Clinical Validation of a Colorimetric Loop-Mediated Isothermal Amplification Using a Portable Device for the Rapid Detection of SARS-CoV-2.

Quick and reliable mass testing of infected people is an effective tool for the contingency of SARS-CoV-2. During the COVID-19 pandemic, Point-of-Care (POC) tests using Loop-Mediated Isothermal Amplification (LAMP) arose as a useful diagnostic tool. LAMP tests are a robust and fast alternative to Polymerase Chain Reaction (PCR), and their isothermal property allows easy incorporation into POC platforms. The main drawback of using colorimetric LAMP is the reported short-term stability of the pre-mixed reagents, as well as the relatively high rate of false-positive results. Also, low-magnitude amplification can produce a subtle color change, making it difficult to discern a positive reaction. This paper presents Hilab Molecular, a portable device that uses the Internet of Things and Artificial Intelligence to pre-analyze colorimetric data. In addition, we established manufacturing procedures to increase the stability of colorimetric RT-LAMP tests. We show that ready-to-use reactions can be stored for up to 120 days at -20 °C. Furthermore, we validated both the Hilab Molecular device and the Hilab RT-LAMP test for SARS-CoV-2 using 581 patient samples without any purification steps. We achieved a sensitivity of 92.93% and specificity of 99.42% (samples with CT ≤ 30) when compared to RT-qPCR.

Manifestations musculosquelettiques du SRAS-CoV-2 dans une population pédiatrique – expérience d'une unité de rhumatologie pédiatrique

Introduction Les infections à coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) peuvent provoquer une inflammation sévère et déclencher des manifestations auto-immunes. Plusieurs rapports de cas chez des adultes ont décrit la production d'autoanticorps et manifestations musculosquelettiques (MMS) après une infection par le SRAS-CoV-2 (chez environ 27 %), mais les informations chez les enfants sont rares. Objectif Décrire les MMS, après infection par le SRAS-CoV-2, dans une population pédiatrique sans maladie rhumatismale (MR) connue antérieurement adressée à unité de rhumatologie pédiatrique. Patients et méthodes Les dossiers cliniques de tous les nouveaux patients en rhumatologie pédiatrique (RP), entre avril 2020 et août 2022, présentant MMS et/ou résultats sérologiques liés à des MR après une infection par le SRAS-CoV-2, ont été examinés. Les patients avec des antécédents de MR connus ont été exclus. Résultats Pendant la période d'études, 325 nouveaux patients ont été référés à unité de RP, dont 20 (6,2 %) présentaient MMS et/ou résultats sérologiques liés à des MR après infection. Sur les 20 patients (60 % femmes), l'âge moyen au moment du diagnostic d'infection était de 12,6 ± 4,2 [2–17] ans et le délai moyen pour les MMS ou sérologiques après l'infection était de 21,6 ± 10,8 [9–49] jours. Tous les patients avaient une infection asymptomatique ou légère. Après infection, les principaux MMS étaient : arthralgies (12/20, 60 %), myalgies (8/20, 40 %) et acrocyanose (5/20, 25 %). Les MR les plus fréquemment identifiés étaient : myosite (3/20, 15 %), maladies du tissu conjonctif (3/20, 15 %), perniose (3/20, 15 %) et douleurs musculosquelettiques non spécifiques (DMNS : 5/20, 25 %). Un garçon de 12 ans a eu deux infections enregistrées par le SRAS-CoV-2 avec différentes manifestations cliniques : suite à la première infection, il a développé une DMNS et six mois plus tard, après la seconde, il a présenté une arthrite qui a ensuite été diagnostiquée comme une arthrite juvénile idiopathique. 2 patients (0,6 %) ont été référés en raison de résultats sérologiques positifs (un avec ANCA-PR3 et un avec anticoagulant lupique), malgré l'absence de manifestations cliniques évocatrices de MR. Cinq patients (25 %) ont été hospitalisés en raison de la gravité du MR : 2 lupus érythémateux disséminés (10 %) et 3 myositis (15 %), 3 ont nécessité injections d'immunoglobuline et méthylprednisolone. Au cours du suivi, les patients atteints de MR inflammatoire ont été majoritairement traités par prednisolone orale (n = 6), hydroxychloroquine (n = 3) et anti-inflammatoire oral (n = 3). Les autres avaient des symptômes contrôlés par la physiothérapie (n = 4), myorelaxant (n = 4) ou traitement topique (n = 2). Après un suivi moyen de 8,9 ± 6,0 [1–20] mois, tous les patients ont présenté une évolution favorable : 16 (80 %) avaient une maladie contrôlée et 4 (20 %) avaient une rémission complète. Discussion À notre connaissance, il s'agit de l'une des rares études analysant l'atteinte MMS induite par SRAS-CoV-2 dans une population pédiatrique. Dans notre cohorte, les MMS étaient peu fréquents (6,2 %), par rapport aux adultes, et les plus fréquents étaient myositis, maladies du tissu conjonctif, perniose et DMNS. Toutes ont été identifiées, traitées et 20 % ont atteint une rémission complète. Conclusion Les MMS induites par SRAS-CoV-2 dans la population pédiatrique de notre unité étaient rares et présentaient un large spectre de gravité, allant de légères à potentiellement mortelles.

Bologna and COVID-19. Evidence about students' autonomy

In recent years, serious doubts have arisen in Spain as to whether student autonomy is really being promoted in university classrooms, as promoted by the European Higher Education Area. The situation experienced due to the lockdown of 2020 by COVID-19 presented us with an ideal scenario to find out to what extent university students are autonomous as well as how much autonomy is promoted by their professors. In this paper we find out the students' demands regarding to their learning process during lockdown and infer from them whether autonomous work really takes place in university classrooms. After analysing the data collected on a survey, the most frequently mentioned categories we identified are those referring to: continuing giving classes during lockdown, the professors' ability to adapt to the new situation and the fact of maintaining in contact, both for academic aspects (appropriate explanations and feedback) as well as for personal issues, with express reference to empathy. To a lesser extent, references are made to the fact of carrying out an assessment adapted to the circumstances and the appropriate use of ICT. After relating the categories identified in the survey, with the characteristics of autonomy-promoting teaching, we can see that very few students are demanding autonomy-promoting teaching, which leads us to deduce that the teaching staff do not promote it in their teaching practice.

Intermittent non-pharmaceutical strategies to mitigate the COVID-19 epidemic in a network model of Italy via constrained optimization

This paper is concerned with the design of intermittent non-pharmaceutical strategies to mitigate the spread of the COVID-19 epidemic exploiting network epidemiological models. Specifically, by studying a variational equation for the dynamics of the infected, we derive, using contractivity arguments, a condition that can be used to guarantee that the effective reproduction number is less than unity. This condition (i) is easily computable, (ii) is interpretable, being directly related to the model parameters, and (iii) can be used to enforce a scalability condition that prohibits the amplification of disturbances within the network system. We then include satisfaction of such a condition as a constraint in a Model Predictive Control problem so as to mitigate (or suppress) the spread of the epidemic while minimizing the economic impact of the interventions. A data-driven model of Italy as a network of three macro-regions (North, Center, and South), whose parameters are identified from real data, is used to illustrate and evaluate the effectiveness of the proposed control strategy.

COVID-19 in Pregnant Women With Rheumatic Disease: Data From the COVID-19 Global Rheumatology Alliance.

OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) and pregnancy outcomes in patients with rheumatic disease who were pregnant at the time of infection. METHODS: Since March 2020, the COVID-19 Global Rheumatology Alliance has collected cases of patients with rheumatic disease with COVID-19. We report details of pregnant women at the time of COVID-19 infection, including obstetric details separately ascertained from providers. RESULTS: We report on 39 patients, including 22 with obstetric detail available. The mean and median age was 33 years, range 24-45 years. Rheumatic disease diagnoses included rheumatoid arthritis (n = 9), systemic lupus erythematosus (n = 9), psoriatic arthritis/other inflammatory arthritides (n = 8), and antiphospholipid syndrome (n = 6). Most had a term birth (16/22), with 3 preterm births, 1 termination, and 1 miscarriage; 1 woman had yet to deliver at the time of report. One-quarter (n = 10/39) of pregnant women were hospitalized following COVID-19 diagnosis. Two of 39 (5%) required supplemental oxygen (both hospitalized); no patients died. The majority did not receive specific medication treatment for their COVID-19 (n = 32/39, 82%), and 7 patients received some combination of antimalarials, colchicine, anti-interleukin 1ß, azithromycin, glucocorticoids, and lopinavir/ritonavir. CONCLUSION: Women with rheumatic diseases who were pregnant at the time of COVID-19 had favorable outcomes. These data have limitations due to the small size and methodology; however, they provide cautious optimism for pregnancy outcomes for women with rheumatic disease particularly in comparison to the increased risk of poor outcomes that have been reported in other series of pregnant women with COVID-19.

Rapid Serological Tests for SARS-CoV-2: Diagnostic Performance of 4 Commercial Assays.

OBJECTIVE: To assess the diagnostic performance of lateral flow immunochromatographic assays (LFAs) of 4 different manufacturers to identify SARS-CoV-2 antibodies (IgM, IgG, or total), comparing them with the nucleic acid amplification test (NAAT) or the clinical defined test (definite or probable SARS-CoV-2 infection, respectively). METHODS: One hundred nineteen serum samples were randomly selected by convenience and distributed in the following groups: (1) group with SARS-CoV-2 infection (n = 82; RT-qPCR positive [definite, n = 70] and probable [n = 12]); (2) other diseases (n = 27; other viruses identified [n = 8] and SARS of other etiologies [n = 19]); and (3) healthy control group (n = 10). LFAs of 4 manufacturers were compared: MedTest Coronavirus (COVID-19) IgG/IgM (MedLevensohn, Brazil); COVID-19 IgG/IgM ECO Test (Ecodiagnóstica, Brazil); Camtech COVID-19 IgM/IgG Rapid Test Kit (Camtech Diagnostics Pte Ltd, Singapore); and 1-Step COVID-19 Test for total antibodies (Guangzhou Wondfo Biotech Co., China). RESULTS: The 4 tests studied showed high diagnostic performance characteristics for the diagnoses of definite or probable SARS-CoV-2 infection. The best measures were for the Wondfo test: sensitivity (86.59%; 95% CI: 77.26-93.11%), specificity (100%; 90.51-100%), DOR (257; 60-1,008), LR+ (33.43; 4.82-231.85), LR- (0.13; 0.08-0.23), accuracy (90.76%; 84.06-95.29%), and Matthews correlation coefficient (MCC) 0.82. Although considering only the probable SARS-CoV-2 infection (PCR-) cases, all the kits studied showed limited values. CONCLUSION: Our data demonstrate the excellent performance of LFA for the diagnoses of definite or probable SARS-CoV-2 infection. There was substantial heterogeneity in sensitivities of IgM and IgG antibodies among the different kits. LFA tests cannot replace molecular diagnostics but should be used as an additional screening tool.

Methodology for the analysis of oxygen saturation and heart rate in the development of online classes, in children, product of the covid-19 pandemic

In these times of pandemic caused by COVID-19, many of the activities we carry out are changing, education is one of the main ones that changed considerably and in the face of this change, certain manifestations that normally could not be identified are taking place, such as This is the case of the pressure and stress that the students are being subjected to, due to the fact that they spend most of the day at home in a kind of voluntary confinement, added to the realization of online classes from home, With parents attentive to the class, being able to understand teachers, conducting evaluations, among others, present in students an increase in pressure and levels of stress that are commonly subjected. The methodology that is proposed is related to being able to evaluate the level of oxygen saturation and the heart rate that they are developing in the realization of the online classes, this evaluation is carried out using low-cost devices known as clocks. intelligent, the results show that depending on the age the students are able to distinguish the different pressures that are manifested in the variability of the heart rate, we can indicate that at an older age the students can distinguish these pressures, it is concluded that it is possible to perform these measurements with The following purposes, the first to be able to monitor the students if they present any symptoms of COVID-19 and second if they present any manifestation of a possible problem related to the respiratory and cardiac system, the study recommends keeping in mind the manifestations that the students are developing. students in online classes and it is very helpful to be able to assess these vital signs to to be able to assess these manifestations as a result of pressure and stress. © 2021 Karadeniz Technical University. All rights reserved.

Bronchoscopy in times of the covid-19 pandemic. Organizational model and operating procedures experience of A.O. Dei colli, Naples

Summary SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) causes combined al-veolar-capillary lung damage, with bilateral pneumonia and thrombosis of the vessels resulting in respiratory failure. Expertise in airway management with invasive procedures such as gold-tracheal intubation and videobronchoscopy are required;procedures that expose healthcare professionals to inhalation of aerosols from the respiratory tract with very high infectious risk. In this work, the authors propose the organizational model and operating procedures applied by the clinical experience of the A.O. dei Colli (P.O. Monaldi-Cotugno, Naples) for the execution of videobronchoscopies in the COVID-19 era from 25/02/2020 to 30/04/2020 ensuring a high standard of protection for healthcare workers. These instruments have been used with a differentiated model in two paths: COVID area and non-COVID area. The authors emphasize that the application of this organizational model has allowed a high level of protection such that none of the operators has been infected, guaranteeing bronchological assistance to patients.

European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era.

The coronavirus disease 2019 (COVID-19) pandemic is unlike anything seen before by modern science-based medicine. Health systems across the world are struggling to manage it. Added to this struggle are the effects of social confinement and isolation. This brings into question whether the latest guidelines are relevant in this crisis. We aim to support urologists in this difficult situation by providing tools that can facilitate decision making, and to minimise the impact and risks for both patients and health professionals delivering urological care, whenever possible. We hope that the revised recommendations will assist urologist surgeons across the globe to guide the management of urological conditions during the current COVID-19 pandemic.