CoV-2 mRNA vaccine is very promising, the seroconversion rate of dialysis patients is lower than healthy controls. Periodically assessment of antibody levels of hemodialysis patients at short intervals is recommended.
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Affiliation(s)
- Shahab Falahi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
| | - Hojjat Sayyadi
- Department of Biostatistics, Faculty of HealthIlam University of Medical SciencesIlamIran
| | - Azra Kenarkoohi
- Zoonotic Diseases Research CenterIlam University of Medical SciencesIlamIran
- Department of Microbiology, Faculty of MedicineIlam University of Medical SciencesIlamIran
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Alebna PL, Bellamy S, Tabur TA, Mangia A. Rare Case of Persistently Depressed T Lymphocyte Subsets After SARS-CoV-2 Infection. AMERICAN JOURNAL OF CASE REPORTS 2022; 23:e937760. [PMID: 36318517 PMCID: PMC9638916 DOI: 10.12659/ajcr.937760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/22/2022] [Accepted: 09/06/2022] [Indexed: 08/26/2023]
Abstract
BACKGROUND On rare occasions, viral infections are known to also depress immune cell lines, further worsening clinical outcomes. We describe a patient who presented 3 weeks after recovery from mild COVID-19 disease with clinical features of an atypical pneumonia and was found to have a low CD4+ T-cell count. CASE REPORT An 82-year-old man with a past medical history of coronary artery disease, rheumatoid arthritis, gout, hypertension, and atrial fibrillation presented with a 1-week history of progressively worsening shortness of breath and cough. He was noted to have recovered from mild SARS-CoV-2 infection 3 weeks prior to his current presentation and had been at his baseline level of health following infection. A T cell subset panel was obtained, which revealed an absolute CD3 count of 92 (reference range 840-3060), absolute CD4 count of 52 (reference range 500-1400), absolute CD8 count of 37 (reference range 180-1170), and a normal CD4: CD8 ratio. He was subsequently started on atovaquone for pneumocystis jiroveci pneumonia prophylaxis. CONCLUSIONS This case highlights the need for a high index of suspicion for lymphocyte depletion in older patients with multiple comorbidities who present during or after SARS-CoV-2 infection with atypical symptoms that are suggestive of immunosuppression. In such instances, there should be a low threshold to start prophylactic therapy for possible opportunistic infections.
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Affiliation(s)
- Pamela L. Alebna
- Department of Internal Medicine, Rutgers/Robert Wood Johnson BarnabasHealth, Jersey City Medical Center, Jersey City, NJ, USA
| | - Shannay Bellamy
- Department of Internal Medicine, Rutgers/Robert Wood Johnson BarnabasHealth, Jersey City Medical Center, Jersey City, NJ, USA
| | - Terrence A. Tabur
- Department of Internal Medicine, Rutgers/Robert Wood Johnson BarnabasHealth, Jersey City Medical Center, Jersey City, NJ, USA
| | - Anthony Mangia
- Department of Infectious Disease, Rutgers/Robert Wood Johnson Barnabas Health, Jersey City Medical Center, Jersey City, NJ, USA
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Trevijano-Contador N, Torres-Cano A, Carballo-González C, Puig-Asensio M, Martín-Gómez MT, Jiménez-Martínez E, Romero D, Nuvials FX, Olmos-Arenas R, Moretó-Castellsagué MC, Fernández-Delgado L, Rodríguez-Sevilla G, Aguilar-Sánchez MM, Ayats-Ardite J, Ardanuy-Tisaire C, Sanchez-Romero I, Muñoz-Algarra M, Merino-Amador P, González-Romo F, Megías-Lobón G, García-Campos JA, Mantecón-Vallejo MÁ, Alcoceba E, Escribano P, Guinea J, Durán-Valle MT, Fraile-Torres AM, Roiz-Mesones MP, Lara-Plaza I, de Ayala AP, Simón-Sacristán M, Collazos-Blanco A, Nebreda-Mayoral T, March-Roselló G, Alcázar-Fuoli L, Zaragoza O. Global Emergence of Resistance to Fluconazole and Voriconazole in Candida parapsilosis in Tertiary Hospitals in Spain During the COVID-19 Pandemic. Open Forum Infect Dis 2022; 9:ofac605. [PMID: 36467290 PMCID: PMC9709632 DOI: 10.1093/ofid/ofac605] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/03/2022] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Candida parapsilosis is a frequent cause of candidemia worldwide. Its incidence is associated with the use of medical implants, such as central venous catheters or parenteral nutrition. This species has reduced susceptibility to echinocandins, and it is susceptible to polyenes and azoles. Multiple outbreaks caused by fluconazole-nonsusceptible strains have been reported recently. A similar trend has been observed among the C. parapsilosis isolates received in the last 2 years at the Spanish Mycology Reference Laboratory. METHODS Yeast were identified by molecular biology, and antifungal susceptibility testing was performed using the European Committee on Antimicrobial Susceptibility Testing protocol. The ERG11 gene was sequenced to identify resistance mechanisms, and strain typing was carried out by microsatellite analysis. RESULTS We examined the susceptibility profile of 1315 C. parapsilosis isolates available at our reference laboratory between 2000 and 2021, noticing an increase in the number of isolates with acquired resistance to fluconazole, and voriconazole has increased in at least 8 different Spanish hospitals in 2020-2021. From 121 recorded clones, 3 were identified as the most prevalent in Spain (clone 10 in Catalonia and clone 96 in Castilla-Leon and Madrid, whereas clone 67 was found in 2 geographically unrelated regions, Cantabria and the Balearic Islands). CONCLUSIONS Our data suggest that concurrently with the coronavirus disease 2019 pandemic, a selection of fluconazole-resistant C. parapsilosis isolates has occurred in Spain, and the expansion of specific clones has been noted across centers. Further research is needed to determine the factors that underlie the successful expansion of these clones and their potential genetic relatedness.
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Affiliation(s)
- Nuria Trevijano-Contador
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
| | - Alba Torres-Cano
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
| | - Cristina Carballo-González
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
| | - Mireia Puig-Asensio
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-Institut d´Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Center for Biomedical Research in Network in Infectious Diseases (CIBERINFEC, CB21/13/00009), Instituto de Salud Carlos III, Madrid, Spain
| | - María Teresa Martín-Gómez
- Department of Microbiology, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Emilio Jiménez-Martínez
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-Institut d´Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Daniel Romero
- Department of Microbiology, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesc Xavier Nuvials
- Intensive Care Unit, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roberto Olmos-Arenas
- Microbiology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | | | | | | | | | - Josefina Ayats-Ardite
- Microbiology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Carmen Ardanuy-Tisaire
- Microbiology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
- Center for Biomedical Research Network in Respiratory Diseases (CIBERES-CB06/06/0037), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Sanchez-Romero
- Microbiology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - María Muñoz-Algarra
- Microbiology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Paloma Merino-Amador
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Fernando González-Romo
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Gregoria Megías-Lobón
- Department of Clinical Microbiology, Hospital Universitario de Burgos, Burgos, Castilla y León, Spain
| | - Jose Angel García-Campos
- Department of Clinical Microbiology, Hospital Universitario de Burgos, Burgos, Castilla y León, Spain
| | | | - Eva Alcoceba
- Clinical Microbiology Department, Hospital Universitari Son Espases, Mallorca, Spain
| | - Pilar Escribano
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Jesús Guinea
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Center for Biomedical Research Network in Respiratory Diseases (CIBERES-CB06/06/0058), Madrid, Spain
| | | | | | - María Pía Roiz-Mesones
- Microbiology Department, Marqués de Valdecilla Universitary Hospital and Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria,Spain
| | - Isabel Lara-Plaza
- Microbiology Department, Marqués de Valdecilla Universitary Hospital and Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria,Spain
| | | | - María Simón-Sacristán
- Microbiology and Parasitology Department, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - Ana Collazos-Blanco
- Microbiology and Parasitology Department, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - Teresa Nebreda-Mayoral
- Microbiology and Immunology Unit, Universitary Clinic Hospital of Valladolid, Valladolid, Spain
| | - Gabriel March-Roselló
- Microbiology and Immunology Unit, Universitary Clinic Hospital of Valladolid, Valladolid, Spain
| | - Laura Alcázar-Fuoli
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
- Center for Biomedical Research in Network in Infectious Diseases (CIBERINFEC-CB21/13/00105), Instituto de Salud Carlos III, Madrid, Spain
| | - Oscar Zaragoza
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
- Center for Biomedical Research in Network in Infectious Diseases (CIBERINFEC-CB21/13/00105), Instituto de Salud Carlos III, Madrid, Spain
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Kondaka S, Singh VD, Vadlamudi C, Bathala LR. Prosthetic rehabilitation of untailored defects using patient-specific implants. Dent Res J (Isfahan) 2022; 19:83. [PMID: 36426284 PMCID: PMC9680695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/09/2022] [Accepted: 05/17/2022] [Indexed: 06/16/2023] Open
Abstract
The restoration of speech, deglutition, mastication, and respiration in patients with bimaxillary resection involving the maxillae, hard and soft palates, and paranasal sinuses poses a significant challenge. This clinical report describes the prosthodontic management of a patient with bilateral maxillectomy caused due to post-COVID-19 mucormycosis. A patient-specific implants (PSI) that matched the remnants of the zygoma complex was designed to improve the patient's severely impaired speech and swallowing. The patient's postsurgical anatomy was first visualized using three-dimensional computed tomography data. Following that, a customized zygoma-supported titanium framework was designed to support the prosthesis based on the data. Two weeks after the framework was installed, an open-tray impression was made and the prosthesis was fabricated. These findings suggest that PSI-retained prosthesis can be considered in cases with severely compromised maxillary bone anatomy, impaired oral functioning, and no viable conventional reconstruction options.
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Affiliation(s)
- Sudheer Kondaka
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Vankudoth Dal Singh
- Department of Oral and Maxillofacial Surgery, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Chakradhar Vadlamudi
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Lakshmana Rao Bathala
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
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Cadelis M, Grey A, van de Pas S, Geese S, Weir BS, Copp B, Wiles S. Terrien, a metabolite made by Aspergillus terreus, has activity against Cryptococcus neoformans. PeerJ 2022; 10:e14239. [PMID: 36275475 PMCID: PMC9586122 DOI: 10.7717/peerj.14239] [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: 06/29/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023] Open
Abstract
Antimicrobial compounds, including antibiotics, have been a cornerstone of modern medicine being able to both treat infections and prevent infections in at-risk people, including those who are immune-compromised and those undergoing routine surgical procedures. Their intense use, including in people, animals, and plants, has led to an increase in the incidence of resistant bacteria and fungi, resulting in a desperate need for novel antimicrobial compounds with new mechanisms of action. Many antimicrobial compounds in current use originate from microbial sources, such as penicillin from the fungus Penicillium chrysogenum (renamed by some as P. rubens). Through a collaboration with Aotearoa New Zealand Crown Research Institute Manaaki Whenua-Landcare Research we have access to a collection of thousands of fungal cultures known as the International Collection of Microorganisms from Plants (ICMP). The ICMP contains both known and novel species which have not been extensively tested for their antimicrobial activity. Initial screening of ICMP isolates for activity against Escherichia coli and Staphylococcus aureus directed our interest towards ICMP 477, an isolate of the soil-inhabiting fungus, Aspergillus terreus. In our investigation of the secondary metabolites of A. terreus, through extraction, fractionation, and purification, we isolated nine known natural products. We evaluated the biological activity of selected compounds against various bacteria and fungi and discovered that terrein (1) has potent activity against the important human pathogen Cryptococcus neoformans.
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Affiliation(s)
- Melissa Cadelis
- School of Chemical Sciences, University of Auckland, Auckland, New Zealand,Bioluminescent Superbugs Lab, Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Alex Grey
- Bioluminescent Superbugs Lab, Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Shara van de Pas
- Bioluminescent Superbugs Lab, Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Soeren Geese
- Bioluminescent Superbugs Lab, Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Bevan S. Weir
- Manaaki Whenua – Landcare Research, Auckland, New Zealand
| | - Brent Copp
- School of Chemical Sciences, University of Auckland, Auckland, New Zealand
| | - Siouxsie Wiles
- Bioluminescent Superbugs Lab, Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
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Каzachinskaia EI, Chepurnov AA, Shelemba AA, Guseinova SA, Magomedov MG, Коnonova YV, Romanyuk VV, Shestopalov AM. Inhibitory activity of aqueous extracts of tea compositions, individual ingredients for their preparation and some plants against replication of Herpes simplex virus type 2 <i>in vitro</i>. SOUTH OF RUSSIA: ECOLOGY, DEVELOPMENT 2022. [DOI: 10.18470/1992-1098-2022-3-135-152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aim. In vitro analysis of the inhibitory activity of aqueous extracts of tea compositions, plant raw materials and as well as plants from different families against replication of Herpes simplex virus type 2.Material and Methods. The viral strain MS of HSV‐2 was passivated on Vero cell culture. Antiviral (inhibitory) activity of aqueous extracts was studied in vitro according to the classical scheme of neutralization (inactivation) of the virus.Results. For comparison we used control samples of aqueous extracts of Chaga mushroom (Inonotus obliquus) and grass of Alchemilla vulgaris L. with EC50 equal to 21.36±3.92 and 39.67±8.75 µg/ml (for dry raw materials) versus 103 PFU/ml HSV‐2. As a result the prevailing activity (from 15.25±3.92 to 1.71±0.54 µg/ml) was identified for extracts of tea compositions based on black and green tea, as well as individual ingredients for their composition – black tea, leaves of Mentha piperita L., flowers of Lavandula angustifolia Mill. and clove spices (Syzygium aromaticum L.). Extracts obtained from plants that are not part of tea compositions of interest are fermented leaves of Epilobium angustifolium L. (Onagraceae) and grass of two species Euphorbia (E. pilosa L. and E. esula L., Euphorbiaceae) with inhibitory activity at concentrations of 10.675±1.96; 2.29±0.57 and 1.71±0.54 µg/ml, respectively.Conclusion. The results presented can become the basis for the search for individual biologically active substances of plant origin that inhibit HSV‐2 replication as well as for the development of effective medicines in the form of tea beverages and/or formulations for topical use to reduce relapses of chronic herpes.
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Affiliation(s)
- E. I. Каzachinskaia
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences
| | - A. A. Chepurnov
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences
| | - A. A. Shelemba
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences
| | | | | | - Yu. V. Коnonova
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences
| | | | - A. M. Shestopalov
- Research Institute of Virology, Federal Research Centre of Fundamental and Translational Medicine, Siberian Branch, Russian Academy of Sciences
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Averyanov AV, Danilevskaya OV. Diffuse Lung Disease in Convalescents of COVID-19. HERALD OF THE RUSSIAN ACADEMY OF SCIENCES 2022; 92:412-417. [PMID: 36091843 PMCID: PMC9447983 DOI: 10.1134/s1019331622040037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/11/2022] [Accepted: 03/09/2022] [Indexed: 06/15/2023]
Abstract
The most common causes of diffuse interstitial lung damage following COVID-19, often either imitate it but have a different nature or remain due to prolonged persistence of SARS-CoV-2 in the lower respiratory tract. A diagnostic algorithm is proposed to make mostly a correct diagnosis, the key element of which is study of the bronchoalveolar lavage fluid.
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Affiliation(s)
- A. V. Averyanov
- Pulmonology Research Institute, Federal Medical‒Biological Agency, Moscow, Russia
| | - O. V. Danilevskaya
- Pulmonology Research Institute, Federal Medical‒Biological Agency, Moscow, Russia
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Badillo-Almaraz JI, Cardenas-Cadena SA, Gutierrez-Avella FD, Villegas-Medina PJ, Garza-Veloz I, Almaraz VB, Martinez-Fierro ML. COVID-19 Syndemic: Convergence of COVID-19, Pulmonary Aspergillosis (CAPA), Pulmonary Tuberculosis, Type 2 Diabetes Mellitus, and Arterial Hypertension. Diagnostics (Basel) 2022; 12:diagnostics12092058. [PMID: 36140460 PMCID: PMC9498291 DOI: 10.3390/diagnostics12092058] [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: 07/28/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022] Open
Abstract
Bacterial coinfections, which increase the severity of respiratory viral infections, are frequent causes of mortality in influenza pandemics but have not been well characterized in patients with Coronavirus disease 2019 (COVID-19). Moreover, the association of COVID-19 infection with pulmonary Mycobacterium tuberculosis disease (TB) and concurrent pulmonary fungal infection is not well known. The classification of patients with COVID-19-associated pulmonary aspergillosis (CAPA) using the current definitions for invasive fungal diseases has proven difficult. In this study, we aimed to provide information about three patients with underlying diseases ongoing with COVID-19 and co-infection with pulmonary TB, and with COVID-19-associated pulmonary aspergillosis (CAPA). At the time of hospital admission, each patient presented complications such as decompensated T2DM with diabetic ketoacidosis and/or hypertension. Findings of chest computed tomography and serum galactomannan by radioimmunoassay were useful for classifying them as possible CAPA. One of the three possible CAPA cases was fatal. These three cases are rare and are the first of their kind reported worldwide. The generation of reliable algorithms, early diagnosis, standardization of classification criteria, and the selection of specific and personalized treatments for COVID-19-associated opportunistic infections, including CAPA, are necessary to improve outcomes in these kinds of patients.
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Affiliation(s)
- Jose Isaias Badillo-Almaraz
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Campus UAZ siglo XXI-L1, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico
- Hospital General Luz Gonzalez Cosio, Circuito ciudad Gobierno, Zacatecas 98160, Mexico
- Clinica San Antonio Memorial Center, Rio Grande, Zacatecas 98400, Mexico
| | - Sergio Andres Cardenas-Cadena
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Campus UAZ siglo XXI-L1, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico
| | | | | | - Idalia Garza-Veloz
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Campus UAZ siglo XXI-L1, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico
| | - Valentin Badillo Almaraz
- Unidad Academica de Estudios Nucleares. Universidad Autonoma de Zacatecas, Zacatecas 98000, Mexico
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Campus UAZ siglo XXI-L1, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico
- Correspondence: ; Tel.: +52-(492)-9256690 (ext. 2102)
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Mazaherifar S, Solhjoo K, Abdoli A. Outbreak of cutaneous leishmaniasis before and during the COVID-19 pandemic in Jahrom, an endemic region in southwest of Iran. Emerg Microbes Infect 2022; 11:2218-2221. [PMID: 35998176 PMCID: PMC9542410 DOI: 10.1080/22221751.2022.2117099] [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] [Indexed: 12/02/2022]
Abstract
The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic has a considerable effect on the burden of other diseases. Cutaneous leishmaniasis (CL) is an endemic parasitic disease in Iran. Here, we report an outbreak of zoonotic cutaneous leishmaniasis (ZCL) during the COVID-19 pandemic in Jahrom county, which is an endemic region in the southwest of Iran. Before the pandemic, the annual occurrence of CL was less than 240 cases per year, while the number of cases increased to 307 and 771 cases in the first and second years after the pandemic, respectively. Molecular detection of some isolates identified Leishmania major. The rodent control program was completely interrupted during the first year of the COVID-19 outbreak in Jahrom (February to December 2020), then the program restarted again as routine from the summer of 2021 till now. Interrupted rodent control program along with inadequate screening programs of CL patients were probably one of the causes of this outbreak in Jahrom.
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Affiliation(s)
- Samaneh Mazaherifar
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Kavous Solhjoo
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
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50
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Singh S, Singh US. Coinfection with Strongyloides and Ascaris in a COVID-19-positive male presenting with acute abdomen: a case report. Future Microbiol 2022; 17:1099-1105. [PMID: 35899471 PMCID: PMC9332911 DOI: 10.2217/fmb-2022-0027] [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] [Indexed: 11/21/2022] Open
Abstract
Ascaris lumbricoides and Strongyloides stercoralis are soil-transmitted helminthic infections usually seen in people with poor socioeconomic conditions, hygiene and fecal sanitation living in endemic countries. Here, we present a case of coinfection in a COVID-positive older adult male presenting to our facility with symptoms of acute abdomen. Investigative workup guided timely diagnosis of the case. Prompt initiation of antihelminthic drugs together with antibiotics/antivirals for COVID symptoms resulted in favorable outcome in the case. A high index of suspicion on the part of the treating and diagnosing doctor is required in the COVID era. This will help not only in diagnosis but will also give an understanding to the exact pathogenesis for better patient outcome.
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Affiliation(s)
- Sweta Singh
- Department of Microbiology, Autonomous State Medical College, Mirzapur UP, India
| | - Uday S Singh
- Department of Radiodiagnosis, Advance Diagnostic Centre, Lucknow, UP, India
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