Optimization of common hand cleansers for protection from viral spread and occupational hand dermatoses

Irritant contact dermatitis (ICD) affects over 20% of health care workers, who manage their condition by substituting soap with an emollient cleanser. It is not clear whether emollient cleansers have the same level of virus eliminating activity as soap. Therefore, we evaluated a range of emollient cleansers for virus eliminating activity against enveloped (coronavirus and herpes simplex virus) and nonenveloped viruses (adenovirus (Ad)). In accordance with European standards a range of cleansers were combined with viruses under different (‘clean’ and ‘dirty’ hand hygiene) conditions. Virus viability and architecture were determined by plaque /TCDI50 assays and transmission electron microscopy. Traditional soaps (natural fatty acid), synthetic soaps and emollient cleansers (e.g., ceramide-containing cleansers) exhibited significant antiviral activity in enveloped viruses. However, the antiviral activity of traditional soaps reduced drastically when combined with hard water. Moreover, nonenveloped viruses were less susceptible to both synthetic soaps and emollients cleansers. Interestingly, traditional soaps inhibited the viability of Ad at high concentrations, but only in soft water. Most emollient cleansers were effective at eliminating enveloped viruses, suggesting that they are an acceptable substitute for soap to control the spread of viruses, like SARS-CoV-2, and protect against ICD. Nonenveloped viruses showed resistance to most of the hand hygiene products tested, except for traditional soap. This suggests that hand washing alone may not be sufficient to control the spread of nonenveloped viruses. Taken together this suggests that different virus strains respond differently to soaps and cleansers, and that this should be considered in the guidance for hand hygiene.

Significant different Perceptions of the Viral Dynamics and the Immune System to Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCOV- 2) Exposure

Aim: The knowledge of viral characteristics in addition immune reply to severe respiratory disorder (Sars Syndrome Coronavirus 2 (SARS-CoV-2) contamination still has significant gaps. Methods: In a retrospective longitudinal cohort analysis of 140 cases having PCR-established SARS-CoV-2 disease, researchers analyzed those parameters and demonstrated their correlation with symptom manifestations (mean age, 44 years;54 percent male;48 percent through comorbidities). Breathing models (n = 76) remained obtained for viral culture, serum specimens (n = 32) for IgM/IgG levels, and plasma samples (n = 82) for inflammatory cytokines and chemokines. The illness burden remained connected to the findings of viral culture, serologic tests, also immunological markers. Results: Fifty-eight (58%) cases established viral pneumonia, including 22 (18%) requiring supplementary oxygen and 14 (11%) requiring invasive mechanical ventilation. Twenty of the 77 individuals were positive for viral culture from respiratory samples (24 percent). When the PCR cycle threshold (Ct) value remained more than 31 or greater than 15 days following indication onset, no virus was recovered. Seroconversion happened at a median (IQR) of 13.6 (10-20) days for IgM and 16.1 (14-22) days for IgG;56/63 patients (88.2 percent) seroconverted on day 15 or later. Health hazard appeared linked to quicker seroconversion as well as greater peak IgM and IgG levels. Conclusion: Researchers discovered that viral viability significantly related having such a lower PCR Ct charge in the initial stages of disease. The seriousness of the illness was linked to a greater antibody level. Overcharged pro-inflammatory immune markers provide marks for host-directed immunotherapy, that would have been investigated in randomized precise studies.

SARS-CoV-2 Viral Viability Culture and Sequencing from Immunocompromised Patients with Persistently Positive SARS-CoV-2 PCR Results

Background. Immunocompromised (IC) patients (pts) can have prolonged SARS-CoV-2 PCR positivity, even after resolution of COVID-19 symptoms. This study aimed to determine if viable virus could be detected in samples collected > 21 days after an initial positive (pos) SARS-CoV-2 PCR in IC pts. Methods. We obtained 20 remnant SARS-CoV-2 PCR pos nasopharyngeal swabs from IC pts (bone marrow or solid organ transplant, high dose steroids, immunosuppressive medications) with a pos repeat PCR within the previous 30 days. The repeat specimens were cultured on Vero-hACE2-TMPRSS2 cells and incubated for 96 hours to assess viral viability. Viable RNA and infectious virus in the cultured cells were measured by qPCR and infectious plaque assays. RNA sequencing was performed on a HiSeq platform (Illumina). Samples also underwent SARS-CoV-2 antigen (Ag) testing (BD Veritor). Clinical data were extracted from the electronic health record by chart review. Results. Pt characteristics are in Table 1. Viral cultures from the repeat specimen were negative (neg) for 18 pts and pos for 2 (Table 2). Pt 1 is a 60M treated with obinatuzumab 19 days prior to his first pos PCR test, with repeat specimen collected 21 days later (cycle threshold (Ct) not available). Pt 1 had a low viral titer (27 PFU/mL) & a D614G mutation on sequencing. Pt 2 is a 75M treated with rituximab 10 days prior to his first pos PCR test, with repeat specimen collected 23 days later (Ct 27.56/27.74). Pt 2 had a high viral titer (2e6 PFU/mL) and D614G, S98F, and S813I mutations. Demographics of Study Population (N=20) Characteristics of patients with a positive SARS-CoV-2 viral culture Conclusion. 90% of specimens collected > 21 days after an initial pos SARS-CoV-2 PCR did not have viable virus detected on their repeat specimen. The 2 pts with pos viral cultures had active hematologic malignancies treated with an anti-CD20 mAb at the time of COVID-19 diagnosis. One pt had a high concentration of active, viable virus. No known variants of concern were noted in this cohort, collected in Q2 2020, though prolonged replication is a risk for variant development. Further data are needed about risk factors for persistent viable viral shedding & methods to prevent transmission of viable virus from IC hosts.

Covid-19 antigen testing: better than we know? A test accuracy study.

BACKGROUND: Antigen testing for SARS-CoV-2 is considered to be less sensitive than the standard reference method - real-time PCR (RT-PCR). It has been suggested that many patients with positive RT-PCR 'missed' by antigen testing might be non-infectious. METHODS: In a real-world high-throughput setting for asymptomatic or mildly symptomatic patients, 494 patients were tested using RT-PCR as well as a single lateral flow antigen test (Ecotest, AssureTech, China). Where the results differed, virus viability was evaluated by cell culture. The test parameters were calculated with RT-PCR and RT-PCR adjusted on viability as reference standards. RESULTS: The overall sensitivity of the used antigen test related to the RT-PCR only was 76.2%, specificity was 97.3%. However, 36 out of 39 patients 'missed' by the antigen test contained no viable virus. After adjusting on that, the sensitivity grew to 97.7% and, more importantly for disease control purposes, the negative predictive value reached 99.2%. CONCLUSIONS: We propose that viability testing should be always performed when evaluating a new antigen test. A well-chosen and validated antigen test provides excellent results in identifying patients who are shedding viable virus (although some caveats still remain) in the real-world high-throughput setting of asymptomatic or mildly symptomatic individuals.