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Turbawaty DK, Sudjadi A, Lismayanti L, Rostini T, Logito V. The Performance of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Virus Using the Colorimetric Reverse-Transcription Loop Mediated Isothermal Amplification (RT-LAMP) Method in Saliva Specimens of Suspected COVID-19 Patients. Int J Gen Med 2024; 17:3329-3335. [PMID: 39081671 PMCID: PMC11288315 DOI: 10.2147/ijgm.s461613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Corona Virus Disease-19 (COVID-19) is a disease caused by Severe-Acute-Respiratory-Syndrome-Coronavirus-2 (SARS-CoV-2). The most reliable and widely accepted method for diagnosing this infection, despite facing various challenges, is the Reverse Transcription Polymerase Chain Reaction (RT-PCR) method, which utilizes nasopharyngeal swab sample. Reverse-transcription loop mediated isothermal amplification (RT-LAMP) is a simpler nucleic acid amplification method compared to the RT-PCR method. This method has several advantages, including: of amplification at constant temperature, faster results, and potentially greater examination capacity. Purpose This study aimed to compare the validity of the RT-LAMP method using saliva specimens with that of the RT-PCR method using nasopharyngeal smears. Methods This was an analytical observational study with a cross-sectional design. The participants were inpatients in the COVID-19 special isolation building of Hasan Sadikin General Hospital, Indonesia with a probable (clinical symptoms of covid, but not confirm NAAT examination) or confirmed diagnosis of COVID-19 from September 2021 to February 2022. The inclusion criteria are COVID-19 patients with symptoms, adult subjects, and composite mentions. Patients who were unable to secrete saliva were also excluded. Results In total, 118 specimens were collected. The validity test results of the saliva specimens using the RT-LAMP method showed sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), of 65.5%, 100%, 100%, and 75%, respectively. The results increased in subjects treated between 3 and 7 days after symptom onset ie 73.2%, 100%, 100%, and 82.3%, respectively. Conclusion The very strong specificity accompanied by good sensitivity and NPV in the group of subjects treated 3-7 days after the onset of symptoms indicates that the RT-LAMP method using saliva specimens can be an efficient and reliable alternative tool in detecting the SARS-CoV-2 virus.
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Affiliation(s)
- Dewi Kartika Turbawaty
- Department of Clinical Pathology, Faculty of Medicine Padjadjaran University/ Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Andy Sudjadi
- Department of Clinical Pathology, Faculty of Medicine Padjadjaran University/ Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Leni Lismayanti
- Department of Clinical Pathology, Faculty of Medicine Padjadjaran University/ Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Tiene Rostini
- Department of Clinical Pathology, Faculty of Medicine Padjadjaran University/ Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Verina Logito
- Department of Clinical Pathology, Faculty of Medicine Padjadjaran University/ Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
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Shire FM, Sharbatti S, AlNajjar F, Sulaiman Abumuaileq L, Abuelkher R, Sabri H, Beevi A, Alqahtani A, Beshtawy R. The Impact of Viral Load on the Severity and Outcome Among Patients With COVID-19: A Cross-Sectional Study. Cureus 2024; 16:e64137. [PMID: 39119409 PMCID: PMC11307488 DOI: 10.7759/cureus.64137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Objectives This study aimed to assess the relationship between illness severity and mortality among COVID-19 patients along with the cycle threshold (Ct) value measured by viral load. Methods A cross-sectional study was conducted based on records of the emergency room at Rashid Hospital located in Dubai, United Arab Emirates. This research was carried out on all of the appropriate records of patients who were hospitalized at Rashid Hospital in Dubai between May 2020 and January 2021. Clinical and laboratory data were used as severity indicators, and in-hospital death was designated as the outcome. Results A total of 1,633 cases were included in the analysis. The percentage of deceased patients was higher in patients with a low Ct value (11.6%) than in patients with a high Ct value (6.9%) (p-value = 0.003). Logistic analysis revealed a statistically significant correlation (OR=2.046; p-value=0.002) between mortality and viral load, as measured by the Ct value. Patients with low Ct values and aberrant laboratory findings had a higher frequency of respiratory problems and required oxygen therapy, according to clinical and laboratory markers. Conclusions A correlation was found between viral load and mortality. Advanced age, history of chronic disease, and abnormal clinical and laboratory findings were all independently linked to a greater mortality rate in COVID-19 patients, indicating that they might be utilized as predictive and prognostic factors along with the viral load.
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Affiliation(s)
- Fatma M Shire
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Shatha Sharbatti
- Community Medicine Department, Gulf Medical University, Ajman, ARE
| | - Firas AlNajjar
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | | | - Rand Abuelkher
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Hebah Sabri
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Aasiya Beevi
- Medical Education Department, Dubai Medical College for Girls, Dubai, ARE
| | - Alia Alqahtani
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Rami Beshtawy
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
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Sikhosana ML, Welch R, Musekiwa A, Makatini Z, Ebonwu J, Blumberg L, Jassat W. Association between SARS-CoV-2 gene specific Ct values and COVID-19 associated in-hospital mortality. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1375975. [PMID: 38737987 PMCID: PMC11082284 DOI: 10.3389/fepid.2024.1375975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/08/2024] [Indexed: 05/14/2024]
Abstract
Background Since there are currently no specific SARS-CoV-2 prognostic viral biomarkers for predicting disease severity, there has been interest in using SARS-CoV-2 polymerase chain reaction (PCR) cycle-threshold (Ct) values to predict disease progression. Objective This study assessed the association between in-hospital mortality of hospitalized COVID-19 cases and Ct-values of gene targets specific to SARS-CoV-2. Methods Clinical data of hospitalized COVID-19 cases from Gauteng Province from April 2020-July 2022 were obtained from a national surveillance system and linked to laboratory data. The study period was divided into pandemic waves: Asp614Gly/wave1 (7 June-22 Aug 2020); beta/wave2 (15 Nov 2020-6 Feb 2021); delta/wave3 (9 May-18 Sept 2021) and omicron/wave4 (21 Nov 2021-22 Jan 2022). Ct-value data of genes specific to SARS-CoV-2 according to testing platforms (Roche-ORF gene; GeneXpert-N2 gene; Abbott-RdRp gene) were categorized as low (Ct < 20), mid (Ct20-30) or high (Ct > 30). Results There were 1205 recorded cases: 836(69.4%; wave1), 122(10.1%;wave2) 21(1.7%; wave3) and 11(0.9%;in wave4). The cases' mean age(±SD) was 49 years(±18), and 662(54.9%) were female. There were 296(24.6%) deaths recorded: 241(81.4%;wave1), 27 (9.1%;wave2), 6 (2%;wave3), and 2 (0.7%;wave4) (p < 0.001). Sample distribution by testing platforms was: Roche 1,033 (85.7%), GeneXpert 169 (14%) and Abbott 3 (0.3%). The median (IQR) Ct-values according to testing platform were: Roche 26 (22-30), GeneXpert 38 (36-40) and Abbott 21 (16-24). After adjusting for sex, age and presence of a comorbidity, the odds of COVID-19 associated death were high amongst patients with Ct values 20-30[adjusted Odds Ratio (aOR) 2.25; 95% CI: 1.60-3.18] and highest amongst cases with Ct-values <20 (aOR 3.18; 95% CI: 1.92-5.27), compared to cases with Ct-values >30. Conclusion Although odds of COVID19-related death were high amongst cases with Ct-values <30, Ct values were not comparable across different testing platforms, thus precluding the comparison of SARS-CoV-2 Ct-value results.
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Affiliation(s)
- Mpho L. Sikhosana
- Department of Virology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Department of Virology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Welch
- Department of Public Health and Outbreak Response, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Alfred Musekiwa
- Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Zinhle Makatini
- Department of Virology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
- Department of Virology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joy Ebonwu
- Department of Public Health and Outbreak Response, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Lucille Blumberg
- Department of Public Health and Outbreak Response, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Waasila Jassat
- Department of Public Health and Outbreak Response, National Institute for Communicable Diseases, Johannesburg, South Africa
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Long MB, Howden AJM, Keir HR, Rollings CM, Giam YH, Pembridge T, Delgado L, Abo-Leyah H, Lloyd AF, Sollberger G, Hull R, Gilmour A, Hughes C, New BJM, Cassidy D, Shoemark A, Richardson H, Lamond AI, Cantrell DA, Chalmers JD, Brenes AJ. Extensive acute and sustained changes to neutrophil proteomes post-SARS-CoV-2 infection. Eur Respir J 2024; 63:2300787. [PMID: 38097207 PMCID: PMC10918319 DOI: 10.1183/13993003.00787-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 11/23/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND Neutrophils are important in the pathophysiology of coronavirus disease 2019 (COVID-19), but the molecular changes contributing to altered neutrophil phenotypes following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not fully understood. We used quantitative mass spectrometry-based proteomics to explore neutrophil phenotypes immediately following acute SARS-CoV-2 infection and during recovery. METHODS Prospective observational study of hospitalised patients with PCR-confirmed SARS-CoV-2 infection (May to December 2020). Patients were enrolled within 96 h of admission, with longitudinal sampling up to 29 days. Control groups comprised non-COVID-19 acute lower respiratory tract infection (LRTI) and age-matched noninfected controls. Neutrophils were isolated from peripheral blood and analysed using mass spectrometry. COVID-19 severity and recovery were defined using the World Health Organization ordinal scale. RESULTS Neutrophil proteomes from 84 COVID-19 patients were compared to those from 91 LRTI and 42 control participants. 5800 neutrophil proteins were identified, with >1700 proteins significantly changed in neutrophils from COVID-19 patients compared to noninfected controls. Neutrophils from COVID-19 patients initially all demonstrated a strong interferon signature, but this signature rapidly declined in patients with severe disease. Severe disease was associated with increased abundance of proteins involved in metabolism, immunosuppression and pattern recognition, while delayed recovery from COVID-19 was associated with decreased granule components and reduced abundance of metabolic proteins, chemokine and leukotriene receptors, integrins and inhibitory receptors. CONCLUSIONS SARS-CoV-2 infection results in the sustained presence of circulating neutrophils with distinct proteomes suggesting altered metabolic and immunosuppressive profiles and altered capacities to respond to migratory signals and cues from other immune cells, pathogens or cytokines.
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Affiliation(s)
- Merete B Long
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
- Indicates equal contribution
| | - Andrew J M Howden
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee, UK
- Indicates equal contribution
| | - Holly R Keir
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
- Indicates equal contribution
| | - Christina M Rollings
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee, UK
- Indicates equal contribution
| | - Yan Hui Giam
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Thomas Pembridge
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Lilia Delgado
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Hani Abo-Leyah
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Amy F Lloyd
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee, UK
| | - Gabriel Sollberger
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee, UK
- Max Planck Institute for Infection Biology, Berlin, Germany
| | - Rebecca Hull
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Amy Gilmour
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Chloe Hughes
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Benjamin J M New
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Diane Cassidy
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Amelia Shoemark
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Hollian Richardson
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Angus I Lamond
- Division of Molecular, Cell and Developmental Biology, School of Life Sciences, University of Dundee, Dundee, UK
| | - Doreen A Cantrell
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee, UK
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
- Indicates joint senior authorship
| | - Alejandro J Brenes
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee, UK
- Division of Molecular, Cell and Developmental Biology, School of Life Sciences, University of Dundee, Dundee, UK
- Indicates joint senior authorship
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Kim SR, Waghmare A, Hijano DR. Approach to hematopoietic cell transplant candidates with respiratory viral detection. Front Pediatr 2024; 11:1339239. [PMID: 38304442 PMCID: PMC10830789 DOI: 10.3389/fped.2023.1339239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/19/2023] [Indexed: 02/03/2024] Open
Abstract
The management of respiratory viruses prior to hematopoietic cell transplant (HCT) can be controversial and requires special consideration of host factors, transplant parameters, and the specific respiratory virus (RV). In the setting of adenovirus (ADV), human metapneumovirus (HMPV), influenza, parainfluenza virus (PIV), and respiratory syncytial virus (RSV) detection prior to hematopoietic cell transplant (HCT), clinical practice guidelines recommend transplant delay when possible; however, there is much more ambiguity when other respiratory viruses, such as seasonal coronaviruses (CoVs), human rhinovirus (HRV), and SARS-CoV-2, are detected. Our aims for this review include detailing clinical practical guidelines and reviewing current literature on pre-transplant respiratory viral infections (RVIs), including antiviral therapies and prevention strategies, when available. We will center our discussion on three representative clinical scenarios, with the goal of providing practical guidance to clinicians.
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Affiliation(s)
- Sara R. Kim
- Division of Pediatric Infectious Diseases, Seattle Children’s Hospital, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Alpana Waghmare
- Division of Pediatric Infectious Diseases, Seattle Children’s Hospital, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Diego R. Hijano
- Departments of Infectious Diseases, St. Jude Children’s Research Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, United States
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Ajmera H, Lakhawat SS, Malik N, Kumar A, Bhatti JS, Kumar V, Gogoi H, Jaswal SK, Chandel S, Sharma PK. Global Emergence of SARS-CoV2 Infection and Scientific Interventions to Contain its Spread. Curr Protein Pept Sci 2024; 25:307-325. [PMID: 38265408 DOI: 10.2174/0113892037274719231212044235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 01/25/2024]
Abstract
The global pandemic caused by COVID-19 posed a significant challenge to public health, necessitating rapid scientific interventions to tackle the spread of infection. The review discusses the key areas of research on COVID-19 including viral genomics, epidemiology, pathogenesis, diagnostics, and therapeutics. The genome sequencing of the virus facilitated the tracking of its evolution, transmission dynamics, and identification of variants. Epidemiological studies have provided insights into disease spread, risk factors, and the impact of public health infrastructure and social distancing measures. Investigations of the viral pathogenesis have elucidated the mechanisms underlying immune responses and severe manifestations including the long-term effects of COVID-19. Overall, the article provides an updated overview of the diagnostic methods developed for SARS-CoV-2 and discusses their strengths, limitations, and appropriate utilization in different clinical and public health settings. Furthermore, therapeutic approaches including antiviral drugs, immunomodulatory therapies, and repurposed medications have been investigated to alleviate disease severity and improve patient outcomes. Through a comprehensive analysis of these scientific efforts, the review provides an overview of the advancements made in understanding and tackling SARS-CoV-2, while underscoring the need for continued research to address the evolving challenges posed by this global health crisis.
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Affiliation(s)
- Himanshu Ajmera
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | | | - Naveen Malik
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | - Akhilesh Kumar
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | - Jasvinder Singh Bhatti
- Department of Human Genetics & Molecular Medicine, Central University of Punjab, Bathinda, India
| | - Vikram Kumar
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | - Himanshu Gogoi
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster 3rd milestone Faridabad, Haryana, India
| | - Sunil Kumar Jaswal
- Department of Biotechnology, Himachal Pradesh University Summer Hill, Shimla, India
| | - Sanjeev Chandel
- Department of Nursing, GHG College of Nursing Rajkot Road, Ludhiana, Punjab, India
| | - Pushpender Kumar Sharma
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
- Amity Centre for Nanobiotechnology and Nanomedicine, Amity University Rajasthan, Jaipur, 303002, India
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Wong CKH, Mak LY, Au ICH, Cheng WY, So CH, Lau KTK, Lau EHY, Cowling BJ, Leung GM, Yuen MF. Risk of acute liver injury following the nirmatrelvir/ritonavir use. Liver Int 2023; 43:2657-2667. [PMID: 37448114 DOI: 10.1111/liv.15673] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/21/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Elevations in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were reported as adverse events of nirmatrelvir/ritonavir users in the EPIC-HR trial. AIM To quantify the risk and severity of acute liver injury (ALI) associated with nirmatrelvir/ritonavir use. METHODS This self-controlled case-series study was conducted using electronic medical records of patients with confirmed diagnosis of SARS-CoV-2 infection between 26th February 2022 and 12th February 2023 in Hong Kong. RESULTS Among 2 409 848 patients with SARS-CoV-2 infection during the study period, 153 853 were prescribed with nirmatrelvir/ritonavir, of whom 834 (.5%) had incident ALI (moderate: 30.5%; moderate to severe: 18.9%; severe or fatal: 5.8%). Compared with the non-exposure period, risk of ALI increased significantly during the pre-exposure period (IRR = 38.13, 95% CI = 29.29-49.62) and remained elevated during the five-day nirmatrelvir/ritonavir treatment (IRR = 20.75, 95% CI = 17.06-25.25) and during wash-out period (IRR = 16.27, 95% CI = 13.23-20.01). Compared to the pre-exposure period, risk of ALI was not increased during the five-day nirmatrelvir/ritonavir treatment period (IRR = .54, 95% CI = .43-.70). Compared to 5469 non-nirmatrelvir/ritonavir users with incident ALI, nirmatrelvir/ritonavir users had less severe ALI by the severity index (p < .001) and peak INR (1.7 vs. 2.3; p < .001). ALI cases with nirmatrelvir/ritonavir use had lower risk of all-cause death (29.1% vs. 39.1%; OR = .64; p < .001) and no increase in risk of liver decompensation (1.0% vs. 1.3%; OR = .62; p = .230) compared to non-users. CONCLUSION The risk of ALI associated with nirmatrelvir/ritonavir treatment for COVID-19 was elevated in the pre-exposure period, but not following nirmatrelvir/ritonavir initiation. ALI following nirmatrelvir/ritonavir treatment were mostly mild and less severe than ALI events in non-nirmatrelvir/ritonavir users.
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Affiliation(s)
- Carlos King Ho Wong
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - Lung Yi Mak
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong SAR, China
| | - Ivan Chi Ho Au
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Wing Yiu Cheng
- School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ching Hei So
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Kristy Tsz Kwan Lau
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Eric Ho Yin Lau
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Benjamin J Cowling
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gabriel M Leung
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Man Fung Yuen
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong SAR, China
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Jemmieh K, Tawengi M, Alyaarabi T, Hassona A, Ghoul I, Al Abdulla S, Elzawawi KE, Karen O, Doi SA, Chivese T. No Association Between Ct Value and COVID-19 Severity and Mortality in Qatar. Int J Gen Med 2023; 16:5323-5331. [PMID: 38021068 PMCID: PMC10658937 DOI: 10.2147/ijgm.s404696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background The association between the cycle threshold (Ct) which reflects the SARS-CoV-2 viral load and the severity of COVID-19 is still not clear. We investigated the association between Ct values, symptoms and the risk of ICU admission and mortality from COVID-19 in Qatar. Methods This case-control study used data of hospitalized individuals with confirmed COVID-19 during the period March to September 2020. Cases were defined as individuals with confirmed COVID-19 who were admitted to the intensive care unit (ICU) or died and controls as those who were not admitted to the ICU. The association between Ct value, symptoms, ICU admission and mortality was investigated using Ct value as a categorical variable (below and above 25) in multivariable regression models and adjusted for relevant confounders. Results A total of 622 participants with median age 53 (IQR: 53-63), of which 69% were males, were included. There were 236 ICU admissions and 111 deaths. When categorized, Ct value (<25 vs ≥25) had no association with the odds of ICU admission (OR 0.85, 95% CI 0.56 to 1.29) or odds of mortality (OR 1.21, 95% CI 0.71 to 2.08). Respiratory (OR 2.95, 95% CI 1.57 to 5.56) and gastrointestinal symptoms (OR 1.99, 95% CI 1.18 to 3.35) were associated with higher odds of ICU admission. Similarly, respiratory (OR 4.96, 95% CI 1.10 to 22.43) and gastrointestinal symptoms (OR 3.17, 95% CI 1.29 to 7.84) were associated with higher odds of mortality. Conclusion Although RT-PCR Ct has good diagnostic value, its prognostic value appears to be unreliable. Respiratory and gastrointestinal symptoms are associated with COVID-19 criticality and mortality in this setting.
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Affiliation(s)
- Khaleed Jemmieh
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Mohamed Tawengi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Tamader Alyaarabi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Aseel Hassona
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ikhlas Ghoul
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Sara Al Abdulla
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Khaled E Elzawawi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Omar Karen
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Suhail A Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
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Kim J, Choi G, Oh J, Park K, Yoo SJ. Comparative Study on Two COVID-19 Outbreaks at a Long-Term Mental Health Facility in Korea in 2020 and 2022. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1170. [PMID: 37374374 DOI: 10.3390/medicina59061170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
(1) Background and Objectives: There were two distinct coronavirus disease 2019 (COVID-19) outbreaks in 2020 and 2022 at a long-term mental health facility (LTMHF) in Gyeonggi Province, Korea. We aimed to compare the two outbreaks and identify differences in epidemiological and clinical outcomes due to changes in epidemic timing and management methods. (2) Materials and Methods: The structural, operational, and case-specific LTMHF data of COVID-19-confirmed patients during these outbreaks in 2020 and 2022 were retrospectively analyzed. (3) Results: Forty individuals (37 residents) in 2020 and thirty-nine (32 residents) in 2022 were confirmed to have COVID-19, and ten were infected twice. Facility isolation was implemented as an infection control measure, and one COVID-19-related death occurred in 2020. All residents and staff were vaccinated at least twice in 2022; moreover, in 2022, 38 patients (97.4%) received a third vaccination less than months before infection. The average Ct value of the cases in 2022 was significantly higher than that in 2020; however, vaccine-breakthrough (V-BT) and reinfection after vaccination rates were similar. (4) Conclusions: COVID-19 vaccination could help lower the viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was inversely correlated with Ct values, and ventilation system improvements in health facilities might reduce transmissibility.
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Affiliation(s)
- Jina Kim
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon 16508, Republic of Korea
| | - Gawon Choi
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon 16508, Republic of Korea
| | - Jeonghyeon Oh
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon 16508, Republic of Korea
| | - Kunhee Park
- Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon 16508, Republic of Korea
| | - Seok-Ju Yoo
- Department of Preventive Medicine, College of Medicine, Dongguk University, Seoul 04620, Republic of Korea
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10
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Biswas B, Roy S, Banerjee I, Jana S, Bhattacharjee B, Chakraborty S, Mondal A, Goswami R. IL-10/IL-6 ratio from nasal & oral swab samples, acts as an inflammatory indicator for COVID-19 patients infected with the delta variant. Heliyon 2023; 9:e16985. [PMID: 37292329 PMCID: PMC10238278 DOI: 10.1016/j.heliyon.2023.e16985] [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: 10/26/2022] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/10/2023] Open
Abstract
Background Hyper-inflammatory immune response of SARS-CoV-2 is often characterized by the release of multiple pro-inflammatory cytokines with an impact on the expression of numerous other interleukins (ILs). However, from oral and nasal swab samples the specific quantitative association of the different IL-markers with the disease progression and its relationship with the status of vaccination remains unclear. Materials and methods Patients' combined oral and nasal swab samples were collected from both non-vaccinated and double-vaccinated individuals with high (Ct value < 25) and low (Ct value > 30) viral loads, along with uninfected donors. None of the patients were critically ill, or needed ICU support. The expression of different cytokines (IL6, IL10, IL1B, IFNG) and mucin (MUC5AC, MUC1) markers were assessed between different groups by qRT-PCR. The important cytokine markers differentiating between vaccinated and non-vaccinated patients were identified by PCA. Conclusion IL6 expression was higher in non-vaccinated COVID-19 patients infected with delta-variant irrespective of their viral-load compared to uninfected individuals. However, in double-vaccinated patients, only in high viral-load patients (Ct value < 25), IL6 expression increased. In high viral-load patients, irrespective to their vaccination status, IL10 expression was lower compared to the uninfected control group. Surprisingly, IL10 expression was lower in double-vaccinated patients with Ct value > 30. IL1B, and IFNG expression remained unaltered in uninfected and infected individuals. However, MUC5AC expression was lower in non-vaccinated patients with Ct value < 25 compared to control group. Our study unveiled that IL10/IL6 ratio can be used as a biomarker for COVID-19 patients upon proper establishment of it in a clinical setting.
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Affiliation(s)
| | | | | | - Subhasis Jana
- Purba Medinipur District Hospital, West Bengal, India
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11
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Levin Y, Imtiaz A, Borja B. COVID-19 psychosis versus psychosis due to cytotoxic lesion of the corpus callosum (CLOCC): A case report and review. PSYCHIATRY RESEARCH CASE REPORTS 2023; 2:100133. [PMID: 37251527 PMCID: PMC10200715 DOI: 10.1016/j.psycr.2023.100133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 05/31/2023]
Abstract
Background Cytotoxic lesions of the corpus callosum syndrome (CLOCC) is an inflammatory disorder caused by various etiologies such as medications, malignancies, seizure, metabolic abnormalities, and infections, especially COVID-19. It presents on MRI as an area of restricted diffusion in the corpus callosum. We present a case of psychosis and CLOCC in a patient with mild active COVID-19 infection. Case A 25-year-old male with a history of asthma and unclear past psychiatric history presented to the emergency room with shortness of breath, chest pain, and disorganized behavior. His-COVID-19 PCR was negative, and he was voluntarily admitted to psychiatry for management of unspecified psychosis. Overnight, he spiked a fever and was diaphoretic with headache and altered mental status. Repeat COVID-19 PCR at this time was positive and cycle threshold indicated infectivity. A brain MRI showed a new restricted diffusion within the midline of the splenium of the corpus callosum. Lumbar puncture was unremarkable. He continued to have flat affect and exhibit disorganized behavior with unspecified grandiosity, unclear auditory hallucinations, echopraxia, and poor attention and working memory. He was started on risperidone, with an MRI after 8 days showing complete resolution of the lesion in the corpus callosum and symptoms. Conclusion This case discusses diagnostic difficulties and treatment options for a patient presenting with psychotic symptoms and disorganized behavior in the context of active COVID-19 infection and CLOCC and highlights differences between delirium, COVID-19 psychosis and neuropsychiatric symptoms of CLOCC. Future research directions are also discussed.
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Affiliation(s)
- Yuval Levin
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Ayyub Imtiaz
- Department of Behavioral Health, Saint Elizabeths Hospital, Washington, DC, USA
| | - Benedicto Borja
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
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12
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Tavakoli R, Rahimi P, Hamidi-Fard M, Eybpoosh S, Doroud D, Ahmadi I, Anvari E, Aghasadeghi M, Fateh A. Expression of TRIM56 gene in SARS-CoV-2 variants and its relationship with progression of COVID-19. Future Virol 2023; 18:563-574. [PMID: 38051999 PMCID: PMC10348059 DOI: 10.2217/fvl-2022-0210] [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: 12/09/2022] [Accepted: 06/19/2023] [Indexed: 10/13/2023]
Abstract
Aim The present study aimed to determine a correlation between differential TRIM56 expression levels and severe infections of COVID-19 between the Alpha, Delta and Omicron BA.5 variants. Materials & methods This study was performed on 330 COVID-19 patients, including 142 with severe and 188 with mild infections, as well as 160 healthy controls. The levels of TRIM56 gene expression were determined using a qPCR. Results TRIM56 gene showed significantly lower mRNA expression in the severe and mild groups compared with healthy individuals. Our finding indicated the high and low reduction of TRIM56 mRNA expression in Delta and Omicron BA.5 variant, respectively. Conclusion Further research is needed to characterize the impact of TRIM proteins on the severity of COVID-19.
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Affiliation(s)
- Rezvan Tavakoli
- Hepatitis & AIDS Department, Pasteur Institute of Iran, Tehran, Iran
| | - Pooneh Rahimi
- Hepatitis & AIDS Department, Pasteur Institute of Iran, Tehran, Iran
- Viral Vaccine Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Mojtaba Hamidi-Fard
- Hepatitis & AIDS Department, Pasteur Institute of Iran, Tehran, Iran
- Viral Vaccine Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Sana Eybpoosh
- Department of Epidemiology & Biostatistics, Research Centre for Emerging & Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Delaram Doroud
- Quality Control Department, Production & Research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Iraj Ahmadi
- Department of Physiology, School of Medicine, Ilam University of Medical Science, Ilam, Iran
| | - Enayat Anvari
- Department of Physiology, School of Medicine, Ilam University of Medical Science, Ilam, Iran
| | - Mohammadreza Aghasadeghi
- Hepatitis & AIDS Department, Pasteur Institute of Iran, Tehran, Iran
- Viral Vaccine Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology & Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
- Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
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13
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Sigamani A, Mayo KH, Miller MC, Chen-Walden H, Reddy S, Platt D. An Oral Galectin Inhibitor in COVID-19—A Phase II Randomized Controlled Trial. Vaccines (Basel) 2023; 11:vaccines11040731. [PMID: 37112643 PMCID: PMC10140888 DOI: 10.3390/vaccines11040731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Background: SARS-CoV-2 vaccines play an important role in reducing disease severity, hospitalization, and death, although they failed to prevent the transmission of SARS-CoV-2 variants. Therefore, an effective inhibitor of galectin-3 (Gal-3) could be used to treat and prevent the transmission of COVID-19. ProLectin-M (PL-M), a Gal-3 antagonist, was shown to interact with Gal-3 and thereby prevent cellular entry of SARS-CoV-2 in previous studies. Aim: The present study aimed to further evaluate the therapeutic effect of PL-M tablets in 34 subjects with COVID-19. Methods: The efficacy of PL-M was evaluated in a randomized, double-blind, placebo-controlled clinical study in patients with mild to moderately severe COVID-19. Primary endpoints included changes in the absolute RT-PCR Ct values of the nucleocapsid and open reading frame (ORF) genes from baseline to days 3 and 7. The incidence of adverse events, changes in blood biochemistry, inflammatory biomarkers, and levels of antibodies against COVID-19 were also evaluated as part of the safety evaluation. Results: PL-M treatment significantly (p = 0.001) increased RT-PCR cycle counts for N and ORF genes on days 3 (Ct values 32.09 ± 2.39 and 30.69 ± 3.38, respectively) and 7 (Ct values 34.91 ± 0.39 and 34.85 ± 0.61, respectively) compared to a placebo treatment. On day 3, 14 subjects in the PL-M group had cycle counts for the N gene above the cut-off value of 29 (target cycle count 29), whereas on day 7, all subjects had cycle counts above the cut-off value. Ct values in placebo subjects were consistently less than 29, and no placebo subjects were RT-PCR-negative until day 7. Most of the symptoms disappeared completely after receiving PL-M treatment for 7 days in more patients compared to the placebo group. Conclusion: PL-M is safe and effective for clinical use in reducing viral loads and promoting rapid viral clearance in COVID-19 patients by inhibiting SARS-CoV-2 entry into cells through the inhibition of Gal-3.
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Affiliation(s)
- Alben Sigamani
- Carmel Research Consultancy Pvt. Ltd., Bengaluru 560025, Karnataka, India
- Correspondence: ; Tel.: +9188-8443-1444
| | - Kevin H. Mayo
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, 6-155 Jackson Hall, 321 Church Street, Minneapolis, MN 55455, USA
| | - Michelle C. Miller
- Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, 6-155 Jackson Hall, 321 Church Street, Minneapolis, MN 55455, USA
| | - Hana Chen-Walden
- Pharmalectin India Pvt. Ltd., Rangareddy 500039, Telangana, India
| | - Surendar Reddy
- Department of Pulmonology, ESIC Medical College and Hospital, Sanath Nagar, Hyderabad 500038, Telangana, India
| | - David Platt
- Pharmalectin India Pvt. Ltd., Rangareddy 500039, Telangana, India
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14
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Hwang J, Yuen A, Rhoades J, Barnes D, Zakowski P, Megna DJ, Catarino P, Zaffiri L, Rampolla R. Real-time transcription polymerase chain reaction cycle threshold values as criteria for utilization of incidental COVID-19 positive lung donors. J Heart Lung Transplant 2023; 42:301-304. [PMID: 36624019 PMCID: PMC9794393 DOI: 10.1016/j.healun.2022.12.016] [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: 11/16/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Shortage of organ donors is an ongoing limiting factor in lung transplantation (LT). Despite increasing prevalence of asymptomatic COVID-19 infection, positive COVID-19 testing from a potential donor remains a contraindication at many LT centers. In this report, we present the outcomes of LT utilizing an algorithm based on donor clinical presentation, and COVID-19 real-time reverse transcription polymerase chain reaction (RT-PCR) with cycle threshold (Ct) values evaluation. The Ct value threshold for organ acceptance was >35. A total of 8 COVID-positive donors were included. No donor-to-recipient transmissions of COVID-19 were observed. Short-term outcomes were comparable to those reported in pre-COVID literature. Survival-to-date is 100% with median POD of 161 days. Our findings support the safety and efficacy of utilizing our algorithm including Ct value threshold for selection of donors with incidental COVID-19 positive testing.
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15
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Patel AK, Patel D, Shevkani M, Shah A, Madan S, Gohel S, Chhatwani C, Doshi A, Patel V, Sukhwani K, Kareliya H, Shah V, Savaj P, Rana M, Patel KK, Bakshi H. COVID-19 patients' clinical profile and outcome with respect to their vaccination status: A prospective observational multicentre cohort study during third wave in Western India. Indian J Med Microbiol 2023; 41:28-32. [PMID: 36870745 PMCID: PMC9793696 DOI: 10.1016/j.ijmmb.2022.12.004] [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: 07/13/2022] [Revised: 07/17/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To understand the benefits of COVID-19 vaccination (Covishield, Covaxin) on clinical features and outcome of COVID-19 during the third wave in India. MATERIALS AND METHODS The primary study aim was to describe the clinical profile and outcome of COVID-19 regarding their vaccination and to identify risk factors for disease progression in vaccinated patients. This was a prospective observational multicentric study of COVID-19 attended by Infectious Disease physicians during January 15, 2022 to February 15, 2022. Adult patients with positive RT-PCR or rapid antigen test for COVID-19 were enrolled. Patient received treatment as per local institutional protocol. Chi square test for categorical and Mann Whitney test for continuous variables were applied for the analysis. Logistic regression was used to calculate adjusted odds ratios. RESULTS A total of 788 patients were included in analysis out of 883 enrolled patients from 13 centers across Gujarat. By the end of two weeks' follow up, 22 patients (2.8%) had expired. The Median age of subjects was 54 years, with a (55.8%) male. 90% of the subjects were vaccinated, majority (77%) of them had received 2 doses of vaccine with Covishield (659, 93%). Mortality among the non-vaccinated was significantly (11.4%) higher than vaccinated (1.8%). Logistic regression analysis showed numbers of comorbidities (p = 0.027), baseline higher WBC count (p = 0.02), higher NLR (p = 0.016), and Ct value (p = 0.046) were associated with mortality while vaccination was associated with survival (p = 0.001). The factors associated with mortality among vaccinated were age, comorbidities, baseline higher WBC, NLR, and CRP. CONCLUSIONS Omicron variant was associated with mild symptoms. Clinical and laboratory risk factors for getting severe disease with Omicron variant were the same with previous SARS CoV-2 strain. Two doses of vaccine protect people against severe disease and death. Age, comorbidities, baseline leucocytosis, high NLR, elevated CRP are the risk factors for poor outcome in vaccinated patients.
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Affiliation(s)
- Atul K Patel
- Infectious Diseases Department, Sterling Hospital, Ahmedabad 380052, India.
| | - Dhruv Patel
- Infectious Diseases and Tropical Medicine Clinic, Gala Business Center II, Off C G Road, Ahmedabad 380006, India
| | | | - Aniket Shah
- Infectious Diseases, Shraddha Hospital, 14 Harihar Society, Maninagar, Ahmedabad 380008, India
| | - Surabhi Madan
- Marengo CIMS Hospital, Off Science City Road, Sola, Ahmedabad, India
| | - Swati Gohel
- Narayana Multispeciality Hospital, Rakhiyal Cross Road, Rakhiyal, Ahmedabad 380023, India
| | - Chirag Chhatwani
- Ashirwad Infectious Disease Clinic (AIDC), 313-315, Zenon Apartment, Opp. Unique Hospital, Off. Ring Road, Surat 395007, India
| | | | - Vipul Patel
- Infectious Diseases Care Clinic (IDCC), 302 Shubham Super Speciality Hospital, Near Sardar Patel Statue, Ahmedabad 380013, India
| | | | | | - Vipul Shah
- Healthcare Infectious Diseases Clinic, 301, Sankalp Square 2, Near Kalgi Cross Road, Ellisbridge, Ahmedabad 380006, India
| | - Pratik Savaj
- 405, AXIS Business Space, Nanpura, Surat 395001, India
| | - Manish Rana
- Community Medicine Department, GMERS Medical College, Sola, Ahmedabad, Gujarat 380060, India
| | - Ketan K Patel
- Infectious Diseases Department, Sterling Hospital, Ahmedabad 380052, India
| | - Harsh Bakshi
- Community Medicine Department, GMERS Medical College, Sola, Ahmedabad, Gujarat 380060, India
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16
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Ergoren MC, Akan G, Volkan E, Kandemis E, Evren EU, Evren H, Volkan E, Tuncel G, Suer K, Sanlidag T. The "vaccine" hubbub: Viral load comparisons of SARS-CoV-2 Delta and Omicron variants against different vaccine-booster vaccine combinations. J Med Virol 2023; 95:e28309. [PMID: 36377303 DOI: 10.1002/jmv.28309] [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: 07/26/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Abstract
There is a significant body of evidence showing that efficient vaccination schemes against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is helping control the coronavirus disease 2019 (COVID-19) pandemic. However, this goal cannot be achieved without real world data highlighting the impact of vaccines against viral spread. In this study, we have aimed at differentially investigating the impact of COVID-19 vaccines (CoronaVac, Pfizer/BioNTech, Astra/Zeneca Oxford, Janssen) used in North Cyprus in limiting the viral load of Delta and Omicron variants of SARS-COV-2. We have utilized real-time quantitative polymerase chain reaction cycle threshold values (Ct values) as a proxy of viral load of the two SARS-CoV-2 variants. Our results indicate that the administration of at least two doses of the messenger RNA-based Pfizer/BioNTech vaccine leads to the lowest viral load (highest Ct values) obtained for both Omicron and Delta variants. Interestingly, regardless of the vaccine type used, our study revealed that Delta variant produced significantly higher viral loads (lower Ct values) compared with the Omicron variant, where the latter was more commonly associated with younger patients. Viral spread is a crucial factor that can help determine the future of the pandemic. Thus, prioritizing vaccines that will play a role in not only preventing severe disease but also in limiting viral load and spread may contribute to infection control strategies.
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Affiliation(s)
- Mahmut C Ergoren
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Gokce Akan
- DESAM Research Institute, Near East University, Nicosia, Cyprus
| | - Ender Volkan
- Department of Microbiology, Faculty of Pharmacy, Cyprus International University, Nicosia, Cyprus.,Department of Microbiology, Biotechnology Research Center, Cyprus International University, Nicosia, Cyprus
| | - Emine Kandemis
- Department of Medical Biology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Emine U Evren
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
| | - Hakan Evren
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
| | - Eliz Volkan
- Department of Psychology, Faculty of Arts and Sciences, Cyprus International University, Nicosia, Cyprus
| | - Gulten Tuncel
- DESAM Research Institute, Near East University, Nicosia, Cyprus
| | - Kaya Suer
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Tamer Sanlidag
- DESAM Research Institute, Near East University, Nicosia, Cyprus
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17
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Baldanti F, Ganguly NK, Wang G, Möckel M, O’Neill LA, Renz H, dos Santos Ferreira CE, Tateda K, Van Der Pol B. Choice of SARS-CoV-2 diagnostic test: challenges and key considerations for the future. Crit Rev Clin Lab Sci 2022; 59:445-459. [PMID: 35289222 PMCID: PMC8935452 DOI: 10.1080/10408363.2022.2045250] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A plethora of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic tests are available, each with different performance specifications, detection methods, and targets. This narrative review aims to summarize the diagnostic technologies available and how they are best selected to tackle SARS-CoV-2 infection as the pandemic evolves. Seven key settings have been identified where diagnostic tests are being deployed: symptomatic individuals presenting for diagnostic testing and/or treatment of COVID-19 symptoms; asymptomatic individuals accessing healthcare for planned non-COVID-19-related reasons; patients needing to access emergency care (symptom status unknown); patients being discharged from healthcare following hospitalization for COVID-19; healthy individuals in both single event settings (e.g. airports, restaurants, hotels, concerts, and sporting events) and repeat access settings (e.g. workplaces, schools, and universities); and vaccinated individuals. While molecular diagnostics remain central to SARS-CoV-2 testing strategies, we have offered some discussion on the considerations for when other tools and technologies may be useful, when centralized/point-of-care testing is appropriate, and how the various additional diagnostics can be deployed in differently resourced settings. As the pandemic evolves, molecular testing remains important for definitive diagnosis, but increasingly widespread point-of-care testing is essential to the re-opening of society.
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Affiliation(s)
- Fausto Baldanti
- Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Guiqiang Wang
- The Center for Liver Diseases, Peking University First Hospital, Beijing, China
| | - Martin Möckel
- Charité – Universitätsmedizin, Berlin, Germany,CONTACT Martin Möckel Departments of Emergency Medicine and Chest Pain Units CVK/CCM, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany
| | - Luke A. O’Neill
- Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen and Marburg GmbH, Giessen, Germany,Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Barbara Van Der Pol
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
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18
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Muacevic A, Adler JR, Kumar D, Purohit A, Garg M, Kanchan DT, Dutt N, Kothari N, Bhaskar S, Elhence P, Bhatia P, Nag VL, Garg MK, Misra S, Pandey A, Dhawan A. Ultrastructural Changes in Autopsy Tissues of COVID-19 Patients. Cureus 2022; 14:e31932. [PMID: 36582579 PMCID: PMC9794915 DOI: 10.7759/cureus.31932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic resulted in substantial morbidity and mortality across the world. The prognosis was found to be poor in patients with co-morbidities such as diabetes, hypertension, interstitial lung disease, etc. Although biochemical studies were done in patient samples, no study has been reported from the Indian subcontinent about ultrastructural changes in the vital organs of COVID-19 patients. The present study was, therefore, conducted to understand the ultrastructural changes in the lung, liver, and brain of the deceased patients. METHODS The present study was conducted on samples obtained from reverse transcription-polymerase chain reaction (RT-PCR)-positive patients who were admitted to a tertiary care hospital in Western India. Core needle biopsies were done in eight fatal cases of COVID-19. The samples were taken from the lungs, liver, and brain and subjected to light microscopy, immunohistochemistry (IHC), and transmission electron microscopy (TEM). Clinical details and biochemical findings were also collected. Results: The study participants included seven males and one female. The presenting complaints included fever, breathlessness, and cough. Light microscopy revealed diffuse alveolar damage in the lungs. Further, a positive expression of SARS-CoV-2 nucleocapsid protein was observed in the pulmonary parenchyma of five patients. Also, the TEM microphotograph showed viral particles of size up to 80nm localized in alveolar epithelial cells. However, no viral particles were found in liver or brain samples. In the liver, macrovesicular steatosis and centrizonal congestion with loss of hepatocytes were observed in light microscopy. CONCLUSION This is the first study in the Indian population showing the in-situ presence of viral particles in core biopsies from fatal cases of COVID-19. As evident from the results, histology and ultrastructural changes in the lung correlated with the presence of viral particles. The study revealed a positive correlation between the damage in the lungs and the presence of viral particles.
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19
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Retrospective Analysis of the SARS-CoV-2 Infection Profile in COVID-19 Positive Patients in Vitoria da Conquista, Northeast Brazil. Viruses 2022; 14:v14112424. [PMID: 36366521 PMCID: PMC9699198 DOI: 10.3390/v14112424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is responsible for causing Coronavirus Disease-2019 (COVID-19), a heterogeneous clinical condition that manifests varying symptom severity according to the demographic profile of the studied population. While many studies have focused on the spread of COVID-19 in large urban centers in Brazil, few have evaluated medium or small cities in the Northeast region. The aims of this study were: (i) to identify risk factors for mortality from SARS-CoV-2 infection, (ii) to evaluate the gene expression patterns of key immune response pathways using nasopharyngeal swabs of COVID-19 patients, and (iii) to identify the circulating SARS-CoV-2 variants in the residents of a medium-sized city in Northeast Brazil. A total of 783 patients infected with SARS-CoV-2 between May 2020 and August 2021 were included in this study. Clinical-epidemiological data from patients who died and those who survived were compared. Patients were also retrospectively divided into three groups based on disease severity: asymptomatic, mild, and moderate/severe. Samples were added to a qPCR array for analyses of 84 genes involved with immune response pathways and sequenced using the Oxford Nanopore MinION technology. Having pre-existing comorbidity; being male; having cardiovascular disease, diabetes, and/or chronic obstructive pulmonary disease; and PCR cycle threshold (Ct) values under 22 were identified as risk factors for mortality. Analysis of the expression profiles of inflammatory pathway genes showed that the greater the infection severity, the greater the activation of inflammatory pathways, triggering the cytokine storm and downregulating anti-inflammatory pathways. Viral genome analysis revealed the circulation of multiple lineages, such as B.1, B.1.1.28, Alpha, and Gamma, suggesting that multiple introduction events had occurred over time. This study's findings help identify the specific strains and increase our understanding of the true state of local health. In addition, our data demonstrate that epidemiological and genomic surveillance together can help formulate public health strategies to guide governmental actions.
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Snouber A, Metahri M, Chahraoui S, Benatta D, Boukhari S, Hadjouj A, Larbi D, Rahmani M, Douichine M, Zouaoui A, Djaid M, Ben Saad H. Clinical and computed tomography features of patients suspected of COVID-19 in the university hospital of Oran, Algeria. LA TUNISIE MEDICALE 2022; 100:374-383. [PMID: 36206086 PMCID: PMC9552237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The analysis of the clinical and radiological characteristics of COVID-19 patients around the world observed a rich semiology, different from one country to another, and within the same country. AIM To analyze the clinical, computed tomography (CT) features, and the outcome of patients suspected of COVID-19 hospitalized in a COVID-19 unit of Oran university hospital (Algeria). METHODS We collected retrospectively the files of patients suspected of COVID-19 admitted in a COVID-19 unit during July 2020. Data were collected on standardized questionnaire with prior coding of parameters. Patients were admitted according to a triage based on their clinical situation and the chest CT aspects suggestive of COVID-19. Two physicians reviewed the high-resolution CT (HR-CT) images independently, and discrepancies were resolved by consensus with the input of two others experimented physicians. RESULTS 112 patients (64% males, median age: 68 (18-88) years) were included. The main symptoms were dyspnea (51.7%), cough (34%), fatigue (14%). Almost the half (49.1%) of patients had hypoxemia. The HR-CT findings were typical of COVID-19 in 96% of patients. Although 61% of patients had favorable prognosis, mortality rate was 30%. Mutlivariate analysis of risk factors for death showed that patients aged > 60 years had a 4-fold risk of death (95% confidence interval: [1.27-12.58], p=0.018). CONCLUSION Dyspnea, cough and fatigue were predominant symptoms, moderate and severe COVID-19 characterized our patients. Age > 60 years was a major risk factor for the deaths of our patients.
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21
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Rawat P, Zerbato JM, Rhodes A, Chiu C, Tran T, Rasmussen TA, Druce J, Lewin SR, Roche M. Factors associated with weak positive SARS-CoV-2 diagnosis by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR). Pathology 2022; 54:623-628. [PMID: 35778288 PMCID: PMC9239708 DOI: 10.1016/j.pathol.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/12/2022] [Accepted: 04/29/2022] [Indexed: 11/17/2022]
Abstract
During the COVID-19 pandemic, the reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) assay has been the primary method of diagnosis of SARS-CoV-2 infection. However, RT-qPCR assay interpretation can be ambiguous with no universal absolute cut-off value to determine sample positivity, which particularly complicates the analysis of samples with high Ct values, or weak positives. Therefore, we sought to analyse factors associated with weak positive SARS-CoV-2 diagnosis. We analysed sample data associated with all positive SARS-CoV-2 RT-qPCR diagnostic tests performed by the Victorian Infectious Diseases Reference Laboratory (VIDRL) in Melbourne, Australia, during the Victorian first wave (22 January 2020–30 May 2020). A subset of samples was screened for the presence of host DNA and RNA using qPCR assays for CCR5 and 18S, respectively. Assays targeting the viral RNA-dependent RNA polymerase (RdRp) had higher Ct values than assays targeting the viral N and E genes. Weak positives were not associated with the age or sex of individuals’ samples nor with reduced levels of host DNA and RNA. We observed a relationship between Ct value and time post-SARS-CoV-2 diagnosis. High Ct value or weak positive SARS-CoV-2 was not associated with any particular bias including poor biological sampling.
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Affiliation(s)
- Priyank Rawat
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Jennifer M Zerbato
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Ajantha Rhodes
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Chris Chiu
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Thomas Tran
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Thomas A Rasmussen
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Sharon R Lewin
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Vic, Australia
| | - Michael Roche
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; STEM College, RMIT University, Melbourne, Vic, Australia.
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22
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Hoteit R, Yassine HM. Biological Properties of SARS-CoV-2 Variants: Epidemiological Impact and Clinical Consequences. Vaccines (Basel) 2022; 10:919. [PMID: 35746526 PMCID: PMC9230982 DOI: 10.3390/vaccines10060919] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus that belongs to the coronavirus family and is the cause of coronavirus disease 2019 (COVID-19). As of May 2022, it had caused more than 500 million infections and more than 6 million deaths worldwide. Several vaccines have been produced and tested over the last two years. The SARS-CoV-2 virus, on the other hand, has mutated over time, resulting in genetic variation in the population of circulating variants during the COVID-19 pandemic. It has also shown immune-evading characteristics, suggesting that vaccinations against these variants could be potentially ineffective. The purpose of this review article is to investigate the key variants of concern (VOCs) and mutations of the virus driving the current pandemic, as well as to explore the transmission rates of SARS-CoV-2 VOCs in relation to epidemiological factors and to compare the virus's transmission rate to that of prior coronaviruses. We examined and provided key information on SARS-CoV-2 VOCs in this study, including their transmissibility, infectivity rate, disease severity, affinity for angiotensin-converting enzyme 2 (ACE2) receptors, viral load, reproduction number, vaccination effectiveness, and vaccine breakthrough.
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Affiliation(s)
- Reem Hoteit
- Clinical Research Institute, Faculty of Medicine, American University of Beirut, Beirut 110236, Lebanon;
| | - Hadi M. Yassine
- Biomedical Research Center and College of Health Sciences-QU Health, Qatar University, Doha 2713, Qatar
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23
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Souverein D, van Stralen K, van Lelyveld S, van Gemeren C, Haverkort M, Snijders D, Soetekouw R, Kapteijns E, de Jong E, Hermanides G, Aronson S, Herpers B, den Boer J, Wagemakers A, Euser S. Initial SARS-CoV-2 viral load is associated with disease severity: a retrospective cohort study. Open Forum Infect Dis 2022; 9:ofac223. [PMID: 35821732 PMCID: PMC9272435 DOI: 10.1093/ofid/ofac223] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background We assessed the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and hospital admission, intensive care unit (ICU) admission, and in-hospital mortality. Methods All SARS-CoV-2–positive persons with a combined nasopharyngeal and oropharyngeal swab that was collected between 17 March 2020 and 31 March 2021 in public health testing facilities were included. Results From 20 207 SARS-CoV-2–positive persons, 310 (1.5%) were hospitalized within 30 days. High viral loads (crossing point [Cp] <25) were associated with an increased risk of hospitalization as compared to low viral loads (Cp >30), adjusted for age and sex (adjusted odds ratio [aOR], 1.57 [95% confidence interval {CI}, 1.11–2.26]). The same association was seen for ICU admission (aOR, 7.06 [95% CI, 2.15–43.57]). The median [interquartile range] Cp value of the 17 patients who died in hospital was significantly lower compared to the 226 survivors (22.7 [3.4] vs 25.0 [5.2]). Conclusions Higher initial SARS-CoV-2 viral load is associated with an increased risk of hospital admission, ICU admission, and in-hospital mortality. Our findings emphasize the added value of reporting SARS-CoV-2 viral load or cycle threshold/Cp values to identify persons who are at the highest risk of adverse outcomes such as hospital or ICU admission and who therefore may benefit from more intensive monitoring or early initiation of antiviral therapy.
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Affiliation(s)
- Dennis Souverein
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | | | | | | | - Milly Haverkort
- Public Health Service Kennemerland, Haarlem, the Netherlands
| | | | | | | | | | | | - Sem Aronson
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
- Spaarne Gasthuis, Hoofddorp/Haarlem, the Netherlands
| | - Bjorn Herpers
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | - Jeroen den Boer
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | - Alex Wagemakers
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
| | - Sjoerd Euser
- Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands
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24
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Myers NT, Laumbach RJ, Black KG, Ohman‐Strickland P, Alimokhtari S, Legard A, De Resende A, Calderón L, Lu FT, Mainelis G, Kipen HM. Portable air cleaners and residential exposure to SARS-CoV-2 aerosols: A real-world study. INDOOR AIR 2022; 32:e13029. [PMID: 35481935 PMCID: PMC9111720 DOI: 10.1111/ina.13029] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 05/04/2023]
Abstract
Individuals with COVID-19 who do not require hospitalization are instructed to self-isolate in their residences. Due to high secondary infection rates in household members, there is a need to understand airborne transmission of SARS-CoV-2 within residences. We report the first naturalistic intervention study suggesting a reduction of such transmission risk using portable air cleaners (PACs) with HEPA filters. Seventeen individuals with newly diagnosed COVID-19 infection completed this single-blind, crossover, randomized study. Total and size-fractionated aerosol samples were collected simultaneously in the self-isolation room with the PAC (primary) and another room (secondary) for two consecutive 24-h periods, one period with HEPA filtration and the other with the filter removed (sham). Seven out of sixteen (44%) air samples in primary rooms were positive for SARS-CoV-2 RNA during the sham period. With the PAC operated at its lowest setting (clean air delivery rate [CADR] = 263 cfm) to minimize noise, positive aerosol samples decreased to four out of sixteen residences (25%; p = 0.229). A slight decrease in positive aerosol samples was also observed in the secondary room. As the world confronts both new variants and limited vaccination rates, our study supports this practical intervention to reduce the presence of viral aerosols in a real-world setting.
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Affiliation(s)
- Nirmala T. Myers
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Robert J. Laumbach
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
| | - Kathleen G. Black
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Pamela Ohman‐Strickland
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Biostatistics and EpidemiologyRutgers School of Public HealthRutgers UniversityPiscatawayNew JerseyUSA
| | - Shahnaz Alimokhtari
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Alicia Legard
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Adriana De Resende
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Leonardo Calderón
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Frederic T. Lu
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Gediminas Mainelis
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Howard M. Kipen
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
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25
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Mahmood ZS, Fadhil HY, Abdul Hussein TA, Ad'hiah AH. Severity of coronavirus disease 19: Profile of inflammatory markers and ACE (rs4646994) and ACE2 (rs2285666) gene polymorphisms in Iraqi patients. Meta Gene 2022; 31:101014. [PMID: 35036327 PMCID: PMC8744396 DOI: 10.1016/j.mgene.2022.101014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/06/2022] [Indexed: 12/27/2022] Open
Abstract
Susceptibility to coronavirus disease 2019 (COVID-19) and disease severity has recently been associated with inflammatory markers and genetic polymorphisms of ACE (angiotensin-converting enzyme) and ACE2 genes, but the evidence has been inconclusive. This case-control study (99 COVID-19 patients and 96 controls) sought to assess the significance of age, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and SARS-CoV-2 RT-PCR cycle threshold (Ct) in severity of COVID-19. Besides, two variants of ACE and ACE2 genes (rs4646994 and rs2285666, respectively) were analyzed to determine their role in COVID-19 susceptibility and/or disease severity. Results revealed that age, CRP and NLR were significantly elevated in severe cases compared to moderate cases, while RT-PCR Ct value was significantly decreased. Allele and genotypes of both variants were not associated with COVID-19 risk, with the exception of rs2285666 A allele. It showed a significantly higher frequency in female patients than in female controls (probability = 0.041). In conclusion, the study indicated the role of age, CRP, NLR and SARS-CoV-2 RT-PCR Ct in susceptibility to COVID-19 severity. However, analysis of the ACE and ACE2 gene variants (rs4646994 and rs2285666, respectively) showed that the two variants were not associated with the risk of developing COVID-19.
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Affiliation(s)
- Zainab S Mahmood
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | - Hula Y Fadhil
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | | | - Ali H Ad'hiah
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
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26
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Halaji M, Pournajaf A, Sadeghi F, Hasanzadeh A, Chehrazi M, Gholinia H, Hejazi Amiri F, Saber Amoli S, Javanian M, Bayani M, Sadeghi Haddad Zavareh M, Shokri M, Babazadeh A, Bazi Broun M, Mohammadi M, Mehdinezhad H, Monadi M, Amri Maleh P, Nouri HR, Daraei A, Yousefnia Pasha M, Tourani M, Ahmadian SR, Esmailzadeh N, Mirtabar SM, Asadi S, Yousefghahary B, Babaei M, Nabipour M, Vakili Sadeghi M, Pourkia R, Jafarypour I, Zieaie Amiri N, Akbary R, Asgharpour M, Oliaei F, Zahedpasha Y, Mahmoodi H, Akbarian Rad Z, Haghshenas Mojaveri M, Seyfi S, Shokri Shirvani J, Alhooee S, Abedi H, Behzad K, Bayani MA, Kheirkhah F, Saadat P, Nasiraie E, Ezami N, Gorjinejad S, Fallhpour K, Fakhraie F, Beheshti Y, Baghershiroodi M, Rasti F, Salehi M, Aleahmad A, Nasrollahian S, Babapour R, Malekzadeh R, Habibzadeh Kashi R, Shams Esmaili MA, Javadian Kotnaei M, Ghanbarpour A, Yahyapour Y. One-year prevalence and the association between SARS-CoV-2 cycle threshold, comorbidity and outcomes in population of Babol, North of Iran (2020-2021). CASPIAN JOURNAL OF INTERNAL MEDICINE 2022; 13:244-253. [PMID: 35872672 PMCID: PMC9272954 DOI: 10.22088/cjim.13.0.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 03/10/2023]
Abstract
BACKGROUND The present study aimed to investigate the one-year prevalence of SARS-CoV-2, common comorbidities and demographic information among negative- and positive rRT-PCR in health care workers (HCW), hospitalized and outpatients. Also, the association between SARS-CoV-2 cycle threshold (Ct) and the outcomes of patients were analyzed in Babol, northern Iran. METHODS This large retrospective cross-sectional study was performed between March 2020 and March 2021. The records of 19232 hospitalized, outpatients and HCW suspected to COVID-19 were collected from teaching hospitals in the North of Iran. RESULTS Out of the 19232 suspected to COVID-19 patients, 7251 (37.7%) had a positive rRT-PCR result; 652 (9%), 4599 (63.4%) and 2000 (27.6%) of those were categorized as HCW, hospitalized and outpatients, respectively. Moreover, between the hospitalized and the outpatient group, 10.2 and 0.8% cases died, whereas no death cases were reported in the HCW. Furthermore, it seems that death rate was significantly different between the three groups of Ct value, the highest mortality in those with Ct between 21 and 30 (group B=7.6%) and the lowest in the group with the highest Ct (between 31 and 40 = 5.5%) (p<0.001). CONCLUSION In summary, 37.7% of cases were positive for SARS-CoV-2; of which, 63.4, 27.6 and 9% were hospitalized, outpatients and HCW, respectively. With regard to the mortality rate in hospitalized patients and the significant association with Ct under 20 and 30, it seems that the early detection and the initial quantification of SARS-CoV-2 in the first week of the conflict and therapeutic considerations to reduce the relative load can reduce the mortality rate.
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Affiliation(s)
- Mehrdad Halaji
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.,These authors contributed equally to this work
| | - Abazar Pournajaf
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.,These authors contributed equally to this work
| | - Farzin Sadeghi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Hasanzadeh
- Department of Medical Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Hejazi Amiri
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Saghar Saber Amoli
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Masoumeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Sadeghi Haddad Zavareh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mehran Shokri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mana Bazi Broun
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Mohammadi
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hamed Mehdinezhad
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Monadi
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Parviz Amri Maleh
- Department of Anesthesiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hamid Reza Nouri
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Abdolreza Daraei
- Department of Medical Genetics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Mehdi Tourani
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Nadia Esmailzadeh
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Shakiba Asadi
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Behnaz Yousefghahary
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mansour Babaei
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Majid Nabipour
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Vakili Sadeghi
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Roghayeh Pourkia
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Iraj Jafarypour
- Department of Cardiology, School of Medicine , Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Naghmeh Zieaie Amiri
- Department of Cardiology, School of Medicine , Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Roghayeh Akbary
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Masoumeh Asgharpour
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farshid Oliaei
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Yadollah Zahedpasha
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hasan Mahmoodi
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Akbarian Rad
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohsen Haghshenas Mojaveri
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shahram Seyfi
- Department of Anesthesiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Javad Shokri Shirvani
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Saman Alhooee
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hasan Abedi
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Katrin Behzad
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Ali Bayani
- Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Payam Saadat
- Part of Infectious Control, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Ebrahim Nasiraie
- Part of Infectious Control, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Nafiseh Ezami
- Part of Medical Records, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Shahrbano Gorjinejad
- Part of Infectious Control, Amirkola Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Kobra Fallhpour
- Part of Infectious Control, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Fakhraie
- Part of Infectious Control, Shahid Yahyanejad Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Yousef Beheshti
- Department of Medical Genetics, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mahnaz Baghershiroodi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faeze Rasti
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Salehi
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Atiyeh Aleahmad
- Department of Clinical Biochemistry, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Sina Nasrollahian
- Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Rahman Babapour
- Babol Health Center, Babol University of Medical Sciences, Babol, Iran
| | - Rahim Malekzadeh
- Babol Health Center, Babol University of Medical Sciences, Babol, Iran
| | | | | | - Maryam Javadian Kotnaei
- Department of Obstetrics and Gynecology, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Azita Ghanbarpour
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Yousef Yahyapour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Medical Microbiology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
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27
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Hwang H, Lim JS, Song SA, Achangwa C, Sim W, Kim G, Ryu S. Transmission dynamics of the Delta variant of SARS-CoV-2 infections in South Korea. J Infect Dis 2021; 225:793-799. [PMID: 34865022 DOI: 10.1093/infdis/jiab586] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/29/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The Delta variant of SARS-CoV-2 is now the predominant variant worldwide. However, its transmission dynamics remain unclear. METHODS We analyzed 405 local case-patients infected with the Delta variant of SARS-CoV-2 and temporal patterns of viral shedding identified between 22 June and 31 July 2021 in Daejeon, South Korea. RESULTS Overall, 20% were presymptomatic at the time of epidemiological investigation. We identified six clustered outbreaks, and all were associated with indoor facilities. In 23 household contacts, the secondary attack rate was 63%. We estimated the mean serial interval as 3.26 days (95% credible interval, 2.92-3.60), and 15% (95% confidence interval, 13-18%) of cases seeded 80% of all local transmission. Analysis of the nasopharyngeal swab samples identified virus shedding from the presymptomatic patients, and the highest viral load was observed two days after symptom onset. CONCLUSIONS Our findings suggest that the Delta variant is highly transmissible in indoor settings and households. Rapid contact tracing, isolation of the asymptomatic contacts, strict adherence to public health measures, and increased uptake of COVID-19 vaccination including booster doses are needed to reduce the community transmission of the Delta variant.
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Affiliation(s)
- Hari Hwang
- Department of Infectious Disease Control, Daejeon Metropolitan Government, Daejeon, South Korea
| | - Jun-Sik Lim
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea.,Onehealth Research Institute, Konyang University College of Medicine, Daejeon, South Korea
| | - Sun-Ah Song
- Department of Infectious Disease Research, Health and Environmental Research Institute, Daejeon Metropolitan Government, Daejeon, South Korea
| | - Chiara Achangwa
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea.,Onehealth Research Institute, Konyang University College of Medicine, Daejeon, South Korea
| | - Woobeom Sim
- Department of Infectious Disease Control, Daejeon Metropolitan Government, Daejeon, South Korea
| | - Giho Kim
- Department of Infectious Disease Control, Daejeon Metropolitan Government, Daejeon, South Korea
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, South Korea.,Onehealth Research Institute, Konyang University College of Medicine, Daejeon, South Korea
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