Seroprevalence of Immunoglobulin G Antibody among Contacts of COVID-19 Cases: A Study from India

Objective: To estimate COVID-19 seropositivity among contacts of cases and to compare the seropositivity among different types of contact for assessing the differential risk & transmission dynamics. Material and Methods: A large-scale population-based serosurvey was carried out among the general population of Ahmedabad during the second half of October 2020. The contacts of cases were selected based on the population proportion and enrolled as an additional category. The seropositivity among the contacts was estimated using the enzyme-linked immunosorbent assay and compared with different types of contact and available demographic factors. Results: As of October 2020, the seropositivity against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) among contacts of cases in Ahmedabad was 26.0% [95% confidence interval 24.2–28.0]. The seropositivity among family contacts was significantly higher (28.8%) compared to other contacts (24.4%) (Z=2.19, p-value=0.028). This trend was seen across all age groups and both sexes. The seropositivity was higher among females (27.7%) compared to males (24.5%) but the difference was statistically not significant (Z=1.64, p-value=0.101). In terms of age groups, the positivity had an increasing trend up to 60 years but declined after that. Conclusion: A seropositivity of 26.0% among contacts indicates that a large proportion of contacts demonstrated Immunoglobulin-G antibodies. This highlights asymptomatic transmission and/or low sensitivity of the diagnostic tests. The current strategy for contact tracing and testing among contacts is justified based on the significantly higher seropositiviamong family contacts. © 2021 JHSMR.

Rhino-orbital-cerebral mucormycosis: fungal epidemic in a viral pandemic.

BACKGROUND: Treatment of coronavirus disease 2019 infection can result in immunosuppression. Rhino-orbital-cerebral mucormycosis is a frequent co-infection, even after recovery. METHODS: An ambispective interventional study was conducted of 41 coronavirus patients with rhino-orbital-cerebral mucormycosis at a tertiary care centre from March to May 2021. RESULTS: There were 28 males and 13 females with a mean age of 48.2 years (range, 21-68 years). Twelve had long-standing diabetes mellitus and 28 had been recently diagnosed. Thirty-six had received systemic corticosteroids for coronavirus disease 2019. Nasal signs were present in 95 per cent of patients, ophthalmic symptoms and signs in 87 per cent, palatal necrosis in 46.3 per cent, facial signs in 24.3 per cent, nerve palsies in 60.9 per cent, and intracranial involvement in 21.9 per cent. Treatment with amphotericin B was based on clinical features and co-morbidities. Endonasal debridement was performed in 51.2 per cent of patients, total maxillectomy in 14.6 per cent and orbital exenteration in 9.7 per cent. At the last follow up, 37 patients (90.24 per cent) were on antifungal therapy; 4 (9.75 per cent) did not survive. CONCLUSION: Early detection may improve survival. Follow up of high-risk patients after coronavirus disease 2019 infection is paramount.

Serosurveillance among covid-19 cases in ahmedabad using sars-cov2 igg antibodies

Background: Serosurveillance study focusing on antibodies against SARS-CoV2 among the Covid19 cases can add value in the scientific knowledge & help in formulating valid predictions regarding immunity status in the post-covid period. Objectives: To estimate seropositivity among covid19 cases and to identify various factors affecting seropositivity. Methods: During second half of October 2020, a population based serosurvey on Covid19 cases was carried out in Ahmedabad. Covid-Kavach test kits were used and estimated seroprevalence was compared with available demographic and covid19 case related parameters to identify factors affecting seropositivity in the post-covid period. Simple proportions and Z-test were used as appropriate. Results: As on October 2020, the sero-positivity among Covid19 cases in Ahmedabad was 54.51% [95% Confidence Interval (CI) 52.14-56.86%]. Females have higher positivity (54.78%) as compared to males (54.30%) but the difference was statistically not significant (Z=0.19, P=0.84). Among children and elderly, the positivity is high and from young adults to elderly the seropositivity has an increasing trend. Severity of clinical illness and longer duration of hospitalization are associated with higher seropositivity. Conclusion: With 54.51% seropositivity among covid19 cases, it is clear that all the covid19 cases may not have developed IgG antibodies, have undetectable level or might have disappeared during the post-covid period. Comparison of seropositivity with age group and clinical case details clearly suggest close correlation with the severity of clinical symptoms. The seronegative cases indicate the need for further in-depth scientific research to identify the factors affecting immunity and to uncover the reasons behind the same. © 2021, Indian Association of Preventive and Social Medicine. All rights reserved.