ABSTRACT
Background: High-titer neutralizing anti-cytokine autoantibodies have been shown to be involved in several acquired diseases, including pulmonary alveolar proteinosis, cryptococcal meningitis, and disseminated/extrapulmonary Nocardia infections (anti-GM-CSF autoantibodies), disseminated mycobacterial disease (anti-IFN-gamma autoantibodies), and some cases of severe COVID-19 infection (anti-type 1 interferons). Currently, patient blood samples are shipped via courier and require temperaturecontrolled conditions for transfer. This method is expensive and requires patients to have access to medical personnel to draw the blood. However, the well-established technique of collecting blood on a paper card as a dried blood spot (DBS) for diagnosis offers a point of care alternative which can be performed with a simple finger prick. This method is less invasive, cheaper, and allows for easy transport of patient samples. Method(s): 30 uL of whole blood from patients was blotted on filter paper and stored at 4C until use. The filter paper was hole punched and each punched spot was eluted with 150 uL of a 0.05% Tween PBS solution at room temperature overnight. The eluate was screened for anti-cytokine autoantibodies using a particle-based approach. Patient plasma was also screened in conjunction for comparison. Result(s): We confirmed the presence of autoantibodies in the DBS eluate from 4 previously diagnosed patients with anti-GM-CSF autoantibodies and 2 patients with anti-IFN-gamma autoantibodies. Functional studies showed the DBS eluate from a patient with anti-GM-CSF autoantibodies was able to block GM-CSF-induced STAT-5 phosphorylation in normal PBMC. As a proof of concept and to increase the number of patients evaluated, we also confirmed the presence of anti-cytokine autoantibodies using dried plasma eluate from 9 patients with known anti-GM-CSF autoantibodies and 9 patients with anti-IFN-gamma autoantibodies. Levels detected in DBS analyses were comparable to the levels found in plasma from the same patients not subjected to blotting and elution. Temperature studies showed that the autoantibodies were detected at similar levels when stored at 4C, 25C, and 40C for a week. Conclusion(s): The diagnosis of pathogenic anti-cytokine autoantibodies should be considered in the context of unusual or adult-onset infections, and screening for this diagnosis can be performed with dried blood spot testing.Copyright © 2023 Elsevier Inc.
ABSTRACT
Literature data show that acute, severe, and also chronic stress play an important role in the development of somatic and mental disorders. It is well documented in the literature that starting university studies results in anxiety in many ways for individuals. In this present work, we examined how perceived stress affects the appearance of depression and sleep disorders among a special group: the first-year undergraduates. In February 2020, 134 students completed a 14-question Perceived Stress Scale questionarre. In addition, the 13-question Beck Depression Scale and the 8-question Athens Insomnia Scale were used as measures to assess their current mental health status. Following the outbreak of the COVID-19 pandemic, the extent to which anxiety and depressive symptoms changed had become a major issue worldwide. In June 2020, we repeated our previous measures in the given population with the same methods. Our research clearly proved higher perceived stress values among undergraduate students, which were associated with high depressive symptom parameters and insomnia. However, unexpectedly, questionnaires completed during the quarantine period of the COVID pandemic showed lower perceived stress, which was accompanied by a decrease in depressive symptoms and insomnia. © 2022 UCU.
ABSTRACT
Background: Coronavirus disease-19 (COVID-19) is associated with disturbed hemostasis balance. Little is known about COVID-19- associated hemostasis alterations in pregnancy and their associations with the clinical course. Aim(s): We aimed to test hemostasis alterations in COVID-19- positive pregnant women as compared to non-infected pregnancies and to correlate results with maternal and perinatal outcomes. Method(s): In this single-center observational case-control study, 80 women with acute COVID-19 infection at 24-40 gestational weeks (COVID-19+ group) and 80 healthy age-and gestational week-matched pregnant women (COVID-19- group) were enrolled. All women were outpatients with mild/no symptoms at admission. Acute infection was confirmed/ruled out using SARS-CoV- 2 RT-PCR and/or antigen test. Blood taken on admission was analyzed for markers of inflammation (CRP, ferritin, IL-6), D-dimer, fibrinogen, von Willebrand factor antigen, factor VIII (FVIII) and factor XIII (FXIII) activity, clot-lysis assay, thrombin generation, ACE1, ACE2 activity, and anti-SARS- CoV- 2 antibody levels. Detailed clinical parameters of pregnancy, labor and post-partum period were registered. Pregnancies were followed for 6 weeks after childbirth. Result(s): In the COVID-19+ group, APTT was significantly prolonged, while PT, fibrinogen, and D-dimer levels did not significantly differ from the non-infected group. FVIII activity was significantly lower in the COVID-19+ group as compared to COVID-19- group (183.7 +/- 55.9% vs. 201.7 +/- 49.2%, p = 0.03). Similarly, FXIII activity was significantly reduced in COVID-19+ pregnant women (80.6 +/- 23.5% vs. COVID-19- group: 91.6 +/- 22.5%, p = 0.04). Pregnancy-associated complications were observed in 5 COVID-19+ cases, with marked alterations of coagulation screening tests, clot-lysis assay, and increased D-dimer. Perinatal complications were observed in 6 cases and one newborn tested positive for SARS-CoV- 2. Two cases of severe post-partum hemorrhage were observed in the COVID-19+ group. No post-partum thrombotic events occurred. Conclusion(s): In this cohort, third-trimester COVID-19+ pregnancies were associated with reduced levels of FVIII and FXIII activity. In a few cases, marked alterations of hemostasis and fibrinolysis balance occurred, which were accompanied by pregnancy complications.
ABSTRACT
The transmission of Severe Acute Respiratory Syndrome Coronavirus-2 in a community can be monitored by a wastewater-based epidemiological approach due to fecal shedding. Although sewage surveillance has gained a con-siderable amount of attention over the last 16 months, an indirect issue within the topic is whether traditional wastewater treatment technologies are sufficiently efficient to eliminate the genetic material of SARS-CoV-2. Samples were taken from the Wastewater Treatment Plant in Nagykanizsa before the virus was concentrated, nucleic acid extracted and SARS-CoV-2 detected by RT-qPCR (Quantitative reverse transcription PCR). The influent and primary treated samples tested positive, while after the secondary treatment, all the results were negative. Consequently, the activated sludge process proved to be efficient in terms of the removal of SARS-CoV-2.
ABSTRACT
The new coronavirus infection (COVID-19) is associated with significant changes in hemostasis parameters, however, little is known about COVID-19-associated coagulopathy in pregnancy. In this observational case-control study, 39 women with acute COVID-19 infection at 36-40 gestational weeks of their pregnancy (COVID-19+ group) and 21 healthy age-and gestational week-matched pregnant women were enrolled (COVID-19-group). All women were outpatients and acute infection was confirmed or ruled out using SARS-CoV-2 RT-PCR or antigen test. In addition to screening tests of coagulation, D-dimer, fibrinogen, von Willebrand factor antigen, chromogenic factor VIII (FVIII) activity, factor XIII (FXIII) activity, in vitro clot-lysis, angiotensin convertase enzyme (ACE) activity, and anti-SARS-CoV-2 antibody levels were measured. In the COVID-19+ group, APTT was significantly increased, while PT, TT, fibrinogen and D-dimer were not significantly different as compared to the COVID-19-group. FVIII activity was significantly lower in the COVID-19+ group (183.7±47.7%) as compared to COVID-19-group (226.7±62.5%, p=0.01). Similarly, FXIII activity was reduced in the COVID-19+ group (82.3±23.5% vs. COVID-19-group: 96.2±26.6%, p=0.04). Pregnancy-associated complications including HELLP syndrome were observed in 2 cases of COVID-19+ group, with marked alterations of coagulation screening tests, clot-lysis and D-dimer levels. Conclusion: Pregnancy associated with SARS-CoV-2 infection in the third trimester leads to reduced levels of FVIII and FXIII activity, most likely as a result of increased coagulation activation and consumption.