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Objectives: To estimate the reclassification of COVID-19 related ICD-10 codes from admission to discharge using Real-World Data (RWD) from the 2020 Mexican Ministry of Health (MoH) hospitals discharge dataset. Method(s): In this retrospective study, we analyzed all COVID-19 related discharges in the 2020 MoH open database, according to ten ICD-10 codes that the WHO associated with COVID-19. Reclassification was defined as those COVID-19 related cases who were discharged with a different ICD-10 code compared to their ICD-10 admission code. Result(s): From a total of 1,937,360 discharges reported in the MoH's 2020 database 63,740 (3.3%), mostly men (60.8%), with a median age of 56 years, were discharged with a COVID-19 related ICD-10 code and 12,945 of these were reclassified (20.3%). Although "2019-nCoV acute respiratory disease" (U071) had the greatest frequency of reclassified discharges (12,013, 22.3%), the "other coronavirus as the cause of diseases classified elsewhere" (B972) was associated with the greatest reclassification proportion (68, 74.7%) followed by "pneumonia case confirmed as due to COVID-19" (J128) (26.0%). Codes with lower percentages were "acute respiratory distress syndrome due to COVID-19" (J80X) and "acute respiratory failure due to COVID-19" (J960) with 6.3% and 3.8%, respectively. From 63,740 discharges, 50.7% were due to clinical improvement, followed by death (38.2%), transfer to another unit (5.2%) and voluntary discharge (3.3%). The J960 code had the highest mortality (67%) followed by codes J80X (59.7%) and U071 (35.5%). Conclusion(s): In our RWD analysis, we identified that 1 in 5 COVID-19 discharges were admitted with different diagnoses, highlighting the enormous challenges faced by the Mexican MoH during the global health crisis to establish an accurate COVID-19 diagnosis and coding. Given that this is the first reclassification analysis in Mexico, the conduction of future studies is essential to gain more insights on the consequences of reclassification at a health system level.Copyright © 2023
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Junior Physician Investigator Award Recipient Purpose of study Severe acute respiratory syndrome coronavirus- 2 (SARS-CoV-2) is the causative agent of the Coronavirus disease 2019 (COVID-19) pandemic. Convalescent plasma obtained from recovered persons was used for previous respiratory pandemics. Convalescent plasma with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antibodies (CCP) was proposed as an option that may hold promise as treatment for COVID-19. Our aim was to retrospectively evaluate the efficacy of CCP treatment of patients with severe to life-threatening COVID-19 hospitalized at Montefiore Medical Center (MMC) in the Bronx, NY between April 13 to May 4, 2020. Methods used We administered CCP as part of the Mayo Clinic expanded access investigational new drug (IND) program for hospitalized patients. We compared the mortality and clinical outcome of 73 patients with COVID-19 who received 200 mL of CCP with a Spike protein IgG titer >=1:2,430 (median 1:47,385) within 72 hours of admission to 1:1 propensity score-matched controls. Matching criteria for controls were age, sex, body mass index, race, ethnicity, comorbidities, week of admission, oxygen requirement, D-dimer, lymphocyte counts, corticosteroids, and anticoagulation use (figure 1). We additionally measured Spike protein IgG and neutralizing antibody titer in CCP and pre- and post-transfusion Spike protein IgG, IgM and IgA titer in CCP recipients. The primary outcome was all-cause mortality at day 28 post-CCP. The secondary outcomes were improvement in oxygenation status or mortality at day 28 post-CCP. Exploratory outcomes were associations between pre-CCP SARS-CoV-2 antibody titers and mortality at day 28. Summary of results There was no difference in mortality or oxygenation between CCP recipients and controls at day 28. When stratified by age, compared to matched controls, CCP recipients < 65 years had 4-fold lower mortality and 4-fold lower deterioration in oxygenation or mortality at day 28 (figure 2, 3). There was no association between CCP IgG or neutralizing antibody titer and clinical outcome. For CCP recipients, pre-transfusion Spike protein IgG, IgM and IgA titers were associated with mortality at day 28 in univariate analyses but not in multivariable analyses. Pre-transfusion Spike protein IgG titer was significantly correlated with Ddimer and detected viral load measured by cycle threshold (Ct) value of nasopharyngeal SARS-CoV-2 reverse-transcriptase- polymerase-chain-reaction (figure 4). No adverse effects of CCP were observed. Conclusions We report that CCP administration within 72 hours of hospitalization demonstrated a possible signal of reduced mortality in patients < 65 years. Pre-transfusion IgG titer may be a proxy for disease severity that may be useful in identifying those who are more likely to respond to CCP. Data from controlled trials is needed to validate this finding and establish the effect of ageing on CCP efficacy. (Figure Presented).
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Background: Galectin-3 is a beta-galactoside-binding lectin that has been described to be overexpressed in inflammation, atherosclerosis, and in myocardial fibrosis. In COVID-19, galectin-3 has been proposed as an important regulator of the inflammatory response and fibrosis processes. The role of galectin-3 as a platelet activator and thrombosis enhancer has been also recently described. However, the role of galectin-3 in the thrombotic risk in COVID-19 hasn't been studied extensively. Method(s): Patients with moderate to severe COVID-19 were included in the study. Hospitalized patients with acute respiratory diseases without COVID-19 were examined as controls. We compared the levels of galectin- 3, soluble ST2, tissue factor and tissue factor activity (TFa) as well as several other markers of increased thrombogenicity in both groups. The correlations between galectin-3 and coagulation as well as inflammation markers were assessed. The SOFA score was used as a marker for the clinical outcome. Result(s): 93 patients were included into the study of which 56 were SARS-CoV-2 positive (COV+) and 37 were SARS-CoV-2 negative controls (COV-). Galectin-3 levels were higher in the COV+ group (median 7.10 ng/ml [IQR 4.61-9.81] vs. 5.47 ng/ml [3.63-6.66] p=0.016) as well as the TFa (median 334.48 pM [115.19-632.58] vs. 134.02 pM [86.92- 206.66]) and the ST2 levels (median 5.49 ng/ml [2.40-9.28] vs. 2.19 ng/ml [0.66-3.91] p<0.001). We also observed a positive correlation between galectin-3 and IL-6 (r=0.559, p<0.001), ST2 (r=0.332, p=0.005), SOFA score (r=0.441, p=0.003), von Willebrand factor (r=0.401, p<0.001), plasminogen (r=0.361, p=0.001), antithrombin (r=0.453, p<0.001), and Ddimer (r=0.377, p=0.001). Conclusion(s): In patients with acute respiratory diseases, especially with COVID-19, galectin-3 is a marker for increased hypercoagulability and worse clinical outcome. Galactin-3 might be a useful therapeutic target for patients with COVID-19.
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Introduction: During the COVID-19 pandemic, alternatives to face-to-face teaching were on the urge. What's more, in the context of the respiratory support of COVID patients, the training and capacitation of personnel capable of taking care of these patients was critical. Aims and objectives: Develop a Virtual Reality (VR) app for remote training of medical staff in the management of different acute respiratory diseases, including COVID-19. Method(s): Pulmonologists and software developers designed an app based on a virtual hospital using VR glasses. The teacher programs different clinical scenarios, where the student can converse with the patient and explore him, observing the respiratory mechanics and the skin coloration, auscultating different noises in various cardiac and pulmonary foci, edema in the lower extremities, etc. The student can request different tests (blood analysis, radiography, etc.) and prescribe treatment, including oxygen therapy and respiratory support. The clinical situation of the patient can change during the simulation. Result(s): Different acute respiratory diseases were successfully simulated, with a correct interaction between the student and the teacher. Conclusion(s): VR can be used as a tool for the remote training of medical staff, and provide high fidelity simulations for training in a wide variety of clinical situations.
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Introduction: Vaccination has become a main tool in combat against coronavirus disease 2019 (COVID-19). ORF1ab (open reading frame1ab) is biggest ORF of severe acute respiratory disease coronavirus 2 (SARS-CoV-2) genome. Moreover ORF1ab protein is early translated in infected cells. Besides ORF1ab is genetically stable and could be a valuable source of conserved epitopes appropriate to prepare effective protein vaccines for control of many SARS-CoV-2 variants. Hypersensitivity responses to SARS-CoV-2 vaccines have been reported by numerous studies. Objective(s): In this study SARS-CoV-2 ORF1ab protein allergenicity was predicted by bioinformatic. Method(s): The amino acid sequences of SARS-CoV-2 ORF1ab protein were obtained in NCBI database at www.ncbi.nlm.nih.gov in FASTA format. Next, allergenicity of the SARS-CoV-2 ORF1ab protein was evaluated with Allergen FP server V.1. Result(s): ORF1ab protein of SARS-CoV-2 was found to be an allergen as was confirmed by allergen FP server V.1. Conclusion(s): According to our data, ORF1ab protein of COVID-19 was potentially allergenic. Hypersensitivity reactions to some SARS-CoV-2 vaccines reported by various studies may be partly due to ORF1ab protein allergenicity. Meanwhile ORF1ab protein being a valuable source of conserved epitopes is suitable to make efficient protein vaccines for control of many SARS-CoV-2 variants. For preparation of safe and effective anti- SARS-CoV-2 vaccines from ORF1ab protein, recognition and elimination of its allergenic epitope (s) is necessary. Altogether immunization with an allergenically engineered ORF1ab protein might have potential implication in fighting the virus.
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Currently, the disease caused by the new coronavirus (COVID-19) and the possibility of co-infection with SARS-CoV-2 and other pathogens in the current epidemic situation continues to be of particular interest. The review, based on the analysis of literature and own materials, outlines the features of the relationship between SARS-CoV-2 and pathogens of acute respiratory viral infections (ARVI). Particular attention is paid to the combined course of COVID-19 and influenza, a comparative characteristic of the severity of the clinical picture. An assessment of the epidemic situation against the backdrop of the COVID-19 pandemic in foreign countries and the Russian Federation (RF) revealed the presence of the phenomenon of SARS-CoV-2 interference with other viral respiratory agents, based on the facts of a sharp suppression of the circulation of influenza viruses, respiratory syncytial virus (RSV) and other ARVI pathogens during the period of active spread of pandemic coronavirus. The main epidemiological indicators of the course of coronavirus infection were compared and the contribution of various pathogens to the etiology of acute respiratory viral infections during the development of the second wave of COVID-19 in the RF was assessed. It was noted that the decrease in the number of new cases by 11.4 and deaths by 2.1 times due to COVID-19 at 6 and 13 weeks in 2022 occurred with unchanged laboratory detection of the influenza virus (0.8%) and an increase in the frequency detection of pathogens of other SARS. The results of observations showed that against the background of a decrease in the incidence of COVID-19, there was no increase in the proportion of diagnosed cases of infections caused by other pathogens, especially influenza. The results obtained confirm the need to ensure effective epidemiological surveillance and additional application of pathogen identification methods for monitoring various ARVI, which can significantly affect the approach to differential diagnosis, patient management tactics and the decision on appropriate preventive measures.Copyright © 2022 Saint Petersburg Pasteur Institute. All rights reserved.
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This study compared the efficacy of different therapies for ARVI during the COVID-19 pandemic. Objective. To compare clinical efficacy of Cycloferon and Ingavirin in children aged 4-17 years treated in outpatient facilities during the epidemic season of SOVID-19. Patients and methods. This study included 101 patients who provided 143 oro-and nasopharyngeal swabs tested using certified PCR tests. Of them, 128 samples (89.5%) were positive, whereas 15 samples (10.5%) were negative. We identified the most common viruses circulating in January-May 2021, including (seasonal) coronaviruses (35.9%), rhinoviruses (20.3%), and other viruses. We also analyzed respiratory viruses that have circulated in Moscow during the last 6 years and found higher levels of seasonal coronaviruses. The most common ARVI symptoms in 2021 were fever, rhinitis, pharyngeal hyperemia, and fatigue. Fewer children had headache, cough, and enlarged lymph nodes. Results. We compared ARVI treatment with broad-spectrum antivirals in children aged between 4 and 17 years. Children in group 1 (n = 51) received Cycloferon, while children in Group (n = 50) received Ingavirin. Study participants were diagnosed with ARVI and moderate nasopharyngitis. Children from the Cycloferon group demonstrated a more significant dynamics of such clinical symptoms as headache (p < 0.05), cough (p < 0.01), rhinitis (p < 0.01), abundant mucus (p < 0.001), and enlarged lymph nodes (p < 0.001) than children from the Ingavirin group (there was a significant difference in the duration of these symptoms). Only 2 children from group 1 required antibiotics (3.4%), whereas in group 2, 11 children needed antibacterial therapy (22%).Copyright © 2022, Dynasty Publishing House. All rights reserved.
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Introduction: Incidence of AKI reported varies from 0.5% to 37%.These incidence cannot be extrapolated in our patients as the severity of COVID-19 infection, the ethnicity of the patients l, the clinical profile and the healthcare delivery system is different.The aim of this study was to explore whether urinary cell cycle arrest markers and other renal biomarkers have a role in predicting AKI in critically ill patients with COVID-19 and acute respiratory disease Methods: This prospective, longitudinal cohort study included critically ill COVID-19 patients without AKI at study entry. Patients aged more than 18 years with moderate or severe respiratory disease as defined by Berlin criteria were subsequently recruited from November 2020 to May 2021. Urine samples were collected on admission to critical care areas for determination of KIM1, NGAL, IL-18,IGF-BP-7, TIMP -2 at the time point of study inclusion, 12h, 24h, 48h, after inclusion. The demographic information, comorbidities, clinical, and laboratory data were recorded. The study outcomes were the development of AKI and mortality during hospitalization. Result(s): [Formula presented] ROC analysis was done to determine the diagnostic performance of the various urinary biomarkers;AUC was 0.655 for normalised IL-18, 0.685 for normalised NGAL, 0.658 for normalised TIM-1, and so on Conclusion(s): AKI was common in critically ill COVID-19 patients. Raised values of urinary biomarkers with clinical information, are useful for the identification of AKI in critically ill COVID-19 patients. No conflict of interestCopyright © 2023
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Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common and associated with respiratory function decline, increased morbidity and mortality. It is unclear how COVID19 has impacted AECOPD phenotype and if it is associated with worse outcomes compared to other infections in COPD patients. Aim(s): To explore changes in AECOPD clinical characteristics and outcomes during the COVID-19 pandemic. Method(s): A prospective cohort study of all adults >=18y admitted to either acute care hospital in Bristol UK, Aug 20- Jul 21. Patients presenting with signs/symptoms or a clinical/radiological diagnosis of acute respiratory disease were included. Result(s): 2557 hospitalisations with AECOPD were recorded (incidence 361 per 100000);13% had SARS-CoV-2 identified, 69% had another pathogen and 18% had no infectious aetiology identified. Patient characteristics and clinical features were similar for patients with and without COVID19. ICU admissions were more common with SARS-CoV-2 than other infections (4% v 1%, P<0.001). SARS-CoV-2 associated AECOPD had greater inpatient (25% v 9%, P<0.001) and 30-day mortality (25% v 12%, P<0.001) than AECOPD associated with other infections. Among all AECOPD patients who had received >=1 dose of any COVID vaccination, ICU admission rates were lower than for unvaccinated persons (4% v 0%, P<0.01). Discussion(s): SARS-CoV-2 infection was associated with worse outcomes among persons hospitalized with AECOPD. SARS-CoV-2 vaccination was effective in reducing disease severity and ICU admission. More data are needed about the effectiveness of COVID19 vaccines for modifying disease severity in COPD patients.
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This study compared the efficacy of different therapies for ARVI during the COVID-19 pandemic. Objective. To compare clinical efficacy of Cycloferon and Ingavirin in children aged 4–17 years treated in outpatient facilities during the epidemic season of СOVID-19. Patients and methods. This study included 101 patients who provided 143 oro-and nasopharyngeal swabs tested using certified PCR tests. Of them, 128 samples (89.5%) were positive, whereas 15 samples (10.5%) were negative. We identified the most common viruses circulating in January–May 2021, including (seasonal) coronaviruses (35.9%), rhinoviruses (20.3%), and other viruses. We also analyzed respiratory viruses that have circulated in Moscow during the last 6 years and found higher levels of seasonal coronaviruses. The most common ARVI symptoms in 2021 were fever, rhinitis, pharyngeal hyperemia, and fatigue. Fewer children had headache, cough, and enlarged lymph nodes. Results. We compared ARVI treatment with broad-spectrum antivirals in children aged between 4 and 17 years. Children in group 1 (n = 51) received Cycloferon®, while children in Group (n = 50) received Ingavirin®. Study participants were diagnosed with ARVI and moderate nasopharyngitis. Children from the Cycloferon group demonstrated a more significant dynamics of such clinical symptoms as headache (p < 0.05), cough (p < 0.01), rhinitis (p < 0.01), abundant mucus (p < 0.001), and enlarged lymph nodes (p < 0.001) than children from the Ingavirin group (there was a significant difference in the duration of these symptoms). Only 2 children from group 1 required antibiotics (3.4%), whereas in group 2, 11 children needed antibacterial therapy (22%).
ABSTRACT
Currently, the disease caused by the new coronavirus (COVID-19) and the possibility of co-infection with SARS-CoV-2 and other pathogens in the current epidemic situation continues to be of particular interest. The review, based on the analysis of literature and own materials, outlines the features of the relationship between SARS-CoV-2 and pathogens of acute respiratory viral infections (ARVI). Particular attention is paid to the combined course of COVID-19 and influenza, a comparative characteristic of the severity of the clinical picture. An assessment of the epidemic situation against the backdrop of the COVID-19 pandemic in foreign countries and the Russian Federation (RF) revealed the presence of the phenomenon of SARS-CoV-2 interference with other viral respiratory agents, based on the facts of a sharp suppression of the circulation of influenza viruses, respiratory syncytial virus (RSV) and other ARVI pathogens during the period of active spread of pandemic coronavirus. The main epidemiological indicators of the course of coronavirus infection were compared and the contribution of various pathogens to the etiology of acute respiratory viral infections during the development of the second wave of COVID-19 in the RF was assessed. It was noted that the decrease in the number of new cases by 11.4 and deaths by 2.1 times due to COVID-19 at 6 and 13 weeks in 2022 occurred with unchanged laboratory detection of the influenza virus (0.8%) and an increase in the frequency detection of pathogens of other SARS. The results of observations showed that against the background of a decrease in the incidence of COVID-19, there was no increase in the proportion of diagnosed cases of infections caused by other pathogens, especially influenza. The results obtained confirm the need to ensure effective epidemiological surveillance and additional application of pathogen identification methods for monitoring various ARVI, which can significantly affect the approach to differential diagnosis, patient management tactics and the decision on appropriate preventive measures.
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The aim of this study was to analyze the efficacy and safety of using etiotropic therapy with favipiravir and molnupiravir that can selectively bind and inhibit not only SARS-CoV-2 proteins but also other RNA-containing pathogens of acute respiratory diseases. High transmission of pathogens, the risk of becoming chronic, frequent complications, cases of co-infection with several pathogens, which can lead to a more severe course of the disease, insufficient vaccination effectiveness, all this requires additional strategies for both prevention and treatment of acute respiratory viral infections. RNA-dependent RNA polymerase (RdRp), which has no equivalent in human cells, is involved in RNA synthesis and is an excellent therapeutic target for diseases caused by RNA viruses, including SARS-CoV-2. The long process of drug development and the "reuse" of drugs approved for other indications or successfully tested in terms of safety and tolerability pose the challenge of rapid establishment of an effective drug, including for the treatment of severe cases of COVID-19. Copyright © 2022, Dynasty Publishing House.
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BACKGROUND AND PURPOSE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a widespread virus that led to the acute respiratory disease named coronavirus disease 2019 (COVID-19).1 Similarly to SARS-COV in 2002, many individuals post COVID-19 are experiencing persistent respiratory impairments and decreased exercise capacity limiting their ability to complete activities of daily living (ADLs) and affecting their quality of life (QOL).2,3 Post COVID-19 patients are demonstrating decreased pulmonary function as measured on pulmonary function tests (PFTs)with 39% of individuals having reduced diffusion capacity, 15% having restrictive patterns, and 7% having obstructive patterns.4 Pulmonary rehabilitation has demonstrated the ability to improve exercise capacity, QOL, fatigue level, and strengthen respiratory musculature to improve pulmonary function.5 The purpose of this case study is to demonstrate the positive impact pulmonary rehabilitation has on aerobic capacity, PFTs, exertional dyspnea, and QOL in an individual post long COVID-19. CASE DESCRIPTION: Patient is a 44 year-old female presenting to pulmonary rehabilitation post hospitalization for COVID-19. Patient was hospitalized for over one-month secondary to developing acute hypoxemic respiratory failure on 2 accounts requiring high flow nasal cannula, steroids, and ICU management. Post hospitalization, patient continued to have decreased pulmonary function asmeasured on PFTs, dyspnea with ADLs, desaturation below 90% on room air with stair negotiation and brisk walking, and required 2 liters per minute (L/min) of supplemental oxygen for management. Patient underwent a 3-month outpatient pulmonary rehabilitation program consisting of aerobic treadmill training, upper (UE) and lower extremity (LE) strength training, functional mobility training (step-up and sit to stand), and patient education (energy conservation, breathing techniques, vital sign monitoring, and exercise intensity progression). OUTCOME(S): At discharge, patient demonstrated significant improvement in exercise capacity as she improved by 610 ft (46.9% improvement from initial evaluation [IE]) on the 6-min walk test (6MWT). Subjectively, patient noted decreased shortness of breath (7/10 (IE) to 3/10 on the Modified Borg Dyspnea Scale) while performing the 6MWT. Patient demonstrated improvements in PFTs as her FVC and FEV1 reached normal based upon the percent predicted method6 (FVC: 72.7% to 90% of predicted, FEV1: 77.8% to 95.2% of predicted), and DLCO improved from 45% to 70.3% of predicted. In the subjective questionnaires, patient had significant improvement on the UCSD Shortness of Breath questionnaire (6 unit improvement, MCID: 57), and clinical improvement noted on the Duke Health Profile questionnaire with a decrease in disability score (100 (IE) to 0) and depression score (50 (IE) to 40). DISCUSSION: This case study demonstrates that pulmonary rehabilitation is a safe and effective exercise program that results in improvements in exercise capacity, pulmonary function, exertional dyspnea, and QOL in individuals recovering from long COVID-19.
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The aim of this study was to analyze the efficacy and safety of using etiotropic therapy with favipiravir and molnupiravir that can selectively bind and inhibit not only SARS-CoV-2 proteins but also other RNA-containing pathogens of acute respiratory diseases. High transmission of pathogens, the risk of becoming chronic, frequent complications, cases of co-infection with several pathogens, which can lead to a more severe course of the disease, insufficient vaccination effectiveness, all this requires additional strategies for both prevention and treatment of acute respiratory viral infections. RNA-dependent RNA polymerase (RdRp), which has no equivalent in human cells, is involved in RNA synthesis and is an excellent therapeutic target for diseases caused by RNA viruses, including SARS-CoV-2. The long process of drug development and the "reuse" of drugs approved for other indications or successfully tested in terms of safety and tolerability pose the challenge of rapid establishment of an effective drug, including for the treatment of severe cases of COVID-19. Copyright © 2022, Dynasty Publishing House.
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Since the beginning of the year in January 2020, the world witnessed a terrifying unpredictable health emergency of human life which resulted in an outbreak of a disease known as a novel coronavirus (SARS CoV-2 / COVID-19-acute respiratory disease) which was declared a pandemic by the World Health Organization (WHO). With an abrupt increase in the number of cases, a nationwide lockdown was imposed where Pharmacists served as a lifeline by supplying medicines to people across the world and their operation has made a big difference amid the global pandemic. In such difficult times, Pharmacists have helped vulnerable patients stay well and ensured their safety amidst the pandemic. Although pharmacies and drug stores play an important part in the healing process, many people have the perception that they provide a commercial or business-like service. The doctor prescribes the right medicine with the right instructions, and the pharmacist fills the prescription for a fee. In a nutshell, it's a straightforward business. With the advancement of the healthcare system, the role of the Pharmacist has become crucial in today's era which is defined by insights and discoveries that elevate the greater well-being of humans. Due to the rapid expansion, the urban concentration of health services remains a challenge in a country like India. Hence there has to be strict monitoring governance over the healthcare framework. Copyright © 2022, Anka Publishers. All rights reserved.
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Background The Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has spread worldwide since its first recorded case in the city of Wuhan, China, in December 2019. SARS-CoV-2 infection causes asymptomatic to sever pneumonia. Severe cases may develop acute respiratory disease symdrome (ARDS), with an average mortality rate of 6.9%. Real Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR) assay is the current reference standard laboratory method for the diagnosis of SARS-CoV-2 infection. However, it takes around 6-8 hours to get the result and is time consuming. Therefore, rapid and accurate tests for SARS-CoV-2 screening are essential to expedite disease prevention and control. Lateral flow immunoassay using monoclonal anti SARS-CoV-2 antibodies which target for SARS-CoV-2 antigen can be complimentary screening test if their accuracy were comparable to that of the real time reverse transcription-polymerase chain reaction (RT-PCR) assay. Objective To find the sensitivity and specificity of a rapid antigentest kit in comparison to reverse transcription-polymerase chain reaction (RT-PCR). Method A cross-sectional hospital based study was carried out at Shree Birendra Army Hospital, Kathmandu for a period of four months. Result Our finding shows sensitivity and specificity of rapid diagnostic tests (RDT) Ag kit as 60.6% and 96.4% respectively. Positive and negative predictive value was 83.7% and 89.0%. Likewise, positive and negative likelihood ratio was 17.0 and 0.4. The overall accuracy of the antigen kit was 88.1% in comparison to reverse transcription-polymerase chain reaction (RT-PCR) as the gold standard. Conclusion Our study concluded the use of rapid antigen kit is mainly useful for screening purposes. Copyright © 2022, Kathmandu University. All rights reserved.
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The registered incidence of influenza and acute respiratory diseases (ARD) in Bulgaria remains low in the epidemic period of time during 2020-2021, in the absence of a clear epidemic curve. For the first year during the winter season, influenza viruses were not detected. Continuation of restrictive and preventive measures related to the COVID-19 pandemic and the increase in influenza vaccination coverage enable maintaining the influenza activity at low levels during the winter season. It is required to perform a thorough assessment of the effectiveness of preventive and anti-epidemic measures and the possibilities for their implementation in the following seasons to limiting the spread of influenza and ARD.
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Introduction: Once considered a pediatric concern, respiratory syncytial virus (RSV) infection is gaining importance as a cause of significant hospitalisation, need for ICU care and mortality in adults of all ages with chronic comorbidities. Description of the case: A 66-years old woman with an history of smoking, diabetes, obesity, hypertension, chronic renal failure and COPD was admitted to our hospital because of sudden onset of respiratory failure preceded by fever and dry cough since 1 week. At the admission we obtain two negative nasopharyngeal swab test for SARS-CoV-2 RT-PCR assays and, subsequently a positive test for RSV on Respiratory Multiplex PCR assay. A bilateral interstitial pneumonia was detected by a pulmonary CT-scan;blood tests showed WBC 14.400/mm3 Hb 10,5 g/dL PLT 121.000/mm3, CRP 16,3 mg/dL, creatinine 2,81 mg/dL. The patient was treated with intravenous broad-spectrum antibiotic therapy, supplemental 02 with face mask, corticosteroids and loop diuretics, with progressive improvement of clinical status, blood tests and arterial ABG values. A successive control with CT-scan showed a reduction of pneumonia extension and the patient started a respiratory rehabilitation. Conclusions: The COVID-19 pandemic has pointed-out the need for greater diagnostic accuracy of acute respiratory diseases. RSV infection is an often underdiagnosed cause of hospitalisation and mortality even in non-immunocompromised adults affected from chronic comorbidities.