Diagnostic Utility of Antigen Detection Rapid Diagnostic Tests for Covid- 19: A Systematic Review and Meta-Analysis

BackgroundEarly detection of coronavirus disease (COVID-19) infection to improve disease management, becomes the greatest challenge. Despite high sensitivity of RT-PCR, not only it was reported that 20-67% of infected patients have false negative results. Rapid diagnostic tests (RDTs) are widely used as a point-of-care test for SARS-CoV-2 detection in both pharyngeal and blood specimens. To be less time-consuming, not seem so costly, and requiring no special training make it more favorable, but the low sensitivity is the main limitation. Several reports indicated rapid test of blood and pharyngeal samples has the same sensitivity as the RT-PCR, but some reports have lower sensitivity especial in asymptomatic patients. MethodsIn the present survey, we investigate the eligible studies for sensitivity and specificity of rapid tests and explore the factors that influence the result to help better diagnose COVID-19 infection. 20 studies met the inclusion criteria, which impose 33 different tests. ResultsOur findings showed, type of sample, type of assay, time of sampling, and load of virus influence on sensitivity of RDTs. ConclusionThis research extends our knowledge of how to improve the sensitivity of RDTs to better diagnose of infected patients to address the controlling COVID-19 pandemic.

Global health security capacity against COVID-19 outbreak and its association with the case fatality rate: an analysis of annual data from 210 countries and territories

BackgroundBecause infectious diseases, such as COVID-19, do not have specific boundaries, all countries must prioritize and use the necessary capabilities to prevent, detect, and respond quickly to public health emergencies. In this context, we aimed to review most recent GHS index annual report to observe the regional and global level of health security against COVID-19 outbreak, as well as their relationship with case fatality rate, among 210 countries and territories worldwide. MethodsWe reviewed and analyzed October 2019 GHS index co-leaders joint report, to review health security capacities on the basis of the GHS index in the context of six categories. we prioritized not only the capacities of 210 countries and territories around the world using the GHS Index, but also the existence of functional, tested, proven capabilities for stopping outbreaks at the source. Data were collected from global databases including Worldometer, WHO, and Disease Control and Prevention Center (CDC). FindingsThis study recruited data on 210 countries and territories, of which up to 14 April 2020, 72 countries (34.28%) with more than 1000 total COVID-19 cases were presents. In "most prepared group", number of total COVID-19 diagnostic tests had a significant positive relation with GHS index (r=0.713; p=0.006). Case fatality rate was directly associated with the detection index (r=0.304; p=0.023) in "more prepared group". In "Lower-middle-income economies" group, case fatality rate positively related to detection, response and risk environment indices. ImplementationWith the exception of a very small number, countries that were ranked as most prepared countries, they were more likely to be affected by the COVID-19 outbreak of the virus and its health consequences, and needed to seriously reconsider their capabilities and health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against disease outbreak Research in contextO_ST_ABSEvidence before this studyC_ST_ABSGiven the very rapid spread of the COVID-19 disease in a very short time, limited and few studies have shown weakness and strength in national and international capacity to deal with health emergencies. We systematically searched the Scopus, ISI web of science and PubMed from Jan 2019 to April 2020, using the search terms "health security" OR "emergency preparedness" AND "COVID-19" OR "SARS-CoV-2/nCoV-2019". Our search returned only limited number of published evidences (n=37), of which only one was assessed the operational readiness among 182 countries based on the International Health Regulations (IHR) annual report 1. Added value of this studyGiven a very limited and insufficient on the regional, as well as global preparedness capacities to combat health emergencies, such as COVID-19 disease, we used most recent GHS index annual report (October 2019), to observe the regional and global level of health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against COVID-19 outbreak among 210 countries and territories around the world. We found information about only 195 countries in the recent used report and imputed the data for the rest 15 countries and territories that facing COVID-19 outbreak. Implications of all the available evidenceOur results showed that, with the exception of a very small number of countries that were ranked as most prepared countries, they were more likely to be affected by the COVID-19 outbreak of the virus and its health consequences, and needed to seriously reconsider their capabilities and health security in the context of detection, prevention, rapid response, health system facilities, and risk environment against disease outbreak.

Laboratory findings, signs and symptoms, clinical outcomes of Patients with COVID-19 Infection: an updated systematic review and meta-analysis

Background and AimCoronaviruses disease 2019 (COVID-19), for the first time detected in Wuhan, China, rapidly speared around the world and be a Public Health Emergency of International Concern (PHEIC). The aim of the current survey is collecting laboratory findings, analysis them and reporting a specific pattern for help to COVID-19 diagnosis. MethodsTo collect laboratory characteristics, we searched "PubMed" electronic database with the following keywords: "COVID-19" "2019 novel coronavirus" "laboratory findings" "clinical characteristics". ResultsOnce the initial searches 493 studies were yielded. After removing duplicates studies 480 studies were remained. The 12 studies obtained from the literature, of which 58.3% (7) of studies were case-control (8-14), and 41.7% (5) remaining studies were designed as cross-sectional (1,15-18) ConclusionThe result of the current study showed that in the early stage of COVID-19 infection, maybe there are not significant laboratory findings, but with disease progression, the one or more than signs include increasing AST, ALT, LDH, CK, CRP, ESR, WBC, neutrophil, and decreasing Hemoglobin, lymphocyte count, eosinophil count can be seen. Elevating D-dimer and FDP are associated with ARDS development and can be used as prognostic factors.

Bibliometric Analysis of Global Scientific Research on SARSCoV-2 (COVID-19)

Background and AimSince late 2019, an unknown-origin pneumonia outbreak detected in Wuhan city, Hubei Province, China. We aimed to build a model to qualitatively and quantitatively assess publications of research of COVID-19 from 2019 to 2020. Materials and MethodsData were obtained from the Web of Science (WOS), PubMed, and Scopus Core Collection on March 02, 2020, and updated on March 10. We conducted a qualitative and quantitative analysis of publication outputs, journals, authors, institutions, countries, cited references, keywords, and terms according to bibliometric methods using VOS viewer c software packages. ResultsInitially, we identified 227 papers, of which after an exclusion process, 92 studies were selected for statistical analyses. China accounted for the highest proportion of published research (44 papers, 40.48%), followed by the United States (21 papers, 19.32%), and Canada (7 papers, 6.44%). Adjusted by gross domestic product (GDP), ranked first, with 0.003 articles per billion GDP. In total, the top 10 journals published 47 articles, which accounted for 51.08% of all publications in this Feld. A total of 6 studies (05.52%) were supported by National Natural Science Foundation of China. Chinese Academy of Sciences ranked second 2, 2.76%). ConclusionBibliometric and visualized mapping may quantitatively monitor research performance in science and present predictions. The subject of this study was the fast growing publication on COVID-19. Most studies are published in journals with very high impact factors (IFs) and other journals are more interested in this type of research. HighlightsO_LIBibliometric description and mapping provided a birds-eye view of information on Covid-19 related research C_LIO_LIReaders to comprehend the history of published Covid-19 articles in just a few minutes. C_LIO_LIWe evaluated the research strength of countries and institutions, C_LIO_LIScholars might refer to in order to find cooperative institutions. C_LIO_LIDuring our research using the selected database, we tried to guarantee comprehension and objectivity. C_LI

COVID-19 Patients: A Systematic Review and Meta-Analysis of Laboratory Findings, Comorbidities, and Clinical Outcomes Comparing Medical Staff versus the General Population

This review compared coronavirus disease 2019 (COVID-19) laboratory findings, comorbidities, and clinical outcomes in patients from the general population versus medical staff to aid diagnosis of COVID-19 in a more timely, efficient, and accurate way. Electronic databases were searched up to 23rdMarch, 2020. The initial search yielded 6,527 studies. Following screening, 24 studies were included [18 studies (11,564 cases) of confirmed COVID-19 cases in the general public, and 6 studies (394 cases) in medical staff] in this review. Significant differences were observed in white blood cell counts (p < 0.001), lymphocyte counts (p < 0.001), platelet counts (p = 0.04), procalcitonin levels (p < 0.001), lactate dehydrogenase levels (p < 0.001), and creatinine levels (p = 0.03) when comparing infected medical staff with the general public. The mortality rate was higher in the general population than in medical staff (8% versus 2%). This review showed that during the early stages of COVID-19, laboratory findings alone may not be significant predictors of infection and may just accompany increasing C-reactive protein levels, erythrocyte sedimentation rates, and lactate dehydrogenase levels. In the symptomatic stage, the lymphocyte and platelet counts tended to decrease. Elevated D-dimer fibrin degradation product was associated with poor prognosis.

Cross-Country Comparison of Case Fatality Rates ofCOVID-19/SARS-COV-2

Objectives@#Case fatality rates (CFR) and recovery rates are important readouts during epidemics andpandemics. In this article, an international analysis was performed on the ongoing coronavirus disease2019 (COVID-19) pandemic. @*Methods@#Data were retrieved from accurate databases according to the user’s guide of data sourcesfor patient registries, CFR and recovery rates were calculated for each country. A comparison of CFRbetween countries with total cases ≥ 1,000 was observed for 12th and 23rd March. @*Results@#Italy’s CFR was the highest of all countries studied for both time points (12th March, 6.22% versus23rd March, 9.26%). The data showed that even though Italy was the only European country reported on12rd March, Spain and France had the highest CFR of 6.16 and 4.21%, respectively, on 23rd March, whichwas strikingly higher than the overall CFR of 3.61%. @*Conclusion@#Obtaining detailed and accurate medical history from COVID-19 patients, and analyzingCFR alongside the recovery rate, may enable the identification of the highest risk areas so that efficientmedical care may be provided. This may lead to the development of point-of-care tools to helpclinicians in stratifying patients based on possible requirements in the level of care, to increase theprobabilities of survival from COVID-19 disease.

Biology and bioinformatics of myeloma cell.

Multiple myeloma (MM) is a plasma cell disorder that occurs in about 10% of all hematologic cancers. The majority of patients (99%) are over 50 years of age when diagnosed. In the bone marrow (BM), stromal and hematopoietic stem cells (HSCs) are responsible for the production of blood cells. Therefore any destruction or/and changes within the BM undesirably impacts a wide range of hematopoiesis, causing diseases and influencing patient survival. In order to establish an effective therapeutic strategy, recognition of the biology and evaluation of bioinformatics models for myeloma cells are necessary to assist in determining suitable methods to cure or prevent disease complications in patients. This review presents the evaluation of molecular and cellular aspects of MM such as genetic translocation, genetic analysis, cell surface marker, transcription factors, and chemokine signaling pathways. It also briefly reviews some of the mechanisms involved in MM in order to develop a better understanding for use in future studies.

Miltefosine-Induced Apoptotic Cell Death on Leishmania major and L. tropica Strains

The aim of this study was to assess the cytotoxic effects of various concentrations of miltefosine on Leishmania major (MRHO/IR/75/ER) and L. tropica (MHOM/IR/02/Mash10) promastigotes and to observe the programmed cell death features. The colorimetric MTT assay was used to find L. major and L. tropica viability and the obtained results were expressed as 50% inhibitory concentration (IC50). Also, 50% effective doses (ED50) for L. major and L. tropica amastigotes were also determined. Annexin-V FLUOS staining was performed to study the cell death properties of miltefosine using FACS analysis. Qualitative analysis of the total genomic DNA fragmentation was performed by agarose gel electrophoresis. Furthermore, to observe changes in cell morphology, promastigotes were examined using light microscopy. In both strains of L. major and L. tropica, miltefosine induced dose-dependent death with features of apoptosis, including cell shrinkage, DNA laddering, and externalization of phosphatidylserine. The IC50 was achieved at 22 microM and 11 microM for L. major and L. tropica after 48 hr of incubation, respectively. ED50 of L. major and L. tropica amastigotes were 5.7 microM and 4.2 microM, respectively. Our results indicate that miltefosine induces apoptosis of the causative agent of cutaneous leishmaniasis in a dose-dependent manner. Interestingly, L. major did not display any apoptotic changes when it was exposed to miltefosine in concentrations sufficient to kill L. tropica.

Application of diagnostic methods and molecular diagnosis of hemoglobin disorders in Khuzestan province of Iran.

BACKGROUND: The hemoglobinopathies refer to a diverse group of inherited disorders characterized by a reduced synthesis of one or more globin chains (thalassemias) or the synthesis of structurally abnormal hemoglobin (Hb). The thalassemias often coexist with a variety of structural Hb variants giving rise to complex genotypes and an extremely wide spectrum of clinical and hematological phenotypes. Hematological and biochemical investigations and family studies provide essential clues to the different interactions and are fundamental to DNA diagnostics of the Hb disorders. Although DNA diagnostics have made a major impact on our understanding and detection of the hemoglobinopathies, DNA mutation testing should never be considered a shortcut or the test of first choice in the workup of a hemoglobinopathy. MATERIALS AND METHODS: A careful three-tier approach involving: (1) Full blood count (2) Special hematological tests, followed by (3) DNA mutation analysis, provides the most effective way in which to detect primary gene mutations as well as gene-gene interactions that can influence the overall phenotype. With the exception of a few rare deletions and rearrangements, the molecular lesions causing hemoglobinopathies are all identifiable by PCR-based techniques. Furthermore, each at-risk ethnic group has its own combination of common Hb variants and thalassemia mutations. In Iran, there are many different forms of α and ß thalassemia. Increasingly, different Hb variants are being detected and their effects per se or in combination with the thalassemias, provide additional diagnostic challenges. RESULTS: We did step-by-step diagnosis workup in 800 patients with hemoglobinopathies who referred to Research center of Thalassemia and Hemoglobinopathies in Shafa Hospital of Ahwaz Joundishapour University of medical sciences, respectively. We detected 173 patients as iron deficiency anemia (IDA) and 627 individuals as thalassemic patients by use of different indices. We have successfully detected 75% (472/627) of the ß-thalassemia mutations by using amplification refractory mutation system (ARMS) technique and 19% (130/627) of the ß-thalassemia mutations by using Gap-PCR technique and 6% (25/627) as Hb variants by Hb electrophoresis technique. We did prenatal diagnosis (PND) for 176 couples which had background of thalassemia in first pregnancy. Result of PND diagnosis in the first trimester was 35% (62/176) affected fetus with ß-thalassemia major and sickle cell disease that led to termination of the pregnancy. CONCLUSION: Almost all hemoglobinopathies can be detected with the current PCR-based assays with the exception of a few rare deletions. However, the molecular diagnostic service is still under development to try and meet the demands of the population it serves. In the short term, the current generation of instruments such as the capillary electrophoresis systems, has greatly simplified DNA sequence analysis.