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1.
Toxicology Letters ; 368(Supplement):S2, 2022.
Article in English | EMBASE | ID: covidwho-2211541

ABSTRACT

Vaccines are powerful tools for preventing infection or disease from the infectious pathogens they target, but they may induce additional effects unrelated to the intended targets. Similar to other pharmaceutical products, vaccines may cause side effects, but tolerance to these is extremely low due to the use of vaccines in healthy people, particularly children. Redness, swelling or soreness at the site of injection are common for many vaccines under the term of reactogenicity. High fever can be present at a rate of 1/100 to /100 000 as can fever-induced convulsions from vaccines such as measles, mumps or rubella. Rotavirus vaccines are suspected to be associated with intussusception in about 1/100 000 first doses. Allergic reactions are in the same range. The massive H1N1 vaccination in the world has also been potentially associated with an increase in narcolepsia in patients with a risk allele. More recently, the SARS-CoV-2 vaccine ChAdOx1 nCov-19 have been found to cause a thromboembolic complication termed vaccine-induced immune thrombotic thrombocytopenia in very few people. Consequently, vaccines must undergo vigorous assessment before and after licensure to minimize safety concerns. Potential safety concerns should be identified as early as possible during the development for vaccines. In this CEC, along with courses, the attendees will have to work in small groups on real case studies associating non-clinical development and regulatory strategies. Copyright © 2022 Elsevier B.V.

2.
Methods in Molecular Biology ; 2610:109-127, 2023.
Article in English | MEDLINE | ID: covidwho-2173495

ABSTRACT

Influenza A virus H1N1, a respiratory virus transmitted via droplets and responsible for the global pandemic in 2009, belongs to the Orthomyxoviridae family, a single-negative-stranded RNA. It possesses glycoprotein spikes neuraminidase (NA), hemagglutinin (HA), and a matrix protein named M2. The Covid-19 pandemic affected the world population belongs to the respiratory virus category is currently mutating, this can also be observed in the case of H1N1 influenza A virus. Mutations in H1N1 can enhance the viral capacity which can lead to another pandemic. This virus affects children below 5 years, pregnant women, old age people, and immunocompromised individuals due to its high viral capacity. Its early detection is necessary for the patient's recovery time. In this book chapter, we mainly focus on the detection methods for H1N1, from traditional ones to the most advance including biosensors, RT-LAMP, multi-fluorescent PCR.

3.
Chung-Hua Yu Fang i Hsueh Tsa Chih [Chinese Journal of Preventive Medicine] ; 56(12):1751-1758, 2022.
Article in Chinese | MEDLINE | ID: covidwho-2201071

ABSTRACT

Objective: To investigate the distribution characteristics of respiratory non-bacterial pathogens in children in Ningbo from 2019 to 2021.

4.
Methods in Molecular Biology ; 2610:v, 2023.
Article in English | Scopus | ID: covidwho-2168041
5.
BIOpreparations. Prevention, Diagnosis, Treatment ; 22(2):170-186, 2022.
Article in Russian | EMBASE | ID: covidwho-2067593

ABSTRACT

The COVID-19 pandemic has exacerbated the public’s need for effective vaccines. Consequently, significant financial support has been provided to developers of a number of innovative vaccines, including the vaccines with saponin-based adjuvants. In 2021, the World Health Organisation recommended Mosquirix, the first malaria vaccine, which contains a saponin adjuvant. An anti-covid vaccine by Novavax is in the approval phase. A promising approach to vaccine development is presented by the use of virus-like immune-stimulating complexes (ISCOMs) containing saponins and by the creation of combinations of ISCOMs with antigens. The aim of the study was to develop, produce and characterise virus-like immune-stimulating complexes based on saponins of Quillaja saponaria, as well as similar saponins of Russian-sourced Polemonium caeruleum. Materials and methods: The ISCOM adjuvants, Matrix-BQ and Matrix-BP, were produced using liquid chromatography and examined using electron microscopy. Balb/c mice were immunised intraperitoneally and intramuscularly with ISCOM-antigen preparations. Afterwards, the immunised animals were challenged with the influenza virus strain, A/California/4/2009(H1N1)pdm09, adapted and lethal to mice. The serum samples were examined using haemagglutination inhibition (HI) tests. Results: The authors produced the ISCOMs containing saponins of Quillaja saponaria and Polemonium caeruleum. After one intramuscular injection of either of the ISCOM-antigen preparations with 1 µg of each of A/Brisbane/02/2018 (H1N1) pdm09, A/Kansas/14/2017 (H3N2), and B/Phuket/3073/2013 haemagglutinin antigens (HAs), HI tests detected serum antibody titres to the corresponding antigens of ≥1:40. Two intramuscular injections of the ISCOM-antigen preparation containing 50 ng of each of the HAs and Matrix-BQ resulted in a protective response. In some animals, two intraperitoneal injections of ISCOM-antigen preparations resulted in the maximum antibody titre to the A/Kansas/14/2017 (H3N2) vaccine strain of 1:20,480. Two intramuscular injections of a test preparation containing 5 µg, 1 µg, 200 ng, or 50 ng of each of the HAs and Matrix-BQ or a control preparation containing 5 µg, 1 µg, or 200 ng of each of the HAs (commercially available vaccines) to the mice that were afterwards infected with the lethal influenza strain protected the experimental animals from death. Conclusions: The ISCOM-based preparations had high immunostimulatory activity in the mouse-model study. The presented results indicate the potential of further studies of ISCOM-based preparations in terms of both vaccine and immunotherapeutic development.

6.
Journal of Cardiac Critical Care ; 6(2):103-107, 2022.
Article in English | EMBASE | ID: covidwho-2062347

ABSTRACT

Introduction Respiratory extracorporeal membrane oxygenation (ECMO) is well established and its popularity has increased during coronavirus disease 2019 (COVID-19) time. The efficacy of ECMO has been proved in refractory respiratory failure with varied etiology. More than 85,000 respiratory ECMO cases (neonatal, pediatric, adult) registered as per Extracorporeal Life support Organization (ELSO) statistics April 2022 report, with survived to discharge or transfer ranging from 58 to 73%. Early initiation of ECMO is usually associated with shorter ECMO run and better outcome. Many patient factors have been associated with mortality while on ECMO. Pre-ECMO patient pH and arterial partial pressure of carbon dioxide (paCO2) have been associated with poor outcome. We designed a retrospective study from a single tertiary care center and analyzed our data of all respiratory ECMO (neonatal, pediatric, and adult) to understand the effect of pre ECMO, paCO2, and arterial pH to ECMO outcome. Methods It is a retrospective analysis of data collected of patients with acute respiratory failure managed on ECMO from January 2010 to December 2021. Pre-ECMO (1-6 hours before initiation), paCO2, and arterial pH level were noted and analyzed with primary and secondary outcome. Primary outcome goal was survivor and discharged home versus nonsurvivor, while secondary goal was the number of ECMO days and incidence of neurological complications. The statistical analysis was done for primary outcome and incidences of neurological complications and p-value obtained by using chi-squared method. Meta-analysis was done by classifying the respiratory ECMO cases in three major category-COVID-19, H1N1 non-COVID-19, and H1N1 respiratory failure. Results The total 256 patients of respiratory failure were treated with ECMO during specified period by Riddhi Vinayak Multispecialty Hospital ECMO team. Data analysis of 251 patients (5 patients were transferred for lung transplant, hence been not included in study) done. Patients were divided on the basis of pH level less than 7.2 and more than 7.2 and analyzed for primary and secondary outcome. Similarly, patients were divided on the basis of paCO2 level of less than 45 and more than 45. Patient with pre-ECMO pH level more than 7.2 has statistically better survived extracorporeal life support (ECLS) (p-value: 0.008) and survival to discharge home (p-value: 0.038) chances. Pre-ECMO paCO2 level of less than 45 also showed better survival chance of survived ECLS (46.67 vs. 36.02) and survived to discharge home (42.22 vs. 31.06) but not statistically significant (p-value: 0.15 and 0.18, respectively). There was no significant difference in average number of ECMO days in patient survived to discharge home with paCO2 less than 45 and more than 45 (15.7 vs. 11.1 days), and also in pH more than 7.2 and pH less than 7.2 (15.8 vs. 11.6). The incidence of neurological complications was also found lower in patient with pH more than 7.2 (7.5 vs. 17.3%, p-value: 0.034) and in paCO2 level of less than 45 (4.4 vs. 12.65, p-value: 0.15). Conclusion Pre-ECMO arterial pH of more than 7.2 (statistically significant) and paCO2 of less than 45 (statistically not significant) have definitely better survival chances and have lesser incidences of neurological complications. There was no significance difference in the number of ECMO days in either group. Authors recommends early initiation of ECMO for mortality and morbidity benefits.

7.
Chest ; 162(4):A430, 2022.
Article in English | EMBASE | ID: covidwho-2060595

ABSTRACT

SESSION TITLE: Issues After COVID-19 Vaccination Case Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Since the onset of the COVID-19 pandemic, vaccines were introduced to mitigate the spread of the virus. Depending on the COVID-19 vaccine, regimens consist of one dose (ie, J&J) or two doses (ie, Pfizer and Moderna) and is followed by a third dose/booster (for immunocompromised/immunocompetent individuals). Here, we present a case of COVID-19 infection in a triple vaccinated patient with concurrent rheumatoid arthritis (RA) receiving disease modifying antirheumatic drugs (DMARDs) who was unable to mount an adequate immune response to the vaccine. CASE PRESENTATION: Patient is a 67 year old male with PMH of RA (on DMARDs) presented to the ED with complaints of shortness of breath. He was on treatment for RA with leflunomide, rituximab and prednisone. He was COVID-19 triple vaccinated. In ED, the patient was found to be hypoxic, saturating at 87% on room air with a respiratory rate of 18. Physical examination was significant for coarse breath sounds bilaterally and remaining vitals were unremarkable. Patient was initially placed on 3 L oxygen via NC but due to persistent hypoxia, was transitioned to high-flow nasal cannula. Further investigations revealed that the patient was COVID-19 positive. He was treated with remdesivir and dexamethasone. His oxygen requirements continued to escalate and he was ultimately intubated. While in the ICU, the patient's hypoxia continued to worsen despite optimal medical and ventilatory management and he subsequently died. DISCUSSION: DMARDs are a group of medications used to slow the progression of rheumatoid arthritis. They work by reducing the immune response of B cells, T cells and cytokines. Our patient was on two commonly prescribed medications for rheumatoid arthritis, leflunomide and rituximab. The former acts by inhibiting the pyrimidine synthesis pathway, thereby decreasing T lymphocyte production and the latter depletes CD-20 positive B cells. While there is limited data on COVID-19 vaccine, it has been established that patients on DMARDs have reduced antibody titres after immunization against influenza and pneumonia vaccinations [1, 2]. A study assessing the effectiveness of a third vaccine dose in patients taking rituximab vs placebo found a significant difference in seroconversion (78.8% vs 18.2%, p=<0.0001) and neutralizing activity (80.0% vs 21.9%, p=<0.0001) [3]. In our case, the patient was on two immunosuppressive drugs which suppressed both the humoral and cell mediated immunity, resulting in an inadequate immune response and subsequently developing COVID. CONCLUSIONS: This case highlights patients on immunosuppressant therapy failing to mount an adequate immune response to the COVID-19 vaccine, warranting more booster doses in patients on DMARDs. Reference #1: Adler S, Krivine A, Weix J et al. Protective effect of A/ H1N1 vaccination in immune-mediated disease–a prospectively controlled vaccination study. Rheumatology 2012;51:695–700. Reference #2: Franca ILA, Ribeiro ACM, Aikawa NE et al. TNF blockers show distinct patterns of immune response to the pandemic influenza A H1N1 vaccine in inflammatory arthritis patients. Rheumatology 2012;51:2091–8. Reference #3: David S, Koray T, Filippo F et al. Efficacy and safety of SARS-CoV-2 revaccination in non-responders with immune-mediated inflammatory disease. http://dx.doi.org/10.1136/annrheumdis-2021-221554 DISCLOSURES: No relevant relationships by Gursharan Kaur No relevant relationships by Aishwarya Krishnaiah No relevant relationships by sandeep mandal

8.
Indian Journal of Critical Care Medicine ; 26:S89, 2022.
Article in English | EMBASE | ID: covidwho-2006376

ABSTRACT

Introduction: Although NIV is a common mode of respiratory support in hypoxic respiratory failure, its use is not adequately supported by literature and guidelines. But in recent times NIV is used extensively in COVID pneumonia patients. Earlier, H1N1 pneumonia group of patients were identified to benefit from use of NIV. But their success in preventing intubation or reducing mortality were not validated by studies. Objective: Our aim was to retrospectively look into the COVID patients admitted to our ICU, observe the outcome benefits of NIV use and compare the difference in outcome benefits of NIV use in the H1NI patients during the previous year. Materials and methods: Retrospective analysis of the COVID pneumonia patients admitted to ICU over one year period in our multi-speciality tertiary care hospital in south India was undertaken. Details were collected from the electronic charting and patient files retrospectively. The data on the usage of non-invasive ventilation as the initial mode of ventilation for hypoxic respiratory failure in these patient groups were analysed. The findings were compared with the data from the H1N1 pandemic patients in 2018 collected from our ICU. The outcome benefit in terms of subsequent invasive ventilation need, mortality and duration of ICU stay were measured. Results of COVID patients: Average age of patient was 62.6 years and male:female ratio was 50%. All patients had associated significant co-morbidities. Average duration of symptom prior to ICU admission was 5.1 days. Length of ICU days was at an average of 6.75 days with 2-18-day variation. 66% had Severe ARDS. In 83% of patients NIV was used and 16% had HFNC and 41% had both NIV and HFNC during the stay. Overall 41% needed invasive ventilation. Only 30% of those who were on NIV went to receive invasive ventilation. Overall mortality was at 41%. Results compared with H1N1 patients: 78.6% of H1N1 patients received NIV, of which 42% improved, but 57% needed invasive ventilation when compared to 30% in COVID pneumonia. However, mortality was 36%, which was lower compared to COVID patients. Conclusion: Significant proportion of COVID patients when compared to H1N1 had probably benefited from NIV usage. Whether NIV delayed the needed intubation early is not clear and would it have prevented mortality is not clear either. HFNC is newer mode of Non-Invasive ventilation mode that has gained popularity during the COVID pandemic. There is significant mortality associated with the second wave of COVID pandemic from our experience of treating patients with severe ARDS. Conflict of interest: None declared by any of the authors.

9.
Cytotherapy ; 24(5):S35, 2022.
Article in English | EMBASE | ID: covidwho-1996713

ABSTRACT

Background & Aim: From SARS-CoV-1 outbreak in 2002 to the most recent SARS-CoV-2 pandemic (COVID-19), emergence of viral diseases has repeatedly threatened humanity over the recent decades. These viral diseases mainly cause respiratory symptoms, which can even lead to death when appropriate measures are not taken. In this study, we investigated whether adipose tissue-derived mesenchymal stem cell EVs (ASC-EVs) can attenuate acute lung injury (ALI) induced by H1N1 influenza A virus and SARS-CoV-2 and by what mechanism the ant-viral effect may occurs. Methods, Results & Conclusion: EVs were isolated from ASC or HEK293T conditioned media by tangential flow filtration, and were characterized according to MISEV recommendation. Influenza A/ Puerto Rico/08/1934 (H1N1) and SARS-CoV-2 (NCCP43326) were used to model highly pathogenic human influenza A and SARS-CoV-2 virus infection, respectively, in mice and Syrian hamsters respectively. Treatment of ASC-EVs, from 0.15 x 109 to 5.0 x 109 particles/mL, showed inhibitory activities on cytopathic effects and replication of H1N1 and SARS-CoV-2 in MDCK cells and Vero E6 cells, respectively. In the mouse H1N1 influenza A virus induced acute lung injury (ALI) model, total of 4 daily injections of 1 x 1010 particles of ASC-EVs administration resulted in significantly increased survival rate by 30 – 40%, recovery of body weight, and improved clinical disease score from 9 dpi. In addition, ASC-EV treatment downregulated various inflammatory cytokines such as IL-1β, IL-6 and TNFα in lung tissue by up to 77%. In the Syrian hamster SARS-CoV-2 induced ALI model, total of 4 daily injections of ASC-EVs at a dose of 3 x 1010 or 1 x 1010 particles resulted recovery of body weights from 5 dpi, in a dose-dependent manner, by 9.7% - 12.75%. Further, ASC-EV treatment resulted in significant downregulation of viral genes and IL-1 beat in lung tissue. To elucidate the molecular mechanisms of the observed anti-viral effects of ASC-EVs, the role of multiple miRNAs and proteins present in the ASC-EVs were assessed in vitro. We identified one specific protein that conveyed anti-viral efficacy against the two studied viruses including SARS-CoV-2. Loss and gain of function studies revealed that this protein may be involved in the anti-viral efficacy of the ASC-EVs. Our findings support the concept that that ASC-EVs have anti-viral effects against virus induced ALI, which may have implications for the treatment of not only treatment COVID-19, but also future ALI-inducing virus diseases.

10.
Gazzetta Medica Italiana Archivio per le Scienze Mediche ; 181(3):177-182, 2022.
Article in Italian | EMBASE | ID: covidwho-1988845

ABSTRACT

A COVID-19 patient at the limit of hospitalization (SpO2 at 93%), treated at home, found benefit in the use of antiviral medicinal mushrooms. The main agent would be Cordyceps sinensis, used in traditional Chinese medicine from 620 BC. This fungus has been studied by numerous scientists who have demonstrated its antiviral action against HIV-1, the syncytial respiratory virus, the coxsackie B3 virus, the A and “H1N1” influenza viruses, the Epstein Barr Virus. This patient treated at a time when treatments with antiretrovirals, enoxaparin or hydroxychloroquine were not yet permitted at home showed an immediate reversal of symptoms after taking Cordyceps sinensis and beta-glucans extracted from other mushrooms. The antiviral properties of the components of the drug used in this clinical case are described through the literature (mini review). The strong point, which would explain the rapid action (if it is not placebo), is the known affinity of the beta-glucans of the medicinal mushroom wall, towards the integrin-based receptors, usually present on neutrophil leukocytes, but also on the “thorns” of the CoV-2. This strong peculiarity that CoV-2 has become a weak point, if we get to inhibit it before it attacks the cells of the respiratory system.

11.
Journal of Investigative Dermatology ; 142(8):S10, 2022.
Article in English | EMBASE | ID: covidwho-1956214

ABSTRACT

Pandemic respiratory viral pathogens like Influenza A and SARS COV2 exhibit continuous and evasive mutations in cell surface molecules, making vaccination with the goal of antibody-mediated protection elusive. CD8 T cells mediate eradication of viral disease, and vaccination to conserved internal viral proteins to elicit CD8 T cell memory is a promising strategy. Using a mouse model, we compared pulmonary infection with H1N1 influenza with skin (epidermal) vaccination using Modified Vaccinia Ankara (MVA) expressing highly conserved NP or another conserved Ags. H1N1 influenza pulmonary infection led to recruitment and lung infiltration with Ag specific CD8 T cells by day 5-10. By day 40, abundant CD8 lung TRM and LN TCM were present. Surprisingly, by day 80, both lung TRM and systemic TCM cells were greatly diminished and were absent at day 120. These mice were protected against lethal challenge at day 40 but not day 80, suggesting built-in obsolescence of CD8 memory. In contrast, epidermal vaccination led to CD8 T cell infiltration of lung at day 5-10, measurable at day 40 and still detectable at day 80 in lung, LN and spleen. In addition, a novel intravascular lung population of CD8 T cells was present at all time points. These mice were completely protected against lethal flu challenge at day 80 and 120. Protection was observed after pulmonary challenge with either H1N1 or H3N2 influenza as well as in B cell depleted mice. We analyzed protective immunity in skin vaccinated mice. At 2 hours after pulmonary challenge, Ag specific CD8 T cells moved from the intravascular space into the lung parenchyma, were abundant at day 3 and persisted for >80 days. Single cell RNA sequencing indicated that these intravascular T cells were transcriptionally distinct from systemic TEM and TCM. We conclude that CD8 T cell immunity after pulmonary infection is powerful but short-lived, while skin vaccine induced CD8 T cell protective immunity is mediated by lung intravascular T cells is protective and durable.

12.
Emerging Infectious Diseases ; 28(7):1537-1539, 2022.
Article in English | EMBASE | ID: covidwho-1938598
13.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927890

ABSTRACT

Rationale. Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the third leading cause of death in the United States. While many risk factors for severe COVID-19 are emerging, the effects by which other inhalational exposures affect susceptibility are not well defined. Patients with COVID-19 demonstrate high rates of co-infection with respiratory viruses, including influenza A (IAV). When infected with IAV, human small airway epithelial cells (SAEC) exhibit increased abundance of angiotensin-converting enzyme 2 (ACE2), the primary receptor for SARS-CoV-2. However, it remains unknown if this effect increases the risk for COVID-19. Similarly, there are conflicting reports of the effect of e-cigarette (E-cig) vaping on COVID-19 manifestations. We hypothesized that exposures to IAV or E-cig increase the severity of SARS-CoV-2 infection. Methods. Golden Syrian hamsters (male and female) were exposed to E-cig vapor via nebulization for 5d. IAV was administered intranasally once on day 6 (A/California/07/2009 H1N1, 106 PFU/hamster). On day 3 post-IAV infection, SARSCoV- 2 was administered intranasally (WA01;104 PFU/hamster). On day 7 post-SARS-CoV-2 infection animals were sacrificed, bronchoalveolar lavage fluid (BALF) cell differentials were obtained, and inflated lung sections were stained and scored for immunohistology. Lung RNA was quantified for ACE2, TMPRSS2, STAT1, CXCL10, IFN-gamma, gene expression using RT-qPCR. Results: SARS-CoV-2 infection caused progressive weight loss that was less pronounced in animals pre-infected with IAV. SARS-CoV-2 titers from nasal swabs peaked at day 2 in both groups. IAV pre-infection reduced PMN and eosinophils in the BALF, and the overall inflammatory cell infiltration in the lung parenchyma of SARS-CoV-2-infected animals. IAV pre-infection reduced lung levels of STAT1, CXCL10 (2.5-fold;p<0.01), CCL5, and IFN-gamma in SARS-CoV-2-infected animals compared to animals that were only infected with SARS-CoV-2. Pre-exposure to E-cig worsened the SARS-CoV-2-induced weight loss in female animals only. E-cig pre-exposure increased lymphocytes and decreased PMN and eosinophils in the BALF compared to animals that were only infected with SARS-CoV-2. E-cig pre-exposure increased lung levels of STAT1, CXCL10 (2.5-fold;p<0.05), CCL5, and IFN-gamma in SARS-CoV-2-infected animals compared to animals that were only infected with SARS-CoV-2. Conclusion: Pre-infection with IAV resulted in decreased inflammatory response to SARS-CoV-2 infection. In contrast, pre-exposure to E-cig vaping increased the severity of the inflammatory response to SARS-CoV-2 with notable differences between sexes. Whereas anti-viral priming effects of prior viral infection are well described, the mechanisms that explain the worsening effects of E-cig on SARS-CoV-2 outcomes remain unknown.

14.
Revue Medicale Suisse ; 16(691):839-841, 2020.
Article in French | EMBASE | ID: covidwho-1870377

ABSTRACT

Children infected with SARS-CoV-2 are underrepresented during the current COVID-19 outbreak. Unlike other respiratory viruses, SARS-CoV-2 rather infects adults who subsequently infect their children. From recent Chinese and Italian data, children commonly present mild to moderate disease, a large proportion of them being asymptomatic. In particular, children present significantly less fever, cough and pneumonia compared to adults. However, more cases of pneumonia were reported from children infected with SARS-CoV-2 compared to those infected with H1N1. No vertical transmission of SARS-CoV-2 has been described so far.

15.
Journal of Acute Disease ; 11(2):45-51, 2022.
Article in English | EMBASE | ID: covidwho-1822496

ABSTRACT

Cardiovascular manifestations and electrocardiographic abnormalities have been reported among some prevalent infections in tropical regions, which lead to a great amount of morbidity and mortality. The major infectious diseases include chikungunya, dengue fever, H1N1 influenza, and coronavirus disease-19 (COVID-19) in the viral category, leptospirosis, salmonellosis, scrub typhus and tuberculosis in the bacterial category, and malaria in the protozoan parasite category. All these infirmities constitute a foremost infection burden worldwide and have been linked to the various cardiac rhythm aberrancies. So we aimed to identify and compile different studies on these infections and associated acute electrocardiographic (ECG) changes. The search was made in online international libraries like PubMed, Google Scholar, and EMBASE, and 38 most relevant articles, including original research, systematic reviews, and unique case reports were selected. All of them were evaluated thoroughly and information regarding ECG was collected. Myocarditis is the predominant underlying pathology for rhythm disturbance and can be affected either due to the direct pathogenic effect or the abnormal immune system activation. ECG variabilities in some infections like chikungunya, scrub typhus, and leptospirosis are associated with longer hospital stay and poor outcome. Tropical infective diseases are associated with prominent acute cardiac rhythm abnormalities due to myocarditis, which can be identified preliminarily by ECG changes.

16.
Clinical Osteology ; 26(2):98-102, 2021.
Article in Slovak | EMBASE | ID: covidwho-1820597

ABSTRACT

Heterotopic ossification is well-described, often complication after musculoskeletal trauma, surgery and neuro-trauma. We present a patient who developed heterotopic ossification of hip joints with bony ankylosis after prolonged artificial pulmonary ventilation because of pulmonary failure after H1N1 pneumonia. Atraumatic heterotopic ossification occurs in critically ill patients after mechanical ventilation, including patients with COVID-19 disease. We consider imobilization and artificial pulmonary ventilation as a possible causal factors of heterotopic ossification. Early diagnosis and implementation of potentional preventive and therapeutical tools, such as anti-inflammatory drugs and appropriate physiotherapy, are needed to decrease morbidity in patients with risk factors. The timing of surgical excision must be considered according to a risk of recurrence and irreversible joint damage.

17.
Respirology ; 27(SUPPL 1):207, 2022.
Article in English | EMBASE | ID: covidwho-1816635

ABSTRACT

Introduction/Aim: The use of veno-venous Extracorporeal Membrane Oxygenation (V-V ECMO) in the management of refractory respiratory failure due to viral illnesses has increased with recent pandemics. The aim of this study is to describe the clinical characteristics and outcomes of hospitalized patients with COVID-19 requiring ECMO and compare this population to that observed during the H1N1-influenza pandemic at Royal Prince Alfred Hospital (RPAH). Methods: Between March to October 2021, medical records of inpatients diagnosed with COVID-19 at RPAH requiring v-v ECMO were analysed. The clinical characteristics and outcomes of these patients were compared to data from patients with H1N1 influenza requiring ECMO at RPAH between July 2009 and August 2017. The primary outcome was analysed using Cox Regression Model, categorical variables were analysed using Fisher's exact test and continuous variables were analysed using two-sample T-test. Results: ECMO was used for 18 patients with COVID-19 and 32 patients for H1N1 at RPAH. The COVID-19 group was older. Both groups were obese with low rates of comorbidities prior to admission. The in-hospital mortality rate was significantly higher for the COVID-19 group with an odds ratio of 6.31 (95%CI 1.3-30.0;p = 0.01). Days on ECMO were longer in the COVID-19 group, with similar rates of ECMO related complications. There was a trend to higher rates of secondary infection in the COVID group, with a significant increase in blood stream infections compared to the H1N1 group. Conclusion: Our single centre experience demonstrates the significant in-hospital morbidity and mortality of severe COVID-19 requiring ECMO above and beyond that experienced during the H1N1 pandemic. (Figure Presented).

18.
Trends Food Sci Technol ; 104: 219-234, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1791132

ABSTRACT

BACKGROUND: Garlic (Allium sativum L.) is a common herb consumed worldwide as functional food and traditional remedy for the prevention of infectious diseases since ancient time. Garlic and its active organosulfur compounds (OSCs) have been reported to alleviate a number of viral infections in pre-clinical and clinical investigations. However, so far no systematic review on its antiviral effects and the underlying molecular mechanisms exists. SCOPE AND APPROACH: The aim of this review is to systematically summarize pre-clinical and clinical investigations on antiviral effects of garlic and its OSCs as well as to further analyse recent findings on the mechanisms that underpin these antiviral actions. PubMed, Cochrane library, Google Scholar and Science Direct databases were searched and articles up to June 2020 were included in this review. KEY FINDINGS AND CONCLUSIONS: Pre-clinical data demonstrated that garlic and its OSCs have potential antiviral activity against different human, animal and plant pathogenic viruses through blocking viral entry into host cells, inhibiting viral RNA polymerase, reverse transcriptase, DNA synthesis and immediate-early gene 1(IEG1) transcription, as well as through downregulating the extracellular-signal-regulated kinase (ERK)/mitogen activated protein kinase (MAPK) signaling pathway. The alleviation of viral infection was also shown to link with immunomodulatory effects of garlic and its OSCs. Clinical studies further demonstrated a prophylactic effect of garlic in the prevention of widespread viral infections in humans through enhancing the immune response. This review highlights that garlic possesses significant antiviral activity and can be used prophylactically in the prevention of viral infections.

19.
New Zealand Medical Journal ; 134(1542):56-66, 2021.
Article in English | EMBASE | ID: covidwho-1766672

ABSTRACT

AIM: We sought to describe the aetiology, demographics and outcomes of patients with pneumonia undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO) in Aotearoa New Zealand. METHODS: Retrospective observational study. RESULTS: Between January 2004 and August 2020, 133 patients underwent VV-ECMO for pneumonia. This VV-ECMO cohort is representative of the geographic and ethnic distribution of the population of Aotearoa New Zealand. Six-month survival was 85/133 (64%). A primary viral aetiology was identified in 63/133 cases (47%) with bacterial co-infection present in 34/63 viral pneumonias (54%). Primary bacterial pneumonia was identified in 48/133 cases (36%). Twenty-three (17%) of 133 patients developed necrotising pneumonia. The most commonly identified microorganisms were influenza A, Staphylococcus aureus and Streptococcus pneumoniae. Infection with Staphylococcus aureus or Streptococcus species was strongly associated with necrotising pneumonia (OR 10.18, 95% CI 3.52–37.13, P<0.0001). Necrotising pneumonia was more common in Māori and Pacific Peoples than in other ethnic groups (OR 3.08, 95% CI 1.16–7.96, P=0.02). DISCUSSION: Outcomes from VV-ECMO for pneumonia in Aotearoa New Zealand are comparable to large international series. Although the use of VV-ECMO was matched to the ethnic distribution of the population of Aotearoa New Zealand, Māori may have reduced access because they have higher rates of pneumonia than non-Māori.

20.
Open Forum Infectious Diseases ; 8(SUPPL 1):S757, 2021.
Article in English | EMBASE | ID: covidwho-1746295

ABSTRACT

Background. The COVID-19 pandemic led to the implementation of several strategies (e.g., masking, physical distancing, daycare/school and business closures, hand hygiene, surface disinfection) intended to mitigate the spread of disease in the community. Our objective was to evaluate the impact of these strategies on the activity of respiratory viral pathogens (other than SARS-CoV-2) and norovirus. Methods. At University of North Carolina (UNC) Hospitals, we compared the percent positivity for respiratory viral pathogens and norovirus by calendar year for 2014-2019 and the first three months of 2020 to the percent positivity in the subsequent months of 2020 and the first quarter of 2021. Patients were included in the study if they had a positive specimen obtained in a clinic, ED or as an inpatient. Three molecular tests were used to detect these viruses: adenoviruses, endemic coronaviruses (OC43, 229E, NL63, HKU1), influenza A (subtypes H3, H1, H1N1pdm), influenza B, metapneumovirus (MPV), parainfluenza viruses 1-4 (PIV), rhinovirus and/or enterovirus (RhV/EV), and respiratory syncytial virus (RSV). Two molecular tests were used to detect norovirus. We calculated point prevalence rates with 95% confidence intervals to assess statistical differences in percent positivity. Results. There was a statistically significant decline in percent positivity for endemic coronaviruses, influenza, MPV, PIV, RSV and norovirus during the time-periods after March 2020 when compared to all other time-periods (Figure). RhV/EV, followed by adenovirus were the most prevalent types of respiratory viruses circulating during height of COVID-19. There was a statistically significant decline seen in RhV/ EV in April-Dec 2020, but activity increased in 2021. There was no difference seen in adenovirus activity across time-periods. Percent Positivity of Respiratory Viral Pathogens and Norovirus by Time Period Conclusion. Our study demonstrated statistically significant decreases in the percent positivity of several respiratory viral pathogens, as well as norovirus, during the time-period of high community prevalence of SARS-CoV-2. Strategies put in place to mitigate SARS-CoV-2 transmission likely contributed to these differences. Non-enveloped viruses like rhinovirus and adenoviruses may have been less impacted by these strategies since they are more resistant to disinfection.

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