Performance of an alternative RT-PCR procedure using residual sample from the Panbio™ Ag COVID-19 test

ABSTRACT Introduction: In the current standard of care (SoC) RT-PCR method for COVID-19, the patient's swab was extracted in viral transport media (VTM). For the PanbioTM COVID-19 Ag Rapid Test, the patient swab is flushed out in extraction buffer, of which a small fraction is used for testing, leaving more than half the sample unused. This study was designed to show that RT-PCR results from the residual sample of the PanbioTM COVID-19 Ag Rapid Test (called Novel RT-PCR) are not worse than the SoC RT-PCR result. Methods: The study was performed using (1) dilution series of five patient samples, and (2) 413 patient samples comparing SOC versus Novel RT-PCR results. Results: For the dilution series samples, all tested positive by both methods. The bias between Ct values of Novel RT-PCR and SoC RT-PCR did not exceed 3.00 Ct using primers N1 and N2. A total of 413 COVID symptomatic patients seeking COVID testing were tested, of which 89 patients tested positive and 324 tested negative with SoC RT-PCR. In 324 patients who tested negative with SoC RT-PCR, 323 tested negative with Novel RT-PCR, and one (1) tested positive. Out of 89 who tested positive with SoC RT-PCR, 80 tested positive with the Novel RT-PCR, and nine patients showed a negative test result. The Overall Percent Agreement for the 413 valid patient sample pairs was 97.5 [95% CI 97 to 98]. Conclusion: The study demonstrated that the performance of the Novel RT-PCR method is acceptable compared to the SoC RT-PCR method and can be a useful tool to perform RTPCR without the need for new swab collections.

Identification and characterisation of SARS-CoV-2 and Human alphaherpesvirus 1 from a productive coinfection in a fatal COVID-19 case

BACKGROUND During routine Coronavirus disease 2019 (COVID-19) diagnosis, an unusually high viral load was detected by reverse transcription real-time polymerase chain reaction (RT-qPCR) in a nasopharyngeal swab sample collected from a patient with respiratory and neurological symptoms who rapidly succumbed to the disease. Therefore we sought to characterise the infection. OBJECTIVES We aimed to determine and characterise the etiological agent responsible for the poor outcome. METHODS Classical virological methods, such as plaque assay and plaque reduction neutralisation test combined with amplicon-based sequencing, as well as a viral metagenomic approach, were performed to characterise the etiological agents of the infection. FINDINGS Plaque assay revealed two distinct plaque phenotypes, suggesting either the presence of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains or a productive coinfection of two different species of virus. Amplicon-based sequencing did not support the presence of any SARS-CoV-2 genetic variants that would explain the high viral load and suggested the presence of a single SARS-CoV-2 strain. Nonetheless, the viral metagenomic analysis revealed that Coronaviridae and Herpesviridae were the predominant virus families within the sample. This finding was confirmed by a plaque reduction neutralisation test and PCR. MAIN CONCLUSIONS We characterised a productive coinfection of SARS-CoV-2 and Herpes simplex virus 1 (HSV-1) in a patient with severe symptoms that succumbed to the disease. Although we cannot establish the causal relationship between the coinfection and the severity of the clinical case, this work serves as a warning for future studies focused on the interplay between SARS-CoV-2 and HSV-1 coinfection and COVID-19 severity.

Modulação metabólica pelo exercício e manejo de recursos ergogênicos na doença pulmonar obstrutiva crônica / Metabolic modulation by exercise and ergogenic aids in treatment of chronic obstructive pulmonary disease

Um dos focos dos projetos de saúde pública cursando com altaincidência e prevalência em adultos e idosos. A abordagem terapêuticaa DPOC compreende o entendimento das vias moleculares deinfl ação, degradação proteica e hipertrofi a. Objetivo: Discutir asvias de sinalização para hipotrofi a/hipertrofi a adjuntas as diferentessuplementações para o paciente com DPOC compensada. Método:Foram cotejados e analisados artigos publicados em revistas presentesna base de dados da PubMed, utilizando-se palavras em inglêscomo: amino acids supplementation, COPD, hypertrophy pulmonaryrehabilitation em diferentes combinações, mas sempre com a palavraCOPD presente. Resultados: O exercício é um estressor metabólicoque aumenta a mobilização de aminoácidos e a infl amação local eaguda com sinalização para síntese proteica. Diferentes peptídeos deprodução rápida estão envolvidos neste mecanismo com modulaçãono status muscular, sendo a intensidade e a velocidade de execuçãodo exercício os principais mediadores do processo. A suplementaçãonutricional e hormonal associadas a um programa de exercícios sãoestratégias que aumentam a força e resistência muscular e reduzemo risco de internação e êxito letal...

Chronic Obstructive Pulmonary Disease (COPD)is one the most important challenge in public health with highincidence and prevalence in adults and elderly. One of the challengesis the understanding of molecular infl ammation and proteinbreakdown pathways. Objective: To review the signaling pathwaysof hypertrophy/hypotrophy associated to diff erent supplementationswith COPD patient compensation. Results: Were analyzedrecent articles in the PubMed database, using words as: amino acidssupplementation, COPD, hypertrophy pulmonary rehabilitation indiff erent combinations, but with the word COPD always present.Conclusion: Exercise is an eff ective non pharmacological interventionin treatment of patients with metabolic disease subsequent toCOPD. Drugs and nutritional supplementations are useful in dailytreatment in order to increase lean mass and physical resistance...

Fatores de risco da doença cárie de acometimento precoce / Risk factors of early childhood caries

Neste artigo os autores fazem uma revisão da literatura sobre cárie de acometimento precoce em crianças (ECC) e sugerem que essa modalidade de acometimento de doença cárie, se tornou um problema de saúde pública, devido sua alta prevalência e rápida progressão, podendo levar a destruição dos elementos dentários. Os autores discutem os critérios de diagnóstico da cárie de acometimento precoce, revelando suas causas e determinantes de risco sociais e econômicos como fatores de risco da doença. A doença cárie de acometimento precoce é um problema crescente em muitos países e a complexidade de seus determinantes e fatores de risco, faz com que a evidencia científica no que tange modelos explicativos confiáveis ainda é insuficiente, necessitando de mais pesquisas para esclarecer seu mecanismo e prevenir sua ocorrência.