ABSTRACT
A clinical analysis of COVID-19 cases combined with acute respiratory diseases is presented. The aim of the study was to analyze clinical and laboratory data of patients with combined COVID-19 infection. In patient A. infected with SARS-CoV-2 without X-ray confirmation of lung damage, acute tonsillitis, polyadenopathy, hepatosplenomegaly, moderate leukocytosis, lymphomonocytosis and the presence of reactive lymphocytes were detected. Serological and molecular biological studies were carried out for the purpose of differential diagnosis. A positive test result for IgM antibodies to EBV was obtained. The method of polymerase chain reaction (PCR) revealed EBV DNA in blood plasma. The result of the determination of heterogeneous IgG antibodies to the EBV caspid antigen is negative. Clinical symptoms of the patient with coronavirus infection COVID-19, confirmed by radiological and serological screening, included: fever, sore throat, hyperemia and hypertrophy of the palatine tonsils, hepatomegaly, changes of the cellular composition of the blood. At the same time, the lymph nodes in the neck, chest and abdominal cavity were not enlarged;the presence of reactive lymphocytes and plasma cells was not detected. Serological markers of EBV were also not detected. A PCR test for Epstein-Barr virus DNA was negative.Copyright © 2022 Infectious Diseases: News, Opinions, Training.
ABSTRACT
The level and duration of protective immunity are often analyzed qualitatively or semi-quantitatively. The same strategy is applied to the analysis of antibody dynamics. At some point in time t after exposure or immunization, the presence of immunity against the infection is inferred from the level of specific antibodies by comparing it to a reference value. This approach does not account for the stochastic nature of human disease after exposure to a pathogen. At the same time, it is not fully clear what antibody level should be considered protective. The aim of this study was to develop a mathematical model for quantitative determination of protective immunity against SARS-CoV-2 and its duration. We demonstrate that the problem of describing protective immunity in quantitative terms can be broken down into 2 interrelated problems: describing the quantitative characteristics of a pathogen's virulence (in our case, the pathogen is SARS-CoV-2) and describing the dynamics of antibody titers in a biological organism. Below, we provide solutions for these problems and identify parameters of the model which describes such dynamics. Using the proposed model, we offer a theoretical solution to the problem of protective immunity and its duration. We also note that in order to quantitatively determine the studied parameters in a homogenous population group, it is necessary to know 5 parameters of the bivariate probability density function for correlated continuous random variables: the infective dose of the pathogen and the antibody titer at which the disease develops and which are still unknown.Copyright © Extreme Medicine.All right reserved.
ABSTRACT
Intro: The COVID-19 pandemic continues to spread worldwide, and it is likely to overlap with the dengue epidemics in tropical countries. Although most children and young people who develop COVID-19 have no symptoms or very mild ones at the time, we now know that a small number develop Paediatric Inflammatory Multisystem Syndrome (PIMS) a few weeks afterwards. Due to overlapping of clinical and laboratory features, it may be difficult to distinguish PIMS from dengue fever. So this study was undertaken to analyse the clinical features and laboratory investigations in these patients. Method(s): We retrospectively studied the case records of 21 patients diagnosed as pediatric inflammatory multisystem syndrome (based on WHO case definition) and dengue fever (either NS1 antigen positive or IgM antibody positive). A total of 106 patients were diagnosed with dengue fever. Out of these SARS-CoV-2 antibodies were positive in 57 patients. However, only 21 patients full filled the case definition for multi-inflammatory syndrome in children (MIS-C). Clinical features and laboratory investigations were entered in a proforma and results analysed. Finding(s): Out of 21 children's maximum children were older than 10 years age (76.2%). Commonest finding on abdominal sonography was gall bladder wall edema followed by ascites. Thrombocytopenia was seen in 18 (85.7 %) patients at admission and in 14 (66.7%) platelets were less than 50000/mm3.LDH was raised in 19 (90.4%), Ferritin in 18 (85.7%) and D-Dimer in 13 (61.9%) of patients (Table 2). Fever was seen in all the patients,17 (80.9%) patients had shock on admission. Rash was seen in 15 (71.4 %) of the patients. All the patients were discharged. Conclusion(s): Many of clinical features are common to both diseases. However, increased levels of serum ferritin, d-dimer and CRP are more commonly seen in pediatric inflammatory multisystem syndrome due to covid as compared to lower platelet counts which are more frequently seen in dengue fever patients.Copyright © 2023
ABSTRACT
Patients with end-stage chronic kidney disease treated with hemodialysis are at risk of infection and severe course of the new coronavirus infection. This opinion was based on the data obtained as a result of PCR testing during the active phase of the disease with detailed clinical symptoms. However, this diagnostic method does not allow one to fully assess the prevalence of infection in the population. The aim - studying of the frequency of SARS-CoV-2 infection in patients receiving hemodialysis treatment and the spectrum of antiviral antibodies, depending on the nature of the course of COVID-19. Material and methods. 100 patients with chronic kidney disease (stage 5D) treated at the outpatient Dialysis Center (MCVTP) were included in the study by a simple random sample. The assessment of SARS-CoV-2 infection was carried out by analyzing the material of smears obtained from the naso-oropharynx by PCR and blood serum samples by ELISA. The study excluded 14 patients with dubious results for the determination of serological markers SARS-CoV-2 and 1 patient with active infection, who was isolated from the RNA of the virus. Results. IgM and IgG antibodies were detected in 49 (57.6%) of the 85 examined patients. 24 of them (group 1) were diagnosed with COVID-19 infection with typical clinical symptoms 3-9 months ago, and 25 (group 2) had no clinical manifestations of the acute respiratory infection at the appropriate time suggesting an asymptomatic course of the disease. IgM class antibodies were detected with equal frequency in group 1 and in group 2 (33.3 vs 24.0%, respectively, p<0.6). IgG antibodies exclusively to the nucleocapsid N-protein (IgGn) were detected only in the latent form of the disease (32%), while antibodies against the S-protein (spike protein) of the virus (IgGs and IgGn+s) were detected more often in the manifest form compared to the asymptomatic one (100 vs 60%, respectively, p<0.05). Conclusion. In a random cohort of patient receiving hemodialysis treatment, more than half were asymptomatic.Despite a wide range of prevention measures, SARS-CoV-2 infection among patients treated with hemodialysis is more than 2 times higher than in the general population.Copyright © 2021 Geotar Media Publishing Group. All rights reserved.
ABSTRACT
Aim. An online survey among social network users was conducted to assess the frequency of COVID-19 cases, the spectrum of medications used for treatment, and the subjective assessment of clinical manifestations of the disease. Material and methods. An anonymous online survey was conducted among users of various social networks using a questionnaire created on the SurveyMonkey survey and research platform. During the first month of December 2021, the survey included 23 questions regarding the clinical and demographic characteristics of respondents, the number of COVID-19 cases, clinical manifestations, and severity, as well as the need for medical help and medication. Results. 752 respondents took part in the online survey, more than 70% of them are under 50 years old. Among the respondents 59.73% had a new coronavirus infection (COVID-19). More than 40% of the participants had COVID-19 in the period from September 2020 to April 2021 (2nd wave in Russia). In 79.2% of people, the presence of a new coronavirus infection was confirmed by one of the diagnostic methods: polymerase chain reaction (PCR test), radiography, the presence of antibodies to Ig G/M, and took into account the presence of contact with infected SARS-CoV-2. 411 participants observed any clinical manifestations of the disease. Most often respondents who had COVID-19 indicated weakness, cough, dyspnea, disappearance or decrease in the acuity of smell and taste. The volume of lung tissue damage in 36.5% of cases was less than 25%. The disappearance of any clinical manifestations of the disease immediately after recovery was noted by 32.0% of respondents. Most of the patients (59.2%) sought medical help at the polyclinic, 38.9% had to self-medicate. 71.9% respondents indicated they had been vaccinated against COVID-19, but without specifying the timing and completeness of the course. Side effects after immunization (fever, weakness, soreness, and redness at the injection site) were subjectively assessed by 41.9% of respondents. Conclusion. Among the surveyed respondents, 62.7% of the disease symptoms were mild. The highest number of cases occurred in the 2nd and 4th waves of COVID-19 morbidity in Russia. Most often respondents indicated symptoms of acute respiratory infection. The complete disappearance of clinical manifestations of the disease immediately after recovery was noted by 32.0 % of respondents, and the persistence of symptoms for up to a year - 7.5. More than 70% of the participants in the online survey reported vaccination against COVID-19, but the questionnaire did not include questions about the timing of vaccinations (before or after COVID-19) and the completeness of the course.Copyright © Eco-Vector, 2023. All rights reserved.
ABSTRACT
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.
ABSTRACT
Background: The aim of this study was to estimate the seroprevalence of SARS-CoV-2 infection in a general population from Kermanshah province, Iran. Method(s): The present study was a population-based cross-sectional design conducted in Kermanshah province in 2020. Sampling was performed in a multi-stage process, and 1967 participants were considered, and also 174 interviewers were assigned to collect data online. Then, 5 mL of blood sample was taken from every participant. The blood samples were centrifuged with the ELISA method to detect SARS-CoV-2-specific IgG and IgM antibodies in serum samples. Seropositive prevalence was adjusted by means of survey analysis. Case fatality rate (CFR) and infection fatality rate (IFR) were estimated. Result(s): A total of 1967 people from 14 cities of the province participated in the study. The mean age of participants was 35.7+/-16.9, and 50.4% were female. The lowest and highest seroprevalence was found in the cities of Paveh (2.3% [0.3-4.2]) and Harsin (61.6% [54.7-68.5]), respectively. The CFR and IFR in men and women were 3.4 vs. 3.3 and 0.1 vs. 0.3. The aged 60 years or older had the highest CFR and IFR with 11.2 and 3.7%, respectively. Conclusion(s): The prevalence of SARS-CoV-2 infection and IFR among the general population of Kermanshah province was 18.3 and 0.3%, respectively. The results of this study can assist the policymaker in assessing risk factors, and transmission dynamics of SARS-CoV-2 in a population and implementing preventive and control interventions.Copyright © 2023 Shadmani et al.
ABSTRACT
Towards the end of 2019 a novel severe acute respiratory syndrome (SARS)-like coronavirus (SARS-CoV-2) caused the ongoing global pandemic. The virus surface consists of spike proteins that mediate SARS-CoV-2 entry into cells through its receptor-binding domain (RBD) that attaches to the human receptor Angiotensin- Converting Enzyme 2 (ACE2). Upon infection with foreign material, like viruses and bacteria, the human immune system responds by producing a humoral response specific to the viral antigen. Cells from the innate immune system and antibodies generated in the humoral response work to destroy and block infectious antigens from causing damage to the human cells. The S protein of SARSCoV- 2 is the key protein that stimulates the immune system to generate neutralizing antibodies. To safely test and investigate SARS-CoV-2 in BSL-2 lab setting, we propagated a surrogate pseudo typed virus to evaluate the ability of antibodies to reduce viral cell entry and replication in SARS-CoV-2 infected mice model. Quantifying the functional ability of neutralizing antibodies would help us understand how they influence reinfection in recovered individuals. We hypothesize that antibodies generated in SARS-CoV-2 infected mice models will induce a protective immune response against the SARSCoV- 2 infection. To detect and quantify the protective immune response generated in mice, we performed two different serological assays and identified antibodies endpoint titers. Mice were infected with Delta and Beta at time points Day 3 and Day 4. We performed a SARS-CoV-2 Spike pseudo virus neutralization assay and measured luminescence to determine the percentage neutralization of functional antibodies induced in mice serum samples upon infection. Utilizing indirect ELISAs,' we measured absorbance for IgA antibodies in Bronchoalveolar lavage fluid (BALF) serum and total IgG antibodies in cardiac bleeds. Our results showed we did not obtain neutralizing activity of antibodies in mice serum samples taken at early time points, 24 hrs and 4 days, after infection with the Delta variant of SARS CoV2 virus using both the pseudo viruses Omicron andWA spike.We obtained 100% neutralizing activity in mice serum samples taken at day 21 and infected with Beta variant of SARS CoV2 virus using both the pseudo viruses Omicron and WA spike demonstrating that there is cross-neutralization against various variants of concern. Antibodies (IgA, IgM, IgG) generated in mice 3 weeks post infection with SARS CoV2 (Beta) virus are capable of neutralizing and inhibiting the entry of WA spike and Omicron pseudo viruses in human HEK293 T Ace2 cells. Moving forward utilizing samples with timepoints surpassing 3 weeks could possibly yield higher concentrations of IgA and IgM antibodies that can neutralize the SARS-CoV-2 pseudo virus. Thank you to Dr. Rhea Coler, the entire Coler lab, National Institutes of Health (NIH), and Seattle Children's Research Institute.Copyright © 2023 The American Society for Biochemistry and Molecular Biology, Inc.
ABSTRACT
Introduction: Seroepidemiological studies can help to understand the dynamics of the infection by the type 2 severe acute respiratory syndrome virus (SARS-CoV-2) in the community. Objective(s): To determine the seroprevalence of COVID-19 Ciudad del Este district of Alto Parana department in Paraguay. Method(s): Descriptive cross-sectional study based on population. A rapid immunochromatographic test was used for the detection of anti-SARS-CoV-2 IgG/IgM antibodies. 1043 households were surveyed between October 27 and November 21, 2020. Result(s): Of the 1978 participants, women prevailed (60.3 %), 39.6 % had secondary education, 32.9 % were engaged in commerce. The most frequent risk factors were hypertension (13.7%), overweight or obesity (16.4%) and diabetes mellitus (6.1%). A total of 415 people (21%) had symptoms compatible with COVID-19, with headache being the most frequent (10.8%), followed by anosmia (10.4%) and sore throat (10.1%). 15.4% of respondents said they had been in contact with a COVID-19 case. 10.8% of participants had undergone a laboratory test for the diagnosis of COVID-19, of them, 72 people (33.6%) reported a positive result. Seroprevalence was high, with one in five reporting symptoms compatible with COVID-19. Conclusion(s): Despite the high anti-COVID-19 seroprevalence, most residents had mild infection, the proportion of hospitalized patients was low, and no fatal cases were reported.Copyright © 2023, Editorial Ciencias Medicas. All rights reserved.
ABSTRACT
Background: Excessive activation of coagulation causing thrombotic complications was observed during Covid-19 infection. The objective of this study was to evaluate the frequency of antiphospholipid antibodies (aPL) in a group of patients with this infection. Method(s): 45 patients (10 Women and 35 men) diagnosed with SARS Cov2 infection were included in our study. The mean age was 63 +/- 10.7 years. Moderate, severe and critical forms were noted in 7%, 51% and 42% of patients, respectively. The IgG/IgM antibodies anti beta2 glycoprotein 1 (beta2 GP1) and IgG/ IgM anti cardiolipin (aCL) were assessed by an immuno-enzymatic assay (ELISA). Result(s): IgG, IgM anti beta2 GP1 and IgG, IgM aCL were positive in respectively 20%, 10%, 25% and 9% of patients. Stratification according to the form of infection showed a positive APL in 66%, 22% and 32% of moderate, severe and critical forms. Also, these APL were positive in 37% of deceased patients versus 23% of stable patients. Conclusion(s): The positivity of aPL appears to be high in our study. Early and effective anticoagulant treatment in Covid-19 patients is needed to avoid any complications.
ABSTRACT
Introduction: Patients with end-stage kidney disease have been among the most affected by the covid-19 pandemic. Vaccination has been imposed in several countries as the main preventive measure. We conducted this study with the aim of evaluating the immunological response to vaccination in senegalese hemodialysis patients, and therefore the effectiveness of mass vaccination in this population. Method(s): We conducted a prospective, cohort study, in two dialysis centers, over a period of 5 months from March 30, 2021 to August 30, 2021. All patients who had been on dialysis for more than 6 months, vaccinated against SARS-CoV2 and who were willing to participate in the study were systematically included. All included patients received 2 doses of ChAdOx1 nCoV-19/AZD1222 vaccine at 12-week intervals according to the original WHO-recommended vaccination schedule. A vaccine response was considered positive when seroconversion was observed after one dose of vaccine. Vaccine protection was judged by the absence of new COVID-19 infection confirmed by RT-PCR in patients who received a complete vaccination schedule. Result(s): Among the 81 patients included in our study, 2.46% had detectable anti-S IgM antibodies before the first dose of vaccine, while the positivity rate was 12.34% one month after the first dose and 2.46% at M4, 1 month after the 2nd dose. Prior to vaccination, 45.68% of patients had detectable IgG anti-S antibodies, while at M1, 1 month after the first dose, 69.14% of patients were positive and at M4 59.26% of patients were. Of the 19 patients infected with Sars-cov-2 prior to vaccination, 2 (10,52%) had detectable IgM antibodies at M0, then 6 (31.58%) at M1 and 2(10.52%) at M4, while in the covid naive group there was no IgM positive subject at M0, 4(6.45%) at M1 and none at M4. Following the same trend, 17 (89.47%) of the previously infected patients had detectable IgG antibodies at M0, 18 (94.73%) at M1 and and 17 (89.47%) at M4, while in the covid naive group 20(32.26%) had detectable IgG at M0, 38 (61.29%) at M1 and 31 (50%) at M4. The seroconversion rate for IgM anti-S antibodies at M1 was 11.39% and statistically significant. At M4, the seroconversion rate compared to the pre-vaccination threshold was 2.53% and not significant. The seroconversion rate for IgG anti-S antibodies at M1 was 56.81% and statistically significant. At M4, the seroconversion rate compared to the pre-vaccination threshold was 52.27% without reaching the significance threshold. IgG-positive patients after two doses of vaccine had a mean length of dialysis of 22 months, which was significantly lower by 10 months than those who did not develop IgG. None of the other parameters studied showed a statistically significant difference between these two groups, including the number of patients with COVID19 infection before or after vaccination and the use of immunosuppressive therapy. Conclusion(s): Vaccination is currently the main measure in the fight against covid, especially in resource limited countries. However, it appears from this study that the protection it offers in haemodialysis patients is neither definitive nor absolute, and that it can be influenced, among other things, by the time spent on dialysis. No conflict of interestCopyright © 2023
ABSTRACT
Passive immunization with mAbs has been employed in COVID-19. We performed a systematic review of the literature assessing the endogenous humoral immune response against SARS-CoV-2 in patients treated with mAbs. Administration of mAbs in seronegative patients led to a reduction in both antibody titres and neutralizing activity against the virus.Copyright © 2022
ABSTRACT
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery);recent (1-6 weeks before surgery);previous (>=7 weeks before surgery);or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2;2.2% (50/2317) in patients with peri-operative SARS-CoV-2;1.6% (15/953) in patients with recent SARS-CoV-2;and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3-6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.Copyright © 2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.
ABSTRACT
Immunoglobulin A (IgA) nephropathy is the most common type of glomerulonephritis worldwide characterized by excessive serum levels of glycosylated which triggers the generation of glycan-specific IgG and IgA autoantibodies. This pathological condition results in the formation of circulatory IgA immune complexes, which are essential for the development of glomerular inflammation, especially IgA nephropathy. The serum galactosylated IgA1, IgG, and IgA autoantibodies are suggested as the biomarkers of IgA nephropathy since IgA antibodies are early markers for disease activity too. Serum IgA antibodies emerged as the early COVID-19-specific antibody response about two days after initial symptoms of COVID-19 in comparison with IgG and IgM antibody concentrations, which appeared after five days. IgA nephropathy is frequently presented as microscopic or macroscopic hematuria and proteinuria with a male predominance. COVID-19 infection can include several organs aside from the lungs, such as kidneys through different mechanisms. It is demonstrated in most cases that short-lasting symptoms such as gross hematuria resolve either spontaneously or following a short course of steroids. This review summarized the reported cases of relapses or denovo reported cases of relapses or de-novo IgA nephropathy and IgA vasculitis following COVID-19 vaccination.Copyright © 2023 The Author(s);Published by Society of Diabetic Nephropathy Prevention. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2. Since 2019, it has spread all over the globe, causing a pandemic that is still ongoing. COVID-19 vaccines protect against this disease through different strategies. Pfizer-BioNTech and Sinopharm vaccines were the most used vaccines in Iraq. Both vaccines have a specific mechanism to trigger the immune system in cells. This research aims to compare the biochemical and immunological responses in vaccinated individuals with either the Pfizer-BioNTech COVID-19 vaccine or the Sinopharm vaccine. This cohort study included 120 Iraqi adults vaccinated with two doses, 21 days apart, using either the Pfizer or the Sinopharm vaccine. Forty subjects received the Pfizer vaccine, 40 subjects received the Sinopharm vaccine, and the other 40 subjects were unvaccinated. After 6 weeks, the second dose was administered, and the blood samples were collected. Our findings revealed that the biochemical biomarkers, urea, creatinine, aspartate aminotransferase, and alkaline phosphatase, seem to be not affected by the vaccines used. However, both vaccines significantly reduced alanine aminotransferase levels (p < 0.05). In contrast, the immunological biomarkers such as IgG, IgM, C3, IL-2, and hs-CRP remarkably responded to both vaccines (p < 0.01), while procalcitonin levels were significantly increased by the Pfizer vaccine (p < 0.05). The study concluded that the Pfizer-BioNTech vaccine boosted the immune system more than the Sinopharm vaccine. A booster dose is advised for people who have already taken Sinopharm or have long-term immunosuppressive diseases.Copyright © 2022 Edan, Khalaf, Geeran, licensee HBKU Press.
ABSTRACT
Covid19 is still one of the major public health problems of all countries nowadays. The most common cardiac manifestations reported till now are acute coronary syndrome, myocarditis, and arrhythmia. The prevalence of COVID-19 induced arrhythmias is different in recent reports and varies from benign sinus tachycardia to more ominous cases of severe bradycardia or even malignant ventricular arrhythmias. Here in, we describe a case of complete heart block in severe covid-19 pneumonia and review all recent relevant case reports published to date in order to understand the probable mechanisms and contributing factors of this rare complication of the disease.Copyright © 2022, Isfahan University of Medical Sciences(IUMS). All rights reserved.
ABSTRACT
Objective Mycobacterium tuberculosis is an immobile aerobic bacillus that causes tuberculosis (TB) disease. We aimed to evaluate the association between coronavirus disease 2019 (COVID-19), COVID-19-related drugs, TB reactivation, and TB incidence during the pandemic. Methods Eight patients who were diagnosed as having TB in Meram Medical Faculty, Necmettin Erbakan University between March 1, 2020, and December 31, 2021, at the beginning of the pandemic, were enrolled in this study. The presence of COVID-19 infection was confirmed using COVID-19 antibody tests and the patients' COVID-19 history. We evaluated the demographic data, laboratory findings, imaging tests, and pathology results of all patients. Results We checked all our patients with TB using COVID-19 antibodies (immunoglobulin [Ig]G + IgM) or polymerase chain reaction. Seven of the eight patients were female (87.5%). The median age was 16 years. Family screening of all patients was negative, and they had bacillus Calmette-Guerin vaccine scars. Two patients had chronic diseases. One was diagnosed as having primary ciliary dyskinesia in our department (patient no. 8) and the second was under follow-up by the rheumatology department with a diagnosis of juvenile idiopathic rheumatoid arthritis. Conclusion There has been an increase in the incidence of TB in children, especially in adolescents, during the pandemic period. This may be due to the pathogenic structure of the COVID-19 virus with an unknown mechanism. In addition, lifestyle changes and changes in health care policies during the pandemic may have caused this. Further research should be performed on this topic.Copyright © 2023 Authors. All rights reserved.
ABSTRACT
Introduction: Research on Coronavirus Disease-2019 (COVID-19) seroprevalence in children and adolescent population across the globe is quite limited. In India, there is a dearth of data on COVID-19 seropositivity, especially in unvaccinated paediatric population, particularly in the Himalayan region. Aim: To estimate the seroprevalence of COVID-19 in children presenting in a tertiary care health institution. Materials and Methods: A hospital-based cross-sectional serosurvey was conducted on 500 children, from October 2021 to March 2022 in paediatric age group, attending Indira Gandhi Medical College Shimla, Himachal Pradesh, India, for various health related concerns such as fever, cough, loose stools, vomiting and fast breathing using convenience sampling. Socio-demographic profile was recorded and blood sample was drawn for COVID-19 antibody titre estimation. Chi-squared and Fisher's-exact tests for proportions was used for testing statistical significance. Results: A total of 500 children, age ranged from 12 hours to 17 years 7 months were enrolled with maximum children belonging to 01-05 years age group and there was slight male preponderance. Seropositivity in males (27.3%) was significantly higher than females (8.3%). Highest (42.3%) seropositivity was seen in age group of 06 months to 01 year. About 10.8% of cases were positive for Immunoglobulin (Ig) G antibody, 4.4% were positive for IgM antibody, while about 6.6% cases were positive for both antibodies. Conclusion: The seroprevalence status of children and adolescents is quite low in this region, revealing the high susceptibility of children to SARS-CoV-2 in the study region. It further emphasises benefits of serological testing in children for SARS-CoV-2 as well as the need of safe and effective vaccination for the unimmunised, unprotected and vulnerable paediatric age group.
ABSTRACT
Case Report: Prolonged fever in children is a symptom that is seen in many different diseases, infections, malignancies, and autoimmune conditions. This can, at times, make the correct diagnosis challenging. A previously healthy 10-year-old male was transferred to our institution with one week history of fever, fatigue, abdominal pain, and vomiting. Laboratory studies demonstrated pancytopenia, transaminitis, electrolyte abnormalities, elevated pro-inflammatory markers & D-Dimer, and hypoalbuminemia. COVID-19 IgG was reactive. Due to the severity in presentation the patient was transferred to the ICU with a presumptive diagnosis of MIS-C. Hewas started on IVIG as well as a five-day course of high-dose methylprednisolone per protocol. Aspirin was added, but later discontinued, due to worsening thrombocytopenia. CT imaging with contrast showed small bilateral pleural effusions & periportal edema, mild splenomegaly, and echocardiogram showed diffuse dilation of the left main and left anterior descending arteries. Given the laboratory findings the differential diagnosis was expanded, Ehrlichia caffeensis serology was sent and empiric Doxycycline started. EBV Nuclear Antigen IgG antibody and EBV Viral Capsid Antigen IgM Antibody resulted as positive suggesting recent or reactivated infection. Respiratory viral PCR with COVID-19, Cytomegalovirus and Parvovirus PCR were negative. Despite initial treatment, the patient continued to have persistent fever, severe pancytopenia, and high ferritin up to 24 426 ng/mL, raising suspicion for Haemophagocytic Lymphohistiocytosis (HLH). Soluble interleukin-2 level was elevated & his presentation was then considered to be more consistent with HLH given that he met 6/8 criteria. Screening for primary HLH including CD107a, perforin and granzyme B, SAP, and XIAP resulted in the latter three being normal but CD107a was abnormal. Next generation sequencing for primary criteria was negative. E. Chaffeensis resulted positive: IgM 1:80, IgG 1:256. MIS-C and HLH have overlapping features but differ in some clinical manifestations. Timely recognition and management is paramount as the management differs. This case illustrates the importance of performing a broad search for potential causes, allowing for appropriate and timely treatment. COVID-19 serology alone should not be the basis for diagnosis of MIS-C in a patient with fever and inflammation. This is important as SARS-CoV2 becomes endemic. Infections such as EBV and Ehrlichiosis should be on the differential particularly in endemic areas and during seasons of higher prevalence for the latter, as these have been well documented to cause HLH. Copyright © 2023 Southern Society for Clinical Investigation.