ABSTRACT
Literature offers plenty of cases of immunocompromised patients, who develop chronic and severe SARS-CoV-2 infections. The aim of this study is to provide further insight into SARS-CoV-2 evolutionary dynamic taking into exam a subject suffering from follicular lymphoma, who developed a persistent infection for over 7 months. Eight nasopharyngeal swabs were obtained, and were analyses by qRT-PCR for diagnostic purposes. All of them were considered eligible (Ct < 30) for NGS sequencing. Sequence analysis showed that all sequences matched the B.1.617.2 AY.122 lineage, but they differed by few mutations identifying three genetically similar subpopulations, which evolved during the course of infection, demonstrating that prolonged replication is paralleled with intra-host virus evolution. These evidences support the hypothesis that SARS-CoV-2 adaptive capacities are able to shape a heterogeneous viral population in the context of immunocompromised patients. Spill-over of viral variants with enhanced transmissibility or immune escape capacities from these subjects is plausible.
Subject(s)
COVID-19 , Humans , SARS-CoV-2/genetics , Immunocompromised Host , MutationABSTRACT
Since late December 2019, severe acute respiratory syndrome coronavirus 2 has spread across the world, which resulted in the World Health Organization declaring a global pandemic. Coronavirus disease 2019 (COVID-19) presents a highly variable spectrum with regard to the severity of illness. Most infected individuals exhibit a mild to moderate illness (81%); however, 14% have a serious disease and 5% develop severe acute respiratory distress syndrome (ARDS), requiring intensive care support. The mortality rate of COVID-19 continues to rise across the world. Data regarding predictors of mortality in patients with COVID 19 are still scarce but are being actively investigated. The present multicenter retrospective observational study provides a complete description of the demographic and clinical characteristics, comorbidities and laboratory abnormalities in a population of 421 hospitalized patients recruited across eight infectious disease units in Southern Italy (Sicily) with the aim of identifying the baseline characteristics predisposing COVID-19 patients to critical illness or death. In this study, older age, pre-existing comorbidities and certain changes in laboratory markers (such as neutrophilia, lymphocytopenia and increased C-reactive protein levels) at the time of admission were associated with a higher risk of mortality. Male sex, on the other hand, was not significantly associated with increased risk of mortality. Symptoms such as fatigue, older age, a number of co-pathologies and use of continuous positive airway pressure were the most significant contributors in the estimation of clinical prognosis. Further research is required to better characterize the epidemiological features of COVID-19, to understand the related predictors of death and to develop new effective therapeutic strategies.
ABSTRACT
Introduction Mediterranean spotted fever (MSF) is a zoonotic disease caused by Rickettsia conorii, an obligate intracellular gram-negative bacteria [1]. While blood chemistry tests showed neutrophilic leukocytosis (white blood cells 18.090 mm3 with 95% neutrophils), thrombocytopenia (platelet count 79.000 mm3), creatinine 1.3 mg/ dl;values in the normal range of PT, PTT, fibrinogen, antithrombin III, transaminases and bilirubin;increase in inflammation index with C-Reactive Protein 250 mg/L (normal value <5 mg/L) and procalcitonin 14.4 ng/ml (normal value <0.5 ng/ml). According to the guidelines of the Italian Society of Tropical Diseases, treatment of MSF is doxicicline 100 mg os q12h for 10 days [16]. [...]Mediterranean Spotted Fever is a disease that can have different clinical pictures: from benign pictures to really serious manifestations.