Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 874
Filter
1.
Akademik Acil Tip Olgu Sunumlari Dergisi ; 12(3):85-87, 2021.
Article in English | EMBASE | ID: covidwho-1822751

ABSTRACT

Introduction: Epistaxis and gingival bleeding are among the most common presentation to the emergency department for patients with thrombocytopenia. Here, we present a case who was admitted to the emergency department with thrombocytopenia and was diagnosed with metastatic cancer of unknown primary origin. Case Report: A 26-year-old male patient was admitted to the emergency department with gingival bleeding and epistaxis. The body temperature was 38.3 °C. Petechial rash, ecchymosis or organomegaly was not detected on physical examination. Laboratory results revealed thrombocytopenia as 31 × 103 (159-388 × 103/μL). Although hemoglobin and leukocyte counts were normal, no band or precursor cell was observed in the patient's peripheral blood smear. There was no history of weight loss, night sweats, arthritis, malar rash, photosensitivity, contact with ticks, animals, or a COVID-19 patient. Serological tests performed for infections such as HIV, EBV, HCV, Crimean-Congo hemorrhagic fever were negative. Bone marrow biopsy was performed due to the unexplained cytopenia, reported as "signet ring cell metastatic adenocarcinoma". Gastrointestinal system endoscopy was performed to detect primary cancer. A biopsy was taken from the antrum and corpus revealed gastritis. An FDG PET-CT was revealed heterogeneously pathologically increased FDG attitude in all axial and appendicular bones. Despite all the modalities of diagnosis, the origin was not found and the patient was transferred to the oncology department for treatment with a diagnosis of cancer of unknown origin with bone marrow infiltration. Conclusion: Bone marrow metastases should be kept in mind in patients presenting with thrombocytopenia.

2.
Ochsner Journal ; 22(1):85-88, 2022.
Article in English | EMBASE | ID: covidwho-1822732

ABSTRACT

Background: The common dermatologic manifestations seen in patients with coronavirus disease 2019 (COVID-19) include mor-billiform, pernio-like, urticarial, macular erythematous, vesicular, and papulosquamous disorders, as well as retiform purpura. Although cases of acro-ischemia have been demonstrated, they are not well studied or reported. Case Report: A 73-year-old male was admitted for acute hypoxic respiratory failure secondary to COVID-19 infection. During the patient’s hospital course, his oxygen requirement progressively increased, and he developed painful, violaceous purpura on his right lower extremity digits. The patient was treated with therapeutic doses of enoxaparin and nitroglycerin ointment in the hospital and apixaban on discharge. The patient was lost to follow-up. Conclusion: The multiorgan dysfunction associated with COVID-19 includes dermatologic manifestations. This case illustrates that acro-ischemia can resolve with guideline-based medical treatment.

3.
Revista de la Facultad de Medicina Humana ; 22(2):446-451, 2022.
Article in English | EMBASE | ID: covidwho-1822695

ABSTRACT

Introduction: The epidemic that had its beginning in the city of Wuhan in December 2019, has become a public health problem that is advancing at dizzying steps. Objective: To determine the clinical and epidemiological profile in Covid-19 patients attended at the HASA-I - Utcubamba, 2020. Methods: The type of research was observational, descriptive and retrospective cross-sectional. The population consisted of 312 patients from which a sample of 173 patients was extracted that met the conditions of being representative and adequate. All data processing and statistical calculations were performed using Microsoft Excel 2019 software. Results: Regarding the results, it was determined that the epidemiological profile: male gender a total of 102 and female gender 71, representing 59,0% and 41,0% respectively;average age of 45 years;most affected place of origin, the city of Bagua Grande, with a frequency of 162, which represents 93,6%. Regarding the clinical profile: diabetes mellitus presented a total of 7 cases, representing 4,1%;cardiovascular diseases with a frequency of 6, representing 3,5%;general malaise with a total of 75 cases, representing 43,4%;fever with a frequency of 66 cases, representing 38,2%;cough with a frequency of 56 cases, representing 32,4%;headaches with a frequency of 50 cases, representing 28,9%;and dyspnea with a frequency of 34, representing 19,7%. Conclusion: The male gender was predominant with comorbidities such as diabetes mellitus, general malaise and elevated CRP.

4.
Journal of the Liaquat University of Medical and Health Sciences ; 21(1):16-22, 2022.
Article in English | EMBASE | ID: covidwho-1822684

ABSTRACT

OBJECTIVE: To evaluate the pattern of serum electrolytes abnormalities and their impact on ICU admitted Covid-19 patient outcomes. METHODOLOGY: This retrospective study was carried out at OMI hospital and Dr. Ziauddin Hospital, Karachi, Pakistan, between August to December 2020. Total 102 PCR positive, ICU admitted with severe Covid-19 patients as per WHO criteria were included. The patient's demographic characteristics, clinical features including co-morbidities, electrolytes reports at the time of admission, length of ICU and/or hospital stay, and outcome (expired/survived) were evaluated. RESULTS: Biochemical testing found abnormal electrolyte levels in 90.2% ICU admitted Covid-19 patients. Electrolytes abnormalities including hyponatremia 45.1%, hypermagnesemia 40.2%, hypocalcemia 31.4%, hyperchloremia23.5% and hyperphosphatemia in 20.6% patients. Out of the total, 28.4% of patients needed invasive respiratory support, and 37.3% could not survive. A higher incidence of mortality (39.1% vs. 20%) was seen in patients with electrolytes abnormalities compared to those presented with normal values. CONCLUSION: Electrolyte abnormalities were found in 90% of the ICU Admitted Covid-19 patients. The most common abnormalities found among the patients were hyponatremia, hypermagnesemia, and Hypocalcemia. The findings revealed that several electrolyte imbalances harm patients' in-hospital outcomes. Electrolyte assessment of Covid-19 patients at the time of admission would be helpful in risk stratification for adverse outcomes.

5.
ARYA Atherosclerosis ; 17(2), 2022.
Article in English | EMBASE | ID: covidwho-1822674

ABSTRACT

BACKGROUND: COVID-19 was introduced by the World Health Organization (WHO) as a global pandemic. The disease manifestations ranges from a mild common cold to severe disease and death. It has a higher mortality rate in people with a history of comorbidities, including cardiovascular disease (CVD) and can also contribute to cardiac injury. This study was conducted to evaluate the relationship between troponin levels as a cardiac marker and adverse outcomes in this disease. METHODS: The study sample included 438 patients hospitalized with COVID-19;however, the troponin data of 6 patients were not available. The need to be admitted to the intensive care unit (ICU), and death were considered the adverse outcome in patients with COVID-19. Troponin levels were checked in all patients on day 1 and day 3 of hospitalization. Multiple logistic regression analysis was performed to determine whether there was an independent association between the adverse outcomes and troponin enzyme in hospitalized patients with COVID-19. RESULTS: The mean age of patients was 61.29 ± 15.84 years. Among the 432 patients tested on day 1 of hospitalization, 24 patients (5.6%) tested positive (Troponin 1), and among the 303 patients tested on day 3, 13 patients (4.3%) tested positive (Troponin 2). Based on our results, Troponin 1 showed an independent association with both death (3.008 [95%CI = 1.091-8.290];P = 0.033) and need for ICU admission (8.499 [95%CI = 3.316-21.788];P < 0.001) in multiple logistic regression analysis. Moreover, the status of Troponin 2 had an independent significant association with both death (4.159 [95%CI = 1.156-14.961];P = 0.029) and ICU admission (7.796 [95%CI = 1.954-31.097];P = 0.004). CONCLUSION: Troponin showed a significant association with adverse outcomes in people who were hospitalized with COVID-19. The periodical assessment of this enzyme from the time of hospitalization may improve the clinical decision making of clinicians.

6.
Siberian Journal of Oncology ; 21(1):29-36, 2022.
Article in Russian | EMBASE | ID: covidwho-1822670

ABSTRACT

The aim. To analyze the blood levels of endothelin-1 (ET - 1) and high molecular weight kininogen (HMWK) in patients with breast cancer (BC) previously infected with the new coronavirus. Material and methods. The study group included 20 patients with stage II - IV BC (invasive carcinoma). All patients were receiving chemotherapy at the time of their SA RS-CoV-2 infection. The comparison group included 19 women without breast cancer, who were matched for age. All women of both groups had an RT-PC R confirmed SA RS-Cov-2 infection. Blood levels of ET - 1 and HMWK were measured by ELISA 3-10 weeks after the positive antigen test results. The control group included 10 women of the same age without cancer and without CO VID - 19 symptoms and anti-SA RS-CoV-2 antibodies. Results. The ET - 1 levels in the comparison group were within the reference range, while HMWK levels were significantly higher than those in breast cancer patients. In BC patients with lung metastases, the ET - 1 levels were higher than those in the comparison group patients, while in others (no history of lung metastases, with mild infection course or pneumonia), the ET - 1 levels were similar to those in the comparison and control groups. The HMWK levels in the study and comparison groups were significantly higher than those in controls. Among BC patients, there were women who had significantly higher ET - 1 and HMWK levels compared to the reference levels, and the majority of these patients had lung metastases and previous CO VID - 19 pneumonia. Conclusion. The measurement of HMWK blood levels demonstrated that the plasma contact activation system and the kallikrein-kinin system were active for a long period after the infection both in BC patients and in women without cancer. A high level of ET - 1, the endothelial dysfunction marker, persisted for a long time in some BC patients. Our results were consistent with results of other studies supporting the hypothesis that SA RS-CoV-2 virus infection is a systemic vascular disease with long-term consequences, and its mechanisms require further study.

7.
ACG Case Reports Journal ; 9(3), 2022.
Article in English | EMBASE | ID: covidwho-1822626

ABSTRACT

Liver injury is a common manifestation of coronavirus disease 2019 (COVID-19), with most injuries manifesting as transient mild hepatocellular injury. Cholestatic injury occurs less commonly and is typically mild. Severe cholestatic injury is rare, with only 4 cases reported in the literature. We present a 70-year-old woman with no known liver disease who presented with severe COVID-19 and developed severe cholestatic hepatitis. A liver biopsy was performed demonstrating bile duct injury, uncommonly reported in patients with COVID-19. This complication needs greater awareness because it has been known to cause progressive liver disease requiring transplantation.

8.
Biomedical and Pharmacology Journal ; 15(1):305-312, 2022.
Article in English | EMBASE | ID: covidwho-1822618

ABSTRACT

SARS COV-2is a very dangerous virus that has led to many deaths. H. Influenzais a bacteria that causes many infections inside the human body, such as pneumonia. In this study, a total of (60)blood samples were taken from patients infected with SARS COV-2shared with H. Influenza infection who attended Ibn-Al-Baladi Hospital/Baghdad city during the period from 15th January to 1st December 2021. Venous blood samples were also taken from (60) healthy individuals as a control group. The results showed that the distribution rate of the SARS COV-2 IgG and H. influenza IgG among the male patients was twice44 (73.3%)more than the distribution rate among female patients. The prevalence of SARS COV-2 IgG and H. influenza IgG was shown to be the highest among the age group (>51) years, followed by the age group (21-30) years. The cases of SARS COV-2and H. influenza infections among the studied patients according to residency were shown to be almost equal among rural and urban residents 30,30 (49.2%,50.8%) respectively. Regarding the relationship between SARS COV-2 IgG and H. influenza IgG and CRP levels, the mean level of CRP in the patients was (73.72±17.05) and in the the controls was (8.71±1.12), while the mean level of H. influenza IgG in the patients was (1.05±0.23) and in the control group was (0.3±0.02), whereas the mean level of SARS COV-2 IgG was (7.00±2.15) in the patients andwas (0.35 ±0.19) in the controls with a highly significant differences (HS). The number and percentage of patients with positive SARS COV-2 and H. influenza IgG was 38(95.0%) who had high levels of GOT up to 65 U/L, while 2(50%) of those patients had GOT >65 U/L, while the Negative infections with SARS COV-2 IgG, H. influenza IgG 17(85.0%) had up 65 U/L and 3(15.0 %) had>65 U/L level (P =0.03).In addition, high levels of GPT, Alkaline phosphates, urea and creatinine were recorded among patients groups when compared with the healthy controls.

9.
Pakistan Journal of Medical Sciences ; 38(5), 2022.
Article in English | EMBASE | ID: covidwho-1822610

ABSTRACT

Objectives: To determine the association between the laboratory biomarkers (C-reactive protein (CRP), Ferritin, lactate dehydrogenase (LDH), Procalcitonin, and D-dimer) with complications and in-hospital mortality in COVID-19 patients. Methods: This single-center, cross-sectional study was conducted at the Department of Emergency Medicine of Aga Khan University Hospital from April 01, 2020, to July 31, 2020. Descriptive statistics were presented as Mean±SD and Median along with Range. The frequencies and percentages were calculated for all categorical variables. Univariate and multivariate analysis was carried out to evaluate the significant association between the laboratory biomarkers and in-hospital mortality. Results: A total of 310 adult COVID positive patients were included. The most common complication was acute respiratory distress syndrome (ARDS) (37.1%), followed by myocardial injury (MI) (10.7%), deep vein thrombosis (DVT) (0.6%), and pulmonary embolism (PE) (0.3%). In-hospital mortality was 15.2%. In univariate analysis, it was observed that increased values of all biomarkers were significantly associated with the prediction of in-hospital mortality using binary logistic regression analysis (OR > 1.0, P <0.05). In multivariate analysis, increased levels of LDH and D-dimer at admission were significantly associated with increased odds of mortality (P <0.05). Conclusion: Serum CRP, ferritin, Procalcitonin, LDH, and D-dimer levels at the time of admission can predict complications like ARDS and MI and also predict mortality in COVID-19 infection. Serum LDH and D-dimer are the best amongst them for predicting mortality.

10.
Journal of Acute Disease ; 11(2):77-84, 2022.
Article in English | EMBASE | ID: covidwho-1822498

ABSTRACT

Objective: To evaluate patient demographic characteristics and risk factors for mortality during the first and the second wave among COVID-19 patients in a tertiary care hospital of India. Methods: Data were taken from the hospital's electronic system for COVID-19 patients from August 2020 to December 2020, and the second from January 2021 to May 2021. The mortality rate, demographic and clinical characteristics, laboratory profile, and reasons for the death of the two waves were retrieved and compared, and the risk factors of the two waves were determined. Results: In the first wave, 1 177 COVID-19 cases visited the hospital and 96 (8.2%) died. In comparison, the death rate in the second wave was significantly higher (244/2 038, 12.0%) (P<0.001). No significant difference in age [60 (50-69) vs. 60.5 (53-70), P=0.11] or gender (P=0.34) was observed between the two waves. Compared to the first wave. there were significantly more cases with fever, cough, weakness, loss of taste and smell, and sore throat during the second wave (P<0.05), but significantly fewer cases with kidney disease (6.6% vs. 13.5%, P=0.038) and diabetes mellitus (35.7% vs. 50.0%, P=0.015). Besides, during the second wave, more patients had abnormal X-ray findings, higher levels of lymphocytes and serum ferritin (P<0.05). In addition, there were significant differences in the rate of death cases with acidosis, septic shock, acute kidney injury, diabetes mellitus, cardiovascular events, hypothyroidism (P<0.05). Multivariate regression showed that during the first wave, age (OR: 1.10;95% CI: 1.02-1.21), diabetes mellitus (OR: 3.16;95% CI: 2.08-3.53), and abnormal X-ray (2.67;95% CI: 2.32-2.87) were significant independent risk factors of mortality;while in the second wave, age (OR: 1.13;95% CI: 1.12-1.28), diabetes mellitus (OR: 8.98;95% CI: 1.79-45.67), abnormal X-ray (OR: 12.83;95% CI: 2.32-54.76), high D-dimer (OR: 10.89;95% CI: 1.56-134.53), and high IL-6 (OR: 7.89;95% CI: 1.18-47.82) were significant independent risk factors of mortality. Conclusion: Overall mortality and incidence of severe diseases are higher in the second wave than the first wave. Demographic characteristics, co-morbidities, and laboratory inflammatory parameters, especially D-dimer and IL-6, are significant risk facors of mortality during the COVID-19 pandemic.

11.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822475

ABSTRACT

Background: Longitudinal surveys to monitor the seroprevalence are required to support efforts for assessment of the levels of endemic stability in certain countries. We investigated seroprevalence of anti-SARS-CoV-2-S1 receptor-binding domain (RBD)-specific antibodies in the serum samples in 2011–2021, including a cohort study of 2019–2021, to evaluate the vaccination and anti-IgG-SARS-CoV-2–S1 RBD-positive statuses to assess the resistance and severity of COVID-19. Materials and Methods: Anti-SARS-CoV-2-S1 RBD-specific antibodies were assayed in the serum samples (N = 565) randomly selected from various cohorts previously recruited from 2011 to 2021 from the city of Moscow and Moscow Region. Among them there were the participants (N = 310) recruited in 2019–2021 with an endpoint of 30 October 2021 when these participants were interviewed over phone with relevant questionnaire. Results: Obtained data indicated a percentage of 3–6% of SARS-CoV-2-S1 RBD-specific antibodies detected in participants recruited in 2011–2019. The percentage of SARS-CoV-2-S1 RBD-specific antibodies was increased to 16.5% in 2020 and to 46% in 2021. The vaccination rate of 238 respondents of this cohort was 58% from August 2020 to October 2021. In total, 12% of respondents were hospitalized. The morbidity rate in the subgroup of anti-SARS-CoV-2-S1 RBD-positive respondents was 5.4-fold higher than that in the subgroup of vaccinated respondents. Conclusions: A small percentage of SARS-CoV-2-S1 RBD-specific antibodies detected in 2011–2019 indicated possible spreading of coronaviruses during the pre-pandemic period. Collective immunity in Moscow and the Moscow region was able to reach 69% from August 2020 to October 2021 if this rate is added to the rate of not vaccinated SARS-CoV-2-S1 RBD-positive subjects.

12.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822468

ABSTRACT

A unique case of multiple metastatic melanoma skin nodules regression in a heavily pretreated, 72-year-old Caucasian female, after administering the second dose of the SARS-CoV-2 mRNA Pfizer-BioNTech vaccine, is presented. Two days after vaccination, all her melanoma skin nodules became painful and were significantly reduced in size. Physical examination and ultrasound imaging confirmed the patient’s observation. The effect was sustained, and further reduction of the nodules occurred after the third vaccine dose. One of the reduced nodules was removed, histologically examined, and its histopathology was compared to that of another such nodule removed and examined earlier. Distinct differences were observed between the two histopathologies, with the most notable the unexpected finding of the absence of infiltrating lymphocytes in the reducer nodule’s melanoma tissue. Based on this observation, the possible immunological mechanism(s) leading to the vaccine’s effect are speculated. More possible is the vaccine’s antitumor and apoptotic activity via stimulation of the Tol Like Receptors 3, 7, and 8, and (downstream) the nuclear factor kappa-light-chain-enhancer of the activated B cells pathway of the non-lymphocytic immune effector cells.

13.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822461

ABSTRACT

This was a retrospective cohort study, which aimed to investigate the factors associated with hesitancy to receive a third dose of a coronavirus disease 2019 (COVID-19) vaccine. A paper-based questionnaire survey was administered to all participants. This study included participants who provided answers in the questionnaire about whether they had an intent to receive a third dose of a vaccine. Data on sex, age, area of residence, adverse reactions after the second vaccination, whether the third vaccination was desired, and reasons to accept or hesitate over the booster vaccination were retrieved. Among the 2439 participants, with a mean (±SD) age of 52.6 ± 18.9 years, and a median IgG-S antibody titer of 324.9 (AU/mL), 97.9% of participants indicated their intent to accept a third vaccination dose. The logistic regression revealed that participants of a younger age (OR = 0.98;95% CI: 0.96–1.00) and with a higher antibody level (OR = 2.52;95% CI: 1.27–4.99) were positively associated with hesitancy over the third vaccine. The efficacy of the COVID-19 vaccine and concerns about adverse reactions had a significant impact on behavior regarding the third vaccination. A rapid increase in the booster dose rate is needed to control the pandemic, and specific approaches should be taken with these groups that are likely to hesitate over the third vaccine, subsequently increasing booster contact rate.

14.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822452

ABSTRACT

Emergent SARS-CoV-2 variants and waning humoral immunity in vaccinated individuals have resulted in increased infections and hospitalizations. Children are not spared from infection nor complications of COVID-19, and the recent recommendation for boosters in individuals ages 12 years or older calls for broader understanding of the adolescent immune profile after mRNA vaccination. We tested the durability and cross-reactivity of anti-SARS-CoV-2 serologic responses over a six-month time course in vaccinated adolescents against the SARS-CoV-2 D614G (“wild type”) and Omicron antigens. Serum from 77 adolescents showed that anti-Spike antibodies wane significantly over six months. After completion of a two-vaccine series, cross-reactivity against Omicron-specific receptor-binding domain (RBD) was seen. Functional humoral activation against wild type and Omicron SARS-CoV-2 also declines over time in vaccinated adolescent children. Evidence of waning mRNA-induced vaccine immunity underscores vulnerabilities in long-term pediatric protection against SARS-CoV-2 infection, while cross-reactivity highlights the additional benefits of vaccination. Characterization of adolescent immune signatures post-vaccination will inform guidance on vaccine platforms and timelines, and ultimately optimize immunoprotection of children.

15.
Viruses ; 14(5), 2022.
Article in English | EMBASE | ID: covidwho-1822442

ABSTRACT

A canine coronavirus (CCoV) has now been reported from two independent human samples from Malaysia (respiratory, collected in 2017–2018;CCoV-HuPn-2018) and Haiti (urine, collected in 2017);these two viruses were nearly genetically identical. In an effort to identify any novel adaptations associated with this apparent shift in tropism we carried out detailed evolutionary analyses of the spike gene of this virus in the context of related Alphacoronavirus 1 species. The spike 0-domain retains homology to CCoV2b (enteric infections) and Transmissible Gastroenteritis Virus (TGEV;enteric and respiratory). This domain is subject to relaxed selection pressure and an increased rate of molecular evolution. It contains unique amino acid substitutions, including within a region important for sialic acid binding and pathogenesis in TGEV. Overall, the spike gene is extensively recombinant, with a feline coronavirus type II strain serving a prominent role in the recombinant history of the virus. Molecular divergence time for a segment of the gene where temporal signal could be determined, was estimated at around 60 years ago. We hypothesize that the virus had an enteric origin, but that it may be losing that particular tropism, possibly because of mutations in the sialic acid binding region of the spike 0-domain.

16.
Frontiers in Pediatrics ; 10, 2022.
Article in English | EMBASE | ID: covidwho-1822393

ABSTRACT

Objectives: The COVID-19 virus is highly contagious primarily via aerosol transmission and has a high mortality rate. On March 13, 2020, the United States declared a national emergency in response to the COVID-19 pandemic. This study aims to enumerate the effect of the pandemic on vaccination rates during the COVID-19 lockdown and the aftermath in pediatric patients aged 6weeks-6 years. Study Design: A retrospective review of medical records was performed of missed well childcare visits at MetroHealth from March 1, 2020 to June 30, 2020. The sample size of 400 children aged 6 weeks to 6 years were randomly selected. Demographic data, number of calls made to attempt, scheduled WCC, no show rates for clinic appointments, number of missed WCC, location of MH facility, insurance type, vaccination status prior to the pandemic were collected. Statistical analysis was performed with SPSS software (IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp). Results: From this descriptive study, we found that 43.5% of patients were not up to date on their childhood vaccination. The mean age was 24.38 months (SD 20.15). There were slightly more males (52.8%) in the study than females (47.3%) and most children were of African American descent. More than 50% of patients missed a scheduled well child appointment and 27% had a missed at least two consecutive appointments. Conclusion: The COVID-19 pandemic has no doubt made a significant mark on health care;the effects would be both immediate and delayed, with vulnerable population being the most impacted. There is an urgent need to prevent a large-scale health disaster of catastrophic potential that could occur if an effective vaccination strategy is not implemented rapidly.

17.
Frontiers in Pediatrics ; 10, 2022.
Article in English | EMBASE | ID: covidwho-1822391

ABSTRACT

Acute interstitial nephritis (AIN) has been recently recognized as one of the infrequent kidney involvement phenotypes among adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although SARS-CoV-2 associated intrinsic kidney disease has been scarcely reported in children, only one case of AIN temporally associated with the infection has been described in the pediatric population so far. We presented a case of a 12-year old boy who presented with fatigue, anorexia, and polydipsia following an RT-PCR that confirmed SARS-CoV-2 infection seven weeks prior to admission. Initial workup revealed increased serum creatinine (235 μmol/L), glucosuria, low-molecular-weight proteinuria, mild leukocyturia, and microhematuria with hyaline and granular casts on microscopy. Antibodies against the SARS-CoV-2 S protein receptor-binding domain confirmed prior infection with high titers. Kidney biopsy showed diffuse active interstitial nephritis with negative immunofluorescence and positive immunohistochemistry for SARS-CoV-2 in the inflammatory cells within the interstitium. Electron microscopy revealed several SARS-CoV-2-like particles. Kidney function continued to deteriorate despite several days of supportive therapy only (peak serum creatinine 272 μmol/L);thus, treatment with methylprednisolone pulse-dose therapy was initiated and was followed by oral prednisolone with gradual tapering. Kidney function completely recovered after 3 weeks post-discharge and remained normal after 11 weeks of follow-up (last estimated glomerular filtration rate 106 ml/min/1.73 m2) with only residual microhematuria. Our case adds to the emerging evidence of SARS-CoV-2 as a potential etiological agent of AIN in children and also suggests that interstitial kidney injury may result from secondary inflammatory damage. Epidemiological history, serologic testing, and SARS-CoV-2 detection in biopsy should be considered in the work-up of children with AIN of unknown etiology.

18.
Frontiers in Microbiology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1822384

ABSTRACT

Serological testing is recommended to support the detection of undiagnosed coronavirus disease 2019 (COVID-19) cases. However, the performance of serological assays has not been sufficiently evaluated. Hence, the performance of six severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binding antibody assays [three chemiluminescence (CLIAs) and three lateral flow immunoassays (LFIAs)] and a surrogate virus neutralization test (sVNT) was analyzed in a total of 988 serum samples comprising 389 COVID-19-positives and 599 COVID-19-negatives. The overall diagnostic sensitivities of CLIAs and LFIAs ranged from 54.2 to 56.6% and from 56.3 to 64.3%, respectively. The overall diagnostic specificities of CLIAs and LFIAs ranged from 98.2 to 99.8% and from 97.3 to 99.0%, respectively. In the symptomatic group (n = 321), the positivity rate increased by over 80% in all assays > 14 days after symptom onset. In the asymptomatic group (n = 68), the positivity rate increased by over 80% in all assays > 21 days after initial RT-PCR detection. In LFIAs, negatively interpreted trace bands accounted for the changes in test performance. Most false-positive results were weak or trace reactions and showed negative results in additional sVNT. For six binding antibody assays, the overall agreement percentages ranged from 91.0 to 97.8%. The median inhibition activity of sVNT was significantly higher in the symptomatic group than in the asymptomatic group (50.0% vs. 29.2%;p < 0.0001). The median times to seropositivity in the symptomatic group were 9.7 days for CLIA-IgG, 9.2 and 9.8 days for two CLIAs-Total (IgM + IgG), 7.7 days for LFIA-IgM, 9.2 days for LFIA-IgG, and 8.8 days for sVNT-IgG, respectively. There was a strong positive correlation between the quantitative results of the four binding antibody assays and sVNT with Spearman ρ-values ranging from 0.746 to 0.854. In particular, when using LFIAs, we recommend using more objective interpretable assays or establishing a band interpretation system for each laboratory, accompanied by observer training. We also anticipate that sVNT will play an essential role in SARS-CoV-2 antibody testing and become the practical routine neutralizing antibody assay.

19.
Frontiers in Microbiology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1822382

ABSTRACT

Identifying immunogenic targets of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is critical to advance diagnostic and disease control strategies. We analyzed humoral (ELISA) and T-cell (ELISpot) immune responses to spike (S) and nucleocapsid (N) SARS-CoV-2 proteins as well as to human endemic coronavirus (eCoV) peptides in serum from convalescent coronavirus disease 2019 (COVID-19) patients from Tatarstan, Russia. We identified multiple SARS-CoV-2 peptides that were reactive with serum antibodies and T cells from convalescent COVID-19. In addition, age and gender associated differences in the reactivity to S and N protein peptides were identified. Moreover, several SARS-CoV-2 peptides tested negatively correlated with disease severity and lung damage. Cross-reactivity to eCoV peptides was analyzed and found to be lower in COVID-19 compared to controls. In this study, we demonstrate the changing pattern of immunogenic peptide reactivity in COVID-19 serum based on age, gender and previous exposure to eCoVs. These data highlight how humoral immune responses and cytotoxic T cell responses to some of these peptides could contribute to SARS-CoV-2 pathogenesis.

20.
FASEB Journal ; 35(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1821974

ABSTRACT

Symbiotic interaction between the human body and its microbiota is an important issue of modern biomedicine and personalized medicine. However, little is known on molecular mechanisms of that relationship. Bearing in mind the ubiquitous participation of peptides in biomolecular interactions and regulatory processes we attempted direct search of blood peptides originated from microbial proteins. LC-MS/MS analysis was carried out of blood serum and plasma samples taken from 20 healthy donors on Q Exactive HF-X Hybrid Quadrupole-Orbitrap mass-spectrometer. Sample preparation was carried out based on our previously developed method of peptide desorption from the surface of major blood plasma proteins followed by standard chromatographic steps. Mascot and X! Tandem search engines were used for peptide identification. Human protein sequences were taken from UniProt Knowledgebase and sequences of human microbiota proteins-from NIH Human Microbiome Project (HMP). As a result, out of 13625 identified peptides 912 were unique fragments of microbial precursors, which is 6.69% of the total amount of detected bloodstream peptides. In 30 cases peptide identification was confirmed by mass-spectral study of individual synthetic samples. Absolute quantification by the mass-spectrometric method of multiple reaction monitoring (MRM) confirmed the presence of bacterial peptides in plasma and serum in the range of approximately 0.1 nMol/L to 1 mkMol/L, which is comparable to physiologically significant hormone concentrations in human blood in normal conditions. Analysis of the in silico obtained hydrolyzates of microbiotic proteins showed that significant number of the identified peptides are derived from the precursor proteins as a result of hydrolysis with trypsin, chymotrypsin and pepsin, the main proteases of the gastrointestinal system. 60% of the identified “microbial” peptides are derived from the intestine flora, about 20% - from oral microbiota and 20% fall on the remaining microbiotic communities. Most of the precursor proteins refer to intracellular, cytoplasmic proteins. The isolated fraction of peripheral blood mononuclear cells showed increase secretion of proinflammatory cytokines, colony stimulating factors and chemoattractants as the response to the addition of some of the identified microbiotic peptides. The data obtained serve as a basis for the ongoing study of the functional properties of microbiome derived peptides.

SELECTION OF CITATIONS
SEARCH DETAIL