Clinical profile and outcomes of Coronavirus Disease 19 (COVID-19) patients who underwent Hemoperfusion (HP) in a tertiary COVID-19 referral hospital: A descriptive study

Introduction@#As of February 4, 2021, a total of 530,118 COVID-19 cases were recorded in the Philippines with a fatality rate of 2.1%. Significant morbidity from COVID-19 is caused by hyperinflammation. Hemoperfusion (HP), which adsorbs inflammatory cytokines, has been performed in the Philippine General Hospital (PGH) as an adjunct to management given to COVID-19 patients. @*Objectives@#This study aimed to describe the clinical and laboratory profile, ventilatory support, therapeutic regimens, and outcomes of COVID-19 patients who underwent hemoperfusion in PGH. @*Methods@#The COVID-19 patient electronic database (April to September 2020) of the Division of Nephrology was reviewed and we included patients with COVID-19 who underwent hemoperfusion. Demographic, clinical, and laboratory data as well as therapeutics and outcomes were described. @*Results@#Sixty-six patients with COVID-19 underwent hemoperfusion. The majority were male (59.1%) with an average age of 61.3 years (SD 15). Hypertension was the most common comorbidity (62.1%). Acute kidney injury (AKI) requiring dialysis comprised 28.8% while 33.3% had diagnosed chronic kidney disease (CKD). The majority were critical COVID-19 cases who had acute respiratory distress syndrome (ARDS) (56.1%). The mean baseline inflammatory marker levels (Il-6, CRP, LDH, ferritin) were elevated. Post-HP inflammatory markers decreased except for IL-6 among patients who died. Most patients were mechanically ventilated (54.5%). Steroids were the most common medications administered (71.2%). Mortality occurred in 62.1% of the patients. The average length of hospital stay was 20.8 days (SD 19.5), duration from admission to first HP 5.9 days (SD 5.8), and 15.3 days (SD 17.4) from first HP to death or discharge. @*Conclusion@#Our study showed the characteristics of patients with COVID-19 who underwent HP. Majority were hypertensive men in their early 60s with critical COVID-19 disease. The mean inflammatory markers were elevated with a decrease in most markers post-hemoperfusion (except for IL-6 among those who died). Despite this, mortality was still high and the average length of hospital stay was long.

Generation and Biological Characterization of a Neutralization-Resistant Mutant of Newcastle Disease Virus

A neutralization-resistant mutant of Newcastle disease virus (NDV) Kr005 strain belonging to class II genotype VII was generated using a neutralizing monoclonal antibody and its biological effects were assessed. The mutant showed single amino acid substitution (E to K) at position 347 of the hemagglutinin-neuraminidase (HN) protein (E347K mutant). The E347K mutant exhibited marked rounding of the cells and few syncytia in infected chicken embryofibroblast (CEF) cells. The hemadsorption and neuraminidase activities of the E347K mutant of the wild-type virus were 118% and 166%, respectively. The mutant produced a rapid elution pattern whereas the wild type had a slow elution pattern. Growth kinetics studies showed that the E347K mutant produced an 80-times higher yield of extracellular virus in CEF cells compared with the wild-type virus. The time-course virus titer showed a marked increase in mutant-infected cells from 6 h to 12 h post infection (pi), which was consistent with the titer pattern time-course for NA activity. The E347K mutant virus showed a slight decrease in virulence compared to the wild-type virus, but there was no change in pathotype when measured by in vivo pathogenicity testing. These results suggest that an E347K mutation in HN protein might be associated with increased NA activity and subsequent enhancement of virus release from infected cells without change in viral pathotype.

Analysis of the amino acid changes of the hemagglutinin of H5 avian influenza virus / 病毒学报

We introduced 38 single-point amino acid changes into the hemagglutinin (HA) protein of the reassortmented A/Duck/Mongolia/54/01 (H5N2) strain by a PCR random mutation method. The percentage of amino acid changes on the HA domain that did not abrogate hemadsorption activity was calculated to be 89%. Changes in the amino acids of the HA2 domain were observed to be about half of those in the HA1 domain of these mutants. We assumed that amino acid changes in the HA1 domain afforded more flexibility in maintaining the functions of the HA protein than did those in the HA2 domain. Changes at two positions allowed the mutants to have same characteristics with respect to HA function despite the difference in the substituted amino acid. The results suggested that the effect on hemadsorption activity of an amino acid change on the HA protein primarily depends on the position rather than the species of substituted amino acid. An amino acid change at residue 122 from Trp to Arg and 179 from His to Arg resulted in the loss of hemadsorption activity of the HA protein. Site 122 is near the antibody binding site A, and site 179 is in the receptor binding domain (RBD) of HSHA. So that we suggest residue position 179 or 122 is very important to maintain the structure of RBD or antigenic site of H5HA. Position 4 in HA1 changed from Cys to Arg and position 148 in HA2 changed from Cys to Tyr also resulted in the loss of hemadsorption activity of the HA protein. Cys plays an important role in maintaining the structure of HA protein by means of S-S bonds. 3 potential glycosylation sites (Asn-X-Ser/Thr) were lost in our experiment that did not lose the hemadsorption activity of HA. Some interesting positions need to be analyzed more finely. Some amino acid changes identified in vitro experiment may serve as molecular markers for assessing the pandemic potential of H5N1 field isolates.

O surto de peste suína africana ocorrido em 1978 no município de Paracambi, Rio de Janeiro / The outbreak of African swine fever which ocurred in 1978 in the county of Paracambi, Rio de Janeiro, Brazil

Em função das dúvidas que ainda perduram 25 anos após a ocorrência do surto de peste suína africana (PSA), em Paracambi, Estado do Rio de Janeiro, Brasil, em 1978, são apresentados os resultados, relativos a este foco, obtidos pelos estudos epidemiológico, clínico-patológico, virológico, bacteriológico e ultra-estrutural dos casos naturais, bem como os relativos à reprodução experimental da doença no Brasil e sua confirmação por isolamento e determinação de patogenicidade realizada no Plum Island Animal Disease Center, New York, EUA. Os animais se infectaram pela ingestão de restos de comida de aviões procedentes de Portugal e da Espanha, países nos quais a doença existia. De acordo com publicação do Ministério da Agricultura, após o diagnóstico do surto de PSA descrito neste trabalho, 223 novos focos foram relatados, entre 1978 e 1979, em todas Regiões do país (Norte, Nordeste, Centro-Oeste, Sudeste e Sul) e focos adicionais em 1981, sem informações exatas referentes ao seu número. O último caso foi relatado em 15 de novembro de 1981, e em 5 de dezembro 1984 o Brasil foi declarado livre da PSA. Para o diagnóstico da PSA foram processadas 54.002 amostras no Departamento de Virologia do Instituto de Microbiologia da Universidade Federal do Rio de Janeiro, no período de 1978 a 1981. No processamento das amostras foram usadas as técnicas de hemadsorção em cultura de leucócitos (HAd), imunoflorescência em cortes de tecido (FATS), imunoflorescência em cultivo celular (FATCC), imuno-eletrosmoforese (IEOP) e imunoflorescência...

Partial characterization of hemagglutinin activity of the marine sponge Anthosigmella varians

The marine sponge Anthosigmella varians contains proteins that agglutinate human erythrocytes irrespective of their ABO group antigens. The hemagglutination reaction depends on divalent cations andf is not inhibited by L-arabinose, D-xylose, L-rhamnose, D-galactose, D-glucose, L and D-fucose, N-acetyl-D-galactosamine, N-acetyl-D-glucosamine, methyl-alpha-Dmannopiranoside, D-cellobiose, lactose, maltose, melibiose nor raffinose (33 mM each). A partial purification of the hemagglutinins with 31-fold ioncrease in SA and 80% recovery of activity was obtained after gel filtration and ion-exchange gradient elution chromatography. Hemadsorption experiments carried our with out with the semipurified fraction using glutaraldehyde-fixed human erythrocytes suggest that protein with molecular weight of 90 and 34 kDa participate in this rection

Detection of specific IgM in dengue infection.

A modification of the IgM-capture ELISA which can provide an early diagnosis for dengue infection is presented. The test is technically simple compared to HI and appears to be more sensitive. It has the advantage over HIT for the detection of specific IgM in that it is more sensitive and the reading of the result is not subjective. There is the possibility of the test being able to replace HI and HIT in the future.