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1.
Curr Mol Med ; 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2109531

ABSTRACT

We present a Direct SARS-CoV-2 Detection System that achieves sample-to-results in less than two hours in three simple steps. The Detection System includes Direct one-step Reverse Transcription PCR (RT-PCR) reagents (Qexp-MDx kit), a portable thermal cycler (Qamp-mini) with a pre-programmed chip and a simple-to-use Capillary Gel Electrophoresis system (Qsep Series Bio-Fragment Analyzer) with high fluorescence detection sensitivity to solve the problems associated with traditional real-time PCR (qPCR) systems which produces inaccurate test results with high false negative and false positive rates. The proposed simple-to-use detection platform can provide high detection sensitivity (identify less than 20 copies), fast results (less than 120 minutes) and cost-effective results which should be suitable for decentralized testing application of COVID-19.

2.
J Int Med Res ; 50(11): 3000605221133147, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2108537

ABSTRACT

OBJECTIVE: The primary goals of this research were to analyze the relationship between ABO blood types and the severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and investigate the effect of vaccination in Iraq. METHODS: Data and outcomes were gathered from the medical records of 200 patients. Patients were categorized by blood group and vaccination status in the analysis. RESULTS: In total, 200 hospitalized patients (125 men and 75 women) with confirmed SARS-CoV-2 infection and blood group (ABO) and clinical data were enrolled. Of the 200 patients, 155 (77.5%) were vaccinated against SARS-CoV-2. The results illustrated that 25 patients died, which might have been attributable to a lack of vaccination or older age. Our analysis revealed that blood group O individuals were much less likely to be infected by SARS-CoV-2 than non-O subjects, whereas blood group A individuals carried a higher risk of infection. CONCLUSIONS: Our findings illustrated that immunization significantly reduces COVID-19 risk across all age groups, but there has been an increase in the number of cases because of decreased vaccine efficacy in older patients and persons with comorbidities. However, 45% vaccination coverage lowered the outbreak's peak.


Subject(s)
COVID-19 , SARS-CoV-2 , Male , Humans , Female , Aged , ABO Blood-Group System , COVID-19/epidemiology , Iraq/epidemiology , Vaccination
3.
Int J Cardiol Heart Vasc ; 43: 101144, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2086280

ABSTRACT

Background: Coronavirus-2019 (COVID-19) is known to affect the heart and is associated with a pro-inflammatory state. Most studies to date have focused on clinically sick subjects. Here, we report cardiac and proinflammatory biomarkers levels in ambulatory young adults with asymptomatic or mild COVID-19 infection compared to those without infection 4-8 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) testing. Methods: 131 asymptomatic or mildly symptomatic subjects were enrolled following testing for SARS-COV-2. Fifty subjects tested negative, and 81 subjects tested positive. Serum samples were collected for measurement of C-reactive protein, ferritin, interleukin-6, NT-pro-B-type natriuretic peptide, and cardiac troponin 28-55 days after SARS-COV-2 RT-PCR testing. Results: Biomarker levels trended higher in SARS-COV-2-positive vs negative subjects, but differences in biomarker levels or proportion of subjects with elevated biomarkers were not statistically significant with respect to SARS-COV-2 status. Among individuals with ≥ 1 comorbidity, odds of elevated CRP were greater compared to individuals without any comorbidities (odds ratio [OR] = 2.90); this effect size was increased 1.4-fold among SARS-COV-2-positive subjects (OR = 4.03). Similarly, NT-pro-BNP was associated with CVD, with the strongest association in COVID-positive individuals (OR = 16.9). Conclusions: In a relatively young, healthy adult population, mild COVID-19 infection was associated with mild elevations in cardiac and proinflammatory biomarkers within 4-8 weeks of mild or asymptomatic COVID-19 infection in individuals with preexisting comorbidities, but not among individuals without comorbidities. For the general population of young adults, we did not find evidence of elevation of cardiac or proinflammatory biomarkers 4-8 weeks after COVID-19 infection.Clinical Perspective: This is a characterization of cardiac and proinflammatory biomarkers in ambulatory subjects following asymptomatic or mild COVID-19 infection. Young, ambulatory individuals did not have cardiac and proinflammatory biomarker elevation 4-8 weeks after mild COVID-19 infection. However, COVID-19 infection was associated with biomarker elevations in select individuals with comorbidities.Clinical study number: H-47423.

4.
AORN J ; 116(5): 416-424, 2022 11.
Article in English | MEDLINE | ID: covidwho-2084985

ABSTRACT

Resuming elective surgeries that were canceled during the COVID-19 pandemic necessitated a change to preprocedure patient preparation at a pediatric tertiary care center in middle Tennessee. We conducted a prospective, observational, mixed-methods study to determine the effectiveness of a preprocedure COVID-19 testing team to prevent COVID-19-related cancellations among pediatric patients receiving planned anesthesia. The intervention involved family member and patient education and a change in health record reporting to include COVID-19 test results. A team tasked with follow-up reviewed test results, consulted with families, and coordinated the administration of rapid tests if necessary. We compared preimplementation and postimplementation cancellation rates in four procedural areas and found no significant difference in the cancellation or rescheduling rates (P = .89, 95% confidence interval = -4.29 to 3.09). The team-based intervention was associated with the preservation of low procedural cancellation rates by mitigating barriers to preprocedural testing.


Subject(s)
COVID-19 , Child , Humans , COVID-19 Testing , Elective Surgical Procedures , Pandemics/prevention & control , Prospective Studies
5.
J Formos Med Assoc ; 121(9): 1857-1863, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2069317

ABSTRACT

BACKGROUND/PURPOSE: This population-based study aimed to compare the accuracy of Rapid antigen detection (RAD) and reverse transcription-polymerase chain reaction (RT-PCR) assays for diagnosing individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the COVID-19 outbreak in Taipei, from May to June 2021. METHODS: In response to the outbreak of COVID-19 in mid-May 2021, Taipei City Hospital set up 12 citywide proactive community testing (PCT) stations for early identification of infected individuals from May 17 to June 20, 2021. Individuals with RAD positivity were isolated and later confirmed by RT-PCR. The c-statistic value was estimated to indicate the level of diagnostic accuracy of RAD tests. RESULTS: Of the 33,798 individuals who were evaluated for SARS-CoV-2 infection, 4.4% tested positive for RAD. There was a moderate concordance (kappa = 0.67) between the RAD tests and RT-PCR assay for identifying infectious individuals. The c-statistic value of the RAD test for the diagnosis of SARS-CoV-2 infection was 0.8. There was a positive linear trend between the accuracy of the RAD tests and the prevalence of SARS-CoV-2 infection in the study population (ß = 0.04; p = .03). As the cycle threshold value decreased, the sensitivity rate of the RAD tests increased (p < .001). After implementation of the PCT program, the prevalence of COVID-19 decreased from 8.4% to 3.3% (p < .001). CONCLUSION: Proactive community testing for SARS-CoV-2 infection using RAD tests could rapidly identify and quarantine the most infectious patients in the early phase of COVID-19 outbreak.


Subject(s)
COVID-19 , COVID-19 Testing , Disease Outbreaks , Humans , SARS-CoV-2 , Sensitivity and Specificity
6.
World J Clin Cases ; 10(29): 10820-10822, 2022 Oct 16.
Article in English | MEDLINE | ID: covidwho-2067270

ABSTRACT

Defining con-founders that affect the reliability of diagnostic tests for coronavirus disease 2019 is vital to breaking the chain of infection. The elderly population is a higher risk group for the emerging virus. However, gender seems to exert a critical role in modifying the infection risk among women owing to hormonal changes. The menopause transition is an exceptional period for older women where the protective and immunomodulatory effects of the estrogen hormone are lost. Accordingly, attention should be given to postmenopausal women since they will have an increased risk compared to their pre-menopausal peers.

7.
NeuroQuantology ; 20(10):6860-6870, 2022.
Article in English | EMBASE | ID: covidwho-2067308

ABSTRACT

The year 2019 is a outbreak year during which the whole globe has suffered from Covid19 pandemic which has been spotted initially in China and later spread to the whole world;as a result of this viral disease, the whole world had shut down affecting billions of people but till today the Covid battle is on and people are suffering not only from this disease but also in terms of economy, starving being jobless etc. This paper briefs about Corona virus, its types, and structure;the replication and spreading of this virus, Covid19 detection methods, research on vaccination developed across the world to curb this virus;virus impact on various sectors, precautions to be taken to stay away from this virus and Ayurvedic remedy for it. The waves of corona had taken many lives on the globe & have its effect on life style of people. To curb this virus, prevention vaccination has to be found and we people must change in a way so that we could avoid future consequences for the upcoming generation. Keywords.

8.
Journal of Clinical and Diagnostic Research ; 16(9):OC21-OC24, 2022.
Article in English | EMBASE | ID: covidwho-2067195

ABSTRACT

Introduction: The clinical diagnosis of COVID-19 is supplemented by clinical severity indices. These indices are the National Early Warning Score (NEWS, which aids in risk stratification), CT severity score (radiological severity score), and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) cycle threshold (Ct value, which provides a semi-quantitative measure of viral load). Aim(s): To assess the correlation between NEWS at admission, RT-PCR Ct value and CT severity score in mild and moderate COVID-19 patients. Methods and Materials: This prospective cohort study was conducted in Maulana Azad Medical College and Lok Nayak hospital, New Delhi, from January to June 2021. The study included 50 subjects (25 with mild COVID-19 and 25 with moderate COVID-19). NEWS was calculated at admission and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Ct value was estimated using real-time RT-PCR. CT severity score was calculated based on High Resolution Computed Tomography (HRCT) chest findings. The correlation among the parameters was determined using Pearson correlation formula. Result(s): The mean age of subjects in the mild and moderate COVID-19 groups were 49.52 years and 51.84 years, respectively. The mean RT-PCR Ct value of E gene was 24.48 and Rdrp gene was 24.56 in the mild COVID-19 group;while in the moderate group it was 23.72 for both E gene and Rdrp genes. The correlation between NEWS and Ct value of E gene (r-value=-0.06, p-value=0.68), Ct value of Rdrp gene (r-value=-0.03, p-value=0.79) and the correlation between CT severity score and Ct value of E gene (r-value=-0.05, p-value=0.73), Ct value of Rdrp gene (r-value=-0.06, p-value=0.68) was negative and insignificant. The mean CT severity score in mild COVID-19 group was 3.92, and in moderate COVID-19 group was 9.88. A significant positive correlation was found between the CT severity score and NEWS at admission. Conclusion(s): The clinical severity of COVID-19 as estimated by NEWS corroborates with CT severity score while the relationship between RT-PCR Ct value and clinicoradiological severity needs to be ascertained by further research. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

9.
Journal of Clinical and Diagnostic Research ; 16(9):ED01-ED03, 2022.
Article in English | EMBASE | ID: covidwho-2067193

ABSTRACT

Sickle Cell Disease (SCD) is an inherited disorder with variable clinical presentation and low immunity. Coronavirus Disease-2019 (COVID-19)is a pandemic disease with a high-risk in chronic disease patients and older adults. SCD is widely distributed in Sudan;many SCD patients are infected with COVID-19. Despite this, no published data is available. This case report demonstrated the haematological and clinical course of a Sudanese sickle cell anaemia patient with COVID-19. A 20-year-old male patient was admitted to a hospital for 15 days. Demographic and clinical data were obtained from his medical records. A blood sample was taken at the time of admission and during hospitalisation. Tests were performed during admission, including Complete Blood Count (CBC), liver function test, renal function test, coagulation studies, viral screening, and urine general. The patient was diagnosed with COVID-19 using the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test based on the nasopharyngeal swab and COVID-19 IgG and IgM using Enzyme Linked Immunosorbent Assay (ELISA) for the previous infection. The patient received intravenous fluids, antibiotics, analgesia, oxygen supplementation, and blood transfusion two times during hospitalisation, and there was no need for Intensive Care Unit (ICU) admission. The patient's prognosis was good;he was discharged on day 16 with no symptoms and a negative result of the COVID-19 PCR test. A severe illness was expected because he was infected twice by COVID-19, the patient showed mild clinical symptoms with a good prognosis, so further studies are required to understand COVID-19 among Sudanese SCD patients.

10.
Journal of Clinical and Diagnostic Research ; 16(9):EC41-EC46, 2022.
Article in English | EMBASE | ID: covidwho-2067190

ABSTRACT

Introduction: Coronavirus Disease 2019 (COVID-19) is an extremely transmissible infectious disease. Detection of coronavirus by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) requires expert skills and moreover, it is not widely available in all the laboratories. Aim: To evaluate Red Blood Cell (RBC), platelet histogram and White Blood Cell (WBC) scattergram graphic patterns and interpretation of corresponding parameters along with peripheral smear in 500 COVID-19 RT-PCR positive study cases (COVID-19) and to compare them with normal study controls (non COVID-19). Materials and Methods: This was a laboratory-based observational study, conducted at a fully accredited National Accreditation Board for testing and calibration Laboratories’s (NABL) Central Diagnostic Research Laboratory, RL Jalapa Hospital Tamaka, Kolar, Karnataka, India from September 2020 to April 2021. RBC, platelet histogram, WBC scattergram graphic patterns with corresponding parameters were noted in RT-PCR COVID-19 positive patients and compared with controls using (Automated Haematology Analyser XN11500). Cases were further subcategorised into moderate and severe categories. For statistical analysis, Chi-square test or Fisher’s exact test, Independent t test was used for assessing qualitative and quantitative data respectively. Mean and standard deviation were depicted in box plots. Receiver Operating Characteristic (ROC) curve was used for predicting severity. A p-value <0.05 was considered statistically significant. results: Among 500 subjects, males were 359 and females 141 with the mean age 50.5 years. Present study showed a characteristic finding of “sandglass” effect in WBC scattergram which is described as discontinuous cluster of plasmacytoid lymphocytes. RBC histogram and parameters did not show any significant changes. In severe COVID-19 cases among WBC parameters most common finding was neutrophilia. Platelet Lymphocyte Ratio (PLR), Platelet Monocyte Ratio (PMR), Platelet Neutrophil Ratio (PNR) were statistically significant in severe COVID-19 cases (p-value <0.001) corresponding ROC curve for WBC and platelet showed WBC count and PLR as the significant parameter in severe COVID-19 positive cases. conclusion: Current study reported a specific and unique sandglass effect in WBC scattergram in severe COVID-19 subjects which can help the physicians for predicting the severity of disease and to prevent further pro ression of disease

11.
Haseki Tip Bulteni ; 60(4):318-324, 2022.
Article in English | EMBASE | ID: covidwho-2066931

ABSTRACT

Aim: We think that the nasopharyngeal swab sample should be taken bilaterally to improve the sensitivity of the real-time-reverse transcriptase-polymerase chain reaction (RT-PCR) test since there may be pathologies that cause nasal obstruction, such as nasal septum deviation (NSD). In this context, we investigated the effect of the nasopharyngeal swab sampling method and the presence of nasal obstruction on the detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Method(s): This prospective clinical study was conducted from March 2021 to January 2022. Forty-four hospitalized patients with NSD were included in the study group, and 44 hospitalized patients without NSD were included in the control group. The results of the RT-PCR test studied with a unilateral nasopharyngeal swab sample taken during hospitalization and the RT-PCR test studied with a bilateral nasopharyngeal swab sample taken on the 2nd day of hospitalization and the visual analog scale (VAS) scores showing the patients' pain during the first sampling were determined. Result(s): In the first test, 23 (52.3%) patients in the study group and 32 (72.7%) patients in the control group were evaluated as SARS-CoV-2 positive. The first test sensitivity was significantly higher in the control group (p=0.048). The VAS score was significantly higher in the study group (p=0.00008). In the second test, 35 (79.5%) patients in the study group and 37 (84.1%) patients in the control group were evaluated as SARS-CoV-2 positive. The sensitivity increases in the study group and in the population were statistically significant (p=0.007 and p=0.004, respectively). The consistency of the first and second test results increased in patients without NSD and in patients with low VAS scores [odds ratio (OR)=3.779;p=0.001, OR=2.572;p=0.005, respectively]. Conclusion(s): Nasopharyngeal swab sampling may be affected by nasal congestion and the sampling method. To avoid this, it may be more appropriate to take a nasopharyngeal swab sample through the bilateral nasal cavity. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.

12.
Open Access Macedonian Journal of Medical Sciences ; 10:1914-1921, 2022.
Article in English | EMBASE | ID: covidwho-2066688

ABSTRACT

BACKGROUND: The fluctuating COVID-19 cases among the pregnant women’s population encountered increased of cases and maternal mortality. AIM: This research aimed to describe the case of maternal deaths caused by COVID-19. CASE REPORT: We present nine serial cases of maternal death caused by COVID-19 who were admitted to Dr. Soetomo General Academic Hospital for 14 days in June. We found 32 positive COVID-19 obstetric cases and reported nine maternal deaths with a fatality rate of up to 28%. Seven of nine patients had reverse transcription-polymerase chain reaction–confirmed SARS-CoV-2 infection, while two had a positive antigen swab. Half of the patients ≥35 years old, and five of nine patients had Class I obesity as preexisting comorbidity. This study reported the death of pregnant woman at their 2nd trimester and 3rd trimester presenting infected by severe COVID-19. The usual symptoms are dyspnea, cough, fever, and decreased consciousness. The result of chest X-ray examination among eight patients showed bilateral pneumonia. Most of cases were referrals from a secondary hospital due to overload hospital capacity. Three patients were directly transferred to the tertiary hospital without receiving initial treatment. Eight of 9 patients (88.9%) were transferred to intensive care unit and intubated due to low oxygen saturation. CONCLUSION: In conclusion, the limited hospital facility and lack of intensive care capacity for obstetric cases during the second wave of the COVID-19 pandemic may enhance the probability of mortality and morbidity in pregnant women infected by COVID-19.

13.
Open Access Macedonian Journal of Medical Sciences ; 10(C):246-251, 2022.
Article in English | EMBASE | ID: covidwho-2066676

ABSTRACT

BACKGROUND: Pregnancy state affects the immune regulation including physical barrier, innate, and adaptive immunity-related to susceptibility of infections and increasing risk for severe to critical case of COVID-19. Further, high risk of thrombosis becomes a challenge in the management of COVID19 in pregnancy due to the strong association with worse outcome. CASE REPORT: Here, we present three cases of pregnant women infected with COVID-19 pneumonia with different outcomes in maternal and fetal condition related to high-risk thrombosis. Serial inflammatory markers were needed to the early detect the disease progressivity in pregnant women with COVID-19. Further, complete assessment of fetus including reverse transcriptase-polymerase chain reaction and chest X-ray must be performed to the early diagnosis of COVID-19 in neonatal whose mother was infected by SARS-CoV-2. CONCLUSION: Pregnancy state affects the immune regulation including physical barrier, innate, and adaptive immunity-related to susceptibility of infections and increasing risk for severe to critical case of COVID-19. Further, high risk of thrombosis becomes a challenge in the management of COVID19 in pregnancy due to the strong association with worse outcome. Although fetal transmission of COVID-19 to fetus remains unclear, complete assessment of fetus including RT-PCR, and chest X-ray must be performed to the early diagnosis of COVID-19 in neonatal whose mother was infected by SARS-CoV-2.

14.
Cardiology in the Young ; 32(Supplement 2):S119-S120, 2022.
Article in English | EMBASE | ID: covidwho-2062133

ABSTRACT

Background and Aim: Accumulation of cases is needed to determine whether vaccines should be recommended for children because of their potential to cause myocarditis in healthy children. Method(s): We report a case in which changes in laboratory data, electrocardiogram (ECG), and magnetic resonance imaging (MRI) were tracked at our hospital. Result(s): A 12-year-old girl developed fever a day after receiving the second dose of the COVID-19 vaccine. Three days after vaccina-tion, she also developed chest pain and went to a hospital. ECG showed ST-T segment elevation. However, the symptoms were mild, and she was treated with antipyretics and analgesics. The next day, she visited the hospital again because she had mild chest pain. ECG showed a negative T-wave, and she was referred to our hos-pital. Her real-time reverse-transcription polymerase chain reac-tion tests for COVID-19 yielded negative results. Computed tomography revealed no anatomical abnormalities of the coronary arteries. The serum concentration of troponin T was elevated by 131 ng/L. Echocardiography showed the left ventricular ejection fraction to be 64%. MRI showed a normal T2 value on T2-weighted imaging;however, extracellular volume increased by 33%. Although the Lake Louise criteria was not met, we diagnosed the condition as myocarditis. She was hospitalized for 2 days and discharged without the need for steroids or gamma globulin treat-ment to relieve her symptoms. Although these findings improved 17 days after vaccination, late gadolinium enhancement was noticed on MRI. Conclusion(s): The COVID-19 vaccine-related myocarditis (C-VAM) in this case was mild and like as cases in Europe and the United States. The risk of COVID-19 associated myocarditis is more than three times the risk of C-VAM. In addition, the mor-tality rate for COVID-19 associated myocarditis is higher than that for C-VAM. The need for a vaccine to protect populations from COVID-19 should be properly recognized. However, because the symptoms of C-VAM are mild, there may be many potential patients with C-VAM. Therefore, it may be advisable to avoid strenuous exercise for approximately 1 week after vaccination. Further research is needed to determine the long-term outcomes of C-VAM because of the late enhancement identified on MRI.

16.
Chest ; 162(4):A2554, 2022.
Article in English | EMBASE | ID: covidwho-2060960

ABSTRACT

SESSION TITLE: Lung Transplantation Cases SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 10:15 am - 11:10 am INTRODUCTION: A shortage of lungs persists despite the addition of increased-risk donors to the transplantation pool. Waitlist mortality increased from 14.7 to 16.1 deaths per 100 waitlist years from 2019 to 2020. (1) Novel strategies are needed to further expand the donor pool. We report a case of intentional transplant of recently infected acute respiratory virus syndrome 2 (SARS-CoV-2) donor lungs to a patient with end-stage Idiopathic Pulmonary Fibrosis (IPF). CASE PRESENTATION: A 67 year old man with IPF, former tobacco and alcohol abuse, hypertension and gastroesophageal reflux disease underwent a sequential bilateral lung transplant on cardiopulmonary bypass. His post-operative course was complicated by Pseudomonas Aeruginosa pneumonia and bilateral pleural effusions status-post bilateral chest tube placement. He was extubated 4 days after surgery and had his chest tubes removed within 1 week. He discharged on room air 17 days after transplant and appeared well at his 3 week post-operative clinic visit. The donor lungs came from a 28 year old woman with chronic hepatitis C and recent asymptomatic SARS-CoV-2 infection. She tested positive for SARS-CoV-2 on reverse transcriptase polymerase chain reaction (RT-PCR) nasopharyngeal (NP) swabs at 12 and 7 days prior to surgery. She had negative SARS-CoV-2 results on lower respiratory tract testing via bronchioalveolar lavage (BAL) at 7 and 2 days prior to surgery. Recipient RT-PCR NP testing was negative on post-operative days 3, 10, and 17. Two subsequent BAL samples were negative in the first week post-operation. The recipient consented to transplant and was aware of the donor's recent SARS-CoV-2 and chronic hepatitis C infections. Infectious disease did not recommend any SARS-CoV-2 anti-viral therapy or post-exposure prophylaxis. Hepatology prescribed treatment for donor derived hepatitis C viremia on discharge. DISCUSSION: Emerging pathogens present a challenge in minimizing donor-derived diseases. The utilization of lungs, including patients with recent SARS-CoV-2 infection, should be considered carefully. Institutional guidelines vary in donor exclusion criteria based on history of prior SARS-CoV-2 infection, severity of prior infection, timing of last SARS-CoV-2 result, and type of screening test. (2,3) We report a case of intentional lung transplant with asymptomatic SARS-CoV-2 infection on NP swab 1 week prior to transplant and negative lower respiratory tract testing 2 days prior to transplant. Our recipient patient has remained SARS-CoV-2 free at 3 weeks post-operation on serial testing. We propose that the timing of recent donor infection, even within 10 days of positive results, is less important as infectious status based on lower respiratory tract testing at the time of transplant. CONCLUSIONS: We demonstrate that donor lung donation following very recent asymptomatic SARS-CoV-2 infection can be done safely with good short-term outcomes. Reference #1: (1) 2020 Annual Data Report. Scientific Registry of Transplant Recipients https://srtr.transplant.hrsa.gov/annual_reports/2020/Lung.aspx Accessed [03/23/22] Reference #2: (2) Querrey, M, Kurihara, C, Manerikar, A, et al. Lung donation following SARS-CoV-2 infection. Am J Transplant. 2021;21: 4073– 4078. https://doi.org/10.1111/ajt.16777 Accessed [03/23/22] Reference #3: (3) Summary of Current Evidence and Information– Donor SARS-CoV-2 Testing & Organ Recovery from Donors with a History of COVID-19. Version Release Date: January 21, 2022. US Department of Health & Human Services. Organ Procurement and Transplantation Network https://optn.transplant.hrsa.gov/media/kkhnlwah/sars-cov-2-summary-of-evidence.pdf Accessed [03/23/22] DISCLOSURES: No relevant relationships by Thomas Meehan No relevant relationships by Jagadish Patil No relevant relationships by Huddleston Stephen

17.
Chest ; 162(4):A491, 2022.
Article in English | EMBASE | ID: covidwho-2060608

ABSTRACT

SESSION TITLE: COVID-19 Case Report Posters 3 SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: The SARS-CoV-2 pandemic quickly spread throughout the world after it was first identified in Wuhan, China in 2019. Severe cases of hypoxic respiratory failure have since filled hospitals over the past few years. We present a case of an immunosuppressed patient with persistent respiratory failure from SARS-CoV-2, with a failure to mount antibody response, treated with convalescent plasma. CASE PRESENTATION: We present a 54-year-old female with a past medical history significant for rheumatoid arthritis on immunosuppression with methotrexate, prednisone, sulfasalazine, and rituximab who presented with diarrhea, cough, and shortness of breath. She was unvaccinated and tested positive for COVID-19 pneumonia, which was treated with corticosteroids and Remdesevir. CT thorax revealed diffuse infiltrates (Figure-1). She had progressive hypoxia requiring ICU stay and her course was complicated by inferior wall STEMI, requiring Intra-aortic balloon pump and intubation given worsening hypoxia. She had progressive improvement and was discharged from the hospital on 4 L of supplemental oxygen after a 30-day hospital stay. She presented two days after discharge with cough, fevers and increasing oxygen requirements up to 100% high flow nasal cannula. She was septic and was treated with steroids and antibiotics. She was febrile despite broad spectrum antibiotics. CT thorax demonstrated diffuse infiltrates worsened from the previous and steroid dosing was increased (Figure-2). No obvious source of infection was found, and further evaluation revealed positive Covid-19 RT-PCR. Despite her initial infection occurring two months prior, COVID-19 anti-spike and anti-nucleocapsid antibodies were negative. She was treated with two doses of convalescent plasma and had improvement in her oxygenation, going from 80% high-flow nasal cannula to 6L of supplemental oxygen within two days of administration. DISCUSSION: It's unclear whether immunosuppressed patients with rheumatologic disease are at an increased risk of severe SARS-CoV-2 infection. However, the use of immunosuppressants places patients at risk of an improper immune response to infection. In immunocompetent patients, the typical time to negative SARS-CoV-2 RT-PCR is 3 weeks after positivity (1), and most patients develop antibodies within 2-3 weeks after viral exposure (2). Anti-CD20 monoclonal antibodies like rituximab, commonly used for rheumatologic diseases, can hinder humoral immunity, and impair vaccine response (3). Given our patient's immunosuppressive regimen, we suspect she failed to mount an immune response to COVID-19, resulting in 56 days of infection without an adequate antibody response, successfully treated with convalescent plasma. CONCLUSIONS: Patients with significant immunosuppression regimens may fail to produce antibody responses to SARS-CoV-2, resulting in prolonged infection. Reference #1: Rodríguez-Grande, C., Adán-Jiménez, J., Catalán, P., Alcalá, L., Estévez, A., Muñoz, P., Pérez-Lago, L., de Viedma, D. G., Adán-Jiménez, J., Alcalá, L., Aldámiz, T., Alonso, R., Álvarez, B., Álvarez-Uría, A., Arias, A., Arroyo, L. A., Berenguer, J., Bermúdez, E., Bouza, E., … de la Villa, S. (2021). Inference of active viral replication in cases with sustained positive reverse transcription-PCR results for SARS-CoV-2. Journal of Clinical Microbiology, 59(2). https://doi.org/10.1128/JCM.02277-20 Reference #2: Boechat, J. L., Chora, I., Morais, A., & Delgado, L. (2021). The immune response to SARS-CoV-2 and COVID-19 immunopathology – Current perspectives. In Pulmonology (Vol. 27, Issue 5). https://doi.org/10.1016/j.pulmoe.2021.03.008 Reference #3: Eisenberg, R. A., Jawad, A. F., Boyer, J., Maurer, K., McDonald, K., Prak, E. T. L., & Sullivan, K. E. (2013). Rituximab-treated patients have a poor response to influenza vaccination. Journal of Clinical Immunology, 33(2). https://doi.org/10.1007/s10875-012-9813-x DISCLOSURES No relevant relationships by Issa Makki No relevant relationships by John Parent No relevant relationships by Jay Patel No relevant relationships by Ruchira Sengupta

18.
Revista de Nefrologia, Dialisis y Trasplante ; 42(3):181-188, 2022.
Article in English | EMBASE | ID: covidwho-2058474

ABSTRACT

Aim: Coronavirus infection can lead to severe acute respiratory distress syndrome. Information on COVÍD-19 infection in patients with kidney transplants (KT) is lacking yet. In our study, clinical, radiological, laboratory features and clinical course of COVÍD-19 infection in these patients were investigated. Methods: We retrospectively investigated KT recipient patients with COVID-19 diagnosed between March 15, 2020, and December 15, 2020. Clinical, radiological, laboratory features and clinical course of COVID-19 infection in these patients were recorded. Results: We identified 23 KT recipient patients with COVID-19 infection. Eighteen KT patients (78.3%) had positive reverse transcription polymerase chain reaction (RT-PCR) results for COVID-19, 5 patients (21.7%) were negative. Twelve KT patients (52.2%) were male and 11 (47.8%) were female. Fifteen of the KT patients (65.2%) had comorbidity. Thorax computed tomography showed infiltrations in 21 KT patients (91.3%). There were 14 patients (60.8%) with glomerular filtration rate (GFR) below 60 ml/ min, who were considered acute renal failure. One patient needed plasma treatment, 2 needed hemodialysis. Mortality rate was 26%. Conclusion: COVÍD-19 infection causes kidney failure in patients with kidney transplant. Mortality is high in kidney transplant patients with COVÍD-19 infection. Suggested poor prognostic factors increasing death risk are being 60 years or older, recent transplantation, low oxygen saturation level, high WBC count, high CRP level, high troponin level, high D-dimer level, high creatinine level, low GFR value, low sodium level.

19.
Investigative Ophthalmology and Visual Science ; 63(7):1001-F0248, 2022.
Article in English | EMBASE | ID: covidwho-2058363

ABSTRACT

Purpose : The full scope of ophthalmic manifestations of coronavirus disease 2019 (COVID-19) has yet to be appreciated. We used optical coherence tomography (OCT) to compare subjects with a history of COVID-19 disease and those without evidence of past disease across qualitative and quantitative metrics. Methods : Subjects diagnosed by reverse-transcriptase polymerase chain reaction with COVID-19 or presence of SARS-CoV-2 antibodies (N=25) and those with no history or antibody evidence of disease (N=25) were prospectively assessed using a Zeiss Cirrus HD OCT Model 5000. Retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC), and foveal thickness were tabulated. Retinal structural findings were evaluated by a retina specialist. Results were stratified by age, race, ethnicity, gender, and presence of comorbidities (diabetes and hypertension). Student's t-test, linear and logistic regression, univariate analysis with COVID+ subjects, and multivariate analysis with all subjects were performed. Significance was set at p<0.05. Results : COVID+ subjects did not show significant differences compared to COVID- subjects across any parameters. There were significant differences across demographic groups. Univariate analysis showed that COVID+ Asians had thinner RNFL (p=0.014, right;p=0.018, left) and GCC (p=0.041, right;p=0.051, left) than COVID+ Blacks and Whites. COVID+ Hispanics had decreased foveal thickness compared to COVID+ non-Hispanics (p=0.019, right;p=0.004, left). Multivariate analysis confirmed that Blacks (p=0.015, left) and Whites (p=0.010, left) had thicker GCC than Asians and that Hispanics had decreased foveal thickness (p=0.041, left) compared to non-Hispanics. The middle age group had thinner GCC (p=0.022, right;p=0.024, left) than the youngest age group. While COVID+ Blacks were more likely to have retinal structural changes than COVID+ subjects of other races with a trend toward significance (OR=5.00, p=0.084), multivariate analysis did not confirm this disparity. Conclusions : Analysis of this cohort did not reveal significant differences between COVID+ and COVID- individuals. However, comparison of demographic parameters did show significant differences across age, race, and ethnicity. The reasons for these disparities are obscure. Further studies with a greater number of subjects may reveal differences based on COVID-19 status.

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Investigative Ophthalmology and Visual Science ; 63(7):3315-F0124, 2022.
Article in English | EMBASE | ID: covidwho-2058161

ABSTRACT

Purpose : Long-COVID is assumed to have an autoimmune component. As a seropositivity of functional active autoantibodies against G-protein coupled receptors (GPCR-AAb) and an impaired retinal microcirculation, measured by OCT-angiography (OCT-A), was observed after COVID-19 infection, it was the aim of the present study to investigate the impact of GPCR-AAbs on retinal microcirculation in patients with LongCOVID. Methods : Seventy-six patients with Long-COVID (COVID-19 infection was confirmed by real time rt-PCR) were recruited. A seropositivity for GPCR-AAbs (Nociceptin-AAb, ß2-AAb, AT1-AAb, α1-AAb, MAS-AAb, M2-AAb, ETA-AAb) was analyzed by a specific rat cardiomyocyte bioassay in vitro. Macular (superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP)) and peripapillary vessel density (VD) were measured by OCT-A (Spectralis II, Heidelberg, Germany). VD analysis was done by the Erlangen-Angio tool, including an APSifyed and Bruch's membrane opening (BMO) based analysis. Data were analyzed by mixed model (SAS version 9.4). Gender and age were set as covariates. The study was approved by the local ethics committee and was done in accordance with the tenets of the Declaration of Helsinki. Informed consent was achieved. Results : All patients with Long-COVID showed a seropositivity for GPCR-AAbs (100%). Female patients with Long-COVID showed lower macular and peripapillary VD compared to men. A significant effect of a seropositivity of AT1-AAb on age-corrected least squares means (LS-means) overall VD of DCP ([CI: 0,25;6.07], p=0.03). A seropositivity of α1-AAb showed a significant effect on age-corrected LS-mean overall VD of SVP ([CI: 0.07;2.69], p=0.04), of DCP ([CI: 0.36;3.25], p=0.01), and of PH ([CI: 1.17;5.59], p=0.01), respectively. A seropositivity of MAS-AAb yielded a significant effect on age-corrected LS-mean overall VD of DH (CI: 1.48;6.07, p=0.001). A seropositivity of ß2-AAb has a significant effect on agecorrected LS-mean overall VD of MH (CI: 0,02;1,94, p=0.04). For those effects, the covariate age was significant in the type III tests (p<0.05), thus analysis was done considering this age-effect. Conclusions : As autoimmune mechanisms were reported to be involved in the pathogenesis of Long-COVID, we postulate that functional active GPCR-AAb may have an impact on retinal microcirculation, being a propable correlate to systemic disease.

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