RabbitV: fast detection of viruses and microorganisms in sequencing data on multi-core architectures.

MOTIVATION: Detection and identification of viruses and microorganisms in sequencing data plays an important role in pathogen diagnosis and research. However, existing tools for this problem often suffer from high runtimes and memory consumption. RESULTS: We present RabbitV, a tool for rapid detection of viruses and microorganisms in Illumina sequencing datasets based on fast identification of unique k-mers. It can exploit the power of modern multi-core CPUs by using multi-threading, vectorization, and fast data parsing. Experiments show that RabbitV outperforms fastv by a factor of at least 42.5 and 14.4 in unique k-mer generation (RabbitUniq) and pathogen identification (RabbitV), respectively. Furthermore, RabbitV is able to detect COVID-19 from 40 samples of sequencing data (255GB in FASTQ format) in only 320 seconds. AVAILABILITY: RabbitUniq and RabbitV are available at https://github.com/RabbitBio/RabbitUniq and https://github.com/RabbitBio/RabbitV. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Clinical and Intestinal Histopathological Findings in SARS-CoV-2/COVID-19 Patients with Hematochezia.

Gastrointestinal (GI) symptoms of SARS-CoV-2/COVID-19 in the form of anorexia, nausea, vomiting, abdominal pain and diarrhea are usually preceded by respiratory manifestations and are associated with a poor prognosis. Hematochezia is an uncommon clinical presentation of COVID-19, and we hypothesize that older patients with significant comorbidities (obesity and cardiovascular) and prolonged hospitalization are susceptible to ischemic injury to the bowel. We reviewed the clinical course, key laboratory data including acute-phase reactants, and drug/medication history in 2 elderly male patients admitted for COVID-19 respiratory failure. Both patients had a complicated clinical course and suffered from hematochezia, acute blood loss, and anemia which led to hemodynamic instability requiring blood transfusion around day 40 of their hospitalization. Colonoscopic impressions were correlated with the histopathological findings in the colonic biopsies that included changes compatible with ischemia and nonspecific acute inflammation, edema, and increased eosinophils in the lamina propria. Both patients were hemodynamically stable, on prophylactic anticoagulants, multiple antibiotics, and antifungal agents due to respiratory infections at the time of lower GI bleeding. Hematochezia resolved spontaneously with supportive care. Both patients eventually recovered and were discharged. Elderly patients with significant comorbid conditions are uniquely at risk for ischemic injury to the bowel. This case report highlights hematochezia as an uncommon GI manifestation of spectrum of COVID-19 complications. The causes of bleeding in these COVID-19 associated cases are likely multifactorial and can be attributed to concomitant etiologies based on their age, multiple comorbid conditions, prolonged hospitalization compounded by lung injury, and hypoxia precipitated by the virus. We hypothesize that rather than a direct viral cytopathic effect, ischemia and hypoperfusion may be unleashed due to the cytokine storm orchestrated by the virus that leads to abnormal coagulation profile. Additional factors that may contribute to ischemic injury are prophylactic use of anticoagulants and polypharmacy. There were no other causes to explain the brisk lower GI bleeding. Presentation of hematochezia was followed by hemodynamic instability that may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.