Performances of Dried Blood Spots and Point-of-Care Devices to Identify Virological Failure in HIV-Infected Patients: A Systematic Review and Meta-Analysis.

To broaden access to HIV viral load monitoring (VLM), the use of blood samples from dried blood spots (DBS) or point-of-care (POC) devices, could be of great help in settings where plasma is not easily accessible. The variety of assays available makes the choice complex. This systematic review and meta-analysis aims to estimate the sensitivity and specificity of DBS and POC devices to identify patients in virological failure using World Health Organization (WHO) recommendations (viral load ≥1000 copies/mL), compared with plasma, for the assays currently available. Four databases were searched for articles, and two reviewers independently identified articles reporting sensitivity and specificity of DBS and/or POC to identify patients in virological failure. We excluded articles that used other thresholds as well as articles with a total number of participants below 50 to avoid reporting bias. Heterogeneity and factors associated with assays' performances were assessed by I2 statistics and metaregression. The protocol of this review follows the PRISMA guidelines. Out of 941 articles, 47 were included: 32 DBS evaluations and 16 POC evaluations. Overall, when using DBS, the Abbott RT HIV-1, Roche CAP-CTM, NucliSENS BioMerieux and Aptima assays presented sensitivity and specificity exceeding 85%, but reported results were highly heterogeneous. Factors associated with better performances were high volume of blood and the use of the same assay for DBS and plasma VLM. Regarding the POC devices, SAMBA I, SAMBA II, and GeneXpert devices presented high sensitivity and specificity exceeding 90%, with less heterogeneity. DBS is suitable VLM, but performances can vary greatly depending on the protocols, and should be performed in trained centers. POC is suitable for VLM with less risk of heterogeneity but is more intensive in costs and logistics.

SARS-CoV-2 Reinfection and Severity of the Disease: A Systematic Review and Meta-Analysis.

Since the discovery of SARS-CoV-2, changes in genotype and reinfection with different variants have been observed in COVID-19-recovered patients, raising questions around the clinical pattern and severity of primary infection and reinfection. In this systematic review, we summarize the results of 23 studies addressing SARS-CoV-2 reinfections. A total of 23,231 reinfected patients were included, with pooled estimated reinfection rates ranging from 0.1 to 6.8%. Reinfections were more prevalent during the Omicron variant period. The mean age of reinfected patients was 38.0 ± 6. years and females were predominant among reinfected patients (M/F = 0.8). The most common symptoms during the first and second infection were fever (41.1%), cough (35.7% and 44.6%), myalgia (34.5% and 33.3%), fatigue (23.8% and 25.6%), and headaches (24.4% and 21.4%). No significant differences of clinical pattern were observed between primary infection and reinfection. No significant differences in the severity of infection were observed between primary infection and reinfection. Being female, being a patient with comorbidities, lacking anti-nucleocapsid IgG after the first infection, being infected during the Delta and Omicron wave, and being unvaccinated were associated with a higher risk of reinfection. Conflicting age-related findings were found in two studies. Reinfection with SARS-CoV-2 suggests that natural immunity is not long-lasting in COVID-19 patients.

Willingness and attitudes of parents towards COVID-19 vaccines for children in Vietnam.

BACKGROUND: With an increasing need for COVID-19 vaccination around the globe, we aim to investigate willingness and attitudes of parents regarding COVID-19 vaccines for children in Vietnam. METHOD: A 24-item online survey was conducted among 602 parents and legal guardians of children under 18 years of age. RESULTS: There were 82.6% of parents willing to vaccinate their children. The principal reasons for willingness were: the need for vaccination to control the COVID-19 pandemic and to reduce the risk of SARS-CoV-2 transmission when children return to school. The most common reason for refusing COVID-19 vaccine was the concern about vaccine side effects in children (73.3%), followed by perceived lack of scientific research on COVID-19 vaccines in children (31.4%). The main associated factors with increased willingness of parents towards childhood COVID-19 vaccine were: willingness to allow children to participate in a clinical vaccine trial (aOR = 3.58); possible increase in COVID-19-related mortality (aOR = 3.69); and positive media information regarding COVID-19 vaccine (aOR = 2.04). Noteworthy, higher educational status of parents was associated with decreased willingness for childhood COVID-19 vaccine (aOR = 0.26). CONCLUSION: Understanding reasons of parents to accept childhood COVID-19 vaccines will help future plans in COVID-19 vaccination program. A larger sample size study at a national level is needed to verify the results.

PCR investigation of infections in patients consulting at a healthcare centre over a four-year period during the Grand Magal of Touba.

BACKGROUND: Respiratory and gastrointestinal symptoms and febrile illness are the most common complaints among ill pilgrims attending the Grand Magal of Touba (GMT) in Senegal. METHODS: Patients presenting with respiratory or gastrointestinal symptoms or febrile systemic illnesses were recruited between 2018 and 2021 at a healthcare centre close to Touba. Respiratory, gastrointestinal and blood samples were tested for potential pathogens using qPCR. RESULTS: 538 patients were included. 45.5% of these were female, with a median age of 17 years. Of the 326 samples collected from patients with a cough, 62.8% tested positive for at least one virus, including influenza viruses (33.1%). A high positivity rate of bacterial carriage was observed for Haemophilus influenzae (72.7%), Streptococcus pneumoniae (51.2%) and Moraxella catarrhalis (46.0%). Of the 95 samples collected from patients with diarrhoea, 71.3% were positive, with high rates of bacterial carriage, ranging from 4.2% for Tropheryma whipplei to 45.3% for Entero-pathogenic Escherichia coli. Of the 141 blood samples collected from patients with fever, 31.9% were positive including Plasmodium falciparum (21.3%), Borrelia sp. (5.7%) and dengue virus (5.0%). CONCLUSION: This study provides insight into the aetiology of most common infections at the GMT on which to base therapeutic options.

COVID-19 in Southeast Asia: current status and perspectives.

Coronavirus Disease-2019 (COVID-19) has spread globally with catastrophic damages to the public health, social and economy since the beginning of the outbreak. In 2020, Southeast Asia proved that it could prevent the worst effects of a pandemic through the closure of activities and borders and movement restriction, as well as social distancing. Nevertheless, with the occurrence of the common variants of concern (VOCs), especially Alpha (B.1.1.7), Beta (B.1.351), Delta (B.1.617.2), Southeast Asia is facing a significant increase in the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections. Now, the area also has the threats of the spreading out of the dangerous variant - Omicron (B.1.1.529) from other close countries or regions. COVID-19 countermeasures such as closures and social distancing seem to be insufficient. Moreover, Southeast Asia is being held back by a shortage of vaccines and other medical resources. This work focuses on describing the COVID-19 situation, the virus variants, and the coverage of COVID-19 vaccination in the area. We also provide perspectives on the COVID-19 vaccine distribution, protecting the economic capitals, developing the green zone, and the importance of finding more vaccine supplies in Southeast Asia.

Mapping COVID-19 related research from Vietnam: a scoping review.

Introduction: The situation of COVID-19 pandemic is becoming more complex. The research institutes should focus on the most important challenge related to this outbreak at the national level. We aim to realize this scoping review to map publications on COVID-19 in Vietnam in order to guide research priorities and policies in the country. Methods: This study was conducted at the Thai Binh University of Medicine and Pharmacy, from May to August 2020, according to the guidance for conducting systematic scoping review. Results: A total of 72 studies met the inclusion criteria. The most frequent publications were original articles (27.8%), followed by letter to editor/correspondence (26.4%). According to the research priorities for COVID-19 set by the WHO, 41.7% studies focused on control and prevention of COVID-19, but none of studies on personal protective equipment or protocol for healthcare workers' safety were conducted. 12.5% studies carried out a thorough investigation into epidemiology of the COVID-19 pandemic in Vietnam. Virology and genomics, natural history of the virus and its transmission in Vietnam were described by 18.1% papers. Only one study was conducted in terms of development for candidate therapeutics. Conclusion: We call for national investigation on treatment against SARS-CoV-2 and protocol for medical staff protection. The government and academic institutions should work in collaboration with international stakeholders, including the WHO, to combat together the COVID-19.

Respiratory pathogens among ill pilgrims and the potential benefit of using point-of-care rapid molecular diagnostic tools during the Hajj.

We investigated respiratory pathogens among ill Hajj pilgrims from Marseille. We also discuss the potential role of point-of-care (POC) rapid molecular diagnostic tools for this purpose. Clinical data were collected using a standardised questionnaire. Influenza A and B viruses, human rhinovirus and human coronaviruses, Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Klebsiella pneumoniae were investigated using real-time PCR in respiratory samples obtained during travel, at the onset of symptoms. 207 participants were included. A cough, expectoration, rhinitis and a sore throat were the most frequent respiratory symptoms, followed by loss of voice and dyspnoea. 38.7% and 25.1% of pilgrims reported a fever and influenza-like symptoms, respectively. 59.4% pilgrims received antibiotics. Rhinovirus (40.6%) was the most frequent pathogen, followed by S. aureus (35.8%) and H. influenzae (30.4%). Virus and bacteria co-infections were identified in 28.5% of participants. 25.1% pilgrims who were positive for respiratory bacteria did not receive antibiotic treatment. In the context of the Hajj pilgrimage, it is important to detect infections that can be easily managed with appropriate treatment, and those that can affect prognosis, requiring hospitalisation. POC rapid molecular diagnostic tools could be used for patient management at small Hajj medical missions and to rationalise antibiotic consumption among Hajj pilgrims.

Short-Term Adverse Effects Immediately after the Start of COVID-19 Booster Vaccination in Vietnam.

BACKGROUND: Risk communication is necessary to improve the booster vaccination rate, but Vietnam does not have a system to collect and disclose such information. Therefore, the purpose of this study was to clarify adverse reactions and their frequency in the early period after booster vaccination, and to obtain primary data for improving the booster vaccination rate. METHODS: A cross-sectional survey was conducted among adults aged ≥18 years. Clinical data were collected 14 days after booster vaccination by using a standard questionnaire. RESULTS: A total of 1322 participants were included with median age = 23 and sex ratio (Male/Female) = 0.53. AstraZeneca was the most commonly used vaccine for the first and second doses, while Pfizer was the most commonly used vaccine for booster shots. Injection site pain, fatigue, and myalgia were the most common side effect reported (71.9%, 28.1%, and 21.8%, respectively). Compared to previous COVID-19 vaccine injections, 81.9% of participants reported that their symptoms were similar or milder after receiving the booster dose. They were more likely to present injection site pain (OR = 1.43, p < 0.0001) and lymphadenopathy (OR = 4.76, p < 0.0001) after receiving the booster shot. Fever (OR = 0.33, p < 0.0001) and fatigue (OR = 0.77, p = 0.002) were less often reported after booster shots compared to the first and second injections. The severity of symptoms occurring after booster dose versus first and second doses increased significantly with each additional year of age and among participants receiving the Pfizer and Moderna vaccines. CONCLUSION: Adverse reactions to booster vaccination are minor and their incidence is the same as for the first or the second vaccination. Multicenter studies with larger sample sizes on the side effects and safety of COVID-19 vaccine booster shots need to be conducted to make the population less worried, in order to increase the vaccination rate, to protect individuals' and communities' health.

Risk factors for symptoms of infection and the acquisition of pathogens among pilgrims at the Grand Magal of Touba, 2017-2021.

BACKGROUND: Respiratory and gastrointestinal symptoms are frequent in pilgrims at the Grand Magal of Touba (GMT). METHODS: Pilgrims were prospectively investigated in 2017-2021 for demographics, chronic conditions, preventive measures, respiratory and gastrointestinal symptoms, and pathogen carriage using PCR assays. RESULTS: 535 pilgrims were included. 54.8% and 13.3% reported respiratory and gastrointestinal symptoms, respectively. 18.4% acquired respiratory viruses, notably rhinovirus (10.1%) and coronaviruses (5.6%) and 39.9% bacteria, notably Haemophilus influenzae (18.9%) and Streptococcus pneumoniae (14.1%). The acquisition of gastrointestinal pathogens was lower, with enteroaggregative Escherichia coli (18.9%) and enteropathogenic Escherichia coli (10.5%) being the most frequent. A decrease was observed in the acquisition rates of pathogens in 2020-2021 GMT. Female pilgrims were more at risk of respiratory and gastrointestinal symptoms. Respiratory symptoms were associated with virus acquisition (aRR: 2.20, 95%CI [1.38-3.50]) and S. pneumoniae acquisition (aRR: 2.76, 95%CI = [1.64-4.62]). Using hand soap was associated with a decrease in the acquisition of rhinovirus (aRR: 0.42, 95%CI [0.22-0.80]) and coronavirus (aRR: 0.42, 95%CI [0.22-0.81]). Using face masks was associated with a decrease in reporting of respiratory symptoms (aRR: 0.54, 95% [0.35-0.86]). CONCLUSION: Hand washing with soap and wearing face masks should be recommended to GMT pilgrims.

COVID-19 and environmental health: A systematic analysis for the global burden of biomedical waste by this epidemic

Since the beginning of this outbreak, much evidence stated that the climb in the amount of biomedical waste harmed human health and had adverse effects on the environment. With the increase of cases of COVID-19 all around the globe, the amount of biomedical waste was also constantly rising. Also, many solutions regarding either reducing or recycling biomedical waste. However, the potential global burden of biomedical waste during this pandemic was not yet been analyzed. Herein, we perform a systematic review of literature on these modalities, including mentioning types of biomedical waste, the effect on health, the environment, and methods of handling biomedical waste during this pandemic. A total of 3551 published papers were identified by two databases. In the end, 15 references were selected for this systematic analysis. Most of the included studies focus on research on the impact of medical waste caused by the COVID-19 pandemic on the environment. The total biomedical waste during the COVID-19 pandemic was approximately 16,649.48 tons/day. Most publications agreed that the amount of waste has also increased due to the rapidly rising number of COVID-19 patients. In 15 articles, we identified 2 mentioning the COVID-19 biomedical waste on health. 9 out of 15 gave out the context related to the solution of BMW by COVID-19. More studies, including meta-analyses, are recommended to shed more light on the effects of medical waste on environmental health during the COVID-19 pandemic.

Subacute thyroiditis after receiving the vaccine for COVID-19: a case report and literature review.

A 38-year-old female patient, with healthy history, was vaccinated with ChAdOx1 nCoV-19 (Astra Zeneca Cambridge, UK). Five days after the second injection, the patient presented headache, vertigo, then fatigue, nervousness, palpitations, shortness of breath, small amplitude tremors, and sweating episodes. Laboratory investigation revealed a suppressed thyroid-stimulating hormone (TSH), with elevated free thyroxine. However, the TSH receptor antibody and anti-thyroid peroxidase antibody were normal and thyroid-stimulating immunoglobulin negative. The patient was maintained on Metoprolol, and no specific treatment was added. After 3 months of following, the patient now feels comfortable. Our literature review found that 21 cases of subacute thyroiditis (SAT) following coronavirus disease 2019 (COVID-19) vaccines were reported. Most patients were young women who presented neck pain and systemic symptoms, with or without fever. These symptoms can appear as early (3 to 5 days), or later (1 month) after vaccination, regardless of vaccine type and mechanism of action. Laboratory tests showed decreased levels of TSH and elevated thyroid hormone. The mechanism of this event remains unknown. Further study is recommended to investigate the possible predisposing factors to developing SAT after receiving the COVID-19 vaccine.

Effect of the COVID-19 Outbreak on the Incidence of Other Respiratory and Gastrointestinal Infections in Children in Thai Binh, Vietnam in 2020.

INTRODUCTION: To evaluate the impact of COVID-19 mitigation measures on the total number of consultations for respiratory and gastrointestinal infections among children under 16 years in Thai Binh Pediatric Hospital, Vietnam during the year 2020. METHODS: A retrospective study was carried out to review consecutive consultations occurring in children admitted from January 01, 2016 to December 31, 2020. All medical records were collected from the central numeric database of the hospital. Diagnoses were documented according to the International Classification of Diseases 10 criteria. RESULTS: 436,276 children consulted at the outpatient department during the period of study. A gradual increase in the total number of outpatients was observed from 2016 to 2019, including those consulting for respiratory and gastrointestinal infections. However, the total number of outpatients and the numbers of those consulting for respiratory and gastrointestinal infections dramatically decreased in 2020. A significant decrease of respiratory infections relative proportion was observed in 2020 when compared to 2016-2019 (p < 0.0001). By contrast, the relative proportion of gastrointestinal infections did not significantly vary (p = 0.91). The proportion of outpatients aged under 5 years was significantly lower in 2020 compared to previous years (p < 0.0001). The proportion of male patients was significantly higher in 2020 than from 2016 to 2019 (p = 0.001). CONCLUSION: Public health measures against the COVID-19 pandemic likely decreased the prevalence of other respiratory tract infections. Further studies are needed to validate the effectiveness of each type of measure. Microbiological studies are also recommended, to better understand the effect of preventive measures.

Characteristics of the first 1119 SARS-CoV-2 Omicron variant cases, in Marseille, France, November-December 2021.

One thousand one hundred and nineteen cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant cases have been diagnosed at the Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France, between November 28, 2021, and December 31, 2021. Among the 825 patients with known vaccination status, 383 (46.4%) were vaccinated, of whom 91.9% had received at least two doses of the vaccine. Interestingly, 26.3% of cases developed SARS-CoV-2 infection within 21 days following the last dose of vaccine suggesting possible early production of anti-SARS-CoV-2 facilitating antibodies. Twenty-one patients have been hospitalized, one patient required intensive care, and another patient who received a vaccine booster dose died.

Seroprevalence of SARS-CoV-2 among high-density communities and hyper-endemicity of COVID-19 in Vietnam.

OBJECTIVE: To assess the magnitude of active and recovering COVID-19 patients among at-risk communities and to identify the factors associated with positive serology. METHODS: Four hundred and eighty-three close contacts of COVID-19 patients residing in Ho Chi Minh City, Vietnam, during the fourth wave of the COVID-19 epidemic (September and October 2021) were included. Five weeks after exposure to a COVID-19 patient, they underwent a serology test using the BIOSYNEX COVID-19 BSS kit. RESULTS: The median age of participants was 37 years. A total of 34.6% individuals presented at least one clinical symptom between the time of contact with the COVID-19 patient and inclusion in study. A total of 1.7% unvaccinated individuals tested positive for SARS-CoV-2 using real-time PCR, and 9.5% had evidence of recent infection (positive PCR and/or IgM). A further 26.7% unvaccinated individuals presented evidence of a past infection (positive IgG only). Socio-demographic characteristics, vaccination status and clinical symptoms were not associated with a positive IgM test. CONCLUSION: This is the first serosurvey conducted during the fourth wave of the epidemic in Vietnam. It revealed a seropositivity rate higher than in previous studies and confirmed the hyperendemicity of SARS-CoV-2. Testing using rapid serological tests proved to be a reliable, easy-to-use method and enabled a rapid estimation of the burden of COVID-19.

Long-Term Persistence of Olfactory and Gustatory Disorders in COVID-19 Patients.

Smell and taste disorders are frequent symptoms during acute COVID-19 and may persist long after the resolution of the initial phase. This study aims to estimate the proportion and risk factors for smell and/or taste disorders at the onset of symptoms and their persistence after more than 6 months of follow-up in COVID-19 patients. We analyzed a prospective cohort of COVID-19 patients admitted to our institute in Marseille, France in early 2020. After being discharged from the hospital, patients with smell and/or taste disorders were contacted for a telephone interview. Logistic regression analysis was performed to determine the risk factors for smell and/or taste disorders. A total of 3,737 patients were included, of whom 1,676 reported smell and/or taste disorders at the onset of symptoms. Taste and/or smell disorders were independently associated with being younger and female, a lower likelihood of suffering from diabetes, cardiovascular diseases and cancer, a longer delay between the onset of symptoms and consultation, and non-severe forms of COVID-19 at admission. Of the 605 patients with smell and/or taste disorders who were followed-up, 154 (25.5%) reported the persistence of symptoms for more than 6 months. At the time of follow-up, being female, having a chronic respiratory disease and using angiotensin-converting enzyme inhibitors (ACEis) were factors independently associated with the persistence of smell and/or taste disorders. In conclusion, the long-term persistence of olfactory and gustative disorders is frequent among COVID-19 patients, notably affecting female patients and patients who suffered from chronic respiratory diseases before infection. The role of ACEis needs to be further evaluated in larger numbers of patients.

SARS-CoV-2 reinfection and COVID-19 severity.

SARS-CoV-2 reinfection rate is low. The relative severity of the first and second episodes of infection remains poorly studied. In this study, we aimed at assessing the frequency of SARS-CoV-2 reinfections and comparing the severity of the first and second episodes of infection. We retrospectively included patients with SARS-CoV-2 positive RT-PCR at least 90 days after clinical recovery from a COVID-19 episode and with at least one negative RT-PCR after the first infection. Whole genome sequencing and variant-specific RT-PCR were performed and clinical symptoms and severity of infection were retrospectively documented from medical files. A total of 209 COVID-19 reinfected patients were identified, accounting for 0.4% of positive cases diagnosed from 19 March 2020 to 24 August 2021. Serology was performed in 64 patients, of whom 39 (60.1%) had antibodies against SARS-CoV-2 when sampled at the early stage of their second infection. Only seven patients (3.4%) were infected twice with the same variant. We observed no differences in clinical presentation, hospitalization rate, and transfer to ICU when comparing the two episodes of infections. Our results suggest that the severity of the second episode of COVID-19 is in the same range as that of the first infection, including patients with antibodies.