Point-of-care testing of SARS -CoV-2 and influenza A and B at hospital emergency room during Covid-19 pandemic among patients with acute respiratory diseases

Introduction. The most common causes of acute respiratory diseases (ARD) with significant morbidity and mortality include, for a long time, the influenza virus and, in recent years, also the SARS-Cov-2 virus. Patients with various clinical symptoms are triaged in emergency rooms of hospitals, and therefore their rapid and reliable diagnostics is essential in order to prevent the spread of ARD. Molecular genetic point-of-care testing (POCT) at the point of care represents a significant advance in clinical diagnostics. Materials and methods. Diagnostics of viral agents of ARD took place from December 2021 to February 2022. 1046 nasopharynx swabs samples were collected in the emergency room of I. Internal Clinic of the Faculty of Medicine at Comenius University and the University Hospital in Bratislava. SARSCov-2 and influenza were detected from the same sample using the cobas® SARS-Cov-2 & Influenza A/B test on the cobas® Liat® system. Results. From the total number of biological material collected, the SARS-Cov-2 virus was detected in 135 samples (12.9 %), while the highest incidence of positive samples was in February 2022 - 86 (20.9 % positivity), followed by December 2021 - 31 (23.0 % positivity) and January 2022 - 18 (13.3% positivity). Influenza type A virus was detected in two samples (0.2%) and influenza type B virus was not detected. Conclusion. POCT made it possible to significantly improve the screening of patients and minimize the risk of nosocomial transmission of respiratory infections in the hospital thanks to the rapid and accurate diagnosis of the SARS-CoV-2 virus and influenza A/B (Fig. 3, Ref. 32). Text v PDF www.lekarsky.herba. sk. © 2023, Lekarsky Obzor. All Rights Reserved.

Economic impact of acute respiratory disease pandemics: A scoping review.

Background: The economic impact of acute respiratory disease pandemics has yet to be specifically systematically reviewed. The aim of this scoping review is to identify and classify the economic impacts and its values and ranges. Materials and Methods: We conducted a literature search across three key databases using an extensive list of keywords. Then, we included studies which explored direct and indirect costs as well as broader economic impact associated with different nine acute respiratory diseases, i.e., pandemic and seasonal influenza, avian influenza, equine influenza, swine influenza, severe acute respiratory syndrome, coronavirus disease 2019, Middle East respiratory syndrome, H1N1, and H7N9. Results: We included 62 studies in English language between 1987 and 2020, mostly from the countries of East Asia and Pacific pertinent. We classified the economic impact into 5 main categories and 18 subcategories. The main categories were macroeconomic impacts, impacts on health cost, industry, businesses and trade, and education. Conclusion: Respiratory disease pandemics have widely impacted different sectors of economy such as the direct cost on macroeconomic, providing and receiving health services, disease management, industries, business and trade, education, and indirect costs due to productivity losses. However, lots of the reviewed studies were unable to quantify the actual economic cost of these impacts. This made it challenging to conduct any kind of quantitative comparison of the results. A key priority for future research is to develop standard methods to quantify the broader economic costs of respiratory disease pandemics. Understanding the total economic impact of respiratory disease pandemics is a key step to inform national and international priority setting for disease prevention and pandemic control interventions.

Adapting an integrated acute respiratory infections sentinel surveillance to the COVID-19 pandemic requirements, Egypt, 2020-2022.

Objectives: In Egypt, an integrated surveillance for acute respiratory infections (ARIs) was established in 2016 to identify the causes of ARIs. The surveillance system includes 19 governmental hospitals. In response to the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organisation (WHO) requested surveillance adaptation to address the emerging challenges. This study aims to describe the experience in Egypt of adapting ARI surveillance to the COVID-19 pandemic. Methods: WHO case definitions were used to identify patients with ARIs. Nasopharyngeal/oropharyngeal swabs were collected for SARS-CoV-2 and influenza testing. Demographic and clinical information were obtained by interviewing patients at the hospitals. During the COVID-19 pandemic, the first two outpatients daily and every fifth admitted patient were enrolled in the study. To determine the status of ARIs in Egypt during the pandemic, patient demographic, clinical and laboratory data from 2020 to 2022 were obtained and descriptive analyses were performed. Results: Overall, 18,160 patients were enrolled in the study, including 7923 (43.6%) seen at outpatient clinics and 10,237 (56.4%) inpatients. Of the study participants, 6453 (35.5%) tested positive for ARIs, including 5620 (87.1%) for SARS-CoV-2, 781 (12.1%) for influenza and 52 (0.8%) for SARS-CoV-2/influenza coinfection. SARS-CoV-2 was the cause for 95.3% of admitted patients and 65.4% of outpatients. Influenza subtypes included A/H3 (55.7%), Influenza-B (29.1%) and H1/pdm09 (14.2%). Compared with influenza, SARS-CoV-2 tended to infect the elderly, in warm weather and in urban governorates, and resulted in more hospitalisations, longer hospital stays and higher case fatalities (16.3% vs 6.6%, p < 0.001). Conclusions: ARI surveillance in Egypt was successfully adapted to the COVID-19 pandemic and effectively described the clinical characteristics and severity of circulating viruses. Surveillance reported the re-emergence of influenza with a severe course and high fatality. Surveillance is essential for monitoring the activity of respiratory viruses with the aim of guiding clinical management, including preventative and control measures.

Early stage nonclinical pulmonary disorder in COVID-19 may present asymptomatic and fuel the contagion.

Evidence shows that pulmonary problems in coronavirus disease 2019 (COVID-19) may set off from vascular injury that progresses to physiological disturbances through a compromised gas exchange, following an infection with the severe acute respiratory syndrome coronavirus 2. In this process, inefficient gas exchange in the alveolar could precipitate silent nonclinical hypoxemia. Unfortunately, patients with "silent hypoxemia" do not necessarily experience any breathing difficulty (dyspnea) at the early stage of COVID-19 while the disease progresses. As a result, several asymptomatic, presymptomatic and patients with mild symptoms may escape quarantine measure and thus continue to spread the virus through contacts. Therefore, early diagnosis of "silent hypoxemia", which attracts no clinical warnings, could be an important diagnostic measure to prevent acute respiratory distress syndrome from the risk of pulmonary failure among the presymptomatic and as a screening tool in the asymptomatic who are hitherto potential spreaders of the virus.