Coronavirus Disease 2019 Positivity Immediately After Lung Transplantation: A Case Report.

Management of COVID-19 in lung transplant recipients is challenging. We report a case of a 71-year-old male who underwent bilateral lung transplantation with an unexpected case of COVID-19. The patient had been fully vaccinated. The patient and donor tested negative for pretransplant COVID-19. On routine bronchoscopy on day 1 after transplant, the COVID-19 test was positive. Mycophenolic mofetil and the second dose of basiliximab were skipped, but tacrolimus and prednisone were continued. He was treated with casirivimab/imdevimab and remdesivir. He was discharged on day 14 and has had no episodes of acute rejection during the 3 months.

Successful pilot of DIAL digital & interventionless gas lift production optimization system offshore Malaysia

Objectives/Scope: This paper describes a pilot installation of a digital intelligent artificial lift (DIAL) gas lift production optimization system. The work was inspired by PETRONAS' upstream digitalization strategy with five single and dual-string gas lift completions planned from 2018 to 2020, offshore Malaysia. The authors evaluate the impact of the DIAL system in terms of increasing production, optimizing lift-gas injection, reducing well intervention frequency, as well as OPEX and risk reduction. Methods, Procedure, Process: DIAL is a unique technology that enhances the efficiency of gas lift production. Downhole monitoring of production parameters informs remote surface-controlled adjustment of gas lift valves. This enables automation of production optimization removing the need for well intervention. The paper focuses on a well installed in June 2020, the first in a five well campaign. The authors will provide details of the technology, and pilot program phases: system design;pre-job preparations;run in hole and surface hook-up;commissioning and unloading;and subsequent production operations. For each phase, challenges encountered, and lessons learned will be listed together with observed benefits. Results, Observations, Conclusions: DIAL introduces a paradigm shift in the design, installation, and operation of gas lifted wells. This paper will compare the differences between this digital technology and conventional gas lift techniques. It will consider the value added from the design stage through installation operations to production optimization. The DIAL system's ability to operate at greater than 80-degree deviation enabled deeper injection while avoiding tractor interventions for GLV maintenance in the highly deviated section of the well. Built-in downhole sensors provided real-time pressure monitoring that enabled a better understanding of reservoir behaviour and triggered data-driven reservoir stimulation decisions. The technology also proved very beneficial for production optimization, with the intervention-less adjustment of gas injection rate and depth downhole, based on the observed reservoir response in real time. The variable port sizes can be manipulated by means of surface switch/control. Overcoming the completion challenges due to COVID-19 restrictions, the well was unloaded and brought online with the assistance of personnel located in Houston and Dubai using Silverwell's visualization software. The well continues to be remotely monitored and controlled ensuring continuous production optimization, part of PETRONAS' upstream digitization strategic vision. Novel/Additive Information: First deployment worldwide of new and unique gas lift production optimization technology in offshore highly deviated well. The technology deployment was the result of collaborative work between a multi-discipline engineering team in PETRONAS, Silverwell, and Neural Oilfield Service. © 2021, Society of Petroleum Engineers.

Alteration in Nasopharyngeal Microbiota Profile in Aged Patients with COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is an infectious virus that causes coronavirus disease 2019 (COVID-19) transmitted mainly through droplets and aerosol affecting the respiratory tract and lungs. Little is known regarding why some individuals are more susceptible than others and develop severe symptoms. In this study, we analyzed the nasopharyngeal microbiota profile of aged patients with COVID-19 (asymptomatic vs. symptomatic) vs. healthy individuals. We examined the nasopharynx swab of 84 aged-matched patients, out of which 27 were negative asymptomatic (NegA), 30 were positive asymptomatic (PA), and 27 patients were positive symptomatic (PSY). Our analysis revealed the presence of abundant Cyanobacterial taxa at phylum level in PA (p-value = 0.0016) and PSY (p-value = 0.00038) patients along with an upward trend in the population of Litoricola, Amylibacter, Balneola, and Aeromonas at the genus level. Furthermore, to know the relationship between the nasal microbiota composition and severity of COVID-19, we compared PA and PSY groups. Our data show that the nasal microbiota of PSY patients was significantly enriched with the signatures of two bacterial taxa: Cutibacterium (p-value = 0.045) and Lentimonas (p-value = 0.007). Furthermore, we also found a significantly lower abundance of five bacterial taxa, namely: Prevotellaceae (p-value = 7 × 10-6), Luminiphilus (p-value = 0.027), Flectobacillus (p-value = 0.027), Comamonas (p-value = 0.048), and Jannaschia (p-value = 0.012) in PSY patients. The dysbiosis of the nasal microbiota in COVID-19 positive patients might have a role in contributing to the severity of COVID-19. The findings of our study show that there is a strong correlation between the composition of the nasal microbiota and COVID-19 severity. Further studies are needed to validate our finding in large-scale samples and to correlate immune response (cytokine Strome) and nasal microbiota to identify underlying mechanisms and develop therapeutic strategies against COVID-19.

Countering the double-whammy of zoonotic diseases. (Special Section: One health.)

A zoonotic disease (zoonoses) can infect both animals and people and be transmitted between vertebrate animals and people. Of the known (approximately 1,400) human pathogens 60 per cent have come from diseases that were first in animals. This historical trend has accelerated recently;of the newly emerging diseases in people approximately 75 per cent are believed to have come from animals. The virus that causes COVID-19, SARS-CoV-2, is the most recent example of a pathogen in animals then infecting people.

Different-team procurements: A potential solution for the unintended consequences of change in lung allocation policy.

The new lung allocation policy has led to an increase in distant donors and consequently enhanced logistical burden of procuring organs. Though early single-center studies noted similar outcomes between same-team transplantation (ST, procuring team from transplanting center) and different-team transplantation (DT, procuring team from different center), the efficacy of DT in the contemporary era remains unclear. In this study, we evaluated the trend of DT, rate of transplanting both donor lungs, 1-year graft survival, and risk of Grade 3 primary graft dysfunction (PGD) using the Scientific Registry of Transplant Recipient (SRTR) database from 2006 to 2018. A total of 21619 patients (DT 2085, 9.7%) with 19837 donors were included. Utilization of DT decreased from 15.9% in 2006 to 8.5% in 2018. Proportions of two-lung donors were similar between the groups, and DT had similar 1-year graft survival as ST for both double (DT, HR 1.108, 95% CI 0.894-1.374) and single lung transplants (DT, HR 1.094, 95% CI 0.931-1.286). Risk of Grade 3 PGD was also similar between ST and DT. Given our results, expanding DT may be a feasible option for improving lung procurement efficiency in the current era, particularly in light of the COVID-19 pandemic.

Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy.

SARS-CoV-2 emerged from animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here, we report a large-scale study to assess SARS-CoV-2 infection in 919 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.3% of dogs and 5.8% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation.