SARS-COV-2 Infection in Children and Young People in Bulgaria - A Prospective, Single-Center, Cohort Study

Compared to other respiratory viruses, the proportion of hospitalizations due to SARS-CoV-2 among children is relatively low. While severe illness is not common among children and young individuals, a particular type of severe condition called multisystem inflammatory syndrome in children (MIS-C) has been reported. The aim of this prospective cohort study, which followed a group of individuals under the age of 19, was to examine the characteristics of patients who had contracted SARS-CoV-2, including their coexisting medical conditions, clinical symptoms, laboratory findings, and outcomes. The study also aimed to investigate the features of children who met the WHO case definition of MIS-C, as well as those who required intensive care. A total of 270 patients were included between March 2020 and December 2021. The eligible criteria were individuals between 0-18 with a confirmed SARS-CoV-2 infection at the Infectious Disease Hospital "Prof. Ivan Kirov"in Sofia, Bulgaria. Nearly 76% of the patients were <= 12 years old. In our study, at least one comorbidity was reported in 28.1% of the cases, with obesity being the most common one (8.9%). Less than 5% of children were transferred to an intensive care unit. We observed a statistically significant difference in the age groups, with children between 5 and 12 years old having a higher likelihood of requiring intensive care compared to other age groups. The median values of PaO2 and SatO2 were higher among patients admitted to the standard ward, while the values of granulocytes and C-reactive protein were higher among those transferred to the intensive care unit. Additionally, we identified 26 children who met the WHO case definition for MIS-C. Our study data supports the evidence of milder COVID-19 in children and young individuals as compared to adults. Older age groups were associated with higher incidence of both MIS-C and ICU admissions.Copyright © 2023 P. Velikov et al., published by Sciendo.

Postnatal SARSCOV2 Infection in Neonates, Characteristics and Outcomes: An Observational Study

Background: Many aspects of the severe acute respiratory syndrome coronavirus 2 (SARSCoV2) pandemic in 2019 have been unclear, especially in newborns, and reports of neonatal diseases are usually associated with perinatal infection. Objective(s): The purpose of this study was to evaluate clinical and para-clinical manifestations in newborns that contracted the infection after birth. Method(s): This observational research was conducted from October 2020 to March 2022 to examine postnatal SARSCoV2 infection in infants admitted to the NICU or neonatal ward at the Children's Medical Center in Tehran, Iran. Inclusion in the study was open to neonates who had positive RT-PCR results postnatally. Result(s): In total, 55 newborns were confirmed to have postnatal SARSCOV2. Fever was the most frequently observed symptom, with 35 (61%). Necrotizing enterocolitis was seen in 18% of neonates, and 30% of them were preterm. Neutropenia was seen in 34% of cases, with five cases having severe neutropenia. All neonates had a normal platelet count. Twenty percent of patients showed C-reactive protein higher than 6 mg/L. Two newborns had co-existing bacterial urinary tract infections. Our neonates didn't require antiviral, anticoagulant, or corticosteroid medications, and they recovered while receiving only supportive care. Everyone in the group of newborns was discharged without complications, and there were no deaths. Conclusion(s): The high rate of fever, high C-reactive protein, and neutropenia in SARSCoV2 neonates suggests that more observational research is needed to compare these symptoms to bacterial sepsis to avoid the overuse of antibiotics in these patients.Copyright © 2023, Author(s).

Validating saliva as a biological sample for cost-effective, rapid and routine screening for SARS-CoV-2

Purpose: Compared to nasopharyngeal/oropharyngeal swabs (N/OPS-VTM), non-invasive saliva samples have enormous potential for scalability and routine population screening of SARS-CoV-2. In this study, we investigate the efficacy of saliva samples relative to N/OPS-VTM for use as a direct source for RT-PCR based SARS-CoV-2 detection. Method(s): We collected paired nasopharyngeal/oropharyngeal swabs and saliva samples from suspected positive SARS-CoV-2 patients and tested using RT-PCR. We used generalized linear models to investigate factors that explain result agreement. Further, we used simulations to evaluate the effectiveness of saliva-based screening in restricting the spread of infection in a large campus such as an educational institution. Result(s): We observed a 75.4% agreement between saliva and N/OPS-VTM, that increased drastically to 83% in samples stored for less than three days. Such samples processed within two days of collection showed 74.5% test sensitivity. Our simulations suggest that a test with 75% sensitivity, but high daily capacity can be very effective in limiting the size of infection clusters in a workspace. Guided by these results, we successfully implemented a saliva-based screening in the Bangalore Life Sciences Cluster (BLiSC) campus. Conclusion(s): These results suggest that saliva may be a viable alternate source for SARS-CoV-2 surveillance if samples are processed immediately. Although saliva shows slightly lower sensitivity levels when compared to N/OPS-VTM, saliva collection is logistically advantageous. We strongly recommend the implementation of saliva-based screening strategies for large workplaces and in schools, as well as for population-level screening and routine surveillance as we learn to live with the SARS-CoV-2 virus.Copyright © 2023 Indian Association of Medical Microbiologists

A one-enzyme rt-qpcr assay for sars-cov-2, and procedures for reagent production

Given the scale of the ongoing COVID-19 pandemic, the need for reliable, scalable testing, and the likelihood of reagent shortages, especially in resource-poor settings, we have developed an RTqPCR assay that relies on an alternative to conventional viral reverse transcriptases, a thermostable reverse transcriptase/DNA polymerase (RTX) (Ellefson et al., 2016). Here we show that RTX performs comparably to the other assays sanctioned by the CDC and validated in kit format. We demonstrate two modes of RTX use - (i) dye-based RT-qPCR assays that require only RTX polymerase, and (ii) TaqMan RT-qPCR assays that use a combination of RTX and Taq DNA polymerases (as the RTX exonuclease does not degrade a TaqMan probe). We also provide straightforward recipes for the purification of this alternative reagent RTX. We anticipate that in low resource or point-of-need settings researchers could obtain the available constructs and begin to develop their own assays, within whatever regulatory framework exists for them.Copyright © 2021 Bio-protocol LLC. All Rights Reserved.

SARS-CoV-2 Alpha Variant Infection of a Patient Immunized by Inactive Sinovac (CoronaVac) Vaccine

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in December 2019, and shortly after pandemic has been declared by the World Health Organization (WHO) due to its unstoppable global spread. Considerable amount of effort has beenput around the World in order to develop a safe and effective vaccine against SARS-CoV-2. Inactivated and RNA vaccines have already passed phase three studies showing sufficient efficacy and safety, respectively. Nowadays, there is a noticeable dominance of SARS-CoV-2 variants with various mutations over the wild type SARS-CoV-2. However, there is no report showing the efficacy of these vaccines on these variants. This case study describes a thirty-eight-year-old male reported to be infected with SARS-CoV-2 alpha variant following two doses of inactive CoronaVac administration with a protective level of SARS-CoV-2 specific antibodies. The variant analysis of the virus reported to be positive for N501Y mutation.This is the first case in the literature demonstrating that inactive SARS-CoV-2 vaccine might have a lower efficacy on alpha variant.Copyright © 2022 Cenk Serhan Ozverel et al., published by Sciendo.

Clinical and immunological parallels in children patients with COVID-19

The problem of the incidence of new coronavirus infection in childhood is becoming increasingly important. At the same time, questions arise regarding the peculiarities of the pathogenesis of COVID-19 in children. The aim of the research was to study the clinical and immunological features of COVID-19 in children hospitalized with a severe course of the disease. Material and methods. We examined 53 children from 0 to 15 years old, hospitalized with suspected new coronavirus infection at Children's Clinical Hospital No. 3 in Novosibirsk from October to December 2020. Determination of specific IgM and IgG antibodies to SARS-CoV-2 antigens in serum blood was carried out using the ELISA method. SARS-CoV-2 virus RNA in nasopharyngeal and oropharyngeal swabs was determined using commercial kits for PCR diagnostics. A z-test was used to compare relative numbers. The significance level was taken equal to 5% (p=0.05). Results and discussion. All examined children hospitalized with suspected COVID-19, regardless of the duration of the disease, had specific IgG antibodies to SARS-CoV-2 antigens, which confirms earlier contact with the new coronavirus in relation to the time of the examination. In 63.6% of cases, specific IgM antibodies of the class to SARS-CoV-2 were detected in the blood serum, in 6% of cases the result was doubtful. IgM antibodies were not detected in blood serum in 30.3% of patients. The results obtained for the determination of IgG and IgM antibodies to SARS-CoV-2 antigens may reflect the atypical nature of seroconversion in COVID-19. An extremely diverse clinical symptomatology was revealed, including, in addition to catarrhal syndrome and intoxication syndrome, abdominal, meningeal, and articular syndromes. In 24.3% of children, polymorphic exanthema was detected, which may be a manifestation of the systemic nature of damage to the vascular wall. Conclusion. With serologically confirmed SARS-CoV-2 etiology of the infectious process in the examined children, an extremely diverse clinical symptomatology was revealed, which, most likely, may be associated with multiple organ damage.Copyright © Transplantologiya. The Russian Journal of Transplantation.All right reserved.

Classifying Chest X-rays for COVID-19 using Deep Learning

A developing virus called COVID-19 infects the lungs and upper layer respiratory system. Medical imaging and PCR assays can be used to identify COVID-19. Medical images are used to identify COVID-19 diseases in the proposed classification model, which works well. A crucial step in the battle against this fatal illness may turn out to be an efficient screening and diagnostic phase in treating infected sufferers. Chest X-ray (CXR) scans could be used to do this. The utilization of chest X-ray imaging for early detection may prove to be a crucial strategy in the fight against COVID-19. Many computer- aided diagnostic (CAD) methods have been developed to help radiologists and provide them with more information for the same. In a training network with many classes, tertiary classification starts to become more accurate as the number of classes increases. © 2023 IEEE.

Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Methods: Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Result(s): Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion(s): Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months.Copyright: © 2023 Jarju S et al.

Comparison of biomarkers of COVID-19 patients with the alpha variant (B.1.1.7), the delta variant (B.1.617), and no mutation detected

Objectives: We aimed to compare biomarkers of COVID-19 patients with the Alpha variant (B.1.1.7), the Delta variant (B.1.617), and no mutation detected in our study. Method(s): A total of 600 patients with positive COVID PCR test and Alpha, Delta variant and no mutation detected with Covid PCR mutation test were included in the study. Troponin I, creatinine, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Lactate Dehydrogenase (LDH), fibrinogen, D-dimer, ferritin, number of lymphocytes, lymphocytes (%), platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), trombosite ratio in the blood (PCT), C-reactive protein (CRP) values were analyzed retrospectively. The age, gender, and hospitalization of the patients were evaluated concurrently. Result(s): Age, troponin, creatinine, LDH, PLT, MPV, and D-dimer were laboratory parameters that vary significantly with COVID-19 virus mutation. Age, troponin, LDH, and MPV values were lower in patients with Delta variant according to patients with the Alpha variant. Lymphocytes (N) and lymphocytes (%) values were lower in hospitalized patients relative to outpatients while age, troponin, LDH, CRP, and D-dimer values were higher in hospitalized patients than outpatients irrespective of mutation. Creatinine values were higher only in hospitalized patients with no mutation detected while ferritin and fibrinogen values were higher in hospitalized patients with Delta variant and no mutation detected. Conclusion(s): Age, troponin, creatinine, LDH, PLT, MPV, D-dimer, fibrinogen, ferritin, CRP, lymphocytes (N), and lymphocytes (%) values can guide to evaluate the diagnosis and hospitalization of patients with future different mutations.Copyright © 2023 by Prusa Medical Publishing.

Clinical and laboratory features of patients with post-COVID- 19 condition and reactivation of herpesvirus infections

Background: After infection with SARS-CoV- 2 is observed short-term and long-term post-acute sequelae of COVID-19 (PASC). A systematic review of 57 studies comprising more than 250 000 survivors of COVID-19 indicates that more than half of COVID-19 survivors experienced PASC 6 months after recovery. The most common PASC involved functional mobility impairments, pulmonary abnormalities, and mental health disorders [Groff D et al]. It has been suggested that co-infection of SARS-CoV- 2 with EBV or other herpes viruses (HSV1 / 2, HHV6, CMV) contributes to both severe COVID-19 and post-COVID symptoms. Method(s): 88 patients with the post-COVID- 19 condition were examined, including 52.3 % female, 47.7 % male, mean age 41.4 +/- 6.7 years. Patients underwent the following studies: anamnestic, clinical, general laboratory, biochemical and immunological analysis. PCR DNA of EBV, HHV6, CMV in blood, saliva, and the posterior pharyngeal mucosa was performed by Rotor-Gene 6000 (Corbett Research, Australia) and EBNA-IgG, VCAEBV-IgG, HHV6-IgG was performed by ELISA. Result(s): There were 2 groups of patients: the first included 68 patients with the post-COVID- 19 condition and active phase of herpesviruses. They were found positive EBV DNA -in 29 (42.6%) patients, positive HHV6 DNA -17 (25.0%) patients, positive EBV DNA, and HHV6 -in 22 (32, 4%) patients;the second group included 20 patients with the post-COVID- 19 condition and latent phase of herpesviruses and negative DNA EBV and/or HHV6 were found. In patients of the first group compared with the second group, patients were found COVID-19 had a severe course, pneumonia was diagnosed more often (77.9% vs. 40.0%), patients needed oxygen support and inpatient treatment lasted longer (16 +/- 7 vs. 10 +/- 4 days). In the first group patients compared with the second group patients were subfebrile temperature, headache, irritability, depression, myalgia, arthralgia, shortness of breath (p < 0.05). In patients of the first group compared with the second group in serum blood, we found elevated ESR, lymphopenia, monocytosis, increased activity of liver enzymes ALT and AST, CRP, D-dimer (p < 0.05) Conclusion(s): 1. Reactivation of herpesvirus infections is common in 72.3% of patients with the post-COVID- 19 condition: the EBV DNA positive were found in 42,6% of patients, the HHV6 DNA positive in 25,0% of patients, and EBV+HHV6 DNA positive in 32,4% of patients. 2. Patients with the post-COVID- 19 condition and reactivation of herpesviruses were characterized by severe COVID-19, manifestations of subfebrile, impaired mobility, mental disorders, and pulmonary abnormalities, as well as changes in laboratory parameters. 3. Our studies confirm the possible participation of reactivated herpesvirus infections (EBV, HHV6) in the formation of post-COVID- 19 conditions, which suggests the need for diagnosis of these infections and specific treatment. (Figure Presented).

Immunologic Profile of Severe COVID-19 Patients in Alborz Province, Iran

Background: The coronavirus disease 2019 (COVID-19) pandemic has prompted researchers to look for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenicity in depth. Immune system dysregulation was one of the major mechanisms in its pathogenesis. The evidence regarding the levels of interferons (IFNs) and pro-and anti-inflammatory cytokines in COVID-19 patients is not well-established. Objective(s): Therefore, this study evaluated the expression level of type-I, II, III IFNs, along with interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-10 (IL-10), and FOXP3 genes in patients with severe COVID-19 to provide additional insights regarding the regulation of these cytokines during COVID-19 infection. Method(s): Peripheral blood mononuclear cells were isolated from two groups, including severe COVID-19 patients and healthy con-trols. Ribonucleic acid was extracted to evaluate the expression level of IFN-a, IFN-b, IFN-g, IFN-la, IL-1, IL-6, IL-10, and FOXP3 genes using real-time polymerase chain reaction. The correlations between the expression levels of these genes were also assessed. Result(s): A total of 40 samples were divided into two groups, with each group consisting of 20 samples. When comparing the severe COVID-19 group to the controls, the expression levels of IFN-g, tumor necrosis factor-alpha (TNF-alpha), IL-6, and IL-10 genes were sig-nificantly higher in the severe COVID-19 group. The two groups had no significant differences in IFN-a, IFN-b, IFN-la, IL-1, and FOXP3 expression. The correlation analysis revealed a negative correlation between type I and type III IFNs (i.e., IFN-a and IFN-la) and pro-inflammatory cytokines (i.e., IL-1 and IL-10). Conclusion(s): This study suggests the possible upregulation of IFN-g, IL-6, IL-10, and TNF-alpha during SARS-CoV-2 pathogenicity. The pre-liminary findings of this study and those reported previously show that the levels of IFNs and pro-and anti-inflammatory cytokines are not uniformly expressed among all COVID-19 patients and might differ as the disease progresses to the severe stage.Copyright © 2023, Author(s).

In silico identification of potential miRNAs -mRNA inflammatory networks implicated in the pathogenesis of COVID-19

COVID-19 has been found to affect the expression profile of several mRNAs and miRNAs, leading to dysregulation of a number of signaling pathways, particularly those related to inflammatory responses. In the current study, a systematic biology procedure was used for the analysis of high-throughput expression data from blood specimens of COVID-19 and healthy individuals. Differentially expressed miRNAs in blood specimens of COVID-19 vs. healthy specimens were then identified to construct and analyze miRNA-mRNA networks and predict key miRNAs and genes in inflammatory pathways. Our results showed that 171 miRNAs were expressed as outliers in box plot and located in the critical areas according to our statistical analysis. Among them, 8 miRNAs, namely miR-1275, miR-4429, miR-4489, miR-6721-5p, miR-5010-5p, miR-7110-5p, miR-6804-5p and miR-6881-3p were found to affect expression of key genes in NF-KB, JAK/STAT and MAPK signaling pathways implicated in COVID-19 pathogenesis. In addition, our results predicted that 25 genes involved in above-mentioned inflammatory pathways were targeted not only by these 8 miRNAs but also by other obtained miRNAs (163 miRNAs). The results of the current in silico study represent candidate targets for further studies in COVID-19.Copyright © 2023 Elsevier B.V.

Effects of Various Mrna-Lnp Vaccine Doses on Neuroinflammation in Balb/C Mice

It has been proven that mRNA vaccines are highly effective against the COVID-19 outbreak, and low prevalence of side effects has been shown. However, there are still many gaps in our understanding of the biology and biosafety of nucleic acids as components of lipid nanoparticles (LNPs) most often used as a system for inctracellular delivery of mRNA-based vaccines. It is known that LNPs cause severe injection site inflammation, have broad biodistribution profiles, and are found in multiple tissues of the body, including the brain, after administration. The role of new medications with such pharmacokinetics in inflammation developing in inaccessible organs is poorly understood. The study was aimed to assess the effects of various doses of mRNA-LNP expressing the reporter protein (0, 5, 10, and 20 microg of mRNA encoding the firefly luciferase) on the expression of neuroinflammation markers (Tnfalpha, Il1beta, Gfap, Aif1) in the prefrontal cortex and hypothalamus of laboratory animals 4, 8, and 30 h after the intramuscular injection of LNP nanoemulsion. It was shown that mRNA-LNP vaccines in a dose of 10-20 microg of mRNA could enhance Aif1 expression in the hypothalamus 8 h after vaccination, however, no such differences were observed after 30 h. It was found that the Gfap, l11beta, Tnfalpha expression levels in the hypothalamus observed at different times in the experimental groups were different. According to the results, mRNA-LNPs administered by the parenteral route can stimulate temporary activation of microglia in certain time intervals in the dose-dependent and site specific manner.Copyright © 2022 Pirogov Russian National Research Medical University. All rights reserved.

The effect of ACE inhibitors on inflammation and clinical end-points in COVID-19 patients Relationship of ACE inhibitors to COVID-19 patients

Aim: COVID-19 infection has affected the whole world. It has been speculated that the virus might hold on to angiotensin-converting enzyme 2 (ACE 2) surfaces of type 2 alveolar cells. ACE inhibitors and angiotensin receptor antagonists (ARBs) are essential antihypertensive and cardiac failure drugs in the guidelines. In this study, we aimed to find the effect of these drugs on clinical, laboratory courses, and outcomes of COVID-19 patients. Material(s) and Method(s): We included 109 patients in this study. There were 43 patients in the ACE/ARB group and 66 patients in the non-ACE/ARB group. The mean age was 60 years in the ACE/ARB group and 52 years old in the non-ACE/ARB group. Basal symptoms, hemogram, CRP, D-dimer, LDH, Ferritin, AST, duration of hospitalization, percentage of intensive care unit (ICU) need, length of stay in ICU were compared between the groups. Result(s): The mean age in the ACE/ARB group was higher than in the other group and was statistically significant (p=.027). The initial symptoms were not different. There were no differences between the laboratory results of the groups. The ICU need was higher in the patients who do not use the drug than in the users (p<.020). Discussion(s): ACE/ARB usage in COVID-19 patients did not worsen the course of the disease. However, ACE/ARB users before COVID-19 pandemic were taken to ICU at a low rate.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Comparison of Clinical and Laboratory Findings at Different Clinical Stages in Cats Naturally Infected with Feline Coronavirus

Feline coronavirus (FCoV) infections occur commonly in cats, with entrocyte and monocyte-macrophage tropism. Most FCoV-infected cats remain asymp tomatic, but up to 10% develop fatal feline infectious peritonitis (FIP). This study aims to investigate the diagnostic utility of clinical and laboratory examinations including serum and effusion AGP levels in cats either with symptomatic effusive FIP or asymptomatic feline enteric coronavirus (FECV). The study included 40 cats with effusive FIP and 10 cats with FECV infection. The FIP group was divided into two subgroups: Abdominal (AE;n=30) and thoracic effusion (TE;n=10). Clinical and laboratory examinations, including serum or effusion AGP measurement, were performed. Among all the groups, TE group had higher body temperature, heart and respiratory rates (P<0.000). Compared with the FECV group, the FIP group had lower pH and HCO3 levels and higher base excess and lactate levels (P<0.05). The leukocyte and lymphocyte counts were higher and the hematocrit was lower in the AE group among all the groups (P<0.023). MCV was lower in the FIP group compared to the FECV group (P<0.002). In the AE group, total protein level was the lowest and the AST, GGT, total bilirubin and cholesterol levels were the highest (P<0.032) among all the groups. Magnesium level was lower in the FIP group compared to the FECV group (P<0.044). Although the serum AGP level was highest in the TE group among all groups (P<0.004), the AGP levels of cats with FECV were similar to the AE group (P>0.05). Since FECV-positive cats will likely develop FIP, differences in clinical and laboratory findings in FECV-positive cats were identified. Among them, pH, HCO3, base excess, lactate, MCV and magnesium were found to be important in the course of the disease, and AGP in the evaluation of the presence of an inflammatory state. It was concluded that clinical, laboratory and serum AGP evaluation could be used in the index of suspicion of development of FIP and FECV.Copyright © 2023 Erdem Gulersoy et al., published by Sciendo.

Association of immature granulocytes (IG) with prognosis in severe COVID-19 patients Immature granulocytes and COVID-19

Aim: Recent research have shown that immature granulocytes (IG) can be utilized to predict severe infection, inflammation, and sepsis. As a result, the ability of IG levels to predict the severity of severe COVID-19 and its association with prognosis were studied in our study. Material and Mthods: A total of 317 patients diagnosed with severe COVID-19 in the emergency department were analyzed retrospectively. IGC and IG% levels were compared statistically between patient groups (survivors and non-survivors, those who received and did not get mechanical ventilation (MV) assistance, patients who required and did not require vasopressors, and hospital stays >=10 and <10 days). Result(s): When compared to patients who survived but did not get treatment, non-survivors who got MV and vasopressor support had substantially higher IGC and IG% values (for all p<0.001). Additionally, it was shown that the IG% of patients with hospital stays of >=10 days was substantially greater than that of patients with hospital stays of <10 days (p<0.001). While the IG% cut-off value was >0.45, it reached 75.5% sensitivity, 81.9% specificity, 87.6% NPV and 66.4% PPV for predicting mortality (AUC:0.86, p<0.001). Discussion(s): IG levels are a low-cost, easily accessible, and strong marker that may be used to predict mortality and prognosis in COVID-19 patients.Copyright © 2023, Derman Medical Publishing. All rights reserved.

The Circulation of Common Respiratory Viruses and Their Co-infection with Severe Acute Respiratory Syndrome Coronavirus 2 Before and After Coronavirus Disease of 2019 Vaccination

Background: Respiratory viruses play important roles in respiratory tract infections;they are the major cause of diseases such as the common cold, bronchiolitis, pneumonia, etc., in humans that circulate more often in the cold seasons. During the COVID-19 pandemic, many strict public health measures, such as hand hygiene, the use of face masks, social distancing, and quarantines, were implemented worldwide to control the pandemic. Besides controlling the COVID-19 pandemic, these introduced measures might change the spread of other common respiratory viruses. Moreover, with COVID-19 vaccination and reducing public health protocols, the circulation of other respiratory viruses probably increases in the community. Objective(s): This study aims to explore changes in the circulation pattern of common respiratory viruses during the COVID-19 pan-demic. Method(s): In the present study, we evaluated the circulation of seven common respiratory viruses (influenza viruses A and B, rhi-novirus, and seasonal human Coronaviruses (229E, NL63, OC43, and HKU1) and their co-infection with SARS-CoV-2 in suspected cases of COVID-19 in two time periods before and after COVID-19 vaccination. Clinical nasopharyngeal swabs of 400 suspected cases of COVID-19 were tested for SARS-CoV-2 and seven common respiratory viruses by reverse transcription real-time polymerase chain reaction. Result(s): Our results showed common respiratory viruses were detected only in 10% and 8% of SARS-CoV-2-positive samples before and after vaccination, respectively, in which there were not any significant differences between them (P-value = 0.14). Moreover, common viral respiratory infections were found only in 12% and 32% of SARS-CoV-2-negative specimens before and after vaccination, respectively, in which there was a significant difference between them (P-value = 0.041). Conclusion(s): Our data showed a low rate of co-infection of other respiratory viruses with SARS-CoV-2 at both durations, before and after COVID-19 vaccination. Moreover, the circulation of common respiratory viruses before the COVID-19 vaccination was lower, probably due to non-pharmaceutical interventions (NPI), while virus activity (especially influenza virus A) was significantly in-creased after COVID-19 vaccination with reducing strict public health measures.Copyright © 2023, Author(s).

Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic. Method(s): Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Result(s): Overall virus positivity was 44.2%, with prevalence higher in children <5 years (80%) compared to children aged 5-17 years (53.1%), adults aged 18-50 (39.5%) and >50 years (39.9%), p<0.0001. After SARS-CoV-2 (18.3%), rhinoviruses (10.5%) and influenza viruses (5.5%) were the most prevalent. SARS-CoV-2 positivity was lower in children <5 (4.3%) and 5-17 years (12.7%) than in adults aged 18-50 (19.3%) and >50 years (24.3%), p<0.0001. In contrast, rhinoviruses were most prevalent in children <5 years (28.7%), followed by children aged 5-17 (15.8%), adults aged 18-50 (8.3%) and >50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion(s): Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months.Copyright © 2022 Jarju S et al.

Outbreak of Hemolytic-Uremic Syndrome in Children in Belarus: Epidemiology, Features of Clinical Course and Laboratory Changes, and Outcomes.

Introduction. Outbreaks of hemolytic uremic syndrome (HUS) have been described in many countries around the world, but no such information is available for Eastern European countries. Purpose. To determine clinical and laboratory differences, and to evaluate morbidity and outcomes during and outside the outbreak of HUS in children in Belarus. Materials and methods. A total o f 80 children diagnosed with HUS in 2021 in Belarus were included in the study;64 of them were admitted to the pediatric dialysis center in Minsk and divided into 2 groups: group 1 (29 children) - outside the HUS outbreak, and group 2 (35 children) - during the outbreak. In addition to standard laboratory tests, 52 children underwent stool analysis for Shiga toxin-producing Escherichia coli by real-time PCR (TaqMan Array Card). Results. The incidence of HUS in 2021 was 5.0/100 000 children <15 years (80 cases) and 10.6/100 000 children <5 years (59 cases). Boys were 52%, children <5 years old were 74%, patients with atypical HUS were 2.5%. Between 27.09.2021 and 29.10.2021 an outbreak of HUS was registered in 45 children, mostly from three country's regions: Minsk city - 17, Minsk region - 16 and Vitebsk region - 11. Patients of groups 1 and 2 did not differ in terms of age, 2.5 (1.6;5.1) and 3.6 (2.2;5.1) years, respectively, incidence of hemocolitis: 62% and 69%, respectively, baseline hemoglobin levels, 85 (77;99) and 102 (90;105) g/L, respectively, and platelet counts, 45 (25;71)x109/L and 53 (29;78) x109/L, respectively, need for dialysis, 79% and 57%, respectively, duration of anuria, 13 (7;16) and 12 (8;15) days, respectively, mortality, 3.4% (aHUS) and 2.9% (on the background of COVID-19), respectively, incidence of Shigatoxin-producing E. coli in faecal samples, 33% and 37%, respectively. The cause of HUS outbreak remained undetermined. Conclusions. Thus, the incidence of HUS in children in Belarus remains one of the highest in Europe. A national algorithm should be developed to detect the source of infection and to indicate and identify the pathogen in STEC infections.Copyright © 2022, Professionalnye Izdaniya. All rights reserved.

Outbreak of Hemolytic-Uremic Syndrome in Children in Belarus: Epidemiology, Features of Clinical Course and Laboratory Changes, and Outcomes.

Introduction. Outbreaks of hemolytic uremic syndrome (HUS) have been described in many countries around the world, but no such information is available for Eastern European countries. Purpose. To determine clinical and laboratory differences, and to evaluate morbidity and outcomes during and outside the outbreak of HUS in children in Belarus. Materials and methods. A total o f 80 children diagnosed with HUS in 2021 in Belarus were included in the study;64 of them were admitted to the pediatric dialysis center in Minsk and divided into 2 groups: group 1 (29 children) - outside the HUS outbreak, and group 2 (35 children) - during the outbreak. In addition to standard laboratory tests, 52 children underwent stool analysis for Shiga toxin-producing Escherichia coli by real-time PCR (TaqMan Array Card). Results. The incidence of HUS in 2021 was 5.0/100 000 children <15 years (80 cases) and 10.6/100 000 children <5 years (59 cases). Boys were 52%, children <5 years old were 74%, patients with atypical HUS were 2.5%. Between 27.09.2021 and 29.10.2021 an outbreak of HUS was registered in 45 children, mostly from three country's regions: Minsk city - 17, Minsk region - 16 and Vitebsk region - 11. Patients of groups 1 and 2 did not differ in terms of age, 2.5 (1.6;5.1) and 3.6 (2.2;5.1) years, respectively, incidence of hemocolitis: 62% and 69%, respectively, baseline hemoglobin levels, 85 (77;99) and 102 (90;105) g/L, respectively, and platelet counts, 45 (25;71)x109/L and 53 (29;78) x109/L, respectively, need for dialysis, 79% and 57%, respectively, duration of anuria, 13 (7;16) and 12 (8;15) days, respectively, mortality, 3.4% (aHUS) and 2.9% (on the background of COVID-19), respectively, incidence of Shigatoxin-producing E. coli in faecal samples, 33% and 37%, respectively. The cause of HUS outbreak remained undetermined. Conclusions. Thus, the incidence of HUS in children in Belarus remains one of the highest in Europe. A national algorithm should be developed to detect the source of infection and to indicate and identify the pathogen in STEC infections.Copyright © 2022, Professionalnye Izdaniya. All rights reserved.