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2.
Int J Hematol ; 115(6): 826-837, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1872733

ABSTRACT

Coagulation and fibrinolytic mechanisms are enhanced in patients with coronavirus (COVID-19), but disturbances in the balance of both functions in COVID-19 patients remain unclear. We assessed global coagulation and fibrinolysis in plasma from 167 COVID-19 patients (mild/moderate/severe: 62/88/17, respectively) on admission using clot-fibrinolysis waveform analysis (CFWA). Maximum coagulation velocity (|min1|) and maximum fibrinolysis velocity (|FL-min1|) were expressed as ratios relative to normal plasma. Ten patients (6.0%) developed thrombosis, 5 (3.0%) had bleeding tendency, and 13 (7.8%) died during admission. FDP levels increased with severity of COVID-19 symptoms (mild/moderate/severe; median 2.7/4.9/9.9 µg/mL, respectively). The |min1| ratios were elevated in all categories (1.27/1.61/1.58) in keeping with enhanced coagulation potential, with significant differences between mild cases and moderate to severe cases. The |FL-min1| ratios were also elevated in all groups (1.19/1.39/1.40), reflecting enhanced fibrinolytic potential. These data identified coagulation dominance in moderate to severe cases, but balanced coagulation and fibrinolysis in mild cases. There were significant differences in FDP and TAT, but no significant differences in |min1| or |FL-min1| ratios, between patients with and without thrombosis. CFWA monitoring of coagulation and fibrinolysis dynamics could provide valuable data for understanding hemostatic changes and disease status in COVID-19 patients.


Subject(s)
COVID-19 , Thrombosis , Blood Coagulation , Fibrinolysis , Hemostasis , Humans , Thrombosis/etiology
3.
Jpn J Radiol ; 40(8): 800-813, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1782926

ABSTRACT

PURPOSE: Using CT findings from a prospective, randomized, open-label multicenter trial of favipiravir treatment of COVID-19 patients, the purpose of this study was to compare the utility of machine learning (ML)-based algorithm with that of CT-determined disease severity score and time from disease onset to CT (i.e., time until CT) in this setting. MATERIALS AND METHODS: From March to May 2020, 32 COVID-19 patients underwent initial chest CT before enrollment were evaluated in this study. Eighteen patients were randomized to start favipiravir on day 1 (early treatment group), and 14 patients on day 6 of study participation (late treatment group). In this study, percentages of ground-glass opacity (GGO), reticulation, consolidation, emphysema, honeycomb, and nodular lesion volumes were calculated as quantitative indexes by means of the software, while CT-determined disease severity was also visually scored. Next, univariate and stepwise regression analyses were performed to determine relationships between quantitative indexes and time until CT. Moreover, patient outcomes determined as viral clearance in the first 6 days and duration of fever were compared for those who started therapy within 4, 5, or 6 days as time until CT and those who started later by means of the Kaplan-Meier method followed by Wilcoxon's signed-rank test. RESULTS: % GGO and % consolidation showed significant correlations with time until CT (p < 0.05), and stepwise regression analyses identified both indexes as significant descriptors for time until CT (p < 0.05). When divided all patients between time until CT of 4 days and that of more than 4 days, accuracy of the combined quantitative method (87.5%) was significantly higher than that of the CT disease severity score (62.5%, p = 0.008). CONCLUSION: ML-based CT texture analysis is equally or more useful for predicting time until CT for favipiravir treatment on COVID-19 patients than CT disease severity score.


Subject(s)
COVID-19 , Algorithms , Amides , Artificial Intelligence , COVID-19/diagnostic imaging , Humans , Lung/pathology , Prospective Studies , Pyrazines , SARS-CoV-2 , Tomography, X-Ray Computed/methods
4.
Jpn J Infect Dis ; 75(2): 202-204, 2022 Mar 24.
Article in English | MEDLINE | ID: covidwho-1761197

ABSTRACT

Many studies have been conducted on ventilator-associated complications (VACs) in patients with coronavirus 2019 (COVID-19). However, in these studies, the causative organisms were similar, and there were no reports on VAC corresponding with Corynebacteria. Coryneforms are frequently cultured in cases of polymicrobial infections and are usually considered contaminants in respiratory specimens. However, Corynebacterium pseudodiphtheriticum or C. striatum is known to be a pathogen in lower respiratory tract infections. We report three cases of VAC, probably due to C. pseudodiphtheriticum, in patients with COVID-19. If purulent lower respiratory tract specimens showed coryneform predominantly upon Gram staining, empirical therapy should be started. Furthermore, species identification and drug susceptibility testing should be performed.


Subject(s)
COVID-19 , Coinfection , Corynebacterium Infections , Mycobacterium tuberculosis , Coinfection/complications , Corynebacterium , Corynebacterium Infections/complications , Corynebacterium Infections/diagnosis , Humans , Microbial Sensitivity Tests , Respiration, Artificial/adverse effects
5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-318236

ABSTRACT

Objective: To evaluate whether patients with COVID-19 who have tested re-positive with the PCR test for the SARS-CoV-2 virus are infectious is a challenge in the current circumstances. A follow-up survey was conducted with healthcare personnel (HCP) who were exposed to a patient whose PCR test results for SARS-CoV-2 were re-positive 18 days after the initial confirmation of negative PCR results. Results: : We studied a total of 15 HCP who had contact exposures (15/15) and aerosol exposures (7/15). None of them tested positive for IgG against SARS-CoV-2 on blood examination. None of them had any symptoms during 10 days of active isolation. All PCR tests conducted using the nasopharyngeal swabs collected from the HCP on day 10 were negative. No apparent infection was found in any of the HCP who had contact exposure with and/or aerosol exposure from the patient whose PCR test results for SARS-CoV-2 were re-positive 18 days after the initial confirmation of negative results of PCR tests for SARS-CoV-2.Trial Registration: No. 170, approved June 10 th , 2020 by the ethics committee of Sakai City Medical Center.

6.
Sci Rep ; 11(1): 23695, 2021 12 08.
Article in English | MEDLINE | ID: covidwho-1561520

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread across the world. Inactivating the virus in saliva and the oral cavity represents a reasonable approach to prevent human-to-human transmission because the virus is easily transmitted through oral routes by dispersed saliva. Persimmon-derived tannin is a condensed type of tannin that has strong antioxidant and antimicrobial activity. In this study, we investigated the antiviral effects of persimmon-derived tannin against SARS-CoV-2 in both in vitro and in vivo models. We found that persimmon-derived tannin suppressed SARS-CoV-2 titers measured by plaque assay in vitro in a dose- and time-dependent manner. We then created a Syrian hamster model by inoculating SARS-CoV-2 into hamsters' mouths. Oral administration of persimmon-derived tannin dissolved in carboxymethyl cellulose before virus inoculation dramatically reduced the severity of pneumonia with lower virus titers compared with a control group inoculated with carboxymethyl cellulose alone. In addition, pre-administration of tannin to uninfected hamsters reduced hamster-to-hamster transmission of SARS-CoV-2 from a cohoused, infected donor cage mate. These data suggest that oral administration of persimmon-derived tannin may help reduce the severity of SARS-CoV-2 infection and transmission of the virus.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Diospyros/chemistry , Tannins/therapeutic use , Administration, Oral , Animals , Antiviral Agents/chemistry , Antiviral Agents/isolation & purification , Antiviral Agents/pharmacology , COVID-19/pathology , COVID-19/transmission , COVID-19/virology , Cricetinae , Diospyros/metabolism , Disease Models, Animal , Interleukin-1beta/genetics , Interleukin-1beta/metabolism , Interleukin-6/genetics , Interleukin-6/metabolism , Lung/pathology , Lung/virology , Male , Mesocricetus , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , Severity of Illness Index , Tannins/chemistry , Tannins/isolation & purification , Tannins/pharmacology , Viral Load/drug effects
7.
Jpn J Infect Dis ; 75(2): 202-204, 2022 Mar 24.
Article in English | MEDLINE | ID: covidwho-1389797

ABSTRACT

Many studies have been conducted on ventilator-associated complications (VACs) in patients with coronavirus 2019 (COVID-19). However, in these studies, the causative organisms were similar, and there were no reports on VAC corresponding with Corynebacteria. Coryneforms are frequently cultured in cases of polymicrobial infections and are usually considered contaminants in respiratory specimens. However, Corynebacterium pseudodiphtheriticum or C. striatum is known to be a pathogen in lower respiratory tract infections. We report three cases of VAC, probably due to C. pseudodiphtheriticum, in patients with COVID-19. If purulent lower respiratory tract specimens showed coryneform predominantly upon Gram staining, empirical therapy should be started. Furthermore, species identification and drug susceptibility testing should be performed.


Subject(s)
COVID-19 , Coinfection , Corynebacterium Infections , Mycobacterium tuberculosis , Coinfection/complications , Corynebacterium , Corynebacterium Infections/complications , Corynebacterium Infections/diagnosis , Humans , Microbial Sensitivity Tests , Respiration, Artificial/adverse effects
8.
J Infect Chemother ; 27(6): 864-868, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1087053

ABSTRACT

INTRODUCTION: Knowledge is limited on the virologic course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, particularly the time taken for viral clearance and the optimal time to discontinue isolation. This study aims to identify the clinical and demographic factors influencing the time taken for viral clearance in patients with COVID-19 to determine the optimal isolation period. METHODS: This two-center retrospective observational cohort study was conducted between March 1 and June 31, 2020. Patients with COVID-19, which was confirmed by real-time reverse transcription polymerase chain reaction, were included. Data were extracted from medical records. The positive duration, which was defined as the period from the day of symptom onset to the negative conversion day, was assessed using a generalized linear model. RESULTS: We included 63 patients. The mean positive duration was 20 days. The positive duration was significantly shorter for patients younger than 30 years of age and those between 30 and 60 years of age than for patients older than 60 years of age. We observed a more scattered distribution of the positive duration in older patients than in younger patients. CONCLUSIONS: Younger patients who recovered from COVID-19 took less time to clear SARS-CoV-2 than older patients; thus, a classification of the isolation periods based on age could be considered. A uniform viral clearance period for older patients may be difficult to determine because of biases such as underlying medical conditions. Further surveillance measures are recommended to determine the viral clearance time and the optimal isolation period.


Subject(s)
COVID-19/diagnosis , Patient Isolation , Viral Load , Adult , Aged , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , COVID-19/virology , COVID-19 Nucleic Acid Testing , Female , Humans , Hypertension , Male , Middle Aged , Real-Time Polymerase Chain Reaction , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2
9.
The Journal of Therapy ; 102(11):1373-1377, 2020.
Article in Japanese | CiNii Articles | ID: covidwho-937900
10.
BMC Res Notes ; 13(1): 511, 2020 Nov 07.
Article in English | MEDLINE | ID: covidwho-916352

ABSTRACT

OBJECTIVE: To evaluate whether patients with COVID-19 who have tested re-positive with the PCR test for the SARS-CoV-2 virus are infectious is a challenge in the current circumstances. A follow-up survey was conducted with healthcare personnel (HCP) who were exposed to a patient whose PCR test results for SARS-CoV-2 were re-positive 18 days after the initial confirmation of negative PCR results. RESULTS: We studied a total of 15 HCP who had contact exposures (15/15) and aerosol exposures (7/15). None of them tested positive for IgG against SARS-CoV-2 on blood examination. None of them had any symptoms during 10 days of active isolation. All PCR tests conducted using the nasopharyngeal swabs collected from the HCP on day 10 were negative. No apparent infection was found in any of the HCP who had contact exposure with and/or aerosol exposure to the patient whose PCR test results for SARS-CoV-2 were re-positive 18 days after the initial confirmation of negative results of PCR tests for SARS-CoV-2. CLINICAL TRIAL: Trial Registration: No. 170, approved June 10th, 2020 by the ethics committee of Sakai City Medical Center.


Subject(s)
Coronavirus Infections/transmission , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Pneumonia, Viral/transmission , Adult , Antibodies, Viral/blood , Antibodies, Viral/immunology , Betacoronavirus/immunology , COVID-19 , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Male , Middle Aged , Pandemics , Polymerase Chain Reaction , SARS-CoV-2 , Young Adult
11.
J Atheroscler Thromb ; 28(4): 396-401, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-895581

ABSTRACT

Patients with severe COVID-19 often experience complications including coagulopathy and fatal thrombosis. COVID-19 pneumonia sometimes leads to acute respiratory distress syndrome, requiring extracorporeal membrane oxygenation (ECMO), during which thrombosis and bleeding are major causes of death. Anticoagulation such as heparin is essential for COVID-19 patients on ECMO; however, bleeding might be caused by not only heparin, but also acquired von Willebrand syndrome (AVWS). To date, no study has examined ECMO-related bleeding and AVWS in COVID-19 patients.We report a COVID-19 patient who experienced bleeding from AVWS in addition to disseminated intravascular coagulation (DIC) during ECMO. The level of high-molecular weight VWF multimers decreased during ECMO therapy, and these findings promptly improved after discontinuation of ECMO. Plasma levels of VWF antigen were extremely high, probably due to endothelial cell damage caused by COVID-19. On the other hand, plasma levels of ADAMTS13 activity were moderately reduced, to 20-30% of normal. The patient was successfully treated with cryoprecipitate in bleeding during ECMO without a reduction in heparin, which might have induced thromboembolism. Bleeding found in this patient might be caused by AVWS and DIC.Severe COVID-19 patients are in a thrombotic state and need to receive anticoagulant therapy. However, once they receive ECMO therapy, bleeding symptoms could be observed. In such cases, physicians should think of AVWS in addition to the side effect of heparin and DIC.


Subject(s)
COVID-19/complications , COVID-19/therapy , Extracorporeal Membrane Oxygenation/methods , von Willebrand Diseases/complications , Anticoagulants/therapeutic use , Disseminated Intravascular Coagulation/complications , Disseminated Intravascular Coagulation/therapy , Extracorporeal Membrane Oxygenation/adverse effects , Hemorrhage , Heparin/pharmacology , Humans , Male , Middle Aged , Thromboembolism/complications , von Willebrand Diseases/therapy , von Willebrand Factor/analysis
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