Factors associated with prolonged viral shedding in older patients infected with Omicron BA.2.2 (preprint)

Background To explore the risk factors associated with the viral shedding time in the elder Chinese patients infected with SARS-CoV-2 omicron.Methods Participants infected with SARS-CoV-2 omicron were enrolled in a retrospective study, and divided into two groups according to the shedding time of omicron [≥ 10 days, "late clearance group" and < 10 days, "early clearance group"].Results 180 patients were enrolled in the study (88 early, 92 late), with a median time of viral shedding was 10 days and a mean age of 77.02 years. When comparing patients between either group, prolonged SARS-CoV-2 omicron shedding was associated with old age (P = 0.007), unvaccinated (P = 0.001), delayed admission to hospital after illness onset (P = 0.001), D-dimer (P = 0.003) and methylprednisolone treatment (P = 0.048). In the multivariable analysis, vaccinated [OR], 0.319 [95% CI, 0.130–0.786], P = 0.013), paxlovid (OR, 0.259 [95% CI, 0.104–0.643], P = 0.004), and time from onset to admission (OR, 1.802 [95% CI, 1.391–2.355], P = 0.000) were significantly associated with viral clearance.Conclusions The older age, methylprednisolone therapy, and D-dimer were associated with prolonged duration of omicron viral shedding. The time from onset to hospitalization, unused paxlovid and unvaccinated were independent risk factors in patients infected with SARS-CoV-2 omicron.

Association between urinary VEGFA and renal pathology of IgA nephropathy patients.

BACKGROUND: Renal biopsy remains the golden standard for diagnosing and monitoring IgA nephropathy (IgAN). Vascular endothelial growth factor A (VEGFA) was crucial for the survival of glomerular cells. Our aim was to screen the expression pattern of urinary, circulating and renal VEGFA in IgAN patients to reveal their relationship with renal pathology and outcomes. METHODS: Baseline VEGFA levels were determined with ELISA, real-time PCR and immunohistochemistry. Associations between VEGFA expression and clinical-pathological parameters, and renal outcomes were evaluated. RESULTS: Compared with healthy controls, urinary VEGFA level was obviously elevated in IgAN patients (76.19 ± 63.67 pg/mg Cr vs 146.67 ± 232.71 pg/mg Cr, p = 0.0291) and not correlated with serum VEGFA level. Baseline urinary VEGFA was significantly associated with gender and tubular atrophy/interstitial fibrosis by stepwise multivariate regression analysis. Urinary VEGFA was higher in male patients accompanied with higher serum creatinine, larger proportion of hypertension and recurrent hematuria than in female patients. In the kidney of IgAN patients, VEGFA were robustly expressed in the parietal epithelial cells, podocytes, mesangial cells and tubular epithelial cells. After a follow-up duration of 38.53 ± 27.14 months, IgAN patients with higher urinary VEGFA level were found to have a poorer renal outcome of renal replacement therapy (HR = 1.027, p = 0.037) or composite outcome (HR = 1.023, p = 0.039) after adjusting for confounders. CONCLUSIONS: Increased urinary VEGFA might reflect certain renal pathology and, although not fully specific, still could be served as a valuable noninvasive indicator in predicting renal progression of IgAN.