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1.
J Endocrinol Invest ; 2022 Jul 13.
Article in English | MEDLINE | ID: covidwho-1930621

ABSTRACT

PURPOSE: Thyroid dysfunction in COVID-19 carries clinical and prognostic implications. In this study, we developed a prediction score (ThyroCOVID) for abnormal thyroid function (TFT) on admission amongst COVID-19 patients. METHODS: Consecutive COVID-19 patients admitted to Queen Mary Hospital were prospectively recruited during July 2020-May 2021. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were measured on admission. Multivariable logistic regression analysis was performed to identify independent determinants of abnormal TFTs. ThyroCOVID was developed based on a clinical model with the lowest Akaike information criteria. RESULTS: Five hundred and forty six COVID-19 patients were recruited (median age 50 years, 45.4% men, 72.9% mild disease on admission). 84 patients (15.4%) had abnormal TFTs on admission. Patients with abnormal TFTs were more likely to be older, have more comorbidities, symptomatic, have worse COVID-19 severity, higher SARS-CoV-2 viral loads and more adverse profile of acute-phase reactants, haematological and biochemical parameters. ThyroCOVID consisted of five parameters: symptoms (malaise), comorbidities (ischaemic heart disease/congestive heart failure) and laboratory parameters (lymphocyte count, C-reactive protein, and SARS-CoV-2 cycle threshold values). It was able to identify abnormal TFT on admission with an AUROC of 0.73 (95% CI 0.67-0.79). The optimal cut-off of 0.15 had a sensitivity of 75.0%, specificity of 65.2%, negative predictive value of 93.5% and positive predictive value of 28.1% in identifying abnormal TFTs on admission amongst COVID-19 patients. CONCLUSION: ThyroCOVID, a prediction score to identify COVID-19 patients at risk of having abnormal TFT on admission, was developed based on a cohort of predominantly non-severe COVID-19 patients.

4.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-327005

ABSTRACT

Highly transmissible SARS-CoV-2 Omicron variant has posted a new crisis for COVID-19 pandemic control. Within a month, Omicron is dominating over Delta variant in several countries probably due to immune evasion. It remains unclear whether vaccine-induced memory responses can be recalled by Omicron infection. Here, we investigated host immune responses in the first vaccine-breakthrough case of Omicron infection in Hong Kong. We found that the breakthrough infection rapidly recruited potent cross-reactive broad neutralizing antibodies (bNAbs) against current VOCs, including Alpha, Beta, Gamma, Delta and Omicron, from unmeasurable IC50 values to mean 1:2929 at around 9-12 days, which were higher than the mean peak IC50 values of BioNTech-vaccinees. Cross-reactive spike- and nucleocapsid-specific CD4 and CD8 T cell responses were detected. Similar results were also obtained in the second vaccine-breakthrough case of Omicron infection. Our preliminary findings may have timely implications to booster vaccine optimization and preventive strategies of pandemic control.

5.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326824

ABSTRACT

The Omicron (B.1.1.529) variant of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was only recently detected in southern Africa, but its subsequent spread has been extensive, both regionally and globally1. It is expected to become dominant in the coming weeks2, probably due to enhanced transmissibility. A striking feature of this variant is the large number of spike mutations3 that pose a threat to the efficacy of current COVID-19 (coronavirus disease 2019) vaccines and antibody therapies4. This concern is amplified by the findings from our study. We found B.1.1.529 to be markedly resistant to neutralization by serum not only from convalescent patients, but also from individuals vaccinated with one of the four widely used COVID-19 vaccines. Even serum from persons vaccinated and boosted with mRNA-based vaccines exhibited substantially diminished neutralizing activity against B.1.1.529. By evaluating a panel of monoclonal antibodies to all known epitope clusters on the spike protein, we noted that the activity of 17 of the 19 antibodies tested were either abolished or impaired, including ones currently authorized or approved for use in patients. In addition, we also identified four new spike mutations (S371L, N440K, G446S, and Q493R) that confer greater antibody resistance to B.1.1.529. The Omicron variant presents a serious threat to many existing COVID-19 vaccines and therapies, compelling the development of new interventions that anticipate the evolutionary trajectory of SARS-CoV-2.

6.
Journal of Diabetes Investigation ; 12(SUPPL 1):15-16, 2021.
Article in English | EMBASE | ID: covidwho-1518048

ABSTRACT

OBJECTIVE: We aimed to evaluate the impact of glycaemic status on clinical outcomes and anti-SARS-CoV-2 antibody (Ab) response among patients with predominantly non-severe COVID-19, highly relevant to the current COVID-19 vaccination programme. METHODS: We included consecutive adults admitted to Queen Mary Hospital for COVID-19 from July 2020 to May 2021. Glycaemic status was defined by HbA1c on admission: normoglycaemia (<5.7%), prediabetes (5.7-6.4%) and diabetes (≥6.5% or known diabetes). Clinical deterioration was defined by radiological progression, new oxygen requirement, intensive care unit admission, or death. COVID-19 survivors had Ab measurements at 1-month, 2-month, 3- month and 6-month post-discharge, with a live SARS-CoV-2-based microneutralization assay which correlated well with anti-SARS-CoV-2 receptor binding domain IgG (≥1:20 defined as positive). RESULTS: Among 605 patients (age 50.2 - 17.1 years;45.1% men;96.9% non-severe COVID-19), 325 had normoglycaemia, 185 had prediabetes and 95 had diabetes. 74 had clinical deterioration (12.2%): 16 required intensive care and 4 died. Clinical deterioration was more likely with worse glycaemic status (P < 0.001) and higher HbA1c (OR 1.403, P < 0.001). Older age (P < 0.001), higher viral loads (P < 0.001), higher C-reactive protein (CRP) (P < 0.001) and symptomatic presentation (P = 0.008), but not glycaemic status/HbA1c, independently predicted clinical deterioration. 314 patients had Ab measured upon follow-up (1-month: 295;2-month: 227;3-month: 207;6-month: 122). Ab titres were comparable across glycaemic status throughout follow-up period. CRP (P = 0.003), but not glycaemic status/HbA1c, was the only positive independent determinant of Ab levels. Rate of decline of Ab titre was comparable across glycaemic status, and did not correlate with HbA1c. Furthermore, most patients remained Ab-positive throughout follow-up (1-month: 94.9%, 2-month: 93.8%, 3-month: 87.4%, 6-month 80.3%), similar across glycaemic status. CONCLUSION: Worse glycaemic status was associated with a higher chance of clinical deterioration in COVID-19, contributed by older age, more severe inflammation and higher viral loads. Importantly, glycaemic status did not adversely influence the Ab response.

8.
Hong Kong Journal of Paediatrics ; 26(2):111-115, 2021.
Article in English | EMBASE | ID: covidwho-1431534

ABSTRACT

Since the coronavirus disease 2019 (COVID-19) outbreak in late December 2019, and escalation of the public hospital infectious disease outbreak response level to the highest "emergency" level three days after two COVID-19 cases were diagnosed on 22 January 2020, all public hospitals implemented a series of isolation policies, rescheduled clinical services and mobilised resources to support frontline clinical staff. This article reviewed these multi-level policies adopted in the Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, which have ensured that the healthcare system was not overwhelmed and frontline staff was not over-stressed and infected.

9.
Hong Kong Med J ; 27(5): 326-327, 2021 10.
Article in English | MEDLINE | ID: covidwho-1359443
10.
Journal of Thoracic Disease ; (2072-1439 (Print))2020.
Article in English | PMC | ID: covidwho-854260

ABSTRACT

In 2003, severe acute respiratory syndrome coronavirus (SARS-CoV) caused one of the most devastating epidemics known to the developed world. There were two important lessons from this epidemic. Firstly, coronaviruses, in addition to influenza viruses, can cause severe and rapidly spreading human infections. Secondly, bats can serve as the origin and natural animal reservoir of deadly human viruses. Since then, researchers around the world, especially those in Asia where SARS-CoV was first identified, have turned their focus to find novel coronaviruses infecting humans, bats, and other animals. Two human coronaviruses, HCoV-HKU1 and HCoV-NL63, were identified shortly after the SARS-CoV epidemic as common causes of human respiratory tract infections. In 2012, a novel human coronavirus, now called Middle East respiratory syndrome coronavirus (MERS-CoV), has emerged in the Middle East to cause fatal human infections in three continents. MERS-CoV human infection is similar to SARS-CoV in having a high fatality rate and the ability to spread from person to person which resulted in secondary cases among close contacts including healthcare workers without travel history to the Middle East. Both viruses also have close relationships with bat coronaviruses. New cases of MERS-CoV infection in humans continue to occur with the origins of the virus still unknown in many cases. A multifaceted approach is necessary to control this evolving MERS-CoV outbreak. Source identification requires detailed epidemiological studies of the infected patients and enhanced surveillance of MERS-CoV or similar coronaviruses in humans and animals. Early diagnosis of infected patients and appropriate infection control measures will limit the spread in hospitals, while social distancing strategies may be necessary to control the outbreak in communities if it remained uncontrolled as in the SARS epidemic. FAU - To, Kelvin K. W.

11.
Transfus Med ; 31(3): 223-224, 2021 06.
Article in English | MEDLINE | ID: covidwho-814247
12.
J Hosp Infect ; 106(2): 226-231, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-635357

ABSTRACT

BACKGROUND: In late 2019, a novel human coronavirus - severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) - emerged in Wuhan, China. This virus has caused a global pandemic involving more than 200 countries. SARS-CoV-2 is highly adapted to humans and readily transmits from person-to-person. AIM: To investigate the infectivity of SARS-CoV-2 under various environmental and pH conditions. The efficacies of various laboratory virus inactivation methods and home disinfectants against SARS-CoV-2 were investigated. METHODS: The residual virus in dried form or in solution was titrated on to Vero E6 cells on days 0, 1, 3, 5 and 7 after incubation at different temperatures. Viral viability was determined after treatment with various disinfectants and pH solutions at room temperature (20-25oC). FINDINGS: SARS-CoV-2 was able to retain viability for 3-5 days in dried form or 7 days in solution at room temperature. SARS-CoV-2 could be detected under a wide range of pH conditions from pH 4 to pH 11 for several days, and for 1-2 days in stool at room temperature but lost 5 logs of infectivity. A variety of commonly used disinfectants and laboratory inactivation procedures were found to reduce viral viability effectively. CONCLUSION: This study demonstrated the stability of SARS-CoV-2 on environmental surfaces, and raises the possibility of faecal-oral transmission. Commonly used fixatives, nucleic acid extraction methods and heat inactivation were found to reduce viral infectivity significantly, which could ensure hospital and laboratory safety during the SARS-CoV-2 pandemic.


Subject(s)
Betacoronavirus/growth & development , Betacoronavirus/pathogenicity , Coronavirus Infections/physiopathology , Microbial Viability , Pneumonia, Viral/physiopathology , Severe Acute Respiratory Syndrome/pathology , Virulence , Virus Inactivation , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Humans , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Severe Acute Respiratory Syndrome/epidemiology
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