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Non-conventional | WHO COVID | ID: covidwho-689150


Background: A recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), which began in Wuhan, China, with a high level of human-to-human transmission has been reported There are limited data available on Coronavirus Disease 2019 (COVID-19) patients with hematological malignancies with more than 60 days of follow-up This study describes the clinical characteristics, including multiple recurrences of COVID-19, in a patient with chronic lymphocytic leukemia (CLL) during 69 days of follow-up Case Presentation: A 72-year-old female was admitted to hospital isolation after being infected with COVID-19 as part of a family cluster on January 30, 2020 Apart from SARS-Cov-2 virus infection, laboratory results revealed lymphocytosis of uncertain etiology and abnormal distribution of T lymphocytes On blood smears, small blue lymphocytes with scant cytoplasm were observed, and the presence of high levels of circulating clonal B cells was also demonstrated by flow cytometry The patient was diagnosed with COVID-19 and CLL Among her family members, she had the highest viral loads and the fastest progression on lung injury and developed severe pneumonia Serological results showed she had both 2019-nCoV-specific IgM and IgG antibodies;however, only IgG antibodies were detected in her husband's plasma Results: A combination regimen of antiviral therapy and high-dose intravenous immunoglobulin (IVIG) in the early stage seemed to be effective for treating CLL and SARS-Cov-2 infection Because of the low humoral immune response, the CLL patient could not effectively clear the SARS-Cov-2 infection and suffered from recurrence twice during the 69-day follow-up Conclusion: In CLL, a neoplastic antigen-specific B-cell clone proliferates, and the progeny cells accumulate and outgrow other B cells, leading to immune deficiency Considering the low humoral immune response and ineffective clearance of SARS-Cov-2 in CLL patients, the follow-up and home quarantine period should be extended We need further studies to clarify suspending or continuing CLL therapy during COVID infection For those patients who are prone to progression to severe disease, administering humoral immunity therapies can help to prevent disease progression and quickly meet the cure criteria

Gastroenterology Report ; 8(3):167-174, 2020.
Article | WHO COVID | ID: covidwho-632301


Novel coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing public-health pandemic worldwide Although SARS-CoV-2 has been known to spread primarily through respiratory droplets, recent evidence also supports fecal/oral as an additional route of transmission, raising concerns over gastrointestinal (GI) transmission of the infection Herein, we, as the front-line Chinese GI surgeons, would like to share our experience and lessons in the combat against COVID-19 It is essential to create science-based, rational, and practical strategies during the outbreak of COVID-19 Here, we provide multi-institutional consensus on minimizing disease transmission while continuing to provide care from all aspects for patients in GI surgery, including outpatient clinics, inpatient units, gastrointestinal endoscopy centers, and adjustments in perioperative care Our experiences and recommendations are worth sharing and may help to establish specific infection-control and outcome measures

Am J Transl Res ; 2020.
Article | WHO COVID | ID: covidwho-157816


BACKGROUND: Since December 2019, there had been an outbreak of COVID-19 in Wuhan, China At present, diagnosis COVID-19 were based on real-time RT-PCR, which have to be performed in biosafe laboratory and is unsatisfactory for suspect case screening Therefore, there is an urgent need for rapid diagnostic test for COVID-19 OBJECTIVE: To evaluate the diagnostic performance and clinical utility of the colloidal gold immunochromatography assay for SARS-Cov-2 specific IgM/IgG anti-body detection in suspected COVID-19 cases METHODS: In the prospective cohort, 150 patients with fever or respiratory symptoms were enrolled in Taizhou Public Health Medical Center, Taizhou Hospital, Zhejiang province, China, between January 20 to February 2, 2020 All patients were tested by the colloidal gold immunochromatography assay for COVID-19 At least two samples of each patient were collected for RT-PCR assay analysis, and the PCR results were performed as the reference standard of diagnosis Meanwhile 26 heathy blood donor were recruited The sensitivity and specificity of the immunochromatography assay test were evaluated Subgroup analysis were performed with respect to age, sex, period from symptom onset and clinical severity RESULTS: The immunochromatography assay test had 69 positive result in the 97 PCR-positive cases, achieving sensitivity 71 1% [95% CI 0 609-0 797], and had 2 positive result in the 53 PCR-negative cases, achieving specificity 96 2% [95% CI 0 859-0 993] In 26 healthy donor blood samples, the immunochromatography assay had 0 positive result In subgroup analysis, the sensitivity was significantly higher in patients with symptoms more than 14 days 95 2% [95% CI 0 741-0 998] and patients with severe clinical condition 86 0% [95% CI 0 640-0 970] CONCLUSIONS: The colloidal gold immunochromatography assay for SARS-Cov-2 specific IgM/IgG anti-body had 71 1% sensitivity and 96 2% specificity in this population, showing the potential for a useful rapid diagnosis test for COVID-19 Further investigations should be done to evaluate this assay in variety of clinical settings and populations