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1.
J Neuroimmunol ; 353: 577521, 2021 04 15.
Article in English | MEDLINE | ID: covidwho-1091758

ABSTRACT

BACKGROUND: Serious neurological complications of SARS-CoV-2 are increasingly being recognized. CASE: We report a novel case of HHV6 myelitis with parainfectious MOG-IgG in the setting of COVID-19-induced lymphopenia and hypogammaglobulinemia. The patient experienced complete neurological recovery with gancyclovir, high dose corticosteroids, and plasma exchange. To our knowledge, this is the first case of HHV6 reactivation in the central nervous system in the setting of COVID19 infection and the first case of MOG-IgG myelitis in the setting of SARS-CoV-2 and HHV6 coinfection. CONCLUSION: Patients with neurological manifestations in the setting of COVID19-related immunodeficiency should be tested for opportunistic infections including HHV6. Viral infection is a known trigger for MOG-IgG and therefore this antibody should be checked in patients with SARS-CoV-2 associated demyelination.


Subject(s)
COVID-19/complications , Coinfection/complications , Lymphopenia/virology , Myelitis, Transverse/virology , Roseolovirus Infections/immunology , Anti-Inflammatory Agents/therapeutic use , Antiviral Agents/therapeutic use , Autoantibodies/immunology , Autoantigens/immunology , COVID-19/immunology , Coinfection/immunology , Ganciclovir/therapeutic use , Herpesvirus 6, Human , Humans , Male , Methylprednisolone/therapeutic use , Middle Aged , Myelitis, Transverse/immunology , Myelitis, Transverse/therapy , Plasma Exchange/methods , Roseolovirus Infections/drug therapy , SARS-CoV-2 , Virus Activation/immunology
2.
Cornea ; 40(3): 383-386, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1066450

ABSTRACT

PURPOSE: To present a patient with bilateral conjunctivitis, testing positive for viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in both nasopharyngeal and conjunctival samples. METHODS: A 40-year-old man with bilateral acute conjunctivitis and suspicious signs of coronavirus disease 2019 (COVID-19) presented to the hospital. A detailed ophthalmic examination was performed. Samples obtained from conjunctival and nasopharyngeal swabs were tested by reverse transcription PCR (RT-PCR) for the detection of SARS-CoV-2 virus. Ocular findings and duration of the presence of viral RNA in the conjunctival specimens were evaluated at follow-up visits. RESULTS: Slit-lamp biomicroscopy revealed bilateral acute follicular conjunctivitis. The RT-PCR assay demonstrated the presence of viral RNA in the nasopharyngeal and conjunctival specimens at the initial visit and at the 4-day follow-up. Conjunctivitis findings were decreased after 4 days and recovered completely without any sequelae within10 days. The PCR results of both nasopharyngeal and conjunctiva specimens were negative for the viral RNA at 10 days. CONCLUSIONS: Bilateral conjunctivitis is rare in patients infected with COVID-19. Although it is difficult to detect viral RNA from conjunctival swabs, conjunctival secretions may be a source of contamination, and protective measures must be taken.


Subject(s)
COVID-19/virology , Conjunctiva/virology , Conjunctivitis, Viral/virology , Eye Infections, Viral/virology , Nasopharynx/virology , RNA, Viral/genetics , SARS-CoV-2/isolation & purification , Administration, Ophthalmic , Administration, Oral , Adult , Antirheumatic Agents/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19 Nucleic Acid Testing , Conjunctivitis, Viral/diagnosis , Conjunctivitis, Viral/drug therapy , Drug Therapy, Combination , Eye Infections, Viral/diagnosis , Eye Infections, Viral/drug therapy , Ganciclovir/therapeutic use , Humans , Hydroxychloroquine/therapeutic use , Intraocular Pressure , Male , Pharmaceutic Aids/therapeutic use , Povidone/therapeutic use , SARS-CoV-2/genetics , Slit Lamp Microscopy , Visual Acuity
3.
J Cataract Refract Surg ; 46(12): e61-e63, 2020 12.
Article in English | MEDLINE | ID: covidwho-910345

ABSTRACT

This case report describes a negative result for antigen testing for the SARS-CoV-2 virus in an aqueous sample taken during the management of suspected herpes simplex keratitis from a patient with confirmed SARS-CoV-2 based on antigen testing of high nasal swab. The implications of no viral load detectable in the aqueous sample are discussed in context of routine phacoemulsification surgery during the SARS-CoV-2 pandemic.


Subject(s)
Aqueous Humor/virology , COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , Corneal Stroma/virology , Keratitis, Herpetic/diagnosis , SARS-CoV-2/isolation & purification , Antiviral Agents/therapeutic use , COVID-19/genetics , COVID-19/virology , Ganciclovir/therapeutic use , Humans , Keratitis, Herpetic/drug therapy , Keratitis, Herpetic/virology , Male , Middle Aged , Recurrence , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , Simplexvirus/pathogenicity , Visual Acuity/physiology
4.
Antiviral Res ; 180: 104857, 2020 08.
Article in English | MEDLINE | ID: covidwho-602131

ABSTRACT

SARS-CoV-2, a member of the coronavirus family, is responsible for the current COVID-19 worldwide pandemic. We previously demonstrated that five nucleotide analogues inhibit the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp), including the active triphosphate forms of Sofosbuvir, Alovudine, Zidovudine, Tenofovir alafenamide and Emtricitabine. We report here the evaluation of a library of nucleoside triphosphate analogues with a variety of structural and chemical features as inhibitors of the RdRps of SARS-CoV and SARS-CoV-2. These features include modifications on the sugar (2' or 3' modifications, carbocyclic, acyclic, or dideoxynucleotides) or on the base. The goal is to identify nucleotide analogues that not only terminate RNA synthesis catalyzed by these coronavirus RdRps, but also have the potential to resist the viruses' exonuclease activity. We examined these nucleotide analogues for their ability to be incorporated by the RdRps in the polymerase reaction and to prevent further incorporation. While all 11 molecules tested displayed incorporation, 6 exhibited immediate termination of the polymerase reaction (triphosphates of Carbovir, Ganciclovir, Stavudine and Entecavir; 3'-OMe-UTP and Biotin-16-dUTP), 2 showed delayed termination (Cidofovir diphosphate and 2'-OMe-UTP), and 3 did not terminate the polymerase reaction (2'-F-dUTP, 2'-NH2-dUTP and Desthiobiotin-16-UTP). The coronaviruses possess an exonuclease that apparently requires a 2'-OH at the 3'-terminus of the growing RNA strand for proofreading. In this study, all nucleoside triphosphate analogues evaluated form Watson-Crick-like base pairs. The nucleotide analogues demonstrating termination either lack a 2'-OH, have a blocked 2'-OH, or show delayed termination. Thus, these nucleotide analogues are of interest for further investigation to evaluate whether they can evade the viral exonuclease activity. Prodrugs of five of these nucleotide analogues (Cidofovir, Abacavir, Valganciclovir/Ganciclovir, Stavudine and Entecavir) are FDA-approved medications for treatment of other viral infections, and their safety profiles are well established. After demonstrating potency in inhibiting viral replication in cell culture, candidate molecules can be rapidly evaluated as potential therapies for COVID-19.


Subject(s)
Antiviral Agents/pharmacology , Coronavirus Infections/virology , Nucleotides/pharmacology , Pneumonia, Viral/virology , RNA-Dependent RNA Polymerase/antagonists & inhibitors , SARS Virus/enzymology , Severe Acute Respiratory Syndrome/virology , Antiviral Agents/chemistry , Antiviral Agents/therapeutic use , Betacoronavirus/enzymology , Betacoronavirus/genetics , COVID-19 , Cidofovir/chemistry , Cidofovir/pharmacology , Cidofovir/therapeutic use , Coronavirus Infections/drug therapy , Dideoxynucleosides/chemistry , Dideoxynucleosides/pharmacology , Dideoxynucleosides/therapeutic use , Ganciclovir/chemistry , Ganciclovir/pharmacology , Ganciclovir/therapeutic use , Guanine/analogs & derivatives , Guanine/chemistry , Guanine/pharmacology , Guanine/therapeutic use , Nucleotides/chemistry , Nucleotides/therapeutic use , Pandemics , Pneumonia, Viral/drug therapy , Prodrugs/chemistry , Prodrugs/pharmacology , Prodrugs/therapeutic use , RNA, Viral/antagonists & inhibitors , RNA, Viral/biosynthesis , SARS Virus/genetics , SARS-CoV-2 , Severe Acute Respiratory Syndrome/drug therapy , Stavudine/chemistry , Stavudine/pharmacology , Stavudine/therapeutic use , Valganciclovir/chemistry , Valganciclovir/pharmacology , Valganciclovir/therapeutic use
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