First isolation and characterization of the prototype strain of the SARSCoV-2 virus at the beginning of the COVID-19 pandemic in Peru

Introduction: Currently, isolated from SARS-CoV-2 virus exceed 600 million cases in the world. Objective(s): Isolation and characterization of the SARS-CoV-2 virus causing COVID-19 at the beginning of the pandemic in Peru. Method(s): Twenty nasal and pharyngeal swab samples were isolated from SARS-CoV-2 using two cell lines, Vero ATCC CCL-81 and Vero E-6;virus identification was performed by RT-PCR and the onset of cytopathic effect (CPE) was evaluated by indirect immunofluorescence and subsequent identification by genomic sequencing. One of the most widely circulating isolates were selected and named the prototype strain (PE/B.1.1/28549/2020). Then 10 successive passages were performed on Vero ATCC CCL-81 cells to assess mutation dynamics. Result(s): Results detected 11 virus isolates by cytopathic effect, and subsequently confirmed by RT-PCR and indirect immunofluorescence. Of these, six were sequenced and identified as the lineages B.1, B.1.1, B.1.1.1, and B.1.205 according to the Pango lineage nomenclature. The prototype strain corresponded to lineage B.1.1. The analysis of the strains from the successive passages showed mutations mainly at in the spike (S) protein of the virus without variation in the identity of the lineage. Conclusion(s): Four lineages were isolated in the Vero ATCC CCL-81 cell line. Subcultures in the same cell line showed mutations in the spike protein indicating greater adaptability to the host cell and variation in pathogenicity in vitro, a behavior that allows it to have more survival success.Copyright © 2023 Anales de la Facultad de Medicina. All rights reserved.

A Laboratory Validation of Self-Collected Nasal Swab and Rhinoswab for the Detection of Sars-Cov-2

Intro: In Australia, the main methods to diagnose COVID-19 are through rapid antigen tests (RATs) and through nucleic acid amplification testing (NAAT, including polymerase chain reaction) on healthcare worker (HCW)-collected combined nose/throat swabs. With self-collection widely used by the public for RATs, the aim of this study was to evaluate the performance of self-collected samples using commercial NAAT for SARS-CoV-2. Method(s): Consenting participants aged 14 years and older were provided with a self-collection pack containing instructions and either a FLOQSwab (Copan) or a Rhinoswab (Rhinomed). Participants collected their own nasal sample unsupervised prior to having a HCW-collected combined nose and throat swab taken for standard of care NAAT. Paired self-collected and HCW samples were tested on the cobas SARS-CoV-2 assay (Roche) and the Aptima SARS-CoV-2 assay (Hologic). Finding(s): We demonstrated comparable sensitivity, specificity, and agreement between self-collected nasal and Rhinoswab samples, compared to HCW- collected samples tested using the cobas SARS-CoV-2 and Aptima SARS-CoV-2 assays. In our study the clinical performance of self-collected specimens was comparable to HCW-collected samples, with both self-collect nasal and Rhinoswab samples resulting in 90-95% sensitivity, and in most cases >95% specificity. Discussion(s): Without the availability of samples for NAAT the ability to perform genomic testing is limited, reducing surveillance and public health investigations. We showed that genomic sequencing from self-collected samples can correctly identify the virus lineage and that the main determination of successful genomic testing is a high viral load rather than collection method. Conclusion(s): These data support self-collection as an accessible method for community testing for COVID-19 and introduces a novel collection device, the Rhinoswab as an alternative to the standard nasal swab. The testing method of self-collection can be expanded from the widely used RATs to NAAT and genomic testing which may inform the management and public health response to the COVID-19 pandemic.Copyright © 2023

Severe Acute Hepatitis: An Emerging Grave Illness in Children

Acute hepatitis of unknown origin in children has been recently described in the literature, and a case definition has also been proposed for this condition. The exact etiology is unknown and exclusion of infectious, metabolic, autoimmune and toxin mediated injuries is essential. Management for this condition is supportive, but some may require liver transplantation. Infection prevention and control practices are important as the etiology remains unidentified.Copyright © 2023, Indian Academy of Pediatrics.

CLINICAL CASE OF SEVERE COVID-19 IN A CHILD WITH MORBID OBESITY.

The pandemic of coronavirus infection is characterized by a low percentage of complications and severe forms in sick children compared to the adult population. However, there have been described cases of severe clinical course of COVID-19 in children with comorbidities among which is obesity. The aim of this study was to analyze the severe course of a new coronavirus infection paralleled with morbid obesity in a pediatric patient. Materials and methods. All accompanying patient medical documentation was examined. Results and discussion. From the anamnesis of life it is known that the patient was long time complained of intensively increased body weight, on which she repeatedly underwent examinations. In 2018, hypothalamic pubertal syndrome was diagnosed for the first time, for which the patient received hypoglycemic and antihypertensive drugs, hepatoprotectors on an ongoing basis. In the epidemiological anamnesis, the intrafamilial COVID-19 contact with mother was established. The main disease began acutely with a rise in body temperature up to 39-39.5degreeC, cough and weakness. During the first week of illness, the patient did not seek medical help and receive self-treatment, but the positive effect was not achieved. Saturation measurement showed low oxygen level (SpO2 71%). In this regard, the patient underwent chest computed tomography, which revealed a bilateral interstitial polysegmental lung lesion with signs of consolidation. After emergency hospitalization, the patient was prescribed empiric antibiotic therapy, anti-inflammatory and antithrombotic treatment, as well as respiratory support. A positive PCR result of a throat and nasal swab for SARS-CoV-2 was obtained in the hospital. Due to a poor response to therapy, the patient was transferred to a respiratory hospital. At the time of hospitalization, the condition was considered severe due to severe respiratory failure and premorbidity. The range of treatments included oxygenotherapy, antibacterial and anticoagulation therapy, as well as surfactant and the nucleoside analogue Remdesivir. During treatment, the clinical picture gained a positive trend, and after 6 days of hospitalization the patient no longer needed respiratory support. According to the results of repeated computed tomography, bilateral interstitial polysegmental pneumonia was diagnosed with damage to the lung tissue up to 95%. The patient remained stable and showed no signs of respiratory failure during the following days of hospitalization. On the 20th day of ilness, the patient was discharged from hospital with full clinical recovery. Conclusion. This clinical case demonstrates the role of premorbid background in aggravating the clinical picture of a new coronavirus infection in a child. Careful study of anamnestic characteristics is necessary in patients of any age, even with an uncomplicated disease course.Copyright © 2023 Saint Petersburg Pasteur Institute. All rights reserved.

Nonhuman Primate Model of Long Covid: Immune Insights of Glycometabolic Dysfunctions

Background: A major consequence of COVID-19 is long-term metabolic complications (metabolic PASC or Long COVID) following acute disease resolution leading to hyperglycemia, increased risk of diabetes or defects in glucose metabolism. However, the mechanisms underlying the links between COVID-19 and glycometabolic disruptions remain unclear. Method(s): 15 African green monkeys (AGM;Chlorocebus aethiops) were infected with SARS-CoV-2 (Wuhan stain) and divided into two groups: unvaccinated (n=10) and vaccinated (BNT162b2 (Pfizer) 4-days post infection;n=5). Subgenomic SARS-CoV-2 mRNA (sgRNA) reflecting active replication was quantified in nasal and pharyngeal swabs, and blood chemistry analysis was performed longitudinally up to 18 weeks post-infection. We quantified liver glycogen at necropsy using Periodic acid-Schiff staining. Finally, we longitudinally analyzed 96 plasma proteins using a proximity extension assay (Olink). STRING was used to identify enriched protein networks. Comparisons between the two groups over time were performed using PERMANOVA. Result(s): All animals had detectable sgRNA ( >3.64x106) at day 3, and only two were undetectable at week 5. Post-infection BNT162b2 vaccination partially inhibited the SARS-CoV-2 mediated disruption of glucose levels (P=0.001, Fig. 1A). Liver glycogen levels following necropsy correlated positively with blood glucose levels at week 12 (r=0.74, P =0.003). Histopathological analysis revealed no marked evidence of long-term inflammation or fibrosis of pancreatic islets. Using the plasma proteomic data, we identified a signature of 15 SARS-CoV-2-modulated plasma proteins coinciding with early onset hyperglycemia during acute infection (P=0.001, Fig. 1B). These proteins are enriched for biological processes linked to chemotaxis (FDR=1.38E-06), and viral protein interaction with cytokines (FDR=1.01E-12) (Fig. 1C). Of these, CCL25 and glial cell derived neurotrophic factor (GDNF) remained persistently elevated post-acute infection and correlated with blood glucose levels (r=0.57, P=0.0003;and r=0.64, P<0.0001, respectively, Fig. 1D). Conclusion(s): Our AGM model validates phenotypes of metabolic PASC and offers an opportunity to mechanistically study the manifestations of PASC. Our preliminary data suggest that vaccine-preventable early insults by metabolicregulating immune factors may contribute to long-term dysregulated liver and systemic glucose homeostasis during PASC. These immune factors warrant further investigation for their mechanistic links to PASC. (Figure Presented).

PROTECTION AGAINST HETEROLOGOUS CHALLENGE 1 YEAR AFTER INFANT SARS-CoV-2 IMMUNIZATION

Background: Although mRNA SARS-CoV-2 vaccines have received emergencyuse- authorization for infants age 6 months and older, vaccine uptake is slow, stressing that questions of safety and durability of vaccine efficacy remain prominent. Method(s): Infant rhesus macaques (RMs) (n=8/group) at 2 months of age, comparable to human toddler age, were immunized intramuscularly at weeks 0 and 4 with 30mug stabilized prefusion SARS-CoV-2 S-2P spike (S) protein (Washington strain) encoded by mRNA encapsulated in lipid nanoparticles (mRNA-LNP) or 15mug S protein mixed with 3M-052 in stable emulsion (Protein). At 1 year, vaccinated and age-matched unvaccinated RM (n=8) were challenged intranasally (106pfu) and intratracheally (2x106pfu) with B.1.617.2. Lung radiographs and pathology were blindly assessed, viral N gene RNA (vRNA) copies were measured by qPCR in pharyngeal swabs and lung, and neutralizing antibody and peripheral blood T cell responses were measured. Result(s): At 1 year, D614G-specific neutralizing antibody (nAb) titers were still detectable in the Protein (ID50=755;range: 359-1,949) and mRNA-LNP groups (ID50=73;range: 41-240). Both vaccines also induced cross-neutralizing antibodies to B.1.617.2. Peripheral blood CD4+ T cell responses to the ancestral spike protein at week 52 did not differ between the groups. However, median CD8+ T cell responses were higher (p=0.002, Mann Whitney) in the mRNA-LNP group (2.8%;range: 0.9%-7.1%) compared to the Protein group (0.8%;range: 0.1%-1.6%). Control RMs had significantly higher median vRNA copies/ml (1.4+/-2.7x108) in day 4 pharyngeal swabs compared to Protein (3.8+/-6.8x103) or mRNA-LNP (4.4+/-9.7x105) vaccinated RMs. Severe lung pathology was observed in 7 of 8 controls compared to 1 of 8 or 0 of 8 RMs in the mRNA-LNP or Protein group respectively. Protection against lung inflammation was associated with nAb titers (r=-0.592, p=0.003) (Figure 1). Conclusion(s): These results demonstrate that despite lower vaccine doses compared to adults, both protein and mRNA vaccines were safe, induced durable immune responses and provided comparable protective efficacy against infection with a heterologous SARS-CoV-2 variant in infants, implying that early life vaccination of human infants may lead to durable immunity. Neutralizing ID50 antibody titers are a correlate of protection in infant RMs challenged with SARS-CoV-2.

Evaluation of the Effect of Favipiravir Use on Inr, Pt, Aptt Tests in Covid-19 Patients

Objective: Studies have shown that high mortality rates associated with abnormal coagulation response, bleeding and coagulation disorders in COVID-19 patients. In our study, it was aimed to investigate the effect of the use of favipiravir on coagulation tests such as INR, PTT and Aptt. Materials-Methods: 50 patients who had a positive RT-PCR in nasal and throat swabs result and were diagnosed with COVID-19 using favipiravir and 50 non-users favipiravir COVID-19 patients were included. INR, PT, Aptt data were evaluated for all patients. Result(s): Results of patients using favipiravir;INR 1.3+/-0.2, PT(s) 16.4+/-3.4, Aptt(s) 40.7+/-10.1, while the results of patients who did not use favipiravir were INR 1,2+/-0.2, PT(s) 14.6+/-2.5, Aptt(s) was found 38.4+/-7.8. While PT and INR were found to be significantly higher in patients using favipiravir (p<0.05), the elevation in Aptt values was not significant. Conclusion(s): As a result, it was observed that favipiravir prolongs the clotting time. In the light of these RESULTS, it is recommended to consider this in anticoagulant therapy used for treatment.

Efficacy of home respiratory culture kits in people with cystic fibrosis

Background: Respiratory cultures are an important part of clinical care for people with cystic fibrosis (CF). Telemedicine visits during the COVID-19 pandemic have not allowed for routine collection. To address this, the University of Michigan Adult Cystic Fibrosis Program mailed home culture kits to patients. We hypothesized that results from home sputum samples would be consistent with prior cultures obtained in sputum collected in clinic but that self-collected throat swabs would provide false-negative results. We also sought to determine percentage return rate. Method(s): Adults with CF were sent culture kits containing a specimen cup and a throat swab. Patients had the choice to submit either sample for processing. Medical personnel provided written instructions with the culture kits and, on occasion, instructed patients on proper collection techniques via phone. Samples were then refrigerated for up to 24 hours before a delivery service returned the specimen to a University of Michigan laboratory for analysis. Data collected from December 2020 to December 2021 (N = 77) included percentage return rate, result, source, and presence of microorganisms. Pairwise culture data of samples collected in clinic versus home-collected samples within 1 yearwere included in the analysis. Descriptive statistics and Cohen kappa correlation coefficients were computed for all culture data and subgroups (Table 1A-E). Result(s): Of 77 culture kits returned, 46 had corresponding clinic samples collected using the same method, and the remaining 21 were collected using different methods (throat swab vs sputum sample). Overall, approximately 200 kits were mailed to patients, with a return rate of 38.5%. A similar percentage of positive culture results was obtained with same method of collection: sputum and throat samples (Table 1C, D, E), although the discordance rate between cultures collected in clinic and at home ranged from approximately 10% to 30%. Correlation between clinic and home culture data was generally good throughout, except for clinic Table 1 ( 115): Analysis of respiratory culture results for (A) all cultures, (B) different collection, and (C, D, E) same collection method. *p < 0.05. Cohen kappa correlation coefficient between groups: poor agreement <0.20;fair agreement = 0.21-0.40;moderate agreement = 0.41-0.60;good agreement = 0.61-0.80;very good agreement = 0.81-1.00. PsA = Pseudomonas aeruginosa;Staph = Staphylococcus aureus.(Table Presented)versus home throat swabs, probably because of a lowevent rate in the small sample size. Conclusion(s): The data suggest that, overall, clinic and home culture kits provide similar positive results, although discordance in specific culture results was common. This may be due to natural fluctuations from culture to culture in people with CF. A limitation of this study is that the cultures being compared in our study were not completed on the same day. Nevertheless, our data also indicate that collection technique may influence results for certain microorganisms. How these differences might influence antibiotic selection and treatment outcomes in the era of telemedicine requires more investigation. The return rate was found to be relatively low, demonstrating the need for interventions to improve patient outreach and compliance.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Pulmonary function in non-hospitalized adults and children after mild Covid-19

Objective Asesmentof lung function impairment after mild SARS-CoV-2 infection in non-hospitalized children and adults. Additionally focusing on previous and persistent symptoms due to Covid-19 as well as current respiratory tract infection status. Methods Patients aged 6-60 years were recruited by telephone after laboratory-confirmed positive PCR result for SARS-CoV-2. Excluding criteria were hospitalization during Covid-19, pre-existing lung diseases (bronchial asthma, COPD) and smoking within the last five years. Pulmonary function testing was performed 4-12 weeks after infection, including Multiple-breath washout (LCI), spirometry (FEV?, FVC, Tiffeneau-Index) and diffusion capacity testing (DLCO, TLC;Hb corrected). All patients answered a questionnaire regarding previous and persistent symptoms. To gather information about the current infection status, a pharyngeal swab was taken to detect common respiratory bacterial and viral pathogens using a multiplex PCR approach. Patients with abnormalities in pulmonary function were invited to a follow up testing three months later. Results 110 patients, 90 adults and 20 children, were included. 44 adults and 17 children had at least one abnormal value in pulmonary function tests after an average of 7.7 weeks (range 4.3-11.3) to confirmed SARS-Cov-2 infection. Among these 44 adults, 33 reported pulmonary symptoms during Covid-19 and 19 persistent respiratory symptoms. No abnormalities in DLCO were found in adults. At the second pulmonary function testing 12.5 weeks (range 11.0-16.7) on average after the first appointment, improvement was shown in 61,7% ( n=29 of 47) with previous abnormal LCI, in 69,2% (n=9 of 13) with prior abnormal FVC and in 4 of 5 children with abnormal DLCO. No large correlation was detected between impaired pulmonary function and multiplex PCR results. Conclusion Mild lung function impairment was shown at the first appointment, particularly in LCI, but not equally measured in the entirety of lung function tests. Pulmonary function results were not affected by current infection status and partially mismatching with stated persisting symptoms. Within 3 months, most initially abnormal values improved, and self- perceived health status increased. Long term pulmonary function impairment was rarely detected after mild, non-hospitalized Covid-19 course. .

Bacterial and viral upper and lower airways infection in people with cystic fibrosis in stable condition

Background: Bacterial and viral airway infections are adverse factors for prognosis in people with cystic fibrosis (CF). The role of viral infections is unclear. Proper microbiological follow-up is essential, and the correlation between upper (UAW) and lower airway (LAW) microbiology may be important for lung disease management. We aim to evaluate airway microbiology in patients in stable clinical condition. Method(s): Between September 2021 and March 2022 in the Florence CF center, 144 nasal lavage-throat swab paired samples were collected from 72 clinically stable people with CF not chronically colonized by Pseudomonas aeruginosa. The study enrolled 59 children (median age 9, range 2-16) and 13 adults (median age 28, range 18-59). LAW specimens (72)were sampled as throat swab and UAWspecimens (72)were randomly collected by nasal lavage with two methods-Mainz (44) or Ryno-set (28). We performed conventional microbiological analyses on all samples. To screen for respiratory viruses, multiplex polymerase chain reaction (BioFire FilmArray RP 2.1 Plus) was performed. Respiratory symptoms and forced expiratory volume in 1 second (FEV1) valueswere evaluated for all patients. Result(s): Twenty-one (29%) patients tested positive for at least one virus in UAW and LAW specimens. The most frequently identified viruses were human rhinovirus or enterovirus (22%) and respiratory syncytial virus (6%). Two (3%) patients tested positive for SARS-CoV-2. Concordance between sampling methods for viral detection in UAW and LAW specimens was observed in 59 paired samples (82%), including 40 patients with no viral infections and 19 virus positive for both samples. Discordance was described in 13 subjects;10 of 13 did not show viral infection in nasal lavage. Twenty-one percent of positive nasal lavage was performed using Ryno-set and 36% using the Mainz approach. The prevalent bacteriumwas Staphylococcu aureus in UAW (53%) and LAW (69%) cultures, followed by Enterobacteriaceae (UAW 8%, LAW 6%), methicillin-resistant S. aureus (UAW 7%, LAW 6%), P. aeruginosa (UAW 4%, LAW 6%), and other clinically relevant gram-negative bacteria such as Achromobacter xylosoxidans, Stenotrophomonas maltophilia, and Ochrobactrum anthropi (UAW 7%, LAW 13%). Nasal lavage performed with Ryno-set tested positive in 72% of patients, and 64% of Mainz lavage were positive. Mainz nasal lavage showed different S. aureus and P. aeruginosa isolations (48% and 5%, respectively) than the samples collected with Ryno-set technique (61% and 4%, respectively). Concordance between sampling methods for bacterial detection in UAW and LAW was the same with the two methods (53%). Bacterial and viral infections were found in UAWand LAWof stable people with CF, but no clinical correlation was observed. Conclusion(s): The two methods of UAW lavage had slight differences in performance. Virus infection appeared to be less prevalent than bacterial infection in UAWand LAW.We did not find correlations between presence of viruses and respiratory symptoms, but further investigation is needed for a better understanding of the clinical role of viral infection in people with CF.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

A Case of Covid-19 with Isolated Thrombocytopenia

COVID-19 can affect many systems out of the respiratory system. In this article, a COVID-19 case with fever and isolated severe thrombocytopenia without pulmonary involvement is presented. A 25-year-old male patient admitted to our hospital with complaints of fever and headache was hospitalized for close follow-up because of severe thrombocytopenia in peripheral blood and a positive result of SARS-CoV-2 PCR in the combined nasal and throat swab sample. Daily hemogram follow-up was done. The patient, whose fever decreased under COVID-19 treatment and whose thrombocyte count tended to increase, was discharged on the 5th day of treatment. Other tests performed in terms of thrombocytopenia etiology were negative. In particular, it is not enough to suspect COVID-19 in patients with only respiratory system findings and fever, but rarer presentations should be kept in mind.

[A cross-sectional study of enterovirus nucleic acid test with throat swabs for term late neonates during coronavirus disease 2019]. / æ–°åž‹å† çŠ¶ç— æ¯’æ„ŸæŸ“æœŸé—´è¶³æœˆçš„æ™šæœŸæ–°ç”Ÿå„¿å’½æ‹­å­è‚ é“ç— æ¯’æ ¸é ¸æ£€æµ‹æ¨ªæ–­é¢ç ”ç©¶.

OBJECTIVES: To investigate the positive rate of enterovirus (EV) nucleic acid in throat swabs of term late neonates hospitalized during the coronavirus disease 2019 (COVID-19) epidemic and the clinical characteristics of the neonates. METHODS: A single-center cross-sectional study was performed on 611 term late infants who were hospitalized in the neonatal center from October 2020 to September 2021. Throat swabs were collected on admission for coxsackie A16 virus/EV71/EV universal nucleic acid testing. According to the results of EV nucleic acid test, the infants were divided into a positive EV nucleic acid group (8 infants) and a negative EV nucleic acid group (603 infants). Clinical features were compared between the two groups. RESULTS: Among the 611 neonates, 8 tested positive for EV nucleic acid, with a positive rate of 13.1‰, among whom 7 were admitted from May to October. There was a significant difference in the proportion of infants contacting family members with respiratory infection symptoms before disease onset between the positive and negative EV nucleic acid groups (75.0% vs 10.9%, P<0.001). There were no significant differences between the two groups in demographic data, clinical symptoms, and laboratory test results (P>0.05). CONCLUSIONS: There is a certain proportion of term late infants testing positive for EV nucleic acid in throat swabs during the COVID-19 epidemic, but the proportion is low. The clinical manifestations and laboratory test results of these infants are non-specific. Transmission among family members might be an important cause of neonatal EV infection.

Covid-19: A Review Report

COVID-19 may be a very contagion caused by a recently discovered called corona virus. Novel corona virus was found in December 2019 in Wuhan, China. World Health Organization has declared the COVID-19 as pandemic disease and outbreak as a health emergency globally. Novel Corona Virus is additionally referred to as severe acute respiratory syndrome corona virus- 2. The foremost infected people with corona virus show commonly respiratory illness like- fever, cold, sneezing, cough, pneumonia, upper respiratory illness, GIT disease like nausea, vomiting as symptoms. Recently published evidences stated that light Fever and cough within the 80 % patients, shortness of breath in 30-35% patients and 10-15% patients show Muscle ache and other ache. Novel Corona virus enters through the membrane ACE-2 receptor within the human cell. Corona virus is spherical or pleomorphic, single stranded, enveloped ribose macromolecule and included club shaped glycoprotein. SARS, Respiratory (breathing) infections are often transmission via droplets of various diameter like >5-10 micrometer. Molecular test administered with respiratory samples, like throat swab, sputum and broncholveolar lavage and in some severe cases it reported in stool and blood also. After the WHO and other diagnostic guideline said that the PCR and RT-PCR test reported for corona diagnosis.Copyright © 2022 Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

Epidemiological study of COVID-19 pneumonia in pregnant woman and their neonates, report of thirteen confirmed COVID-19 pregnant women

Background: In new pandemic, the probable effects of COVID-19 pneumonia on pregnant woman and their infant is one of new critical challenge for health care. Here we presented clinical symptoms, laboratory findings and outcome of COVID-19 pneumonia in pregnant woman. Method(s): In a case series study, from 15 Feb to 15 June 2020, all women with RT-PCR COVID-19 who referred to two hospitals (Taleghani and Qods Hospital) affiliated to Arak University of Medical Sciences were selected. The epidemiological and demographic variables, laboratory test and outcomes obtained from patient's medical records. Result(s): In this case series, we presented thirteen confirmed COVID-19 pregnant women. Their mean age was 34.6 (S.D.: 5.9) years and the mean gestational age was 32.4 (S.D.: 7.3) weeks. Most of patient didn't show any maternal complication and intrauterine vertical transmission. The large number of pregnant women had normal HRCT and also in terms of laboratory most of the patients had normal laboratory tests. Amniotic fluids, cord blood, the throat swab of neonate in our pregnant woman with delivery were tested for COVID-19 and all of them were negative. Conclusion(s): The COVID-19 mothers and their infant didn't have higher risk for morbidity and mortality and this virus didn't associate with intrauterine vertical transmission.Copyright © 2020 Ubiquity Press. All rights reserved.

Comparison between suspected and confirmed COVID-19 respiratory patients: a pilot study

Introduction: The spread of COVID-19 imposed a re-organization of healthcare services. The increased circulation of the virus among the population and the need for a quick diagnosis suggest the identification of new decisionmaking actions. Aim(s): We aimed to determine whether clinical, laboratory and imaging characteristics can reliably differentiate suspected COVID from positives tested with nasal-pharyngeal(N-P)swab. Method(s): This is a retrospective, cross-sectional study on data collected(March-May 2020)at the Lung Unit, University of Pavia(confirmed cases=50)and at the Emergency Unit, University of Palermo(suspected cases=103). COVID-19 was confirmed by positive N-P swab. Suspected were tested negative. We recorded clinical, laboratory and radiological variables and compared them by Chi-squared or t-test. Logistic regression estimated which variables increased the risk of COVID-19 in both groups. A prediction model and derived ROC-AUCcurve, assessed the accuracy. P<0.05 was considered significant. Result(s): High ReactiveC-Protein, suggestive CTimages, dyspnea and respiratory failure increased the risk of COVID-19, whereas pleural effusion decreased the risk(table). ROC confirmed the discriminative role of these variables between suspected and confirmed COVID-19(AUC 0.91). Conclusion(s): Clinical, laboratory and imaging features predict the diagnosis of COVID-19, independently of the N-P swab result. We suggest the inclusion of these elements in the decision-making to facilitate the management of suspected COVID.

Hydroxychloroquine Induced DRESS (Drug Rash with Eosinophilia and Systemic Symptoms Syndrome) Mimicking SARS-COV-2 Illness: A Case Report with Review

Background: In the current pandemic of COVID-19, hydroxychloroquine (HCQ) is recom-mended as an experimental drug for prophylaxis and treatment of the illness. Although it is a safe drug, it can rarely produce a severe drug reaction 'drug rash with eosinophilia and systemic symptoms syndrome (DRESS)', and to differentiate it from systemic viral infections is challenging. Case Presentation: A 45-year old male nurse working in a COVID-19 ward consumed HCQ weekly for two weeks for prevention of SARS-COV-2 illness. He presented with fever, pruritic maculopapular palmar rash, cervical lymphadenopathy for 12 hours and was quarantined as a suspected COVID-19 case. His laboratory tests revealed lymphopenia, eosinophilia, atypical lymphocytes, raised liver en-zymes along with IgM negative, IgG positive rapid antibody test of SARS-COV-2. However, his throat swabs for SARS-COV-2 by real-time PCR were negative on day 1 and 7. He was finally diagnosed as definite DRESS based on the RegiSCAR score of six. He responded to levocetirizine 5 mg OD and oral prednisolone 60 mg daily tapered over 7 days. Conclusion(s): DRESS due to HCQ is 'probable', 'of moderate severity', and 'not preventable' adverse effect mimicking SARS-COV-2 illness.Copyright © 2021 Bentham Science Publishers.

A Clinical and Demographic Profile of Tonsillitis Patients during the COVID-19 Pandemic

Background: Tonsillitis is a common public health problem seen by otorhinolaryngology surgeons. It has socio-occupational and economic impact. Most of the tonsillitis is treated by antibiotic but some can lead to life threatening complication if not treated on time and not diagnosed the impending complication. Aim and Objectives: The objective of this work was to study the epidemiological and complications profile of acute and chronic tonsillitis and their distribution, followed by final outcome of the treatment adopted in the ANIIMS Portblair, ENT Department. Material(s) and Method(s): This is a retrospective study over a 12-month period from September 2020 to Aug 2021 including 225 patients who presented with tonsillitis and/or their complications were analysed. Their demography, clinical findings, types of tonsillitis, month wise distribution of types of disease and final outcome after medical treatment was analyzed. Result(s): Two hundred and twenty five (225) patients were studied. The mean +/- SD of cases studied was 23.32 +/- 12.98 years with minimum - maximum age range was 02 - 60 years. In this study there were 92/225 (40.9%) males and 133/225 (59.1%) females with a male to female ratio of 1:1.44. 76.88% of the patients showed a good outcome, 14.22% showed a moderate outcome, 07.55% showed an average outcome and 00.88% showed poor outcome. 19/ 225 (08.44%) of the patients who showed poor and average response were advised tonsillectomy after the COVID-19 pandemic in this study. Conclusion(s): Chronic Tonsillitis was a common throat disorder observed during COVID-19 pandemic. Males were more commonly affected. The increased attendance of patient's throat complaints was high due to awareness and similarity of symptoms of tonsillitis and COVID-19 disease. Low socio economic groups were more affected. The common types of tonsillitis were parenchymatous type, follicular type. Complications due to acute infection frequently observed were peritonsillar abscess, neck abscess. Medical treatment with Amoxycillin and clavulinic acid combination was highly responsive with 76.88% responding well.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

The scintigraphic diagnosis of subacute thyroiditis in hospitalized patients with acute COVID-19 infection

Introduction: Extrapulmonary manifestations of COVID-19 must not be neglected during the pandemic. Subacute thyroiditis is one of the possible complications people encounter during post-COVID-19 days. Thyroid scintigraphy and radioiodine uptake test help discriminate hyperthyroidism from destructive thyrotoxicosis. Finding a more precise way to diagnose subacute thyroiditis can help in the early detection and treatment of thyroid-related disorders. Method(s): In this cross-sectional study, we evaluated 69 cases of COVID-19. Patients were divided into moderate and severe groups based on their clinical conditions. A thyroid scintigraphy scan was performed on the discharge day. Imaging was done 15-20 minutes after intravenous administration of 3-5 mCi of [99mTc]TcO4-. Scan findings were compared between moderate and severe groups and other participants' demographic and clinical features. Result(s): In 69 patients, according to thyroid scintigraphy, 25 (36%) cases were reported as thyroiditis, and the rest were normal. There was no significant difference between the normal and subacute thyroiditis groups based on age, gender, past medical history, the severity of COVID-19, laboratory values and clinical signs and symptoms. Patients with subacute thyroiditis experienced palpitation and sore throat significantly higher than the normal group (P=0.002 and P=0.009, respectively). Conclusion(s): We conclude that patients admitted due to acute COVID-19 infection experiencing palpitation and sore throat can develop subacute thyroiditis more than others. Whereas the severity of the disease and laboratory testing were not diagnostic in subacute thyroiditis, thyroid scintigraphy may help in early detection.Copyright © 2023 The Authors.

Multicenter post-marketing clinical evaluation on the clinical performance of the five domestic fast nucleic acid detection reagents for 2019-nCoV.

Objective This multicenter clinical evaluation analyzed the clinical performance of five fast nucleic acid detection systems for 2019-nCoV. Methods Clinical performance of the five fast nucleic acid detection reagents approved in China was evaluated in the present study. Fifty-seven throat swabs samples from COVID-19 patients and fifteen throat swabs samples from healthy people were collected from the First Affiliated Hospital of Zhejiang University school of Medicine, Tongji Hospital of Tongji Medical College of HUST, and National Institute of Viral Disease Control and Prevention of CDC to evaluate the positive coincidence rate, negative coincidence rate, total coincidence rate, the detection time and retest rate as well as the relation between positive intensity and positive coincidence rate of the five fast nucleic acid detection systems in November 2020. Results The positive coincidence rates of the five kits were 92.59% (50/54), 83.64% (46/55), 98.25% (56/57), 94.44% (51/54) and 98.18% (54/55);and the negative coincidence rates were 93.33% (14/15), 93.33% (14/15), 86.67% (13/15), 100% (14/14) and 93.33% (14/15);and the total coincidence rates were 92.75% (64/69), 85.71% (60/70), 95.83% (69/72), 94.20% (65/69) and 97.14% (68/70), respectively. The positive coincidence rate of the five kits reached 100% for the strong-positive (90/90) and medium-positive samples (84/84), but only 82.18% (83/101) for weak-positive samples (cycle threshold value>33), and the retest rate of two kits were 15.28% (11/72) and 12.50% (9/72), which were both higher than 10%. Total time from sample extraction to amplification was between 32.33-65.33 minutes for these five kits. Conclusion The five fast nucleic acid detection reagents have good performance and can be used as a supplement to routine nucleic acid detection reagents.Copyright © 2022 Chinese Journal of Laboratory Medicine. All rights reserved.