SARS-CoV-2 infection of companion animals in Egypt and its risk of spillover.

BACKGROUND: Reverse zoonoses occur because of interactions between humans and animals. Homology of ACE-2 cell receptors in different hosts and high mutation rate of SARS-CoV-2 enhance viral transmission among species. OBJECTIVES: This study aimed to investigate spillover of SARS-CoV-2 between humans and companion animals. METHODS: A cross-sectional study was constructed using nasopharyngeal/oropharyngeal swabs, serum and blood samples collected from 66 companion animals (33 cats and 33 dogs) that were in contact with SARS-CoV-2-positive owners from December 2020 to March 2021. Swabs were screened by rRT-PCR and some positive cases were confirmed by partial spike gene sequencing. Clinical pathology and pathological studies were also performed. RESULTS: Our findings revealed that 30% of cats (10/33) and 24% of dogs (8/33) were SARS-CoV-2 positive. While 33% of these animals were asymptomatic (6/18), 28% showed mild respiratory signs (5/18) and 39% displayed severe respiratory signs (7/18) including 4 dead cats 40% (4/10). Partial spike gene sequencing of 6 positive samples collected in December 2020 were identical to SARS-CoV-2 that was detected in humans in Egypt in that time frame. Clinical pathology findings revealed thrombocytopenia, lymphocytopenia, as well as elevated levels of D-dimer, LDH, CRP, and ferritin. Post-mortem and histopathological examinations illustrated multisystemic effects. CONCLUSIONS: There is a potential occurrence of SARS-CoV-2 spillover between humans and pet animals. IMPACTS: The present study highlighted the potential occurrence of SARS-CoV-2 spillover between humans and their companion animals. Biosecurity measures should be applied to decrease spread of SARS-CoV-2 among humans and pet animals.

Immediate breast reconstruction with expander assisted latissimus dorsi flap after skin sparing mastectomy.

BACKGROUND AND PURPOSE: The latissimus dorsi myocutaneous flap (LDMF) used to be the standard practice for breast reconstruction; however, with the increased use of tissue expanders and the development of the transverse rectus-abdominis myocutaneous flap for autologous tissue breast reconstruction, its use has decreased. To reassess the role of the LDMF in breast reconstruction, a prospective study was performed to evaluate women who had a skin sparing mastectomy followed by immediate reconstruction with a latissimus dorsi flap and tissue expander implant. PATIENTS AND METHODS: Twenty-five women with early breast cancer underwent immediate latissimus dorsi myocutaneous flaps with tissue expander after skin sparing mastectomy. The oncologic safety of skin sparing mastectomy, the postoperative aesthetic results and complications were evaluated. RESULTS: Between May 2003 and April 2005, 25 consecutive women diagnosed with breast cancer underwent skin sparing mastectomy and expander assisted immediate latissimus dorsi breast reconstruction. Their median age was 42 years, ranging from 34 to 48 years. The procedure duration ranged from 2.5 to 6 hours, with a median of 3.9 hours, however, expansion was completed by 4 months (range 1 to 8 months). Patients were discharged 7 days after surgery with a range of 5 to 15 days. The complication rate was low, manifesting with skin flap necrosis in 12%, wound infection in 4%, and port site extrusion in 4%. There was no flap loss. With the exception of seroma formation, the donor site morbidity was low (seroma 40%, hematoma 4%, back pain 8%, and limited arm movement 4%). No local recurrence was recorded. The aesthetic result of surgery was rated as excellent in 20%, good in 60%, fair in 24%, and poor in 4% of cases. The duration of post-operative follow up was 14.7 months, ranging from 6 to 24 months. CONCLUSIONS: Skin sparing mastectomy and immediate breast reconstruction is an oncologically safe technique. The use of latissimus dorsi myocutaneous flap with tissue expansion has proved to be an effective and aesthetic method of immediate breast reconstruction after skin sparing mastectomy.