Aki in Hospitalized Covid-19 Patients- an Epidemiology Study in a Tertiary Center

Introduction: Coronavirus disease 2019 (COVID-19) related acute kidney injury (AKI) is a recognized complication of the disease and may result in high morbidity and mortality rate. The reported incidence and outcome vary worldwide. This study aimed to assess the AKI rate in hospitalized COVID-19 patients and identify risk predictors/prognosticator associated with the complication. Method(s): This is a retrospective study of hospitalized COVID-19 patients at the University Malaya Medical Center admitted from January 2021 until June 2021. Data on patients who were>= 18 years old and hospitalized for >= 48 hours for confirmed COVID-19 infection were captured. Clinical parameters and demographic of patients were collected from electronic medical records. The staging of AKI was based on criteria as per KDIGO guidelines. Result(s): A total of 1529 patients were found to have fulfilled the criteria for the study with a male-to-female ratio of 759 (49.6%) to 770 (50.3%). The median age was 55 (IQR: 36-66). 500 patients (32.7%) had diabetes, 621 (40.6%) had hypertension, and 5.6% (n=85) had pre-existing chronic kidney disease (CKD). The incidence rate of AKI was 21.1% (n=323). The proportion of different AKI stages of 1,2 and 3 were 16.3%, 2.1%, and 2.7%, respectively. A total of 15 hospitalized patients (0.98%) needed dialysis. 190 patients (58.8%) of AKI group had complete recovery of renal function. Demographic factors that were associated with an increased risk of developing AKI included: age (p< 0.001), diabetes (p<0.001), hypertension (p<0.001), CKD (p<0.001) and vaccination status (p=0.002). Analysis of biochemical parameters in AKI cohort revealed statistically significant lower lymphocytes & platelet counts, higher ferritin levels, and poorer renal function (creatinine based)) compared with the non-AKI cohort. Outcome analysis in our cohort revealed that AKI was associated with prolonged hospitalization (p<0.001) and higher mortality rates with P< 0.001). [Formula presented] Conclusion(s): AKI is a common complication among hospitalized COVID-19 patients. The increased risk was associated with underlying comorbidities and had an adverse outcome on patient morbidity and mortality. No conflict of interestCopyright © 2023

Development of a novel peptide to prevent entry of SARS-CoV-2 into lung and olfactory bulb cells of hACE2 expressing mice.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that has caused a global pandemic Coronavirus Disease 2019 (COVID-19). Currently, there are no effective treatments specifically for COVID-19 infection. The initial step in SARS-CoV-2 infection is attachment to the angiotensin-converting enzyme 2 (ACE2) on the cell surface. We have developed a protein peptide that effectively disrupts the binding between the SARS-CoV-2 spike protein and ACE2. When delivered by nasal spray, our peptide prevents SARS-CoV-2 spike protein from entering lung and olfactory bulb cells of mice expressing human ACE2. Our peptide represents a potential novel treatment and prophylaxis against COVID-19.

Surgical outcomes inchildren with perioperative SARS-CoV-2 diagnosis.

OBJECTIVE: To understand whether perioperative SARS-CoV-2 infection increases risk of pulmonary complications in children. METHODS: A retrospective cohort study of children who underwent surgery with perioperative SARS-CoV-2 infection at a children's hospital from March 1, 2020, to June 30, 2021. Uninfected, age-matched control patients who underwent the same procedure as infected patients over the past ten years were included in the study in a 3:1 ratio to infected patients. Primary outcomes were 7- and 30-day mortality. Secondary outcomes were development of pulmonary complications, readmission, length of hospital or ICU stay, and oxygen administration in post-anesthesia care unit (PACU). RESULTS: Our study included 73 patients who underwent surgery with perioperative diagnosis of SARS-CoV-2, and 218 control patient undergoing similar procedures. One total mortality event was observed within 7 days in an uninfected control patient, and none occurred in infected patients. Perioperative SARS-CoV-2 infection was associated with increased risk for pulmonary complications in univariate analysis. Infection was not associated with any of our other secondary outcomes. Symptomatic SARS-CoV-2 infection and timing of diagnosis was not associated with development of pulmonary complications among infected patients. CONCLUSIONS: Children with perioperative SARS-CoV-2 infection may be at increased risk for development of pulmonary complications. Larger studies should be performed to confirm our results.

POS-289 PARAFFIN WASHOUT IMMUNOFLUORESCENCE TECHNIQUE IMPROVE SAFETY AND ADEQUACY OF NATIVE KIDNEY BIOPSY AND TRANSPLANT KIDNEY BIOPSY IN A TERTIARY TEACHING HOSPITAL

Introduction: Kidney biopsy (KB) tissues are usually dissected 0.5-1.0 cm for fresh sample immunofluorescence study (FSIF). Paraffin washed-out immunofluorescence (PWIF) technique doesn’t require segmentation of the kidney biopsy sample that may jeopardise the sample adequacy for histopathological examination (HPE). Hypothetically, it reduces biopsy passes and complications. We examine the safety and adequacy of native kidney biopsy (NKB) and transplant kidney biopsy (TKB) using the FSIF technique and PWIF technique in HPE preparation for immunofluorescent study. Methods: We retrospectively collected clinical history, blood results, and renal biopsy reports for all the patients who had undergone KB using electronic medical records at University Malaya Medical Centre, Kuala Lumpur, Malaysia from 1/1/2015 to 31/4/2021. We performed 1520 KBs (795 NKBs & 725 TKBs) and 1336 KBs with complete data analysed (670 NKBs & 666 TKBs). Sixty-one of the 670 (9.1%) NKBs and 48 of the 666 (7.2%) TKBs employed the PWIF method from 13/10/2020 to 31/4/2021 (6 months) because of the COVID-19 pandemic. We collected 62 NKBs and 65 TKBs from 13/10/2018 to 31/4/2019 (6 months) as the control group which used the FSIF method. The control is chosen as such to correlate with the same months of another year. Results: There were no statistically significant differences in the baseline characteristics between the two groups of each cohort respectively except for the ethnicity distribution in the TKB cohort (p=0.037) and INR in NKB and TKB cohorts (p=0.000 & p=0.002 respectively). PWIF group in NKB and TKB recorded lesser pass (p=0.000 for both), longer HPE core (p=0.001 & p=0.024 respectively), better HPE adequacy (p=0.006 & p=0.012 respectively). There were no statistical differences in the diagnostic yield, immediate pain, gross haematuria, haematoma, and admissions or prolong hospitalisation due to biopsy complications in both groups for NKB and TKB cohorts (Table 1 & 2). [Formula presented] Conclusions: Paraffin washed-out immunofluorescence technique increased the native and transplant kidney biopsy adequacy with a lesser pass and better biopsy sample adequacy for histopathological examination but no difference in the incidence of complications. However, a greater number of cases are required to assess the statistically significant difference in the incidence of complications. No conflict of interest

The Impact of COVID-19 on Psychiatric Emergency and Inpatient Services in the First Month of the Pandemic in a Large Urban Mental Health Hospital in Ontario, Canada.

The World Health Organization characterized COVID-19 (coronavirus disease 2019) as a pandemic on March 11, 2020 (WHO). Within a couple of days, all Canadian provinces announced the implementation of social distancing measures. We evaluated the immediate effect of COVID-19 on psychiatric emergency and inpatient services in Canada's largest psychiatric hospital in the first month of the pandemic. We extracted data from the electronic medical records of the Center for Addiction and Mental Health in Toronto, Canada. We compared emergency department visits, inpatient occupancy rates, and length of stay in March 2019 and March 2020, and during the first and second half of March 2020. There was a decrease in the number of emergency department visits and inpatient occupancy rates in March 2020 compared to March 2019. There was also a significant decrease in the number of emergency department visits and inpatient occupancy rates in the second half of March 2020 compared to the first half. Our findings suggest that the pandemic was followed by a rapid decrease in the usage of psychiatric emergency and inpatient services in a large mental health hospital. Future studies will need to assess whether this decrease will be followed by a return to baseline or an increase in need for these services.

First lung and kidney multi-organ transplant following COVID-19 Infection.

As the world responds to the global crisis of the COVID-19 pandemic an increasing number of patients are experiencing increased morbidity as a result of multi-organ involvement. Of these, a small proportion will progress to end-stage lung disease, become dialysis dependent, or both. Herein, we describe the first reported case of a successful combined lung and kidney transplantation in a patient with COVID-19. Lung transplantation, isolated or combined with other organs, is feasible and should be considered for select patients impacted by this deadly disease.

Long, Noncoding RNA Dysregulation in Glioblastoma.

Transcription occurs across more than 70% of the human genome and more than half of currently annotated genes produce functional noncoding RNAs. Of these transcripts, the majority-long, noncoding RNAs (lncRNAs)-are greater than 200 nucleotides in length and are necessary for various roles in the cell. It is increasingly appreciated that these lncRNAs are relevant in both health and disease states, with the brain expressing the largest number of lncRNAs compared to other organs. Glioblastoma (GBM) is an aggressive, fatal brain tumor that demonstrates remarkable intratumoral heterogeneity, which has made the development of effective therapies challenging. The cooperation between genetic and epigenetic alterations drives rapid adaptation that allows therapeutic evasion and recurrence. Given the large repertoire of lncRNAs in normal brain tissue and the well-described roles of lncRNAs in molecular and cellular processes, these transcripts are important to consider in the context of GBM heterogeneity and treatment resistance. Herein, we review the general mechanisms and biological roles of lncRNAs, with a focus on GBM, as well as RNA-based therapeutics currently in development.

SARS-CoV-2 transmission routes from genetic data: A Danish case study

BACKGROUND: The first cases of COVID-19 caused by the SARS-CoV-2 virus were reported in China in December 2019. The disease has since spread globally. Many countries have instated measures to slow the spread of the virus. Information about the spread of the virus in a country can inform the gradual reopening of a country and help to avoid a second wave of infections. Our study focuses on Denmark, which is opening up when this study is performed (end-May 2020) after a lockdown in mid-March. METHODS: We perform a phylogenetic analysis of 742 publicly available Danish SARS-CoV-2 genome sequences and put them into context using sequences from other countries. RESULTS: Our findings are consistent with several introductions of the virus to Denmark from independent sources. We identify several chains of mutations that occurred in Denmark. In at least one case we find evidence that the virus spread from Denmark to other countries. A number of the mutations found in Denmark are non-synonymous, and in general there is a considerable variety of strains. The proportions of the most common haplotypes remain stable after lockdown. CONCLUSION: Employing phylogenetic methods on Danish genome sequences of SARS-CoV-2, we exemplify how genetic data can be used to trace the introduction of a virus to a country. This provides alternative means for verifying existing assumptions. For example, our analysis supports the hypothesis that the virus was brought to Denmark by skiers returning from Ischgl. On the other hand, we identify transmission routes which suggest that Denmark was part of a network of countries among which the virus was being transmitted. This challenges the common narrative that Denmark only got infected from abroad. Our analysis concerning the ratio of haplotypes does not indicate that the major haplotypes appearing in Denmark have a different degree of virality.

Airborne Aerosolized Mouse Cytomegalovirus From Common Otolaryngology Procedures: Implications for COVID-19 Infection.

OBJECTIVES: To determine whether common otolaryngology procedures generate viable aerosolized virus through a murine cytomegalovirus (mCMV) model for infection. STUDY DESIGN: mCMV model of infection. SETTING: University of Utah laboratory. METHODS: Three-day-old BALB/c mice were inoculated with mCMV or saline. Five days later, each mouse underwent drilling, microdebrider, coblation, and electrocautery procedures. Particle size distribution and PM2.5 (particulate matter <2.5 µm) concentration were determined with a scanning mobility particle sizer and an aerosol particle sizer in the range of 15 nm to 32 µm. Aerosolized samples from these procedures were collected with an Aerosol Devices BioSpot sampler for viral titer based on polymerase chain reaction and for viable virus through viral culture. RESULTS: As compared with the background aerosol concentrations, coblation and electrocautery showed statistically significant increases in airborne aerosols (Tukey-adjusted P value <.040), while microdebrider and drilling at 30,000 rpm did not (.870 < Tukey-adjusted P value < .930). We identified viral DNA in samples from coblation and drilling procedures, although we did not identify viable viruses in aerosol samples from any of the 4 procedures. CONCLUSION: Coblation and electrocautery procedures generate >100-fold increases in aerosol concentrations over background; only coblation and drilling produce aerosolized viral DNA. The high concentration of aerosols from coblation and electrocautery suggests the need for appropriate safeguards against particle exposure to health care workers. The presence of viral DNA from drilling and coblation procedures warrants the need for appropriate protection against droplet and aerosol exposure.