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Alsanei W, Alhussin E, Natto ZS, Afeef M, Aktar T. Determining the sweet detection threshold of COVID-19 patients during infection and recovery periods. PLoS One 2024; 19:e0309342. [PMID: 39208140 PMCID: PMC11361598 DOI: 10.1371/journal.pone.0309342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/10/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The loss of taste and smell is a common symptom of COVID-19, affecting individuals' quality of life and nutritional status. Detecting sweet thresholds during infection and recovery periods can assist in implementing dietary modifications and nutritional strategies for these patients. OBJECTIVE To investigate the changes and differences in sweet detection thresholds of confirmed COVID-19 patients on Day 1, Day 10, and Day 14 of the infection and recovery periods. METHODS The demographic factors such as gender, smoking status, BMI, and age group were abstracted on Excel sheet from the medical health records for confirmed COVID-19 patients, who were admitted to King Fahad General Hospital in Jeddah, Saudi Arabia, a COVID-19 care facility, from September 2021 to July 2022. Sweet detection thresholds were determined using a pair-wise comparison procedure and sugar solutions with varying concentrations, arranged in ascending order and presented to participants until the lowest detected concentration was noted after three consecutive positive detections, with the median just noticeable difference (JND) value calculated as the population average threshold. Sensory tests were conducted on COVID-19 patients during their infection and recovery periods to evaluate their taste sensation thresholds. The demographic factors of gender, smoking status, BMI, and age group were considered in the analysis. RESULTS A total of 37 patients who met the inclusion criteria of the study were enrolled as participants. Significant variances in sweet detection thresholds were observed among the COVID-19 patients, with consistent decreases over the three testing days, indicating increasing sucrose sensitivity. Infected men showed significant returns to sweet detection thresholds on Day 14 compared to women, while infected smokers exhibited greater recoveries than non-smokers. Overweight patients had consistently elevated thresholds and recovery rates that were comparable to those of normal-weight patients by Day 14, while younger patients had lower thresholds than their older counterparts. On Day 14, the thresholds had significantly recovered to a level comparable to that of healthy individuals (approximately 0.23%). CONCLUSION These findings suggest that sweet detection thresholds can be used as a marker for assessing the progression and recovery of COVID-19 patients. These findings highlight the importance of recognizing and managing alterations in sweet detection thresholds promptly in COVID-19 patients, as this could positively impact dietary management, nutritional recommendations, and interventions during infection and recovery periods.
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Affiliation(s)
- Woroud Alsanei
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Esraa Alhussin
- Department of Nursing Education, King Fahad Hospital Jeddah, Jeddah, Saudi Arabia
| | - Zuhair S. Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marwah Afeef
- Department of Research and Studies, Al-Thagher Hospital, Jeddah, Saudi Arabia
| | - Tugba Aktar
- Department of Food Engineering, Faculty of Engineering, Alanya Alaaddin Keykubat University, Antalya, Turkey
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Oordt-Speets AM, Spinardi JR, Mendoza CF, Yang J, del Carmen Morales G, Kyaw MH. Duration of SARS-CoV-2 shedding: A systematic review. J Glob Health 2024; 14:05005. [PMID: 38547496 PMCID: PMC10978056 DOI: 10.7189/jogh.14.05005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
Background Positive viral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cultures indicate shedding of infectious virus and corresponding transmission risk of coronavirus disease 2019 (COVID-19). The research question of this systematic review was: Is there a discernible pattern in the timing of SARS-CoV-2 virus isolation, and what is the proportion of positive and negative results for isolation of SARS-CoV-2 virus with viral culture relative to the onset of clinical symptoms or the day of diagnosis, as indicated by longitudinal studies? Methods We systematically searched PubMed and Embase from inception to 16 February 2023 for English-language studies with serial viral culture testing within symptomatic or asymptomatic SARS-CoV-2 infected persons during the post-vaccination period. Outcomes of interest were the daily culture status per study and the overall daily culture positivity rate of SARS-CoV-2. We critically appraised the selected studies using the Newcastle-Ottawa quality assessment scale. Results We included 14 viral shedding studies in this systematic review. Positive viral SARS-CoV-2 cultures were detected in samples ranging from 4 days before to 18 days after symptom onset. The daily culture SARS-CoV-2 positivity rate since symptom onset or diagnosis showed a steep decline between day 5 and 9, starting with a peak ranging from 44% to 50% on days -1 to 5, decreasing to 28% on day 7 and 11% on day 9, and finally ranging between 0% and 8% on days 10-17. Conclusions Viral shedding peaked within 5 days since symptom onset or diagnosis and the culture positivity rate rapidly declined hereafter. This systematic review provides an overview of current evidence on the daily SARS-CoV-2 culture positivity rates during the post-vaccination period. These findings could be used to estimate the effectiveness of public health control measures, including treatment and preventive strategies, to reduce the spread of COVID-19.
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Affiliation(s)
| | - Julia R Spinardi
- Vaccine Medical Affairs, Emerging Markets, Pfizer Inc., Itapevi, Brazil
| | | | - Jingyan Yang
- Global Value and Access, Pfizer Inc., New York, USA
| | | | - Moe H Kyaw
- Vaccine Scientific Affairs, Emerging Markets, Pfizer Inc., New York, USA
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Coelho FF, da Silva MA, Lopes TB, Polatto JM, de Castro NS, Andrade LAF, Lourenço KL, Sato HI, de Carvalho AF, Coelho HP, Bagno FF, Luz D, Viala VL, Cattony PQ, Melo BDS, Moro AM, Quintilio W, Barbosa AP, Bomfim CG, Soares CP, Guzzo CR, Fonseca FG, Durigon EL, Gazzinelli RT, Ribeiro Teixeira SM, Piazza RMF, Fernandes AP. SARS-CoV-2 Rapid Antigen Test Based on a New Anti-Nucleocapsid Protein Monoclonal Antibody: Development and Real-Time Validation. Microorganisms 2023; 11:2422. [PMID: 37894080 PMCID: PMC10608853 DOI: 10.3390/microorganisms11102422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/27/2023] [Accepted: 09/01/2023] [Indexed: 10/29/2023] Open
Abstract
SARS-CoV-2 diagnostic tests have become an important tool for pandemic control. Among the alternatives for COVID-19 diagnosis, antigen rapid diagnostic tests (Ag-RDT) are very convenient and widely used. However, as SARS-CoV-2 variants may continuously emerge, the replacement of tests and reagents may be required to maintain the sensitivity of Ag-RDTs. Here, we describe the development and validation of an Ag-RDT during an outbreak of the Omicron variant, including the characterization of a new monoclonal antibody (anti-DTC-N 1B3 mAb) that recognizes the Nucleocapsid protein (N). The anti-DTC-N 1B3 mAb recognized the sequence TFPPTEPKKDKKK located at the C-terminus of the N protein of main SARS-CoV-2 variants of concern. Accordingly, the Ag-RDT prototypes using the anti-DTC-N 1B3 mAB detected all the SARS-CoV-2 variants-Wuhan, Alpha, Gamma, Delta, P2 and Omicron. The performance of the best prototype (sensitivity of 95.2% for samples with Ct ≤ 25; specificity of 98.3% and overall accuracy of 85.0%) met the WHO recommendations. Moreover, results from a patients' follow-up study indicated that, if performed within the first three days after onset of symptoms, the Ag-RDT displayed 100% sensitivity. Thus, the new mAb and the Ag-RDT developed herein may constitute alternative tools for COVID-19 point-of-care diagnosis and epidemiological surveillance.
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Affiliation(s)
- Fabiana Fioravante Coelho
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil;
- Hospital da Polícia Militar de Minas Gerais, Polícia Militar de Minas Gerais, Belo Horizonte 30110-013, Brazil
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Miriam Aparecida da Silva
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Thiciany Blener Lopes
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Juliana Moutinho Polatto
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Natália Salazar de Castro
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Luis Adan Flores Andrade
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Karine Lima Lourenço
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Hugo Itaru Sato
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Alex Fiorini de Carvalho
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Helena Perez Coelho
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Flávia Fonseca Bagno
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Daniela Luz
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Vincent Louis Viala
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Pedro Queiroz Cattony
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Bruna de Sousa Melo
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Ana Maria Moro
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Wagner Quintilio
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Ana Paula Barbosa
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Camila Gasque Bomfim
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (C.G.B.); (C.P.S.); (C.R.G.); (E.L.D.)
| | - Camila Pereira Soares
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (C.G.B.); (C.P.S.); (C.R.G.); (E.L.D.)
| | - Cristiane Rodrigues Guzzo
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (C.G.B.); (C.P.S.); (C.R.G.); (E.L.D.)
| | - Flavio Guimarães Fonseca
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (C.G.B.); (C.P.S.); (C.R.G.); (E.L.D.)
| | - Ricardo Tostes Gazzinelli
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Santuza M. Ribeiro Teixeira
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
| | - Roxane Maria Fontes Piazza
- Instituto Butantan, São Paulo 05503-900, Brazil; (M.A.d.S.); (J.M.P.); (D.L.); (V.L.V.); (P.Q.C.); (B.d.S.M.); (A.M.M.); (W.Q.); (A.P.B.); (R.M.F.P.)
| | - Ana Paula Fernandes
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil;
- Centro de Tecnologia em Vacinas, Universidade Federal de Minas Gerais, Belo Horizonte 31310-260, Brazil; (T.B.L.); (N.S.d.C.); (L.A.F.A.); (K.L.L.); (H.I.S.); (A.F.d.C.); (H.P.C.); (F.F.B.); (F.G.F.); (R.T.G.); (S.M.R.T.)
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Ng WY, Thoe W, Yang R, Cheung WP, Chen CK, To KH, Pak KM, Leung HW, Lai WK, Wong TK, Lau TK, Au KW, Xu XQ, Zheng XW, Deng Y, Lau YK, To CK, Peiris M, Leung GM, Zhang T, Yang M, An W, Chen W, Wang C, Chui HK. The city-wide full-scale interactive application of sewage surveillance programme for assisting real-time COVID-19 pandemic control - A case study in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 875:162661. [PMID: 36898549 PMCID: PMC9991928 DOI: 10.1016/j.scitotenv.2023.162661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/22/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
The paper discusses the implementation of Hong Kong's tailor-made sewage surveillance programme led by the Government, which has demonstrated how an efficient and well-organized sewage surveillance system can complement conventional epidemiological surveillance to facilitate the planning of intervention strategies and actions for combating COVID-19 pandemic in real-time. This included the setting up of a comprehensive sewerage network-based SARS-CoV-2 virus surveillance programme with 154 stationary sites covering 6 million people (or 80 % of the total population), and employing an intensive monitoring programme to take samples from each stationary site every 2 days. From 1 January to 22 May 2022, the daily confirmed case count started with 17 cases per day on 1 January to a maximum of 76,991 cases on 3 March and dropped to 237 cases on 22 May. During this period, a total of 270 "Restriction-Testing Declaration" (RTD) operations at high-risk residential areas were conducted based on the sewage virus testing results, where over 26,500 confirmed cases were detected with a majority being asymptomatic. In addition, Compulsory Testing Notices (CTN) were issued to residents, and the distribution of Rapid Antigen Test kits was adopted as alternatives to RTD operations in areas of moderate risk. These measures formulated a tiered and cost-effective approach to combat the disease in the local setting. Some ongoing and future enhancement efforts to improve efficacy are discussed from the perspective of wastewater-based epidemiology. Forecast models on case counts based on sewage virus testing results were also developed with R2 of 0.9669-0.9775, which estimated that up to 22 May 2022, around 2,000,000 people (~67 % higher than the total number of 1,200,000 reported to the health authority, due to various constraints or limitations) had potentially contracted the disease, which is believed to be reflecting the real situation occurring in a highly urbanized metropolis like Hong Kong.
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Affiliation(s)
- Wai-Yin Ng
- Environmental Protection Department, Hong Kong SAR Government, China
| | - Wai Thoe
- Environmental Protection Department, Hong Kong SAR Government, China
| | - Rong Yang
- Environmental Protection Department, Hong Kong SAR Government, China
| | - Wai-Ping Cheung
- Environmental Protection Department, Hong Kong SAR Government, China
| | - Che-Kong Chen
- Environmental Protection Department, Hong Kong SAR Government, China
| | - King-Ho To
- Environmental Protection Department, Hong Kong SAR Government, China
| | - Kan-Ming Pak
- Drainage Service Department, Hong Kong SAR Government, China
| | - Hon-Wan Leung
- Drainage Service Department, Hong Kong SAR Government, China
| | - Wai-Kwan Lai
- Drainage Service Department, Hong Kong SAR Government, China
| | - Tsz-Kin Wong
- Drainage Service Department, Hong Kong SAR Government, China
| | - Tat-Kwong Lau
- Drainage Service Department, Hong Kong SAR Government, China
| | - Ka-Wing Au
- Centre for Health Protection, Department of Health, Hong Kong SAR Government, China
| | - Xiao-Qing Xu
- Department of Civil Engineering, The University of Hong Kong, China
| | - Xia-Wan Zheng
- Department of Civil Engineering, The University of Hong Kong, China
| | - Yu Deng
- Department of Civil Engineering, The University of Hong Kong, China
| | - Yan-Kin Lau
- CMA Industrial Development Foundation Limited, Hong Kong, China
| | - Chi-Kai To
- CMA Industrial Development Foundation Limited, Hong Kong, China
| | - Malik Peiris
- School of Public Health, The University of Hong Kong, China
| | | | - Tong Zhang
- Department of Civil Engineering, The University of Hong Kong, China
| | - Min Yang
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Wei An
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Wenxiu Chen
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Chen Wang
- Key Laboratory of Drinking Water Science and Technology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Ho-Kwong Chui
- Environmental Protection Department, Hong Kong SAR Government, China; Hong Kong University of Science and Technology, China.
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Franco EJ, Drusano GL, Hanrahan KC, Warfield KL, Brown AN. Combination Therapy with UV-4B and Molnupiravir Enhances SARS-CoV-2 Suppression. Viruses 2023; 15:1175. [PMID: 37243261 PMCID: PMC10224493 DOI: 10.3390/v15051175] [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: 04/25/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The host targeting antiviral, UV-4B, and the RNA polymerase inhibitor, molnupiravir, are two orally available, broad-spectrum antivirals that have demonstrated potent activity against SARS-CoV-2 as monotherapy. In this work, we evaluated the effectiveness of UV-4B and EIDD-1931 (molnupiravir's main circulating metabolite) combination regimens against the SARS-CoV-2 beta, delta, and omicron BA.2 variants in a human lung cell line. Infected ACE2 transfected A549 (ACE2-A549) cells were treated with UV-4B and EIDD-1931 both as monotherapy and in combination. Viral supernatant was sampled on day three when viral titers peaked in the no-treatment control arm, and levels of infectious virus were measured by plaque assay. The drug-drug effect interaction between UV-4B and EIDD-1931 was also defined using the Greco Universal Response Surface Approach (URSA) model. Antiviral evaluations demonstrated that treatment with UV-4B plus EIDD-1931 enhanced antiviral activity against all three variants relative to monotherapy. These results were in accordance with those obtained from the Greco model, as these identified the interaction between UV-4B and EIDD-1931 as additive against the beta and omicron variants and synergistic against the delta variant. Our findings highlight the anti-SARS-CoV-2 potential of UV-4B and EIDD-1931 combination regimens, and present combination therapy as a promising therapeutic strategy against SARS-CoV-2.
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Affiliation(s)
- Evelyn J. Franco
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA; (E.J.F.); (G.L.D.); (K.C.H.)
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA
| | - George L. Drusano
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA; (E.J.F.); (G.L.D.); (K.C.H.)
| | - Kaley C. Hanrahan
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA; (E.J.F.); (G.L.D.); (K.C.H.)
| | | | - Ashley N. Brown
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA; (E.J.F.); (G.L.D.); (K.C.H.)
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA
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Seymen AA, Gulten E, Ozgur E, Ortaç B, Akdemir I, Cinar G, Saricaoglu EM, Guney-Esken G, Akkus E, Can F, Karahan ZC, Azap A, Tuncay E. Clinical evaluation of DIAGNOVIR SARS-CoV-2 ultra-rapid antigen test performance compared to PCR-based testing. Sci Rep 2023; 13:4438. [PMID: 36932107 PMCID: PMC10021059 DOI: 10.1038/s41598-023-31177-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/07/2023] [Indexed: 03/19/2023] Open
Abstract
Coronavirus Disease-19 (COVID-19) is a highly contagious infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The development of rapid antigen tests has contributed to easing the burden on healthcare and lifting restrictions by detecting infected individuals to help prevent further transmission of the virus. We developed a state-of-art rapid antigen testing system, named DIAGNOVIR, based on immune-fluorescence analysis, which can process and give the results in a minute. In our study, we assessed the performance of the DIAGNOVIR and compared the results with those of the qRT-PCR test. Our results demonstrated that the sensitivity and specificity of the DIAGNOVIR were 94% and 99.2%, respectively, with a 100% sensitivity and 96.97% specificity, among asymptomatic patients. In addition, DIAGNOVIR can detect SARS‑CoV‑2 with 100% sensitivity up to 5 days after symptom onset. We observed that the DIAGNOVIR Rapid Antigen Test's limit of detection (LoD) was not significantly affected by the SARS‑CoV‑2 variants including Wuhan, alpha (B1.1.7), beta (B.1.351), delta (B.1.617.2) and omicron (B.1.1.529) variants, and LoD was calculated as 8 × 102, 6.81 × 101.5, 3.2 × 101.5, 1 × 103, and 1 × 103.5 TCID50/mL, respectively. Our results indicated that DIAGNOVIR can detect all SARS-CoV-2 variants in just seconds with higher sensitivity and specificity lower testing costs and decreased turnover time.
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Affiliation(s)
- Ali Aytac Seymen
- EA Teknoloji LLC Bilkent CyberPark, 06800, Ankara, Turkey
- Felisya Biyomedikal, Bilkent, 06800, Ankara, Turkey
- Institute of Materials Science and Nanotechnology, National Nanotechnology Research Center (UNAM), Bilkent University, Ankara, 06800, Turkey
| | - Ezgi Gulten
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey
| | - Erol Ozgur
- EA Teknoloji LLC Bilkent CyberPark, 06800, Ankara, Turkey
- James C. Wyant College of Optical Sciences, University of Arizona, Tucson, AZ, 85721, USA
| | - Bülend Ortaç
- EA Teknoloji LLC Bilkent CyberPark, 06800, Ankara, Turkey
- Institute of Materials Science and Nanotechnology, National Nanotechnology Research Center (UNAM), Bilkent University, Ankara, 06800, Turkey
| | - Irem Akdemir
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey
| | - Gule Cinar
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey
| | - Elif Mukime Saricaoglu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey
| | - Gulen Guney-Esken
- Koc University IsBank Research Center for Infectious Diseases (KUISCID), Istanbul, Turkey
| | - Erman Akkus
- Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey
| | - Fusun Can
- School of Medicine, Department of Medical Microbiology, Koc University, Istanbul, Turkey
- Koc University IsBank Research Center for Infectious Diseases (KUISCID), Istanbul, Turkey
| | - Zeynep Ceren Karahan
- Department of Medical Microbiology, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey
| | - Alpay Azap
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey
| | - Erkan Tuncay
- Departments of Biophysics, Faculty of Medicine, Ankara University, Ankara, 06230, Turkey.
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7
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Mohapatra S, Bhatia S, Senaratna KYK, Jong MC, Lim CMB, Gangesh GR, Lee JX, Giek GS, Cheung C, Yutao L, Luhua Y, Yong NH, Peng LC, Wong JCC, Ching NL, Gin KYH. Wastewater surveillance of SARS-CoV-2 and chemical markers in campus dormitories in an evolving COVID - 19 pandemic. JOURNAL OF HAZARDOUS MATERIALS 2023; 446:130690. [PMID: 36603423 PMCID: PMC9795800 DOI: 10.1016/j.jhazmat.2022.130690] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/08/2022] [Accepted: 12/27/2022] [Indexed: 05/21/2023]
Abstract
In this study, we report the implementation of a comprehensive wastewater surveillance testing program at a university campus in Singapore to identify Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected individuals and the usage of pharmaceuticals and personal care products (PPCPs) as well as other emerging contaminants (ECs). This unique co-monitoring program simultaneously measured SARS-CoV-2 with chemical markers/contaminants as the COVID-19 situation evolved from pandemic to endemic stages, following a nationwide mass vaccination drive. SARS-CoV-2 RNA concentrations in wastewater from campus dormitories were measured using real-time reverse transcription-polymerase chain reaction (RT-qPCR) and corroborated with the number of symptomatic COVID-19 cases confirmed with the antigen rapid test (ART). Consistent results were observed where the concentrations of SARS-CoV-2 RNA detected in wastewater increased proportionately with the number of COVID-19 infected individuals residing on campus. Similarly, a wide range of ECs, including disinfectants and antibiotics, were detected through sensitive liquid chromatography with tandem mass spectrometry (LC-MS/MS) techniques to establish PPCPs consumption patterns during various stages of the COVID-19 pandemic in Singapore. Statistical correlation of SARS-CoV-2 RNA was observed with few ECs belonging to disinfectants, PCPs and antibiotics. A high concentration of disinfectants and subsequent positive correlation with the number of reported cases on the university campus indicates that disinfectants could serve as a chemical marker during such unprecedented times.
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Affiliation(s)
- Sanjeeb Mohapatra
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 CREATE Way, Singapore 138602, Singapore
| | - Sumedha Bhatia
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore
| | | | - Mui-Choo Jong
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore
| | - Chun Min Benjamin Lim
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore
| | - G Reuben Gangesh
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore
| | - Jia Xiong Lee
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore
| | - Goh Shin Giek
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore
| | - Callie Cheung
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore; Department of Civil & Environmental Engineering, National University of Singapore, Engineering Drive 2, 117576, Singapore
| | - Lin Yutao
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore
| | - You Luhua
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 CREATE Way, Singapore 138602, Singapore
| | - Ng How Yong
- Department of Civil & Environmental Engineering, National University of Singapore, Engineering Drive 2, 117576, Singapore
| | - Lim Cheh Peng
- Office of Risk Management and Compliance, National University of Singapore, 119077, Singapore
| | - Judith Chui Ching Wong
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08, 138667, Singapore
| | - Ng Lee Ching
- Environmental Health Institute, National Environment Agency, 11 Biopolis Way, #06-05/08, 138667, Singapore; School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, 637551, Singapore
| | - Karina Yew-Hoong Gin
- NUS Environmental Research Institute, National University of Singapore, T-Lab Building, 5A Engineering Drive 1, 117411, Singapore; Energy and Environmental Sustainability for Megacities (E2S2) Phase II, Campus for Research Excellence and Technological Enterprise (CREATE), 1 CREATE Way, Singapore 138602, Singapore; Department of Civil & Environmental Engineering, National University of Singapore, Engineering Drive 2, 117576, Singapore.
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8
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Abstract
SARS-CoV-2 viral load and detection of infectious virus in the respiratory tract are the two key parameters for estimating infectiousness. As shedding of infectious virus is required for onward transmission, understanding shedding characteristics is relevant for public health interventions. Viral shedding is influenced by biological characteristics of the virus, host factors and pre-existing immunity (previous infection or vaccination) of the infected individual. Although the process of human-to-human transmission is multifactorial, viral load substantially contributed to human-to-human transmission, with higher viral load posing a greater risk for onward transmission. Emerging SARS-CoV-2 variants of concern have further complicated the picture of virus shedding. As underlying immunity in the population through previous infection, vaccination or a combination of both has rapidly increased on a global scale after almost 3 years of the pandemic, viral shedding patterns have become more distinct from those of ancestral SARS-CoV-2. Understanding the factors and mechanisms that influence infectious virus shedding and the period during which individuals infected with SARS-CoV-2 are contagious is crucial to guide public health measures and limit transmission. Furthermore, diagnostic tools to demonstrate the presence of infectious virus from routine diagnostic specimens are needed.
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Affiliation(s)
- Olha Puhach
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin Meyer
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Isabella Eckerle
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
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9
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Bramble J, Fulk A, Saenz R, Agusto FB. Exploring the role of superspreading events in SARS-CoV-2 outbreaks. J Theor Biol 2023; 558:111353. [PMID: 36396116 PMCID: PMC9661548 DOI: 10.1016/j.jtbi.2022.111353] [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: 06/30/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
The novel coronavirus SARS-CoV-2 emerged in 2019 and subsequently spread throughout the world, causing over 600 million cases and 6 million deaths as of September 7th, 2022. Superspreading events (SSEs), defined here as public or social events that result in multiple infections over a short time span, have contributed to SARS-CoV-2 spread. In this work, we compare the dynamics of SSE-dominated SARS-CoV-2 outbreaks, defined here as outbreaks with relatively higher SSE rates, to the dynamics of non-SSE-dominated SARS-CoV-2 outbreaks. To accomplish this, we derive a continuous-time Markov chain (CTMC) SARS-CoV-2 model from an ordinary differential equation (ODE) SARS-CoV-2 model and incorporate SSEs using an events-based framework. We simulate our model under multiple scenarios using Gillespie's direct algorithm. The first scenario excludes hospitalization and quarantine; the second scenario includes hospitalization, quarantine, premature hospital discharge, and quarantine violation; and the third scenario includes hospitalization and quarantine but excludes premature hospital discharge and quarantine violation. We also vary quarantine violation rates. Results indicate that, with either no control or imperfect control, SSE-dominated outbreaks are more variable but less severe than non-SSE-dominated outbreaks, though the most severe SSE-dominated outbreaks are more severe than the most severe non-SSE-dominated outbreaks. We measure severity by the time it takes for 50 active infections to be achieved; more severe outbreaks do so more quickly. SSE-dominated outbreaks are also more sensitive to control measures, with premature hospital discharge and quarantine violation substantially reducing control measure effectiveness.
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Affiliation(s)
- Jordan Bramble
- Department of Mathematics, University of Kansas, Lawrence, KS, United States of America
| | - Alexander Fulk
- Department of Ecology and Evolutionary Biology, University of Kansas, Lawrence, KS, United States of America
| | - Raul Saenz
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Folashade B Agusto
- Department of Ecology and Evolutionary Biology, University of Kansas, Lawrence, KS, United States of America.
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10
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Sirijatuphat R, Leelarasamee A, Puangpet T, Thitithanyanont A. A Pilot Study of 0.4% Povidone-Iodine Nasal Spray to Eradicate SARS-CoV-2 in the Nasopharynx. Infect Drug Resist 2022; 15:7529-7536. [PMID: 36575672 PMCID: PMC9790155 DOI: 10.2147/idr.s391630] [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: 10/04/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to evaluate the virucidal efficacy of 0.4% povidone-iodine (PVP-I) nasal spray against SARS-CoV-2 in the patients' nasopharynx at 3 minutes and 4 hours after PVP-I exposure. Patients and Methods The study was an open-label, before and after design, single-arm pilot study of adult patients with RT-PCR-confirmed COVID-19 within 24 hours. All patients received three puffs of 0.4% PVP-I nasal spray in each nostril. Nasopharyngeal (NP) swabs were collected before the PVP-I spray (baseline, left NP samples), and at 3 minutes (left and right NP samples) and 4 hours post-PVP-I spray (right NP samples). All swabs were coded to blind assessors and transported to diagnostic laboratory and tested by RT-PCR and cultured to measure the viable SARS-CoV-2 within 24 hours after collection. Results Fourteen patients were enrolled but viable SARS-CoV-2 was cultured from 12 patients (85.7%). The median viral titer at baseline was 3.5 log TCID50/mL (IQR 2.8-4.0 log TCID50/mL). At 3 minutes post-PVP-I spray via the left nostril, viral titers were reduced in 8 patients (66.7%). At 3 minutes post-PVP-I, the median viral titer was 3.4 log TCID50/mL (IQR 1.8-4.4 log TCID50/mL) (P=0.162). At 4 hours post-PVP-I spray via the right nostril, 6 of 11 patients (54.5%) had either the same or minimal change in viral titers. The median viral titer 3 minutes post-PVP-I spray was 2.7 log TCID50/mL (IQR 2.0-3.9 log TCID50/mL). Four hours post-PVP-I spray the median titer was 2.8 log TCID50/mL (IQR 2.2-3.9 log TCID50/mL) (P=0.704). No adverse effects of 0.4% PVP-I nasal spray were detected. Conclusion The 0.4% PVP-I nasal spray demonstrated minimal virucidal efficacy at 3 minutes post-exposure. At 4 hours post-exposure, the viral titer was considerably unchanged from baseline in 10 cases. The 0.4% PVP-I nasal spray showed poor virucidal activity and is unlikely to reduce transmission of SARS-CoV-2 in prophylaxis use.
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Affiliation(s)
- Rujipas Sirijatuphat
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Amorn Leelarasamee
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Faculty of Medicine, Siam University, Bangkok, Thailand,Correspondence: Amorn Leelarasamee, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Thanon Wang Lang, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand, Tel/Fax +66 2 419 7783, Email
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11
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D'Aoust PM, Tian X, Towhid ST, Xiao A, Mercier E, Hegazy N, Jia JJ, Wan S, Kabir MP, Fang W, Fuzzen M, Hasing M, Yang MI, Sun J, Plaza-Diaz J, Zhang Z, Cowan A, Eid W, Stephenson S, Servos MR, Wade MJ, MacKenzie AE, Peng H, Edwards EA, Pang XL, Alm EJ, Graber TE, Delatolla R. Wastewater to clinical case (WC) ratio of COVID-19 identifies insufficient clinical testing, onset of new variants of concern and population immunity in urban communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158547. [PMID: 36067855 PMCID: PMC9444156 DOI: 10.1016/j.scitotenv.2022.158547] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/10/2022] [Accepted: 09/01/2022] [Indexed: 05/14/2023]
Abstract
Clinical testing has been the cornerstone of public health monitoring and infection control efforts in communities throughout the COVID-19 pandemic. With the anticipated reduction of clinical testing as the disease moves into an endemic state, SARS-CoV-2 wastewater surveillance (WWS) will have greater value as an important diagnostic tool. An in-depth analysis and understanding of the metrics derived from WWS is required to interpret and utilize WWS-acquired data effectively (McClary-Gutierrez et al., 2021; O'Keeffe, 2021). In this study, the SARS-CoV-2 wastewater signal to clinical cases (WC) ratio was investigated across seven cities in Canada over periods ranging from 8 to 21 months. This work demonstrates that significant increases in the WC ratio occurred when clinical testing eligibility was modified to appointment-only testing, identifying a period of insufficient clinical testing (resulting in a reduction to testing access and a reduction in the number of daily tests) in these communities, despite increases in the wastewater signal. Furthermore, the WC ratio decreased significantly in 6 of the 7 studied locations, serving as a potential signal of the emergence of the Alpha variant of concern (VOC) in a relatively non-immunized community (40-60 % allelic proportion), while a more muted decrease in the WC ratio signaled the emergence of the Delta VOC in a relatively well-immunized community (40-60 % allelic proportion). Finally, a significant decrease in the WC ratio signaled the emergence of the Omicron VOC, likely because of the variant's greater effectiveness at evading immunity, leading to a significant number of new reported clinical cases, even when community immunity was high. The WC ratio, used as an additional monitoring metric, could complement clinical case counts and wastewater signals as individual metrics in its potential ability to identify important epidemiological occurrences, adding value to WWS as a diagnostic technology during the COVID-19 pandemic and likely for future pandemics.
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Affiliation(s)
- Patrick M D'Aoust
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Xin Tian
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | | | - Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - Elisabeth Mercier
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Nada Hegazy
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Jian-Jun Jia
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Shen Wan
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Md Pervez Kabir
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Wanting Fang
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Meghan Fuzzen
- Department of Biology, University of Waterloo, Waterloo, Canada
| | - Maria Hasing
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Minqing Ivy Yang
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Canada
| | - Jianxian Sun
- Department of Chemistry, University of Toronto, Toronto, Canada
| | - Julio Plaza-Diaz
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Zhihao Zhang
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Aaron Cowan
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada
| | - Walaa Eid
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Sean Stephenson
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Mark R Servos
- Department of Biology, University of Waterloo, Waterloo, Canada
| | - Matthew J Wade
- Data, Analytics and Surveillance Group, UK Health Security Agency, London, United Kingdom
| | - Alex E MacKenzie
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Hui Peng
- Department of Chemistry, University of Toronto, Toronto, Canada
| | - Elizabeth A Edwards
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Canada
| | - Xiao-Li Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Eric J Alm
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - Tyson E Graber
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Robert Delatolla
- Department of Civil Engineering, University of Ottawa, Ottawa, Canada.
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12
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Zhao J, Zhu J, Huang C, Zhu X, Zhu Z, Wu Q, Yuan R. Uncovering the information immunology journals transmitted for COVID-19: A bibliometric and visualization analysis. Front Immunol 2022; 13:1035151. [PMID: 36405695 PMCID: PMC9670819 DOI: 10.3389/fimmu.2022.1035151] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/17/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Since the global epidemic of the coronavirus disease 2019 (COVID-19), a large number of immunological studies related to COVID-19 have been published in various immunology journals. However, the results from these studies were discrete, and no study summarized the important immunological information about COVID-19 released by these immunology journals. This study aimed to comprehensively summarize the knowledge structure and research hotspots of COVID-19 published in major immunology journals through bibliometrics. METHODS Publications on COVID-19 in major immunology journals were obtained from the Web of Science Core Collection. CiteSpace, VOSviewer, and R-bibliometrix were comprehensively used for bibliometric and visual analysis. RESULTS 1,331 and 5,000 publications of 10 journals with high impact factors and 10 journals with the most papers were included, respectively. The USA, China, England, and Italy made the most significant contributions to these papers. University College London, National Institute of Allergy and Infectious Diseases, Harvard Medical School, University California San Diego, and University of Pennsylvania played a central role in international cooperation in the immunology research field of COVID-19. Yuen Kwok Yung was the most important author in terms of the number of publications and citations, and the H-index. CLINICAL INFECTIOUS DISEASES and FRONTIERS IN IMMUNOLOGY were the most essential immunology journals. These immunology journals mostly focused on the following topics: "Delta/Omicron variants", "cytokine storm", "neutralization/neutralizing antibody", "T cell", "BNT162b2", "mRNA vaccine", "vaccine effectiveness/safety", and "long COVID". CONCLUSION This study systematically uncovered a holistic picture of the current research on COVID-19 published in major immunology journals from the perspective of bibliometrics, which will provide a reference for future research in this field.
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Affiliation(s)
- Jiefeng Zhao
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jinfeng Zhu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chao Huang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaojian Zhu
- Center for Digestive Disease, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Zhengming Zhu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qinrong Wu
- Department of General Surgery, Yingtan City People’s Hospital, Yingtan, Jiangxi, China
| | - Rongfa Yuan
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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13
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Gunawardana M, Webster S, Rivera S, Cortez JM, Breslin J, Pinales C, Buser C, Ibarrondo FJ, Yang OO, Bobardt M, Gallay PA, Adler AP, Ramirez CM, Anton PA, Baum MM. Early SARS-CoV-2 dynamics and immune responses in unvaccinated participants of an intensely sampled longitudinal surveillance study. COMMUNICATIONS MEDICINE 2022; 2:129. [PMID: 36238348 PMCID: PMC9553075 DOI: 10.1038/s43856-022-00195-4] [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: 03/10/2022] [Accepted: 09/29/2022] [Indexed: 11/08/2022] Open
Abstract
Background A comprehensive understanding of the SARS-CoV-2 infection dynamics and the ensuing host immune responses is needed to explain the pathogenesis as it relates to viral transmission. Knowledge gaps exist surrounding SARS-CoV-2 in vivo kinetics, particularly in the earliest stages after exposure. Methods An ongoing, workplace clinical surveillance study was used to intensely sample a small cohort longitudinally. Nine study participants who developed COVID-19 between November, 2020 and March, 2021 were monitored at high temporal resolution for three months in terms of viral loads as well as associated inflammatory biomarker and antibody responses. CD8 + T cells targeting SARS-CoV-2 in blood samples from study participants were evaluated. Results Here we show that the resulting datasets, supported by Bayesian modeling, allowed the underlying kinetic processes to be described, yielding a number of unexpected findings. Early viral replication is rapid (median doubling time, 3.1 h), providing a narrow window between exposure and viral shedding, while the clearance phase is slow and heterogeneous. Host immune responses different widely across participants. Conclusions Results from our small study give a rare insight into the life-cycle of COVID-19 infection and hold a number of important biological, clinical, and public health implications.
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Affiliation(s)
- Manjula Gunawardana
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - Simon Webster
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - Sofia Rivera
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - John M. Cortez
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - Jessica Breslin
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - Cristian Pinales
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - Christopher Buser
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - F. Javier Ibarrondo
- University of California, Los Angeles (UCLA), Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Otto O. Yang
- University of California, Los Angeles (UCLA), Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
- University of California, Los Angeles (UCLA), Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA USA
| | - Michael Bobardt
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA USA
| | - Philippe A. Gallay
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA USA
| | - Amy P. Adler
- Jumpstart Research Consulting, LLC, Santa Fe, NM USA
| | - Christina M. Ramirez
- University of California, Los Angeles (UCLA), Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA USA
| | - Peter A. Anton
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
| | - Marc M. Baum
- Department of Chemistry, Oak Crest Institute of Science, 128–132W. Chestnut Ave., Monrovia, CA USA
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14
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Go RC, Nyirenda T. Hydroxychloroquine, azithromycin and methylprednisolone and in hospital survival in severe COVID-19 pneumonia. Front Pharmacol 2022; 13:935370. [PMID: 36238570 PMCID: PMC9551186 DOI: 10.3389/fphar.2022.935370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/07/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction: Severe COVID-19 pneumonia has two phases that are not mutually exclusive. Repurposed drugs target only one phase and the association of combination therapy to survival is unknown. Objective: To determine the association of hydroxychloroquine, azithromycin, and methylprednisolone versus methylprednisolone only to in hospital survival. Methods: This is a secondary analysis of a retrospective cohort of patients admitted for severe covid-19 in 13 hospitals in New Jersey, United States from March–June 2020. Propensity score match with 11 variables was constructed between those who received no methylprednisolone and methylprednisolone. Multivariate Cox regression was used for risk of in hospital mortality. Measurements and main results: There were 759 patients, 380 in no methylprednisolone and 379 with methylprednisolone. Multivariate Cox regression shows that methylprednisolone, hydroxychloroquine, and azithromycin had prolonged survival compared to methylprednisolone alone [HR 0.45 (95% CI 0.22,0.91 p < 0.03)]. In patients who received hydroxychloroquine and azithromycin, those who also received high dose methylprednisolone were associated with worse survival compared to those who received low dose methylprednisolone (HR = 1.642; 95% CI 1.053 to 2.562; p = 0.0287). Nursing home residents [HR 2.77 (95% CI 1.67, 4.59 p < 0.0001)], coronary artery disease [HR 2.93 (95% CI 1.31, 3.15 p = 0.001), and invasive mechanical ventilation [HR 3.02 (95% CI 1.71,5.34 p = 0.0001)] were independently associated with worse survival. Conclusion: Combination therapy was associated with improved survival compared to monotherapy. However, nursing home residents, coronary artery disease, and mechanical ventilation were independently associated with mortality. Larger randomized controlled studies are needed to confirm conclusions.
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Affiliation(s)
- Ronaldo C. Go
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Hackensack University Medical Center, Hackensack, NJ, United States
- Department of Critical Care, Robert Wood Johnson Barnabas Health, Hamilton, NJ, United States
- *Correspondence: Ronaldo C. Go,
| | - Themba Nyirenda
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Hackensack University Medical Center, Hackensack, NJ, United States
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15
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Sirijatuphat R, Leelarasamee A, Horthongkham N. Prevalence and factors associated with COVID-19 among healthcare workers at a university hospital in Thailand. Medicine (Baltimore) 2022; 101:e30837. [PMID: 36197236 PMCID: PMC9508950 DOI: 10.1097/md.0000000000030837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Globally, healthcare workers (HCWs) have a high risk of SARS-CoV-2 infection, but less is known about healthcare workers in Thailand. We estimated the prevalence and risk factors for COVID-19 among HCWs in Bangkok, Thailand. A retrospective cohort study was conducted at a large tertiary care academic hospital in Thailand from May 2020 to May 2021. HCWs that presented with fever and/or acute respiratory tract symptoms who tested with RT-PCR were identified, and their clinical data were collected. There were 1432 HCWs with fever and/or acute respiratory tract symptoms during May 2020 and May 2021. A total of 167 patients were front-line HCWs and 1265 were non-front-line HCWs. Sixty HCWs (4.2%) developed COVID-19; 2 were front-line and 58 were non-front-line HCWs. The prevalence of COVID-19 in front-line HCWs was 1.7% (2/167), and 4.6% (58/1265) in non-front-line HCWs (P = .04). In addition, non-front-line HCWs, non-medical staffs, history of contact with a confirmed COVID-19 case at home/family, unvaccinated status, fair compliance to personal protective equipment (PPE) standard, and initial presentation with pneumonia were significantly more common in HCWs with COVID-19 than those without COVID-19 (P < .05). Front-line HCWs, history of contact with a confirmed COVID-19 case at the clinical care areas in the hospital, vaccinated status, good compliance to PPE standards, and initial presentation with upper respiratory infection were significantly more common in HCWs without COVID-19 than those with COVID-19 (P < .05). Multivariate analysis revealed history of exposure with confirmed COVID-19 case at home or in family, unvaccinated status, non-frontline-HCWs, non-medical staffs, and fair compliance to PPE standard to be independent factors associated with COVID-19 in HCWs. COVID-19 was more common in non-front-line HCWs at this tertiary hospital. Thai guidelines on infection prevention and control for COVID-19 seem to be effective in preventing SARS-CoV-2 transmission. Therefore, the adherence to these recommendations should be encouraged.
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Affiliation(s)
- Rujipas Sirijatuphat
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- *Correspondence: Rujipas Sirijatuphat, Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand (e-mail: )
| | - Amorn Leelarasamee
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Faculty of Medicine, Siam University, Bangkok, Thailand
| | - Navin Horthongkham
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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16
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Performance Analysis of Self-Collected Nasal and Oral Swabs for Detection of SARS-CoV-2. Diagnostics (Basel) 2022; 12:diagnostics12102279. [PMID: 36291968 PMCID: PMC9600397 DOI: 10.3390/diagnostics12102279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third highly pathogenic human coronavirus and is rapidly transmitted by infected individuals regardless of their symptoms. During the COVID-19 pandemic, owing to the dearth of skilled healthcare workers (HCWs) to collect samples for early diagnosis, self-collection emerged as a viable alternative. To evaluate the reliability of self-collection, we compared the virus detection rate using 3990 self-collected swabs and HCW-collected swabs, procured from the same individuals and collected immediately after the self-collection. The results of multiplex reverse-transcription quantitative polymerase chain reaction revealed that the viral load in the HCW-collected swabs was marginally (18.4–28.8 times) higher than that in self-collected swabs. Self-collection showed no significant difference in sensitivity and specificity from HCW-collection (κ = 0.87, McNemar’s test; p = 0.19), indicating a comparable performance. These findings suggest that self-collected swabs are acceptable substitutes for HCW-collected swabs, and that their use improved the specimen screening efficiency and reduced the risk of SARS-CoV-2 infection among HCWs during and after the COVID-19 pandemic.
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17
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Agrawal D, Saigal S. Utilization of SARS-COV-2 positive donors and recipients for liver transplantation in the pandemic era - An evidence-based review. JOURNAL OF LIVER TRANSPLANTATION 2022; 7:100081. [PMID: 38620745 PMCID: PMC8915505 DOI: 10.1016/j.liver.2022.100081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 12/24/2022] Open
Abstract
The current SARS-COV-2 pandemic led to a drastic drop in liver donation and transplantation in DDLT and LDLT settings. Living donations have decreased more than deceased organ donation due to the need to protect the interest of donors. In the SARS-COV-2 pandemic, major professional societies worldwide recommended against the use of organs from donors with acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The basis for these recommendations are; SARS-CoV-2 could be transmitted to the recipient through organ transplantation and can result in severe manifestations; only limited effective targeted therapies are available, risk of transmission to the healthcare professionals, logistical limitations, and ethical concerns. In addition, end-stage liver disease patients on the waiting list represent vulnerable populations and are at higher risk for severe COVID-19 infection. Therefore, deferring life-saving transplants from COVID-positive donors during a pandemic may lead to more collateral damage by causing disease progression, increased death, and dropout from the waitlist. As this SARS-COV-2 pandemic is likely to stay with us for some time, we have to learn to co-exist with it. We believe that utilizing organs from mild/ asymptomatic COVID19 positive donors may expand the organ donor pool and mitigate disruptions in transplantation services during this pandemic.
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Affiliation(s)
- Dhiraj Agrawal
- Department of Gastroenterology and hepatology, PACE Hospitals, HITEC city, Hyderabad 500081, India
| | - Sanjiv Saigal
- Hepatology and Liver Transplant, Center for Liver & Biliary Sciences, Center of Gastroenterology, Hepatology & Endoscopy, Max Super Speciality Hospital, Saket, New Delhi 110017, India
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18
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Hu Z, Yin Y, Wang K, Xu M, Ding C, Song Y, Yi C, Li J, Yi Y, Peng Z. Impact of inactivated COVID-19 vaccines on viral shedding in B.1.617.2 (Delta) variant-infected patients. SCIENCE CHINA LIFE SCIENCES 2022; 65:2556-2559. [PMID: 35717433 PMCID: PMC9206421 DOI: 10.1007/s11427-021-2115-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/22/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Zhiliang Hu
- Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yi Yin
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Kai Wang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Miaomiao Xu
- Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China
| | - Chengyuan Ding
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yan Song
- Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China
| | - Changhua Yi
- Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China
| | - Junwei Li
- Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China
| | - Yongxiang Yi
- Nanjing Infectious Disease Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003, China.
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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19
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Alshukairi AN, Al-Omari A, Al-Tawfiq JA, El-Kafrawy SA, El-Daly MM, Hassan AM, Faizo AA, Alandijany TA, Dada A, Saeedi MF, Alhamlan FS, Al Hroub MK, Qushmaq I, Azhar EI. Active viral shedding in a vaccinated hospitalized patient infected with the delta variant (B.1.617.2) of SARS-CoV-2 and challenges of de-isolation. J Infect Public Health 2022; 15:628-630. [PMID: 35576779 PMCID: PMC9047479 DOI: 10.1016/j.jiph.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 12/02/2022] Open
Abstract
In the era of SARS-CoV-2 variants and COVID-19 vaccination, the duration of infectious viral shedding and isolation in post vaccine breakthrough infections is challenging and depends on disease severity. The current study described a case of SARS-CoV-2 Delta variant pneumonia requiring hospitalization. The patient received two doses of BNT162b2 COVID-19 vaccines, and he had positive SARS-CoV-2 viral cultures 12 days post symptom onset. The time between the second dose of vaccine and the breakthrough infection was 6 months. While immunosuppression is a known risk factor for prolonged infectious viral shedding, age and time between vaccination and breakthrough infection are important risk factors that warrant further studies.
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Affiliation(s)
- Abeer N Alshukairi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; College of Medicine, AlFaisal University, Riyadh, Saudi Arabia.
| | - Awad Al-Omari
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia; Department of Critical Care, Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Sherif A El-Kafrawy
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Mai M El-Daly
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Ahmed M Hassan
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arwa A Faizo
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Thamir A Alandijany
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
| | - Ashraf Dada
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammed F Saeedi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Fatma S Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohammad K Al Hroub
- Department of Infection Control and Hospital Epidemiology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ismael Qushmaq
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Esam I Azhar
- Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia
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20
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Ye Q, Shao W, Meng H. Performance and Application Evaluation of SARS-CoV-2 Antigen Assay. J Med Virol 2022; 94:3548-3553. [PMID: 35445404 PMCID: PMC9088371 DOI: 10.1002/jmv.27798] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 11/22/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) nucleic acid detection is the gold standard for the laboratory diagnosis of coronavirus disease 2019 (COVID‐19). However, this method has high requirements for practitioners' skills and testing sites, so it is not easy to popularize and promote the application in places other than large hospitals. In addition, the detection flux of SARS‐CoV‐2 nucleic acid is small, and the whole detection process takes much time, which cannot meet the actual needs of rapid screening in large quantities. The WHO conditionally approved a batch of SARS‐CoV‐2 antigen reagents for clinical application to alleviate this contradiction. SARS‐CoV‐2 antigen detection offers a trade‐off among clinical performance, speed and accessibility. With the gradual increase in clinical application, the accumulated clinical data show that the sensitivity and specificity of the SARS‐CoV‐2 antigen assay are over 80% and 97%, respectively, which can basically meet the requirements of the WHO. However, the sensitivity of the SARS‐CoV‐2 Antigen Assay among asymptomatic people in low prevalence areas of COVID‐19 cannot meet the standard, leading to a large number of missed diagnoses. In addition, the detection ability of SARS‐CoV‐2 antigen reagent for different SARS‐CoV‐2 mutant strains differs greatly, especially for those escaping the COVID‐19 vaccines. In terms of results interpretation, it is highly reliable to exclude SARS‐CoV‐2 infection based on the high negative predictive value of the SARS‐CoV‐2 antigen assay. However, in the low prevalence environment, the probability of false positives of the SARS‐CoV‐2 antigen assay is high, so the positive results need to be confirmed by the SARS‐CoV‐2 nucleic acid reagent. The SARS‐CoV‐2 antigen assay is only a supplement to SARS‐CoV‐2 nucleic acid detection and can never completely replace it. To date, SARS‐CoV‐2 nucleic acid detection continues to be the standard laboratory method for COVID‐19 diagnosis.
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Affiliation(s)
- Qing Ye
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
| | - Wenxia Shao
- Department of Clinical Laboratory, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hanyan Meng
- Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, 310052, China
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21
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Puhach O, Adea K, Hulo N, Sattonnet P, Genecand C, Iten A, Bausch FJ, Kaiser L, Vetter P, Eckerle I, Meyer B. Infectious viral load in unvaccinated and vaccinated individuals infected with ancestral, Delta or Omicron SARS-CoV-2. Nat Med 2022; 28:1491-1500. [PMID: 35395151 DOI: 10.1038/s41591-022-01816-0] [Citation(s) in RCA: 195] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/06/2022] [Indexed: 11/09/2022]
Abstract
Infectious viral load (VL) expelled as droplets and aerosols by infected individuals partly determines SARS-CoV-2 transmission. RNA VL measured by qRT-PCR is only a weak proxy for infectiousness. Studies on the kinetics of infectious VL are important to understand the mechanisms behind the different transmissibility of SARS-CoV-2 variants and the effect of vaccination on transmission, which allows to guide public health measures. In this study we quantified infectious VL in SARS-CoV-2 infected individuals during the first 5 symptomatic days by in vitro culturability assay in unvaccinated or vaccinated individuals infected with pre-variant of concern (pre-VOC) SARS-CoV-2, Delta, or Omicron. Unvaccinated individuals infected with pre-VOC SARS-CoV-2 had lower infectious VL compared to Delta-infected unvaccinated individuals. Full vaccination (defined as >2weeks after reception of 2nd dose during primary vaccination series) significantly reduced infectious VL for Delta breakthrough cases compared to unvaccinated individuals. For Omicron breakthrough cases, reduced infectious VL was only observed in boosted but not in fully vaccinated individuals compared to unvaccinated subjects. In addition, infectious VL was lower in fully vaccinated Omicron- compared to fully vaccinated Delta-infected individuals, suggesting that other mechanisms than increased infectious VL contribute to the high infectiousness of SARS-CoV-2 Omicron. Our findings indicate that vaccines may lower transmission risk and therefore have a public health benefit beyond the individual protection from severe disease.
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Affiliation(s)
- Olha Puhach
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Kenneth Adea
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicolas Hulo
- Service for Biomathematical and Biostatistical Analyses, Institute of Genetics and Genomics, University of Geneva, Geneva, Switzerland
| | - Pascale Sattonnet
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Camille Genecand
- Cantonal Health Service, General Directorate for Health, Geneva, Switzerland
| | - Anne Iten
- Service of Prevention and Infection Control, Directorate of Medicine and Quality, University Hospital Geneva, HUG, Geneva, Switzerland
| | - Frédérique Jacquérioz Bausch
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.,Primary Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Kaiser
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.,Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Pauline Vetter
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland. .,Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
| | - Isabella Eckerle
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland. .,Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland. .,Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
| | - Benjamin Meyer
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland.
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22
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Antiviral Used among Non-Severe COVID-19 Cases in Relation to Time till Viral Clearance: A Retrospective Cohort Study. Antibiotics (Basel) 2022; 11:antibiotics11040498. [PMID: 35453248 PMCID: PMC9030807 DOI: 10.3390/antibiotics11040498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/26/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Background: The WHO identified COVID-19 as a fast-growing epidemic worldwide. A few antivirals have shown promising effectiveness in treating COVID-19. This study aimed to assess the correlation between antiviral drugs and the time until viral clearance of SARS-CoV-2. (2) Methods: This was a retrospective cohort study that included 1731 non-severe COVID-19 patients treated in NMC Royal Hospital, UAE. (3) Results: A total of 1446 patients received symptomatic treatment only (mean age of 35.6 ± 9.0 years). The analyzed antiviral treatment protocols were azithromycin, hydroxychloroquine, lopinavir/ritonavir, and favipiravir. The produced Kaplan–Meier plots showed no significant differences in the time until viral clearance among the compared protocols, which showed overlapping confidence intervals, which were determined by performing the log-rank and adjusted pairwise log-rank tests (p = 0.2, log-rank = 9.3). The age and gender of patients did not significantly affect the rate of viral clearance regardless of the antiviral therapy administered, even when compared to patients who received symptomatic treatment only, with the exception of hydroxychloroquine (HCQ), azithromycin, and favipiravir, which increased the odds of a faster rate of viral clearance by 46% after adjustments. (4) Conclusions: No significant differences were observed regarding the time until viral clearance among non-severe COVID-19 patients following the prescription of different antiviral drugs.
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23
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van der Velden FJS, van Delft F, Owens S, Llevadias J, McKean M, Pulford L, Taha Y, Williamson G, Campbell-Hewson Q, Hambleton S, Payne R, Duncan C, Johnston C, Spegarova J, Emonts M. Case Report: Severe Acute Pulmonary COVID-19 in a Teenager Post Autologous Hematopoietic Stem Cell Transplant. Front Pediatr 2022; 10:809061. [PMID: 35311038 PMCID: PMC8927762 DOI: 10.3389/fped.2022.809061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/27/2022] [Indexed: 12/15/2022] Open
Abstract
Pulmonary severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is generally described as mild, and SARS-CoV-2 infection in immunocompromised children are observed as generally mild as well. A small proportion of pediatric patients will become critically ill due to (cardio)respiratory failure and require intensive care treatment. We report the case of a teenager with Hodgkin's lymphoma who acquired SARS-CoV-2 (detected by PCR) on the day of her autologous stem cell transplant and developed acute respiratory distress syndrome, successfully treated with a combination of antivirals, immunomodulation with steroids and biologicals, and ECMO.
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Affiliation(s)
- Fabian J. S. van der Velden
- Paediatric Immunology, Infectious Diseases and Allergy, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Frederik van Delft
- Paediatric Oncology, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Stephen Owens
- Paediatric Immunology, Infectious Diseases and Allergy, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Judit Llevadias
- Paediatric Intensive Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Michael McKean
- Paediatric Respiratory Department, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Lindsey Pulford
- Paediatric Intensive Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Yusri Taha
- Virology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Grace Williamson
- Paediatric Intensive Care, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Quentin Campbell-Hewson
- Paediatric Oncology, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sophie Hambleton
- Paediatric Immunology, Infectious Diseases and Allergy, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rebecca Payne
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Christopher Duncan
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Infectious Disease and Tropical Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Catriona Johnston
- Pharmacy, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jarmila Spegarova
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Marieke Emonts
- Paediatric Immunology, Infectious Diseases and Allergy, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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24
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Francisco R, Hernandez SM, Mead DG, Adcock KG, Burke SC, Nemeth NM, Yabsley MJ. Experimental Susceptibility of North American Raccoons ( Procyon lotor) and Striped Skunks ( Mephitis mephitis) to SARS-CoV-2. Front Vet Sci 2022; 8:715307. [PMID: 35097038 PMCID: PMC8790025 DOI: 10.3389/fvets.2021.715307] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/20/2021] [Indexed: 12/20/2022] Open
Abstract
Recent spillback events of SARS-CoV-2 from humans to animals has raised concerns about it becoming endemic in wildlife. A sylvatic cycle of SARS-CoV-2 could present multiple opportunities for repeated spillback into human populations and other susceptible wildlife. Based on their taxonomy and natural history, two native North American wildlife species -the striped skunk (Mephitis mephitis) and the raccoon (Procyon lotor) -represent a high likelihood of susceptibility and ecological opportunity of becoming infected with SARS-CoV-2. Eight skunks and raccoons were each intranasally inoculated with one of two doses of the virus (103 PFU and 105 PFU) and housed in pairs. To evaluate direct transmission, a naïve animal was added to each inoculated pair 48 h post-inoculation. Four control animals of each species were handled like the experimental groups. At predetermined intervals, we collected nasal and rectal swabs to quantify virus shed via virus isolation and detect viral RNA via rRT-PCR and blood for serum neutralization. Lastly, animals were euthanized at staggered intervals to describe disease progression through histopathology and immunohistochemistry. No animals developed clinical disease. All intranasally inoculated animals seroconverted, suggesting both species are susceptible to SARS-CoV-2 infection. The highest titers in skunks and raccoons were 1:128 and 1:64, respectively. Low quantities of virus were isolated from 2/8 inoculated skunks for up to day 5 post-inoculation, however no virus was isolated from inoculated raccoons or direct contacts of either species. Neither species had gross lesions, but recovering mild chronic pneumonia consistent with viral insult was recorded histologically in 5/8 inoculated skunks. Unlike another SARS-CoV-2 infection trial in these species, we detected neutralizing antibodies in inoculated raccoons; thus, future wildlife serologic surveillance results must be interpreted with caution. Due to the inability to isolate virus from raccoons, the lack of evidence of direct transmission between both species, and low amount of virus shed by skunks, it seems unlikely for SARS-CoV-2 to become established in raccoon and skunk populations and for virus to spillback into humans. Continued outbreaks in non-domestic species, wild and captive, highlight that additional research on the susceptibility of SARS-CoV-2 in wildlife, especially musteloidea, and of conservation concern, is needed.
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Affiliation(s)
- Raquel Francisco
- Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, United States
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Sonia M. Hernandez
- Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, United States
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Daniel G. Mead
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Kayla G. Adcock
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Sydney C. Burke
- Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, United States
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Nicole M. Nemeth
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Michael J. Yabsley
- Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, United States
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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25
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Gupta S, Sudhindran S, Saraf N, Vijai A, Swaminathan S, Panackel C, Mehta NN, Varghese J, Singh S, Reddy MS, M. Sivaramakrishnan V, Bhangui P, Mohanka R, Asthana S, Rohatgi S. Liver Transplant Society of India Guidelines for Liver Transplant During COVID-19 times. J Clin Exp Hepatol 2022; 12:180-185. [PMID: 34429571 PMCID: PMC8378015 DOI: 10.1016/j.jceh.2021.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/15/2021] [Indexed: 12/12/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19) pandemic has affected liver transplantation in many ways. There is risk of infection to the transplant recipients; and COVID-19 is associated with significant risk of mortality in patients on wait list. The Liver Transplant Society of India (LTSI) has prepared guidelines regarding selection of adult and pediatric patients for liver transplantation, transplant for acute liver failure, use of deceased donor organs, transplant techniques and minimally invasive donor hepatectomy, pre- and postsurgery testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related coronavirus disease 2019 in donors and recipients, role of COVID-19 antibody testing, shifting of recipients from COVID-19 to non-COVID-19 areas after recovery, isolation policy of team members exposed to COVID-19 patients, drug therapy of proven or suspected COVID-19 infection early posttransplant, care of SARS-CoV-2 positive donors and recipients and a separate COVID-19 consent for surgery.
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Affiliation(s)
| | | | - Neeraj Saraf
- Medanta The Medicity, Gurgaon, India,Address for correspondence: Neeraj Saraf. Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta The Medicity Hospital, Sector 38, Gurgaon, Delhi (NCR), India.
| | - Anand Vijai
- GEM Hospital and Research Center, Coimbatore, India
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26
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How can risk of COVID-19 transmission be minimised in domiciliary care for older people: development, parameterisation and initial results of a simple mathematical model. Epidemiol Infect 2021. [PMCID: PMC8755531 DOI: 10.1017/s0950268821002727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This paper proposes and analyses a stochastic model for the spread of an infectious disease transmitted between clients and care workers in the UK domiciliary (home) care setting. Interactions between clients and care workers are modelled using specially generated networks, with network parameters reflecting realistic patterns of care needs and visit allocation. These networks are then used to simulate a susceptible-exposed-infected-recovered/dead (SEIR/D)-type epidemic dynamics with different numbers of infectious and recovery stages. The results indicate that with the same overall capacity provided by care workers, the minimum peak proportion of infection and the smallest overall size of infection are achieved for the highest proportion of overlap between visit allocation, i.e. when care workers have the highest chances of being allocated a visit to the same client they have visited before. An intuitive explanation of this is that while providing the required care coverage, maximising overlap in visit allocation reduces the possibility of an infectious care worker inadvertently spreading the infection to other clients. The model is generic and can be adapted to any directly transmitted infectious disease, such as, more recently, corona virus disease 2019, provided accurate estimates of disease parameters can be obtained from real data.
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27
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Mencacci A, Gili A, Gidari A, Schiaroli E, Russo C, Cenci E, Camilloni B, Graziani A, Melelli-Roia A, Francisci D, Stracci F. Role of Nucleocapsid Protein Antigen Detection for Safe End of Isolation of SARS-CoV-2 Infected Patients with Long Persistence of Viral RNA in Respiratory Samples. J Clin Med 2021; 10:jcm10184037. [PMID: 34575147 PMCID: PMC8469917 DOI: 10.3390/jcm10184037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022] Open
Abstract
Background. In SARS-CoV-2 infection, viral RNA may persist in respiratory samples for several weeks after the resolution of symptoms. Criteria to assess the end of infectivity are not unequivocally defined. In some countries, time from diagnosis is the unique criterion used, in addition to symptom cessation. This study evaluates the role of the Lumipulse® Antigen Assay (LAA) for the safe end of isolation of patients ≥21 days after the diagnosis of infection. Methods. A total of 671 nasopharyngeal swabs from patients diagnosed with infection at least 21 days before were assessed by RT-PCR and LAA, and the role of LAA in predicting the absence of infectivity was evaluated by virus cell culture. Results. Viable virus was present in 10/138 cultured samples. Eight out of ten infective patients suffered from a concomitant disease, predisposing them to long-term shedding of infective virus. In particular, infectious virus was isolated from 10/20 RT-PCR+/LAA+ cultured samples, whereas no viable virus was found in all 118 RT-PCR+/LAA– cultured swabs. LLA and RT-PCR agreed in 484/671 (72.1%) samples, with 100% and 26.7% concordance in RT-PCR negative and positive samples, respectively. Conclusions. Viable virus can be found ≥21 days after diagnosis in immunocompromised or severely ill patients. LAA better than RT-PCR predicts non-infectivity of patients and can be safely used to end isolation in cases with long persistence of viral RNA in the respiratory tract.
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Affiliation(s)
- Antonella Mencacci
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
- Correspondence: (A.M.); (A.G.); Tel.: +39-0755784277 (A.M.); +39-0755858033 (A.G.)
| | - Alessio Gili
- Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
- Correspondence: (A.M.); (A.G.); Tel.: +39-0755784277 (A.M.); +39-0755858033 (A.G.)
| | - Anna Gidari
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Carla Russo
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Elio Cenci
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Barbara Camilloni
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Alessandro Graziani
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Arduino Melelli-Roia
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Daniela Francisci
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Fabrizio Stracci
- Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
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