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Żegleń S, Nagajewski A, Górski D, Wojarski J, Karlsen W, Akily L, Sunesson F, Sawczuk M, Nojek R, Lipka K, Gallas M, Dukat-Mazurek A, Karolak W. Treatment of Patients After Lung Transplantation With Covid Infection During Long-Term Follow-Up. Transplant Proc 2024; 56:881-884. [PMID: 38714369 DOI: 10.1016/j.transproceed.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/26/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Patients undergoing lung transplantation are routinely managed with lifelong immunosuppression, which is associated with a heightened risk for infections. This study delves into the therapeutic challenges and strategies for managing lung transplant recipients (LTRs) infected with COVID-19 during long-term follow-up. METHODS The was a case series analysis, among which nonstandard therapies consisting of targeted antibody treatment, antiviral drugs, or anti-interleukin-6 drugs were applied in patients after lung transplantation. Additional analysis of laboratory test results for systemic inflammation and imaging studies was also carried out. The study was limited to a dedicated COVID-19 center, commonly known as a temporary hospital, and included patients infected with COVID-19 in the late post-lung transplant period (home-related infection). RESULTS Fifteen post-lung transplantation patients with current COVID-19 infection were treated with antibodies such as tocilizumab, casirivimab, imdevimab, and regdanvimab. Of these patients, 1 was given tocilizumab (7%), 8 casirivimab and imdevimab (53%), and 2 regdanvimab (13%). Of the 15 lung transplant recipients studied, 8 presented COVID-19-associated lung changes in computed tomography scans (53%). Common clinical manifestations included dyspnea, fever, and fatigue. Antiviral agents, like remdesivir, were employed in the remaining 4 cases (27%), and adjunctive therapies, such as corticosteroids and anticoagulants, were used selectively. All treated patients survived the infection without complications; the treatment proved effective and safe.
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Affiliation(s)
- Sławomir Żegleń
- Department of Pneumonology and Allergology, Medical University of Gdansk, Poland.
| | - Adam Nagajewski
- Temporary Hospital - Szczytno, Department of Internal Diseases and Infectious Diseases, Szczytno, Poland
| | - Dominik Górski
- Temporary Hospital - Szczytno, Department of Internal Diseases and Infectious Diseases, Szczytno, Poland
| | - Jacek Wojarski
- Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland
| | - William Karlsen
- Scientific Circle of Lung Transplantology, Department of Lung Transplantation, Medical University of Gdansk, Poland
| | - Lin Akily
- Scientific Circle of Lung Transplantology, Department of Lung Transplantation, Medical University of Gdansk, Poland
| | - Fanny Sunesson
- Emergency Department of Surgery (KAVA), Kristianstad, Sweden
| | - Marcin Sawczuk
- Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland
| | - Rafał Nojek
- Department of Applied Computer Science, AGH University of Science and Technology in Krakow, Poland
| | - Karolina Lipka
- Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland
| | - Marta Gallas
- Institute of Nursing and Midwifery, Department of Nursing Management, Medical University of Gdansk, Poland
| | | | - Wojtek Karolak
- Depatment of Cardiac Surgery, Medical University of Gdańsk, Poland
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Tambe LAM, Mathobo P, Munzhedzi M, Bessong PO, Mavhandu-Ramarumo LG. Prevalence and Molecular Epidemiology of Human Coronaviruses in Africa Prior to the SARS-CoV-2 Outbreak: A Systematic Review. Viruses 2023; 15:2146. [PMID: 38005824 PMCID: PMC10675249 DOI: 10.3390/v15112146] [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: 09/19/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/26/2023] Open
Abstract
Coronaviruses, re-emerging in human populations, cause mild or severe acute respiratory diseases, and occasionally epidemics. This study systematically reviewed human coronavirus (HCoVs) infections in Africa prior to the SARS-CoV-2 outbreak. Forty studies on the prevalence or molecular epidemiology of HCoVs were available from 13/54 African countries (24%). The first published data on HCoV was from South Africa in 2008. Eight studies (20%) reported on HCoV molecular epidemiology. Endemic HCoV prevalence ranged from 0.0% to 18.2%. The prevalence of zoonotic MERS-CoV ranged from 0.0% to 83.5%. Two studies investigated SARS-CoV infection, for which a prevalence of 0.0% was reported. There was heterogeneity in the type of tests used in determining HCoV prevalence. Two studies reported that risk factors for HCoV include exposure to infected animals or humans. The quantity of virologic investigations on HCoV on the African continent was scant, and Africa was not prepared for SARS-CoV-2.
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Affiliation(s)
- Lisa Arrah Mbang Tambe
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa
| | - Phindulo Mathobo
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa
| | - Mukhethwa Munzhedzi
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Department of Biochemistry and Microbiology, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa
| | - Pascal Obong Bessong
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
- Centre for Global Health Equity, School of Medicine, 1400 University Ave, Charlottesville, VA 22903, USA
| | - Lufuno Grace Mavhandu-Ramarumo
- HIV/AIDS & Global Health Research Programme, Faculty of Science, Engineering and Agriculture, University of Venda, Thohoyandou 0950, South Africa; (L.A.M.T.); (P.M.); (M.M.); (P.O.B.)
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Hatanaka S, Yamada Y, Kubo T, Magara K, Ono Y, Sugita S, Tsukahara T, Kyuno D, Hosaka M, Sasaki K, Hirohashi Y, Yamakawa T, Harada K, Bunya N, Narimatsu E, Nakase H, Hasegawa T, Osanai M, Torigoe T. Ischemia-induced intestinal de-epithelization and consequent cholangitis lenta after usage of extracorporeal membrane oxygenation in COVID-19 patients: an autopsy series. Oxf Med Case Reports 2023; 2023:omad031. [PMID: 37091687 PMCID: PMC10120430 DOI: 10.1093/omcr/omad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/21/2023] [Accepted: 03/13/2023] [Indexed: 04/25/2023] Open
Abstract
Since its discovery in late 2019, severe acute respiratory syndrome coronavirus 2 has spread around the world, causing millions of deaths due to coronavirus disease 2019 (COVID-19). Numerous clinical and post-mortem investigations of COVID-19 cases have found myriad clinical and pathological manifestations of the disease. In this report, we present three autopsy cases in which, despite weaning from extracorporeal membrane oxygenation (ECMO), extensive intestinal epithelial shedding, probably due to ischemia, was followed by massive watery diarrhea and the spread of infection via the portal vein due to bacterial translocation, which resulted in cholangitis lenta. Thrombophilia was attributed to ECMO usage and COVID-19-related vascular endothelial damage. These cases provide instructive findings showing that the loss of the intestinal barrier may be the underlying cause of severe watery diarrhea and liver failure in COVID-19 patients, especially with ECMO usage.
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Affiliation(s)
| | | | - Terufumi Kubo
- Correspondence address. Department of Pathology, School of Medicine, Sapporo Medical University, South 1, West 17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan. Tel: +81-0-11-611-2111; Fax: +81-0-11-643-2310; E-mail:
| | - Kazufumi Magara
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yusuke Ono
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Tomohide Tsukahara
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Daisuke Kyuno
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Michiko Hosaka
- Department of Surgical Pathology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Kenta Sasaki
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yoshihiko Hirohashi
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tsukasa Yamakawa
- Department of Gastroenterology and Hepatology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Keisuke Harada
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Naofumi Bunya
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Eichi Narimatsu
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hiroshi Nakase
- Department of Gastroenterology and Hepatology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Makoto Osanai
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Toshihiko Torigoe
- Department of Pathology, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Liu Y, Liao C, Zhuo L, Tao H. Evaluating Effects of Dynamic Interventions to Control COVID-19 Pandemic: A Case Study of Guangdong, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10154. [PMID: 36011787 PMCID: PMC9407938 DOI: 10.3390/ijerph191610154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
The emergence of different virus variants, the rapidly changing epidemic, and demands for economic recovery all require continual adjustment and optimization of COVID-19 intervention policies. For the purpose, it is both important and necessary to evaluate the effectiveness of different policies already in-place, which is the basis for optimization. Although some scholars have used epidemiological models, such as susceptible-exposed-infected-removed (SEIR), to perform evaluation, they might be inaccurate because those models often ignore the time-varying nature of transmission rate. This study proposes a new scheme to evaluate the efficiency of dynamic COVID-19 interventions using a new model named as iLSEIR-DRAM. First, we improved the traditional LSEIR model by adopting a five-parameter logistic function β(t) to depict the key parameter of transmission rate. Then, we estimated the parameters by using an adaptive Markov Chain Monte Carlo (MCMC) algorithm, which combines delayed rejection and adaptive metropolis samplers (DRAM). Finally, we developed a new quantitative indicator to evaluate the efficiency of COVID-19 interventions, which is based on parameters in β(t) and considers both the decreasing degree of the transmission rate and the emerging time of the epidemic inflection point. This scheme was applied to seven cities in Guangdong Province. We found that the iLSEIR-DRAM model can retrace the COVID-19 transmission quite well, with the simulation accuracy being over 95% in all cities. The proposed indicator succeeds in evaluating the historical intervention efficiency and makes the efficiency comparable among different cities. The comparison results showed that the intervention policies implemented in Guangzhou is the most efficient, which is consistent with public awareness. The proposed scheme for efficiency evaluation in this study is easy to implement and may promote precise prevention and control of the COVID-19 epidemic.
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Affiliation(s)
- Yuan Liu
- Guangdong Provincial Engineering Research Center for Public Security and Disaster, School of Geography and Planning, Sun Yat-Sen University, Guangzhou 510006, China
| | - Chuyao Liao
- Guangdong Provincial Engineering Research Center for Public Security and Disaster, School of Geography and Planning, Sun Yat-Sen University, Guangzhou 510006, China
| | - Li Zhuo
- Guangdong Provincial Engineering Research Center for Public Security and Disaster, School of Geography and Planning, Sun Yat-Sen University, Guangzhou 510006, China
- Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519000, China
| | - Haiyan Tao
- Guangdong Provincial Engineering Research Center for Public Security and Disaster, School of Geography and Planning, Sun Yat-Sen University, Guangzhou 510006, China
- Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou 510080, China
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RT-PCR Testing of Organ Culture Medium for Corneal Storage Fails to Detect SARS-CoV-2 Infection Due to Lack of Viral Replication. Pathogens 2022; 11:pathogens11020133. [PMID: 35215077 PMCID: PMC8874787 DOI: 10.3390/pathogens11020133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/13/2022] [Accepted: 01/20/2022] [Indexed: 02/05/2023] Open
Abstract
Concerns of possible transmission of SARS-CoV-2 from donors to patients by corneal transplantation have caused a decline in corneal transplantations. Graft culture media are routinely tested for infectious risks, but it is unclear whether this constitutes a viable means to avoid transmitting SARS-CoV-2 via keratoplasty. We found that SARS-CoV-2 RNA was not present in the medium after seven days of organ culture of corneas from donors (n = 4), who were SARS-CoV-2-positive upon tissue procurement. These medium samples showed no presence of viral RNA. To pursue this question under controlled conditions and further exclude the possibility of productive infection in corneal grafts, we inoculated corneoscleral discs from healthy donors (n = 8) with infectious SARS-CoV-2 and performed PCR testing of the culture medium at various time points. After seven days of culture, we also tested for SARS-CoV-2 RNA within the inoculated corneal tissue. The medium from tissue samples inoculated with SARS-CoV-2 showed no increase in viral RNA, which may indicate lack of viral replication in these corneal grafts. SARS-CoV-2-RNA was, however, detected on or in corneal tissue seven days after inoculation. Our data suggest that corneal grafts may not be permissive for replication of SARS-CoV-2 and demonstrates that PCR testing of culture media cannot safely exclude that tissue has been exposed to SARS-CoV-2. It also demonstrates the difficulty to differentiate between virus adherence and virus replication by PCR testing in SARS-CoV-2 exposed tissue.
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