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Oh B, Park SC, Yang MS, Yang D, Ham G, Tark D, You MJ, Oh SI, Kim B. Difference in Intraspecies Transmissibility of Severe Fever with Thrombocytopenia Syndrome Virus Depending on Abrogating Type 1 Interferon Signaling in Mice. Viruses 2024; 16:401. [PMID: 38543766 PMCID: PMC10974630 DOI: 10.3390/v16030401] [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: 01/29/2024] [Revised: 02/20/2024] [Accepted: 03/01/2024] [Indexed: 05/23/2024] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), a tick-borne zoonotic disease, is caused by infection with SFTS virus (SFTSV). A previous study reported that human-to-human direct transmission of SFTSV can occur. However, potential animal-to-animal transmission of SFTSV without ticks has not been fully clarified. Thus, the objective of this study was to investigate potential mice-to-mice transmission of SFTSV by co-housing three groups of mice [i.e., wild-type mice (WT), mice injected with an anti-type I interferon-α receptor-blocking antibody (IFNAR Ab), and mice with knockout of type I interferon-α receptor (IFNAR KO)] as spreaders or recipients with different immune competence. As a result, co-housed IFNAR Ab and IFNAR KO mice showed body weight loss with SFTS viral antigens detected in their sera, extracorporeal secretions, and various organs. Based on histopathology, white pulp atrophy in the spleen was observed in all co-housed mice except WT mice. These results obviously show that IFNAR Ab and IFNAR KO mice, as spreaders, exhibited higher transmissibility to co-housed mice than WT mice. Moreover, IFNAR KO mice, as recipients, were more susceptible to SFTSV infection than WT mice. These findings suggest that type I interferon signaling is a pivotal factor in mice intraspecies transmissibility of SFTSV in the absence of vectors such as ticks.
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Affiliation(s)
- Byungkwan Oh
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
| | - Seok-Chan Park
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
| | - Myeon-Sik Yang
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
| | - Daram Yang
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
| | - Gaeul Ham
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
| | - Dongseob Tark
- Laboratory for Infectious Disease Prevention, Korea Zoonosis Research Institute, Jeonbuk National University, 820-120, Hana-ro, Iksan 54531, Republic of Korea;
| | - Myung Jo You
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
| | - Sang-Ik Oh
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
| | - Bumseok Kim
- Biosafety Research Institute, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Republic of Korea; (B.O.); (S.-C.P.); (M.-S.Y.); (D.Y.); (G.H.); (M.J.Y.); (S.-I.O.)
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2
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Shoraka S, Mohebbi SR, Hosseini SM, Zali MR. Comparison of plasma mitochondrial DNA copy number in asymptomatic and symptomatic COVID-19 patients. Front Microbiol 2023; 14:1256042. [PMID: 37869674 PMCID: PMC10587688 DOI: 10.3389/fmicb.2023.1256042] [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: 07/10/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Since the beginning of the COVID-19 pandemic, a wide clinical spectrum, from asymptomatic infection to mild or severe disease and death, have been reported in COVID-19 patients. Studies have suggested several possible factors, which may affect the clinical outcome of COVID-19. A pro-inflammatory state and impaired antiviral response have been suggested as major contributing factors in severe COVID-19. Considering that mitochondria have an important role in regulating the immune responses to pathogens, pro-inflammatory signaling, and cell death, it has received much attention in SARS-CoV-2 infection. Recent studies have demonstrated that high levels of cell-free mitochondrial DNA (cf-mtDNA) are associated with an increased risk of COVID-19 intensive care unit (ICU) admission and mortality. However, there have been few studies on cf-mtDNA in SARS-CoV-2 infection, mainly focusing on critically ill COVID-19 cases. In the present study, we investigated cf-mtDNA copy number in COVID-19 patients and compared between asymptomatic and symptomatic cases, and assessed the clinical values. We also determined the cf-nuclear DNA (cf-nDNA) copy number and mitochondrial transcription factor A (TFAM) mRNA level in the studied groups. Materials and methods Plasma and buffy coat samples were collected from 37 COVID-19 patients and 33 controls. Briefly, after total DNA extraction, plasma cf-mtDNA, and cf-nDNA copy numbers were measured by absolute qPCR using a standard curve method. Furthermore, after total RNA extraction from buffy coat and cDNA synthesis, TFAM mRNA levels were evaluated by qPCR. Results The results showed that cf-mtDNA levels in asymptomatic COVID-19 patients were statistically significantly higher than in symptomatic cases (p value = 0.01). However, cf-nDNA levels were higher in symptomatic patients than in asymptomatic cases (p value = 0.00). There was no significant difference between TFAM levels in the buffy coat of these two groups (p value > 0.05). Also, cf-mtDNA levels showed good diagnostic potential in COVID-19 subgroups. Conclusion cf-mtDNA is probably important in the outcome of SARS-CoV-2 infection due to its role in inflammation and immune response. It can also be a promising candidate biomarker for the diagnosis of COVID-19 subgroups. Further investigation will help understanding the COVID-19 pathophysiology and effective diagnostic and therapeutic strategies.
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Affiliation(s)
- Shahrzad Shoraka
- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Seyed Reza Mohebbi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Hosseini
- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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El-Haddad K, Adhikari TM, Tu ZJ, Cheng YW, Leng X, Zhang X, Rhoads D, Ko JS, Worley S, Li J, Rubin BP, Esper FP. Intra-host mutation rate of acute SARS-CoV-2 infection during the initial pandemic wave. Virus Genes 2023; 59:653-661. [PMID: 37310519 DOI: 10.1007/s11262-023-02011-0] [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: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023]
Abstract
SARS-CoV-2 mutation is minimized through a proofreading function encoded by NSP-14. Most estimates of the SARS-CoV-2 mutation rate are derived from population based sequence data. Our understanding of SARS-CoV-2 evolution might be enhanced through analysis of intra-host viral mutation rates in specific populations. Viral genome analysis was performed between paired samples and mutations quantified at allele frequencies (AF) ≥ 0.25, ≥ 0.5 and ≥ 0.75. Mutation rate was determined employing F81 and JC69 evolution models and compared between isolates with (ΔNSP-14) and without (wtNSP-14) non-synonymous mutations in NSP-14 and by patient comorbidity. Forty paired samples with median interval of 13 days [IQR 8.5-20] were analyzed. The estimated mutation rate by F81 modeling was 93.6 (95%CI 90.8-96.4], 40.7 (95%CI 38.9-42.6) and 34.7 (95%CI 33.0-36.4) substitutions/genome/year at AF ≥ 0.25, ≥ 0.5, ≥ 0.75 respectively. Mutation rate in ΔNSP-14 were significantly elevated at AF ≥ 0.25 vs wtNSP-14. Patients with immune comorbidities had higher mutation rate at all allele frequencies. Intra-host SARS-CoV-2 mutation rates are substantially higher than those reported through population analysis. Virus strains with altered NSP-14 have accelerated mutation rate at low AF. Immunosuppressed patients have elevated mutation rate at all AF. Understanding intra-host virus evolution will aid in current and future pandemic modeling.
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Affiliation(s)
- Kim El-Haddad
- Center for Pediatric Infectious Disease, Cleveland Clinic Children's, R3, 9500 Euclid Avenue, Cleveland, 44195 , OH, USA.
| | - Thamali M Adhikari
- Department of Computer and Data Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Zheng Jin Tu
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Yu-Wei Cheng
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaoyi Leng
- Department of Computer and Data Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Xiangyi Zhang
- Department of Computer and Data Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Daniel Rhoads
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jennifer S Ko
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sarah Worley
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Jing Li
- Department of Computer and Data Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Brian P Rubin
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Frank P Esper
- Center for Pediatric Infectious Disease, Cleveland Clinic Children's, R3, 9500 Euclid Avenue, Cleveland, 44195 , OH, USA.
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4
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Jankovics I, Müller C, Gönczöl É, Visontai I, Varga I, Lőrincz M, Kuti D, Hasitz Á, Malik P, Ursu K, Bányász B, Sarkadi J, Dénes B. Asymptomatic and Mild SARS-CoV-2 Infections in a Hungarian Outpatient Cohort in the First Year of the COVID-19 Pandemic. Trop Med Infect Dis 2023; 8:tropicalmed8040204. [PMID: 37104330 PMCID: PMC10146718 DOI: 10.3390/tropicalmed8040204] [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: 12/24/2022] [Revised: 03/14/2023] [Accepted: 03/25/2023] [Indexed: 04/28/2023] Open
Abstract
We aimed to estimate the proportion of the population infected with SARS-CoV-2 in the first year of the pandemic. The study population consisted of outpatient adults with mild or no COVID-19 symptoms and was divided into subpopulations with different levels of exposure. Among the subpopulation without known previous COVID-19 contacts, 4143 patients were investigated. Of the subpopulation with known COVID-19 contacts, 594 patients were investigated. IgG- and IgA-seroprevalence and RT-PCR positivity were determined in context with COVID-19 symptoms. Our results suggested no significant age-related differences between participants for IgG positivity but indicated that COVID-19 symptoms occurred most frequently in people aged between 20 and 29 years. Depending on the study population, 23.4-74.0% PCR-positive people (who were symptomless SARS-CoV-2 carriers at the time of the investigation) were identified. It was also observed that 72.7% of the patients remained seronegative for 30 days or more after their first PCR-positive results. This study hoped to contribute to the scientific understanding of the significance of asymptomatic and mild infections in the long persistence of the pandemic.
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Affiliation(s)
- István Jankovics
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine Budapest, 1143 Budapest, Hungary
| | - Cecília Müller
- Department of Chief Medical Officer, National Public Health Centre, 1097 Budapest, Hungary
| | - Éva Gönczöl
- Division of Project Coordination, National Public Health Centre, 1097 Budapest, Hungary
| | - Ildikó Visontai
- Division of Project Coordination, National Public Health Centre, 1097 Budapest, Hungary
| | - István Varga
- Division of Project Coordination, National Public Health Centre, 1097 Budapest, Hungary
| | - Márta Lőrincz
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine Budapest, 1143 Budapest, Hungary
| | - Dávid Kuti
- Division of Virology, Department of Reference Laboratory for Microbiology, National Public Health Center, 1097 Budapest, Hungary
| | - Ágnes Hasitz
- Family Doctor's Office, 2000 Szentendre, Hungary
| | - Péter Malik
- Veterinary Diagnostic Directorate, National Food Chain Safety Office, 1143 Budapest, Hungary
| | - Krisztina Ursu
- Veterinary Diagnostic Directorate, National Food Chain Safety Office, 1143 Budapest, Hungary
| | - Borbála Bányász
- Veterinary Diagnostic Directorate, National Food Chain Safety Office, 1143 Budapest, Hungary
| | - Júlia Sarkadi
- Division of Virology, Department of Reference Laboratory for Microbiology, National Public Health Center, 1097 Budapest, Hungary
| | - Béla Dénes
- Department of Microbiology and Infectious Diseases, University of Veterinary Medicine Budapest, 1143 Budapest, Hungary
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5
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Valenzuela-Fernández A, Cabrera-Rodriguez R, Ciuffreda L, Perez-Yanes S, Estevez-Herrera J, González-Montelongo R, Alcoba-Florez J, Trujillo-González R, García-Martínez de Artola D, Gil-Campesino H, Díez-Gil O, Lorenzo-Salazar JM, Flores C, Garcia-Luis J. Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19. Front Bioeng Biotechnol 2022; 10:1052436. [PMID: 36507266 PMCID: PMC9732709 DOI: 10.3389/fbioe.2022.1052436] [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: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.
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Affiliation(s)
- Agustín Valenzuela-Fernández
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Romina Cabrera-Rodriguez
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Laura Ciuffreda
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Silvia Perez-Yanes
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Judith Estevez-Herrera
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | | | - Julia Alcoba-Florez
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Rodrigo Trujillo-González
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- Departamento de Análisis Matemático, Facultad de Ciencias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Helena Gil-Campesino
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Oscar Díez-Gil
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - José M. Lorenzo-Salazar
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
| | - Carlos Flores
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, University of Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Jonay Garcia-Luis
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
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6
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Owen C, Wright-Foulkes D, Alvarez P, Delgado H, Durance EC, Wells GF, Poretsky R, Shrestha A. Reduction and discharge of SARS-CoV-2 RNA in Chicago-area water reclamation plants. FEMS MICROBES 2022; 3:xtac015. [PMID: 37332512 PMCID: PMC10117756 DOI: 10.1093/femsmc/xtac015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/14/2022] [Accepted: 05/05/2022] [Indexed: 08/24/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is commonly excreted in the feces and urine of infected individuals and is, therefore, detected in wastewaters where infection is present in the surrounding population. Water reclamation plants (WRPs) that treat these wastewaters commonly discharge treated effluents into the surrounding environment, yet little is known about the removal or persistence of SARS-CoV-2 RNA through wastewater treatment systems and potential for eventual release into the environment. We collected 361 24-hour composite influent and effluent samples from seven WRPs in the Greater Chicago Area in Illinois. Samples were collected over a period of 21 weeks for three large WRPs (with design max flows of 1.89-2.32 billion gallons per day and serving a combined population of 4.62 million people) and 11 weeks for four smaller WRPs (with design max flows of 96.3-186 million gallons per day and serving a combined population of >0.5 million people). A total of two of the larger WRPs implemented seasonal disinfection (using UV light or chlorination/dechlorination) for 8 weeks of this sampling period. SARS-CoV-2 RNA was quantified in the influent and effluent samples by reverse-transcription quantitative PCR (RT-qPCR) of the N1 and N2 targets of the nucleocapsid (N) gene. Although SARS-CoV-2 RNA was regularly detected in influent and effluent from all WRPs, viral RNA concentrations in the effluent samples were considerably lower, with mean effluent: influent gene copy concentration ratios ranging from 1:160 to 1:2.95 between WRPs. Samples collected while disinfection was active vs. inactive did not show any significant difference in the portion of RNA persisting through the treatment process (P > .05).
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Affiliation(s)
- Christopher Owen
- Department of Biological Sciences, University of Illinois Chicago, Chicago, IL 60607, United States
| | - Dorothy Wright-Foulkes
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60610, United States
| | - Prisila Alvarez
- Department of Biological Sciences, University of Illinois Chicago, Chicago, IL 60607, United States
| | - Haidy Delgado
- Department of Biological Sciences, University of Illinois Chicago, Chicago, IL 60607, United States
| | - Eva C Durance
- Department of Biological Sciences, University of Illinois Chicago, Chicago, IL 60607, United States
| | - George F Wells
- Department of Civil and Environmental Engineering, Northwestern University, Evanston, IL 60208, United States
| | - Rachel Poretsky
- Department of Biological Sciences, University of Illinois Chicago, Chicago, IL 60607, United States
| | - Abhilasha Shrestha
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60610, United States
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7
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Amereh F, Jahangiri-Rad M, Mohseni-Bandpei A, Mohebbi SR, Asadzadeh-Aghdaei H, Dabiri H, Eslami A, Roostaei K, Aali R, Hamian P, Rafiee M. Association of SARS-CoV-2 presence in sewage with public adherence to precautionary measures and reported COVID-19 prevalence in Tehran. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152597. [PMID: 34954185 PMCID: PMC8697476 DOI: 10.1016/j.scitotenv.2021.152597] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 05/06/2023]
Abstract
Compared to the growing body of literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection and quantification in sewage, there are limited studies reporting on correlations between the viral loads in sewage and the prevalence of infected patients. The present work is a part of the regular monitoring effort for SARS-CoV-2 in wastewater influents from seven wastewater treatment plants (WWTPs) in Tehran, Iran, starting from late September 2020 until early April 2021. These facilities cover ~64% of the metropolis serving >5000,000 M individuals. The study set out to track the trends in the prevalence of COVID-19 in the community using wastewater based epidemiology (WBE) and to investigate whether these measurements correlate with officially reported infections in the population. Composite sewage samples collected over 16 h were enriched by polyethylene glycol precipitation and the corresponding threshold cycle (Ct) profiles for CDC 'N' and 'ORF1ab' assays were derived through real time RT-qPCR. Monte Carlo simulation model was employed to provide estimates of the disease prevalence in the study area. RNA from SARS-CoV-2 was detectable in 100% ('N' assay) and 81% ('ORF1ab' assay) of totally 91 sewage samples, with viral loads ranging from 40 to 45,000 gene copies/L. The outbreak of COVID-19 positively correlated (R2 = 0.80) with the measured viral load in sewage samples. Furthermore, sewage SARS-CoV-2 RNA loads preceded infections in the population by 1 to 2 days, which were in line with public adherence with and support for government instructions to contain the pandemic. Given the transient presence of human host-restricted infections such as SARS-CoV-2, these results provide evidence for assessment of the effectiveness of coordinated efforts that specifically address public health responses based on wastewater-based disease surveillance against not only COVID-19 but also for future infectious outbreaks.
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Affiliation(s)
- Fatemeh Amereh
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Jahangiri-Rad
- Water Purification Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Anoushiravan Mohseni-Bandpei
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Air Quality and Climate Change Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Mohebbi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Asadzadeh-Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Dabiri
- Department of Medical Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Akbar Eslami
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kasra Roostaei
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rahim Aali
- Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran
| | - Parisa Hamian
- Department Geographic Information Systems, Tehran Sewerage Company, Tehran, Iran
| | - Mohammad Rafiee
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Air Quality and Climate Change Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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8
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Hewitt J, Trowsdale S, Armstrong BA, Chapman JR, Carter KM, Croucher DM, Trent CR, Sim RE, Gilpin BJ. Sensitivity of wastewater-based epidemiology for detection of SARS-CoV-2 RNA in a low prevalence setting. WATER RESEARCH 2022; 211:118032. [PMID: 35042077 PMCID: PMC8720482 DOI: 10.1016/j.watres.2021.118032] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 05/04/2023]
Abstract
To assist public health responses to COVID-19, wastewater-based epidemiology (WBE) is being utilised internationally to monitor SARS-CoV-2 infections at the community level. However, questions remain regarding the sensitivity of WBE and its use in low prevalence settings. In this study, we estimated the total number of COVID-19 cases required for detection of SARS-CoV-2 RNA in wastewater. To do this, we leveraged a unique situation where, over a 4-month period, all symptomatic and asymptomatic cases, in a population of approximately 120,000, were precisely known and mainly located in a single managed isolation and quarantine facility (MIQF) building. From 9 July to 6 November 2020, 24-hr composite wastewater samples (n = 113) were collected daily from the sewer outside the MIQF, and from the municipal wastewater treatment plant (WWTP) located 5 km downstream. New daily COVID-19 cases at the MIQF ranged from 0 to 17, and for most of the study period there were no cases outside the MIQF identified. SARS-CoV-2 RNA was detected in 54.0% (61/113) at the WWTP, compared to 95.6% (108/113) at the MIQF. We used logistic regression to estimate the shedding of SARS-CoV-2 RNA into wastewater based on four infectious shedding models. With a total of 5 and 10 COVID-19 infectious cases per 100,000 population (0.005% and 0.01% prevalence) the predicated probability of SARS-CoV-2 RNA detection at the WWTP was estimated to be 28 and 41%, respectively. When a proportional shedding model was used, this increased to 58% and 87% for 5 and 10 cases, respectively. In other words, when 10 individuals were actively shedding SARS-CoV-2 RNA in a catchment of 100,000 individuals, there was a high likelihood of detecting viral RNA in wastewater. SARS-CoV-2 RNA detections at the WWTP were associated with increasing COVID-19 cases. Our results show that WBE provides a reliable and sensitive platform for detecting infections at the community scale, even when case prevalence is low, and can be of use as an early warning system for community outbreaks.
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Affiliation(s)
- Joanne Hewitt
- Institute of Environmental Science and Research Ltd, 34 Kenepuru Drive, Porirua, 5240, New Zealand.
| | - Sam Trowsdale
- School of Environment, University of Auckland, 23 Symonds Street, Auckland, 1010, New Zealand
| | - Bridget A Armstrong
- Institute of Environmental Science and Research Ltd, 27 Creyke Road, Ilam, Christchurch 8041, New Zealand
| | - Joanne R Chapman
- Institute of Environmental Science and Research Ltd, 34 Kenepuru Drive, Porirua, 5240, New Zealand
| | - Kirsten M Carter
- Institute of Environmental Science and Research Ltd, 34 Kenepuru Drive, Porirua, 5240, New Zealand
| | - Dawn M Croucher
- Institute of Environmental Science and Research Ltd, 34 Kenepuru Drive, Porirua, 5240, New Zealand
| | - Cassandra R Trent
- Watercare Services Limited, 52 Aintree Ave, Airport Oaks, Auckland, New Zealand
| | - Rosemary E Sim
- Watercare Services Limited, 52 Aintree Ave, Airport Oaks, Auckland, New Zealand
| | - Brent J Gilpin
- Institute of Environmental Science and Research Ltd, 27 Creyke Road, Ilam, Christchurch 8041, New Zealand
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9
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Wang Y, Zheng K, Gao W, Lv J, Yu C, Wang L, Wang Z, Wang B, Liao C, Li L. Asymptomatic and pre-symptomatic infection in Coronavirus Disease 2019 pandemic. MEDICAL REVIEW (BERLIN, GERMANY) 2022; 2:66-88. [PMID: 35658110 PMCID: PMC9047649 DOI: 10.1515/mr-2021-0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/11/2022] [Indexed: 12/21/2022]
Abstract
With the presence of Coronavirus Disease 2019 (COVID-19) asymptomatic infections detected, their proportion, transmission potential, and other aspects such as immunity and related emerging challenges have attracted people's attention. We have found that based on high-quality research, asymptomatic infections account for at least one-third of the total cases, whereas based on systematic review and meta-analysis, the proportion is about one-fifth. Evaluating the true transmission potential of asymptomatic cases is difficult but critical, since it may affect national policies in response to COVID-19. We have summarized the current evidence and found, compared with symptomatic cases, the transmission capacity of asymptomatic individuals is weaker, even though they have similar viral load and relatively short virus shedding duration. As the outbreak progresses, asymptomatic infections have also been found to develop long COVID-19. In addition, the role of asymptomatic infection in COVID-19 remains to be further revealed as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to emerge. Nevertheless, as asymptomatic infections transmit the SARS-CoV-2 virus silently, they still pose a substantial threat to public health. Therefore, it is essential to conduct screening to obtain more knowledge about the asymptomatic infections and to detect them as soon as possible; meanwhile, management of them is also a key point in the fight against COVID-19 community transmission. The different management of asymptomatic infections in various countries are compared and the experience in China is displayed in detail.
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Affiliation(s)
- Yutong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ke Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenjing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Centre for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Centre for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Lan Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zijun Wang
- Peking University Centre for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Bo Wang
- Meinian Public Health Institute, Peking University Health Science Center, Beijing, China
| | - Chunxiao Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Centre for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Centre for Public Health and Epidemic Preparedness and Response, Beijing, China
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10
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Stankiewicz Karita HC, Dong TQ, Johnston C, Neuzil KM, Paasche-Orlow MK, Kissinger PJ, Bershteyn A, Thorpe LE, Deming M, Kottkamp A, Laufer M, Landovitz RJ, Luk A, Hoffman R, Roychoudhury P, Magaret CA, Greninger AL, Huang ML, Jerome KR, Wener M, Celum C, Chu HY, Baeten JM, Wald A, Barnabas RV, Brown ER. Trajectory of Viral RNA Load Among Persons With Incident SARS-CoV-2 G614 Infection (Wuhan Strain) in Association With COVID-19 Symptom Onset and Severity. JAMA Netw Open 2022; 5:e2142796. [PMID: 35006245 PMCID: PMC8749477 DOI: 10.1001/jamanetworkopen.2021.42796] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE The SARS-CoV-2 viral trajectory has not been well characterized in incident infections. These data are needed to inform natural history, prevention practices, and therapeutic development. OBJECTIVE To characterize early SARS-CoV-2 viral RNA load (hereafter referred to as viral load) in individuals with incident infections in association with COVID-19 symptom onset and severity. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was a secondary data analysis of a remotely conducted study that enrolled 829 asymptomatic community-based participants recently exposed (<96 hours) to persons with SARS-CoV-2 from 41 US states from March 31 to August 21, 2020. Two cohorts were studied: (1) participants who were SARS-CoV-2 negative at baseline and tested positive during study follow-up, and (2) participants who had 2 or more positive swabs during follow-up, regardless of the initial (baseline) swab result. Participants collected daily midturbinate swab samples for SARS-CoV-2 RNA detection and maintained symptom diaries for 14 days. EXPOSURE Laboratory-confirmed SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES The observed SARS-CoV-2 viral load among incident infections was summarized, and piecewise linear mixed-effects models were used to estimate the characteristics of viral trajectories in association with COVID-19 symptom onset and severity. RESULTS A total of 97 participants (55 women [57%]; median age, 37 years [IQR, 27-52 years]) developed incident infections during follow-up. Forty-two participants (43%) had viral shedding for 1 day (median peak viral load cycle threshold [Ct] value, 38.5 [95% CI, 38.3-39.0]), 18 (19%) for 2 to 6 days (median Ct value, 36.7 [95% CI, 30.2-38.1]), and 31 (32%) for 7 days or more (median Ct value, 18.3 [95% CI, 17.4-22.0]). The cycle threshold value has an inverse association with viral load. Six participants (6%) had 1 to 6 days of viral shedding with censored duration. The peak mean (SD) viral load was observed on day 3 of shedding (Ct value, 33.8 [95% CI, 31.9-35.6]). Based on the statistical models fitted to 129 participants (60 men [47%]; median age, 38 years [IQR, 25-54 years]) with 2 or more SARS-CoV-2-positive swab samples, persons reporting moderate or severe symptoms tended to have a higher peak mean viral load than those who were asymptomatic (Ct value, 23.3 [95% CI, 22.6-24.0] vs 30.7 [95% CI, 29.8-31.4]). Mild symptoms generally started within 1 day of peak viral load, and moderate or severe symptoms 2 days after peak viral load. All 535 sequenced samples detected the G614 variant (Wuhan strain). CONCLUSIONS AND RELEVANCE This cohort study suggests that having incident SARS-CoV-2 G614 infection was associated with a rapid viral load peak followed by slower decay. COVID-19 symptom onset generally coincided with peak viral load, which correlated positively with symptom severity. This longitudinal evaluation of the SARS-CoV-2 G614 with frequent molecular testing serves as a reference for comparing emergent viral lineages to inform clinical trial designs and public health strategies to contain the spread of the virus.
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Affiliation(s)
| | - Tracy Q. Dong
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Christine Johnston
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Kathleen M. Neuzil
- Department of Medicine, University of Maryland School of Medicine, Baltimore
| | - Michael K. Paasche-Orlow
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- Department of Medicine, Boston Medical Center, Boston, Massachusetts
| | | | - Anna Bershteyn
- Department of Population Health, New York University Grossman School of Medicine, New York
| | - Lorna E. Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York
| | - Meagan Deming
- Department of Medicine, University of Maryland School of Medicine, Baltimore
| | - Angelica Kottkamp
- Department of Medicine, New York University Grossman School of Medicine, New York
| | - Miriam Laufer
- Department of Medicine, University of Maryland School of Medicine, Baltimore
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | | | - Alfred Luk
- Department of Medicine, Tulane University, New Orleans, Louisiana
| | - Risa Hoffman
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Craig A. Magaret
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Alexander L. Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Meei-Li Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Keith R. Jerome
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Mark Wener
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
- Division of Rheumatology, University of Washington, Seattle
| | - Connie Celum
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Helen Y. Chu
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Jared M. Baeten
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Anna Wald
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Ruanne V. Barnabas
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Elizabeth R. Brown
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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11
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Dhawan M, Priyanka, Parmar M, Angural S, Choudhary OP. Convalescent plasma therapy against the emerging SARS-CoV-2 variants: Delineation of the potentialities and risks. Int J Surg 2022; 97:106204. [PMID: 34974199 PMCID: PMC8717699 DOI: 10.1016/j.ijsu.2021.106204] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in a catastrophic pandemic and severely impacted people's livelihoods worldwide. In addition, the emergence of SARS-CoV-2 variants has posed a severe threat to humankind. Due to the dearth of therapeutic options during the commencement of the pandemic, convalescent plasma therapy (CPT) played a significant part in the management of patients with severe form of COVID-19. Several recent studies have proposed various protective effects of CPT, such as antiviral, anti-inflammatory, anti-thrombotic, and immunomodulatory actions, curtailing the devastating consequences of the SARS-CoV-2 infection. On the contrary, several clinical studies have raised some serious concerns about the effectiveness and reliability of CPT in the management of patients with COVID-19. The protective effects of CPT in severely ill patients are yet to be proved. Moreover, the emergence of SARS-CoV-2 variants has raised concerns about the effectiveness of CPT against COVID-19. Therefore, to establish concrete evidence of the efficacy of CPT and adjudicate its inclusion in the management of COVID-19, an updated review of present literature is required, which could help in the development of an efficient therapeutic regimen to treat COVID-19 amid the emergence of new viral variants.
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Affiliation(s)
- Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana, 141004, Punjab, India,The Trafford Group of Colleges, Manchester, WA14 5PQ, UK
| | - Priyanka
- Independent Researcher, 07, Type IV Quarter, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University (I), Selesih, Aizawl, 796015, Mizoram, India
| | - Manisha Parmar
- Department of Veterinary Microbiology, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004, Punjab, India
| | - Steffy Angural
- Department of Medical Lab Technology, Faculty of Applied Health Sciences, GNA University, Phagwara-Hoshiarpur Road, Sri Hargobindgarh, 144401, Punjab, India,Corresponding author
| | - Om Prakash Choudhary
- Department of Veterinary Anatomy and Histology, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University (I), Selesih, Aizawl, 796015, Mizoram, India,Corresponding author
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12
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Aimrane A, Laaradia MA, Sereno D, Perrin P, Draoui A, Bougadir B, Hadach M, Zahir M, Fdil N, El Hiba O, El Hidan MA, Kahime K. Insight into COVID-19's epidemiology, pathology, and treatment. Heliyon 2022; 8:e08799. [PMID: 35071819 PMCID: PMC8767941 DOI: 10.1016/j.heliyon.2022.e08799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/08/2021] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
The newly emerged 2019 coronavirus disease (COVID-19) has urged scientific and medical communities to focus on epidemiology, pathophysiology, and treatment of SARS-CoV-2. Indeed, little is known about the virus causing this severe acute respiratory syndrome pandemic, coronavirus (SARS-CoV-2). Data already collected on viruses belonging to the coronaviridae family are of interest to improve our knowledge rapidly on this pandemic. The current review aims at delivering insight into the fundamental advances inSARS-CoV-2 epidemiology, pathophysiology, life cycle, and treatment.
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Affiliation(s)
- Abdelmohcine Aimrane
- Metabolics Platform, Biochemistry Laboratory, Faculty of Medicine, Cadi Ayad University, Marrakech, Morocco
- Nutritional Physiopathology Team, Faculty of Sciences, ChouaibDoukkali University, El Jadida, 24000, Morocco
| | - Mehdi Ait Laaradia
- Laboratory of Pharmacology, Neurobiology and Behavior, Semlalia Faculty of Sciences, Cadi Ayyad University, Marrakech, Morocco
| | - Denis Sereno
- IRD, University of Montpellier, InterTryp, Parasite Infectiology Research Group, 34000, Montpellier, France
| | - Pascale Perrin
- IRD, University of Montpellier, MiVeGec, Parasite Infectiology Research Group, 34000, Montpellier, France
| | - Ahmed Draoui
- Laboratory of Clinical and Experimental Neurosciences and Environment, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Morocco
| | - Blaid Bougadir
- SAEDD Laboratory, School of Technology Essaouira, Cadi Ayyad University of Marrakesh, Morocco
| | - Mohamed Hadach
- SAEDD Laboratory, School of Technology Essaouira, Cadi Ayyad University of Marrakesh, Morocco
| | - Mustapha Zahir
- SAEDD Laboratory, School of Technology Essaouira, Cadi Ayyad University of Marrakesh, Morocco
| | - Naima Fdil
- Metabolics Platform, Biochemistry Laboratory, Faculty of Medicine, Cadi Ayad University, Marrakech, Morocco
| | - Omar El Hiba
- Nutritional Physiopathology Team, Faculty of Sciences, ChouaibDoukkali University, El Jadida, 24000, Morocco
| | | | - Kholoud Kahime
- SAEDD Laboratory, School of Technology Essaouira, Cadi Ayyad University of Marrakesh, Morocco
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13
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Amoah ID, Mthethwa NP, Pillay L, Deepnarain N, Pillay K, Awolusi OO, Kumari S, Bux F. RT-LAMP: A Cheaper, Simpler and Faster Alternative for the Detection of SARS-CoV-2 in Wastewater. FOOD AND ENVIRONMENTAL VIROLOGY 2021; 13:447-456. [PMID: 34308531 PMCID: PMC8310731 DOI: 10.1007/s12560-021-09489-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/14/2021] [Indexed: 05/05/2023]
Abstract
Reverse transcription loop-mediated isothermal amplification (RT-LAMP) has the potential to become a cheaper and faster option for monitoring COVID-19 infections through wastewater-based epidemiology. However, its application in COVID-19 surveillance has been limited to clinical testing only. We present in this paper two optimized RT-LAMP protocols based on colour change and fluorescence detection and application of these protocols for wastewater monitoring from four wastewater treatment plants over 4 weeks. The optimized RT-LAMP protocols have a limit of detection of 10 copies/25 µl reaction with positive amplification within 35 minutes. Over the 4 weeks of monitoring, the colorimetric protocol detected a prevalence of 12.5%, when 1 µl of extracted RNA with 92.7(± 28.2) ng/µl concentration was analysed. When the RNA template was increased by fivefold, the prevalence increased to 44%. The fluorescent RT-LAMP had a prevalence of 31% and 47% for starting templates of 92.7(± 28.2) ng/µl and 480(± 134.5) ng/µl of the extracted RNA, respectively. All samples were positive for SARS-CoV-2 when analysed with droplet digital PCR, with viral loads ranging from 18.1 to 195.6 gc/ml of wastewater. The RT-ddPCR, therefore, confirms the presence of the viral RNA in the wastewater samples, albeit at low concentrations. Additionally, the RT-LAMP protocols positively detected SARS-CoV-2 in wastewater samples with copies as low as 20.7 gc/ml. The results obtained in our study show the potential application of RT-LAMP for the detection of SARS-CoV-2 in wastewater, which could provide a cheaper and faster alternative to RT-qPCR or RT-ddPCR for wastewater-based epidemiological monitoring of COVID-19 and other viral infections.
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Affiliation(s)
- Isaac Dennis Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Nonsikelelo Precios Mthethwa
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Leanne Pillay
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Nashia Deepnarain
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Kriveshin Pillay
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Oluyemi Olatunji Awolusi
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Sheena Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Faizal Bux
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa.
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14
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Maharjan N, Thapa N, Magar BP, Maharjan M, Tu J. Persistent Positivity of Reverse Transcriptase-Polymerase Chain Reaction Test among Patients with COVID-19 in Rural Teaching Hospital: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2021; 59:1136-1140. [PMID: 35199749 PMCID: PMC9124342 DOI: 10.31729/jnma.7077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The persistence positivity detected for severe acute respiratory syndrome coronavirus 2 ribonucleic acid by real-time reverse transcriptase-polymerase chain reaction test in asymptomatic coronavirus disease 2019 positive patients has attracted a lot of attention. There is limited data on the duration of viral shedding. We aimed to determine the proportion of coronavirus disease patients with persistent positivity of real-time reverse transcriptase-polymerase chain reaction test in a teaching hospital of Nepal. METHODS A descriptive cross-sectional study was conducted using medical records from May to September 2020 in a teaching hospital of Nepal. The study was approved by the Institutional Review Committee of Karnali Academy of Health Sciences (Reference no 077/078/03). Convenient sampling method was used. Data was analysed by Statistical Package for the Social Sciences. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS Of the total 95 cases, 9 (9.5%) cases (4.6-14.4 at 90% Confidence Interval), were repeat positive after achieving the first negative. The mean day required of achieving the last negative for the repeat positive group was 62.11±3.95, range (60-70 days). The mean time duration for the virus shedding was found to be 20.43±12.19 days (range 7-60 days) after the first positive test result. CONCLUSIONS This study concludes that there might be a persistent positivity of the polymerase chain reaction test among patients with COVID-19. The majority of the patients were test positive for 8-14 days, and some were positive till 60-70 days.
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Affiliation(s)
- Narayani Maharjan
- Program & Department of Clinical Laboratory Medicine, Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China and Department of Molecular Laboratory, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Niresh Thapa
- Department of General Practice and Emergency Medicine, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Bibek Pun Magar
- Department of Clinical Biochemistry, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Muna Maharjan
- School of Nursing and Midwifery, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Jiancheng Tu
- Program & Department of Clinical Laboratory Medicine, Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
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15
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Heireman L, Abrams S, Bruynseels P, Cartuyvels R, Cuypers L, De Schouwer P, Laffut W, Lagrou K, Hens N, Ho E, Padalko E, Reynders M, Vandamme S, Van der Moeren N, Verstrepen W, Willems P, Naesens R. Evaluation of the SARS-CoV-2 positivity ratio and upper respiratory tract viral load among asymptomatic individuals screened before hospitalization or surgery in Flanders, Belgium. PLoS One 2021; 16:e0259908. [PMID: 34762704 PMCID: PMC8584712 DOI: 10.1371/journal.pone.0259908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/28/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in the Belgian community is mainly estimated based on test results of patients with coronavirus disease (COVID-19)-like symptoms. The aim of this study was to investigate the evolution of the SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) positivity ratio and distribution of viral loads within a cohort of asymptomatic patients screened prior hospitalization or surgery, stratified by age category. MATERIALS/METHODS We retrospectively studied data on SARS-CoV-2 real-time RT-PCR detection in respiratory tract samples of asymptomatic patients screened pre-hospitalization or pre-surgery in nine Belgian hospitals located in Flanders over a 12-month period (1 April 2020-31 March 2021). RESULTS In total, 255925 SARS-CoV-2 RT-PCR test results and 2421 positive results for which a viral load was reported, were included in this study. An unweighted overall SARS-CoV-2 real-time RT-PCR positivity ratio of 1.27% was observed with strong spatiotemporal differences. SARS-CoV-2 circulated predominantly in 80+ year old individuals across all time periods except between the first and second COVID-19 wave and in 20-30 year old individuals before the second COVID-19 wave. In contrast to the first wave, a significantly higher positivity ratio was observed for the 20-40 age group in addition to the 80+ age group compared to the other age groups during the second wave. The median viral load follows a similar temporal evolution as the positivity rate with an increase ahead of the second wave and highest viral loads observed for 80+ year old individuals. CONCLUSION There was a high SARS-CoV-2 circulation among asymptomatic patients with a predominance and highest viral loads observed in the elderly. Moreover, ahead of the second COVID-19 wave an increase in median viral load was noted with the highest overall positivity ratio observed in 20-30 year old individuals, indicating they could have been the hidden drivers of this wave.
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Affiliation(s)
- Laura Heireman
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Steven Abrams
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
- Global Health Institute, Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Peggy Bruynseels
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | | | - Lize Cuypers
- Department of Laboratory Medicine and National Reference Center for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Pieter De Schouwer
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Wim Laffut
- Department of Laboratory Medicine, Heilig Hart Hospital, Lier, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Center for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Niel Hens
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - Erwin Ho
- Department of Laboratory Medicine, Sint-Maarten Hospital, Mechelen, Belgium
| | - Elizaveta Padalko
- Department of Laboratory Medicine, University Hospital Ghent, Ghent, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Sint-Jan Hospital, Bruges, Belgium
| | - Sarah Vandamme
- Department of Laboratory Medicine, Antwerp University Hospital, Antwerp, Belgium
| | | | - Walter Verstrepen
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Philippe Willems
- Department of Laboratory Medicine GasthuisZusters Antwerpen, Antwerp, Belgium
| | - Reinout Naesens
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
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16
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Bruckner T, Das A, Singh P, Boden-Albala B. SARS-CoV-2: An Empirical Investigation of Rose's Population-based Logic. Epidemiology 2021; 32:807-810. [PMID: 34347688 PMCID: PMC8478111 DOI: 10.1097/ede.0000000000001405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/19/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Geoffrey Rose's paper "Sick Individuals, Sick Populations" highlights the counterintuitive finding that the largest share of morbidity arises from populations engaging in low- to moderate-risk behavior. Scholars refer to this finding as the prevention paradox. We examine whether this logic applies to SARS-CoV-2 infected persons considered low to moderate risk. METHODS We conducted a population-representative survey and sero-surveillance study for SARS-CoV-2 among adults in Orange County, California. Participants answered questions about health behaviors and provided a finger-pin-prick sample from 10 July to 16 August 2020. RESULTS Of the 2979 adults, those reporting low- and moderate-risk behavior accounted for between 78% and 92% of SARS-CoV-2 infections. Asymptomatic individuals, as well as persons with low and moderate scores for self-reported likelihood of having had SARS-CoV-2, accounted for the majority of infections. CONCLUSIONS Our findings support Rose's logic, which encourages public health measures among persons who self-identify as unlikely to have SARS-CoV-2. See video abstract at, http://links.lww.com/EDE/B860.
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Affiliation(s)
- Tim Bruckner
- From the Program in Public Health, University of California, Irvine, CA
- Center for Population, Inequality, and Policy, University of California, Irvine, CA
| | - Abhery Das
- From the Program in Public Health, University of California, Irvine, CA
| | - Parvati Singh
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH
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17
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Le NK, Kaman K, Martin HC, Mullur J, Stenehjem KK, Coomar L, Bahar B, Dutta M, Izurieta R, Brooks JP. The immunologic response to severe acute respiratory syndrome coronavirus 2. Allergy Asthma Proc 2021; 42:495-505. [PMID: 34871157 DOI: 10.2500/aap.2021.42.210077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has precipitated the worst global pandemic in a century, which has caused millions of infections and deaths as well as massive economic repercussions. Objective: As with any pathogenic virus, it is crucial to understand its unique interactions with the human immune system so that pharmaceutical and prophylactic interventions can be deployed to effectively control the pandemic. Methods: A literature search by using PubMed was conducted in 2020 with variants of the terms "COVID-19," "SARS-CoV-2," and "immunological response." English language articles that presented original data about the immunologic response to coronavirus disease 2019 (COVID-19) were selected for review. This article reviewed the current understanding of the innate and adaptive immune responses to SARS-CoV-2 infection, including their relationship to current therapeutic and diagnostic strategies. Results: SARS-CoV-2 uses several unique molecular techniques to evade detection by the innate immune system early in the course of infection, and upregulation of these innate immune pathways may possibly accelerate the time to recovery and prevent severe disease. Although the majority of cases results in the patients' recovery, a significant proportion of infections result in deaths prompted by the host's inflammatory overreaction to the infection, a response that can be attenuated with corticosteroids and potentially other immune modulators. Conclusion: Current work by the scientific community to further understand how SARS-CoV-2 interacts with the human immune system will be invaluable to our response and preparedness for future coronavirus pandemics.
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Affiliation(s)
- Nicole K. Le
- From the Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Kelsey Kaman
- Divison of Rheumatology, Allergy and Immunology, Yale University School of Medicine, New Haven, Connecticut
| | - Hannah C. Martin
- Division of Rheumatology, Allergy, and Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jyotsna Mullur
- Division of Rheumatology, Allergy, and Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kristen K. Stenehjem
- Division of Allergy and Immunology, Children's National Hospital, Washington, D.C
| | - Lokesh Coomar
- Department of Anatomical Science and Education, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Burak Bahar
- Division of Laboratory Medicine, Children's National Hospital, Washington, D.C
| | - Mudit Dutta
- From the Department of Surgery, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Ricardo Izurieta
- Division of Global Communicable Disease, College of Public Health, University of South Florida, Tampa, Florida; and
| | - Joel P. Brooks
- Division of Allergy and Immunology, Children's National Hospital, Washington, D.C
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18
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Caplan A, Bates KW, Brioni C, Santos A, Sabatini LM, Kaul KL, Carnethon MR, Khandekar JD, Greenland P. Clinical characteristics and viral load dynamics of COVID-19 in a mildly or moderately symptomatic outpatient sample. PLoS One 2021; 16:e0258970. [PMID: 34673816 PMCID: PMC8530348 DOI: 10.1371/journal.pone.0258970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Studies of outpatients with mild or moderate COVID-19 are uncommon. We studied: 1) association of symptoms with reverse transcriptase polymerase chain reaction (RT-PCR) test results; and 2) association of initial RT-PCR cycle threshold (Ct) in relation to duration of RT-PCR positivity in outpatients with mild or moderate COVID-19. Methods This was a cohort study of outpatients with confirmed COVID-19 and at least one symptom. Participants had repeat nasopharyngeal swabs and symptom checklists every 3–5 days until two consecutive RT-PCR tests were negative. RT-PCR tests were used to assess viral load. Antibody tests for COVID-19 were performed at 2 weeks, 4 weeks, and 8 weeks after symptom onset. Results Twenty-five patients (nine females) were enrolled, ranging in age from 19–58 (median age 28 years). All patients reported at least one symptom, with a median of six symptoms per patient. Symptoms persisted for 6–67 days (median duration 18 days). In all 25 patients, blood samples collected a median of 13 days after symptom onset were positive for SARS-CoV-2 antibodies in 15 (60%). After a median of 28 days following symptom onset, 23/23 patients with available samples tested positive for antibodies. The longest duration of positive RT-PCR test was 49 days from first positive PCR test (Mean = 27.4, SD = 12.5, Median = 24). Initial Ct was significantly associated with longer duration (β = -1.3, SE = 0.3, p<0.01 per 1 cycle higher) of RT-PCR positivity. Conclusions In mildly or moderately ill COVID-19 outpatients, RT-PCT tests remained positive for as long as 49 days and test positivity and symptom duration correlated with initial viral load.
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Affiliation(s)
- Amanda Caplan
- Department of Immediate Care, NorthShore University Health System, Evanston, Illinois, United States of America
| | - Kelly W. Bates
- Department of Immediate Care, NorthShore University Health System, Evanston, Illinois, United States of America
| | - Carla Brioni
- Department of Immediate Care, NorthShore University Health System, Evanston, Illinois, United States of America
| | - Aileen Santos
- Department of Immediate Care, NorthShore University Health System, Evanston, Illinois, United States of America
| | - Linda M. Sabatini
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, United States of America
| | - Karen L. Kaul
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois, United States of America
| | - Mercedes R. Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Janardan D. Khandekar
- Department of Medicine, Center for Personalized Medicine, NorthShore University HealthSystem, Evanston, Illinois, United States of America
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- * E-mail:
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Campione E, Lanna C, Cosio T, Rosa L, Conte MP, Iacovelli F, Romeo A, Falconi M, Del Vecchio C, Franchin E, Lia MS, Minieri M, Chiaramonte C, Ciotti M, Nuccetelli M, Terrinoni A, Iannuzzi I, Coppeta L, Magrini A, Bernardini S, Sabatini S, Rosapepe F, Bartoletti PL, Moricca N, Di Lorenzo A, Andreoni M, Sarmati L, Miani A, Piscitelli P, Squillaci E, Valenti P, Bianchi L. Lactoferrin as Antiviral Treatment in COVID-19 Management: Preliminary Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010985. [PMID: 34682731 PMCID: PMC8535893 DOI: 10.3390/ijerph182010985] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 01/08/2023]
Abstract
Lactoferrin (Lf), a multifunctional cationic glycoprotein synthesized by exocrine glands and neutrophils, possesses an in vitro antiviral activity against SARS-CoV-2. Thus, we conducted an in vivo preliminary study to investigate the antiviral effect of oral and intranasal liposomal bovine Lf (bLf) in asymptomatic and mild-to-moderate COVID-19 patients. From April 2020 to June 2020, a total of 92 mild-to-moderate (67/92) and asymptomatic (25/92) COVID-19 patients were recruited and divided into three groups. Thirty-two patients (14 hospitalized and 18 in home-based isolation) received only oral and intranasal liposomal bLf; 32 hospitalized patients were treated only with standard of care (SOC) treatment; and 28, in home-based isolation, did not take any medication. Furthermore, 32 COVID-19 negative, untreated, healthy subjects were added for ancillary analysis. Liposomal bLf-treated COVID-19 patients obtained an earlier and significant (p < 0.0001) SARS-CoV-2 RNA negative conversion compared to the SOC-treated and untreated COVID-19 patients (14.25 vs. 27.13 vs. 32.61 days, respectively). Liposomal bLf-treated COVID-19 patients showed fast clinical symptoms recovery compared to the SOC-treated COVID-19 patients. In bLf-treated patients, a significant decrease in serum ferritin, IL-6, and D-dimers levels was observed. No adverse events were reported. These observations led us to speculate a potential role of bLf in the management of mild-to-moderate and asymptomatic COVID-19 patients.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
- Correspondence:
| | - Caterina Lanna
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
| | - Terenzio Cosio
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
| | - Luigi Rosa
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Maria Pia Conte
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Federico Iacovelli
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Alice Romeo
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Mattia Falconi
- Structural Bioinformatics Group, Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.I.); (A.R.); (M.F.)
| | - Claudia Del Vecchio
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy; (C.D.V.); (E.F.)
| | - Elisa Franchin
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy; (C.D.V.); (E.F.)
| | - Maria Stella Lia
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Marilena Minieri
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Carlo Chiaramonte
- Department of Statistics, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Marco Ciotti
- Virology Unit, Tor Vergata University Hospital, 00133 Rome, Italy;
| | - Marzia Nuccetelli
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, 00133 Rome, Italy; (M.N.); (S.B.)
| | - Alessandro Terrinoni
- Department of Experimental Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (M.S.L.); (M.M.); (A.T.)
| | - Ilaria Iannuzzi
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Luca Coppeta
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Andrea Magrini
- Occupational Medicine Department, University of Rome “Tor Vergata”, 00133 Rome, Italy; (I.I.); (L.C.); (A.M.)
| | - Sergio Bernardini
- Laboratory Medicine, Department of Experimental Medicine and Surgery, Tor Vergata University Hospital, 00133 Rome, Italy; (M.N.); (S.B.)
| | | | | | | | - Nicola Moricca
- Villa dei Pini Hospital, 00042 Anzio, Italy; (S.S.); (N.M.)
| | - Andrea Di Lorenzo
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Massimo Andreoni
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Loredana Sarmati
- Infectious Disease Unit, Tor Vergata University Hospital, 00133 Rome, Italy; (A.D.L.); (M.A.); (L.S.)
| | - Alessandro Miani
- Department of Environmental Sciences and Policy, University of Milan, 20133 Milan, Italy;
| | - Prisco Piscitelli
- UNESCO Chair on Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy;
| | - Ettore Squillaci
- Department of Diagnostic and Molecular Imaging, Radiation Therapy and Interventional Radiology, University Hospital Tor Vergata, 00133 Rome, Italy;
| | - Piera Valenti
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, 00185 Rome, Italy; (L.R.); (M.P.C.); (P.V.)
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.L.); (T.C.); (L.B.)
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20
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Pillay L, Amoah ID, Deepnarain N, Pillay K, Awolusi OO, Kumari S, Bux F. Monitoring changes in COVID-19 infection using wastewater-based epidemiology: A South African perspective. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 786:147273. [PMID: 33965818 PMCID: PMC8062404 DOI: 10.1016/j.scitotenv.2021.147273] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 05/17/2023]
Abstract
Monitoring of COVID-19 infections within communities via wastewater-based epidemiology could provide a cost-effective alternative to clinical testing. This approach, however, still requires improvement for its efficient application. In this paper, we present the use of wastewater-based epidemiology in monitoring COVID-19 infection dynamics in the KwaZulu-Natal province of South Africa, focusing on four wastewater treatment plants for 14 weeks. The SARS-CoV-2 viral load in influent wastewater was determined using droplet digital PCR, and the number of people infected was estimated using published models as well as using a modified model to improve efficiency. On average, viral loads ranged between 0 and 2.73 × 105 copies/100 ml, 0-1.52 × 105 copies/100 ml, 3 × 104-7.32 × 105 copies/100 ml and 1.55 × 104-4.12 × 105 copies/100 ml in the four wastewater treatment plants studied. The peak in viral load corresponded to the reported COVID-19 infections within the districts where these catchments are located. In addition, we also observed that easing of lockdown restrictions by authorities corresponded with an increase in viral load in the untreated wastewater. Estimation of infection numbers based on the viral load showed that a higher number of people could potentially be infected, compared to the number of cases reported based on clinical testing. The findings reported in this paper contribute to the field of wastewater-based epidemiology for COVID-19 surveillance, whilst highlighting some of the challenges associated with this approach, especially in developing countries.
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Affiliation(s)
- Leanne Pillay
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Isaac Dennis Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Nashia Deepnarain
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Kriveshin Pillay
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Oluyemi Olatunji Awolusi
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Sheena Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa
| | - Faizal Bux
- Institute for Water and Wastewater Technology, Durban University of Technology, P.O. Box 1334, Durban 4000, South Africa.
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21
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Sah P, Fitzpatrick MC, Zimmer CF, Abdollahi E, Juden-Kelly L, Moghadas SM, Singer BH, Galvani AP. Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis. Proc Natl Acad Sci U S A 2021; 118:e2109229118. [PMID: 34376550 PMCID: PMC8403749 DOI: 10.1073/pnas.2109229118] [Citation(s) in RCA: 253] [Impact Index Per Article: 84.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Quantification of asymptomatic infections is fundamental for effective public health responses to the COVID-19 pandemic. Discrepancies regarding the extent of asymptomaticity have arisen from inconsistent terminology as well as conflation of index and secondary cases which biases toward lower asymptomaticity. We searched PubMed, Embase, Web of Science, and World Health Organization Global Research Database on COVID-19 between January 1, 2020 and April 2, 2021 to identify studies that reported silent infections at the time of testing, whether presymptomatic or asymptomatic. Index cases were removed to minimize representational bias that would result in overestimation of symptomaticity. By analyzing over 350 studies, we estimate that the percentage of infections that never developed clinical symptoms, and thus were truly asymptomatic, was 35.1% (95% CI: 30.7 to 39.9%). At the time of testing, 42.8% (95% prediction interval: 5.2 to 91.1%) of cases exhibited no symptoms, a group comprising both asymptomatic and presymptomatic infections. Asymptomaticity was significantly lower among the elderly, at 19.7% (95% CI: 12.7 to 29.4%) compared with children at 46.7% (95% CI: 32.0 to 62.0%). We also found that cases with comorbidities had significantly lower asymptomaticity compared to cases with no underlying medical conditions. Without proactive policies to detect asymptomatic infections, such as rapid contact tracing, prolonged efforts for pandemic control may be needed even in the presence of vaccination.
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Affiliation(s)
- Pratha Sah
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Meagan C Fitzpatrick
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201
| | - Charlotte F Zimmer
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Elaheh Abdollahi
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Lyndon Juden-Kelly
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Seyed M Moghadas
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Burton H Singer
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
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22
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Shah SR, Kane SR, Elsheikh M, Alfaro TM. Development of a Rapid Viability RT-PCR (RV-RT-PCR) Method to Detect Infectious SARS-CoV-2 from Swabs. J Virol Methods 2021; 297:114251. [PMID: 34380012 PMCID: PMC8349479 DOI: 10.1016/j.jviromet.2021.114251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 12/23/2022]
Abstract
Since the rapid onset of the COVID-19 pandemic, its causative virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), continues to spread and increase the number of fatalities. To expedite studies on understanding potential surface transmission of the virus and to aid environmental epidemiological investigations, we developed a rapid viability reverse transcriptase PCR (RV-RT-PCR) method that detects viable (infectious) SARS-CoV-2 from swab samples in <1 day compared to several days required by current gold-standard cell-culture-based methods. The method integrates cell-culture-based viral enrichment in a 96-well plate format with gene-specific RT-PCR-based analysis before and after sample incubation to determine the cycle threshold (CT) difference (ΔCT). An algorithm based on ΔCT ≥ 6 representing ∼ 2-log or more increase in SARS-CoV-2 RNA following enrichment determines the presence of infectious virus. The RV-RT-PCR method with 2-hr viral infection and 9-hr post-infection incubation periods includes ultrafiltration to concentrate virions, resulting in detection of <50 SARS-CoV-2 virions in swab samples in 17 hours (for a batch of 12 swabs), compared to days typically required by the cell-culture based method. The SARS-CoV-2 RV-RT-PCR method may also be useful in clinical sample analysis and antiviral drug testing, and could serve as a model for developing rapid methods for other viruses of concern.
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Affiliation(s)
- Sanjiv R Shah
- Homeland Security and Materials Management Division, Center for Environmental Solutions and Emergency Response, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Staci R Kane
- Lawrence Livermore National Laboratory, Livermore, CA, USA.
| | - Maher Elsheikh
- Lawrence Livermore National Laboratory, Livermore, CA, USA
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23
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Pollmann TR, Schönert S, Müller J, Pollmann J, Resconi E, Wiesinger C, Haack C, Shtembari L, Turcati A, Neumair B, Meighen-Berger S, Zattera G, Neumair M, Apel U, Okolie A. The impact of digital contact tracing on the SARS-CoV-2 pandemic-a comprehensive modelling study. EPJ DATA SCIENCE 2021; 10:37. [PMID: 34306910 PMCID: PMC8290404 DOI: 10.1140/epjds/s13688-021-00290-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 06/22/2021] [Indexed: 05/08/2023]
Abstract
Contact tracing is one of several strategies employed in many countries to curb the spread of SARS-CoV-2. Digital contact tracing (DCT) uses tools such as cell-phone applications to improve tracing speed and reach. We model the impact of DCT on the spread of the virus for a large epidemiological parameter space consistent with current literature on SARS-CoV-2. We also model DCT in combination with random testing (RT) and social distancing (SD). Modelling is done with two independently developed individual-based (stochastic) models that use the Monte Carlo technique, benchmarked against each other and against two types of deterministic models. For current best estimates of the number of asymptomatic SARS-CoV-2 carriers (approximately 40%), their contagiousness (similar to that of symptomatic carriers), the reproductive number before interventions ( R 0 at least 3) we find that DCT must be combined with other interventions such as SD and/or RT to push the reproductive number below one. At least 60% of the population would have to use the DCT system for its effect to become significant. On its own, DCT cannot bring the reproductive number below 1 unless nearly the entire population uses the DCT system and follows quarantining and testing protocols strictly. For lower uptake of the DCT system, DCT still reduces the number of people that become infected. When DCT is deployed in a population with an ongoing outbreak where O (0.1%) of the population have already been infected, the gains of the DCT intervention come at the cost of requiring up to 15% of the population to be quarantined (in response to being traced) on average each day for the duration of the epidemic, even when there is sufficient testing capability to test every traced person.
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Affiliation(s)
- Tina R. Pollmann
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Stefan Schönert
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Johannes Müller
- Center for Mathematical Sciences, Technical University of Munich, 85748 Garching, Germany
- Institute for Computational Biology, Helmholtz Center Munich, 85764 Neuherberg, Germany
| | - Julia Pollmann
- Department of Medical Oncology, University Hospital Heidelberg, National Center for Tumor Diseases (NCT) Heidelberg, 69120 Heidelberg, Germany
| | - Elisa Resconi
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | | | - Christian Haack
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | | | - Andrea Turcati
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Birgit Neumair
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | | | - Giovanni Zattera
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Matthias Neumair
- Department of Mathematics, Technical University of Munich, 85748 Garching, Germany
| | - Uljana Apel
- Center for Mathematical Sciences, Technical University of Munich, 85748 Garching, Germany
| | - Augustine Okolie
- Center for Mathematical Sciences, Technical University of Munich, 85748 Garching, Germany
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Giron CC, Laaksonen A, Barroso da Silva FL. Up State of the SARS-COV-2 Spike Homotrimer Favors an Increased Virulence for New Variants. FRONTIERS IN MEDICAL TECHNOLOGY 2021; 3:694347. [PMID: 35047936 PMCID: PMC8757851 DOI: 10.3389/fmedt.2021.694347] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/31/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has spread worldwide. However, as soon as the first vaccines-the only scientifically verified and efficient therapeutic option thus far-were released, mutations combined into variants of SARS-CoV-2 that are more transmissible and virulent emerged, raising doubts about their efficiency. This study aims to explain possible molecular mechanisms responsible for the increased transmissibility and the increased rate of hospitalizations related to the new variants. A combination of theoretical methods was employed. Constant-pH Monte Carlo simulations were carried out to quantify the stability of several spike trimeric structures at different conformational states and the free energy of interactions between the receptor-binding domain (RBD) and angiotensin-converting enzyme II (ACE2) for the most worrying variants. Electrostatic epitopes were mapped using the PROCEEDpKa method. These analyses showed that the increased virulence is more likely to be due to the improved stability to the S trimer in the opened state, in which the virus can interact with the cellular receptor, ACE2, rather than due to alterations in the complexation RBD-ACE2, since the difference observed in the free energy values was small (although more attractive in general). Conversely, the South African/Beta variant (B.1.351), compared with the SARS-CoV-2 wild type (wt), is much more stable in the opened state with one or two RBDs in the up position than in the closed state with three RBDs in the down position favoring the infection. Such results contribute to understanding the natural history of disease and indicate possible strategies for developing new therapeutic molecules and adjusting the vaccine doses for higher B-cell antibody production.
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Affiliation(s)
- Carolina Corrêa Giron
- Departamento de Ciências Biomoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
- Hospital de Clínicas, Universidade Federal do Triângulo Mineiro, Uberaba, Brazil
| | - Aatto Laaksonen
- Arrhenius Laboratory, Department of Materials and Environmental Chemistry, Stockholm University, Stockholm, Sweden
- State Key Laboratory of Materials-Oriented and Chemical Engineering, Nanjing Tech University, Nanjing, China
- Centre of Advanced Research in Bionanoconjugates and Biopolymers, Petru Poni Institute of Macromolecular Chemistry, Iasi, Romania
- Division of Energy Science, Department of Engineering Sciences and Mathematics, Luleå University of Technology, Luleå, Sweden
| | - Fernando Luís Barroso da Silva
- Departamento de Ciências Biomoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC, United States
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Esposito S, Neglia C, Affanni P, Colucci ME, Argentiero A, Veronesi L, Messina G, Deolmi M, Principi N. Epidemiology of SARS-CoV-2 Infection Evaluated by Immunochromatographic Rapid Testing for the Determination of IgM and IgG Against SARS-CoV-2 in a Cohort of Mask Wearing Workers in the Metal-Mechanical Sector in an Area With a High Incidence of COVID-19. Front Public Health 2021; 9:628098. [PMID: 34249830 PMCID: PMC8267366 DOI: 10.3389/fpubh.2021.628098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/27/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Although the diagnosis of new coronavirus 2019 (COVID-19) is made through the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory secretions by means of molecular methods, a more accurate estimation of SARS-CoV-2 circulation can be obtained by seroprevalence studies. The main aim of this study was to evaluate the true epidemiology of SARS-CoV-2 infection among workers in the metal-mechanical sector who never stopped working during the pandemic period in an area with a high incidence of COVID-19 and to define whether and how they could continue the work without appreciable risks during a second wave. Methods: A total of 815 metal-mechanical workers who had never stopped working even during the pandemic period in three different factories in the Emilia-Romagna Region, Italy, and who had always used face masks during working hours, underwent a capillary blood rapid test for the determination of IgM and IgG against SARS-CoV-2 (COVID-19 IgG/IgM Rapid test, PrimaLab, Modena, Italy). In the event of a positive test, a nasopharyngeal was performed and tested for the presence of SARS-CoV-2. Results: The detection of serum IgG/IgM against SARS-CoV-2 was significantly more common among workers employed in Parma (21/345, 6.1%) than among those employed in Calerno (7/242, 2.9%) or in Spilamberto (3/228, 1.3%) (p <0.001). The analysis of the role of the different variables as predictors of seropositivity for IgG/IgM against SARS-CoV-2 revealed that the presence of specific antibodies was strictly associated with a previous history of COVID-19-like symptoms (odds ratio [OR] 3.95, 95% confidence interval [CI] 1.9–8.2) and household members with COVID-19-like symptoms (OR 2.20, 95% CI 1.04–4.82). Conclusion: This study shows that seropositivity to SARS-CoV-2 is low even among employees who did not interrupt their work during the lockdown phase in a region with a high incidence of COVID-19. The use of face masks appears effective in the avoidance of the transmission of SARS-CoV-2 in factories even in the presence of asymptomatic or mildly symptomatic workers, suggesting that work activities can continue if adequate infection control measures are used during a second wave.
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Comparison of the Quantitative DiaSorin Liaison Antigen Test to Reverse Transcription-PCR for the Diagnosis of COVID-19 in Symptomatic and Asymptomatic Outpatients. J Clin Microbiol 2021; 59:e0037421. [PMID: 33849953 DOI: 10.1128/jcm.00374-21] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
We evaluated the quantitative DiaSorin Liaison severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen test in symptomatic and asymptomatic individuals consulting their general practitioners (GPs) during a period of stable intense virus circulation (213/100,000 habitants per day). Leftover reverse transcription-PCR (RT-PCR) positive (n = 204) and negative (n = 210) nasopharyngeal samples were randomly selected among fresh routine samples collected from patients consulting their GPs. Samples were tested on Liaison XL according to the manufacturer's instructions. Equivocal results were considered negative. The overall sensitivity and specificity of the Liaison antigen test compared to RT-PCR were 65.7% (95% confidence interval [CI], 58.9% to 71.9%) and 100% (CI, 97.8% to 100%). Sensitivity in samples with viral loads of ≥105, ≥104, and ≥103 copies/ml were 100% (CI, 96.3% to 100.0%), 96.5% (CI, 91.8% to 98.7%), and 87.4% (CI, 81.3% to 91.5%), respectively. All samples with ≤103 copies/ml were antigen negative. The ratio of antigen concentration to viral load in samples with ≥103 copies/ml was comparable in symptomatic and asymptomatic individuals (P = 0.58). The proportion of RT-PCR-positive participants with a high viral load (≥105 copies/ml) was not significantly higher in symptomatic than in asymptomatic participants (63.9% [CI, 54.9% to 72.0%] versus 51.9% [CI, 41.1% to 62.6%]; P = 0.11), but the proportion of participants with a low viral load (<103 copies/ml) was significantly higher in asymptomatic than in symptomatic RT-PCR-positive participants (35.4% [CI, 25.8% to 46.4%] versus 14.3% [CI, 9.0% to 21.8%]; P < 0.01). Sensitivity and specificity in samples with a viral load of ≥104 copies/ml were 96.5% and 100%. The correlation of antigen concentration with viral load was comparable in symptomatic and asymptomatic individuals.
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27
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Badu K, Oyebola K, Zahouli JZB, Fagbamigbe AF, de Souza DK, Dukhi N, Amankwaa EF, Tolba MF, Sylverken AA, Mosi L, Mante PK, Matoke-Muhia D, Goonoo N. SARS-CoV-2 Viral Shedding and Transmission Dynamics: Implications of WHO COVID-19 Discharge Guidelines. Front Med (Lausanne) 2021; 8:648660. [PMID: 34239886 PMCID: PMC8259580 DOI: 10.3389/fmed.2021.648660] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/14/2021] [Indexed: 12/20/2022] Open
Abstract
The evolving nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has necessitated periodic revisions of COVID-19 patient treatment and discharge guidelines. Since the identification of the first COVID-19 cases in November 2019, the World Health Organization (WHO) has played a crucial role in tackling the country-level pandemic preparedness and patient management protocols. Among others, the WHO provided a guideline on the clinical management of COVID-19 patients according to which patients can be released from isolation centers on the 10th day following clinical symptom manifestation, with a minimum of 72 additional hours following the resolution of symptoms. However, emerging direct evidence indicating the possibility of viral shedding 14 days after the onset of symptoms called for evaluation of the current WHO discharge recommendations. In this review article, we carried out comprehensive literature analysis of viral shedding with specific focus on the duration of viral shedding and infectivity in asymptomatic and symptomatic (mild, moderate, and severe forms) COVID-19 patients. Our literature search indicates that even though, there are specific instances where the current protocols may not be applicable ( such as in immune-compromised patients there is no strong evidence to contradict the current WHO discharge criteria.
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Affiliation(s)
- Kingsley Badu
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kolapo Oyebola
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Biochemistry and Nutrition Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Department of Zoology, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Julien Z. B. Zahouli
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Centre d'Entomologie Médicale et Vétérinaire, Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Adeniyi Francis Fagbamigbe
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Division of Population and Behavioral Sciences, School of Medicine, St. Andrews University, St. Andrews, United Kingdom
| | - Dziedzom K. de Souza
- African Academy of Sciences Affiliates, Nairobi, Kenya
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Natisha Dukhi
- African Academy of Sciences Affiliates, Nairobi, Kenya
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Ebenezer F. Amankwaa
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Department of Geography and Resource Development, University of Ghana, Accra, Ghana
| | - Mai F. Tolba
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
- The Center of Drug Discovery Research and Development, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
- School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, New Administrative Capital, Egypt
| | - Augustina A. Sylverken
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lydia Mosi
- African Academy of Sciences Affiliates, Nairobi, Kenya
- West African Centre for Cell Biology of Infectious Diseases, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Priscilla Kolibea Mante
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Damaris Matoke-Muhia
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Centre for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Nowsheen Goonoo
- African Academy of Sciences Affiliates, Nairobi, Kenya
- Biomaterials, Drug Delivery and Nanotechnology Unit, Center for Biomedical and Biomaterials Research (CBBR), University of Mauritius, Reduit, Mauritius
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Pedro N, Fernandes V, Cavadas B, Guimarães JT, Barros H, Tavares M, Pereira L. Field and Molecular Epidemiology: How Viral Sequencing Changed Transmission Inferences in the First Portuguese SARS-CoV-2 Infection Cluster. Viruses 2021; 13:1116. [PMID: 34200621 PMCID: PMC8226748 DOI: 10.3390/v13061116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/31/2022] Open
Abstract
Field epidemiology and viral sequencing provide a comprehensive characterization of transmission chains and allow a better identification of superspreading events. However, very few examples have been presented to date during the COVID-19 pandemic. We studied the first COVID-19 cluster detected in Portugal (59 individuals involved amongst extended family and work environments), following the return of four related individuals from work trips to Italy. The first patient to introduce the virus would be misidentified following the traditional field inquiry alone, as shown by the viral sequencing in isolates from 23 individuals. The results also pointed out family, and not work environment, as the primary mode of transmission.
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Affiliation(s)
- Nicole Pedro
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
- ICBAS, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
| | - Veronica Fernandes
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
| | - Bruno Cavadas
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
| | - João Tiago Guimarães
- CHUSJ, Centro Hospitalar Universitário S. João, 4200-319 Porto, Portugal; (J.T.G.); (M.T.)
- FMUP, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal;
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
| | - Henrique Barros
- FMUP, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal;
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
| | - Margarida Tavares
- CHUSJ, Centro Hospitalar Universitário S. João, 4200-319 Porto, Portugal; (J.T.G.); (M.T.)
- FMUP, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal;
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, 4050-091 Porto, Portugal
| | - Luisa Pereira
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (N.P.); (V.F.); (B.C.)
- Ipatimup, Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
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Fontana LM, Villamagna AH, Sikka MK, McGregor JC. Understanding viral shedding of severe acute respiratory coronavirus virus 2 (SARS-CoV-2): Review of current literature. Infect Control Hosp Epidemiol 2021; 42:659-668. [PMID: 33077007 PMCID: PMC7691645 DOI: 10.1017/ice.2020.1273] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/30/2020] [Accepted: 10/09/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Transmission of SARS-CoV-2 has significant implications for hospital infection prevention and control, discharge management, and public health. We reviewed available literature to reach an evidenced-based consensus on the expected duration of viral shedding. DESIGN We queried 4 scholarly repositories and search engines for studies reporting SARS-CoV-2 viral shedding dynamics by PCR and/or culture available through September 8, 2020. We calculated the pooled median duration of viral RNA shedding from respiratory and fecal sources. RESULTS The review included 77 studies on SARS-CoV-2. All studies reported PCR-based testing and 12 also included viral culture data. Among 28 studies, the overall pooled median duration of RNA shedding from respiratory sources was 18.4 days (95% CI, 15.5-21.3; I2 = 98.87%; P < .01). When stratified by disease severity, the pooled median duration of viral RNA shedding from respiratory sources was 19.8 days (95% CI, 16.2-23.5; I2 = 96.42%; P < .01) among severely ill patients and 17.2 days (95% CI, 14.0-20.5; I2 = 95.64%; P < .01) in mild-to-moderate illness. Viral RNA was detected up to 92 days after symptom onset. Viable virus was isolated by culture from -6 to 20 days relative to symptom onset. CONCLUSIONS SARS-COV-2 RNA shedding can be prolonged, yet high heterogeneity exists. Detection of viral RNA may not correlate with infectivity since available viral culture data suggests shorter durations of shedding of viable virus. Additional data are needed to determine the duration of shedding of viable virus and the implications for risk of transmission.
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Affiliation(s)
- Lauren M. Fontana
- Department of Medicine, University of Minnesota Infectious Diseases and International Medicine, Minneapolis, MN, USA
| | - Angela Holly Villamagna
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Monica K. Sikka
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Jessina C. McGregor
- Department of Pharmacy Practice, College of Pharmacy, Oregon State University, Portland, Oregon
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30
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SARS-CoV-2 Reinfection in a Healthcare Worker Despite the Presence of Detectable Neutralizing Antibodies. Viruses 2021; 13:v13040661. [PMID: 33921216 PMCID: PMC8070424 DOI: 10.3390/v13040661] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 12/26/2022] Open
Abstract
So far, only a few reports about reinfections with SARS-CoV-2 have been published, and they often lack detailed immunological and virological data. We report about a SARS-CoV-2 reinfection with a genetically distinct SARS-CoV-2 variant in an immunocompetent female healthcare worker that has led to a mild disease course. No obvious viral escape mutations were observed in the second virus variant. The infectious virus was shed from the patient during the second infection episode despite the presence of neutralizing antibodies in her blood. Our data indicate that a moderate immune response after the first infection, but not a viral escape, did allow for reinfection and live virus shedding.
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31
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Huang CL, Fei L, Li W, Xu W, Xie XD, Li Q, Chen L. A Novel Prediction Model for Long-Term SARS-CoV-2 RNA Shedding in Non-Severe Adult Hospitalized Patients with COVID-19: A Retrospective Cohort Study. Infect Dis Ther 2021; 10:897-909. [PMID: 33788153 PMCID: PMC8011066 DOI: 10.1007/s40121-021-00437-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/17/2021] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Due to the lack of clear direction (evidence) on the duration of viral shedding and thus potential for transmission, this retrospective study aimed to come up with a prediction model of prolonged coronavirus disease-19 (COVID-19) transmission or infection-spreading potential. METHODS A total of 1211 non-severe patients with COVID-19 were retrospectively enrolled. Multivariate Cox regression was performed to identify the risk factors associated with long-term SARS-CoV-2 RNA shedding, and a prediction model was established. RESULTS In the training set, 796 patients were divided into the long-term (> 21 days) group (n = 116, 14.6%) and the short-term (≤ 21 days) group (n = 680, 85.4%) based on their viral shedding duration. Multivariate analysis identified that age > 50 years, comorbidity, CD4-positive T-lymphocytes count (CD4 + T cell) ≤ 410 cells/ul, C-reactive protein (CRP) > 10 mg/L, and the corticosteroid use were independent risk factors for long-term SARS-CoV-2 RNA shedding. Incorporating the five risk factors, a prediction model, named as the CCCCA score, was established, and its area under the receiver operator characteristic curve (AUROC) was 0.87 in the training set and 0.83 in the validation set, respectively. In the validation set, using a cut-off of 8 points, we found sensitivity, specificity, positive predictive value, and negative predictive value of 51.7%, 92.2%, 33.3%, and 96.2%, respectively. Long-term SARS-CoV-2 RNA shedding increased from 14/370 (3.8%) in patients with CCCCA < 8 points to 15/45 (33.3%) in patients with CCCCA ≥ 8 points. CONCLUSION Using the CCCCA score, clinicians can identify patients with long-term SARS-CoV-2 RNA shedding.
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Affiliation(s)
- Chen Lu Huang
- Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China
| | - Ling Fei
- Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China
| | - WeiXia Li
- Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China
| | - Wei Xu
- Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China
| | - Xu Dong Xie
- Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China
| | - Qiang Li
- Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China.
| | - Liang Chen
- Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China.
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Rodríguez-Grande C, Catalán P, Alcalá L, Buenestado-Serrano S, Adán-Jiménez J, Rodríguez-Maus S, Herranz M, Sicilia J, Acosta F, Pérez-Lago L, Muñoz P, García de Viedma D. Different dynamics of mean SARS-CoV-2 RT-PCR Ct values between the first and second COVID-19 waves in the Madrid population. Transbound Emerg Dis 2021; 68:3103-3106. [PMID: 33621389 PMCID: PMC8014596 DOI: 10.1111/tbed.14045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/27/2021] [Accepted: 02/20/2021] [Indexed: 12/26/2022]
Abstract
SARS‐CoV‐2 RT‐PCR cycle threshold values from 18,803 cases (2 March–4 October) in Madrid define three stages: (i) initial ten weeks with sustained reduction in viral load (Ct: 23.4–32.3), (ii) stability with low viral loads (Ct: 31.9–35.5) in the next nine weeks and (iii) sudden increase with progressive higher viral loads until reaching stability at high levels in the next twelve weeks, coinciding with an increased percentage of positive cases and reduced median age. These data indicate differential virological/epidemiological patterns between the first and second COVID‐19 waves in Madrid.
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Affiliation(s)
- Cristina Rodríguez-Grande
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Pilar Catalán
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Luis Alcalá
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Sergio Buenestado-Serrano
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Javier Adán-Jiménez
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Sandra Rodríguez-Maus
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Marta Herranz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Jon Sicilia
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Fermín Acosta
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Laura Pérez-Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | - Darío García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Caronni A, Liaci E, Bianchi A, Viganò A, Marenco F, Comanducci A, Cabrini DM, Meloni M, Alberoni M, Farina E, Bianco M, Galeri S, Devalle G, Navarro J. Clinical course of SARS-CoV-2 infection in patients with severe acquired brain injury and a disorder of consciousness: an observational study. Brain Inj 2021; 35:520-529. [PMID: 33587672 DOI: 10.1080/02699052.2021.1887937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose: SARS-CoV-2 infection can cause the coronavirus disease (COVID), ranging from flu-like symptoms to interstitial pneumonia. Mortality is high in COVID pneumonia and it is the highest among the frailest. COVID could be particularly serious in patients with severe acquired brain injury (SABI), such as those with a disorder of consciousness. We here describe a cohort of patients with a disorder of consciousness exposed to SARS-CoV-2 early after their SABI.Materials and methods: The full cohort of 11 patients with SABI hospitalized in March 2020 in the IRCCS Fondazione Don Gnocchi rehabilitation (Milan, Italy) was recruited. Participants received SARS-CoV-2 testing and different clinical and laboratory data were collected.Results: Six patients contracted SARS-CoV-2 and four of them developed the COVID. Of these, one patient had ground-glass opacities on the chest CT scan, while the remaining three developed consolidations. No patient died and the overall respiratory involvement was mild, requiring in the worst cases low-flow oxygen.Conclusions: Here we report the clinical course of a cohort of patients with SABI exposed to SARS-CoV-2. The infection spread among patients and caused COVID in some of them. Unexpectedly, COVID was moderate, caused at most mild respiratory distress and did not result in fatalities.
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Affiliation(s)
| | - Emanuele Liaci
- Scuola di Specializzazione in Medicina Fisica e Riabilitativa, Università degli Studi di Bari "Aldo Moro", Bari, Italy
| | - Anna Bianchi
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milano, Italy
| | | | | | | | | | - Mario Meloni
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milano, Italy
| | | | | | | | - Silvia Galeri
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milano, Italy
| | - Guya Devalle
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milano, Italy
| | - Jorge Navarro
- IRCCS Fondazione Don Carlo Gnocchi Onlus, Milano, Italy
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Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration. Microorganisms 2021; 9:microorganisms9020300. [PMID: 33540596 PMCID: PMC7912897 DOI: 10.3390/microorganisms9020300] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/12/2022] Open
Abstract
A few molecularly proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases of symptomatic reinfection are currently known worldwide, with a resolved first infection followed by a second infection after a 48 to 142-day intervening period. We report a multiple-component study of a clinically severe and prolonged viral shedding coronavirus disease 2019 (COVID-19) case in a 17-year-old Portuguese female. She had two hospitalizations, a total of 19 RT-PCR tests, mostly positive, and criteria for releasing from home isolation at the end of 97 days. The viral genome was sequenced in seven serial samples and in the diagnostic sample from her infected mother. A human genome-wide array (>900 K) was screened on the seven samples, and in vitro culture was conducted on isolates from three late samples. The patient had co-infection by two SARS-CoV-2 lineages, which were affiliated in distinct clades and diverging by six variants. The 20A lineage was absolute at the diagnosis (shared with the patient’s mother), but nine days later, the 20B lineage had 3% frequency, and two months later, the 20B lineage had 100% frequency. The 900 K profiles confirmed the identity of the patient in the serial samples, and they allowed us to infer that she had polygenic risk scores for hospitalization and severe respiratory disease within the normal distributions for a Portuguese population cohort. The early-on dynamic co-infection may have contributed to the severity of COVID-19 in this otherwise healthy young patient, and to her prolonged SARS-CoV-2 shedding profile.
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Grossi E, Terruzzi V. Exceptionally high COVID-19 viral load and very long duration of shedding in a young pauci-symptomatic child with autism resident in an Italian nursing home. J Infect 2021; 82:e29-e30. [PMID: 32841645 PMCID: PMC7443058 DOI: 10.1016/j.jinf.2020.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Enzo Grossi
- Villa Santa Maria Foundation, Tavernerio, Italy.
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36
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Gulati S, Muddasani R, Gustavo Bergerot P, Pal SK. Systemic therapy and COVID19: Immunotherapy and chemotherapy. Urol Oncol 2021; 39:213-220. [PMID: 33451934 PMCID: PMC7762713 DOI: 10.1016/j.urolonc.2020.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/07/2020] [Accepted: 12/19/2020] [Indexed: 12/19/2022]
Abstract
As the novel severe acute respiratory syndrome coronavirus-2 related pandemic - Corona Virus Disease 2019 (COVID-19) has emerged, decision making in the context of cancer treatment has become more complex. The apprehension of using drugs that could adversely affect infected patients, the risk of not using life-saving treatments and the complexities related to the type of cancer itself, all must be taken into consideration before proceeding with treatment. Data from large registries such as COVID-19 and Cancer Consortium, Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) and NCI COVID-19 in Cancer Patients Study will hopefully provide granularity on the outcomes of patients with cancer who are infected with COVID-19. As these efforts are underway, this review aims to shed light on the management of patients with genitourinary malignancies being treated with systemic therapies while infected with COVID-19.
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Affiliation(s)
- Shuchi Gulati
- Hematology and Oncology, University of Cincinnati Medical Center, Cincinnati, OH
| | - Ramya Muddasani
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA; Department of Medical Oncology, Centro de Câncer de Brasília (CETTRO), Brasília, DF, Brazil
| | - Sumanta K Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA.
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37
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Pollmann TR, Schönert S, Müller J, Pollmann J, Resconi E, Wiesinger C, Haack C, Shtembari L, Turcati A, Neumair B, Meighen-Berger S, Zattera G, Neumair M, Apel U, Okolie A. The impact of digital contact tracing on the SARS-CoV-2 pandemic-a comprehensive modelling study. EPJ DATA SCIENCE 2021; 10:37. [PMID: 34306910 DOI: 10.1101/2020.09.13.20192682v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 06/22/2021] [Indexed: 05/20/2023]
Abstract
Contact tracing is one of several strategies employed in many countries to curb the spread of SARS-CoV-2. Digital contact tracing (DCT) uses tools such as cell-phone applications to improve tracing speed and reach. We model the impact of DCT on the spread of the virus for a large epidemiological parameter space consistent with current literature on SARS-CoV-2. We also model DCT in combination with random testing (RT) and social distancing (SD). Modelling is done with two independently developed individual-based (stochastic) models that use the Monte Carlo technique, benchmarked against each other and against two types of deterministic models. For current best estimates of the number of asymptomatic SARS-CoV-2 carriers (approximately 40%), their contagiousness (similar to that of symptomatic carriers), the reproductive number before interventions ( R 0 at least 3) we find that DCT must be combined with other interventions such as SD and/or RT to push the reproductive number below one. At least 60% of the population would have to use the DCT system for its effect to become significant. On its own, DCT cannot bring the reproductive number below 1 unless nearly the entire population uses the DCT system and follows quarantining and testing protocols strictly. For lower uptake of the DCT system, DCT still reduces the number of people that become infected. When DCT is deployed in a population with an ongoing outbreak where O (0.1%) of the population have already been infected, the gains of the DCT intervention come at the cost of requiring up to 15% of the population to be quarantined (in response to being traced) on average each day for the duration of the epidemic, even when there is sufficient testing capability to test every traced person.
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Affiliation(s)
- Tina R Pollmann
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Stefan Schönert
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Johannes Müller
- Center for Mathematical Sciences, Technical University of Munich, 85748 Garching, Germany
- Institute for Computational Biology, Helmholtz Center Munich, 85764 Neuherberg, Germany
| | - Julia Pollmann
- Department of Medical Oncology, University Hospital Heidelberg, National Center for Tumor Diseases (NCT) Heidelberg, 69120 Heidelberg, Germany
| | - Elisa Resconi
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | | | - Christian Haack
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | | | - Andrea Turcati
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Birgit Neumair
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | | | - Giovanni Zattera
- Physics Department, Technical University of Munich, 85748 Garching, Germany
| | - Matthias Neumair
- Department of Mathematics, Technical University of Munich, 85748 Garching, Germany
| | - Uljana Apel
- Center for Mathematical Sciences, Technical University of Munich, 85748 Garching, Germany
| | - Augustine Okolie
- Center for Mathematical Sciences, Technical University of Munich, 85748 Garching, Germany
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38
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Dastidar MG, Roy S. Public health management during COVID-19 and applications of point-of-care based biomolecular detection approaches. ENVIRONMENTAL AND HEALTH MANAGEMENT OF NOVEL CORONAVIRUS DISEASE (COVID-19 ) 2021. [PMCID: PMC8237533 DOI: 10.1016/b978-0-323-85780-2.00009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The emergence of the novel human coronavirus, characterized as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a worldwide pandemic. The outbreak of SARS-CoV-2 was first reported at a local wet market in the city of Wuhan in the Hubei province of China at a local wet market. This virus is highly contagious, which gives it the potential for rapid transmission across the world. The transmission of SARS-CoV-2 can be triggered via respiratory droplets in the air from an infected individual to a healthy individual. Thus, to restrict the transmission of the virus, proper public health management and early diagnosis of infected individual is extremely essential. Considering this, the development of various point-of-care (POC) biomolecular assays lead to the importance of early diagnoses at a larger scale during this pandemic situation. Detecting a minimum level of specific target analytes to a particular disease with less instrumentation and minimum reagents, as well as immidiate outcomes, has appeared a challenging path for researchers. Apart from early-stage diagnosis, public awareness is also important to prevent the spread of the virus. Proper intensive care units, isolation rooms, maintaining hygiene, and wearing masks in public areas are necessary. In this chapter, we have discussed the public health management steps and current clinical diagnostics processes and various advanced technology including, molecular, serological, and nanobiosensing approaches for SARS-CoV-2 detection. Furthermore, we have highlighted the various challenges and limitations associated with health management and early diagnostics technologies during SARS-CoV-2 pandemic. Additionally, we have summarized various technical aspects of the development of such POC strategies including biomarkers selections, sensing platforms, unit fabrication, and device incorporation.
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39
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DeBiasi RL, Delaney M. Symptomatic and Asymptomatic Viral Shedding in Pediatric Patients Infected With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Under the Surface. JAMA Pediatr 2021; 175:16-18. [PMID: 32857158 DOI: 10.1001/jamapediatrics.2020.3996] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Roberta L DeBiasi
- Division of Pediatric Infectious Diseases, Children's National Hospital and Research Institute, Washington, DC.,Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC.,Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Meghan Delaney
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC.,Division of Laboratory Medicine and Pathology, Children's National Hospital and Research Institute, Washington, DC.,Department of Pathology, The George Washington University School of Medicine and Health Sciences, Washington, DC
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40
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Gidari A, Nofri M, Saccarelli L, Bastianelli S, Sabbatini S, Bozza S, Camilloni B, Fusco-Moffa I, Monari C, De Robertis E, Mencacci A, Francisci D. Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature. Eur J Clin Microbiol Infect Dis 2021; 40:1-12. [PMID: 33037944 PMCID: PMC7547550 DOI: 10.1007/s10096-020-04057-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022]
Abstract
Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved. We tried to analyze local and literature cases with a positive respiratory swab after recovery. We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens. Samples were also assessed for infectivity in vitro. A systematic review of similar cases reported in the literature was performed. The study population was composed of 9 patients during a 4-month study period. Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants. All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein. Conducting a review of the literature, 1350 similar cases have been found. The presumptive reactivation occurred in 34.5 days on average (standard deviation, SD, 18.7 days) after COVID-19 onset, when the 5.6% of patients presented fever and the 27.6% symptoms. The outcome was favorable in 96.7% of patients, while the 1.1% of them were still hospitalized at the time of data collection and the 2.1% died. Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity. According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients. The failure of the virus to replicate in vitro suggests its inability to replicate in vivo.
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Affiliation(s)
- Anna Gidari
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy.
| | - Marco Nofri
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Luca Saccarelli
- Department of Anesthesiology, Intensive Care and Pain therapy Center, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Sabrina Bastianelli
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Silvia Bozza
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Barbara Camilloni
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Igino Fusco-Moffa
- Department of Prevention, Local Health Unit Umbria 1, Travel Medicine Unit, Perugia, Italy
| | - Claudia Monari
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Edoardo De Robertis
- Department of Anesthesiology, Intensive Care and Pain therapy Center, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Antonella Mencacci
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
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Abdallah H, Porterfield F, Fajgenbaum D. Symptomatic relapse and long-term sequelae of COVID-19 in a previously healthy 30-year-old man. BMJ Case Rep 2020; 13:e239825. [PMID: 33318288 PMCID: PMC10577719 DOI: 10.1136/bcr-2020-239825] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 12/27/2022] Open
Abstract
Much has been reported on the clinical course of severe COVID-19, but less is known about the natural history and sequalae of mildly symptomatic cases and the prospects of reinfection or recurrence of symptoms. We report a case of a patient with mildly symptomatic PCR-confirmed COVID-19 who, after being symptom-free for 2 weeks, redeveloped symptoms and was found to be PCR-positive again >4 weeks from original testing. Surprisingly, IgG and IgM antibody testing was negative 2 months after reinfection. Although no negative testing was performed between the two symptomatic bouts, this case raises the possibility of reinfection after controlling the virus and highlights the long period with which a patient can shed virus and experience symptoms after initial infection. Characterising variations in clinical symptoms and length of viral shedding after improvement is essential for informing recommendations on patients safely resuming contact with others.
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Affiliation(s)
- Hatem Abdallah
- Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Florence Porterfield
- Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Fajgenbaum
- Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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42
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Smith DRM, Duval A, Pouwels KB, Guillemot D, Fernandes J, Huynh BT, Temime L, Opatowski L. Optimizing COVID-19 surveillance in long-term care facilities: a modelling study. BMC Med 2020; 18:386. [PMID: 33287821 PMCID: PMC7721547 DOI: 10.1186/s12916-020-01866-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Long-term care facilities (LTCFs) are vulnerable to outbreaks of coronavirus disease 2019 (COVID-19). Timely epidemiological surveillance is essential for outbreak response, but is complicated by a high proportion of silent (non-symptomatic) infections and limited testing resources. METHODS We used a stochastic, individual-based model to simulate transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) along detailed inter-individual contact networks describing patient-staff interactions in a real LTCF setting. We simulated distribution of nasopharyngeal swabs and reverse transcriptase polymerase chain reaction (RT-PCR) tests using clinical and demographic indications and evaluated the efficacy and resource-efficiency of a range of surveillance strategies, including group testing (sample pooling) and testing cascades, which couple (i) testing for multiple indications (symptoms, admission) with (ii) random daily testing. RESULTS In the baseline scenario, randomly introducing a silent SARS-CoV-2 infection into a 170-bed LTCF led to large outbreaks, with a cumulative 86 (95% uncertainty interval 6-224) infections after 3 weeks of unmitigated transmission. Efficacy of symptom-based screening was limited by lags to symptom onset and silent asymptomatic and pre-symptomatic transmission. Across scenarios, testing upon admission detected just 34-66% of patients infected upon LTCF entry, and also missed potential introductions from staff. Random daily testing was more effective when targeting patients than staff, but was overall an inefficient use of limited resources. At high testing capacity (> 10 tests/100 beds/day), cascades were most effective, with a 19-36% probability of detecting outbreaks prior to any nosocomial transmission, and 26-46% prior to first onset of COVID-19 symptoms. Conversely, at low capacity (< 2 tests/100 beds/day), group testing strategies detected outbreaks earliest. Pooling randomly selected patients in a daily group test was most likely to detect outbreaks prior to first symptom onset (16-27%), while pooling patients and staff expressing any COVID-like symptoms was the most efficient means to improve surveillance given resource limitations, compared to the reference requiring only 6-9 additional tests and 11-28 additional swabs to detect outbreaks 1-6 days earlier, prior to an additional 11-22 infections. CONCLUSIONS COVID-19 surveillance is challenged by delayed or absent clinical symptoms and imperfect diagnostic sensitivity of standard RT-PCR tests. In our analysis, group testing was the most effective and efficient COVID-19 surveillance strategy for resource-limited LTCFs. Testing cascades were even more effective given ample testing resources. Increasing testing capacity and updating surveillance protocols accordingly could facilitate earlier detection of emerging outbreaks, informing a need for urgent intervention in settings with ongoing nosocomial transmission.
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Affiliation(s)
- David R M Smith
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France.
- Modélisation, épidémiologie et surveillance des risques sanitaires (MESuRS), Conservatoire national des arts et métiers, Paris, France.
| | - Audrey Duval
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
| | - Koen B Pouwels
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- The National Institute for Health Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK
| | - Didier Guillemot
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
- AP-HP, Paris Saclay, Public Health, Medical Information, Clinical Research, Le Kremlin-Bicêtre, France
| | - Jérôme Fernandes
- Clinique de soins de suite et réadaptation, Choisy-Le-Roi, France
| | - Bich-Tram Huynh
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
| | - Laura Temime
- Modélisation, épidémiologie et surveillance des risques sanitaires (MESuRS), Conservatoire national des arts et métiers, Paris, France
- PACRI unit, Institut Pasteur, Conservatoire national des arts et métiers, Paris, France
| | - Lulla Opatowski
- Institut Pasteur, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-Le-Bretonneux, France
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Yanes-Lane M, Winters N, Fregonese F, Bastos M, Perlman-Arrow S, Campbell JR, Menzies D. Proportion of asymptomatic infection among COVID-19 positive persons and their transmission potential: A systematic review and meta-analysis. PLoS One 2020; 15:e0241536. [PMID: 33141862 PMCID: PMC7608887 DOI: 10.1371/journal.pone.0241536] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/18/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The study objective was to conduct a systematic review and meta-analysis on the proportion of asymptomatic infection among coronavirus disease 2019 (COVID-19) positive persons and their transmission potential. METHODS We searched Embase, Medline, bioRxiv, and medRxiv up to 22 June 2020. We included cohorts or cross-sectional studies which systematically tested populations regardless of symptoms for COVID-19, or case series of any size reporting contact investigations of asymptomatic index patients. Two reviewers independently extracted data and assessed quality using pre-specified criteria. Only moderate/high quality studies were included. The main outcomes were proportion of asymptomatic infection among COVID-19 positive persons at testing and through follow-up, and secondary attack rate among close contacts of asymptomatic index patients. A qualitative synthesis was performed. Where appropriate, data were pooled using random effects meta-analysis to estimate proportions and 95% confidence intervals (95% CI). RESULTS Of 6,137 identified studies, 71 underwent quality assessment after full text review, and 28 were high/moderate quality and were included. In two general population studies, the proportion of asymptomatic COVID-19 infection at time of testing was 20% and 75%, respectively; among three studies in contacts it was 8.2% to 50%. In meta-analysis, the proportion (95% CI) of asymptomatic COVID-19 infection in obstetric patients was 95% (45% to 100%) of which 59% (49% to 68%) remained asymptomatic through follow-up; among nursing home residents, the proportion was 54% (42% to 65%) of which 28% (13% to 50%) remained asymptomatic through follow-up. Transmission studies were too heterogenous to meta-analyse. Among five transmission studies, 18 of 96 (18.8%) close contacts exposed to asymptomatic index patients were COVID-19 positive. CONCLUSIONS Despite study heterogeneity, the proportion of asymptomatic infection among COVID-19 positive persons appears high and transmission potential seems substantial. To further our understanding, high quality studies in representative general population samples are required.
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Affiliation(s)
- Mercedes Yanes-Lane
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nicholas Winters
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada
| | - Federica Fregonese
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Mayara Bastos
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Sara Perlman-Arrow
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jonathon R. Campbell
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada
- McGill International TB Centre, Montreal, Quebec, Canada
| | - Dick Menzies
- Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Quebec, Canada
- McGill International TB Centre, Montreal, Quebec, Canada
- Division of Respiratory Medicine, Department of Medicine, McGill University, Quebec, Canada
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Reply to: Asymptomatic infection by SARS 2 coronavirus: invisible but invincible. Int J Infect Dis 2020; 102:85-86. [PMID: 33080400 PMCID: PMC7568516 DOI: 10.1016/j.ijid.2020.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/10/2020] [Indexed: 11/23/2022] Open
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45
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Liu W, Guan WJ, Zhong NS. Strategies and Advances in Combating COVID-19 in China. ENGINEERING (BEIJING, CHINA) 2020; 6:1076-1084. [PMID: 33078078 PMCID: PMC7558233 DOI: 10.1016/j.eng.2020.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 05/02/2023]
Abstract
Coronavirus disease 2019 (COVID-19)-the third in a series of coronavirus infections-has caused a global public health event in the 21st century, resulting in substantial global morbidity and mortality. Building on its legacy of managing severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), China has played a key role in the scientific community by revealing the viral transmission routes and clinical characteristics of COVID-19 and developing novel therapeutic interventions and vaccines. Despite these rapid scientific and technological advances, uncertainties remain in tracing the original sources of infection, determining the routes of transmission and pathogenesis, and addressing the lack of targeted clinical management of COVID-19. Here, we summarize the major COVID-19 research advances in China in order to provide useful information for global pandemic control.
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Affiliation(s)
- Wei Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
| | - Nan-Shan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou 510120, China
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