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1.
Int J Infect Dis ; 2022 Apr 12.
Article in English | MEDLINE | ID: covidwho-1783424

ABSTRACT

OBJECTIVES: To conduct a diagnostic validation study of SARS-CoV-2 diagnostic kits. METHODOLOGY: We compared SARS-CoV-2 diagnostic test results from three RT-PCR assays used by the Zambian government between Nov 2020 to Feb 2021 (the Panther Fusion® assay, Da An Gene's 2019-nCoV RNA kit and Maccura's PCR Kit) with the Altona RealStar RT-PCR kit which served as the gold standard. We also evaluated results from rapid antigen testing, and whether co-morbidities were linked with increased odds of infection. RESULTS: We recruited 244 participants, 61% (149/244) were positive by at least one PCR assay. Da An Gene, Maccura and Panther Fusion assays had sensitivities of 0.0% (95%CI 0-41%), 27.1% (95%CI 15-42%) and 76% (95%CI 65-85%) respectively but specificity was low (<85% for all three assays). HIV and TB were not associated with SARS-CoV-2, whereas female sex (OR 0.5 (0.3-0.9), p = 0.026) and Chronic Pulmonary Disease (0.1 (0.0-0.8), p = 0.031), were associated with lower odds of SARS-CoV-2 infection. 84% of 44 samples sequenced were Beta variant. CONCLUSIONS: The RT-PCR assays evaluated did not meet WHO recommended minimum sensitivity of 80%. Local diagnostic validation studies should be embedded within preparedness plans for future outbreaks to improve the public health response.

6.
Int J Infect Dis ; 114: 151-154, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1506382

ABSTRACT

OBJECTIVE: Variants of concern (VOCs) associated with relatively high transmissibility appear to be rapidly spreading in Gabon. Therefore, it is imperative to understand the distribution of several VOCs in the population, which could have implications for transmissibility and vaccine efficacy. METHODS: Between February and May 2021, SARS-CoV-2 genomes were sequenced using the Oxford nanopore MinION method and the respective genome diversity was elucidated. Phylogenetic analysis was performed and genomes were classified using pangolin lineages. RESULTS: The results highlighted an increase (46%) in the alpha VOC (B.1.1.7) in the Gabonese population over the study period. In addition, an increase (31%) in the B.1.1.318 lineage, which is associated with high transmission and impaired vaccine efficacy (D614G+E484K+Y144del), was detected. CONCLUSION: With the second wave ongoing, these findings highlight the need for surveillance of the SARS-CoV-2 genome in the Republic of Gabon and should provide useful guidance to policymakers in selecting an appropriate vaccine for this population.


Subject(s)
COVID-19 , SARS-CoV-2 , Gabon/epidemiology , Humans , Incidence , Mutation , Phylogeny
7.
EBioMedicine ; 72: 103629, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1469839

ABSTRACT

The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) poses an unprecedented challenge to humanity. SARS-CoV-2 infections range from asymptomatic to severe courses of COVID-19 with acute respiratory distress syndrome (ARDS), multiorgan involvement and death. Risk factors for disease severity include older age, male sex, increased BMI and pre-existing comorbidities. Ethnicity is also relevant to COVID-19 susceptibility and severity. Host genetic predisposition to COVID-19 is now increasingly recognized and whole genome and candidate gene association studies regarding COVID-19 susceptibility have been performed. Several common and rare variants in genes related to inflammation or immune responses have been identified. We summarize research on COVID-19 host genetics and compile genetic variants associated with susceptibility to COVID-19 and disease severity. We discuss candidate genes that should be investigated further to understand such associations and provide insights relevant to pathogenesis, risk classification, therapy response, precision medicine, and drug repurposing.


Subject(s)
COVID-19/genetics , Genetic Predisposition to Disease , Immunity , COVID-19/enzymology , COVID-19/immunology , COVID-19/metabolism , Humans , Severity of Illness Index
8.
Int J Infect Dis ; 111: 28-30, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1364098

ABSTRACT

With reasonably good specificity and sensitivity, the speed and convenience of COVID-19 antigen tests have led to self-testing in schools, offices, and universities in the European Union (EU). Although self-testing can be beneficial and increase the accessibility to testing, there are potential ways to confound a positive COVID-19 lateral flow test. We observed that all soft drinks, energy drinks, alcoholic beverages (vodka, whiskey, and brandy), commercially bottled mineral water, and carbonated mineral water caused the appearance of a red test line. However, when equal volumes of the buffer and the respective beverages are mixed, there are no false-positive test lines. Deceitful methods may easily lead to misuse of COVID-19 antigen rapid tests and lead to false-positive results; however, this does not prove that these tests are unreliable when performed correctly.


Subject(s)
COVID-19 , Antigens, Viral , COVID-19 Testing , Carbonated Beverages , Humans , SARS-CoV-2 , Sensitivity and Specificity
9.
Wien Klin Wochenschr ; 133(17-18): 931-941, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1351300

ABSTRACT

BACKGROUND: We used the RNActive® technology platform (CureVac N.V., Tübingen, Germany) to prepare CVnCoV, a COVID-19 vaccine containing sequence-optimized mRNA coding for a stabilized form of SARS-CoV­2 spike (S) protein encapsulated in lipid nanoparticles (LNP). METHODS: This is an interim analysis of a dosage escalation phase 1 study in healthy 18-60-year-old volunteers in Hannover, Munich and Tübingen, Germany, and Ghent, Belgium. After giving 2 intramuscular doses of CVnCoV or placebo 28 days apart we assessed solicited local and systemic adverse events (AE) for 7 days and unsolicited AEs for 28 days after each vaccination. Immunogenicity was measured as enzyme-linked immunosorbent assay (ELISA) IgG antibodies to SARS-CoV­2 S­protein and receptor binding domain (RBD), and SARS-CoV­2 neutralizing titers (MN50). RESULTS: In 245 volunteers who received 2 CVnCoV vaccinations (2 µg, n = 47, 4 µg, n = 48, 6 µg, n = 46, 8 µg, n = 44, 12 µg, n = 28) or placebo (n = 32) there were no vaccine-related serious AEs. Dosage-dependent increases in frequency and severity of solicited systemic AEs, and to a lesser extent local AEs, were mainly mild or moderate and transient in duration. Dosage-dependent increases in IgG antibodies to S­protein and RBD and MN50 were evident in all groups 2 weeks after the second dose when 100% (23/23) seroconverted to S­protein or RBD, and 83% (19/23) seroconverted for MN50 in the 12 µg group. Responses to 12 µg were comparable to those observed in convalescent sera from known COVID-19 patients. CONCLUSION: In this study 2 CVnCoV doses were safe, with acceptable reactogenicity and 12 µg dosages elicited levels of immune responses that overlapped those observed in convalescent sera.


Subject(s)
COVID-19 , Nanoparticles , Vaccines , Adolescent , Adult , Antibodies, Viral , COVID-19/therapy , COVID-19 Vaccines , Double-Blind Method , Humans , Immunization, Passive , Immunogenicity, Vaccine , Lipids , Middle Aged , RNA, Messenger , SARS-CoV-2 , Young Adult
10.
Sci Rep ; 11(1): 14471, 2021 07 14.
Article in English | MEDLINE | ID: covidwho-1310815

ABSTRACT

Early detection of severe forms of COVID-19 is absolutely essential for timely triage of patients. We longitudinally followed-up two well-characterized patient groups, hospitalized moderate to severe (n = 26), and ambulatory mild COVID-19 patients (n = 16) at home quarantine. Human D-dimer, C-reactive protein (CRP), ferritin, cardiac troponin I, interleukin-6 (IL-6) levels were measured on day 1, day 7, day 14 and day 28. All hospitalized patients were SARS-CoV-2 positive on admission, while all ambulatory patients were SARS-CoV-2 positive at recruitment. Hospitalized patients had higher D-dimer, CRP and ferritin, cardiac troponin I and IL-6 levels than ambulatory patients (p < 0.001, p < 0.001, p = 0.016, p = 0.035, p = 0.002 respectively). Hospitalized patients experienced significant decreases in CRP, ferritin and IL-6 levels from admission to recovery (p < 0.001, p = 0.025, and p = 0.001 respectively). Cardiac troponin I levels were high during the acute phase in both hospitalized and ambulatory patients, indicating a potential myocardial injury. In summary, D-dimer, CRP, ferritin, cardiac troponin I, IL-6 are predictive laboratory markers and can largely determine the clinical course of COVID-19, in particular the prognosis of critically ill COVID-19 patients.


Subject(s)
COVID-19/blood , COVID-19/diagnosis , Ambulatory Care , Biomarkers/blood , C-Reactive Protein/analysis , Early Diagnosis , Ferritins/blood , Fibrin Fibrinogen Degradation Products/analysis , Follow-Up Studies , Hospitalization , Humans , Interleukin-6/blood , Longitudinal Studies , Pneumonia, Viral/blood , Pneumonia, Viral/diagnosis , Precision Medicine , Prognosis , Quarantine , SARS-CoV-2 , Severity of Illness Index , Troponin I/blood
11.
Cell Mol Life Sci ; 78(16): 5953-5976, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1293344

ABSTRACT

SARS-CoV-2 is the virus causing the major pandemic facing the world today. Although, SARS-CoV-2 primarily causes lung infection, a variety of symptoms have proven a systemic impact on the body. SARS-CoV-2 has spread in the community quickly infecting humans from all age, ethnicities and gender. However, fatal outcomes have been linked to specific host factors and co-morbidities such as age, hypertension, immuno-deficiencies, chronic lung diseases or metabolic disorders. A major shift in the microbiome of patients suffering of the coronavirus disease 2019 (COVID-19) have also been observed and is linked to a worst outcome of the disease. As many co-morbidities are already known to be associated with a dysbiosis of the microbiome such as hypertension, diabetes and metabolic disorders. Host factors and microbiome changes are believed to be involved as a network in the acquisition of the infection and the development of the diseases. We will review in detail in this manuscript, the immune response toward SARS-CoV-2 infection as well as the host factors involved in the facilitation and worsening of the infection. We will also address the impact of COVID-19 on the host's microbiome and secondary infection which also worsen the disease.


Subject(s)
COVID-19/immunology , COVID-19/virology , Lung/immunology , Lung/virology , SARS-CoV-2/immunology , Virus Replication/immunology , Animals , Dysbiosis/immunology , Dysbiosis/virology , Humans , Immunity/immunology , Microbiota/immunology , Pandemics
12.
Int J Infect Dis ; 106: 265-268, 2021 May.
Article in English | MEDLINE | ID: covidwho-1279605

ABSTRACT

INTRODUCTION: Use of hydroxychloroquine in patients with coronavirus disease 2019 (COVID-19) was widespread and uncontrolled until recently. Patients vulnerable to severe COVID-19 are at risk of hydroxychloroquine interactions with co-morbidities and co-medications contributing to detrimental, including fatal, adverse treatment effects. METHODS: A retrospective survey was undertaken of health conditions and co-medications of patients with COVID-19 who were pre-screened for enrolment in a randomized, double-blind, placebo-controlled hydroxychloroquine multi-centre trial. RESULTS: The survey involved 305 patients [median age 71 (interquartile range 59-81) years]. The majority of patients (n = 279, 92%) considered for inclusion in the clinical trial were not eligible, mainly due to safety concerns caused by health conditions or co-medications. The most common were QT-prolonging drugs (n = 188, 62%) and haematologic/haemato-oncologic diseases (n = 39, 13%) which prohibited the administration of hydroxychloroquine. In addition, 165 (54%) patients had health conditions and 167 (55%) patients were on co-medications that did not prohibit the use of hydroxychloroquine but had a risk of adverse interactions with hydroxychloroquine. The most common were diabetes (n = 86, 28%), renal insufficiency (n = 69, 23%) and heart failure (n = 58, 19%). CONCLUSION: The majority of hospitalized patients with COVID-19 had health conditions or took co-medications precluding safe treatment with hydroxychloroquine. Therefore, hydroxychloroquine should be administered with extreme caution in elderly patients with COVID-19, and only in clinical trials.


Subject(s)
COVID-19/drug therapy , Hydroxychloroquine/adverse effects , SARS-CoV-2 , Aged , Aged, 80 and over , Comorbidity , Contraindications, Drug , Drug Interactions , Female , Germany/epidemiology , Humans , Male , Middle Aged , Retrospective Studies
13.
Int J Infect Dis ; 106: 29-32, 2021 May.
Article in English | MEDLINE | ID: covidwho-1258382

ABSTRACT

Indirect effects of the COVID-19 pandemic have the potential to seriously undermine the health system in sub-Saharan Africa with an increase in the incidences of malaria, tuberculosis (TB) and HIV infections. Based on current evidence in the African region the collateral impact of COVID-19 on the "big three diseases" shall be addressed in the following.


Subject(s)
COVID-19/epidemiology , HIV Infections/epidemiology , Malaria/epidemiology , Syndemic , Tuberculosis/epidemiology , Africa South of the Sahara/epidemiology , Humans , Incidence , Pandemics
15.
Int J Infect Dis ; 105: 735-738, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1141903

ABSTRACT

OBJECTIVE: The aim of this study was to carry out whole-genome sequencing (WGS) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using samples collected from Congolese individuals between April and July 2020. METHODS: Ninety-six samples were screened for SARS-CoV-2 using RT-PCR, and 19 samples with Ct values <30 were sequenced using Illumina Next-Generation Sequencing (NGS). The genomes were annotated and screened for mutations using the web tool 'coronapp'. Subsequently, different SARS-CoV-2 lineages were assigned using PANGOLIN and Nextclade. RESULTS: Eleven SARS-CoV-2 genomes were successfully sequenced and submitted to the GSAID database. All genomes carried the spike mutation D614G and were classified as part of the GH clade. The Congolese SARS-CoV-2 sequences were shown to belong to lineage B1 and Nextclade 20A and 20C, which split them into distinct clusters, indicating two separate introductions of the virus into the Republic of Congo. CONCLUSION: This first study provides valuable information on SARS CoV-2 transmission in the central African region, contributing to SARS CoV-2 surveillance on a temporal and spatial scale.


Subject(s)
COVID-19/virology , Genome, Viral , SARS-CoV-2/genetics , Congo , High-Throughput Nucleotide Sequencing , Humans , Mutation , Whole Genome Sequencing
17.
Am J Trop Med Hyg ; 104(3): 1041-1044, 2021 Jan 11.
Article in English | MEDLINE | ID: covidwho-1024748

ABSTRACT

Hypoxemia is readily detectable by assessing SpO2 levels, and these are important in optimizing COVID-19 patient management. Hyperlactatemia is a marker of tissue hypoxia, particularly in patients with increased oxygen requirement and microvascular obstruction. We monitored peripheral venous lactate concentrations in hospitalized patients with moderate to severe COVID-19 (n = 18) and in mild ambulatory COVID-19 patients in home quarantine (n = 16). Whole blood lactate decreased significantly during the clinical course and recovery in hospitalized patients (P = 0.008). The blood lactate levels were significantly higher in hospitalized patients than ambulatory patients (day 1: hospitalized versus ambulatory patients P = 0.002; day 28: hospitalized versus ambulatory patients P = < 0.0001). Elevated lactate levels may be helpful in risk stratification, and serial monitoring of lactate may prove useful in the care of hospitalized COVID-19 patients.


Subject(s)
Ambulatory Care Facilities/statistics & numerical data , COVID-19/physiopathology , Hospitalization/statistics & numerical data , Lactic Acid/blood , Adolescent , Adult , Biomarkers/blood , COVID-19/epidemiology , Comorbidity , Female , Germany/epidemiology , Humans , Hypoxia/blood , Longitudinal Studies , Male , Middle Aged , Severity of Illness Index , Treatment Outcome , Young Adult
18.
19.
Int J Infect Dis ; 100: 112-116, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-959823

ABSTRACT

While successful containment measures of COVID-19 in China and many European countries have led to flattened curves, case numbers are rising dramatically in other countries, with the emergence of a second wave expected. Asymptomatic individuals carrying SARS-CoV-2 are hidden drivers of the pandemic, and infectivity studies confirm the existence of transmission by asymptomatic individuals. The data addressed here show that characteristics of asymptomatic and presymptomatic infection are not identical. Younger age correlates strongly with asymptomatic and mild infections and children as hidden drivers. The estimated proportion of asymptomatic infections ranges from 18% to 81%. The current perception of asymptomatic infections does not provide clear guidance for public-health measures. Asymptomatic infections will be a key contributor in the spread of COVID-19. Asymptomatic cases should be reported in official COVID-19 statistics.


Subject(s)
Asymptomatic Infections/epidemiology , Betacoronavirus , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adult , COVID-19 , Child , Coronavirus Infections/immunology , Coronavirus Infections/transmission , Humans , Immunity, Herd , Middle Aged , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/transmission , Public Health , SARS-CoV-2
20.
Int J Infect Dis ; 103: 278-279, 2021 02.
Article in English | MEDLINE | ID: covidwho-949963
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