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1.
Viruses ; 14(6)2022 Jun 03.
Article in English | MEDLINE | ID: covidwho-1884380

ABSTRACT

In South Africa, high exposure to SARS-CoV-2 occurs primarily in densely populated, low-income communities, which are additionally burdened by highly prevalent Human Immunodeficiency Virus (HIV). With the aim to assess SARS-CoV-2 seroprevalence and its association with HIV-related clinical parameters in non-hospitalized patients likely to be highly exposed to SARS-CoV-2, this observational cross-sectional study was conducted at the Gugulethu Community Health Centre Antiretroviral clinic between October 2020 and June 2021, after the first COVID-19 wave in South Africa and during the second and beginning of the third wave. A total of 150 adult (median age 39 years [range 20-65 years]) HIV-infected patients (69% female; 31% male) were recruited. 95.3% of the cohort was on antiretroviral therapy (ART), had a median CD4 count of 220 cells/µL (range 17-604 cells/µL) and a median HIV viral load (VL) of 49 copies/mL (range 1-1,050,867 copies/mL). Furthermore, 106 patients (70.7%) were SARS-CoV-2 seropositive, and 0% were vaccinated. When stratified for HIV VL, patients with uncontrolled HIV viremia (HIV VL > 1000 copies/mL) had significantly higher odds of SARS-CoV-2 seropositivity than patients with HIV VL < 1000 copies/mL, after adjusting for age, sex and ART status (p = 0.035, adjusted OR 2.961 [95% CI: 1.078-8.133]). Although the cause-effect relationship could not be determined due to the cross-sectional study design, these results point towards a higher risk of SARS-CoV-2 susceptibility among viremic HIV patients, or impaired HIV viral control due to previous co-infection with SARS-CoV-2.

2.
Life (Basel) ; 12(6)2022 Jun 08.
Article in English | MEDLINE | ID: covidwho-1884262

ABSTRACT

BACKGROUND: Coronavirus disease 2019 is a global public health concern. As of December 2020, the therapeutic agents approved for coronavirus disease 2019 in Japan were limited to two drugs: remdesivir, an antiviral drug, granted a Special Approval for Emergency on 7 May 2020, and dexamethasone, which has an anti-inflammatory effect. The aim of this study is to evaluate the efficacy of convalescent plasma collected from donors who recovered from coronavirus disease 2019. METHODS: This is an open-label, randomized controlled trial comprising two groups: a convalescent plasma and a standard-of-care group. Plasma administered to patients with coronavirus disease 2019 randomized in the convalescent plasma group of this trial will be plasma that has been collected and stored in an associated study. Patients with a diagnosis of mild coronavirus disease 2019 will be included in this trial. The efficacy of convalescent plasma transfusion will be evaluated by comparing the convalescent plasma group to the standard-of-care group (without convalescent plasma transfusion) with respect to changes in the viral load and other measures. The primary endpoint will be time-weighted average changes in the SARS-CoV-2 virus load in nasopharyngeal swabs from day 0 to days 3 and 5. It is hypothesized that the intervention should result in a decrease in the viral load in the convalescent plasma group until day 5. This endpoint has been used as a change in viral load has and been used as an index of therapeutic effect in several previous studies. DISCUSSION: The proposed trial has the potential to prevent patients with mild COVID-19 from developing a more severe illness. Several RCTs of convalescent plasma therapy have already been conducted in countries outside of Japan, but no conclusion has been reached with respect to the efficacy of convalescent plasma therapy, which is likely in part because of the heterogeneity of the types of target patients, interventions, and endpoints among trials. Actually, previous clinical trials on plasma therapy have shown inconsistent efficacy and are sometimes ineffective in COVID-19 patients with severe disease, which is due to unmeasured neutralizing antibody titer in the COVID-19 convalescent plasma. To improve this issue, in this study, we measure neutralizing activity of convalescent plasma before administration and provide the plasma with high neutralizing activity to the subjects. It is hoped that this study will further evidence to support the role of convalescent plasma therapy in COVID-19.

3.
Topics in Antiviral Medicine ; 30(1 SUPPL):378, 2022.
Article in English | EMBASE | ID: covidwho-1880919

ABSTRACT

Background: Travel restrictions during the COVID-19 epidemic in China have impacted on the daily life and antiretroviral therapy (ART) of people living with HIV, including men who have sex with men (MSM). As China enters a state of routine COVID-19 prevention and control, it is necessary to understand the conditions of ART interruption (ATI) among HIV-infected MSM during and after the lockdown period (23 January to 7 April 2020) to summarize experience on HIV treatment. Methods: A nationwide cross-sectional online survey was conducted among HIV-infected MSM in China in February 2021, using convenience sampling on the WeChat platform called Li Hui Shi Kong. We collected information during and around lockdown period, including socio-demographics, health behaviors such as physical exercise and alcohol drinking, ART maintenance, CD4 and viral load testing. Pearson's Chi-squared test was performed to compare those characteristics between participants who experienced ATI during the lockdown period and did not. Logistic regression analysis was conducted to assess the correlates of ATI. Results: A total of 1296 participants were included in the analysis. The median age was 29.3 years (interquartile range [IQR] 25.2-34.0). 40.9% (n=530) of them did not exercise regularly in the second half of 2019 and 62.3% (n=808) had alcohol drinking. During the lockdown period, 6.8% (n=88) reported ATI experience, and 49.5% (n=629) performed CD4 cell test. Among the participants who took the last CD4 test after the lockdown, more people had not experienced ATI (66.8%) compared to those had experienced ATI (38.6%). HIV-infected MSM using other ART regimen as temporary substitution were more unlikely to experience ATI, including free ART (adjusted odds ratio [aOR] 0.05, 95% confidence interval [CI] 0.02-0.11) and out-of-pocket ART (aOR 0.11, 95% CI 0.01-0.89), which is different from their previous prescription. Conclusion: COVID-restrictions did not result in significantly negative effects on ART maintenance among HIV-infected MSM in China. In order to reduce the negative impact on HIV-infected MSM, attention should be paid to conducting health behavior education, maintaining ART service and encouraging CD4 and viral load testing during and after public emergencies.

4.
Revista Chilena De Infectologia ; 39(1):35-44, 2022.
Article in Spanish | Web of Science Web of Science | ID: covidwho-1880752

ABSTRACT

Background: The cycle threshold (Ct) of real-time reverse transcription PCR (RT-qPCR) indicates the relative concentration of an RNA sequence, this value has been related to clinical profile in viral infections. Aim: To determine the correlation between the Ct value and the clinical classification of COVID-19. Method: A correlational cross-sectional study was carried out, the Ct values were obtained by RT-qPCR directed to the N gene of SARS-CoV-2, grouping them by means of a central robust estimator and related to the clinical classification of COVID-19. Results: Of the 718 cases included in the study;77.7% (558) were mild;21.3% (153) moderate and 1% (7) severe. The Ct value was grouped into levels: low Ct <= 18.83;medium Ct> 18.83- 30.10 and high Ct> 30.10. There was a weak inverse significant correlation (p = 0.002;Spearman's rho = -0.117) between the Ct value and the clinical classification. The characteristics: sex, age under 65 years, fever, chills, diarrhea, anosmia, and overweight-obesity were associated with the Ct value. Conclusion: The lower the Ct value, a classification of greater severity of COVID-19 is expected, however, because the correlation is weak, its usefulness as a severity predictor is limited.

5.
Topics in Antiviral Medicine ; 30(1 SUPPL):326, 2022.
Article in English | EMBASE | ID: covidwho-1880585

ABSTRACT

Background: The 2013 WHO antiretroviral guidelines recommended routine testing of HIV viral load (VL) (concentration of HIV RNA copies/mL of blood) as the preferred method for monitoring treatment in people living with HIV (PLHIV). The 2020 UNAIDS targets proposed that all PLHIV receiving antiretroviral therapy (ART) have access to HIV viral load testing (VLT) as part of public health programs aiming to reduce HIV transmission. In limited-resource countries, PLHIV are facing various challenges to VLT access, and some might be associated with health-related facility factors. Methods: To identify characteristics of facilities associated with low VLT coverage (VLTC)), we analyzed data reported to the Monitoring, Evaluation, and Reporting (MER) System by 17 PEPFAR-supported sub-Saharan African countries in 2019 and 2020. We used ordinal logistic regression model accounting for clustering with assumption of random effect model on facility. Outcome variable was VLTC (proportion of the number of PLHIV with a VL in the medical record or laboratory record/laboratory information system within the past 12 months divided by the number of PLHIV receiving ART six months earlier) categorized as Low (< 70%), Medium (70% to < 90%), and High (>= 90%). Independent variables were region (Eastern, Southern, Western/Central Africa), age (0-9, 10-19, 20-29, 30-39, 40-49, 50+ years), sex (male, female), and volume (low volume: <100 PLHIV on ART vs. high volume: >=100 PLHIV on ART) by facility. Results: The odds of VLTC were higher in the Southern region (adjusted odds ratio [AOR] = 1.95;95% CI 1.92, 1.97) and lower in the Western/Central region (AOR = 0.86;95% CI 0.85, 0.88) as compared with Eastern region. The AOR for VLTC was lower for high volume as compared with low volume facilities (AOR = 0.69;95% CI 0.67, 0.70). The year 2020 had a lower AOR for VLTC (AOR = 0.98;95% CI 0.97, 0.99) than 2019. Males had an AOR for VLTC of 1.00 compared with females, and as age increased so did AOR for VLTC (AOR = 1.02;95% CI 1.02, 1.02). Conclusion: Gaps in HIV VL testing coverage have increased since 2019, potentially due to the COVID-19 pandemic. Regional gaps were seen in Western/Central Africa and with increased facility volume. Potential gaps might be seen in younger PLHIV. Identifying barriers to scale-up of HIV VL monitoring in facilities with low volume to develop and implement effective public health strategies could help to improve PLHIV outcomes and accelerate progress toward HIV epidemic control in these regions.

6.
Topics in Antiviral Medicine ; 30(1 SUPPL):186-187, 2022.
Article in English | EMBASE | ID: covidwho-1880568

ABSTRACT

Background: In 2018, Uganda began programmatically switching individuals with HIV-1 RNA <1,000 copies/mL on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based ART to a fixed-dose regimen of tenofovir/lamivudine/dolutegravir (TLD). Our objective was to estimate the population effectiveness of the TLD transition in public-sector clinics in Uganda. Methods: We conducted a prospective cohort study that enrolled adults ≥18 years who were switched from NNRTI-based first-line ART to TLD at public-sector clinics in Uganda. We observed participants at 3 study visits over 1 year. We obtained blood specimens at each visit and conducted HIV-1 RNA viral load (VL) testing using Cepheid Xpert assays. We fit multivariable logistic regression models to assess predictors of our composite outcome of interest of viral suppression (<50 copies/mL) with retention in care 1 year after switch to TLD. Results: We enrolled 500 participants with a median age of 47 years (IQR 40-53);41% were women. The most common regimen prior to switch was lamivudine/tenofovir/efavirenz (44%), and median duration on ART prior to switch was 8.8 years (IQR 5.7-12.2). Over 95% (n=475/499) were virally suppressed (<50 copies/mL) at the time of switch to TLD. The final visit for all participants occurred a median of 54 weeks (IQR 49-67) after enrollment, with some participants affected by delays due to COVID-19 mitigation measures. One participant self-elected to disenroll. Only 3% (n=13/499) of participants discontinued TLD due to side effects or clinician discretion. We observed 1% mortality (n=6/499), 2% (n=10/499) lost to follow-up, and 5% (n=23/499) with HIV-1 RNA ≥50 copies/mL at 1 year, with a median VL of 252 copies/mL (IQR 81-78,200 copies/mL). Overall, 92% (n=459/499) were virally suppressed and in care at 1 year. An HIV-1 RNA ≥50 copies/mL at the time of switch to TLD, male gender, and any self-reported ART adherence <90% were all significant negative predictors of the composite outcome of retention in care with a suppressed VL (Table). Conclusion: Rates of viral suppression with retention in care >90% after 1 year on TLD, as well as a 2% TLD discontinuation rate, affirm World Health Organization guidelines for the regional transition to TLD. Nonetheless, an 8% failure rate in HIV-endemic countries corresponds to a large population of individuals. Long-term surveillance of this population, strategies to combat imperfect adherence, and continued attention to treatment options after failure on TLD may be needed.

7.
Topics in Antiviral Medicine ; 30(1 SUPPL):354-355, 2022.
Article in English | EMBASE | ID: covidwho-1879987

ABSTRACT

Background: Historically, control of HIV infection in young men living with HIV (LWH) has been problematic. We examined the STI/HIV burden in young men with urethral discharge syndrome (UDS) in Kampala, Uganda. Methods: Between Oct 2019-Nov 2020, 250 men with UDS were enrolled at 6 urban sites. All HIV positive men (20%, 50/250) had plasma viral load testing (Abbott m2000 RealTime HIV-1);when VL>1000 copies/mL, resistance and recency testing (Asanté HIV-1 Rapid Recency Assay, Sedia Biosciences) were performed. Penile meatal swabs were retrospectively tested for gonorrhea, chlamydia, trichomoniasis, and Mycoplasma genitalium (Hologic Aptima CT/NG, TV, MG). Descriptive statistical analysis, logistic, and bivariable and multivariable regression were undertaken. Results: Among the men LWH, 92% (46/50) had VL<1000;4 were not suppressed, 1 of whom was previously undiagnosed. Among the viremic individuals, no major resistance mutations were found and none appeared recently infected. Men (median age 24[22;32]) reported sex partners/previous 2 months (median 2[1;2]), 61.6% engaged in transactional sex in the previous 6 months, and 48.4% reported alcohol use. 44.4% reported alcohol use before sex in the previous 6 months. Overall, 0.4% reported 'always' condom use, 21.8% continued condomless sex since onset of UDS symptoms. There was a high burden of active, undiagnosed STIs found in these men (see Table);of the 10% who had syphilis, 80% were previously undiagnosed. Agreement between HIV-and syphilis-POC and lab-based testing was 100% and 95% (19/20), respectively. By multivariable logistic regression, alcohol use (OR, 3.32 (95% CI:1.61, 7.11)), and condomless sexual activity since symptom onset (OR, 2.86 (95% CI:1.20, 6.84)) were significantly associated with HIV;92% had at least one other STI. Conclusion: Among men presenting with UDS, bacterial STIs were very common. 20% had HIV with a surprisingly high level of viral suppression and no evidence of resistance in those with detectable VL. Recency testing results were non-discriminatory;none appeared recently infected. Risk of future HIV acquisition is high in those not LWH. Given the high frequency of bacterial STI, alcohol use and unprotected high-risk sexual behavior in this population, men with UDS who test negative for HIV should be prioritized for PrEP. Future research, evaluating the effect of SARS-CoV-2 on the burden of STI and level of viral suppression in this population, is required.

8.
Revista Espanola de Salud Publica ; 95(Perspectivas 18):1-8, 2021.
Article in Spanish | GIM | ID: covidwho-1871641

ABSTRACT

The various SARS-CoV-2 vaccines have been an important and necessary step forward in the fight against the pandemic. Vaccines have been demonstrated to be effective in preventing severe disease and hospitalizations. However, the risk of transmission could remain, so it is also necessary to evaluate the effectiveness of the vaccine against other determinants such as viral load (related to the virus's ability to transmit). In addition to vaccination, there are other factors that influence the reduction of transmission, such as non-pharmacological prevention interventions, individual susceptibility or the characteristics and duration of exposure. This review aims to analyze the possibility of relaxing the pandemic control measures based on vaccine effectiveness, coverage and circulation of new variants, among other factors. It is concluded that at this time some measures can begin to be relaxed in groups of fully vaccinated people, but it is necessary to continue to keep them until enough coverage is achieved, which is calculated could occur at the end of summer 2021.

9.
Vaccines (Basel) ; 10(6)2022 May 31.
Article in English | MEDLINE | ID: covidwho-1869881

ABSTRACT

The purpose of this study was to preliminarily evaluate the immunogenicity and immune persistence of inactivated SARS-CoV-2 vaccines in PLWH in the real world. We collected blood samples from 132 PLWH aged 18-59 years who were vaccinated with two doses of BBIBP-CorV vaccine (Sinopharm) or CoronaVac vaccine (SinoVac) at 28 ± 7 days and 180 ± 20 days the after second dose, to detect the level of Spike receptor binding domain-protein specific IgG (S-RBD-IgG) by using chemiluminescence. We found that the BBIBP-CorV vaccine or the CoronaVac vaccine induced lower S-RBD-IgG antibody seropositivity rates and levels in PLWH than in healthy controls (HCs). The BBIBP-CorV vaccine or the CoronaVac vaccine induced lower humoral immune responses in PLWH, having lower CD4+T cell counts (<350 cells/µL) compared to PLWH, and having higher CD4+T cell counts (≥350 cells/µL) after a second dose of vaccination. The BBIBP-CorV vaccine or the CoronaVac vaccine induced lower S-RBD-IgG antibody levels in PLWH, having CD4+T cell counts ≥350 cells/µL compared to HCs. No negative effects were observed in terms of the CD4+T cell counts and HIV RNA viral load (VL) of PLWH after vaccination. Ninety-nine PLWH and eighty-three HCs completed a second blood collection for testing; we found a statistically significant decrease in the humoral immune response both in PLWH and HCs from 28 days to 180 days after a second dose of BBIBP-CorV vaccine or CoronaVac vaccine. The S-RBD-IgG antibody induced by the BBIBP-CorV vaccine or the CoronaVac vaccine declined faster in the PLWH population than in the healthy population, and two doses of the BBIBP-CorV vaccine or the CoronaVac vaccine may not be enough to provide PLWH with persistent immunity against SARS-CoV-2. It is necessary for PLWH to be prioritized for a third dose over the healthy population, but the immunogenicity of the third dose of the homologous or heterologous vaccine requires further study.

10.
Medicina (Kaunas) ; 58(6)2022 May 26.
Article in English | MEDLINE | ID: covidwho-1869699

ABSTRACT

Background and objectives: This article aims to evaluate the number of days necessary for patients with mild and moderate forms of COVID-19 to reach undetectable levels of SARS-CoV-2 RNA in the upper respiratory tract specimens. As a secondary objective, we sought to establish a correlation between different conditions associated with longer viral load as this could result in a longer period of contagion and infectivity. Materials and Methods: It is a retrospective study. A total of 70 patients with confirmed mild and moderate forms of COVID-19 were enrolled in our study. Results: Number of days with traceable viral load was 25.93 (±6.02) days in patients with mild COVID-19 and 26.97 (±8.30) in moderate form (p = 0.72). Age, male gender, and obesity, along with several chronic conditions (cardiac, liver, renal, and neurological disease), were associated with prolonged positive RT-PCR test from the nasal swab (therefore prolonged viral load). These are in general, risk factors for severe forms of COVID-19. Conclusions: There are several conditions associated with prolonged positive RT-PCR in mild and moderate forms of COVID-19. As to why and what is the significance of it remains to be studied.

11.
Clin Infect Dis ; 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1868256

ABSTRACT

BACKGROUND: SARS-CoV-2 infection can lead to severe acute respiratory distress syndrome needing intensive care admission and may lead to death. As a virus that transmits by respiratory droplets and aerosols, determining the duration of viable virus shedding from the respiratory tract is critical for patient prognosis, and informs infection control measures both within healthcare settings and the public domain. METHODS: We prospectively examined upper and lower airway respiratory secretions for both viral RNA and infectious virions in mechanically ventilated patients admitted to the intensive care unit of the University Hospital of Wales. Samples were taken from the oral cavity (saliva), oropharynx (sub-glottic aspirate), or lower respiratory tract (non-directed bronchoalveolar lavage (NBL) or bronchoalveolar lavage (BAL)) and analyzed by both qPCR and plaque assay. RESULTS: 117 samples were obtained from 25 patients. qPCR showed extremely high rates of positivity across all sample types, however live virus was far more common in saliva (68%) than in BAL/NBAL (32%). Average titres of live virus were higher in subglottic aspirates (4.5x10 7) than in saliva (2.2x10 6) or BAL/NBAL (8.5x10 6) and reached >10 8 PFU/ml in some samples. The longest duration of shedding was 98 days, while most patients (14/25) shed live virus for 20 days or longer. CONCLUSIONS: Intensive care unit patients infected with SARS-CoV-2 can shed high titres of virus both in the upper and lower respiratory tract and tend to be prolonged shedders. This information is important for decision making around cohorting patients, de-escalation of PPE, and undertaking potential aerosol generating procedures.

12.
Ann Med Surg (Lond) ; 78: 103839, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1866822

ABSTRACT

Background: Despite the rapid increase in knowledge about coronavirus disease 2019 (COVID-19), there is limited data on vertical transmission, viral loads in mother-neonate pairs, and health outcomes. We aimed to describe the characteristics, viral loads, and short-and mid-term outcomes of neonates born to mothers with confirmed COVID-19 infection in northern Iran. Materials and methods: In a cross-sectional study, we prospectively collected and analyzed the clinical features, reverse transcription-polymerase chain reaction (RT-PCR) results, viral loads, and outcomes of 60 neonates delivered by 58 SARS-CoV-2 infected pregnant women in maternity hospitals of Mazandaran University of Medical Sciences (northern Iran) during first three waves of the pandemic from March 1 to December 31, 2020. We assessed neonates' short and mid-term outcomes up to 24 months after the pandemic. We also described the timing of mother-to-infant transmission based on the classification presented by the World Health Organization. Results: Of the 17767 deliveries, 58 mothers had confirmed and probable COVID-19 infection. Twenty (33.3%) neonates were positive for SARS-CoV-2, two of whom had possible in utero transmission. Twenty-five (41.2%) neonates were preterm, most of whom were born during the first and second waves in which mothers were critically ill. 19 (31.7%) patients needed resuscitation in the delivery room. 34 (56.7%) neonates were isolated in the neonatal intensive care unit. We observed a significant relationship between the maternal and neonatal viral load (correlation coefficient = 0.983, P = 0.00). No neonatal death was observed and all babies had a good outcome. Conclusions: The results showed that vertical transmission of SARS-CoV-2 is possible but rare. Regional factors and severity of mother's disease may influence the clinical course of neonates. With increasing experience, proper observance of health precautions, and rapid development of evidence-based response systems for regional and global disasters, the transmission rate of SARS-CoV-2 from mother to newborn is reduced.

13.
Meditsinskiy Sovet ; 2022(6):36-42, 2022.
Article in Russian | Scopus | ID: covidwho-1863531

ABSTRACT

With the ongoing pandemic of the SARS-CoV-2 virus and the emergence of its new genovariants, along with the relevance of addressing the issue of vaccination of the population, the importance of non-specific prophylaxis, which is designed to reduce the viral load on the body and slow down the rate of virus spread, is increasing. The currently available research and experience in the use of antiseptic drugs or their combinations with the antimicrobial peptide lysozyme can be used for this purpose.Currently available research and experience in the use of antiseptic drugs or their combinations with the antimicrobial peptide lysozyme can be used for this purpose. Under conditions of lysozyme deficiency unhindered accumulation of non-hydrolyzed substrate, which is a constant source of autoantigens, is accompanied by immunity, metabolic and tissue homeostasis disorders. Analysis of a comparative study of different groups of antiseptics showed high virulicidal efficacy of cetylpyridinium chlorideCetylpyridinium chloride has an electrostatic effect on viral membrane lipids, causing their aggregation and dissolution, which leads to disruption of the integrity of the virus membrane, its interaction with mucosal epithelial cells and penetration into target cells, having a direct virulicide effect on SARS-CoV-2. An important factor of innate mucosal immunity is lysozyme, it has antiviral, antibacterial, antifungal and anti-inflammatory effects, normalizes microbiocenosis, restores immune system activity, increases mucosal barrier function. The combination of cetylpyridinium chloride and lysozyme hydrochloride has a dual antiviral effect, reducing the viral load on the body and enhancing the ability to control the spread of SARS-CoV-2 both from patients in the prodromal period of the disease or with its clinical manifestations, and from asymptomatic carriers with confirmed COVID-19 infection status. © 2022, Remedium Group Ltd. All rights reserved.

14.
Pharmaceutics ; 14(5)2022 May 09.
Article in English | MEDLINE | ID: covidwho-1862877

ABSTRACT

Coronavirus 2019 disease (COVID-19) represents one of the largest pandemics the world has faced, and it is producing a global health crisis. To date, the availability of drugs to treat COVID-19 infections remains limited to supportive care although therapeutic options are being explored. Some of them are old strategies for treating infectious diseases. convalescent plasma (CP) therapy has been used successfully in other viral outbreaks in the 20th century. In this study, we systematically evaluated the effect and safety of CP therapy on hospitalized COVID-19 patients. A structured search was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines using Medline (PubMed), SciELO, Cochrane Library Plus, Web of Science, and Scopus. The search included articles published up to January 2022 and was restricted to English- and Spanish-language publications. As such, investigators identified six randomized controlled trials that met the search criteria. The results determined that in hospitalized COVID-19 patients the administration of CP therapy with a volume between 200-500 mL and a single transfusion performed in 1-2 h, compared to the control group, decreased viral load, symptomatology, the period of infection, and mortality, without serious adverse effects. CP did influence clinical outcomes and may be a possible treatment option, although further studies will be necessary.

15.
Front Microbiol ; 13: 840757, 2022.
Article in English | MEDLINE | ID: covidwho-1862623

ABSTRACT

The emerging SARS-CoV-2 variants of concern (VOCs) may display enhanced transmissibility, more severity and/or immune evasion; however, the pathogenesis of these new VOCs in experimental SARS-CoV-2 models or the potential infection of other animal species is not completely understood. Here we infected K18-hACE2 transgenic mice with B.1, B.1.351/Beta, B.1.617.2/Delta and BA.1.1/Omicron isolates and demonstrated heterogeneous infectivity and pathogenesis. B.1.351/Beta variant was the most pathogenic, while BA.1.1/Omicron led to lower viral RNA in the absence of major visible clinical signs. In parallel, we infected wildtype (WT) mice and confirmed that, contrary to B.1 and B.1.617.2/Delta, B.1.351/Beta and BA.1.1/Omicron can infect them. Infection in WT mice coursed without major clinical signs and viral RNA was transient and undetectable in the lungs by day 7 post-infection. In silico modeling supported these findings by predicting B.1.351/Beta receptor binding domain (RBD) mutations result in an increased affinity for both human and murine ACE2 receptors, while BA.1/Omicron RBD mutations only show increased affinity for murine ACE2.

16.
Food Environ Virol ; 2022 May 24.
Article in English | MEDLINE | ID: covidwho-1859143

ABSTRACT

The transmission pathway of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 also called COVID-19 disease) in indoor environments are the main area of contention between health systems and scientists. In this context, little has been investigated about the collection of airborne viral shedding. Here, we collected air samples from 24 locations inside the sole COVID-19 patient care center in Zabol, Iran, for screening SARS-CoV-2 RNA from March to May 2021. Locations included the ICU, COVID-19 wards (CWs) rooms, corridors, nearby nurses' stations, and toilets. We identified the SARS-CoV-2 RNA in breathing zone of CW, in room air, with the positivity rate of 2.5% at a concentration of 17 × 103 virus genome copies/m3 air. It also investigates the relationship between local climate conditions [i.e., temperature and relative humidity] and COVID-19 transmission with the evolution of daily official data on the number of new cases, hospitalizations, and deaths. Current data explained that the difference of temperature and humidity may affect the behavior of virus along with other factors, i.e., population density, individual viral shedding, and infectious dose of SARS-CoV-2 (both indoor and outdoor). Our data support the potential SARS-CoV-2 airborne transmission indoors suggesting the specific safety assessment of building to improve ventilation solutions besides proper using face masks and extensive public health interventions.

17.
Multidiscip Respir Med ; 17: 825, 2022 Jan 12.
Article in English | MEDLINE | ID: covidwho-1855949

ABSTRACT

The relationship between SARS-CoV-2 quantitative viral load and risk of disease progression, morbidity such as long- COVID or mortality in immunosuppressed, remains largely undefined in COVID-19 patients. Critically ill immunosuppressed patients potentially benefit from remdesivir treatment because of the prolonged course of their infection. Four critically ill immunocompromised patients and the impact of remdesivir on viral dynamics in lower respiratory samples were studied. Bronchoalveolar lavage (BAL) samples were assessed to measure SARS-CoV-2 quantitative viral load using real-time PCR. Corresponding plasma levels of remdesivir and its metabolite GS-441524 were determined. Mean virus load of 39.74 x 107 geq/ml (±33.25 x 107 geq/ml) on day 1 dropped significantly (p<0.008) to 3.54 x 106 geq/ml (±6.93 x 106 geq/ml) on day 3 and to 1.4 x 105 geq/ml (±2.35 x 105 geq/ml) on day 5 of remdesivir treatment. Mean virus load dropped below <1% between day 1 and 5 of remdesivir treatment. Parent prodrug remdesivir and also GS441524 metabolite levels of antiviral activity in our patients were far in excess of EC 50. Our data present that remdesivir treatment potentially reduces the SARS-CoV-2 viral load in immunosuppressed critically ill patients. However, the implication of viral load reduction on morbidity and mortality needs further investigation.

18.
Viruses ; 14(5)2022 05 12.
Article in English | MEDLINE | ID: covidwho-1855815

ABSTRACT

Sentinox (STX) is an acid-oxidizing solution containing hypochlorous acid in spray whose virucidal activity against SARS-CoV-2 has been demonstrated. In this paper, results of a randomized controlled trial (RCT) on the efficacy of STX in reducing viral load in mild COVID-19 patients (NCT04909996) and a complementary in vitro study on its activity against different respiratory viruses are reported. In the RCT, 57 patients were randomized (1:1:1) to receive STX three (STX-3) or five (STX-5) times/day plus standard therapy or standard therapy only (controls). Compared with controls, the log10 load reduction in groups STX-3 and STX-5 was 1.02 (p = 0.14) and 0.18 (p = 0.80), respectively. These results were likely driven by outliers with extreme baseline viral loads. When considering subjects with baseline cycle threshold values of 20-30, STX-3 showed a significant (p = 0.016) 2.01 log10 reduction. The proportion of subjects that turned negative by the end of treatment (day 5) was significantly higher in the STX-3 group than in controls, suggesting a shorter virus clearance time. STX was safe and well-tolerated. In the in vitro study, ≥99.9% reduction in titers against common respiratory viruses was observed. STX is a safe device with large virucidal spectrum and may reduce viral loads in mild COVID-19 patients.


Subject(s)
COVID-19 , Viruses , COVID-19/drug therapy , Humans , SARS-CoV-2 , Serologic Tests , Viral Load
19.
Diagn Microbiol Infect Dis ; 103(4): 115726, 2022 May 20.
Article in English | MEDLINE | ID: covidwho-1850931

ABSTRACT

This study used digital polymerase chain reaction (dPCR) to determine whether envelope (E) gene-negative and nucleocapsid (N2) gene-positive (E-N+) results obtained with the Cepheid Xpert Xpress SARS-CoV-2 assay are reliable. Using droplet digital PCR results as a reference, 18 of 22 E-N+ samples with a low viral load (81.8%) were identified as true positives.

20.
Front Immunol ; 13: 860215, 2022.
Article in English | MEDLINE | ID: covidwho-1847172

ABSTRACT

Background: Evidence on the determinants of the magnitude of humoral responses and neutralizing titers in individuals with mild COVID-19 is scarce. Methods: In this cohort study of mild COVID-19 patients, we assessed viral load (VL) by RT-qPCR at two/three time points during acute infection, and anti-SARS-CoV-2 antibodies by ELISA and plasma neutralizing responses using a pseudovirus assay at day 60. Results: Seventy-one individuals (65% female, median 42 years old) were recruited and grouped into high viral load (VL) >7.5 Log10 copies/mL (n=20), low, VL ≤7.5 Log10 copies/mL (n=22), or as Non-early seroconverters with a positive PCR (n=20), and healthy individuals with a negative PCR (n=9). Individuals with high or low VL showed similar titers of total neutralizing antibodies at day 60, irrespective of maximal VL or viral dynamics. Non-early seroconverters had lower antibody titers on day 60, albeit similar neutralizing activity as the groups with high or low VL. Longer symptom duration and older age were independently associated with increased humoral responses. Conclusions: In mild SARS-CoV-2-infected individuals, the duration of symptoms and age (but not VL) contribute to higher humoral responses.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Antibodies, Neutralizing , Antibodies, Viral , Cohort Studies , Female , Humans , Male
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