ABSTRACT
Candida auris, a multidrug-resistant yeast, can cause primary or secondary infections in a wide range of patients, including those diagnosed with the new coronavirus to even healthy individuals. The fungus has been reported in less than a decade on all six continents and in more than 45 countries. Ease of distribution, long shelf life, and resistance to several antifungal drugs have raised concerns about the prevention and management of patients with C. auris infection. Recent reports indicate serious challenges in identifying, understanding the mechanism of drug resistance, and preventing mortality from the infection with this microorganism. Given the prevalence of COVID-19 infection, it is important to identify patients colonized with C. auris correctly and at the early stages, to control and prevent a possible outbreak. In this article, the widespread occurrence of infections due to C. auris in the world and Iran, its clinical manifestations, risk factors, pathogenic mechanisms, diagnostic enhancements and challenges, drug resistance, treatment options, prevention, and control as well as concomitant C. auris infections in patients with COVID-19 virus, are reviewed.Copyright © 2022 Isfahan University of Medical Sciences(IUMS). All rights reserved.
ABSTRACT
Candida auris, a multidrug-resistant yeast, can cause primary or secondary infections in a wide range of patients, including those diagnosed with the new coronavirus to even healthy individuals. The fungus has been reported in less than a decade on all six continents and in more than 45 countries. Ease of distribution, long shelf life, and resistance to several antifungal drugs have raised concerns about the prevention and management of patients with C. auris infection. Recent reports indicate serious challenges in identifying, understanding the mechanism of drug resistance, and preventing mortality from the infection with this microorganism. Given the prevalence of COVID-19 infection, it is important to identify patients colonized with C. auris correctly and at the early stages, to control and prevent a possible outbreak. In this article, the widespread occurrence of infections due to C. auris in the world and Iran, its clinical manifestations, risk factors, pathogenic mechanisms, diagnostic enhancements and challenges, drug resistance, treatment options, prevention, and control as well as concomitant C. auris infections in patients with COVID-19 virus, are reviewed.
ABSTRACT
Background: Since December 2019, the world is struggling with an outbreak of coronavirus disease-2019 (COVID-19) infection mostly represented as an acute respiratory distress syndrome and has turned into the most critical health issue worldwide. Limited information is available about the association between dynamic changes in the naso/oropharyngeal viral shedding in infected patients and biomarkers, aiming to be assessed in the current study. Materials and Methods: This quasi-cohort study was conducted on 31 patients with moderate severity of COVID-19 manifestations, whose real-time polymerase chain reaction (RT-PCR) test was positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) RNA at baseline. RT-PCR was rechecked for patients every 3-4 days until achieving two negative ones. In parallel, biomarkers, including lymphocyte count, lactate dehydrogenase (LDH), and C-reactive protein (CRP), were assessed every other day, as well. Viral shedding also was assessed. Results: Spearman's correlation test revealed a significant direct correlation between the viral shedding from the symptom onset and the time, in which CRP (P = 0.0015, r = 0.54) and LDH (P = 0.001, r = 0.6207) return to normal levels after symptom onset, but not for lymphocyte count (P = 0.068, r = 0.34). Conclusion: Based on the current study's findings, the duration of SARS-CoV-2 RNA shedding was directly correlated with the required time for LDH and CRP return to normal levels. Therefore, these factors can be considered the determinants for patients' discharge, isolation, and return to social activities;however, further investigations are required to generalize the outcomes.
ABSTRACT
Detection of coronavirus disease 2019 (COVID-19) in early stage is indispensible for outcome improvement and interruption of transmission chain. Clear understanding of the nature of the diagnostic tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and their challenges, collecting the most diagnostically valuable specimen at the right time from the right anatomic site, and interpretation of their findings is important. This review scrutinizes current challenges and interpretation of reverse transcriptase polymerase chain reaction (RT-PCR), as the reference method, loop-mediated isothermal amplification (LAMP), antibody and antigen detection, typical lung imaging characteristics and prominent abnormal changes in laboratory findings of patients with proven COVID-19, and describes how the results may vary over time. Bronchoalveolar lavage fluid and sputum specimens demonstrate the highest positive rates (93% and 72%, respectively) in molecular diagnosis of COVID-19. Alternatively, repeated RT-PCR assays can be performed;as over time, it is an increase in the likelihood of the SARS-CoV-2 being present in the nasopharynx. Combining clinical evidence with results of chest computed tomography (CT) and RT-PCR can minimize the risk of diagnostic errors. Elevated levels of interleukin 6 (IL-6) and D-dimer are thought to be closely associated with the occurrence of severe COVID-19 in adults, and their combined detection can serve as early factors predicting the severity of COVID-19. Moreover, elevated acute phase proteins are associated with a poor outcome in COVID-19. Serological diagnosis also is an important tool to understand the extent of COVID-19 in the community, and to identify individuals, who are immune. Antibodies begin to increase from the second week of symptom onset.
ABSTRACT
Aim: This study aimed to investigate the prevalence of coronavirus disease 2019 (COVID-19) among healthcare workers (HCWs) in Isfahan, Iran. Materials & methods: HCWs in COVID-19 wards of three referral COVID-19 hospitals in Isfahan were screened and tested for COVID-19 infection. Results: In total, 102 HCWs were screened whose median age was 43 years old. Moreover, 21 (20.5%) of them had a history of suspected infection with SARS-CoV2, mostly (66.6%) without any symptoms while six (28.5%) of them suffered from relatively mild diseases and one (4.7%) was diagnosed with pulmonary embolism. Conclusion: It was found that HCWs were prone to be asymptomatic carriers while their computed tomography images were normal. Therefore, it is recommended that reverse-transcriptase real-time-PCR be essential for the diagnosis of infections.
ABSTRACT
Background: Emergence of Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection (coronavirus disease-2019 or COVID-19) in China since late 2019 and its global distribution has attracted a big international attention. As 2019-nCov is an emerging pathogen, extending our knowledge about the similarities/differences of this virus with other members of the Coronaviridae family, its genetic characteristics, and pathogenesis could be beneficial to develop better strategies of diagnosis, control, and treatment. This pandemic disease is still so new to be fully identified, and there is a long way ahead for complete characterization of SARS-COV-2 and its disease.