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Background and Aim: Feline infectious peritonitis (FIP) is an infectious, immune-mediated, and fatal disease in cats caused by a mutant feline coronavirus (FCoV) infection. Feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) are two common retroviruses that play a role in reducing feline immune function with opportunistic retrovirus infection being a predisposing factor for the development of FIP. This study aimed to evaluate the clinicopathological parameters of FIP in cats with and without retrovirus coinfection. Materials and Methods: In total, 62 cats presenting with pleural and/or peritoneal effusion at the Kasetsart University Veterinary Teaching Hospital, Bangkok, Thailand, were selected for the study. Effusion samples were collected and a reverse transcriptase-polymerase chain reaction (RT-PCR) assay was performed on all samples using the 3' untranslated region primer. All FCoV-positive cats were tested for retrovirus infection using a commercial kit (Witness FeLV-FIV [Zoetis]; United States). Clinical signs, hematological, and biochemical parameters of these cats were investigated and grouped. Results: Of the 62 cats with pleural and/or peritoneal effusion, FCoV was detected in 32, of which 21 were highly suspicious for FIP. The cats suspected of FIP were divided into three subgroups following viral detection. A total of 14 had only FCoV infection (Group A), four had FCoV and FeLV infection (Group B), and three had FCoV, FeLV, and FIV infection (Group C). Of the rest, 11 had definitive diagnoses, which included three being FCoV and FeLV-positive (Group D), and eight were retrovirus-negative (Group E). Mild anemia and lymphopenia were found in cats infected with these three viruses. An albumin-to-globulin ratio lower than 0.5 was found in FIP cats with only FCoV infection. Conclusion: Typically, cats with clinical effusion and FIP, with and without retrovirus coinfection, had similar hematological findings. Clinical signs, blood parameters, fluid analysis with cytological assessment, and RT-PCR assays could identify better criteria to diagnose FIP with and without retrovirus coinfection.
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Background: Serum interleukin 6 (IL-6) levels have been studied in the diagnostic evaluation of patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19). Methods: We studied the utility of treatment with tocilizumab in COVID-19 patients (n=19) with a negative nasopharyngeal swab real time reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 who had suggestive computed tomography (CT) findings, namely, COVID-19 Reporting and Data System (CO-RADS) 4,5. Results: Receiver operator characteristic (ROC) curve analysis showed that serum IL 6 at a cut-off of >56.9 pg/L was a predictor of mortality in nasopharyngeal swab RT-PCR negative patients with suggestive CT findings. Tocilizumab had no significant effect on the mortality. Conclusions: In nasopharyngeal swab RT-PCR negative patients with suggestive chest CT findings, elevated serum IL-6 levels > 56.9 pg/L predicted mortality. However, treatment with tocilizumab had no effect on mortality.
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Background: The pandemic of COVID-19 since its beginning has created havoc all-round the globe. The role of oxygen therapy remains constant. Various modalities have been studied for oxygen delivery to hypoxic patients but high flow nasal oxygen (HFNO) has lately gained importance in terms of non-invasive oxygen delivery, easy administration and great improvement in patient's recovery. We conducted this retrospective analysis with the primary objective of looking for the proportion of patients who were successfully weaned off of HFNO or non-invasive ventilation (NIV) and the secondary aim was to look for duration of hospital stay and its effect on clinical recovery based on laboratory parameters. Methods: All patients, positive for COVID-19 infection by real-time reverse transcriptase polymerase chain reaction (RTPCR) were admitted to covid ICU or ward with oxygen requirement and were treated with either NIV or HFNO were enrolled for the study. Patients were grouped under H group (HFNO) or N group (NIV). Daily ABG readings, chest x-ray, respiratory rate, hemodynamic parameters and urine output were noted on 12 hourly intervals. Any changes in above parameters along with need for intubation were assessed. Results: Patients from both the groups showed significant improvement in their oxygen saturation by the fifth day of their treatment. Fourteen patients from the NIV group and 10 from the HFNO group had saturation >90% by Day 5. Of those who presented with saturation of <85%, 2 out of 5 in the NIV group (40%) and 1 of the 2 patients in the HFNO group (50%) showed improvement in their oxygen saturation. The P/F was statistically comparable (p 0.928) in both groups. The levels of bio markers, and the improvement was comparable and correlated with clinical improvement as well. Conclusion: We conclude that though HFNO is accepted better than NIV, the improvement in the respiratory status of the patient was comparable with both the treatment modalities and hence we do not recommend use of HFNO, especially in a situation of gross deficit of oxygen availability as compared to the exponential rise in the demand. © 2023 Tehran University of Medical Sciences.
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To develop a multiplex fluorescent quantitative RT-PCR for the detection of porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV) and swine acute diarrhea syndrome coronavirus (SADS-CoV), in this study, specific primers/probes were designed based on the conserved regions of M, M and N gene sequences of PEDV, PDCoV and SADS-CoV, respectively. After optimization of the reaction conditions, a multiplex fluorescent quantitative RT-PCR for PEDV, PDCoV and SADS-CoV was established. The results of specificity assay showed that the method was positive for detection of PEDV, PDCoV and SADS-CoV, and negative for detection of porcine transmissible gastroenteritis virus, porcine rotavirus, porcine reproductive and respiratory syndrome virus, porcine pseudorabies virus, porcine circovirus type 2, porcine parvovirus, classical swine fever virus and foot-and-mouth disease virus. The results of sensitivity assay showed that the detection limit of this method for PEDV, PDCoV, and SADS-CoV plasmids standard was 1.0x101 copies/L, and had a good linear relationship with their Ct values in the range of 101 copies/L to 106 copies/L. The results of repeatability assay showed that the coefficients of variation (CVs) of intra- and inter-assay reproducibility ranged from 0.33% to 2.53%, indicating good repeatability and stability. To evaluate the effects of the developed method, 100 clinical samples collected from different parts of Henan province were used for detection of these three viruses and compared with those of single RT-PCR and standard methods. The results of multiplex fluorescent quantitative RT-PCR showed that the positive rates of PEDV, PDCoV and SADS-CoV were 38% (38/100), 14% (14/100) and 5% (5/100), respectively. There was no mixed infection. The coincidence rate with the standard detection methods of PEDV and PDCoV was 100%, and the sensitivity was higher than that of single RT-PCR. In this study, a specific, sensitive and rapid multiplex fluorescent quantitative RTPCR method was established for the first time, which could be used for the differential detection of PEDV, PDCoV and SADS-CoV, and laid a foundation for the differential diagnosis and control of porcine diarrheal diseases.
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The emergence of SARS-CoV-2 necessitated the rapid deployment of tests to diagnose COVID-19. To monitor the accuracy of testing across the COVID-19 laboratory network in Thailand, the Department of Medical Sciences under the Ministry of Public Health launched a national external quality assessment (EQA) scheme using samples containing inactivated SARS-CoV-2 culture supernatant from a predominant strain in the early phase of the Thailand outbreak. All 197 laboratories in the network participated; 93% (n=183) of which reported correct results for all 6 EQA samples. Ten laboratories reported false-negative results, mostly for samples with low viral concentrations, and 5 laboratories reported false-positive results (1 laboratory reported false positives and false negatives). An intralaboratory investigation of 14 laboratories reporting incorrect results revealed 2 main causes of error: (1) RNA contamination of the rRT-PCR reaction and (2) poor-quality RNA extraction. Specific reagent combinations were significantly associated with false-negative reports. Thailand's approach to national EQA for SARS-CoV-2 can serve as a roadmap for other countries interested in implementing a national EQA program to ensure laboratories provide accurate testing results, which is crucial in diagnosis, prevention, and control strategies. A national EQA program can be less costly and thus more sustainable than commercial EQA programs. National EQA is recommended to detect and correct testing errors and provide postmarket surveillance for diagnostic test performance.
Subject(s)
COVID-19 , Humans , SARS-CoV-2/genetics , Laboratories , Pandemics/prevention & control , Thailand/epidemiology , RNA, Viral/geneticsABSTRACT
Bovine rhinitis virus (BRV) is an important pathogen responsible for the bovine respiratory disease complex (BRDC) and can be divided into two genotypes (BRAV and BRBV). To establish a duplex quantitative real-time RT-PCR assay for simultaneous detection of BRAV and BRBV, specific primers and TaqMan probes targeting the 5'NTR of BRAV and 3'NTR of BRBV were designed. A duplex quantitative real- time RT- PCR assay for simultaneous detecting BRAV and BRBV was preliminarily established by optimizing reaction conditions for each step. The assay specifically detects BRAV and BRBV, and no crossreaction with other common bovine respiratory pathogens, including IDV, BCoV, BVDV-1, BRSV, BPIV-3, BAdV-3, mycoplasma bovis, Pasteurella multocida, Mannheimia haemolytica, Escherichia coli, and Salmonella, was observed. In addition, the sensitivity test showed that the detection limits of this assay were 3.2x101 copies/L for both BRAV and BRBV plasmid standards. Besides, the repeatability test showed that the variation coefficients of this assay were less than 0.05 from both lot-to-lot and intra-lot. These results showed that the assay has high specificity, extreme sensitivity, and good repeatability. Moreover, a total of 43 nasal swabs of BRDC cattle were tested by our assay and four other quantitative real-time RT-PCR assays, including 3 BRAV assays and 4 BRBV assays. The results showed that the detection rates of our assay were 32.56%(14/43) for BRAV and 30.23%(13/43) for BRBV, and the detection rates of other quantitative real-time RT-PCR assays were 0(0/43), 2.33%(1/43), 23.26%(10/43) for BRAV and 27.91% (12/43), 27.91%(12/43), 27.91%(12/43), 27.91%(12/43) for BRBV, indicating that our assay has a more substantial detection capability than other assays. This study firstly established a duplex quantitative real-time RT-PCR assay for simultaneous detection of BRAV and BRBV, and the assay exhibited high specificity, sensitivity, and stability. Moreover, the study firstly confirmed the existence of BRAV in China, contributing to the prevention and control of BRDC.
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In order to perform the isolation of avian infectious bronchitis virus (IBV) and study the pathogenicity of IBV isolate, the RT-PCR was used to detect nucleic acid extracted from a clinical sample of chickens, which were suspected to be infected with infectious bronchitis virus (IBV) and provided by a farmer in Yuncheng, Shanxi province. And the sample was detected as IBV positive by RT-PCR. Then 9-11-day-old SPF chicken embryonated eggs were inoculated with the sample filtered from the grinding fluid, and the obtained allantoic fluid was blindly passed by three generations (F3) and was also tested as IBV positive;The F11 generation passaged in embryonated eggs caused typical "dwarf embryo" lesions to SPF chicken embryonated eggs, and induced the loss of cilia in tracheal rings. The results showed that an IBV strain was isolated and named as YC181031. The S1 gene amplification and sequencing analysis showed that YC181031 strain belonged to IBV GI-22 genotype, which is also nephropathogenic type IBV. Seven-day-old SPF chicks were used to test the pathogenicity of the isolate. The results showed that several clinical symptoms were showed in chicks infected with YC181031, such as breathing with difficulty, depression, excreting watery droppings and death. The mortality of infected chicks was 20%. Typical pathological changes such as enlargement of kidney and urate deposition in the kidney were observed in infected chicks. The immunohistochemical assay and viral load detection were performed for the tissue samples from infected and dead chicks. The tissue lesions and distribution of virus were observed in the kidney, trachea, lung, glandular stomach, spleen and liver samples of infected chicks. RT-PCR detection of pharyngeal anal swabs showed that the virus shedding by infected chicks could be continuously detected within 14 days of the test period;The viral loads of various tissues were detected by RT-qPCR and the results showed that the viral load from high to low was kidney, trachea, lung, stomach, spleen and liver. The viral load of kidney was significantly higher than that of other tissues (P < 0.05).In this study, the pathogenicity characteristics of GI-22 genotype strain were systematically studied for the first time, providing a reference for the prevention and treatment of the disease.
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Objective: Epidemiology and genetic variations of the infectious bronchitis virus(IBV) in Fujian province were studied. Method: Two strains of virus isolated from the diseased chickens in Fujian in 2021 were identified by chicken embryo pathogenicity test, electron microscope observation, and RT-PCR. S1 genes of the isolates were cloned, sequenced, and analyzed using biological software. Result: The two IBV strains were code named FJ-NP01 and FJ-FZ01. The full length of S1 of FJ-NP01 was 1 629 nt encoding 543 amino acids, and that of FJ-FZ01, 1 620 nt encoding 540 amino acids. The S1 gene cleavage site of FJ-FZ01 was HRRRR, same as all reference strains of genotype I branch;while that of FJ-NP01 HRRKR differed from the reported site of IBV isolated from genotype IV but same as that of TC07-2 reference strain of genotype VI. The homology of nucleotide and amino acid between the two isolates was 83.2% and 79.6%, respectively, but merely 75.7%-76.3%and 77.1%-83.5% with the Mass-type conventional vaccines H120 and H52, respectively. Further analysis showed that FJ-NP01was from a recombination event between CK CH GD LZ12-4 and L-1148, the homology of nucleotide acid between 1438-1506 nt of FJ-NP01 with CK CH GD LZ12-4 was 97%, and 95.9% between the other nucleotide acid of S1 gene with L-1148. Conclusion: It appeared that the IBV epidemic experienced in the province was complex in nature and that the existing Mass vaccines would not provide sufficient immune protection to deter the spread.
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Background: Coronavirus disease 2019 (COVID-19) was a recent global pandemic of the era which posed a great challenge for the health care in terms of preventive, diagnostic and treatment dimensions. The seroprevalence rate of COVID IgG antibodies is very crucial in estimating the susceptibility of a particular area to the viral disease. In our study, we estimated the seroprevalence of COVID-19 in a rural area. Aims and Objectives: We aimed to estimate the seroprevalence of COVID-19 in a rural district of Tamil Nadu, 6 months after the index case. Materials and Methods: We conducted a cross-sectional study of 509 adults aged more than 18 years. From all the seven Taluks, two gram panchayats (administrative cluster of 8-10 villages) were randomly selected followed by one village through convenience. The participants were invited for the study to the community-based study kiosk set up in all the eight villages through village health committees. We collected sociodemographic characteristics and symptoms using a mobile application-based questionnaire, and we tested samples for the presence of IgG antibodies for severe acute respiratory syndrome coronavirus 2 using an electro chemiluminescent immunoassay. We calculated age-gender adjusted and test performance adjusted seroprevalence. Results: The age-and gender-adjusted seroprevalence was 8.5% (95% confidence interval [CI] 6.9-10.8%). The unadjusted seroprevalence among participants with hypertension and diabetes was 16.3% (95% CI: 9.2-25.8) and 10.7% (95% CI: 5.5-18.3), respectively. When we adjusted for the test performance, the seroprevalence was 6.1% (95% CI 4.02-8.17). The study estimated 7 (95% CI 1:4.5-1:9) undetected infected individuals for every reverse transcription polymerase chain reaction confirmed case. Infection fatality rate (IFR) was calculated as 12.38/10,000 infections as on October 22, 2020. History of self-reported symptoms and education were significantly associated with positive status (P<0.05). Conclusion: A significant proportion of the rural population in a district of Tamil Nadu remains susceptible to COVID-19. A higher proportion of susceptible, relatively higher IFR, and a poor tertiary health-care network stress the importance of sustaining the public health measures and promoting early access to the vaccine are crucial to preserving the health of this population. Low population density, good housing, adequate ventilation, limited urbanization combined with public, private, and local health leadership are critical components of curbing future respiratory pandemics. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: The COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge for healthcare systems worldwide. Earlier to SARS-CoV pandemic, coronaviruses were only thought to cause mild, self-limiting upper respiratory tract infections in humans. COVID 19 presents across a spectrum of symptoms. WHO recommends detection of unique sequences of virus RNA by Nucleic Acid Amplification Test (NAAT) such as real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). The aim of this cross sectional study was analysis and confirmation of Nasopharyngeal/oropharyngeal swab specimen by real-time reverse transcription polymerase chain reaction (RT-PCR). Material & Methods: This was a cross-sectional retrospective study that reviewed records of samples collected from June 2021 to March 2022. Nasopharyngeal/oropharyngeal swab specimen were collected from suspected COVID-19 subjects of various districts of Punjab and referred to Viral Research Diagnostic Laboratory [VRDL], Government Medical College [GMC], Amritsar for laboratory analysis and confirmation by real-time reverse transcription polymerase chain reaction (RT-PCR). Results: During the present study, a total of 11,27,005 samples were analyzed from June 2021 to March 2022 for SARS-CoV-2 detection by ICMR approved COVID-19 RT-PCR kits. Out of total 11,27,005 cases, 24,466 cases (2.17%) were found to be SARS-CoV-2 positive while 11,02,539 cases (97.83%) were SARS-CoV-2 negative. Conclusions: Ever since the COVID-19 global pandemic emerged, the developing countries are facing challenges regarding its diagnosis. Isolation of the infected person will eventually decrease the Reproduction number i.e Ro which will further interrupt the transmission cycle leading to decrease in community spread.
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Like elsewhere around the globe, SARS-CoV-2 infection is spreading in rural Egypt. Due to high sensitivity and specificity, the gold standard of diagnostics is reverse transcription polymerase chain reaction PCR (RT-PCR). Rural areas without access to certified laboratories cannot take advantage of RT-PCR testing, and thus are dependent upon rapid antigen testing, a point-of-care test that requires less training and can produce results within 15 minutes. Rapid antigen testing can give an advantage to medical teams in rural settings by affording effective and early control of SARS-CoV-2 infection spread. We sought to assess the contribution of different COVID-19 testing procedures in rural Egypt. We conducted a prospective cohort study in a rural lab in Giza, Egypt. Approximately 223 individuals with potential SARS-CoV-2 infection were involved in the study during the pandemic peak in Giza, Egypt, from March 4 - May 30, 2021. Subjects were subjected to RT-PCR and rapid antigen testing, and the performance of each testing procedure was compared. Between March 4 - May 30, 2021, approximately 223 symptomatic individuals were included in this study. 190 patients (85.2%) were indicated as PCR positive for SARS-CoV-2, while 33 (14.8%) were PCR negative. In comparison, a rapid antigen test showed 178 out of 223 patients (79.8%) were indicated as positive, or 94% of the PCR-positive individuals. In Giza, a rural area of Egypt, RT-PCR had an optimal balance of sensitivity and specificity, however, the turnaround time was a limiting factor. Antigen testing, performed as a rapid point-of-care test, can play an effective role in rural outbreak control due to its ease of use and rapid results.
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Coronavirus disease 2019 (COVID-19), an extremely infectious illness caused by a novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that has spread over the worldwide, has become one of the most difficult public health problems of our time. Age and gender are two major characteristics that influence the risks and outcomes of numerous diseases. Our study will investigate and compare the difference in hematological, biochemical, and serological biomarkers between sexes in order to evaluate severity and pathogenicity. Clinical records were taken from 150 SARS-CoV-2 positive patients were included in this study;the infection was confirmed by real time reverse transcriptase polymerase chain reaction. Blood samples subjected to measure changes in hematological parameters and serum subjected to measure biochemical test including ferritin, creatinine, CRP, D-dimer, and liver function enzyme either for ELISA test to measure serological biomarkers including IgM, IgG, TNF-α, IFN-γ, IL-6, and IL-10. 90 (60%) of whom were male and 60 (40%) of whom were female. Our study found a significant increase in CRP, IgM, IL-6, IL-10, TNF-α, IFN-γ, AST, ALP, and TBIL levels in males compared to females, and the age group most susceptible to SARS-CoV-2 infection was 41-60 years. Based on these findings, we concluded that males and those of older age had a high prevalence of severity and progression than females.
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For the third year COVID-19 pandemic is still a global health challenge, despite the availability of vaccines and protection methods, treatment protocols still being updated continuously to observe the optimum management for patients. Cyclooxegynase (COX) enzymes are involved in inflammation and thrombosis related to COVID-19. COX-Thromboxane2 pathway is one of the important pathways that results in thrombus formation. In this study the COX activity level changes were measured by ELISA technique in COVID-19 plasma samples that treated with SIRT1 activators resveratrol and linear BAS SIRT1 aptamer, a significant lowering in COX activity was observed with promising potential atrithrombotic action in COVID-19 to be further investigated in future.
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The coronavirus invaded the world in late 2019. It includes many subtypes, majorly severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Jordan has faced enormous hardships in dealing with the abrupt spread of the coronavirus disease of 2019 (COVID-19) pandemic. Jordan has taken severe and deterring measures to combat the disease's spread, such as closing Jordanian schools and institutions. Medical imaging professionals (MIPs) play a vital role in corona patients' diagnosis, management, and treatment planning, and their awareness is essential to understand. This study focuses on medical imaging professionals (MIPs) and their aid in COVID-19 planning. The knowledge and perception of the COVID-19 pandemic were assessed using a live cross-sectional survey conducted during the outbreak. Medical imaging professionals and trainees in private, military, and government hospitals provided data. Regarding the diagnosis of COVID-19, the researchers have found that molecular biology techniques are the first line of defence, whereas nasopharyngeal swabs and the polymerase chain reaction (RT-PCR) are also prevalent among medical professionals for COVID-19 testing. Overall, medical imaging experts and interns in Jordan exhibited expected levels of knowledge and perception. They advised following the CDC and WHO guidelines in their healthcare settings to offer an acceptable approach during the pandemic.
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Background: There has been a tremendous increase in number of cases of rhino-orbitocerebral involvement with mucor in the COVID era, as reported from India. It is well established that management of ROCM involves early clinical and radiological diagnosis, reversal of underlying risk factors, prompt antifungal therapy and surgical debridement when indicated. Materials &Methods: Multiplanar MR imaging and CT scan were performed for brain, orbit and paranasal sinuses. All the cases were assessed for involvement of the paranasal sinuses, nasal cavities, orbits and brain. Results: 25 cases with ROCM were identified over 8 months. The mean age of the cases was 56.1 years. 18 of the 25 cases had a positive RT-PCR test result at the time of diagnosis with ROCM. 20 cases had poorly controlled diabetes mellitus, 2 had a hematological malignancy, 2 had chronic kidney disease and 1 had ischemic heart disease. There was involvement of the paranasal sinuses, nasal cavities, orbits and brain inclusing necrosis in most of the cases. The number of cases identified during the interval is much higher than the numbers presenting in the prior 2 years during equivalent intervals than those reported in the literature in different settings in the pre-pandemic era. Conclusions: Rhino-orbito mucormycosis can have aggressive necrosis of the involved paranasal sinuses and orbits with or without cerebral extension. Hence, the correct diagnosis is imperative as prompt antifungal drugs and surgical debridement can significantly reduce mortality and morbidity.
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Purpose: The aim of our study is to present the results of the mobile sampling of the National Public Health Center during the Covid-19 pandemic, the implementation process of the screening buses of the program "We bring the screening tests in place” as static points, as well as the spatial and temporal frequency of use. Methods: Our retrospective analysis was performed in Pest County between 12th of November, 2020 and 18th of April 2022 by evaluating the Covid-19 sampling results from screening buses (N=164,576). Descriptive statistical methods were used to process the data. Results: In most cases, the screening was carried out in the patient's car, which reduced the risk of infection and ensured the safety and smoothness of the work by moving quickly through the screening point. Sampling was performed using AbottTM, Clintest® and VivaDiagTM rapid tests, and in case of a negative result, another nasopharyngeal sampling was performed for RT-PCR. An average of 504 samples were taken per day, of which on average almost 1⁄3(31.41%) were positive. Conclusion: The advantage of the screening buses was the ability to perform a significant number of tests, their mobility, the fact that they can be placed in easily accessible locations and the reduced risk of infection. Mass testing at static points has proven to be an efficient process that can be used in the future if the need arises. Célkitűzés: Tanulmányunk célja a Covid-19-járvány során a Nemzeti Népegészségügyi Központ mobil mintavételezésének, a „Helybe visszük a szűrővizsgálatokat” program szűrőbuszainak statikus pontként történő megvalósítási folyamatának, illetve területi és időbeni igénybevételi gyakoriságának, eredményeinek bemutatása. Vizsgálat módszere: Retrospektív elemzésünk Budapesten és Pest megyében 2020. november 12. és 2022. április 18. között a szűrőbuszokon végzett Covid-19-mintavételi leleteinek értékelésével valósult meg (N=164 576). A kapott adatok feldolgozásához leíró statisztikai módszereket alkalmaztunk. Eredmények: A teszteléseket legtöbb esetben a páciens személygépjárműjében végeztük el, ami csökkentette az infektálódás kockázatát, illetve a szűrőponton való gyors áthaladás szavatolta a munka biztonságát és gördülékenységét is. A mintavételezések során az AbottTM, a Clintest®, valamint a VivaDiagTM rapid tesztjeit használtuk, negatív eredmény esetén újabb nasopharingealis mintavétel történt RT-PCR elvégzése céljából. Naponta átlagosan 504 mintavétel valósult meg, amelynek átlagosan közel egyharmada (31,41%) mutatott pozitivitást. Következtetések: A szűrőbuszok előnye a nagyszámú tesztek elvégzésének lehetőségében, a mozgathatóságban, a mindenki számára könnyen megközelíthető pontokra való kihelyezésben, valamint a fertőződés kockázatának csökkentésében mutatkozott meg. A tömeges tesztelések statikus pontokon való lebonyolítása hatékonynak bizonyult, amely folyamatot a jövőben is alkalmazhatunk, ha arra szükség lesz.
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Background: Whether vertical transmission or placental pathology occurs after maternal infection during pregnancy remains unknown. There is a clear need for studies on the impact of COVID-19 on pregnancy outcome. A systemic inflammatory or hypercoagulable state may be the contributing factor for placental pathology. Methods: The pregnant women with COVID-19 who delivered between May 2020 and May 2021 were followed and data were collected about pregnancy course and placentas were examined for macro- and microscopical changes and were compared to controls with non-infected women. Results: Placenta of COVID-19-infected females had increased prevalence of decidual arteriopathy and placental injury reflecting hypoxia and uteroplacental insufficiency within the intervillous space. Features of maternal vascular malperfusion such as increased syncytial knots were present in 100% cases. Fibrinoid necrosis was seen in 100% cases and increased focal perivillous fibrin depositions were presented in 37.7% cases. About one fourth infected placentas had evidence of villitis. Even after matching for comorbidities like preeclampsia, these changes were present. Conclusion: The most common pathological findings of the placenta of COVID-19 infections are signs of maternal and fetal malperfusion. Future studies should target infections in different stage of gestation, including first and second trimesters.
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Background: To date, most countries worldwide have declared that the pandemic of COVID-19 is over, while the WHO has not officially ended the COVID-19 pandemic, and China still insists on the personalized dynamic COVID-free policy. Large-scale nucleic acid testing in Chinese communities and the manual interpretation for SARS-CoV-2 nucleic acid detection results pose a huge challenge for labour, quality and turnaround time (TAT) requirements. To solve this specific issue while increase the efficiency and accuracy of interpretation, we created an autoverification and guidance system (AGS) that can automatically interpret and report the COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) results relaying on computer-based autoverification procedure and then validated its performance in real-world environments. This would be conductive to transmission risk prediction, COVID-19 prevention and control and timely medical treatment for positive patients in the context of the predictive, preventive and personalized medicine (PPPM). Methods: A diagnostic accuracy test was conducted with 380,693 participants from two COVID-19 test sites in China, the Hong Kong Hybribio Medical Laboratory (n = 266,035) and the mobile medical shelter at a Shanghai airport (n = 114,658). These participants underwent SARS-CoV-2 RT-PCR from March 28 to April 10, 2022. All RT-PCR results were interpreted by laboratorians and by using AGS simultaneously. Considering the manual interpretation as gold standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were applied to evaluate the diagnostic value of the AGS on the interpretation of RT-PCR results. Results: Among the 266,035 samples in Hong Kong, there were 16,356 (6.15%) positive, 231,073 (86.86%) negative, 18,606 (6.99%) indefinite, 231,073 (86.86%, negative) no retest required and 34,962 (13.14%, positive and indefinite) retest required; the 114,658 samples in Shanghai consisted of 76 (0.07%) positive, 109,956 (95.90%) negative, 4626 (4.03%) indefinite, 109,956 (95.90%, negative) no retest required and 4702 (4.10%, positive and indefinite) retest required. Compared to the fashioned manual interpretation, the AGS is a procedure of high accuracy [99.96% (95%CI, 99.95-99.97%) in Hong Kong and 100% (95%CI, 100-100%) in Shanghai] with perfect sensitivity [99.98% (95%CI, 99.97-99.98%) in Hong Kong and 100% (95%CI, 100-100%) in Shanghai], specificity [99.87% (95%CI, 99.82-99.90%) in Hong Kong and 100% (95%CI, 99.92-100%) in Shanghai], PPV [99.98% (95%CI, 99.97-99.99%) in Hong Kong and 100% (95%CI, 99.99-100%) in Shanghai] and NPV [99.85% (95%CI, 99.80-99.88%) in Hong Kong and 100% (95%CI, 99.90-100%) in Shanghai]. The need for manual interpretation of total samples was dramatically reduced from 100% to 13.1% and the interpretation time fell from 53 h to 26 min in Hong Kong; while the manual interpretation of total samples was decreased from 100% to 4.1% and the interpretation time dropped from 20 h to 16 min at Shanghai. Conclusions: The AGS is a procedure of high accuracy and significantly relieves both labour and time from the challenge of large-scale screening of SARS-CoV-2 using RT-PCR. It should be recommended as a powerful screening, diagnostic and predictive system for SARS-CoV-2 to contribute timely the ending of the COVID-19 pandemic following the concept of PPPM.
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Coronavirus disease 2019 (COVID-19) pandemic has led to considerable morbidity and mortality across the world. Lung transplant is a viable option for a few with COVID-19-related lung disease. Whom and when to transplant has been the major question impacting the transplant community given the novelty of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a pitfall of presumed prolonged shedding of SARS-CoV-2 in a patient with COVID-19 associated acute respiratory distress syndrome leading to COVID-19 pneumonia after lung transplant. This raises concerns that replication-competent SARS-CoV-2 virus can persist for months post-infection and can lead to re-infection of grafts in the future.
ABSTRACT
Background: Evidence on performance of Rapid Antigen Detection Tests to recognize SARS-CoV-2 symptomatic patients in our context is limited. This study was aimed to evaluate Panbio™ COVID-19 Ag Rapid Test Device (Abbott Diagnostics, Jena, Germany) in identifying SARS-CoV-2 infection in comparison with RT-PCR test. Methods: This cross-sectional validation study was carried out at Margalla Hospital, Taxila from October, 2020 to March, 2021. Three hundred and eighty-two participants of both gender and all ages, symptomatic for 3-4 days were included in this study. For each participant, two nasopharyngeal swabs were collected by trained lab technicians according to SOPs, one for Rapid Antigen Test and other for RT-PCR.Covid-19 antibodies were checked 4-6 weeks after symptoms among 77 randomly selected participants to further evaluate the performance of Rapid Antigen Test. Data was analyzed using SPSS-26. Results: The mean age of the participants was 43.1 years (SD=15.9). More than half of participants were males (n=213%=55.8) and 169 (44.2%) were females. Sensitivity of Rapid Antigen Test was calculated to be 94.3%, whereas the specificity was 39.7%. Out of 34 RT-PCR negatives that were initially detected positive on Rapid Antigen Test, 33 demonstrated presence of COVID-19 antibodies. Conclusion: Panbio™ COVID-19 Ag Rapid Test was found to have 93.4% overall sensitivity and relatively low overall specificity (37.9%). Rapid antigen testing using Panbio™ COVID-19 Ag Rapid Test Device can be effectively used to scale up mass testing to interrupt transmissibility of COVID-19 infection by generating quick result.