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Proc (Bayl Univ Med Cent) ; 34(4): 437-441, 2021 Mar 30.
Article in English | MEDLINE | ID: covidwho-1160622


The prevalence and seroconversion rate of SARS-CoV-2 infection among asymptomatic health care workers in the US is unclear. Our study utilized real-time polymerase chain reaction (RT-PCR) SARS-CoV-2 testing and serological evaluation to detect IgG antibodies specific to SARS-CoV-2 antigens in asymptomatic health care workers. A total of 197 subjects with a mean age of 35 years were recruited into the study. While most (67%) reported prolonged contact with known COVID-19 patients, only 8 (4.2%) tested positive on RT-PCR and 23 (11.7%) had detectable levels of IgG antibody to SARS-CoV-2. Out of 19 subjects with detectable IgG antibody at week 1, 11 (57.9%) lost their antibody response by week 3. No statistically significant difference was found in baseline characteristics or exposure status between subjects with positive and negative results on RT-PCR or antibody positivity. In conclusion, we found a low incidence of PCR positivity for SARS-CoV-2 in a high-risk group. This likely demonstrates the effectiveness of proper personal protective equipment use and low transmission risk in health care settings. The detectable IgG antibody titer was low, and a significant portion of subjects lost their antibody response on repeat testing. This may mean that antibody response in asymptomatic patients is categorically different than in symptomatic hospitalized patients with COVID-19.

Proc (Bayl Univ Med Cent) ; 33(4): 572-579, 2020 Jun 23.
Article in English | MEDLINE | ID: covidwho-612150


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or novel coronavirus disease 2019 (COVID-19) emerged from China in December 2019 and progressed to become a global pandemic. Our understanding of its pathophysiology and potential management was initially extrapolated from previous epidemics of coronaviruses like SARS and MERS. SARS-CoV-2 is asymptomatic or minimally symptomatic in more than 80% of patients and requires no additional management; however, the remaining patients progress to pneumonia and hypoxemia with ranging severity, including a smaller group that requires intensive care unit admission. To date, there are no approved treatments for SARS-CoV-2, and current management is focused on supplemental oxygen and supportive care. The antiviral medication remdesivir recently received emergency use authorization by the US Food and Drug Administration for patients with severe disease. Multiple clinical trials evaluating different treatment modalities such as antivirals, immunomodulators, convalescent plasma, and monoclonal antibodies, among others, are still ongoing. We believe that patients present with clinical phenotypes that correlate with the spectrum of disease. Each phenotype may benefit from one or multiple interventions. We discuss treatments under evaluation in clinical trials and their potential application based on clinical phenotype presentation.