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Li H, Pinette M, Smith G, Goolia M, Handel K, Nebroski M, Lung O, Pickering BS. Distinguishing host responses, extensive viral dissemination and long-term viral RNA persistence in domestic sheep experimentally infected with Crimean-Congo haemorrhagic fever virus Kosovo Hoti. Emerg Microbes Infect 2024; 13:2302103. [PMID: 38189080 PMCID: PMC10810640 DOI: 10.1080/22221751.2024.2302103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/31/2023] [Indexed: 01/09/2024]
Abstract
Crimean-Congo haemorrhagic fever orthonairovirus (CCHFV) is a tick-borne, risk group 4 pathogen that often causes a severe haemorrhagic disease in humans (CCHF) with high case fatality rates. The virus is believed to be maintained in a tick-vertebrate-tick ecological cycle involving numerous wild and domestic animal species; however the biology of CCHFV infection in these animals remains poorly understood. Here, we experimentally infect domestic sheep with CCHFV Kosovo Hoti, a clinical isolate representing high pathogenicity to humans and increasingly utilized in current research. In the absence of prominent clinical signs, the infection leads to an acute viremia and coinciding viral shedding, fever and markers for potential impairment in liver and kidney functions. A number of host responses distinguish the subclinical infection in sheep versus fatal infection in humans. These include an early reduction of neutrophil recruitment and its chemoattractant, IL-8, in the blood stream of infected sheep, whereas neutrophil infiltration and elevated IL-8 are features of fatal CCHFV infections reported in immunodeficient mice and humans. Several inflammatory cytokines that correlate with poor disease outcomes in humans and have potential to cause vascular dysfunction, a primary hallmark of severe CCHF, are down-regulated or restricted from increasing in sheep. Of particular interest, the detection of CCHFV RNA (including full-length genome) in a variety of sheep tissues long after the acute phase of infection indicates a widespread viral dissemination in the host and suggests a potentially long-term persisting impact of CCHFV infection. These findings reveal previously unrecognized aspects of CCHFV biology in animals.
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Affiliation(s)
- Hongzhao Li
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Mathieu Pinette
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Greg Smith
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Melissa Goolia
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Katherine Handel
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Michelle Nebroski
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Oliver Lung
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Bradley S. Pickering
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Lim SY, Kim JW, Kim JY, Kang SW, Jang CY, Chang E, Yang JS, Kim KC, Jang HC, Kim DS, Shin Y, Lee JY, Kim SH. The association between antibody responses and prolonged viable SARS-CoV-2 shedding in immunocompromised patients: a prospective cohort study. J Infect Dis 2023:jiad579. [PMID: 38114088 DOI: 10.1093/infdis/jiad579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
Immunocompromised COVID-19 patients were prospectively enrolled from March to November 2022 to understand the association between antibody responses and SARS-CoV-2 shedding. A total of 62 patients were analyzed and the results indicated a faster decline in genomic and subgenomic viral RNA in patients with higher neutralizing and S1-specific IgG antibodies (both P < 0.001). Notably, high neutralizing antibody levels were associated with a significantly faster decrease in viable virus cultures (P = 0.04). Our observations suggest the role of neutralizing antibodies in prolonged virus shedding in immunocompromised patients, highlighting the potential benefits of enhancing their humoral immune response through vaccination or monoclonal antibody treatments.
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Affiliation(s)
- So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Jun-Won Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Choi-Young Jang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Sun Yang
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kyung-Chang Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hee-Chang Jang
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Da Sol Kim
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Younmin Shin
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Joo-Yeon Lee
- National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Office for Infection Control, Asan Medical Center, Seoul, South Korea
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Pinto JPG, Magalhães PC, Figueiredo GM, Alves D, Angel DMS. Local protection bubbles: an interpretation of the slowdown in the spread of coronavirus in the city of São Paulo, Brazil, in July 2020. CAD SAUDE PUBLICA 2023; 39:e00109522. [PMID: 38126417 PMCID: PMC10727033 DOI: 10.1590/0102-311xen109522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/07/2023] [Accepted: 09/13/2023] [Indexed: 12/23/2023] Open
Abstract
After four months of fighting the pandemic, the city of São Paulo, Brazil, entered a phase of relaxed social distancing measures in July 2020. Simultaneously, there was a decline in the social distancing rate and a reduction in the number of cases, fatalities, and hospital bed occupancy. To understand the pandemic dynamics in the city of São Paulo, we developed a multi-agent simulation model. Surprisingly, the counter-intuitive results of the model followed the city's reality. We argue that this phenomenon could be attributed to local bubbles of protection that emerged in the absence of contagion networks. These bubbles reduced the transmission rate of the virus, causing short and temporary reductions in the epidemic curve - but manifested as an unstable equilibrium. Our hypothesis aligns with the virus spread dynamics observed thus far, without the need for ad hoc assumptions regarding the natural thresholds of collective immunity or the heterogeneity of the population's transmission rate, which may lead to erroneous predictions. Our model was designed to be user-friendly and does not require any scientific or programming expertise to generate outcomes on virus transmission in a given location. Furthermore, as an input to start our simulation model, we developed the COVID-19 Protection Index as an alternative to the Human Development Index, which measures a given territory vulnerability to the coronavirus and includes characteristics of the health system and socioeconomic development, as well as the infrastructure of the city of São Paulo.
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Affiliation(s)
| | | | | | - Domingos Alves
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Kang SW, Kim JW, Kim JY, Lim SY, Jang CY, Chang E, Yang JS, Kim KC, Jang HC, Kim D, Shin Y, Lee JY, Kim SH. Virological characteristics and the rapid antigen test as deisolation criteria in immunocompromised patients with COVID-19: A prospective cohort study. J Med Virol 2023; 95:e29228. [PMID: 38009999 DOI: 10.1002/jmv.29228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
There are limited data supporting current Centers for Disease Control and Prevention guidelines for the isolation period in moderate to severely immunocompromised patients with coronavirus disease 2019 (COVID-19). Adult COVID-19 patients who underwent solid organ transplantation (SOT) or received active chemotherapy against hematologic malignancy were enrolled and weekly respiratory samples were collected. Samples with positive genomic real-time polymerase chain reaction results underwent virus culture and rapid antigen testing (RAT). A total of 65 patients (40 with hematologic malignancy and 25 SOT) were enrolled. The median duration of viable virus shedding was 4 weeks (interquartile range: 3-7). Multivariable analysis revealed that B-cell depletion (hazard ratio [HR]: 4.76) was associated with prolonged viral shedding, and COVID-19 vaccination (≥3 doses) was negatively associated with prolonged viral shedding (HR: 0.22). The sensitivity, specificity, positive predictive value, and negative predictive value of RAT for viable virus shedding were 79%, 76%, 74%, and 81%, respectively. The negative predictive value of RAT was only 48% (95% confidence interval [CI]: 33-65) in the samples from those with symptom onset ≤20 days, but it was as high as 92% (95% CI: 85-96) in the samples from those with symptom onset >20 days. About half of immunocompromised COVID-19 patients shed viable virus for ≥4 weeks from the diagnosis, and virus shedding was prolonged especially in unvaccinated patients with B-cell-depleting therapy treatment. RAT beyond 20 days in immunocompromised patients had a relatively high negative predictive value for viable virus shedding.
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Affiliation(s)
- Sung-Woon Kang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun-Won Kim
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Choi-Young Jang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Sun Yang
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kyung-Chang Kim
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hee-Chang Jang
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Dasol Kim
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Younmin Shin
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Joo-Yeon Lee
- Center for Emerging Virus Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Nguyen-Tran H, Thompson C, Butler M, Miller KR, Pyle L, Jung S, Rogers S, Ng TFF, Routh J, Dominguez SR, Messacar K. Duration of Enterovirus D68 RNA Shedding in the Upper Respiratory Tract and Transmission among Household Contacts, Colorado, USA. Emerg Infect Dis 2023; 29:2315-2324. [PMID: 37877582 PMCID: PMC10617331 DOI: 10.3201/eid2911.230947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Enterovirus D68 (EV-D68) causes cyclical outbreaks of respiratory disease and acute flaccid myelitis. EV-D68 is primarily transmitted through the respiratory route, but the duration of shedding in the respiratory tract is unknown. We prospectively enrolled 9 hospitalized children with EV-D68 respiratory infection and 16 household contacts to determine EV-D68 RNA shedding dynamics in the upper respiratory tract through serial midturbinate specimen collections and daily symptom diaries. Five (31.3%) household contacts, including 3 adults, were EV-D68-positive. The median duration of EV-D68 RNA shedding in the upper respiratory tract was 12 (range 7-15) days from symptom onset. The most common symptoms were nasal congestion (100%), cough (92.9%), difficulty breathing (78.6%), and wheezing (57.1%). The median illness duration was 20 (range 11-24) days. Understanding the duration of RNA shedding can inform the expected rate and timing of EV-D68 detection in associated acute flaccid myelitis cases and help guide public health measures.
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Liu M, Shen X, Yu Y, Li J, Fan J, Jia X, Dai Y. Effect of Different Levels of Maternally Derived Genotype VII Newcastle Disease Virus-Specific Hemagglutination Inhibition Antibodies on Protection against Virulent Challenge in Chicks. Viruses 2023; 15:1840. [PMID: 37766246 PMCID: PMC10537515 DOI: 10.3390/v15091840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Newcastle disease (ND), caused by the virulent Newcastle disease virus (NDV), is an acute, highly contagious, and economically significant avian disease worldwide. Vaccination is the most effective measure for controlling ND. In recent years, vaccines matched with the prevalent strains of genotype VII have been developed and are now commercially available. These vaccines can provide full protection for chickens against clinical disease and mortality after challenges with genotype VII viruses and significantly decrease virus shedding compared to conventional vaccines belonging to genotypes I and II. Vaccinated hens can transfer antibodies to their offspring through the egg yolk. Maternally derived antibodies can provide passive protection against diseases but can also interfere with vaccination efficacy early in life. This study was conducted on chicks hatched from hens vaccinated with a commercial genotype VII NDV-matched vaccine to investigate the correlation between hemagglutination inhibition (HI) antibody levels in chicks and hens and the decaying pattern of maternally derived HI antibodies, and to evaluate the protective efficacy of different levels of maternally derived HI antibodies against challenge with a virulent NDV strain of genotype VII based on survivability and virus shedding. The HI antibody titers in chicks at hatching were about 1.3 log2 lower than those in hens, indicating an antibody transfer rate of approximately 41.52%. The estimated half-life of these antibodies was about 3.2 days. The protective efficacy of maternally derived HI antibodies was positively correlated with the titer. These antibodies could effectively protect chicks against mortality when the titer was 7 log2 or higher, but they were unable to prevent virus shedding or infection even at a high titer of 11 log2. The obtained results will greatly assist producers in determining the immune status of chicks and formulating appropriate vaccination schedules against ND.
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Affiliation(s)
- Mei Liu
- Jiangsu Institute of Poultry Sciences, Yangzhou 225125, China
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Ge Y, Billings WZ, Opekun A, Estes M, Graham D, Leon J, Koelle K, Shen Y, Atmar R, Lopman B, Handel A. Effect of Norovirus Inoculum Dose on Virus Kinetics, Shedding, and Symptoms. Emerg Infect Dis 2023; 29:1349-1356. [PMID: 37347494 PMCID: PMC10310361 DOI: 10.3201/eid2907.230117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
The effect of norovirus dose on outcomes such as virus shedding and symptoms after initial infection is not well understood. We performed a secondary analysis of a human challenge study by using Bayesian mixed-effects models. As the dose increased from 4.8 to 4,800 reverse transcription PCR units, the total amount of shed virus in feces increased from 4.5 × 1011 to 3.4 × 1012 genomic equivalent copies; in vomit, virus increased from 6.4 × 105 to 3.0 × 107 genomic equivalent copies. Onset time of viral shedding in feces decreased from 1.4 to 0.8 days, and time of peak viral shedding decreased from 2.3 to 1.5 days. Time to symptom onset decreased from 1.5 to 0.8 days. One type of symptom score increased. An increase in norovirus dose was associated with more rapid shedding and symptom onset and possibly increased severity. However, the effect on virus load and shedding was inconclusive.
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Kim KH, Kang G, Woo WS, Sohn MY, Son HJ, Kwon MG, Kim JO, Park CI. Red Sea Bream Iridovirus Kinetics, Tissue Tropism, and Interspecies Horizontal Transmission in Flathead Grey Mullets ( Mugil cephalus). Animals (Basel) 2023; 13:ani13081341. [PMID: 37106904 PMCID: PMC10135084 DOI: 10.3390/ani13081341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Red sea bream iridovirus (RSIV) causes significant economic losses in the aquaculture industry. We analyzed the pathogenicity of RSIV in flathead grey mullets (Mugil cephalus), the correlation of histopathological lesions, and interspecies horizontal transmission, through immersion infection and cohabitation challenges. Flathead grey mullets, which were challenged by immersion infection, exhibited mortality at 14 and 24 days after RSIV exposure. Viral shedding in seawater peaked 2-3 days before or after the observed mortality. Specific lesions of RSIV were observed in the spleen and kidney, and the correlation between histopathological grade and viral load was the highest in the spleen. In a cohabitation challenge, flathead grey mullets were the donors, and healthy rock bream, red sea bream, and flathead grey mullets were the recipients. Viral shedding in seawater was the highest in flathead grey mullet and rock bream at 25 °C, with 106.0 RSIV copies L/g at 14 dpi. No mortality was observed in any group challenged at 15 °C, and no RSIV was detected in seawater after 30 dpi. The virus shed from RSIV-infected flathead grey mullets caused horizontal transmission through seawater. These findings suggest that rapid decision-making is warranted when managing disease in fish farms.
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Affiliation(s)
- Kyung-Ho Kim
- Department of Marine Biology & Aquaculture, Institute of Marine Industry, College of Marine Science, Gyeongsang National University, 2, Tongyeonghaean-ro, Tongyeong 53064, Republic of Korea
| | - Gyoungsik Kang
- Department of Marine Biology & Aquaculture, Institute of Marine Industry, College of Marine Science, Gyeongsang National University, 2, Tongyeonghaean-ro, Tongyeong 53064, Republic of Korea
| | - Won-Sik Woo
- Department of Marine Biology & Aquaculture, Institute of Marine Industry, College of Marine Science, Gyeongsang National University, 2, Tongyeonghaean-ro, Tongyeong 53064, Republic of Korea
| | - Min-Young Sohn
- Department of Marine Biology & Aquaculture, Institute of Marine Industry, College of Marine Science, Gyeongsang National University, 2, Tongyeonghaean-ro, Tongyeong 53064, Republic of Korea
| | - Ha-Jeong Son
- Department of Marine Biology & Aquaculture, Institute of Marine Industry, College of Marine Science, Gyeongsang National University, 2, Tongyeonghaean-ro, Tongyeong 53064, Republic of Korea
| | - Mun-Gyeong Kwon
- Aquatic Disease Control Division, National Fishery Products Quality Management Service, 216, Gijanghaean-ro, Gijang, Busan 46083, Republic of Korea
| | - Jae-Ok Kim
- Aquatic Disease Control Division, National Fishery Products Quality Management Service, 17, Jungnim 2-ro, Tongyeong 53019, Republic of Korea
| | - Chan-Il Park
- Department of Marine Biology & Aquaculture, Institute of Marine Industry, College of Marine Science, Gyeongsang National University, 2, Tongyeonghaean-ro, Tongyeong 53064, Republic of Korea
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Sung-Woon Kang, Heedo Park, Ji Yeun Kim, Joon-Yong Bae, Man-Seong Park, Sung-Han Kim. Comparison of culture-competent virus shedding duration of SARS-CoV-2 omicron variant in regard to vaccination status: a prospective cohort study. Vaccine 2023. [PMID: 37003909 PMCID: PMC10040344 DOI: 10.1016/j.vaccine.2023.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023]
Abstract
Previous studies have shown that fully vaccinated patients with SARS-CoV-2 Delta variants has shorter viable viral shedding period compared to unvaccinated or partially vaccinated patients. However, data about effects of vaccination against the viable viral shedding period in patients with SARS-CoV-2 Omicron variants were limited. We compared the viable viral shedding period of SARS-CoV-2 omicron variant regard to vaccination status. Saliva samples were obtained daily from patients with SARS-CoV-2 Omicron variant, and genomic assessments and virus culture was performed to those samples. We found no difference in viable viral shedding period between fully vaccinated and not or partially vaccinated, nor between 1st boostered vs non-boostered patients with SARS-CoV-2 Omicron variant.
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Shen HC, Feng JY, Sun CY, Huang JR, Chen YM, Chen WC, Yang KY. Analysis of the effect of cytomegalovirus infection in clinical outcomes and prolonged duration of SARS-CoV-2 shedding in intensive care unit patients with COVID-19 pneumonia. Ther Adv Respir Dis 2023; 17:17534666231209150. [PMID: 37949827 PMCID: PMC10640799 DOI: 10.1177/17534666231209150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/05/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a global outbreak disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cytomegalovirus (CMV) infection can occur in critical COVID-19 patients and is associated with adverse clinical outcomes. OBJECTIVE The aim of this study was to explore the clinical characteristics and outcome of CMV infection in critical COVID-19 patients. DESIGN This was a retrospective cohort study. METHODS From May to September 2021, SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients with intensive care unit (ICU) admission were enrolled. CMV infection was confirmed by PCR. Baseline characteristics, critical illness data and clinical outcomes were recorded and analyzed. RESULTS Seventy-two RT-PCR-confirmed COVID-19 patients with ICU admission were included during the study period and 48 (66.7%) patients required mechanical ventilation (MV). Overall, in-hospital mortality was 19.4%. Twenty-one (29.2%) patients developed CMV infection. Patients with CMV infection had a higher likelihood of diabetes, higher lactate dehydrogenase and lactate levels, and higher proportions of MV, anticoagulant, and steroid use. Patients with CMV infection were associated with longer duration of SARS-CoV-2 shedding, longer ICU and hospital stay, and fewer ventilator-free days. The independent risk factor for development of CMV infection was a higher accumulative steroid dose. CONCLUSION CMV infection adversely impacted the outcomes of critical COVID-19 patients, resulting in longer ICU stays, longer mechanical ventilation uses and prolonged shedding of SARS-CoV-2.
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Affiliation(s)
- Hsiao-Chin Shen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei
- Department of Medical Education, Taipei Veterans General Hospital, Taipei
| | - Jia-Yih Feng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Chuan-Yen Sun
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei
| | - Jhong-Ru Huang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Wei-Chih Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
- Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Kuang-Yao Yang
- Department of Chest Medicine, Taipei Veterans General Hospital, Institute of Emergency and Critical Care Medicine and School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Cancer Progression Research Center, National Yang Ming Chiao Tung University, Taipei, #201, Sec. Shih-Pai Road, Taipei 11217
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11
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Kang S, Kim JY, Park H, Lim SY, Kim J, Chang E, Bae S, Jung J, Kim MJ, Chong YP, Lee S, Choi S, Kim YS, Park M, Kim S. Comparison of secondary attack rate and viable virus shedding between patients with SARS-CoV-2 Delta and Omicron variants: A prospective cohort study. J Med Virol 2023; 95:e28369. [PMID: 36458559 PMCID: PMC9877691 DOI: 10.1002/jmv.28369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/12/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Abstract
There are limited data comparing the transmission rates and kinetics of viable virus shedding of the Omicron variant to those of the Delta variant. We compared these rates in hospitalized patients infected with Delta and Omicron variants. We prospectively enrolled adult patients with COVID-19 admitted to a tertiary care hospital in South Korea between September 2021 and May 2022. Secondary attack rates were calculated by epidemiologic investigation, and daily saliva samples were collected to evaluate viral shedding kinetics. Genomic and subgenomic SARS-CoV-2 RNA was measured by PCR, and virus culture was performed from daily saliva samples. A total of 88 patients with COVID-19 who agreed to daily sampling and were interviewed, were included. Of the 88 patients, 48 (59%) were infected with Delta, and 34 (41%) with Omicron; a further 5 patients gave undetectable or inconclusive RNA PCR results and 1 was suspected of being coinfected with both variants. Omicron group had a higher secondary attack rate (31% [38/124] vs. 7% [34/456], p < 0.001). Survival analysis revealed that shorter viable virus shedding period was observed in Omicron variant compared with Delta variant (median 4, IQR [1-7], vs. 8.5 days, IQR [5-12 days], p < 0.001). Multivariable analysis revealed that moderate-to-critical disease severity (HR: 1.96), and immunocompromised status (HR: 2.17) were independent predictors of prolonged viral shedding, whereas completion of initial vaccine series or first booster-vaccinated status (HR: 0.49), and Omicron infection (HR: 0.44) were independently associated with shorter viable virus shedding. Patients with Omicron infections had higher transmission rates but shorter periods of transmissible virus shedding than those with Delta infections.
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Affiliation(s)
- Sung‐Woon Kang
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Ji Yeun Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Heedo Park
- Department of Biomedical Sciences, BK21 Graduate ProgramKorea University College of MedicineSeoulRepublic of Korea
- Department of Microbiology, Institute for Viral Diseases, Vaccine Innovation Center, College of MedicineKorea UniversitySeoulSouth Korea
| | - So Yun Lim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Jeonghun Kim
- Department of Biomedical Sciences, BK21 Graduate ProgramKorea University College of MedicineSeoulRepublic of Korea
- Department of Microbiology, Institute for Viral Diseases, Vaccine Innovation Center, College of MedicineKorea UniversitySeoulSouth Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Jiwon Jung
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sang‐Oh Lee
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Sang‐Ho Choi
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
| | - Man‐Seong Park
- Department of Biomedical Sciences, BK21 Graduate ProgramKorea University College of MedicineSeoulRepublic of Korea
- Department of Microbiology, Institute for Viral Diseases, Vaccine Innovation Center, College of MedicineKorea UniversitySeoulSouth Korea
| | - Sung‐Han Kim
- Department of Infectious Diseases, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
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12
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Yoon J, Park T, Kim A, Park J, Park BJ, Ahn HS, Go HJ, Kim DH, Lee JB, Park SY, Song CS, Lee SW, Choi IS. Molecular surveillance of equine parvovirus-hepatitis from oral, nasal, vaginal, and semen specimens collected from horses living in Korea. Transbound Emerg Dis 2022; 69:e3455-e3461. [PMID: 36271506 DOI: 10.1111/tbed.14746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/27/2022] [Accepted: 10/18/2022] [Indexed: 02/04/2023]
Abstract
Equine parvovirus-hepatitis (EqPV-H) is one of the etiological agents of Theiler's disease, causing fulminant hepatitis; however, its transmission route and pathogenesis remain unclear. In the present study, we aimed to determine EqPV-H shedding in oral/nasal/vaginal swabs or semen samples from horses living in Korea using nested polymerase chain reaction. We then used the data obtained to investigate various risk factors associated with EqPV-H including viral shedding, hepatopathological changes, and genetic diversity. Our data revealed occurrence of EqPV-H shedding in these animals (oral: 3/102 [2.9%]; nasal: 3/102 [2.9%]; semen: 1/9 [11.1%]) and identified that both age and country of foaling were significantly associated with EqPV-H shedding (p < .05). In addition, we noted that one of the newly isolated strains clustered separately from the other strains in the phylogenetic tree, revealing unique nucleotide and amino acid substitutions. This is a field surveillance study providing evidence of natural and venereal shedding of EqPV-H and describing its presence in both oral/nasal fluids and semen. This epidemiological and clinical analysis may help specify the clinicopathological features of EqPV-H and facilitate the development of novel disease prevention strategies.
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Affiliation(s)
- Jungho Yoon
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju-si, Korea.,Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Taemook Park
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju-si, Korea
| | - Ahram Kim
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju-si, Korea
| | - Jongyoung Park
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju-si, Korea
| | - Byung-Joo Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Hee-Seop Ahn
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Hyeon-Jeong Go
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Dong-Hwi Kim
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Joong-Bok Lee
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Seung-Yong Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Chang-Seon Song
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Sang-Won Lee
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - In-Soo Choi
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul, Korea.,KU Center for Animal Blood Medical Science, Konkuk University, Seoul, Korea
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13
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Morgan CN, Whitehill F, Doty JB, Schulte J, Matheny A, Stringer J, Delaney LJ, Esparza R, Rao AK, McCollum AM. Environmental Persistence of Monkeypox Virus on Surfaces in Household of Person with Travel-Associated Infection, Dallas, Texas, USA, 2021. Emerg Infect Dis 2022; 28:1982-1989. [PMID: 35951009 PMCID: PMC9514334 DOI: 10.3201/eid2810.221047] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In July 2021, we conducted environmental sampling at the residence of a person in Dallas, Texas, USA, who had travel-associated human West African monkeypox virus (MPXV-WA). Targeted environmental swab sampling was conducted 15 days after the person who had monkeypox left the household. Results indicate extensive MPXV-WA DNA contamination, and viable virus from 7 samples was successfully isolated in cell culture. There was no statistical difference (p = 0.94) between MPXV-WA PCR positivity of porous (9/10, 90%) vs. nonporous (19/21, 90.5%) surfaces, but there was a significant difference (p<0.01) between viable virus detected in cultures of porous (6/10, 60%) vs. nonporous (1/21, 5%) surfaces. These findings indicate that porous surfaces (e.g., bedding, clothing) may pose more of a MPXV exposure risk than nonporous surfaces (e.g., metal, plastic). Viable MPXV was detected on household surfaces after at least 15 days. However, low titers (<102 PFU) indicate a limited potential for indirect transmission.
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14
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Jacobsen S, Niendorf S, Lorenz R, Bock CT, Mas Marques A. Differentiation between Wild-Type Group A Rotaviruses and Vaccine Strains in Cases of Suspected Horizontal Transmission and Adverse Events Following Vaccination. Viruses 2022; 14. [PMID: 36016292 DOI: 10.3390/v14081670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
Human group A rotaviruses (RVA) are important enteric pathogens, as they are a leading cause of acute gastroenteritis (AGE) in children worldwide. Since 2013, the German Standing Committee on vaccination recommended the routine rotavirus vaccination for infants in Germany. While vaccination has significantly decreased RVA cases and worldwide mortality, in some cases, infants can develop acute gastroenteritis as an adverse reaction after immunization with an attenuated live vaccine. Pediatricians, as well as clinicians and diagnostic laboratories, contacted the Consultant Laboratory for Rotaviruses and inquired whether cases of RVA-positive AGE after vaccination were associated with vaccine or with wild-type RVA strains. A testing algorithm based on distinguishing PCRs and confirmative sequencing was designed, tested, and applied. Diagnostic samples from 68 vaccinated children and six cases where horizontal transmission was suspected were investigated in this study. Using a combination of real-time PCR, fragment-length analysis of amplicons from multiplex PCRs and confirmative sequencing, vaccine-like virus was detected in 46 samples and wild-type RVA was detected in 6 samples. Three mixed infections of vaccine and wild-type RVA were detectable, no RVA genome was found in 19 samples. High viral loads (>1.0 × 107 copies/g stool) were measured in most RVA-positive samples. Furthermore, information on co-infections with other AGE pathogens in the vaccinated study population was of interest. A commercial multiplex PCR and in-house PCRs revealed three co-infections of vaccinated infants with bacteria (two samples with Clostridioides difficile and one sample with enteropathogenic E. coli) and six co-infections with norovirus in a subset of the samples. Human astrovirus was detected in one sample, with suspected horizontal transmission. The cases of suspected horizontal transmission of vaccine RVA strains could not be confirmed, as they either involved wild-type RVA or were RVA negative. This study shows that RVA-positive AGE after vaccination is not necessarily associated with the vaccine strain and provides a reliable workflow to distinguish RVA vaccine strains from wild-type strains.
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15
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Koh T, Ooi XY, Vasoo S, Yeo SC. Impact of Variant of Concern and Vaccination Status on COVID-19 Infection Virological Dynamics in End Stage Kidney Disease Patients Receiving Haemodialysis. Nephrology (Carlton) 2022; 27:804-809. [PMID: 35904135 PMCID: PMC9353295 DOI: 10.1111/nep.14084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND It is unclear if variant of concern and vaccination status impact COVID-19 infection virological dynamics in haemodialysis patients and affect de-isolation protocol for dialysis centres. METHOD We performed a retrospective observational cohort study between February 2020 to September 2021, to examine the virological kinetics of vaccinated and unvaccinated haemodialysis patients with polymerase chain reaction (PCR)-confirmed COVID-19 infection of the delta and pre-delta variants. RESULTS Of the 38 subjects with PCR-confirmed COVID-19 infection, we found that individuals infected during the delta-variant period had higher viral load at presentation and required longer duration to achieve a negative PCR swab, compared to those infected in the pre-delta variant period. Time to achieve negative PCR swab was longest in unvaccinated individuals infected during delta-variant period. However, vaccinated and unvaccinated individuals achieved high PCR cycle threshold value of ≥25 and ≥30 at similar timing. CONCLUSION Our study suggests that patients infected during delta-variant period of COVID-19 illness, have higher viral load at presentation and prolonged viral shedding, especially in the unvaccinated cohort. However, prolonged time to negative PCR is likely due to inactive virus shedding, and that conversion to negative PCR may not be a necessary pre-requisite for de-isolation.
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Affiliation(s)
- Timothy Koh
- Department of Renal Medicine, Tan Tock Seng Hospital, Singapore
| | - Xi Yan Ooi
- Department of Renal Medicine, Tan Tock Seng Hospital, Singapore
| | - Shawn Vasoo
- National Centre for Infectious Diseases, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - See Cheng Yeo
- Department of Renal Medicine, Tan Tock Seng Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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16
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Li LH, Liesenborghs L, Wang L, Lox M, Yakass MB, Jansen S, Rosales Rosas AL, Zhang X, Thibaut HJ, Teuwen D, Neyts J, Delang L, Dallmeier K. Biodistribution and environmental safety of a live-attenuated YF17D-vectored SARS-CoV-2 vaccine candidate. Mol Ther Methods Clin Dev 2022; 25:215-224. [PMID: 35313504 PMCID: PMC8925082 DOI: 10.1016/j.omtm.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/14/2022] [Indexed: 11/06/2022]
Abstract
New platforms are needed for the design of novel prophylactic vaccines and advanced immune therapies. Live-attenuated yellow fever vaccine YF17D serves as a vector for several licensed vaccines and platform for novel candidates. On the basis of YF17D, we developed an exceptionally potent COVID-19 vaccine candidate called YF-S0. However, use of such live RNA viruses raises safety concerns, such as adverse events linked to original YF17D (yellow fever vaccine-associated neurotropic disease [YEL-AND] and yellow fever vaccine-associated viscerotropic disease [YEL-AVD]). In this study, we investigated the biodistribution and shedding of YF-S0 in hamsters. Likewise, we introduced hamsters deficient in signal transducer and activator of transcription 2 (STAT2) signaling as a new preclinical model of YEL-AND/AVD. Compared with YF17D, YF-S0 showed improved safety with limited dissemination to brain and visceral tissues, absent or low viremia, and no shedding of infectious virus. Considering that yellow fever virus is transmitted by Aedes mosquitoes, any inadvertent exposure to the live recombinant vector via mosquito bites is to be excluded. The transmission risk of YF-S0 was hence compared with readily transmitting YF-Asibi strain and non-transmitting YF17D vaccine, with no evidence for productive infection of mosquitoes. The overall favorable safety profile of YF-S0 is expected to translate to other vaccines based on the same YF17D platform.
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Affiliation(s)
- Li-Hsin Li
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium
| | - Laurens Liesenborghs
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium.,Institute of Tropical Medicine, Department of Clinical Sciences, Outbreak Research Team, 2000 Antwerp, Belgium
| | - Lanjiao Wang
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Mosquito Virology Team, 3000 Leuven, Belgium
| | - Marleen Lox
- KU Leuven, Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, 3000 Leuven, Belgium
| | - Michael Bright Yakass
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium.,University of Ghana, Department of Biochemistry, Cell and Molecular Biology, the West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), Legon, Accra 1181, Ghana
| | - Sander Jansen
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium
| | - Ana Lucia Rosales Rosas
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Mosquito Virology Team, 3000 Leuven, Belgium
| | - Xin Zhang
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium
| | - Hendrik Jan Thibaut
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Translational Platform Virology and Chemotherapy (TPVC), 3000 Leuven, Belgium
| | - Dirk Teuwen
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium
| | - Johan Neyts
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium
| | - Leen Delang
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Mosquito Virology Team, 3000 Leuven, Belgium
| | - Kai Dallmeier
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Virology and Chemotherapy, Molecular Vaccinology and Vaccine Discovery Team, 3000 Leuven, Belgium
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17
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Kim DY, Lin MY, Jennings C, Li H, Jung JH, Moore NM, Ghinai I, Black SR, Zaccaro DJ, Brofman J, Hayden MK. Duration of Replication-Competent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Shedding Among Patients With Severe or Critical Coronavirus Disease 2019 (COVID-19). Clin Infect Dis 2022; 76:e416-e425. [PMID: 35607802 PMCID: PMC9213867 DOI: 10.1093/cid/ciac405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/05/2022] [Accepted: 05/18/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Patterns of shedding replication-competent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in severe or critical COVID-19 are not well characterized. We investigated the duration of replication-competent SARS-CoV-2 shedding in upper and lower airway specimens from patients with severe or critical coronavirus disease 2019 (COVID-19). METHODS We enrolled patients with active or recent severe or critical COVID-19 who were admitted to a tertiary care hospital intensive care unit (ICU) or long-term acute care hospital (LTACH) because of COVID-19. Respiratory specimens were collected at predefined intervals and tested for SARS-CoV-2 using viral culture and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Clinical and epidemiologic metadata were reviewed. RESULTS We collected 529 respiratory specimens from 78 patients. Replication-competent virus was detected in 4 of 11 (36.3%) immunocompromised patients up to 45 days after symptom onset and in 1 of 67 (1.5%) immunocompetent patients 10 days after symptom onset (P = .001). All culture-positive patients were in the ICU cohort and had persistent or recurrent symptoms of COVID-19. Median time from symptom onset to first specimen collection was 15 days (range, 6-45) for ICU patients and 58.5 days (range, 34-139) for LTACH patients. SARS-CoV-2 RNA was detected in 40 of 50 (80%) ICU patients and 7 of 28 (25%) LTACH patients. CONCLUSIONS Immunocompromise and persistent or recurrent symptoms were associated with shedding of replication-competent SARS-CoV-2, supporting the need for improving respiratory symptoms in addition to time as criteria for discontinuation of transmission-based precautions. Our results suggest that the period of potential infectiousness among immunocompetent patients with severe or critical COVID-19 may be similar to that reported for patients with milder disease.
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Affiliation(s)
- Do Young Kim
- Correspondence: M. Hayden, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612 ()
| | - Michael Y Lin
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Cheryl Jennings
- Rush Research Cores, Rush University Medical Center, Chicago, Illinois, USA
| | - Haiying Li
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - Jae Hyung Jung
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Nicholas M Moore
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA,Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA,Department of Medical Laboratory Science, Rush University Medical Center, Chicago, Illinois, USA
| | - Isaac Ghinai
- Chicago Department of Public Health, Chicago, Illinois, USA
| | | | - Daniel J Zaccaro
- Social & Scientific Systems, Inc, a DLH Holdings Corporation, Durham, North Carolina, USA
| | | | - Mary K Hayden
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
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18
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Alfano G, Fontana F, Ferrari A, Morisi N, Gregorini M, Cappelli G, Magistroni R, Guaraldi G, Donati G. Which criteria should we use to end isolation in hemodialysis patients with COVID-19? Clin Kidney J 2022; 15:1450-1454. [PMID: 36824062 PMCID: PMC9942439 DOI: 10.1093/ckj/sfac115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Indexed: 11/14/2022] Open
Abstract
Safe and timely discontinuation of quarantine of in-center hemodialysis (HD) patients with a previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a challenging issue for the nephrological community because current guidelines for ending isolation do not mention dialysis patients. To prevent potentially fatal outbreaks of coronavirus disease 2019 (COVID-19), a cautionary approach has been adopted by most dialysis units. The criteria for ending the isolation in the HD population generally coincide with those recommended for immunocompromised people. Thus, a test-based strategy relying on two consecutive negative reverse transcriptase-polymerase chain reaction (RT-PCR) nasopharyngeal swabs has been adopted to terminate quarantine. This strategy has the disadvantage of prolonging isolation as RT-PCR positivity does not equate to SARS-CoV-2 infectivity. Consequentially, prolonged positivity of SARS-CoV-2 results in excessive workload for the HD staff who must face an increasing number of COVID-19 patients requiring isolation. This condition leads also to serious implications for the patients and their households including work productivity loss, postponement of health-care appointments and an increased risk of COVID-19 reinfection. To counteract this problem, other diagnostic tests should be used to provide the best care to HD patients. Recent results seem to encourage the use of RT-PCR cycle threshold (Ct) values and rapid antigen tests given their better correlation with cell culture for SARS-CoV-2 than RT-PCR testing. Here, we provide an overview of the current scientific evidence on the tests used to verify the infectiousness of the virus in order to stimulate the nephrological community to adopt a streamlined and pragmatic procedure to end isolation in COVID-19 patients on HD.
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Affiliation(s)
| | - Francesco Fontana
- Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy
| | - Annachiara Ferrari
- Nephrology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Niccolò Morisi
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Italy
| | - Mariacristina Gregorini
- Nephrology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gianni Cappelli
- Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Italy
| | - Riccardo Magistroni
- Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy,Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Italy
| | - Giovanni Guaraldi
- Clinic of Infectious Diseases, University Hospital of Modena, Modena, Italy
| | - Gabriele Donati
- Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy,Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Italy
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19
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Abstract
Since the start of the coronavirus disease-2019 (COVID-19) pandemic, there has been interest in using wastewater monitoring as an approach for disease surveillance. A significant uncertainty that would improve the interpretation of wastewater monitoring data is the intensity and timing with which individuals shed RNA from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into wastewater. By combining wastewater and case surveillance data sets from a university campus during a period of heightened surveillance, we inferred that individual shedding of RNA into wastewater peaks on average 6 days (50% uncertainty interval (UI): 6-7; 95% UI: 4-8) following infection, and that wastewater measurements are highly overdispersed [negative binomial dispersion parameter, k = 0.39 (95% credible interval: 0.32-0.48)]. This limits the utility of wastewater surveillance as a leading indicator of secular trends in SARS-CoV-2 transmission during an epidemic, and implies that it could be most useful as an early warning of rising transmission in areas where transmission is low or clinical testing is delayed or of limited capacity.
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Affiliation(s)
- Sean Cavany
- Department of Biological Sciences, University of Notre Dame, Notre Dame, USA
| | - Aaron Bivins
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Zhenyu Wu
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Devin North
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - T Alex Perkins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, USA
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20
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Cavany S, Bivins A, Wu Z, North D, Bibby K, Perkins TA. Inferring SARS-CoV-2 RNA shedding into wastewater relative to the time of infection. Epidemiol Infect 2022; 150:e21. [PMID: 35068403 PMCID: PMC8795777 DOI: 10.1017/s0950268821002752] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/18/2021] [Accepted: 12/17/2021] [Indexed: 11/23/2022] Open
Abstract
Since the start of the coronavirus disease-2019 (COVID-19) pandemic, there has been interest in using wastewater monitoring as an approach for disease surveillance. A significant uncertainty that would improve the interpretation of wastewater monitoring data is the intensity and timing with which individuals shed RNA from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into wastewater. By combining wastewater and case surveillance data sets from a university campus during a period of heightened surveillance, we inferred that individual shedding of RNA into wastewater peaks on average 6 days (50% uncertainty interval (UI): 6-7; 95% UI: 4-8) following infection, and that wastewater measurements are highly overdispersed [negative binomial dispersion parameter, k = 0.39 (95% credible interval: 0.32-0.48)]. This limits the utility of wastewater surveillance as a leading indicator of secular trends in SARS-CoV-2 transmission during an epidemic, and implies that it could be most useful as an early warning of rising transmission in areas where transmission is low or clinical testing is delayed or of limited capacity.
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Affiliation(s)
- Sean Cavany
- Department of Biological Sciences, University of Notre Dame, Notre Dame, USA
| | - Aaron Bivins
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Zhenyu Wu
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Devin North
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - T. Alex Perkins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, USA
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21
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Abstract
Since the start of the coronavirus disease-2019 (COVID-19) pandemic, there has been interest in using wastewater monitoring as an approach for disease surveillance. A significant uncertainty that would improve the interpretation of wastewater monitoring data is the intensity and timing with which individuals shed RNA from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into wastewater. By combining wastewater and case surveillance data sets from a university campus during a period of heightened surveillance, we inferred that individual shedding of RNA into wastewater peaks on average 6 days (50% uncertainty interval (UI): 6-7; 95% UI: 4-8) following infection, and that wastewater measurements are highly overdispersed [negative binomial dispersion parameter, k = 0.39 (95% credible interval: 0.32-0.48)]. This limits the utility of wastewater surveillance as a leading indicator of secular trends in SARS-CoV-2 transmission during an epidemic, and implies that it could be most useful as an early warning of rising transmission in areas where transmission is low or clinical testing is delayed or of limited capacity.
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Affiliation(s)
- Sean Cavany
- Department of Biological Sciences, University of Notre Dame, Notre Dame, USA
| | - Aaron Bivins
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Zhenyu Wu
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Devin North
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, Notre Dame, USA
| | - T Alex Perkins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, USA
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22
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Leitão IDC, Calil PT, Galliez RM, Moreira FRR, Mariani D, Castiñeiras ACP, da Silva GPD, Maia RA, Corrêa IA, Monteiro FLL, de Souza MRM, Gonçalves CCA, Higa LM, de Jesus Ribeiro L, Fonseca VWP, Bastos VC, Voloch CM, Faffe DS, da Costa Ferreira O, Tanuri A, Castiñeiras TMPP, da Costa LJ. Prolonged SARS-CoV-2 Positivity in Immunocompetent Patients: Virus Isolation, Genomic Integrity, and Transmission Risk. Microbiol Spectr 2021; 9:e0085521. [PMID: 34787498 PMCID: PMC8597635 DOI: 10.1128/spectrum.00855-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Current guidelines for patient isolation in COVID-19 cases recommend a symptom-based approach, averting the use of control real-time reverse transcription PCR (rRT-PCR) testing. However, we hypothesized that patients with persistently positive results by RT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could be potentially infectious for a prolonged time, even if immunocompetent and asymptomatic, which would demand a longer social isolation period than presently recommended. To test this hypothesis, 72 samples from 51 mildly symptomatic immunocompetent patients with long-lasting positive rRT-PCR results for SARS-CoV-2 were tested for their infectiousness in cell culture. The serological response of samples from those patients and virus genomic integrity were also analyzed. Infectious viruses were successfully isolated from 34.38% (22/64) of nasopharynx samples obtained 14 days or longer after symptom onset. Indeed, we observed successful virus isolation up to 128 days. Complete SARS-COV-2 genome integrity was demonstrated, suggesting the presence of replication-competent viruses. No correlation was found between the isolation of infectious viruses and rRT-PCR cycle threshold values or the humoral immune response. These findings call attention to the need to review current isolation guidelines, particularly in scenarios involving high-risk individuals. IMPORTANCE In this study, we evaluated mildly symptomatic immunocompetent patients with long-lasting positive rRT-PCR results for SARS-CoV-2. Infectious viruses were successfully isolated in cell cultures from nasopharynx samples obtained 14 days or longer after symptom onset. Indeed, we observed successful virus isolation for up to 128 days. Moreover, SARS-CoV-2 genome integrity was demonstrated by sequencing, suggesting the presence of replication-competent viruses. These data point out the risk of continuous SARS-CoV-2 transmission from patients with prolonged detection of SARS-CoV-2 in the upper respiratory tract, which has important implications for current precaution guidelines, particularly in settings where vulnerable individuals may be exposed (e.g., nursing homes and hospitals).
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Affiliation(s)
- Isabela de Carvalho Leitão
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Pedro Telles Calil
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Rafael Mello Galliez
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Filipe Romero Rebello Moreira
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Diana Mariani
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Gustavo Peixoto Duarte da Silva
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Richard Araújo Maia
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Isadora Alonso Corrêa
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Fábio Luís Lima Monteiro
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Marcos Romário Matos de Souza
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Luiza Mendonça Higa
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Liane de Jesus Ribeiro
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Victoria Cortes Bastos
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Carolina Moreira Voloch
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Débora Souza Faffe
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Orlando da Costa Ferreira
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Amilcar Tanuri
- Laboratório de Virologia Molecular, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Luciana Jesus da Costa
- Laboratório de Genética e Imunologia das Infecções Virais, Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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23
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Yoon J, Park T, Kim A, Song H, Park BJ, Ahn HS, Go HJ, Kim DH, Lee JB, Park SY, Song CS, Lee SW, Choi IS. First report of equine parvovirus-hepatitis and equine hepacivirus coinfection in horses in Korea. Transbound Emerg Dis 2021; 69:2735-2746. [PMID: 34919324 DOI: 10.1111/tbed.14425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/04/2021] [Accepted: 11/29/2021] [Indexed: 01/11/2023]
Abstract
Equine parvovirus-hepatitis (EqPV-H) and equine hepacivirus (EqHV) are etiologically associated with Theiler's disease (TD), causing fulminant equine hepatitis, but the transmission route and co-infection effect remain unclear. We determined EqPV-H and EqHV prevalence and coinfection rate in 160 serum and 114 faecal samples using nested polymerase chain reaction. Amino acid and nucleotide analyses were performed and phylogenetic trees were constructed. By measuring liver-specific parameters (AST, GGT, TBIL and A/G ratio), hepatopathological changes in viremia status were compared. We found a high prevalence (EqPV-H: 10.6% in serum, 5.3% in faeces; EqHV: 8.1% in serum) and coinfection rate (35.3% in EqPV-H) of TD-causing agents. The newly identified EqPV-H genomes showed high nucleotide and amino acid similarities with previously reported strains in the USA, China and Austria. In phylogenetic tree and recombination analysis, a natural recombination event was confirmed between Chinese and Korean strains. In the EqPV-H or EqHV viremic horses, AST was significantly elevated and at least two liver-specific parameters were outside the reference intervals in 43.5% (10/23) of horses. To our knowledge, this is the first prevalence field study of EqPV-H and EqHV using both serum and faeces, providing further evidence of faecal-oral transmission of TD. These epidemiologic and clinicopathologic analyses specify the risk factors of TD infection and promote disease prevention strategy.
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Affiliation(s)
- Jungho Yoon
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju, Korea.,Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Taemook Park
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju, Korea
| | - Ahram Kim
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju, Korea
| | - Heeeun Song
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju, Korea
| | - Byung-Joo Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Hee-Seop Ahn
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Hyeon-Jeong Go
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Dong-Hwi Kim
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Joong-Bok Lee
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Seung-Yong Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Chang-Seon Song
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - Sang-Won Lee
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
| | - In-Soo Choi
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea
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24
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Rouamba T, Barry H, Ouédraogo E, Tahita MC, Yaméogo NV, Poda A, Diendéré AE, Ouedraogo AS, Valea I, Koné AM, Thiombiano C, Traoré I, Tarnagda Z, Sawadogo SA, Gansané Z, Kambiré Y, Sanou I, Barro-Traoré F, Drabo MK, Tinto H. Safety of Chloroquine or Hydroxychloroquine Plus Azithromycin for the Treatment of COVID-19 Patients in Burkina Faso: An Observational Prospective Cohort Study. Ther Clin Risk Manag 2021; 17:1187-1198. [PMID: 34815671 PMCID: PMC8604637 DOI: 10.2147/tcrm.s330813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/31/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Though chloroquine derivatives are used in the treatment of coronavirus disease 2019 (COVID-19) in many countries worldwide, doubts remain about the safety and efficacy of these drugs, especially in African communities where published data are scarce. METHODS We conducted an observational prospective cohort study from April 24 to September 03, 2020, in Burkina Faso to assess (as primary outcome) the clinical, biological, and cardiac (electrocardiographic) safety of chloroquine or hydroxychloroquine plus azithromycin administered to COVID-19 patients. The main secondary outcomes were all-cause mortality and median time of viral clearance. RESULTS A total of 153 patients were enrolled and followed for 21 days. Among patients who took at least one dose of chloroquine or hydroxychloroquine (90.1% [138/153]), few clinical adverse events were reported and were mainly rash/pruritus, diarrhea, chest pain, and palpitations. No statistically significant increase in hepatic, renal, and hematological parameters or electrolyte disorders were reported. However, there was a significant increase in the QTc value without exceeding 500ms, especially in those who received chloroquine phosphate. Three adverse events of special interest classified as serious (known from chloroquine derivatives) were recorded namely pruritus, paresthesia, and drowsiness. One case of death occurred. The average onset of SARS-CoV-2 PCR negativity was estimated at 7.0 (95% CI: 5.0-10.0) days. CONCLUSION Hydroxychloroquine appeared to be well tolerated in treated COVID-19 patients in Burkina Faso. In the absence of a robust methodological approach that could generate a high level of scientific evidence, our results could at least contribute to guide health decisions that should be made based on different sources of scientific evidence including those from our study.
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Affiliation(s)
- Toussaint Rouamba
- Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso
| | - Houreratou Barry
- Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Esperance Ouédraogo
- Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso
| | | | | | - Armel Poda
- Centre Hospitalier Universitaire Sourou Sanon, Bobo-Dioulasso, Burkina Faso
| | | | | | - Innocent Valea
- Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso
| | - Amariane M Koné
- Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | | | - Isidore Traoré
- Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Zekiba Tarnagda
- Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso
| | - Serge A Sawadogo
- Centre PrïmO Nelson Mandela (Promotion de la Recherche et de l’Innovation en Immunologie Médicale de Ouagadougou), Ouagadougou, Burkina Faso
| | - Zakaria Gansané
- Clinical Monitoring in Africa-Clinical Research Organization, Ouagadougou, Burkina Faso
| | - Yibar Kambiré
- Centre Hospitalier Universitaire de Tengandogo, Ouagadougou, Burkina Faso
| | - Idrissa Sanou
- Centre Hospitalier Universitaire de Tengandogo, Ouagadougou, Burkina Faso
| | - Fatou Barro-Traoré
- Centre Hospitalier Universitaire de Tengandogo, Ouagadougou, Burkina Faso
| | - Maxime K Drabo
- Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso
| | - On behalf of the CHLORAZ Study Group
- Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso
- Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso
- Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
- Centre Hospitalier Universitaire Sourou Sanon, Bobo-Dioulasso, Burkina Faso
- Centre Hospitalier Universitaire de Bogodogo, Ouagadougou, Burkina Faso
- Centre PrïmO Nelson Mandela (Promotion de la Recherche et de l’Innovation en Immunologie Médicale de Ouagadougou), Ouagadougou, Burkina Faso
- Clinical Monitoring in Africa-Clinical Research Organization, Ouagadougou, Burkina Faso
- Centre Hospitalier Universitaire de Tengandogo, Ouagadougou, Burkina Faso
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25
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Sadr S, Bafrani MA, Abdollahi A, SeyedAlinaghi SA, Mohammadnejad E, Hossienzade R, ShahmariGolestan F, Ahmadinejad Z, Salehi M, Javaherian M, Kimyaee E, Jafari F, Ghiasvand F. Distinguishing repeated polymerase chain reaction positivity from re-infections in COVID-19. Influenza Other Respir Viruses 2021; 15:742-749. [PMID: 34296828 PMCID: PMC8446995 DOI: 10.1111/irv.12883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Possibility of reinfection with SARS-CoV-2 changes our view on herd immunity and vaccination and can impact worldwide quarantine policies. We performed real-time polymerase chain reaction (RT-PCR) follow-up studies on recovered patients to assess possible development of reinfections and re-positivity. METHODS During a 6-month period, 202 PCR-confirmed recovering COVID-19 patients entered this study. Follow-up RT-PCR tests and symptom assessment were performed 1 month after the initial positive results. Patients who tested negative were tested again 1 and 3 months later. The serum IgG and IgM levels were measured in the last follow-up session. RESULTS In the first two follow-up sessions, 82 patients continued their participation, of which four patients tested positive. In the second follow-up 44 patients participated, three of whom tested positive. None of the patients who tested positive in the first and second follow-up session were symptomatic. In the last session, 32 patients were tested and four patients were positive, three of them were mildly symptomatic and all of them were positive for IgG. CONCLUSIONS A positive RT-PCR in a recovering patient may represent reinfection. While we did not have the resources to prove reinfection by genetic sequencing of the infective viruses, we believe presence of mild symptoms in the three patients who tested positive over 100 days after becoming asymptomatic, can be diagnosed as reinfection. The immune response developed during the first episode of infection (e.g., IgG or T-cell mediated responses that were not measured in our study) may have abated the symptoms of the reinfection, without providing complete protection.
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Affiliation(s)
- Sara Sadr
- School of MedicineMazandaran University of Medical SciencesSariIran
| | - Melika Arab Bafrani
- Students Scientific Research Center (SSRC), School of MedicineTehran University of Medical SciencesTehranIran
| | - Alireza Abdollahi
- Department of Pathology, School of Medicine, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Seyed Ahmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk BehaviorsTehran University of Medical SciencesTehranIran
| | - Esmaeil Mohammadnejad
- Nursing Education, Department of Medical‐Surgical Nursing and Basic Science, School of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Roghieh Hossienzade
- Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | | | - Zahra Ahmadinejad
- Liver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Mohamadreza Salehi
- Department of Infectious Diseases, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Mohammad Javaherian
- Department of Physiotherapy, School of Rehabilitation, Liver Transplantation Research Center, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Elahe Kimyaee
- Central Laboratory, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Fatemeh Jafari
- School of MedicineIran University of Medical SciencesTehranIran
| | - Fereshteh Ghiasvand
- Liver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
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26
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Al Dossary R, Alnimr A, Aljindan R, Alkharsah KR, Al-Qurayn AK, Eltreifi O, Alkuwaiti FA, Almashouf AB, Alsahlawi AM, Alshammari A, Hudhaiah D, Alshahrani MS, Bukhari H. Predictors of Illness Severity in COVID-19 Cases in Saudi Arabia. Infect Drug Resist 2021; 14:4097-4105. [PMID: 34675555 PMCID: PMC8502032 DOI: 10.2147/idr.s333300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/28/2021] [Indexed: 01/04/2023] Open
Abstract
Purpose Multiple studies worldwide have reported the clinical and epidemiological features of coronavirus disease 2019 (COVID-19), with limited reports from the Middle East. This study describes the clinical and epidemiological features of COVID-19 cases in the Eastern Province of Saudi Arabia and identified factors associated with the severity of illness. Patients and Methods This was an observational study of 341 COVID-19 cases. These cases were reported in the first three months after the first case in the country was identified. Clinical and demographic data were analyzed and described to identify the effects of age, sex, and ethnicity on illness severity. In addition, the duration of viral shedding and cycle threshold (Ct) values of real-time PCR were evaluated as predictors of severity. Results The median age was 45 years. Males were twice as likely to be infected than females (p <0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Critical cases were significantly higher in men (23% vs 8.7%), senior adults (>65 years), individuals of Bengali ethnicity, and in patients with comorbidities including diabetes, hypertension, and dyslipidemia (p =0.001). The case fatality rate was found to be 10%. The fatality was significantly higher in males than females (13.8% vs 2.6%), and in Asians (17.9%) than Arabs (6%) and Africans (0) (p =0.002). No association was found between viral load, represented by the RT-PCR cycle threshold (Ct) values, and severity of illness. Conclusion Age, sex, and ethnicity are important predictors of COVID-19 severity. The cycle threshold (Ct) of the SARS-CoV-2 RT-PCR test cannot be used as a predictor of the criticality of illness.
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Affiliation(s)
- Reem Al Dossary
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Amani Alnimr
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Reem Aljindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Khaled R Alkharsah
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Ahmed K Al-Qurayn
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Obeid Eltreifi
- Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Feras A Alkuwaiti
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Abdullah B Almashouf
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Ahmed M Alsahlawi
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Amal Alshammari
- Department of Medical Laboratory, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Dhoha Hudhaiah
- Department of Medical Laboratory, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Mohammed S Alshahrani
- Department of Emergency Medicine, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
| | - Huda Bukhari
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman bin Faisal University (IAU), Dammam, Saudi Arabia
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27
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Yoon J, Park T, Kim A, Park J, Park BJ, Ahn HS, Go HJ, Kim DH, Jung S, Seo Y, Lee JB, Park SY, Song CS, Lee SW, Choi IS. First Clinical Case of Equine Parvovirus-Hepatitis-Related Theiler's Disease in Asia. Viruses 2021; 13:v13101917. [PMID: 34696347 PMCID: PMC8541225 DOI: 10.3390/v13101917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 12/29/2022] Open
Abstract
Equine parvovirus-hepatitis (EqPV-H) is a newly identified etiologic agent of Theiler’s disease (TD). We present a case of EqPV-H-related fulminant hepatitis in a 14-year-old thoroughbred mare in Korea. The mare had acute hepatopathy and gastrointestinal symptoms, with abnormal liver-related blood parameters. The horse was born in the USA and imported to Korea in 2017, with no history of administration of equine biological products after entry into Korea. The horse was diagnosed with EqPV-H-associated hepatitis after abdominal ultrasonography, laparotomy, and nested polymerase chain reaction (PCR) and in situ hybridization (ISH) assays. The serum, nasal swab, oral swab, and liver biopsy were positive for EqPV-H according to the PCR assay. Genetic analysis of the partial NS1 gene of EqPV-H showed a unique nucleotide substitution, distinct from that in previously deposited strains. EqPV-H DNA was found not only in hepatocytes but also in bile duct epithelium and Kupffer cells, particularly via ISH. To the best of our knowledge, this is the first case of EqPV-H-associated TD in Asia, providing the first clinical evidence for viral shedding from the mouth and nose, and identification of EqPV-H in the liver. This study contributes to a better understanding of the pathological features of EqPV-H-associated TD.
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Affiliation(s)
- Jungho Yoon
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju 63346, Korea; (J.Y.); (T.P.); (A.K.); (J.P.)
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Taemook Park
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju 63346, Korea; (J.Y.); (T.P.); (A.K.); (J.P.)
| | - Ahram Kim
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju 63346, Korea; (J.Y.); (T.P.); (A.K.); (J.P.)
| | - Jongyoung Park
- Equine Clinic, Jeju Stud Farm, Korea Racing Authority, Jeju 63346, Korea; (J.Y.); (T.P.); (A.K.); (J.P.)
| | - Byung-Joo Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Hee-Seop Ahn
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Hyeon-Jeong Go
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Dong-Hwi Kim
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Soontag Jung
- Department of Food and Nutrition, College of Biotechnology and Natural Resources, Chung-Ang University, Anseong 17546, Korea; (S.J.); (Y.S.)
| | - Yeeun Seo
- Department of Food and Nutrition, College of Biotechnology and Natural Resources, Chung-Ang University, Anseong 17546, Korea; (S.J.); (Y.S.)
| | - Joong-Bok Lee
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Seung-Yong Park
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Chang-Seon Song
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - Sang-Won Lee
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
| | - In-Soo Choi
- Department of Infectious Diseases, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea; (B.-J.P.); (H.-S.A.); (H.-J.G.); (D.-H.K.); (J.-B.L.); (S.-Y.P.); (C.-S.S.); (S.-W.L.)
- Correspondence: ; Tel.: +82-2049-6228
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Homza M, Zelena H, Janosek J, Tomaskova H, Jezo E, Kloudova A, Mrazek J, Svagera Z, Prymula R. Covid-19 antigen testing: better than we know? A test accuracy study. Infect Dis (Lond) 2021; 53:661-668. [PMID: 33985403 PMCID: PMC8127166 DOI: 10.1080/23744235.2021.1914857] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Antigen testing for SARS-CoV-2 is considered to be less sensitive than the standard reference method - real-time PCR (RT-PCR). It has been suggested that many patients with positive RT-PCR 'missed' by antigen testing might be non-infectious. METHODS In a real-world high-throughput setting for asymptomatic or mildly symptomatic patients, 494 patients were tested using RT-PCR as well as a single lateral flow antigen test (Ecotest, AssureTech, China). Where the results differed, virus viability was evaluated by cell culture. The test parameters were calculated with RT-PCR and RT-PCR adjusted on viability as reference standards. RESULTS The overall sensitivity of the used antigen test related to the RT-PCR only was 76.2%, specificity was 97.3%. However, 36 out of 39 patients 'missed' by the antigen test contained no viable virus. After adjusting on that, the sensitivity grew to 97.7% and, more importantly for disease control purposes, the negative predictive value reached 99.2%. CONCLUSIONS We propose that viability testing should be always performed when evaluating a new antigen test. A well-chosen and validated antigen test provides excellent results in identifying patients who are shedding viable virus (although some caveats still remain) in the real-world high-throughput setting of asymptomatic or mildly symptomatic individuals.
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Affiliation(s)
- Miroslav Homza
- Hospital Karvina-Raj, Karvina, Czech Republic
- Faculty of Medicine, Department of Internal Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Hana Zelena
- Institute of Public Health Ostrava, Ostrava, Czech Republic
- Faculty of Medicine, Department of Biomedical Sciences, University of Ostrava, Ostrava, Czech Republic
| | - Jaroslav Janosek
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Hana Tomaskova
- Institute of Public Health Ostrava, Ostrava, Czech Republic
- Faculty of Medicine, Department of Epidemiology and Public Health, University of Ostrava, Ostrava, Czech Republic
| | - Eduard Jezo
- Institute of Public Health Ostrava, Ostrava, Czech Republic
| | - Alena Kloudova
- Institute of Public Health Ostrava, Ostrava, Czech Republic
| | - Jakub Mrazek
- Institute of Public Health Ostrava, Ostrava, Czech Republic
| | - Zdenek Svagera
- Faculty of Medicine, Department of Internal Medicine, University of Ostrava, Ostrava, Czech Republic
- Department of Clinical Biochemistry, University Hospital Ostrava, Ostrava, Czech Republic
| | - Roman Prymula
- Faculty of Medicine Hradec Kralove, Charles University Prague, Hradec Kralove, Czech Republic
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Khantour AE, Houadfi ME, Nassik S, Tligui NS, Mellouli FE, Sikht FZ, Ducatez MF, Soulaymani A, Fellahi S. Protective Efficacy Evaluation of Four Inactivated Commercial Vaccines Against Low Pathogenic Avian Influenza H9N2 Virus Under Experimental Conditions in Broiler Chickens. Avian Dis 2021; 65:351-357. [PMID: 34427407 DOI: 10.1637/aviandiseases-d-21-00015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/03/2021] [Indexed: 11/05/2022]
Abstract
Avian influenza vaccines are commonly used in the poultry industry. The objective of this study was to compare, under experimental conditions, the protective efficacy of four imported commercial inactivated H9N2 vaccines (A, B, C, and D) in broiler chickens. A total of 150 one-day-old chicks were divided into six groups: four experimental groups, each containing 30 chicks, received one of the vaccines (A, B, C, or D) delivered in a 0.3-ml dose subcutaneously at 1 day of age, whereas the control, Group T, was not vaccinated but challenged and Group E was kept unvaccinated and unchallenged. At 21 days postvaccination, Groups A, B, C, D, and T were challenged with 107 embryo infective dose 50% of A/Chicken/Morocco/01/2016 (H9N2). All chicks were observed daily for clinical signs during the 12 days postchallenge (dpc). At 5 and 12 dpc, chicks were euthanatized for necropsy examination. Blood samples were collected weekly for serologic analysis and oropharyngeal swabs were collected for virus detection by real-time RT-PCR. Respiratory signs started at 48 hr pc and maximum severity was observed on 9 dpc. Chiefly, the birds vaccinated with vaccine B showed significantly more respiratory signs than did their counterparts. Serologic analysis revealed that the sera of Groups A and D birds showed a decrease in antibody (Ab) levels up to day 26; then a slight increase of Ab level was observed until day 31, while Group B and C birds showed a stabilization of the titers from day 21 until the end of the experiment. The viral shedding rate was significantly lower in Groups C and A (40%-50% of the birds shed virus for <7 days) compared with other challenged groups (60%-75% of the birds shed virus for ≥9 days). This experiment illustrated that vaccination applied on the first day in the hatchery with the four vaccines tested did not provide an acceptable protection against H9N2 in comparison with the controls that did not receive any vaccine. However, at first glance, we might favor vaccines A and C for their ability to reduce and shorten viral shedding as compared with vaccines B and D.
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Affiliation(s)
- Abderrazak El Khantour
- Laboratoire de Biologie et Santé. Faculté des Sciences de Kénitra Université Ibn Tofail, Kénitra, Morocco (14000).,Division de la pharmacie et des Intrants vétérinaires; Office National de Sécurité Sanitaire des produits Alimentaires(ONSSA). Rue Ikhlas Cym BP 4509 Akkari. Rabat, Morocco (10050)
| | - Mohammed El Houadfi
- Unité de Pathologie Aviaire, Département de Pathologie et Santé Publique Vétérinaire, Institut Agronomique et Vétérinaire Hassan II, Rabat, Morocco (10000)
| | - Saadia Nassik
- Unité de Pathologie Aviaire, Département de Pathologie et Santé Publique Vétérinaire, Institut Agronomique et Vétérinaire Hassan II, Rabat, Morocco (10000)
| | - Nour Said Tligui
- Unité de Pathologie Aviaire, Département de Pathologie et Santé Publique Vétérinaire, Institut Agronomique et Vétérinaire Hassan II, Rabat, Morocco (10000)
| | - Fatiha El Mellouli
- Laboratoire régional d'analyses et de recherches de Casablanca (lRARC); ONSSA, Casablanca, Morocco
| | - Fatima-Zohra Sikht
- Unité de Pathologie Aviaire, Département de Pathologie et Santé Publique Vétérinaire, Institut Agronomique et Vétérinaire Hassan II, Rabat, Morocco (10000)
| | - Mariette F Ducatez
- Unité mixte de recherche, Institut National de Recherche Agricole/Ecole Vétérinaire de Toulouse 1225, Université de Toulouse, 31076 Toulouse, France
| | - Abdelmajid Soulaymani
- Laboratoire de Biologie et Santé. Faculté des Sciences de Kénitra Université Ibn Tofail, Kénitra, Morocco (14000)
| | - Siham Fellahi
- Unité de Pathologie Aviaire, Département de Pathologie et Santé Publique Vétérinaire, Institut Agronomique et Vétérinaire Hassan II, Rabat, Morocco (10000), ,
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Beerens N, Germeraad EA, Venema S, Verheij E, Pritz-Verschuren SBE, Gonzales JL. Comparative pathogenicity and environmental transmission of recent highly pathogenic avian influenza H5 viruses. Emerg Microbes Infect 2021; 10:97-108. [PMID: 33350337 PMCID: PMC7832006 DOI: 10.1080/22221751.2020.1868274] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Strategies to control spread of highly pathogenic avian influenza (HPAI) viruses by wild birds appear limited, hence timely characterization of novel viruses is important to mitigate the risk for the poultry sector and human health. In this study we characterize three recent H5-clade 2.3.4.4 viruses, the H5N8-2014 group A virus and the H5N8-2016 and H5N6-2017 group B viruses. The pathogenicity of the three viruses for chickens, Pekin ducks and Eurasian wigeons was compared. The three viruses were highly pathogenic for chickens, but the two H5N8 viruses caused no to mild clinical symptoms in both duck species. The highest pathogenicity for duck species was observed for the most recent H5N6-2017 virus. For both duck species, virus shedding from the cloaca was higher after infection with group B viruses compared to the H5N8-2014 group A virus. Higher cloacal virus shedding of wild ducks may increase transmission between wild birds and poultry. Environmental transmission of H5N8-2016 virus to chickens was studied, which showed that chickens are efficiently infected by (fecal) contaminated water. These results suggest that pathogenicity of HPAI H5 viruses and virus shedding for ducks is evolving, which may have implications for the risk of introduction of these viruses into the poultry sector.
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Affiliation(s)
- Nancy Beerens
- Wageningen University and Research - Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - Evelien A Germeraad
- Wageningen University and Research - Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - Sandra Venema
- Wageningen University and Research - Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - Eline Verheij
- Wageningen University and Research - Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | | | - Jose L Gonzales
- Wageningen University and Research - Wageningen Bioveterinary Research, Lelystad, The Netherlands
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Gozalbo-Rovira R, Santiso-Bellón C, Buesa J, Rubio-del-Campo A, Vila-Vicent S, Muñoz C, Yebra MJ, Monedero V, Rodríguez-Díaz J. Microbiota Depletion Promotes Human Rotavirus Replication in an Adult Mouse Model. Biomedicines 2021; 9:846. [PMID: 34356911 PMCID: PMC8301474 DOI: 10.3390/biomedicines9070846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/07/2021] [Accepted: 07/15/2021] [Indexed: 11/17/2022] Open
Abstract
Intestinal microbiota-virus-host interaction has emerged as a key factor in mediating enteric virus pathogenicity. With the aim of analyzing whether human gut bacteria improve the inefficient replication of human rotavirus in mice, we performed fecal microbiota transplant (FMT) with healthy infants as donors in antibiotic-treated mice. We showed that a simple antibiotic treatment, irrespective of FMT, resulted in viral shedding for 6 days after challenge with the human rotavirus G1P[8] genotype Wa strain (RVwa). Rotavirus titers in feces were also significantly higher in antibiotic-treated animals with or without FMT but they were decreased in animals subject to self-FMT, where a partial re-establishment of specific bacterial taxons was evidenced. Microbial composition analysis revealed profound changes in the intestinal microbiota of antibiotic-treated animals, whereas some bacterial groups, including members of Lactobacillus, Bilophila, Mucispirillum, and Oscillospira, recovered after self-FMT. In antibiotic-treated and FMT animals where the virus replicated more efficiently, differences were observed in gene expression of immune mediators, such as IL1β and CXCL15, as well as in the fucosyltransferase FUT2, responsible for H-type antigen synthesis in the small intestine. Collectively, our results suggest that antibiotic-induced microbiota depletion eradicates the microbial taxa that restrict human rotavirus infectivity in mice.
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Affiliation(s)
- Roberto Gozalbo-Rovira
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 17, 46010 Valencia, Spain; (R.G.-R.); (C.S.-B.); (J.B.); (S.V.-V.); (C.M.)
| | - Cristina Santiso-Bellón
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 17, 46010 Valencia, Spain; (R.G.-R.); (C.S.-B.); (J.B.); (S.V.-V.); (C.M.)
| | - Javier Buesa
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 17, 46010 Valencia, Spain; (R.G.-R.); (C.S.-B.); (J.B.); (S.V.-V.); (C.M.)
- Hospital Clínico Universitario de Valencia, Instituto de Investigación INCLIVA, 46010 Valencia, Spain
| | - Antonio Rubio-del-Campo
- Department of Biotechnology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980 Valencia, Spain; (A.R.-d.-C.); (M.J.Y.)
| | - Susana Vila-Vicent
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 17, 46010 Valencia, Spain; (R.G.-R.); (C.S.-B.); (J.B.); (S.V.-V.); (C.M.)
| | - Carlos Muñoz
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 17, 46010 Valencia, Spain; (R.G.-R.); (C.S.-B.); (J.B.); (S.V.-V.); (C.M.)
| | - María J. Yebra
- Department of Biotechnology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980 Valencia, Spain; (A.R.-d.-C.); (M.J.Y.)
| | - Vicente Monedero
- Department of Biotechnology, IATA-CSIC, Av. Agustín Escardino 7, Paterna, 46980 Valencia, Spain; (A.R.-d.-C.); (M.J.Y.)
| | - Jesús Rodríguez-Díaz
- Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 17, 46010 Valencia, Spain; (R.G.-R.); (C.S.-B.); (J.B.); (S.V.-V.); (C.M.)
- Hospital Clínico Universitario de Valencia, Instituto de Investigación INCLIVA, 46010 Valencia, Spain
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Gallardo C, Soler A, Nurmoja I, Cano-Gómez C, Cvetkova S, Frant M, Woźniakowski G, Simón A, Pérez C, Nieto R, Arias M. Dynamics of African swine fever virus (ASFV) infection in domestic pigs infected with virulent, moderate virulent and attenuated genotype II ASFV European isolates. Transbound Emerg Dis 2021; 68:2826-2841. [PMID: 34273247 DOI: 10.1111/tbed.14222] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/28/2021] [Accepted: 07/04/2021] [Indexed: 01/15/2023]
Abstract
This study aimed to compare the infection dynamics of three genotype II African swine fever viruses (ASFV) circulating in Europe. Eighteen domestic pigs divided into three groups were infected intramuscularly or by direct contact with two haemadsorbent ASFVs (HAD) from Poland (Pol16/DP/ OUT21) and Estonia (Est16/WB/Viru8), and with the Latvian non-HAD ASFV (Lv17/WB/Rie1). Parameters, such as symptoms, pathogenicity, and distribution of the virus in tissues, humoral immune response, and dissemination of the virus by blood, oropharyngeal and rectal routes, were investigated. The Polish ASFV caused a case of rapidly developing fatal acute disease, while the Estonian ASFV caused acute to sub-acute infections and two animals survived. In contrast, animals infected with the ASFV from Latvia developed a more subtle, mild, or even subclinical disease. Oral excretion was sporadic or even absent in the attenuated group, whereas in animals that developed an acute or sub-acute form of ASF, oral excretion began at the same time the ASFV was detected in the blood, or even 3 days earlier, and persisted up to 22 days. Regardless of virulence, blood was the main route of transmission of ASFV and infectious virus was isolated from persistently infected animals for at least 19 days in the attenuated group and up to 44 days in the group of moderate virulence. Rectal excretion was limited to the acute phase of infection. In terms of diagnostics, the ASFV genome was detected in contact pigs from oropharyngeal samples earlier than in blood, independently of virulence. Together with blood, both samples could allow to detect ASFV infection for a longer period. The results presented here provide quantitative data on the spread and excretion of ASFV strains of different virulence among domestic pigs that can help to better focus surveillance activities and, thus, increase the ability to detect ASF introductions earlier.
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Affiliation(s)
- Carmina Gallardo
- Centro de Investigación en Sanidad Animal, CISA, INIA-CSIC, European Union Reference Laboratory for African Swine Fever (EURL), Valdeolmos, Madrid, Spain
| | - Alejandro Soler
- Centro de Investigación en Sanidad Animal, CISA, INIA-CSIC, European Union Reference Laboratory for African Swine Fever (EURL), Valdeolmos, Madrid, Spain
| | - Imbi Nurmoja
- Estonian Veterinary and Food Laboratory, Estonian ASF-National reference laboratory (NRL), Kreutzwaldi, Tartu, Estonia
| | - Cristina Cano-Gómez
- Centro de Investigación en Sanidad Animal, CISA, INIA-CSIC, European Union Reference Laboratory for African Swine Fever (EURL), Valdeolmos, Madrid, Spain
| | - Svetlana Cvetkova
- Laboratory of Microbiology and Pathology Institute of Food Safety, Animal Health and Enviroment, BIOR, Latvian ASF-National reference laboratory, Lejupes, Riga, Latvia
| | - Maciej Frant
- National Veterinary Research Institute, Poland ASF-National reference laboratory, Partyzantow, Pulawy, Poland
| | - Grzegorz Woźniakowski
- National Veterinary Research Institute, Poland ASF-National reference laboratory, Partyzantow, Pulawy, Poland.,Department of Diagnostics and Clinical Sciences, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Toruń, Lwowska, Toruń, Poland
| | - Alicia Simón
- Centro de Investigación en Sanidad Animal, CISA, INIA-CSIC, European Union Reference Laboratory for African Swine Fever (EURL), Valdeolmos, Madrid, Spain
| | - Covadonga Pérez
- Centro de Investigación en Sanidad Animal, CISA, INIA-CSIC, European Union Reference Laboratory for African Swine Fever (EURL), Valdeolmos, Madrid, Spain
| | - Raquel Nieto
- Centro de Investigación en Sanidad Animal, CISA, INIA-CSIC, European Union Reference Laboratory for African Swine Fever (EURL), Valdeolmos, Madrid, Spain
| | - Marisa Arias
- Centro de Investigación en Sanidad Animal, CISA, INIA-CSIC, European Union Reference Laboratory for African Swine Fever (EURL), Valdeolmos, Madrid, Spain
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Al Khatib HA, Mathew S, Smatti MK, Eltai NO, Pathan SA, Al Thani AA, Coyle PV, Al Maslamani MA, Yassine HM. Profiling of Intestinal Microbiota in Patients Infected with Respiratory Influenza A and B Viruses. Pathogens 2021; 10:761. [PMID: 34204203 DOI: 10.3390/pathogens10060761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 12/23/2022] Open
Abstract
Little is known about the association between respiratory viral infections and their impact on intestinal microbiota. Here, we compared the effect of influenza types, A and B, and influenza shedding in patients’ stools on the gut microbiota diversity and composition. Deep sequencing analysis was performed for the V4 region of the 16S rRNA gene. Fecal samples were collected from 38 adults with active respiratory influenza infection and 11 age-matched healthy controls. Influenza infection resulted in variations in intestinal bacterial community composition rather than in overall diversity. Overall, infected patients experienced an increased abundance of Bacteroidetes and a corresponding decrease in Firmicutes. Differential abundance testing illustrated that differences in gut microbiota composition were influenza type-dependent, identifying ten differentially abundant operational taxonomic units (OTUs) between influenza A- and influenza B-infected patients. Notably, virus shedding in fecal samples of some patients had significantly reduced gut bacterial diversity (p = 0.023). Further taxonomic analysis revealed that the abundance of Bacteroides fragilis was significantly higher among shedders compared to non-shedders (p = 0.037). These results provide fundamental evidence of the direct effect of influenza infection on gut microbiota diversity, as reported in patients shedding the virus.
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Epstein RL, Sperring H, Hofman M, Lodi S, White LF, Barocas JA, Bouton TC, Xiao Y, Hsu HE, Miller NS, Linas BP, Marathe JG. Time to SARS-CoV-2 PCR Clearance in Immunocompromising Conditions: Is Test-Based Removal From Isolation Necessary in Severely Immunocompromised Individuals? Open Forum Infect Dis 2021; 8:ofab164. [PMID: 34189164 PMCID: PMC8231388 DOI: 10.1093/ofid/ofab164] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/25/2021] [Indexed: 12/26/2022] Open
Abstract
To determine the association between immunosuppression and time to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) clearance, we studied 3758 adults retested following initial SARS-CoV-2 infection. Cox proportional hazards models demonstrated delayed PCR clearance with older age, multiple comorbidities, and solid organ transplant but not by degree of immunocompromise. These findings challenge current retesting practices.
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Affiliation(s)
- Rachel L Epstein
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Heather Sperring
- Center for Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
| | | | - Sara Lodi
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Laura F White
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Joshua A Barocas
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Tara C Bouton
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Yian Xiao
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Heather E Hsu
- Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Nancy S Miller
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Benjamin P Linas
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jai G Marathe
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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Murata T, Sakurai A, Suzuki M, Komoto S, Ide T, Ishihara T, Doi Y. Shedding of Viable Virus in Asymptomatic SARS-CoV-2 Carriers. mSphere 2021; 6:e00019-21. [PMID: 34011679 PMCID: PMC8265619 DOI: 10.1128/msphere.00019-21] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/06/2021] [Indexed: 12/19/2022] Open
Abstract
Information regarding the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic carriers is scarce. In order to determine the duration of infectivity and its correlation with reverse transcription-PCR (RT-PCR) results and time since initial positive PCR test in this population, we evaluated SARS-CoV-2 cell infectivity in nasopharyngeal samples longitudinally obtained from asymptomatic carriers who disembarked from a cruise ship during a COVID-19 outbreak. Of 166 nasopharyngeal samples collected from 39 asymptomatic carriers every 48 h until two consecutive negative PCR test results were obtained, SARS-CoV-2 was successfully isolated from 9 PCR-positive samples which were obtained from 7 persons (18%; 7/39). Viable viruses were isolated predominantly within 7 days after the initial positive PCR test, except for one person who shed viable virus until day 15. The median crossing point (Cp) value of RT-PCR of culture-positive samples was 24.6 (interquartile range [IQR], 20.4 to 25.8; range, 17.9 to 30.3), and Cp values were significantly associated with isolation of viable virus (odds ratio, 0.496; 95% confidence interval [CI], 0.329 to 0.747; P value, 0.001), which was consistent with existing data for symptomatic patients. Genome sequence analysis of SARS-CoV-2 samples consecutively obtained from a person who shed viable virus for 15 days identified the emergence of two novel single nucleotide variants (C8626T transition and C18452T transition) in the sample collected on day 15, with the latter corresponding to an amino acid substitution in nonstructural protein 14. The impact of these mutations on prolonged viable-virus shedding is unclear. These findings underscore the potential role of asymptomatic carriers in transmission.IMPORTANCE A growing number of studies suggest the potential role of asymptomatic SARS-CoV-2 carriers as a major driver of the COVID-19 pandemic; however, virological assessment of asymptomatic infection has largely been limited to reverse transcription-PCR (RT-PCR), which can be persistently positive without necessarily indicating the presence of viable virus (e.g., replication-competent virus). Here, we evaluated the infectivity of asymptomatic SARS-CoV-2 carriers by detecting SARS-CoV-2-induced cytopathic effects on Vero cells using longitudinally obtained nasopharyngeal samples from asymptomatic carriers. We show that asymptomatic carriers can shed viable virus until 7 days after the initial positive PCR test, with one outlier shedding until day 15. The crossing point (Cp) value of RT-PCR was the leading predictive factor for virus viability. These findings provide additional insights into the role of asymptomatic carriers as a source of transmission and highlight the importance of universal source control measures, along with isolation policy for asymptomatic carriers.
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Affiliation(s)
- Takayuki Murata
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Aki Sakurai
- Department of Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Masahiro Suzuki
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Tomihiko Ide
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Center for Joint Research Facilities Support, Research Promotion and Support Headquarters, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Yanagido, Gifu, Japan
| | - Yohei Doi
- Department of Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Bao C, Li B, Zhou Y. A triple combination of treatments on moderate COVID-19. Open Med (Wars) 2021; 16:769-772. [PMID: 34027106 PMCID: PMC8122460 DOI: 10.1515/med-2021-0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE A triple combination of interferon (IFN) α-2b, lopinavir tablets, and umifenovir was used to treat COVID-19 patients. It is important to explore whether the benefit of this therapy is time dependent. METHODS A cohort of moderate COVID-19 patients (n = 54) was admitted for hospitalization. The demographic (age, gender, and smoking status) and clinical characteristics (epidemiological trace and comorbidity) were collected from the digital medical records. The length of hospital stay (LOS) and the viral shedding time (VST) were set as the outcomes for COVID-19 cases. RESULTS After control for age, sex, epidemiological trace, smoking, and comorbidity, the time of treatment start had null effect on VST (IRR = 1.09; 95% CI = 0.91-1.30; p = 0.33) or LOS (IRR = 1.10; 95% CI = 0.94-1.28; p = 0.23). CONCLUSION There is no convincing evidence to support a pivotal role of the timing of the therapy in the prognosis of moderate COVID-19 cases.
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Affiliation(s)
- ChunMiao Bao
- Department of Respiratory Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital of Zhejiang Province, Zhejiang, China
| | - BinBin Li
- Department of Infection, YongJia County People’s Hospital, Shangtang Road, Wenzhou, 325000, China
| | - YuFeng Zhou
- Department of Intensive Care Unit, The Affiliated Yangming Hospital of Ningbo University, Yuyao People’s Hospital of Zhejiang Province, Zhejiang, China
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Yang JS, Yoo MG, Lee HJ, Jang HB, Jung HD, Nam JG, Lee JY, Jee Y, Kim SS. Factors Associated With Viral Load Kinetics of Middle East Respiratory Syndrome Coronavirus During the 2015 Outbreak in South Korea. J Infect Dis 2021; 223:1088-1092. [PMID: 32761054 PMCID: PMC7454697 DOI: 10.1093/infdis/jiaa466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
We conducted a retrospective study of Middle East respiratory syndrome coronavirus (MERS-CoV) viral load kinetics using data from patients hospitalized with MERS-CoV infection between 19 May and 20 August 2015. Viral load trajectories were considered over the hospitalization period using 1714 viral load results measured in serial respiratory specimens of 185 patients. The viral load levels were significantly higher among nonsurvivors than among survivors (P = .003). Healthcare workers (P = .001) and nonspreaders (P < .001) had significantly lower viral loads. Viral RNA was present on the day of symptom onset and peaked 4-10 days after symptom onset.
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Affiliation(s)
- Jeong-Sun Yang
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Min-Gyu Yoo
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Hye-Ja Lee
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Han Byul Jang
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Hee-Dong Jung
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Jeong-Gu Nam
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Joo-Yeon Lee
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Youngmee Jee
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Sung Soon Kim
- Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
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Islam SRU, Akther T, Sultana S, Munshi SU. Persistence of SARS-CoV-2 RNA in a male with metabolic syndrome for 72 days: A case report. SAGE Open Med Case Rep 2021; 9:2050313X21989492. [PMID: 33628449 PMCID: PMC7841660 DOI: 10.1177/2050313x21989492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/04/2021] [Indexed: 12/04/2022] Open
Abstract
Coronavirus disease-19 (COVID-19) was first identified in Wuhan, China, and spread gradually throughout the world. There are multiple reports of prolonged viral shedding in people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, such findings have not been documented in Bangladesh. Herein, we present a case of metabolic syndrome that remained positive for SARS-CoV-2 RNA over a prolonged period. On clinical and laboratory examination, the patient was diagnosed with obesity, raised blood pressure, dyslipidemia, and uncontrolled glycemia. However, upon taking appropriate measures and controlling the plasma sugar level, he tested negative for SARS-CoV-2 RNA on the 72nd day since illness onset. We observed that COVID-19 patients with several comorbidities, such as metabolic syndrome, may shed the virus over a prolonged period. Therefore, strict public health measures and isolation rules should be followed by a high-risk population.
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Affiliation(s)
- Sm Rashed Ul Islam
- Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Tahmina Akther
- Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Sharmin Sultana
- Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Saif Ullah Munshi
- Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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Abdul-Jawad S, Baù L, Alaguthurai T, Del Molino Del Barrio I, Laing AG, Hayday TS, Monin L, Muñoz-Ruiz M, McDonald L, Francos Quijorna I, McKenzie D, Davis R, Lorenc A, Chan JNE, Ryan S, Bugallo-Blanco E, Yorke R, Kamdar S, Fish M, Zlatareva I, Vantourout P, Jennings A, Gee S, Doores K, Bailey K, Hazell S, De Naurois J, Moss C, Russell B, Khan AA, Rowley M, Benjamin R, Enting D, Alrifai D, Wu Y, Zhou Y, Barber P, Ng T, Spicer J, Van Hemelrijck M, Kumar M, Vidler J, Lwin Y, Fields P, Karagiannis SN, Coolen ACC, Rigg A, Papa S, Hayday AC, Patten PEM, Irshad S. Acute Immune Signatures and Their Legacies in Severe Acute Respiratory Syndrome Coronavirus-2 Infected Cancer Patients. Cancer Cell 2021; 39:257-275.e6. [PMID: 33476581 PMCID: PMC7833668 DOI: 10.1016/j.ccell.2021.01.001] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/02/2020] [Accepted: 12/30/2020] [Indexed: 01/09/2023]
Abstract
Given the immune system's importance for cancer surveillance and treatment, we have investigated how it may be affected by SARS-CoV-2 infection of cancer patients. Across some heterogeneity in tumor type, stage, and treatment, virus-exposed solid cancer patients display a dominant impact of SARS-CoV-2, apparent from the resemblance of their immune signatures to those for COVID-19+ non-cancer patients. This is not the case for hematological malignancies, with virus-exposed patients collectively displaying heterogeneous humoral responses, an exhausted T cell phenotype and a high prevalence of prolonged virus shedding. Furthermore, while recovered solid cancer patients' immunophenotypes resemble those of non-virus-exposed cancer patients, recovered hematological cancer patients display distinct, lingering immunological legacies. Thus, while solid cancer patients, including those with advanced disease, seem no more at risk of SARS-CoV-2-associated immune dysregulation than the general population, hematological cancer patients show complex immunological consequences of SARS-CoV-2 exposure that might usefully inform their care.
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Affiliation(s)
- Sultan Abdul-Jawad
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Luca Baù
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Thanussuyah Alaguthurai
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK; Breast Cancer Now Research Unit, King's College London, London, UK
| | - Irene Del Molino Del Barrio
- Cancer Immunotherapy Accelerator, UCL Cancer Institute, University College and King's College, London, UK; Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Adam G Laing
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Thomas S Hayday
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | | | | | - Louisa McDonald
- Oncology and Haematology Clinical Trials (OHCT), Guy's and St Thomas' NHS Foundation Trust, London UK
| | | | | | - Richard Davis
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Anna Lorenc
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Julie Nuo En Chan
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Sarah Ryan
- Department of Inflammation Biology, King's College London, London, UK
| | - Eva Bugallo-Blanco
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Rozalyn Yorke
- Department of Inflammation Biology, King's College London, London, UK
| | - Shraddha Kamdar
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Matthew Fish
- Peter Gorer Department of Immunobiology, King's College London, London, UK; Department of Intensive Care Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Iva Zlatareva
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Pierre Vantourout
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Aislinn Jennings
- Peter Gorer Department of Immunobiology, King's College London, London, UK; Department of Intensive Care Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sarah Gee
- Peter Gorer Department of Immunobiology, King's College London, London, UK
| | - Katie Doores
- Department of Infectious Diseases, King's College London, London, UK
| | - Katharine Bailey
- Department of Haematology, Guy's and St Thomas' NHS Foundation trust, London, UK
| | - Sophie Hazell
- Department of Haematology, Guy's and St Thomas' NHS Foundation trust, London, UK
| | - Julien De Naurois
- Department of Medical Oncology Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Charlotte Moss
- Department of Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Beth Russell
- Department of Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Aadil A Khan
- Targeted Therapy Team, The Institute of Cancer Research, London, UK
| | - Mark Rowley
- London Institute for Mathematical Sciences, Mayfair, London, UK; Saddle Point Science Ltd, London, UK
| | - Reuben Benjamin
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK; Department of Haematological Medicine, King's College Hospital, London, UK
| | - Deborah Enting
- Department of Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Doraid Alrifai
- Department of Medical Oncology Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Yin Wu
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK; Cancer Immunotherapy Accelerator, UCL Cancer Institute, University College and King's College, London, UK; Peter Gorer Department of Immunobiology, King's College London, London, UK; The Francis Crick Institute, London, UK
| | - You Zhou
- Systems Immunity University Research Institute and Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Paul Barber
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Tony Ng
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - James Spicer
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - Mieke Van Hemelrijck
- Department of Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Mayur Kumar
- Department of Gastroenterology, Princess Royal University Hospital, Kent, UK
| | - Jennifer Vidler
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Yadanar Lwin
- Department of Haematological Medicine, King's College Hospital, London, UK
| | - Paul Fields
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK; Department of Haematology, Guy's and St Thomas' NHS Foundation trust, London, UK
| | - Sophia N Karagiannis
- Breast Cancer Now Research Unit, King's College London, London, UK; St. John's Institute of Dermatology, King's College London, London, UK; NIHR Biomedical Research Centre, and King's College London, London, UK
| | - Anthony C C Coolen
- Targeted Therapy Team, The Institute of Cancer Research, London, UK; London Institute for Mathematical Sciences, Mayfair, London, UK; Saddle Point Science Ltd, London, UK; Department of Biophysics, Radboud University, Nijmegen, The Netherlands
| | - Anne Rigg
- Department of Medical Oncology Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Sophie Papa
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK; Department of Medical Oncology Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Adrian C Hayday
- Peter Gorer Department of Immunobiology, King's College London, London, UK; The Francis Crick Institute, London, UK
| | - Piers E M Patten
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK; Department of Haematological Medicine, King's College Hospital, London, UK; Medical Research Council (MRC) Clinical Academic Research Partnership, London, UK
| | - Sheeba Irshad
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK; Breast Cancer Now Research Unit, King's College London, London, UK; Department of Medical Oncology Guy's and St Thomas' NHS Foundation Trust, London, UK; Cancer Research UK (CRUK) Clinician Scientist, London, UK.
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Gietl S, Schönegger CM, Falk M, Weiler S, Obererlacher S, Jansen B, Sonnleitner ST, Walder G. Home quarantine in COVID-19: A study on 50 consecutive patients in Austria. Clin Med (Lond) 2021; 21:e9-e13. [PMID: 33479077 DOI: 10.7861/clinmed.2020-0787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A cohort of the first 50 COVID-19 patients in East Tyrol, a region in the southwest of Austria, were monitored in home quarantine. Specific viral ribonucleic acid was detected in throat swabs and stool samples. Analysis indicated a median virus shedding duration of 13 days; however, statistical outliers highlight the importance of consequent testing. This underlines the need of negative throat swabs prior to removing quarantine. We monitored the disease's characteristics via an in-house score called Corona Severity Index, in order to predict an aggravation of the disease. Special attention was paid to early symptoms, such as headache, which appeared to be significantly more common in younger patients (p=0.019). Anosmia and ageusia showed a predominance in female patients (p=0.028). Investigation revealed seven relapses and viral shedding fluctuation in four cases. A follow-up examination shed light on seroconversion which could be observed in 35 of 40 participants. This further clarifies the necessity of establishing discharge standards and follow-up management for COVID-19 patients.
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Affiliation(s)
- Sarah Gietl
- Dr Gernot Walder Medical Laboratory, Außervillgraten, Austria
| | | | - Markus Falk
- Institute of Mountain Emergency Medicine, Bolzano, Italy
| | - Stefanie Weiler
- Dr Gernot Walder Medical Laboratory, Außervillgraten, Austria
| | | | - Bianca Jansen
- Dr Gernot Walder Medical Laboratory, Außervillgraten, Austria
| | | | - Gernot Walder
- Dr Gernot Walder Medical Laboratory, Außervillgraten, Austria
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Jackson D, Pitcher M, Hudson C, Andrews N, Southern J, Ellis J, Höschler K, Pebody R, Turner PJ, Miller E, Zambon M. Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016-2017 and 2017-2018 Influenza Seasons in the United Kingdom. Clin Infect Dis 2021; 70:2505-2513. [PMID: 31642899 PMCID: PMC7286380 DOI: 10.1093/cid/ciz719] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 08/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background The (H1N1)pdm09 live attenuated influenza vaccine (LAIV) strain was changed for the 2017–2018 influenza season to improve viral fitness, following poor protection against (H1N1)pdm09 viruses in 2015–2016. We conducted LAIV virus shedding studies to assess the effect of this change. Methods Children aged 2–18 years were recruited to receive LAIV in the 2016–2017 (n = 641) and 2017–2018 (n = 362) influenza seasons. Viruses from nasal swabs taken 1, 3, and 6 days postvaccination were quantified by reverse-transcription polymerase chain reaction and area under the curve titers were determined. Presence and quantity of shedding were compared between strains and seasons with adjustment for age and prior LAIV (n = 436), inactivated seasonal vaccine (n = 100), or (H1N1)pdm09 vaccine (n = 166) receipt. Results (H1N1)pdm09 detection (positivity) in 2016–2017 and 2017–2018 (11.2% and 3.9%, respectively) was lower than that of H3N2 (19.7% and 18.7%, respectively) and B/Victoria (28.9% and 33.9%, respectively). (H1N1)pdm09 positivity was higher in 2016–2017 than 2017–2018 (P = .005), but within shedding-positive participants, the (H1N1)pdm09 titer increased in 2017–2018 (P = .02). H3N2 and influenza B titers were similar between seasons. Positivity declined with age, and prior vaccination reduced the likelihood of shedding influenza B but not (H1N1)pdm09. Conclusions The (H1N1)pdm09 titer increased in 2017–2018, indicating more efficient virus replication in shedding-positive children than the 2016–2017 strain, although overall positivity was reduced. Age and vaccination history require consideration when correlating virus shedding and protection. Clinical Trials Registration NCT02143882, NCT02866942, and NCT03104790.
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Affiliation(s)
- David Jackson
- Virus Reference Department, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Max Pitcher
- Virus Reference Department, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Chris Hudson
- Virus Reference Department, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Nick Andrews
- Statistics, Modelling and Economics Department, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Jo Southern
- Immunisation and Countermeasures, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Joanna Ellis
- Immunisation and Countermeasures, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Katja Höschler
- Virus Reference Department, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Richard Pebody
- Immunisation and Countermeasures, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Paul J Turner
- Immunisation and Countermeasures, National Infection Service, Public Health England, Colindale, United Kingdom.,Section of Paediatrics, Imperial College London, London, United Kingdom
| | - Elizabeth Miller
- Immunisation and Countermeasures, National Infection Service, Public Health England, Colindale, United Kingdom
| | - Maria Zambon
- Virus Reference Department, National Infection Service, Public Health England, Colindale, United Kingdom
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Abstract
PRACTICAL RELEVANCE Feline leukaemia virus (FeLV) is a retrovirus of domestic cats worldwide. Cats lacking strong FeLV-specific immunity and undergoing progressive infection commonly develop fatal FeLV-associated disease. Many aspects of FeLV infection pathogenesis have been elucidated, some during more recent years using molecular techniques. It is recommended that the FeLV status of every cat is known, since FeLV infection can influence the prognosis and clinical management of every sick cat. Moreover, knowledge of a cat's FeLV status is of epidemiological importance to prevent further spread of the infection. CLINICAL CHALLENGES Diagnosing FeLV infection remains challenging due to different outcomes of infection, which can vary over time depending on the balance between the virus and the host's immune system. Furthermore, testing for FeLV infection has become more refined over the years and now includes diagnostic assays for different viral and immunological parameters. Knowledge of FeLV infection pathogenesis, as well as the particulars of FeLV detection methods, is an important prerequisite for correct interpretation of any test results and accurate determination of a cat's FeLV status. AIMS The current review presents recent knowledge on FeLV pathogenesis, key features to be determined in FeLV infection, and frequently used FeLV detection methods, and their characteristics and interpretation. An algorithm for the diagnosis of FeLV infection in a single cat, developed by the European Advisory Board on Cat Diseases, is included, and FeLV testing in specific situations is addressed. As well as increasing awareness of this deadly infection in domestic cats, the aim is to contribute diagnostic expertise to allow veterinarians in practice to improve their recognition, and further reduce the prevalence, of FeLV infection.
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Affiliation(s)
- Regina Hofmann-Lehmann
- Prof, Dr med vet, FVH Professor of Laboratory Medicine, Director of Department of Clinical Diagnostics and Services, Head of Clinical Laboratory and Centre for Clinical Studies, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Katrin Hartmann
- Prof, Dr med vet, Dr habil, Dip ECVIM-CA (Internal Medicine) Professor of Internal Medicine, Head of Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Germany
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43
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Lewis NM, Duca LM, Marcenac P, Dietrich EA, Gregory CJ, Fields VL, Banks MM, Rispens JR, Hall A, Harcourt JL, Tamin A, Willardson S, Kiphibane T, Christensen K, Dunn AC, Tate JE, Nabity S, Matanock AM, Kirking HL. Characteristics and Timing of Initial Virus Shedding in Severe Acute Respiratory Syndrome Coronavirus 2, Utah, USA. Emerg Infect Dis 2020; 27:352-359. [PMID: 33275874 PMCID: PMC7853554 DOI: 10.3201/eid2702.203517] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Virus shedding in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur before onset of symptoms; less is known about symptom progression or infectiousness associated with initiation of viral shedding. We investigated household transmission in 5 households with daily specimen collection for 5 consecutive days starting a median of 4 days after symptom onset in index patients. Seven contacts across 2 households implementing no precautionary measures were infected. Of these 7, 2 tested positive for SARS-CoV-2 by reverse transcription PCR on day 3 of 5. Both had mild, nonspecific symptoms for 1–3 days preceding the first positive test. SARS-CoV-2 was cultured from the fourth-day specimen in 1 patient and from the fourth- and fifth-day specimens in the other. We also describe infection control measures taken in the households that had no transmission. Persons exposed to SARS-CoV-2 should self-isolate, including from household contacts, wear a mask, practice hand hygiene, and seek testing promptly.
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White LA, Siva-Jothy JA, Craft ME, Vale PF. Genotype and sex-based host variation in behaviour and susceptibility drives population disease dynamics. Proc Biol Sci 2020; 287:20201653. [PMID: 33171094 DOI: 10.1098/rspb.2020.1653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Host heterogeneity in pathogen transmission is widespread and presents a major hurdle to predicting and minimizing disease outbreaks. Using Drosophila melanogaster infected with Drosophila C virus as a model system, we integrated experimental measurements of social aggregation, virus shedding, and disease-induced mortality from different genetic lines and sexes into a disease modelling framework. The experimentally measured host heterogeneity produced substantial differences in simulated disease outbreaks, providing evidence for genetic and sex-specific effects on disease dynamics at a population level. While this was true for homogeneous populations of single sex/genetic line, the genetic background or sex of the index case did not alter outbreak dynamics in simulated, heterogeneous populations. Finally, to explore the relative effects of social aggregation, viral shedding and mortality, we compared simulations where we allowed these traits to vary, as measured experimentally, to simulations where we constrained variation in these traits to the population mean. In this context, variation in infectiousness, followed by social aggregation, was the most influential component of transmission. Overall, we show that host heterogeneity in three host traits dramatically affects population-level transmission, but the relative impact of this variation depends on both the susceptible population diversity and the distribution of population-level variation.
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Affiliation(s)
- Lauren A White
- National Socio-Environmental Synthesis Center SESYNC, 1 Park Place, Suite 300, Annapolis, MD 21401, USA.,Department of Veterinary Population Medicine, University of Minnesota, St Paul, MN 55126, USA
| | - Jonathon A Siva-Jothy
- Institute of Evolutionary Biology, School of Biological Sciences, University of Edinburgh, Ashworth Labs, Charlotte Auerbach Road, Edinburgh EH9 3JT, UK
| | - Meggan E Craft
- Department of Veterinary Population Medicine, University of Minnesota, St Paul, MN 55126, USA
| | - Pedro F Vale
- Institute of Evolutionary Biology, School of Biological Sciences, University of Edinburgh, Ashworth Labs, Charlotte Auerbach Road, Edinburgh EH9 3JT, UK
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Wang K, Zhang X, Sun J, Ye J, Wang F, Hua J, Zhang H, Shi T, Li Q, Wu X. Differences of Severe Acute Respiratory Syndrome Coronavirus 2 Shedding Duration in Sputum and Nasopharyngeal Swab Specimens Among Adult Inpatients With Coronavirus Disease 2019. Chest 2020; 158:1876-1884. [PMID: 32569635 PMCID: PMC7305751 DOI: 10.1016/j.chest.2020.06.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The viral shedding duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not been fully defined. Consecutive detection of SARS-CoV-2 RNA from respiratory tract specimens is essential for determining duration of virus shedding and providing evidence to optimize the clinical management of coronavirus disease 2019 (COVID-19). RESEARCH QUESTION What are the shedding durations of SARS-CoV-2 RNA in the upper and lower respiratory tract specimens? What are their associated risk factors? STUDY DESIGN AND METHODS A total of 68 patients with COVID-19 admitted to Wuhan Taikang Tongji Hospital and Huoshenshan Hospital from February 10, 2020, to March 20, 2020, were recruited. Consecutive SARS-CoV-2 RNA detection from paired specimens of nasopharyngeal swab (NPS) and sputum were carried out. The clinical characteristics of patients were recorded for further analysis. RESULTS SARS-CoV-2 RNA was detected from NPSs in 48 patients (70.6%), and from sputum specimens in 30 patients (44.1%). The median duration of viral shedding from sputum specimens (34 days; interquartile range [IQR], 24-40) was significantly longer than from NPSs (19 days; IQR, 14-25; P < .001). Elderly age was an independent factor associated with prolonged virus shedding time of SARS-CoV-2 (hazard ratio, 1.71; 95% CI, 1.01-2.93). It was noteworthy that in 9 patients, the viral RNA was detected in sputum after NPS turned negative. Chronic lung disease and steroids were associated with virus detection in sputum, and diabetes mellitus was associated with virus detection in both NPS and sputum. INTERPRETATION These findings may impact a test based clearance discharge criteria given patients with COVID-19 may shed virus longer in their lower respiratory tracts, with potential implication for prolonged transmission risk. In addition, more attention should be given to elderly patients who might have prolonged viral shedding duration.
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Affiliation(s)
- Kun Wang
- Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China; Department of Pulmonary and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xin Zhang
- Department of Pulmonary and Critical Care Medicine, People's Liberation Army Joint Logistic Support Force 920th Hospital, Yunnan, China
| | - Jiaxing Sun
- Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Jia Ye
- Department of Respiratory and Critical Care Medicine, People's Liberation Army Joint Logistic Support Force 900th Hospital, Fuzhou, China
| | - Feilong Wang
- Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Jing Hua
- Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Huayu Zhang
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Scotland
| | - Ting Shi
- Centre for Global Health, Usher, University of Edinburgh, Scotland
| | - Qiang Li
- Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Xiaodong Wu
- Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
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Ansari F, Pashazadeh F, Nourollahi E, Hajebrahimi S, Munn Z, Pourjafar H. A Systematic Review and Meta-Analysis: The Effectiveness of Probiotics for Viral Gastroenteritis. Curr Pharm Biotechnol 2020; 21:1042-1051. [PMID: 32297578 DOI: 10.2174/1389201021666200416123931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/22/2020] [Accepted: 03/07/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Probiotics can be used for the treatment of viral gastroenteritis. OBJECTIVE This systematic review is to evaluate the evidence regarding the effect of probiotics on human cases of viral gastroenteritis. METHODS The objective of this review is to evaluate the effectiveness of probiotics against placebo or standard treatment for viral gastroenteritis. A comprehensive search of Cochrane Library, EMBASE, MEDLINE via PubMed and Ovid databases, and unpublished studies (till 27 January 2018) was conducted followed by a process of study selection and critical appraisal by two independent reviewers. Randomized controlled trials assessing probiotic administration in human subjects infected with any species of gastroenteritis viruses were considered for inclusion. Only studies with a confirmed viral cause of infection were included. This study was developed using the JBI methodology for systematic reviews, which is in accordance with the PRISMA guideline. Meta-analysis was conducted where feasible. Data were pooled using the inverse variance method with random effects models and expressed as Mean Differences (MDs) with 95% Confidence Intervals (CIs). Heterogeneity was assessed by Cochran Q statistic and quantified by the I2 statistic. We included 17 RCTs, containing 3,082 patients. RESULTS Probiotics can improve symptoms of viral gastroenteritis, including the duration of diarrhea (mean difference 0.7 days, 95% CI 0.31 to 1.09 days, n = 740, ten trials) and duration of hospitalization (mean difference 0.76 days, 95% CI 0.61 to 0.92 days, n = 329, four trials). CONCLUSION The results of this review show that the administration of probiotics in patients with viral gastroenteritis should be considered.
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Affiliation(s)
- Fereshteh Ansari
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Pashazadeh
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elaheh Nourollahi
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Hajebrahimi
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zachary Munn
- The Joanna Briggs Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Hadi Pourjafar
- Department of Food Sciences and Nutrition, Maragheh University of Medical Sciences, Maragheh, Iran
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47
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Aljumaili OA, Bello MB, Yeap SK, Omar AR, Ideris A. Protective efficacy of inactivated Newcastle disease virus vaccines prepared in two different oil-based adjuvants. ACTA ACUST UNITED AC 2020; 87:e1-e7. [PMID: 33054260 PMCID: PMC7565102 DOI: 10.4102/ojvr.v87i1.1865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/17/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022]
Abstract
Despite the availability of Newcastle disease (ND) vaccines for more than six decades, disease outbreaks continue to occur with huge economic consequences to the global poultry industry. The aim of this study is to develop a safe and effective inactivated vaccine based on a recently isolated Newcastle disease virus (NDV) strain IBS025/13 and evaluate its protective efficacy in chicken following challenge with a highly virulent genotype VII isolate. Firstly, high titre of IBS025/13 was exposed to various concentrations of binary ethylenimine (BEI) to determine the optimal conditions for complete inactivation of the virus. The inactivated virus was then prepared in form of a stable water-in-oil emulsion of black seed oil (BSO) or Freund’s incomplete adjuvant (FIA) and used as vaccines in specific pathogen-free chicken. Efficacy of various vaccine preparations was also evaluated based on the ability of the vaccine to protect against clinical disease, mortality and virus shedding following challenge with highly virulent genotype\VII NDV isolate. The results indicate that exposure of NDV IBS025/13 to 10 mM of BEI for 21 h at 37 °C could completely inactivate the virus without tempering with the structural integrity of the viral hemagglutin-neuraminidase protein. More so, the inactivated vaccines adjuvanted with either BSO- or FIA-induced high hemagglutination inhibition antibody titre that protected the vaccinated birds against clinical disease and in some cases virus shedding, especially when used together with live attenuated vaccines. Thus, genotype VII-based NDV-inactivated vaccines formulated in BSO could substantially improve poultry disease control particularly when combined with live attenuated vaccines.
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Affiliation(s)
- Oday A Aljumaili
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia; and, Laboratory of Vaccines and Immunotherapeutics, Institute of Bioscience, Universiti Putra Malaysia, Serdang.
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48
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Klein-Richers U, Hartmann K, Hofmann-Lehmann R, Unterer S, Bergmann M, Rieger A, Leutenegger C, Pantchev N, Balzer J, Felten S. Prevalence of Feline Corona virus Shedding in German Catteries and Associated Risk Factors. Viruses 2020; 12:E1000. [PMID: 32911718 DOI: 10.3390/v12091000] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this prospective study was to determine prevalence and potential risk factors of feline coronavirus (FCoV) shedding. Four consecutive fecal samples of 179 cats from 37 German breeding catteries were analyzed for FCoV ribonucleic acid (RNA) by real-time reverse transcriptase polymerase chain reaction (RT-qPCR). Prevalence of shedding was calculated using different numbers of fecal samples per cat (1–4) and different sampling intervals (5–28 days). Information on potential risk factors for FCoV shedding was obtained by a questionnaire. Risk factor analysis was performed using a generalized linear mixed model (GLMM). Most cats (137/179, 76.5%, 95% confidence interval (CI) 69.8–82.2) shed FCoV at least at once. None of the tested 37 catteries was free of FCoV. Prevalence calculated including all four (76.5%, 95% CI 69.8–82.2) or the last three (73.7%, 95% CI 66.8–79.7) samples per cat was significantly higher than the prevalence calculated with only the last sample (61.5%, 95% CI 54.2–68.3; p = 0.0029 and 0.0175, respectively). Young age was significantly associated with FCoV shedding while the other factors were not. For identification of FCoV shedders in multi-cat households, at least three fecal samples per cat should be analyzed. Young age is the most important risk factor for FCoV shedding.
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49
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Nazir S, Yegoraw AA, Charlesworth RPG, Williamson S, Sharpe S, Walkden-Brown SW, Gerber PF. Marked differences in virulence of three Australian field isolates of infectious laryngotracheitis virus in meat and layer chickens. Avian Pathol 2020; 49:600-610. [PMID: 32720515 DOI: 10.1080/03079457.2020.1801987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objectives of this study were to compare the virulence of contemporary infectious laryngotracheitis virus (ILTV) field isolates of classes 9, 10, and 14 in meat and layer chickens, and to evaluate cloacal and oropharyngeal swabs and dust as sample types for ILTV detection. A total of 211 chickens were divided into groups and inoculated with ILTV class 9, 10, or 14, or sham-inoculated via eye drop at 15 or 22 days of age. Chickens were euthanized at 5 and 9 days post-infection. Virulence was assessed by scoring of clinical signs (conjunctivitis, dyspnoea, and demeanour), ILTV genomic copies (GC) in oropharyngeal and cloacal swabs, mortality and microscopic lesions in conjunctiva and trachea. Class 14 caused subclinical infection, while inoculation with class 9 or class 10 resulted in severe clinical signs and microscopic lesions. Compared to class 14 (2.25 ± 0.36 log10 GC), higher viral load was observed in oropharyngeal swabs of classes 9 (7.86 ± 0.48) and 10 (7.53 ± 0.36), with a higher proportion of positive oropharyngeal and cloacal swabs in the latter groups (P < 0.0001). Viral detection in cloacal swabs was delayed at early stages of infection compared to oropharyngeal swabs. Dust samples from class 9- and class 10-inoculated groups showed a trend towards higher GC than that of class 14. Overall, clinical scores, mortality, viral load, and microscopic lesions were similar for classes 9 and 10, but class 9 caused more severe disease in layer chickens than meat chickens. In summary, ILTV classes 9 and 10 exhibited severe virulence, while class 14 exhibited very mild virulence. RESEARCH HIGHLIGHTS Wide variation in the virulence of three field Australian field ILTV strains. Class 9 and class 10 strains were highly virulent, while class 14 was mildly virulent. The highly virulent strains were associated with significantly higher viral genome copies in various sample types than the mildly virulent strain.
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Affiliation(s)
- Shahid Nazir
- Animal Science, School of Environmental and Rural Science, University of New England, Armidale, Australia
| | - Addisu A Yegoraw
- Animal Science, School of Environmental and Rural Science, University of New England, Armidale, Australia.,School of Veterinary Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | | | - Sue Sharpe
- Birling Avian Laboratories, Bringelly, Australia
| | - Stephen W Walkden-Brown
- Animal Science, School of Environmental and Rural Science, University of New England, Armidale, Australia
| | - Priscilla F Gerber
- Animal Science, School of Environmental and Rural Science, University of New England, Armidale, Australia
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50
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Colavita F, Lapa D, Carletti F, Lalle E, Messina F, Rueca M, Matusali G, Meschi S, Bordi L, Marsella P, Nicastri E, Marchioni L, Mariano A, Scorzolini L, Ascoli Bartoli T, Di Caro A, Ippolito G, Capobianchi MR, Castilletti C. Virological Characterization of the First 2 COVID-19 Patients Diagnosed in Italy: Phylogenetic Analysis, Virus Shedding Profile From Different Body Sites, and Antibody Response Kinetics. Open Forum Infect Dis 2020; 7:ofaa403. [PMID: 33527081 PMCID: PMC7499768 DOI: 10.1093/ofid/ofaa403] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/28/2020] [Indexed: 12/31/2022] Open
Abstract
Background The pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unclear. We report the detection of viral RNA from different anatomical districts and the antibody profile in the first 2 COVID-19 cases diagnosed in Italy. Methods We tested for SARS-CoV-2 RNA clinical samples, either respiratory and nonrespiratory (ie, saliva, serum, urine, vomit, rectal, ocular, cutaneous, and cervico-vaginal swabs), longitudinally collected from both patients throughout the hospitalization. Serological analysis was carried out on serial serum samples to evaluate IgM, IgA, IgG, and neutralizing antibody levels. Results SARS-CoV-2 RNA was detected since the early phase of illness, lasting over 2 weeks in both upper and lower respiratory tract samples. Virus isolate was obtained from acute respiratory samples, while no infectious virus was rescued from late respiratory samples with low viral RNA load, collected when serum antibodies had been developed. Several other specimens came back positive, including saliva, vomit, rectal, cutaneous, cervico-vaginal, and ocular swabs. IgM, IgA, and IgG were detected within the first week of diagnosis, with IgG appearing earlier and at higher titers. Neutralizing antibodies developed during the second week, reaching high titers 32 days after diagnosis. Conclusions Our longitudinal analysis showed that SARS-CoV-2 RNA can be detected in different body samples, which may be associated with broad tropism and different spectra of clinical manifestations and modes of transmission. Profiling antibody response and neutralizing activity can assist in laboratory diagnosis and surveillance actions.
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Affiliation(s)
- Francesca Colavita
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Daniele Lapa
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Fabrizio Carletti
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Eleonora Lalle
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Francesco Messina
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Martina Rueca
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Giulia Matusali
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Silvia Meschi
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Licia Bordi
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Patrizia Marsella
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Emanuele Nicastri
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Luisa Marchioni
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Andrea Mariano
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Laura Scorzolini
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | | | - Antonino Di Caro
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases "L. Spallanzani" IRCCS, Rome, Italy
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