Impact of the Sars-Cov-2 Pandemic on Feline Lower Urinary Tract Signs

On 11 March 2020, the World Health Organization declared the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak to be a global pandemic. Restrictions were imposed to mitigate the transmission of the virus, and people's daily routines were interrupted. This exposed both cat caregivers and, potentially, their cats to additional stress factors, such as psychosocial stress. Lower urinary tract signs (LUTS) are common in domestic cats and can include some or different combinations of the following clinical signs: dysuria, haematuria, periuria, pollakiuria, stranguria and obstruction. Environmental and management factors, such as indoor environments and an increase in stressors, have been identified as predisposing factors to LUTS. This retrospective study attempted to assess the effects of the pandemic and cat caregiver's confinement at home, which may be considered a stressor, thus triggering more cases of LUTS in cats. The study included 298 cats that were presented to the Veterinary Hospital of Associaicao Zoofila Portuguesa, Lisbon, between 2019 and 2021. A group from the pre-pandemic period (PPP;control group) contained 142 cats and a group from the period during the pandemic (PDP;study group) contained 156 cats. In the PDP group there were decreases in LUTS relapses and subsequent obstructions (P <0.01) and mortality rate (P <0.05) compared with the PPP group. A statistically significant difference was also observed in terms of the number of episodes of LUTS, with the PPP group associated with two episodes and the PDP group more frequently seen with only one episode (P <0.01). The results appear to demonstrate a positive effect of the SARS-COV-2 pandemic on LUTS. This is perhaps owing to the increased wellbeing of the cats due to the increased amount of time caregivers spent with their cats. This might mean they were better able to observe and meet their cats' needs, thus reducing the cats' stress during the period of the pandemic-related restrictions.

THE CAT IS OUT OF THE BAG: PASTEURELLA BACTEREMIA AND PNEUMONIA CAUSING SEPTIC SHOCK IN AN IMMUNOCOMPETENT PATIENT

SESSION TITLE: Atypical Cases of Sepsis SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: Pasteurella multocida is a Gram-negative coccobacillus that causes infections after animal bites or scratches. It typically manifests as cellulitis but severe infections are possible though rare. We present a case of an immunocompetent man with COVID-19 who developed septic shock due to P. multocida bacteremia and pneumonia with no evidence of wound infection. CASE PRESENTATION: A 59-year-old Hispanic man with a history of anxiety and HLD presented with 10 days of nausea, vomiting, chills, and nonproductive cough. He was initially afebrile, on room air but tachycardic. His physical exam was unremarkable. Labs revealed WBC 10x10*3/uL, procal 3.3 ng/mL, negative lactic acid, and positive COVID-19. CT chest showed a right upper lobe consolidation with bilateral patchy infiltrates. He was admitted for sepsis secondary to COVID and superimposed bacterial pneumonia. Ceftriaxone, azithromycin, remdesivir, and dexamethasone were started. Overnight, the patient desaturated to low 80s and required HFNC FiO2 65%. In the morning, FiO2 increased to 80%. ICU was called and upon their assessment, the patient was febrile, tachycardic, tachypneic, hypotensive, and saturating 87-88% on HFNC FiO2 70%. Labs showed WBC 3.1 with left shift, Cr 1.7 mg/dL, lactic acid 5 mmol/L, and procalcitonin >100. He was intubated given persistent hypoxia and increased work of breathing. Antibiotics were broadened to vancomycin, pip/tazo, and azithromycin. The patient acutely decompensated after intubation, requiring multiple high-dose pressor support. Prelim blood cultures grew Gram-negative bacteria so antibiotics were broadened to meropenem. TTE was negative for endocarditis. Pressors were eventually weaned and the patient was extubated. Blood cultures grew P. multocida in 4/4 bottles so meropenem was narrowed to penicillin. His family reported that he was living at a friend's house with cats around but was unaware of any bites or scratches and he had no history of splenectomy. No portal of entry was noted upon careful skin examination. The patient continued to improve clinically with procal that rapidly downtrended. He was eventually discharged home. DISCUSSION: The mortality for severe P. multocida presentations is about 25-30%. Severe cases are generally reported in elderly, immunocompromised, or young immunosuppressed patients. We report what is to our knowledge, the first case of a severe P. multocida infection in an immunocompetent middle-aged man in the background of a COVID-19 infection. It is unclear the degree of COVID contribution and if his bacteremia preceded the pneumonia. His morbidity was primarily driven by the P. multocida bacteremia and pneumonia given the localized right upper lobe consolidation, elevated procal that rapidly decreased with antibiotics, and quick improvement and extubation. CONCLUSIONS: P. multocida infection should be considered in any patient with septic shock and exposure to animals. Reference #1: Blain H, George M, Jeandel C. Exposure to domestic cats or dogs: risk factor for Pasteurella multocida pneumonia in older people? Journal of the American Geriatrics Society. 1998;46(10):1329-1330. Reference #2: Tseng HK, Su SC, Liu CP, Lee CM. Pasteurella multocida bacteremia due to non-bite animal exposure in cirrhotic patients: report of two cases. Journal of microbiology, immunology, and infection= Wei mian yu gan ran za zhi. 2001;34(4):293-296. Reference #3: Kofteridis DP, Christofaki M, Mantadakis E, et al. Bacteremic community-acquired pneumonia due to Pasteurella multocida. International Journal of Infectious Diseases. 2009;13(3):e81-e83. doi:10.1016/j.ijid.2008.06.023 DISCLOSURES: No relevant relationships by Joanne Lin No relevant relationships by Harjeet Singh No relevant relationships by Jose Vempilly No relevant relationships by Joshua Wilkinson

Genomic and phylogenetic analysis of the ORF7b gene from a Chinese feline infectious peritonitis virus isolate

FCoV viruses exhibit great genetic diversity, leading to the presence of FIPV-causing variants. Current molecular evolution analysis and genetic variation studies of FCoV in China are predominately focused on gene encoding the spike protein or other structural proteins, while few studies have evaluated genetic variations in nonstructural FCoV genes, which can play an important role in disease pathogenesis. In this study, the gene encoding the open reading frame (ORF) 7b nonstructural FCoV protein of the Chinese Fujian strain FJLY20201 was amplified from the ascitic fluid of a Chinese domestic cat infected with FIPV and compared with ORF 7b from previously published FCoV strains. Multiple sequence alignment revealed that FJLY20201 exhibited high identity with other Chinese FCoV strains. Phylogenetic analyses indicated that the Chinese strains did not differentiate between type I and type II serotypes of FCoV based on S proteins. In addition, they formed clades and differed genetically from strains originating outside China. This study provides the molecular epidemiology data about the ORF 7b genes of FCoV strains in China. Our results show that the identity of ORF 7b genes was closer between the Chinese isolates, and suggest that variation in ORF 7b is more dependent on geographical origin.

Construction of a Mouse-Feline Chimeric Neutralizing Antibody Against SARS-CoV-2

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the biggest challenge in public health worldwide. Similarities among viral receptors predict that there are several animal species that could function as reservoirs for the virus. Recent studies have reported that felid animals, including wild and domestic cats, are highly susceptible to SARS-CoV-2 infection. These findings cause great concerns on the potential for human-to-animal and animal-to-human transmission, along with the virus mutations that appear as the virus goes back and forth between species. It is urgently needed to develop novel reagents for control of viral infection and preventing interspecies transmission. In this chapter, we described protocols for generation of a mouse-feline chimeric neutralizing antibody against SARS-CoV-2. This chimeric antibody has potential to be developed as a diagnostic tool and therapeutic agent against SARS-CoV-2 infections in cats.

SARS-CoV-2 in domestic cats (Felis catus) in the northwest of Iran: Evidence for SARS-CoV-2 circulating between human and cats.

This study aimed to investigate the prevalence of COVID-19 in domestic cats, focusing on the disease in the northwest of Iran and then showing the natural transmission of SARS-COV-2 circulating between domestic cats and humans. After receiving ethic codes from Tehran University of Medical Sciences (IR.TUMS.VCR.REC.1399.303) and confirmed by the Center of Communicable Diseases Control (CDC) of Iran, 124 domestic cats were collected from the homes and only one hospital of Meshkin -Shahr district from northwestern Iran where SARS-CoV-2 patients were hospitalized and quarantined during 2020. Samples were prepared from fluid materials of oropharynx and nasopharynx. All samples were tested by real-time PCR (RT-PCR) using specific genes N and ORF1ab in Pasteur Institute of Iran, and then partial sequence analyses of S gene were performed. All collected cats were kept in separated cages until SARS-COV-2 infection was confirmed with the RT-PCR. RT- PCR Ct values of 123 collected cats were ≥40; thus, all of them showed negative results, but one of the collected cats with close contact with its owner, whom confirmed SARS-CoV-2 showed positive results with gene N(Ct=30) and gene ORF1ab (Ct=32). Furthermore, the positive pet cat showed respiratory and gastro-intestinal clinical manifestations, and its owner was infected with SARS-CoV-2 two weeks ago. Cats are susceptible animals to SARS-CoV-2 infection. Epidemiological evidence showed that SARS-COV-2 is able to transmit to healthy cats due to having close contact with its owner as a reverse zoonosis.

SARS-CoV-2 infection in domestic and feral cats: current evidence and implications.

Current evidence indicates that cats play a limited role in COVID-19 epidemiology, and pets are probably dead-end hosts of SARS-CoV-2 and pose negligible risks of transmission to humans. Still, one health concept is to be adopted widely as a component of mitigation strategies to tackle the ongoing pandemic. Therefore, in terms of the magnitude of infection and potential to transmit SARS-CoV-2 to humans, our surveillance efforts should mainly focus on mustelids (especially minks, ferrets, and others) for early detection and control of infection. This will ensure that SARS-CoV-2 will not get established in the wild animal population of these susceptible species. We agree with Dr. Passarella Teixeira on the possibility of domestic and feral cats acting as an urban reservoir, subsequently transmitting the virus to human beings. However, it is less likely that such a phenomenon will be reported even if it has occurred due to the efficient and extensive human-to-human transmission of SARS-CoV-2.

Severe acute respiratory syndrome coronavirus 2 in cats: a systematic review.

The epidemiological role of cats in the coronavirus disease pandemic remains unclear despite of several studies that have been conducted to understand it, in other words it is not yet known whether the cat would be able to transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to humans. Taking that into account, the objective of this study was to conduct a systematic review to identify what is known and not known on this topic. Our results revealed that cats can be infected through an airborne (perhaps oral, too) route and that the clinical development of the infection in cats is parallel to that in humans. The majority of infected cats remained asymptomatic, and more severe clinical cases described occurred only in animals with comorbidities. In addition to infection, cats achieved seroconversion with detectable titers. However, the epidemiological role of cats in relation to transmission routes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear and needs to be studied further. We emphasize that, regardless of the conclusion regarding the epidemiological role of cats, this reinforces the concepts of ONE HEALTH to be incorporated into the studies and practices of epidemiological surveillance of infectious diseases, with multidisciplinary teams, to achieve an understanding of the transmission of diseases with zoonotic potential.

O papel epidemiológico dos gatos na pandemia da doença causada pelo novo coronavírus ainda não foi esclarecido. Apesar de vários estudos realizados, ainda não foi determinado se os gatos poderiam transmitir o vírus da síndrome respiratória aguda grave coronavírus 2 (SARS-CoV-2) para os humanos. Diante disso, o objetivo deste estudo foi realizar uma revisão sistemática sobre esse tema. Nossos resultados destacam os achados de que os gatos podem ser infectados por via aérea, talvez oral também, e de que o desenvolvimento clínico da infecção em gatos guarda um paralelo com a infecção em humanos, pois a maioria dos gatos infectados que foram estudados permaneceu assintomática, e os casos clínicos mais graves descritos ocorreram apenas em animais com comorbidades. Além da presença do vírus, os gatos também desenvolvem anticorpos específicos. Ressaltamos que, independentemente da conclusão quanto ao papel epidemiológico dos gatos, os achados desse estudo reforçam os conceitos de ÚNICA SAÚDE a serem incorporados aos estudos e práticas de vigilância epidemiológica de doenças infecciosas, com equipes multidisciplinares, para o entendimento da transmissão de doenças com potencial zoonótico.

The Second Wave of SARS-CoV-2 Circulation-Antibody Detection in the Domestic Cat Population in Germany.

Registered cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the German human population increased rapidly during the second wave of the SARS-CoV-2 pandemic in winter 2020/21. Since domestic cats are susceptible to SARS-CoV-2, the occurrence of trans-species transmission needs to be monitored. A previous serosurvey during the first wave of the pandemic detected antibodies against SARS-CoV-2 in 0.65% of feline serum samples that were randomly sampled across Germany. In the here-presented follow-up study that was conducted from September 2020 to February 2021, the seroprevalence rose to 1.36% (16/1173). This doubling of the seroprevalence in cats is in line with the rise of reported cases in the human population and indicates a continuous occurrence of trans-species transmission from infected owners to their cats.

SARS-CoV-2 Infection and Antibody Response in a Symptomatic Cat from Italy with Intestinal B-Cell Lymphoma.

Since the coronavirus disease (COVID-19) pandemic was first identified in early 2020, rare cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in pet cats have been reported worldwide. Some reports of cats with SARS-CoV-2 showed self-limiting respiratory or gastrointestinal disease after suspected human-to-feline transmission via close contact with humans with SARS-CoV-2. In the present study, we investigated a cat with SARS-CoV-2 that was presented to a private animal clinic in Northern Italy in May 2020 in a weak clinical condition due to an underlying intestinal B-cell lymphoma. The cat developed signs of respiratory tract disease, including a sneeze, a cough and ocular discharge, three days after an oropharyngeal swab tested positive for SARS-CoV-2 viral RNA using two real-time reverse transcriptase polymerase chain reaction (RT-qPCR) assays for the envelope (E) and RNA-dependent RNA polymerase (RdRp) gene. Thus, SARS-CoV-2 viral RNA was detectable prior to the onset of clinical signs. Five and six months after positive molecular results, the serological testing substantiated the presence of a SARS-CoV-2 infection in the cat with the detection of anti-SARS-CoV-2 receptor binding domain (RBD) immunoglobulin (IgG) antibodies and neutralizing activity in a surrogate virus neutralization assay (sVNT). To the best of our knowledge, this extends the known duration of seropositivity of SARS-CoV-2 in a cat. Our study provides further evidence that cats are susceptible to SARS-CoV-2 under natural conditions and strengthens the assumption that comorbidities may play a role in the development of clinical disease.

Detection and Genome Sequencing of SARS-CoV-2 in a Domestic Cat with Respiratory Signs in Switzerland.

Since the emergence of coronavirus disease (COVID-19) in late 2019, domestic cats have been demonstrated to be susceptible to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) under natural and experimental conditions. As pet cats often live in very close contact with their owners, it is essential to investigate SARS-CoV-2 infections in cats in a One-Health context. This study reports the first SARS-CoV-2 infection in a cat in a COVID-19-affected household in Switzerland. The cat (Cat 1) demonstrated signs of an upper respiratory tract infection, including sneezing, inappetence, and apathy, while the cohabiting cat (Cat 2) remained asymptomatic. Nasal, oral, fecal, fur, and environmental swab samples were collected twice from both cats and analyzed by RT-qPCR for the presence of SARS-CoV-2 viral RNA. Both nasal swabs from Cat 1 tested positive. In addition, the first oral swab from Cat 2 and fur and bedding swabs from both cats were RT-qPCR positive. The fecal swabs tested negative. The infection of Cat 1 was confirmed by positive SARS-CoV-2 S1 receptor binding domain (RBD) antibody testing and neutralizing activity in a surrogate assay. The viral genome sequence from Cat 1, obtained by next generation sequencing, showed the closest relation to a human sequence from the B.1.1.39 lineage, with one single nucleotide polymorphism (SNP) difference. This study demonstrates not only SARS-CoV-2 infection of a cat from a COVID-19-affected household but also contamination of the cats' fur and bed with viral RNA. Our results are important to create awareness that SARS-CoV-2 infected people should observe hygienic measures to avoid infection and contamination of animal cohabitants.

Occurrence of Antibodies against SARS-CoV-2 in the Domestic Cat Population of Germany.

Domestic cats (Felis catus) are popular companion animals that live in close contact with their human owners. Therefore, the risk of a trans-species spreading event between domestic cats and humans is ever-present. Shortly after the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its rapid spread around the world, the role of domestic cats in the transmission cycle was questioned. In the present study, the first large-scale survey of antibody occurrence in the domestic cat population in Germany was conducted, in order to assess the incidence of naturally occurring human to cat transmission of SARS-CoV-2. A total of 920 serum samples, which were collected from April to September of 2020, were screened by an indirect multispecies ELISA. Positive samples were verified using an indirect immunofluorescence test (iIFT) and additionally tested for neutralizing antibodies. Furthermore, serum samples were screened for antibodies against feline coronavirus (FCoV), in order to rule out cross-reactivity in the described test systems. Overall, 0.69% (6/920) of serum samples were found to be positive for antibodies against SARS-CoV-2 by ELISA and iIFT. Two of these reactive sera also displayed neutralizing antibodies. No cross-reactivity with FCoV-specific antibodies was observed. The finding of SARS-CoV-2 antibody-positive serum samples in the domestic cat population of Germany, during a period when the incidence of human infection in the country was still rather low, indicates that human-to-cat transmission of SARS-CoV-2 happens, but there is no indication of SARS-CoV-2 circulation in cats.