ABSTRACT
More than 60% of human viral pathogens are of zoonotic origin, resulting from accidental or frequent animal infections. Bats are reservoirs of various viruses, pathogens in humans of varying severity from mild asymptomatic forms to severe lethal outcomes. And are associated with the spread of various viruses (Marburg virus, Ebola virus) and, above all, coronaviruses. Since the 2000s, three independent outbreaks of coronaviruses with the emergence of new zooanthroponotic human coronaviruses (Betacoronavirus) with epidemic and pandemic potential have been registered. The first outbreak was reported in 2002 (SARS), caused by SARS-CoV, in the PRC (Guangdong Province). The second outbreak occurred in 2012 (MERS, MERS), associated with MERS-CoV, Saudi Arabia. The third occurred in 2019 PRC (Hubei Province), this case evolved into a COVID-19 pandemic caused by SARS-CoV-2. These cases seem to be independent, but the literature reports that the emergence of all these viruses is related to evolutionary processes driven by environmental and genetic aspects. It is assumed that the coronavirus causative agent of severe acute respiratory syndrome-2 (SARS-CoV-2) originated from a coronavirus-infected bat of the genus Rhinolophus. After initial emergence, due to the host vector. SARS-CoV-2 is now transmitted worldwide through human-to-human transmission. Data from experimental studies show that animal species such as cats, ferrets, raccoon dogs, Javanese macaques, rhesus macaques, white-tailed deer, rabbits, Egyptian fruit bats and Syrian hamsters are susceptible to SARS-CoV-2 infection. However, natural SARS-CoV-2 infections have only been reported in domestic dogs and cats, tigers, lions, snow leopards, cougars and gorillas in zoos, and farm-raised mink and ferrets. Although human-to-animal transmission has been reported in several cases, animal-to-human transmission of SARS-CoV-2 has been reported only from mink to humans on mink farms. © 2022 The Authors, published by EDP Sciences.
ABSTRACT
The Idea of splicing LEGO bricks is proposed for describing the structure of a composite viral infection, which makes it possible to explain the possibility of a recurrence of the disease and the pattern of peaks in the spread of the disease. Comparing the RNA sequences/fragments of a virus to LEGO bricks, the number of LEGO bricks an individual acquires can be used to estimate the probability of disease and death for that individual. The aim is to advise and help public health security develop appropriate measures to reduce infection, recurrence and death from disease during a pandemic. The purpose is to provide the basis for recommendations and measures developed for public health safety to reduce disease infection, recurrence and death during a pandemic. © 2022 IEEE.
ABSTRACT
A fundamentally new multiphase compartmental mathematical model for predicting the spread of several waves of coronavirus infection has been developed. Quality indicators in comparison with existing single-phase models are analyzed. The developed model will allow to model several waves of the process of spreading new coronavirus infections, to predict the process of loading the medical system, as well as the needs for staff, equipment and hospital beds during pandemics. © 2022 IEEE.
ABSTRACT
In the last decade, anti-neutrophil cytoplasmic antibodies (ANCA)-associated systemic vasculitis (SV) has been treated with the anti-B-cell drug, rituximab (RTM) both for induction and maintenance therapy. One of the problems of the treatment with RTM in patients with ANCA-SV is the risk of late-onset neutropenia (LON), mechanisms of development of which have not been studied enough yet. Objective: To evaluate the incidence and outcomes of LON in patients with ANCA-SV treated with RTM. Patients and methods. A retrospective analysis of the register of 140 patients with ANCA-SV who received RTM treatment at the V.A. Nasonova Research Institute of Rheumatology from 2009 to 2021 years. The median duration of RTM treatment was 49 (6–121) months, the median of the total RTM dose was 3.5 (0.5–9.5) grams. The duration of follow-up exceeded 6 months after the first administration of RTM. Results and discussion. LON was detected in 16 (11.4%) patients, of which 6 suffered from Wegener's granulomatosis with polyangiitis (GPA), 4 – microscopic polyangiitis (MPA), 4 – Churg-Strauss eosinophilic granulomatosis with polyangiitis (EGPA) and 2 – undifferentiated ANCA-SV. In 8 (50%) out of 16 patients, LON developed within 2 months after the 1st course of RTM, in the remaining 8 patients, on average, after 10 (4–15.5) months. A lethal outcome was documented in 5 (31.2%) of 16 cases of LON (1 with MPA, 3 with GPA, and 1 with EGPA) on average 2 (1.5–9) months after the 1st course of RTM, at the same time, in 4 patients LON was complicated by pneumonia, including 2 with septic shock, in another 1 case LON was combined with the development of acute myocardial infarction and progression of chronic renal failure. Overall mortality among 140 patients with ANCA-SV treated with RTM was 11.4%, while in cases with a fatal outcome, the frequency of LON reached 31.2%. Conclusion. Thus, LON induced by RTM is a common (11%) and clinically significant consequence of B-cell depletion in patients with ANCA-SV, in every 5th case it is complicated by serious infections (including sepsis in 13%) and accounts for a significant proportion in the structure of lethal outcomes (31.2%). Patients treated with RTM require careful monitoring of absolute neutrophil count both during the first months after initiation of anti-B-cell therapy and thereafter. In the combined administration of RTM with cytotoxic drugs (primarily cyclophosphamide) in patients with ANCA-SV, it is necessary to consider the risk of LON developing, secondary immunodeficiency, and infectious complications. During the coronavirus pandemic, one should remember that treatment with interleukin 6 inhibitors used in severe COVID-19 can also be accompanied by neutropenia and requires careful dynamic monitoring of the absolute number of neutrophils in patients with ANCA-SV treated with RTM. It is necessary to inform both patients and physicians of the risk of LON development during the treatment of RTM in ANCA-SV and other rheumatic diseases. © Institut français des relations internationales.
ABSTRACT
Background: Anti-B-cell therapy with rituximab (RTX) plays an important role in the induction and maintenance therapy of ANCA-associated vasculitis (AAV). Late-onset neutropenia (LON) has been reported following RTX therapy. Objectives: Based on a retrospective analysis of the register of AAV patients (pts) treated with RTX, to study the incidence and outcomes of LON. Methods: 140 AAV pts (median age 52 (20-83) years, 57% women) were treated with RTX between 2009 to 2021: 63 with granulomatosis with polyangiitis (GPA), 45 microscopic polyangiitis (MPA), 24 eosinophilic granulomatosis with polyangi-itis (EGPA), and 8 unclassifed AAV. The median total dose of RTX was 3.5 (0.5-45) g. As a rule, single 500-mg infusions were used with an interval of 4-6 months for retreatment courses. The duration of follow-up exceeded 6 months after the frst dose of RTX. Regular pts monitoring every 3 months included estimation absolute neutrophil count (ANC). LON was defned as unexplained neutropenia occurring 3 weeks after the last RTX infusion. Results: LON I-IV grade was noted in 16 (11.4%) AAV pts: 6 GPA, 4 MPA, EGPA, and 2 unclassifed AAV. In 7 out of 16 cases (43.7%) LON developed after the frst course of RTX. Neutropenia grade I was observed in 3 pts (ANC 1.68-2.0x109/l, 2-15.5 months after the last RTX infusion), grade II-in 4 patients (1.1-1.5x109/l, 3-9 months after RTX). Neutropenia grade I-II resolved independently, without adverse reactions. LON grade IV was noted in 9 pts (0.06-0.3x109/l, 1.1-11 months after RTX), 3 of them received leukopoie-sis-stimulating drugs with normalization of ANC. In one EGPA pt febrile LON grade IV developed twice (in 2017, 11 months after RTX;in 2019, 4 months after RTX and complicated by uterine bleeding). Fatal outcome occurred in out of 16 cases (31.2%): 1 MPA, 3 GPA, and 1 EGPA. In 3 fatal cases LON was complicated by pneumonia (in 2 with septic shock), in one with acute myocardial infarction and another one with progression of chronic renal failure. According to our registry, the total mortality among 140 AAV pts receiving RTX was 11.4%, while 5 of 16 fatal cases (31.2%) had LON grade IV. Three of the 5 death were noted in 2013-2014, which attributed to the use of cyclophos-phamide >2 gm before RTX, as well as insufficient awareness of the risk of LON, which contributed to the delay in control of a full blood count, untimely diagnosis of LON and late treatment. At the beginning, the original drug Mab-thera was used, while after 2014 biosimilar Acellbia was mainly used. The disadvantages of this study: the lack of information about the ANC in 4 cases with COVID-19 and fatal outcome. Conclusion: LON after RTX therapy can develop in 11.4% of AAV pts, which exceeds the data for rheumatoid arthritis (1,3-3%) [1,2]. Our register data are lower than the rate of LON in AAV, presented by D. Tesfa et al. (23%) [1], which could be affected by the use of low-dose RTX for retreatment courses. LON accounts for a signifcant part in the structure of deaths of AAV pts (31.2%). It needs to careful monitoring of ANC in pts receiving RTX and awareness of both pts and physicians about the risk of LON.
ABSTRACT
In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged from China. Coronaviruses belong to enveloped ssRNA viruses and are classified into four genera: Alpha coronavirus, Beta coronavirus, Gamma coronavirus and Delta coronavirus. It is assumed that SARS-CoV-2 is spread primarily during a personal contact via bigger respiratory droplets. These droplets with viruses can be directly inhaled by other people or can lend on the surfaces with the possibility of further spreading. The ocular surface has been suggested as one of possible infection entries. Human eye has its own renin-angiotensin system with present ACE2 receptors, which bind the virus through spike protein. The most common symptoms of the SARS-CoV-2 infection are fever, cough and dyspnoea. Several clinical entities, such as conjunctivitis, anterior uveitis, retinitis, and optic neuritis have been associated with this infection. The most common ophthalmologic symptom associated with COVID-19 disease is conjunctivitis. Some studies indicate that eye symptoms are commonly present in patients with severe COVID-19 pneumonia and that it is possible to detect viral RNA from the conjunctival sac of these patients. In ophthalmologic praxis, we manage not only the therapy of the eye structures` inflammation in relation with this infection, but also the overall management of the visits and the supervision of the patients who are at risk and positive for coronavirus. Ophthalmologists could potentially have a higher risk of SARS-CoV-2 infection due to personal communication with the patients, frequent exposure to tears and eye secrets and the use of devices. We would like to provide an ophthalmologist`s perspective on this topic.
ABSTRACT
The main feature of feline coronavirus infection is its manifestation in the form of peritonitis. Feline infectious peritonitis is a highly lethal disease that lacks primary prevention and therapy. Therefore, feline infectious peritonitis is an epizootic problem in the near future. In our review, we demonstrate the current clinical, diagnostic, and therapeutic interventions for feline infectious peritonitis, as well as hypotheses of origin. © The Authors, published by EDP Sciences, 2021.