Evidence of Mpox Virus Infection Among Persons Without Characteristic Lesions or Rash Presenting for First Dose of JYNNEOS Vaccine-District of Columbia, August 2022

We assessed mpox virus prevalence in blood, pharyngeal, and rectal specimens among persons without characteristic rash presenting for JYNNEOS vaccine. Our data indicate that the utility of risk-based screening for mpox in persons without skin lesions or rash via pharyngeal swabs, rectal swabs, and/or blood is likely limited.

Public health and clinical approach to proactive Prevalence of symptoms-based diagnosis of mild SARS-CoV-2 infection in southern Tuscany

Background

To date, it is unknown how many Italians have had or have a mild SARS-CoV-2 infection, because of the lack of epidemiological studies involving the general population.

Study design

Aim of this study was to investigate the prevalence/incidence of a symptoms-based mild SARS-CoV-2 infection in southern Tuscany, by using an online survey.

Methods

An anonymous random middle-aged sample of 3,460 individuals completed the survey. A symptom-score ≥5, calculated on 195 patients with RT-PCR COVID-19 disease (sensitivity/specificity of 0.815/0.780 respectively) was used for the diagnosis.

Results

This cut-off highlighted that 12.3% of all the population might have had a SARS-CoV-2 infection, while 3.9% of them might have it at the time of the survey. Female sex (OR=1.334 [1.029-1.728]; p=0.030), obesity status (OR=1.961 [1.304-2.949]; p=0.001), asthma (OR=2.035 [1.433-2.890]; p=0.0001), autoim-mune diseases (OR=2.103 [1.381-3.201]; p=0.001), were all risk factors for showing mild SARS-CoV-2 infection. Instead, the elderly had a low probability to develop mild forms of the disease (OR=0.984 [0.975-0.994]; p=0.001).

Conclusion

A remarkable number of subjects in Southern Tuscany may have already had a mild SARS-CoV-2 infection. Symptoms scores might be used to screen subjects with a suspected infection. Female sex, obesity, asthma, autoimmune diseases may be factors linked with mild forms of COVID-19 disease.

Application of an optimized pharyngeal swab-assisted device in pharyngeal sampling for COVID-19 patients

Background

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has triggered a global pandemic. Healthcare workers are placed at an elevated risk of nosocomial cross-infection from clinical exposure. One diagnostic criterion for COVID-19 is a positive result from a real-time reverse transcriptase-polymerase chain reaction (qRT-PCR) assay of pharyngeal swab specimens, which has been a routine procedure for healthcare workers during the outbreak. In the context of a global shortage of personal protective equipment (PPE), we aimed to lower the probability of clinical cross-infection without impacting the results of pharynx sampling through an optimized pharyngeal swab assisted device (OPAD).

Methods

To evaluate the efficacy and feasibility of an OPAD for the detection of SARS-CoV-2, 22 confirmed COVID-19 cases were enrolled in our self-controlled study. The results of two pharyngeal sampling qRT-PCR tests using the OPAD or the traditional method were recorded each. Clinical data including baseline characteristics, laboratory tests, and computed tomography (CT) results were also collected. The procedure duration and levels of pharynx exposure with the OPAD, and the diagnostic consistency between the OPAD and the traditional method for pharyngeal sampling qRT-PCR, were evaluated individually. Additionally, a questionnaire was designed for healthcare workers who had performed the pharyngeal swab to deepen our understanding of their attitude during their service on the frontline.

Results

In all 44 samplings (22 samples with each method), the qRT-PCR results of 18 pairs (81.82%) were consistent, while 3 (13.64%) were single positive with the OPAD. The positive rate was slightly higher with the OPAD (54.55%, 12/22) than with the traditional method (45.45%, 10/22). Using the OPAD, the average procedure duration of sampling was 30 s (30±13 s). Pharynx exposure was excellent in 21 subjects (95.45%, 21/22), which meant that the operator could acquire the swabs without difficulty.

Conclusions

As the COVID-19 pandemic escalates, our OPAD has identical efficacy compared to the traditional method for pharyngeal swabs, and it can also contribute to protecting the safety of healthcare workers.

Detectable 2019-nCoV viral RNA in blood is a strong indicator for the further clinical severity

The novel coronavirus (2019-nCoV) infection caused pneumonia. we retrospectively analyzed the virus presence in the pharyngeal swab, blood, and the anal swab detected by real-time PCR in the clinical lab. Unexpectedly, the 2109-nCoV RNA was readily detected in the blood (6 of 57 patients) and the anal swabs (11 of 28 patients). Importantly, all of the 6 patients with detectable viral RNA in the blood cohort progressed to severe symptom stage, indicating a strong correlation of serum viral RNA with the disease severity (p-value = 0.0001). Meanwhile, 8 of the 11 patients with annal swab virus-positive was in severe clinical stage. However, the concentration of viral RNA in the anal swab (Ct value = 24 + 39) was higher than in the blood (Ct value = 34 + 39) from patient 2, suggesting that the virus might replicate in the digestive tract. Altogether, our results confirmed the presence of virus RNA in extra-pulmonary sites.

Absence of Streptococcus pneumoniae in pharyngeal swabs of geriatric inpatients

Colonization of the pharynx by Streptococcus pneumoniae was studied in 185 in-hospital geriatric patients (median age 81 years) from 29 March 2011 to 22 June 2011. Swabs were plated on blood agar plates. Colonies with a morphology suggesting S. pneumoniae were further analyzed. Surprisingly, pneumococci were not found in any of the samples. Pneumococci chronically colonizing the pharynx of elderly people may be much rarer than previously thought and probably are not the source of pneumococcal pneumonia in old age.