Journal articles on the topic 'Severe acute respiratory syndrome (SARS) media'
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Tice, Alan Douglas, Mitsumasa Kishimoto, Chuong Hoang Dinh, Geoffrey Tak-Kin Lam, and Michelle Marineau. "Knowledge of Severe Acute Respiratory Syndrome among Community Physicians, Nurses, and Emergency Medical Responders." Prehospital and Disaster Medicine 21, no. 3 (June 2006): 183–89. http://dx.doi.org/10.1017/s1049023x00003654.
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AbstractIntroduction:The preparedness levels of front-line clinicians including physicians, nurses, emergency medical responders (EMRs), and other medical staff working in clinics, offices and ambulatory care centers must be assessed, so these personnel are able to deal with communicable and potentially lethal diseases, such as severe acute respiratory syndrome (SARS). In order to determine the knowledge of these clinicians, a survey of their understanding of SARS and their use of educational resources was administered.Methods:A questionnaire was distributed to physicians, nurses, and EMRs attending conferences on SARS in the summer of 2003. Questions related to information sources, knowledge of SARS, and plans implemented in their workplace to deal with it. Statistical analysis was performed using the Statistical Package for the Social Sciences (10.1 Program, SPSS Inc., Chicago, Illinois).Results:A total of 201 community healthcare providers (HCPs) participated in the study. A total of 51% of the participants correctly identified the incubation period of SARS; 48% correctly identified the symptoms of SARS; and 60% knew the recommended infection control precautions to take for families. There was little difference in knowledge among the physicians, nurses, and EMRs evaluated. Media outlets such as newspapers, journals, television, and radio were reported as the main sources of information on SARS. However, there appears to be a growing use of the Internet, which correlated best with the correct answers on symptoms of SARS. Fewer than one-third of respondents were aware of a protocol for SARS in their workplace. A total of 60% reported that N-95 masks were available in their workplace.Conclusion:These findings suggest the need for more effective means of education and training for front-line clinicians, as well as the institution of policies and procedures in medical offices, clinics, and emergency services in the community.
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Muzzatti, Stephen L. "Bits of Falling Sky and Global Pandemics: Moral Panic and Severe Acute Respiratory Syndrome (SARS)." Illness, Crisis & Loss 13, no. 2 (April 2005): 117–28. http://dx.doi.org/10.1177/105413730501300203.
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Whether it's a story about crime, the weather, politics, Hollywood celebrities, or public health, sensationalistic and exploitative coverage is a media staple. The mass media's coverage of the outbreak of Severe Acute Respiratory Syndrome (SARS) in the spring of 2003 was no exception. The media's construction of the source, virulence, and transmissibility of this disease, a previously unknown cousin of the common cold, diverged considerably from its medical realities and contributed to a widespread though short-lived moral panic. Drawing on work in the areas of the sociology of health and critical criminology, this article explores the claims-making activities behind the SARS “epidemic.” Specifically, it addresses how threats to the public well-being are manufactured by the media and how these threats draw upon past and present cultural myths of dangerous “others” and contribute to unwarranted public fear, intolerance, and distrust.
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Bullard, Jared, Kerry Dust, Duane Funk, James E. Strong, David Alexander, Lauren Garnett, Carl Boodman, et al. "Predicting Infectious Severe Acute Respiratory Syndrome Coronavirus 2 From Diagnostic Samples." Clinical Infectious Diseases 71, no. 10 (May 22, 2020): 2663–66. http://dx.doi.org/10.1093/cid/ciaa638.
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Abstract Background Reverse-transcription polymerase chain reaction (RT-PCR) has become the primary method to diagnose viral diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). RT-PCR detects RNA, not infectious virus; thus, its ability to determine duration of infectivity of patients is limited. Infectivity is a critical determinant in informing public health guidelines/interventions. Our goal was to determine the relationship between E gene SARS-CoV-2 RT-PCR cycle threshold (Ct) values from respiratory samples, symptom onset to test (STT), and infectivity in cell culture. Methods In this retrospective cross-sectional study, we took SARS-CoV-2 RT-PCR–confirmed positive samples and determined their ability to infect Vero cell lines. Results Ninety RT-PCR SARS-CoV-2–positive samples were incubated on Vero cells. Twenty-six samples (28.9%) demonstrated viral growth. Median tissue culture infectious dose/mL was 1780 (interquartile range, 282–8511). There was no growth in samples with a Ct > 24 or STT > 8 days. Multivariate logistic regression using positive viral culture as a binary predictor variable, STT, and Ct demonstrated an odds ratio (OR) for positive viral culture of 0.64 (95% confidence interval [CI], .49–.84; P < .001) for every 1-unit increase in Ct. Area under the receiver operating characteristic curve for Ct vs positive culture was OR, 0.91 (95% CI, .85–.97; P < .001), with 97% specificity obtained at a Ct of > 24. Conclusions SARS-CoV-2 Vero cell infectivity was only observed for RT-PCR Ct < 24 and STT < 8 days. Infectivity of patients with Ct > 24 and duration of symptoms > 8 days may be low. This information can inform public health policy and guide clinical, infection control, and occupational health decisions. Further studies of larger size are needed.
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Pablo Goldschmidt. "Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) detection pitfalls." International Journal of Science and Research Archive 2, no. 2 (May 30, 2021): 008–17. http://dx.doi.org/10.30574/ijsra.2021.2.2.0049.
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The Severe Acute Respiratory Syndrome (CoVID 19) provoked by Coronavirus 2 (SARS CoV 2) require science-based responses. The aim of this work is to assess pitfalls found during the search of viral genomes due to sampling timing, swabbing, storage, heat-infectivity inactivation and further sample processing. According to several meta-analysis, on the day of symptom onset, the median false-negative rate is estimated to be 38% and decreased to 20% on day 8 (3 days after symptom onset) then increased to 66% on day 21 suggesting that rRT-PCRs adds little information immediately after exposure. RNA isolation from samples requires cautious handling using RNase-free solutions, pipet tips and glassware. The rRT PCR detection limits are estimated between 39 and 779 copies/mL but 3000 to 20.000 copies/ml for the antigen test. External cross contamination by imperceptible splatting requires risk management integrating the Pharmacopoeias by processing at least 10 negative contiguous to 10 positive controls in each sennries of 100 tests. . For Ct >34 it was suggested no transmissible disease. The detection of antibodies one month or later after clinical signs may confirm positivity. Lack of immune response in non-immune compromised asymptomatic people may invalidate positivity. False positive disrupts efficiency for containing infections and leads to societal anxiety undermining health workforce. Because spurious methods create confusion, each step of diagnosis requires quality-control and risk assessment, knowing that rRT PCRs amplify more than 10.000 million times the signal of 1 viral element
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Fwoloshi, Sombo, Jonas Z. Hines, Danielle T. Barradas, Samuel Yingst, Mpanji Siwingwa, Lameck Chirwa, James E. Zulu, et al. "Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 Among Healthcare Workers—Zambia, July 2020." Clinical Infectious Diseases 73, no. 6 (March 30, 2021): e1321-e1328. http://dx.doi.org/10.1093/cid/ciab273.
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Abstract Background Healthcare workers (HCWs) in Zambia have become infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). However, SARS-CoV-2 prevalence among HCWs is not known in Zambia. Methods We conducted a cross-sectional SARS-CoV-2 prevalence survey among Zambian HCWs in 20 health facilities in 6 districts in July 2020. Participants were tested for SARS-CoV-2 infection using polymerase chain reaction (PCR) and for SARS-CoV-2 antibodies using enzyme-linked immunosorbent assay (ELISA). Prevalence estimates and 95% confidence intervals (CIs), adjusted for health facility clustering, were calculated for each test separately, and a combined measure for those who had PCR and ELISA was performed. Results In total, 660 HCWs participated in the study, with 450 (68.2%) providing a nasopharyngeal swab for PCR and 575 (87.1%) providing a blood specimen for ELISA. Sixty-six percent of participants were females, and median age was 31.5 years (interquartile range, 26.2–39.8). The overall prevalence of the combined measure was 9.3% (95% CI, 3.8%–14.7%). PCR-positive prevalence of SARS-CoV-2 was 6.6% (95% CI, 2.0%–11.1%), and ELISA-positive prevalence was 2.2% (95% CI, .5%–3.9%). Conclusions SARS-CoV-2 prevalence among HCWs was similar to a population-based estimate (10.6%) during a period of community transmission in Zambia. Public health measures such as establishing COVID-19 treatment centers before the first cases, screening for COVID-19 symptoms among patients who access health facilities, infection prevention and control trainings, and targeted distribution of personal protective equipment based on exposure risk might have prevented increased SARS-CoV-2 transmission among Zambian HCWs.
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Pan, Yanfeng, Xue Yu, Xinwei Du, Qingqing Li, Xianyang Li, Tao Qin, Miaomiao Wang, et al. "Epidemiological and Clinical Characteristics of 26 Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Carriers." Journal of Infectious Diseases 221, no. 12 (April 22, 2020): 1940–47. http://dx.doi.org/10.1093/infdis/jiaa205.
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Abstract Background We retrospectively analyzed 26 persistently asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriers. Methods Epidemiological and clinical characteristics from the 26 asymptomatic patients with positive results for SARS-CoV-2 ribonucleic acid testing were obtained. Results Twenty-two patients (84.6%) correlated with clustering occurrence. The median period from contact to diagnosis and the last positive nucleic acid test was 19 (8–24 days) and 21.5 days (10–36 days), respectively. The median period from diagnosis to negative nucleic acid test was significantly different between patients with normal or atypical chest computed tomography (CT) findings (n = 16, 61.5%; 7.5 days [2–20 days]) and patients with typical ground-glass or patchy opacities on CT (n = 10, 38.5%; 12.5 days [8–22 days]; P < .01). Seven patients (70.0%) with initial positive nucleic acid test results had a negative result simultaneously with improved CT findings. Obvious improvement in CT findings was observed in 3 patients (30.0%) despite positive nucleic acid test results. Conclusions In asymptomatic patients, changes in biochemical and inflammatory variables are small and changes on chest CT can occur. It is worth noting that the long existence of SARS-CoV-2 in some asymptomatic patients and false-negative results need to be considered in SARS-CoV-2 nucleic acid test.
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Lewison, Grant. "The reporting of the risks from severe acute respiratory syndrome (SARS) in the news media, 2003–2004." Health, Risk & Society 10, no. 3 (June 2008): 241–62. http://dx.doi.org/10.1080/13698570802160962.
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Keshavarz, Behnam, Joesph R. Wiencek, Lisa J. Workman, Matthew D. Straesser, Lyndsey M. Muehling, Glenda Canderan, Fabrizio Drago, et al. "Quantitative Measurement of IgG to Severe Acute Respiratory Syndrome Coronavirus-2 Proteins Using ImmunoCAP." International Archives of Allergy and Immunology 182, no. 5 (2021): 417–24. http://dx.doi.org/10.1159/000514203.
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<b><i>Background:</i></b> Detailed understanding of the immune response to severe acute respiratory syndrome coronavirus (SARS-CoV)-2, the cause of coronavirus disease 2019 (COVID-19) has been hampered by a lack of quantitative antibody assays. <b><i>Objective:</i></b> The objective was to develop a quantitative assay for IgG to SARS-CoV-2 proteins that could be implemented in clinical and research laboratories. <b><i>Methods:</i></b> The biotin-streptavidin technique was used to conjugate SARS-CoV-2 spike receptor-binding domain (RBD) or nucleocapsid protein to the solid phase of the ImmunoCAP. Plasma and serum samples from patients hospitalized with COVID-19 (<i>n</i> = 60) and samples from donors banked before the emergence of COVID-19 (<i>n</i> = 109) were used in the assay. SARS-CoV-2 IgG levels were followed longitudinally in a subset of samples and were related to total IgG and IgG to reference antigens using an ImmunoCAP 250 platform. <b><i>Results:</i></b> At a cutoff of 2.5 μg/mL, the assay demonstrated sensitivity and specificity exceeding 95% for IgG to both SARS-CoV-2 proteins. Among 36 patients evaluated in a post-hospital follow-up clinic, median levels of IgG to spike-RBD and nucleocapsid were 34.7 μg/mL (IQR 18–52) and 24.5 μg/mL (IQR 9–59), respectively. Among 17 patients with longitudinal samples, there was a wide variation in the magnitude of IgG responses, but generally the response to spike-RBD and to nucleocapsid occurred in parallel, with peak levels approaching 100 μg/mL, or 1% of total IgG. <b><i>Conclusions:</i></b> We have described a quantitative assay to measure IgG to SARS-CoV-2 that could be used in clinical and research laboratories and implemented at scale. The assay can easily be adapted to measure IgG to mutated COVID-19 proteins, has good performance characteristics, and has a readout in standardized units.
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Shen, Zijie, Yan Xiao, Lu Kang, Wentai Ma, Leisheng Shi, Li Zhang, Zhuo Zhou, et al. "Genomic Diversity of Severe Acute Respiratory Syndrome–Coronavirus 2 in Patients With Coronavirus Disease 2019." Clinical Infectious Diseases 71, no. 15 (March 9, 2020): 713–20. http://dx.doi.org/10.1093/cid/ciaa203.
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Abstract Background A novel coronavirus (CoV), severe acute respiratory syndrome (SARS)–CoV-2, has infected >75 000 individuals and spread to >20 countries. It is still unclear how fast the virus evolved and how it interacts with other microorganisms in the lung. Methods We have conducted metatranscriptome sequencing for bronchoalveolar lavage fluid samples from 8 patients with SARS–CoV-2, and also analyzed data from 25 patients with community-acquired pneumonia (CAP), and 20 healthy controls for comparison. Results The median number of intrahost variants was 1–4 in SARS–CoV-2–infected patients, ranged from 0 to 51 in different samples. The distribution of variants on genes was similar to those observed in the population data. However, very few intrahost variants were observed in the population as polymorphisms, implying either a bottleneck or purifying selection involved in the transmission of the virus, or a consequence of the limited diversity represented in the current polymorphism data. Although current evidence did not support the transmission of intrahost variants in a possible person-to-person spread, the risk should not be overlooked. Microbiotas in SARS–CoV-2–infected patients were similar to those in CAP, either dominated by the pathogens or with elevated levels of oral and upper respiratory commensal bacteria. Conclusion SARS–CoV-2 evolves in vivo after infection, which may affect its virulence, infectivity, and transmissibility. Although how the intrahost variant spreads in the population is still elusive, it is necessary to strengthen the surveillance of the viral evolution in the population and associated clinical changes.
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Rabi, Firas A., Mazhar S. Al Zoubi, Ghena A. Kasasbeh, Dunia M. Salameh, and Amjad D. Al-Nasser. "SARS-CoV-2 and Coronavirus Disease 2019: What We Know So Far." Pathogens 9, no. 3 (March 20, 2020): 231. http://dx.doi.org/10.3390/pathogens9030231.
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In December 2019, a cluster of fatal pneumonia cases presented in Wuhan, China. They were caused by a previously unknown coronavirus. All patients had been associated with the Wuhan Wholefood market, where seafood and live animals are sold. The virus spread rapidly and public health authorities in China initiated a containment effort. However, by that time, travelers had carried the virus to many countries, sparking memories of the previous coronavirus epidemics, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and causing widespread media attention and panic. Based on clinical criteria and available serological and molecular information, the new disease was called coronavirus disease of 2019 (COVID-19), and the novel coronavirus was called SARS Coronavirus-2 (SARS-CoV-2), emphasizing its close relationship to the 2002 SARS virus (SARS-CoV). The scientific community raced to uncover the origin of the virus, understand the pathogenesis of the disease, develop treatment options, define the risk factors, and work on vaccine development. Here we present a summary of current knowledge regarding the novel coronavirus and the disease it causes.
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Takeda, Yohei, Kyohei Tamura, Dulamjav Jamsransuren, Sachiko Matsuda, and Haruko Ogawa. "Severe Acute Respiratory Syndrome Coronavirus-2 Inactivation Activity of the Polyphenol-Rich Tea Leaf Extract with Concentrated Theaflavins and Other Virucidal Catechins." Molecules 26, no. 16 (August 8, 2021): 4803. http://dx.doi.org/10.3390/molecules26164803.
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Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is producing a large number of infections and deaths globally, the development of supportive and auxiliary treatments is attracting increasing attention. Here, we evaluated SARS-CoV-2-inactivation activity of the polyphenol-rich tea leaf extract TY-1 containing concentrated theaflavins and other virucidal catechins. The TY-1 was mixed with SARS-CoV-2 solution, and its virucidal activity was evaluated. To evaluate the inhibition activity of TY-1 in SARS-CoV-2 infection, TY-1 was co-added with SARS-CoV-2 into cell culture media. After 1 h of incubation, the cell culture medium was replaced, and the cells were further incubated in the absence of TY-1. The viral titers were then evaluated. To evaluate the impacts of TY-1 on viral proteins and genome, TY-1-treated SARS-CoV-2 structural proteins and viral RNA were analyzed using western blotting and real-time RT-PCR, respectively. TY-1 showed time- and concentration-dependent virucidal activity. TY-1 inhibited SARS-CoV-2 infection of cells. The results of western blotting and real-time RT-PCR suggested that TY-1 induced structural change in the S2 subunit of the S protein and viral genome destruction, respectively. Our findings provided basic insights in vitro into the possible value of TY-1 as a virucidal agent, which could enhance the current SARS-CoV-2 control measures.
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Teoh, Jeremy Yuen-Chun, Terry Cheuk-Fung Yip, Grace Chung-Yan Lui, Vincent Wai-Sun Wong, Viola Chi-Ying Chow, Tracy Hang-Yee Ho, Timothy Chun-Man Li, et al. "Risks of AKI and Major Adverse Clinical Outcomes in Patients with Severe Acute Respiratory Syndrome or Coronavirus Disease 2019." Journal of the American Society of Nephrology 32, no. 4 (January 22, 2021): 961–71. http://dx.doi.org/10.1681/asn.2020071097.
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BackgroundSevere acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) are closely related. The effect of AKI on the clinical outcomes of these two conditions is unclear.MethodsThis retrospective, territory-wide cohort study used an electronic public healthcare database in Hong Kong to identify patients with SARS or COVID-19 by diagnosis codes, virologic results, or both. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death.ResultsWe identified 1670 patients with SARS and 1040 patients with COVID-19 (median ages, 41 versus 35 years, respectively). Among patients with SARS, 26% met the primary endpoint versus 5.3% of those with COVID-19. Diabetes mellitus, abnormal liver function, and AKI were factors significantly associated with the primary endpoint among patients with either SARS or COVID-19. Among patients with SARS, 7.9%, 2.1%, and 3.7% developed stage 1, stage 2, and stage 3 AKI, respectively; among those with COVID-19, 6.6%, 0.4%, and 1.1% developed stage 1, stage 2, and stage 3 AKI, respectively. In both groups, factors significantly associated with AKI included diabetes mellitus and hypertension. Among patients with AKI, those with COVID-19 had a lower rate of major adverse clinical outcomes versus patients with SARS. Renal function recovery usually occurred within 30 days after an initial AKI event.ConclusionsAKI rates were higher among patients with SARS than those with COVID-19. AKI was associated with major adverse clinical outcomes for both diseases. Patients with diabetes mellitus and abnormal liver function were also at risk of developing severe consequences after SARS and COVID-19 infection.
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Moazzam, Muhammad, Muhammad Imran Sajid, Hamza Shahid, Jahanzaib Butt, Irfan Bashir, Muhammad Jamshaid, Amir Nasrolahi Shirazi, and Rakesh Kumar Tiwari. "Understanding COVID-19: From Origin to Potential Therapeutics." International Journal of Environmental Research and Public Health 17, no. 16 (August 14, 2020): 5904. http://dx.doi.org/10.3390/ijerph17165904.
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Currently, a global pandemic era of public health concerns is going on with the Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first case of COVID-19 was reported from Wuhan’s Huanan seafood market in China late December 2019. Bats, pangolins, and snakes have been nominated as salient carriers of the virus. Thanks to its high pathogenicity, it can cause severe respiratory infections. Fever, dry cough, sore throat, pneumonia, septic shock, and ground-glass opacities are the foremost clinical manifestations of COVID-19. Immunocompromised patients are at high risk for COVID-19 infection and may lead to death. Scientist and government agencies around the globe are putting forward their best efforts and resources for the effective treatment of human coronavirus infections; however, neither vaccines nor antiviral drugs are available for the treatment of human coronaviruses (HCoV) infections such as SARS (severe acute respiratory syndrome), MERS (Middle Eastern respiratory syndrome), and COVID-19. Since the outbreak, a plethora of research and review articles have been published. Moreover, the mass media has bombarded the public with conflicting opinions about the pandemic. There is a dire need for accurate and reliable information concerning this pandemic. In this review, we have compiled the up to date information about the origins, evolution, epidemiology, and pathogenesis of this disease. Moreover, very few reports have addressed the clinical features and current status of treatment for COVID-19; we have adequately addressed these topics in detail in this review. Finally, a detailed account of clinical trials of vaccines and other therapeutics currently in progress has been delineated.
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Hitzenbichler, Florian, Stilla Bauernfeind, Bernd Salzberger, Barbara Schmidt, and Jürgen J. Wenzel. "Comparison of Throat Washings, Nasopharyngeal Swabs and Oropharyngeal Swabs for Detection of SARS-CoV-2." Viruses 13, no. 4 (April 10, 2021): 653. http://dx.doi.org/10.3390/v13040653.
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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA is detected by reverse-transcription quantitative real-time PCR (RT-qPCR) from respiratory specimens. This study compares throat washings (TW), nasopharyngeal swabs (NS) and oropharyngeal swabs (OS). A total of 102 samples from 34 adult patients with confirmed SARS-CoV-2 infection were analysed by RT-qPCR with absolute quantification. The median concentrations and diagnostic sensitivities were 5.8×104 copies/mL, 85% (NS), 1.4×104, 79% (OS) and 4.3×103, 85% (TW). Concentration differences were significant between NS and TW (P = 0.019). Saliva (SA) was available from 21 patients (median 3.4×103). OS and TW can be considered for SARS-CoV-2 diagnostics, although with slightly lower concentrations.
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Ng, Enders K. O., David S. Hui, K. C. Allen Chan, Emily C. W. Hung, Rossa W. K. Chiu, Nelson Lee, Alan Wu, et al. "Quantitative Analysis and Prognostic Implication of SARS Coronavirus RNA in the Plasma and Serum of Patients with Severe Acute Respiratory Syndrome." Clinical Chemistry 49, no. 12 (December 1, 2003): 1976–80. http://dx.doi.org/10.1373/clinchem.2003.024125.
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Abstract Background: The availability of an early diagnostic tool for severe acute respiratory syndrome (SARS) would have major public health implications. We investigated whether the SARS coronavirus (SARS-CoV) can be detected in serum and plasma samples during the early stages of SARS and studied the potential prognostic implications of such an approach. Methods: We developed two real-time quantitative reverse transcription-PCR (RT-PCR) assays, one for the polymerase and the other for the nucleocapsid region of the virus genome, for measuring the concentration of SARS-CoV RNA in serum/plasma samples from SARS patients. Plasma samples were obtained from 12 confirmed SARS patients on the day of hospital admission, as well as on days 7 and 14 after fever onset. Serum samples were also obtained from 23 confirmed SARS patients on the day of hospital admission, 11 of whom subsequently required intensive care. Viral RNA was extracted from the plasma/serum samples. The extracted RNA was subjected to analysis by the RT-PCR assays. Results: The RT-PCR system for the polymerase region detected SARS-CoV RNA in 50% of plasma and 78% of serum samples from SARS patients during the first week of illness. The detection rates for plasma dropped to 25% at day 14 after fever onset. The median serum SARS-CoV concentrations in patients who required and did not require intensive care unit admission during the course of hospitalization were 5800 and 140 copies/mL, respectively (Mann–Whitney test, P <0.005). These data were confirmed by the RT-PCR system for the nucleocapsid region, which showed an even higher detection rate of 87%. The correlation between the results obtained by the two RT-PCR systems was high (Pearson correlation analysis, r = 0.998; P <0.001). Conclusion: Plasma/serum SARS-CoV quantification represents a potentially useful early diagnostic and prognostic tool for SARS.
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Khosla, Shikha G., Eric S. Nylen, and Rahul Khosla. "Rhabdomyolysis in Patients Hospitalized With COVID-19 Infection: Five Case Series." Journal of Investigative Medicine High Impact Case Reports 8 (January 2020): 232470962098460. http://dx.doi.org/10.1177/2324709620984603.
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The novel SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) is now known to cause acute respiratory distress, cytokine storm, and coagulopathy. Multiple other manifestations have been published in recent literature. Rhabdomyolysis is a syndrome of muscle damage, with release of intracellular contents into circulation. It is characterized by marked elevations of creatinine kinase levels and myoglobinuria. In this article, we describe a series of 5 cases who were admitted with COVID-19 pneumonia and had severe muscle injury, as demonstrated by significant elevation (>5 times upper limit of normal) of creatinine kinase levels likely secondary to SARS-CoV-2 virus. The median age for these patients was 65 years, and most of them suffered from diabetes and hyperlipidemia. All patients were hypertensive males. Four out of 5 patients had preserved kidney function at baseline and were chronic kidney disease (CKD) stage 2 or better. However, most of them suffered significant kidney injury and at the time of discharge one patient was CKD stage 2 or better, 2 were CKD stage 3 or worse, and 2 patients had renal failure and died due to complications of SARS-CoV-2 infection.
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Zeng, Qing-Lei, Zu-Jiang Yu, Jian-Jun Gou, Guang-Ming Li, Shu-Huan Ma, Guo-Fan Zhang, Jiang-Hai Xu, et al. "Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in Patients With Coronavirus Disease 2019." Journal of Infectious Diseases 222, no. 1 (April 29, 2020): 38–43. http://dx.doi.org/10.1093/infdis/jiaa228.
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Abstract Currently, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been reported in almost all countries globally. No effective therapy has been documented for COVID-19, and the role of convalescent plasma therapy is unknown. In the current study, 6 patients with COVID-19 and respiratory failure received convalescent plasma a median of 21.5 days after viral shedding was first detected, all tested negative for SARS-CoV-2 RNA within 3 days after infusion, and 5 eventually died. In conclusion, convalescent plasma treatment can end SARS-CoV-2 shedding but cannot reduce the mortality rate in critically ill patients with end-stage COVID-19, and treatment should be initiated earlier.
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Peart Akindele, Nadine, Theodore Kouo, Andrew H. Karaba, Oren Gordon, Katherine Z. J. Fenstermacher, Jeanette Beaudry, Jessica H. Rubens, et al. "Distinct Cytokine and Chemokine Dysregulation in Hospitalized Children With Acute Coronavirus Disease 2019 and Multisystem Inflammatory Syndrome With Similar Levels of Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 Shedding." Journal of Infectious Diseases 224, no. 4 (May 24, 2021): 606–15. http://dx.doi.org/10.1093/infdis/jiab285.
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Abstract Background Multisystem inflammatory syndrome in children (MIS-C) is a severe clinical phenotype of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that remains poorly understood. Methods Hospitalized children <18 years of age with suspected coronavirus disease 2019 (COVID-19) (N = 53) were recruited into a prospective cohort study; 32 had confirmed COVID-19, with 16 meeting the US Centers for Disease Control criteria for MIS-C. Differences in nasopharyngeal viral ribonucleic acid (RNA) levels, SARS-CoV-2 seropositivity, and cytokine/chemokine profiles were examined, including after adjustments for age and sex. Results The median ages for those with and without MIS-C were 8.7 years (interquartile range [IQR], 5.5–13.9) and 2.2 years (IQR, 1.1–10.5), respectively (P = .18), and nasopharyngeal levels of SARS-CoV-2 RNA did not differ significantly between the 2 groups (median 63 848.25 copies/mL versus 307.1 copies/mL, P = .66); 75% of those with MIS-C were antibody positive compared with 44% without (P = .026). Levels of 14 of 37 cytokines/chemokines (interleukin [IL]-1RA, IL-2RA, IL-6, IL-8, tumor necrosis factor-α, IL-10, IL-15, IL-18, monocyte chemoattractant protein [MCP]-1, IP-10, macrophage-inflammatory protein [MIP]-1α, MCP-2, MIP-1β, eotaxin) were significantly higher in children with MIS-C compared to those without, irrespective of age or sex (false discovery rate <0.05; P < .05). Conclusions The distinct pattern of heightened cytokine/chemokine dysregulation observed with MIS-C, compared with acute COVID-19, occurs across the pediatric age spectrum and with similar levels of nasopharyngeal SARS-CoV-2 RNA.
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Ofner-Agostini, Marianna, Denise Gravel, L. Clifford McDonald, Marcus Lem, Shelley Sarwal, Allison McGeer, Karen Green, et al. "Cluster of Cases of Severe Acute Respiratory Syndrome Among Toronto Healthcare Workers After Implementation of Infection Control Precautions: A Case Series." Infection Control & Hospital Epidemiology 27, no. 5 (May 2006): 473–78. http://dx.doi.org/10.1086/504363.
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Objective.To review the severe acute respiratory syndrome (SARS) infection control practices, the types of exposure to patients with SARS, and the activities associated with treatment of such patients among healthcare workers (HCWs) who developed SARS in Toronto, Canada, after SARS-specific infection control precautions had been implemented.Methods.A retrospective review of work logs and patient assignments, detailed review of medical records of patients with SARS, and comprehensive telephone-based interviews of HCWs who met the case definition for SARS after implementation of infection control precautions.Results.Seventeen HCWs from 6 hospitals developed disease that met the case definition for SARS after implementation of infection control precautions. These HCWs had a mean age ( ± SD) of 39 ± 2.3 years. Two HCWs were not interviewed because of illness. Of the remaining 15, only 9 (60%) reported that they had received formal infection control training. Thirteen HCWs (87%) were unsure of proper order in which personal protective equipment should be donned and doffed. Six HCWs (40%) reused items (eg, stethoscopes, goggles, and cleaning equipment) elsewhere on the ward after initial use in a room in which a patient with SARS was staying. Use of masks, gowns, gloves, and eyewear was inconsistent among HCWs. Eight (54%) reported that they were aware of a breach in infection control precautions. HCWs reported fatigue due to an increase number and length of shifts; participants worked a median of 10 shifts during the 10 days before onset of symptoms. Seven HCWs were involved in the intubation of a patient with SARS. One HCW died, and the remaining 16 recovered.Conclusion.Multiple factors were likely responsible for SARS in these HCWs, including the performance of high-risk patient care procedures, inconsistent use of personal protective equipment, fatigue, and lack of adequate infection control training.
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De Araújo Filho, Walter Duarte, Luciana Martins Pereira De Araújo, Anderson Silva De Oliveira, Vagner Cardoso Da Silva, and Aníbal de Freitas Santos Júnior. "NEBULIZERS: AERODYNAMIC DROPLET DIAMETER CHARACTERIZATION AND PHYSICOCHEMICAL PROPERTIES OF DRUGS TO TREAT SEVERE ACUTE RESPIRATORY SYNDROME CORONA VIRUS 2 (SARS-COV-2)." International Journal of Research -GRANTHAALAYAH 8, no. 7 (July 26, 2020): 80–97. http://dx.doi.org/10.29121/granthaalayah.v8.i7.2020.420.
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Currently, several drugs are being used systemically to treat Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). However, few studies discuss the possibility of using the inhalation route for this treatment. Pneumatic and ultrasonic nebulizers are increasingly used due to the ease with which these media deliver drugs through an aerosol suspension to deliver drugs in a localized manner in the respiratory tract, providing greater efficiency of absorption. This study aims to characterize the droplet diameters by bands of "breathable particles" generated by nebulizers commercialized in Brazil (2 pneumatic and 1 ultrasonic), using the direct laminar incidence (DLI) technique. In addition, to discuss the use of drugs by inhalation based on the physicochemical and pharmacology properties. In the nebulization procedure, the images of the dispersed aero droplets were captured using the DLI technique. Droplet diameter distribution histograms were elaborated, emphasizing the range of droplets with diameters between 1.0 to 5.0 µm. The results attested that each nebulizer has its own characteristic of delivering the aerodynamic suspension in the nebulization process. In this study, DLI represents a viable alternative for characterization of the aero dispersed droplets, of drugs used worldwide to treat SARS-CoV-2 signs and symptoms.
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Lin, Aifen, Ze-Bao He, Sheng Zhang, Jian-Gang Zhang, Xia Zhang, and Wei-Hua Yan. "Early Risk Factors for the Duration of Severe Acute Respiratory Syndrome Coronavirus 2 Viral Positivity in Patients With Coronavirus Disease 2019." Clinical Infectious Diseases 71, no. 16 (April 27, 2020): 2061–65. http://dx.doi.org/10.1093/cid/ciaa490.
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Abstract Background Pneumonia coronavirus disease 2019 (COVID-19) has became a pandemic. However, information on early risk factors for the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral positivity is not yet available. Methods In this prospective study, a cohort of 137 patients with confirmed SARS-CoV-2 were enrolled. Clinical information and laboratory data were retrieved from electronic medical records. Viral positivity duration was calculated by the interval from the day of confirmed SARS-CoV-2 positive results to the day SARS-CoV-2 testing showed negative results in these 137 patients with COVID-19. Early risk factors for the duration of SARS-CoV-2 viral positivity were evaluated. Results The median SARS-CoV-2 viral positivity duration is 12 days (range, 4 to ~45) for this cohort. Cox regression results showed a significantly shorter viral positivity duration was related to younger age (hazard ratio [HR], .658; P = .017); disease not being severe (HR, .653; P = .076); higher lymphocyte (HR, 1.464; P = .033), eosinophil (HR, 1.514; P = .020), and CD8+ T-cell (HR, 1.745; P = .033) counts; and lower IL-6 (HR, .664; P = .036) and IL-10 (HR, .631; P = .021). Multivariate analysis with covariable-adjusted results showed that the CD8+ T-cell count (HR, 2.376; P= .114) was a predominant risk factor for the duration of SARS-CoV-2 viral positivity. Conclusions Our findings show early laboratory parameters such as CD8+ T-cell count to be risk factors for the duration of SARS-CoV-2 viral positivity, which has significance in the control and prevention of the disease.
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Dhakal, Janak, Mo Jia, Jonathan D. Joyce, Greyson A. Moore, Reza Ovissipour, and Andrea S. Bertke. "Survival of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Herpes Simplex Virus 1 (HSV-1) on Foods Stored at Refrigerated Temperature." Foods 10, no. 5 (May 4, 2021): 1005. http://dx.doi.org/10.3390/foods10051005.
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Outbreaks of coronavirus infectious disease 2019 (COVID-19) in meat processing plants and media reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection on foods have raised concerns of a public health risk from contaminated foods. We used herpes simplex virus 1, a non-Biosafety Level 3 (non-BSL3) enveloped virus, as a surrogate to develop and validate methods before assessing the survival of infectious SARS-CoV-2 on foods. Several food types, including chicken, seafood, and produce, were held at 4 °C and assessed for infectious virus survival (herpes simplex virus 1 (HSV-1) and SARS-CoV-2) at 0 h, 1 h, and 24 h post-inoculation (hpi) by plaque assay. At all three time points, recovery of SARS-CoV-2 was similar from chicken, salmon, shrimp, and spinach, ranging from 3.4 to 4.3 log PFU/mL. However, initial (0 h) virus recovery from apples and mushrooms was significantly lower than that from poultry and seafood, and infectious virus decreased over time, with recovery from mushrooms becoming undetectable by 24 hpi. Comparing infectious virus titers with viral genome copies confirmed that PCR-based tests only indicate presence of viral nucleic acid, which does not necessarily correlate with the quantity of infectious virus. The survival and high recovery of SARS-CoV-2 on certain foods highlight the importance of safe food handling practices in mitigating any public health concerns related to potentially contaminated foods.
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Gagnon, Marilou, and Amélie Perron. "Nursing Voices during COVID-19: An Analysis of Canadian Media Coverage." Aporia 12, no. 1 (August 26, 2020): 109–13. http://dx.doi.org/10.18192/aporia.v12i1.4842.
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While it is generally recognized that nurses and nursing issues are underrepresented in the media, the contrary is also true during major public health care crises like Ebola and SARS (Severe Acute Respiratory Syndrome). We see this phenomenon unfolding in the midst of the current COVID-19 pandemic with nurses and nursing issues receiving extensive media coverage in Canada and internationally. To gain more insights into this media coverage, we analyzed the content of Canadian news stories published in both English and French during the first five months of the COVID-19 pandemic. This paper presents the findings of our analysis and identifies important lessons learned. We believe that our findings serve as an important starting point for understanding nurses’ agency and the media savviness they displayed during the first months of the pandemic.
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Cho, Jang-Hee, Seok Hui Kang, Hayne Cho Park, Dong Ki Kim, Sang-Ho Lee, Jun Young Do, Jong Won Park, et al. "Hemodialysis with Cohort Isolation to Prevent Secondary Transmission during a COVID-19 Outbreak in Korea." Journal of the American Society of Nephrology 31, no. 7 (June 1, 2020): 1398–408. http://dx.doi.org/10.1681/asn.2020040461.
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Background Health care–associated infections during previous coronavirus epidemics involving severe acute respiratory syndrome and Middle East respiratory syndrome resulted from human-to-human transmission in hemodialysis (HD) facilities. The effect of a strategy of HD with cohort isolation—separate dialysis sessions for close contacts of patients with confirmed coronavirus disease 2019 (COVID-19)—on the prevention of secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in HD units is unknown.MethodsOur multicenter cohort study of an HD with cohort isolation strategy enrolled close contacts of patients with confirmed COVID-19, including patients on HD and health care workers in HD units. Close contacts had been identified by epidemiologic investigation and tested negative on an immediate screening test for SARS-CoV-2.ResultsAs of March 14, 11 patients on HD and 7 health care workers from 11 HD centers were diagnosed as having COVID-19. The immediate screening test was performed in 306 people, and among them, 302 close contacts with negative test results were enrolled. HD with cohort isolation was performed among all close contacts for a median of 14 days in seven centers. During cohort isolation, nine patients showed symptoms but tested negative for SARS-CoV-2. Two health care workers in the HD units (0.66% of the total group) were diagnosed at the termination test for SARS-CoV-2.ConclusionsThe transmission of COVID-19 can be controlled without closure of HD centers by implementing preemptive activities, including early detection with rapid testing, cohort isolation, collaboration between institutions, and continuous monitoring of infection. Our strategy and experience may provide helpful guidance for circumstances involving the rapid spread of infectious diseases such as COVID-19.
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Belhadjer, Zahra, Mathilde Méot, Fanny Bajolle, Diala Khraiche, Antoine Legendre, Samya Abakka, Johanne Auriau, et al. "Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic." Circulation 142, no. 5 (August 4, 2020): 429–36. http://dx.doi.org/10.1161/circulationaha.120.048360.
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Background: Cardiac injury and myocarditis have been described in adults with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is typically minimally symptomatic. We report a series of febrile pediatric patients with acute heart failure potentially associated with SARS-CoV-2 infection and the multisystem inflammatory syndrome in children as defined by the US Centers for Disease Control and Prevention. Methods: Over a 2-month period, contemporary with the SARS-CoV-2 pandemic in France and Switzerland, we retrospectively collected clinical, biological, therapeutic, and early outcomes data in children who were admitted to pediatric intensive care units in 14 centers for cardiogenic shock, left ventricular dysfunction, and severe inflammatory state. Results: Thirty-five children were identified and included in the study. Median age at admission was 10 years (range, 2–16 years). Comorbidities were present in 28%, including asthma and overweight. Gastrointestinal symptoms were prominent. Left ventricular ejection fraction was <30% in one-third; 80% required inotropic support with 28% treated with extracorporeal membrane oxygenation. Inflammation markers were suggestive of cytokine storm (interleukin-6 median, 135 pg/mL) and macrophage activation (D-dimer median, 5284 ng/mL). Mean BNP (B-type natriuretic peptide) was elevated (5743 pg/mL). Thirty-one of 35 patients (88%) tested positive for SARS-CoV-2 infection by polymerase chain reaction of nasopharyngeal swab or serology. All patients received intravenous immunoglobulin, with adjunctive steroid therapy used in one-third. Left ventricular function was restored in the 25 of 35 of those discharged from the intensive care unit. No patient died, and all patients treated with extracorporeal membrane oxygenation were successfully weaned. Conclusions: Children may experience an acute cardiac decompensation caused by severe inflammatory state after SARS-CoV-2 infection (multisystem inflammatory syndrome in children). Treatment with immunoglobulin appears to be associated with recovery of left ventricular systolic function.
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Diorio, Caroline, Kevin O. McNerney, Michele Lambert, Michele Paessler, Elizabeth M. Anderson, Sarah E. Henrickson, Julie Chase, et al. "Evidence of thrombotic microangiopathy in children with SARS-CoV-2 across the spectrum of clinical presentations." Blood Advances 4, no. 23 (December 8, 2020): 6051–63. http://dx.doi.org/10.1182/bloodadvances.2020003471.
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Abstract Most children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have mild or minimal disease, with a small proportion developing severe disease or multisystem inflammatory syndrome in children (MIS-C). Complement-mediated thrombotic microangiopathy (TMA) has been associated with SARS-CoV-2 infection in adults but has not been studied in the pediatric population. We hypothesized that complement activation plays an important role in SARS-CoV-2 infection in children and sought to understand if TMA was present in these patients. We enrolled 50 hospitalized pediatric patients with acute SARS-CoV-2 infection (n = 21, minimal coronavirus disease 2019 [COVID-19]; n = 11, severe COVID-19) or MIS-C (n = 18). As a biomarker of complement activation and TMA, soluble C5b9 (sC5b9, normal 247 ng/mL) was measured in plasma, and elevations were found in patients with minimal disease (median, 392 ng/mL; interquartile range [IQR], 244-622 ng/mL), severe disease (median, 646 ng/mL; IQR, 203-728 ng/mL), and MIS-C (median, 630 ng/mL; IQR, 359-932 ng/mL) compared with 26 healthy control subjects (median, 57 ng/mL; IQR, 9-163 ng/mL; P < .001). Higher sC5b9 levels were associated with higher serum creatinine (P = .01) but not age. Of the 19 patients for whom complete clinical criteria were available, 17 (89%) met criteria for TMA. A high proportion of tested children with SARS-CoV-2 infection had evidence of complement activation and met clinical and diagnostic criteria for TMA. Future studies are needed to determine if hospitalized children with SARS-CoV-2 should be screened for TMA, if TMA-directed management is helpful, and if there are any short- or long-term clinical consequences of complement activation and endothelial damage in children with COVID-19 or MIS-C.
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Chandrashekar, Abishek, Jinyan Liu, Amanda J. Martinot, Katherine McMahan, Noe B. Mercado, Lauren Peter, Lisa H. Tostanoski, et al. "SARS-CoV-2 infection protects against rechallenge in rhesus macaques." Science 369, no. 6505 (May 20, 2020): 812–17. http://dx.doi.org/10.1126/science.abc4776.
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An understanding of protective immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical for vaccine and public health strategies aimed at ending the global coronavirus disease 2019 (COVID-19) pandemic. A key unanswered question is whether infection with SARS-CoV-2 results in protective immunity against reexposure. We developed a rhesus macaque model of SARS-CoV-2 infection and observed that macaques had high viral loads in the upper and lower respiratory tract, humoral and cellular immune responses, and pathologic evidence of viral pneumonia. After the initial viral clearance, animals were rechallenged with SARS-CoV-2 and showed 5 log10 reductions in median viral loads in bronchoalveolar lavage and nasal mucosa compared with after the primary infection. Anamnestic immune responses after rechallenge suggested that protection was mediated by immunologic control. These data show that SARS-CoV-2 infection induced protective immunity against reexposure in nonhuman primates.
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Graff, Jonathan, Michelle Thompson, Zachary Berriochoa, Bryan Kuhn, Anne-Michelle Ruha, and Christopher Lipinski. "Chloroquine Ingestion to Prevent SARS-CoV-2 Infection: A Report of Two Cases." Clinical Practice and Cases in Emergency Medicine 2, no. 5 (May 7, 2021): 234–38. http://dx.doi.org/10.5811/cpcem.2021.3.51329.
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Introduction: Amid the global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), chloroquine and hydroxychloroquine were being studied as agents to prevent and treat coronavirus disease 2019. Information about these agents and their effects circulated throughout the general public media, raising the concern for self-directed consumption of both pharmaceutical and non-pharmaceutical products. Case Report: We present two cases of chloroquine toxicity that occurred after ingestion of an aquarium disinfectant that contained chloroquine phosphate in a misguided attempt to prevent infection by SARS-CoV-2. One patient had repeated emesis and survived, while the other was unable to vomit, despite attempts, and suffered fatal cardiac dysrhythmias. Conclusion: These cases illustrate the spectrum of toxicity, varied presentations, and importance of early recognition and management of chloroquine poisoning. In addition, we can see the importance of sound medical guidance in an era of social confusion compounded by the extremes of public and social media.
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Yu, Fuxun, Mai Quynh Le, Shingo Inoue, Futoshi Hasebe, Maria del Carmen Parquet, Shigeru Morikawa, and Kouichi Morita. "Recombinant Truncated Nucleocapsid Protein as Antigen in a Novel Immunoglobulin M Capture Enzyme-Linked Immunosorbent Assay for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus Infection." Clinical and Vaccine Immunology 14, no. 2 (January 3, 2007): 146–49. http://dx.doi.org/10.1128/cvi.00360-06.
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ABSTRACT We report the development of an immunoglobulin M (IgM) antibody capture enzyme-linked immunosorbent assay (MAC-ELISA) for severe acute respiratory syndrome coronavirus (SARS-CoV) by using recombinant truncated SARS-CoV nucleocapsid protein as the antigen. The newly developed MAC-ELISA had a specificity and sensitivity of 100% as evaluated by using sera from healthy volunteers and patients with laboratory-confirmed SARS. Using serial serum samples collected from SARS patients, the times to seroconversion were determined by IgM antibody detection after SARS-CoV infection. The median time to seroconversion detection was 8 days (range, 5 to 17 days) after disease onset, and the seroconversion rates after the onset of illness were 33% by the first week, 97% by the second week, and 100% by the third week. Compared with the results of our previous report on the detection of IgG, the median seroconversion time by IgM detection was 3 days earlier and the seroconversion rate by the second week after the illness for IgM was significantly higher than by IgG assay. Our results indicating that the IgM response appears earlier than IgG after SARS-CoV infection in consistent with those for other pathogens. Our newly developed MAC-ELISA system offers a new alternative for the confirmation of SARS-CoV infection.
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Yao, Lin, Guo-Lin Wang, Yuan Shen, Zhuang-Ye Wang, Bing-Dong Zhan, Li-Jun Duan, Bing Lu, et al. "Persistence of Antibody and Cellular Immune Responses in Coronavirus Disease 2019 Patients Over Nine Months After Infection." Journal of Infectious Diseases 224, no. 4 (May 12, 2021): 586–94. http://dx.doi.org/10.1093/infdis/jiab255.
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Abstract Background The duration of humoral and T and B cell response after the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear. Methods We performed a cross-sectional study to assess the virus-specific antibody and memory T and B cell responses in coronavirus disease 2019 (COVID-19) patients up to 343 days after infection. Neutralizing antibodies and antibodies against the receptor-binding domain, spike, and nucleoprotein of SARS-CoV-2 were measured. Virus-specific memory T and B cell responses were analyzed. Results We enrolled 59 patients with COVID-19, including 38 moderate, 16 mild, and 5 asymptomatic patients; 31 (52.5%) were men and 28 (47.5%) were women. The median age was 41 years (interquartile range, 30–55). The median day from symptom onset to enrollment was 317 days (range 257 to 343 days). We found that approximately 90% of patients still have detectable immunoglobulin (Ig)G antibodies against spike and nucleocapsid proteins and neutralizing antibodies against pseudovirus, whereas ~60% of patients had detectable IgG antibodies against receptor-binding domain and surrogate virus-neutralizing antibodies. The SARS-CoV-2-specific IgG+ memory B cell and interferon-γ-secreting T cell responses were detectable in more than 70% of patients. Conclusions Severe acute respiratory syndrome coronavirus 2-specific immune memory response persists in most patients approximately 1 year after infection, which provides a promising sign for prevention from reinfection and vaccination strategy.
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Lee, Bruce Y., Sarah M. Bartsch, Marie C. Ferguson, Patrick T. Wedlock, Kelly J. O’Shea, Sheryl S. Siegmund, Sarah N. Cox, and James A. McKinnell. "The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection." PLOS Computational Biology 17, no. 1 (January 7, 2021): e1008470. http://dx.doi.org/10.1371/journal.pcbi.1008470.
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Finding medications or vaccines that may decrease the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could potentially reduce transmission in the broader population. We developed a computational model of the U.S. simulating the spread of SARS-CoV-2 and the potential clinical and economic impact of reducing the infectious period duration. Simulation experiments found that reducing the average infectious period duration could avert a median of 442,852 [treating 25% of symptomatic cases, reducing by 0.5 days, reproductive number (R0) 3.5, and starting treatment when 15% of the population has been exposed] to 44.4 million SARS-CoV-2 cases (treating 75% of all infected cases, reducing by 3.5 days, R0 2.0). With R0 2.5, reducing the average infectious period duration by 0.5 days for 25% of symptomatic cases averted 1.4 million cases and 99,398 hospitalizations; increasing to 75% of symptomatic cases averted 2.8 million cases. At $500/person, treating 25% of symptomatic cases saved $209.5 billion (societal perspective). Further reducing the average infectious period duration by 3.5 days averted 7.4 million cases (treating 25% of symptomatic cases). Expanding treatment to 75% of all infected cases, including asymptomatic infections (R0 2.5), averted 35.9 million cases and 4 million hospitalizations, saving $48.8 billion (societal perspective and starting treatment after 5% of the population has been exposed). Our study quantifies the potential effects of reducing the SARS-CoV-2 infectious period duration.
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Nichols, Courtney, Mahdee Sobhanie, Nora Colburn, Mark Lustberg, Zeinab El Boghdadly, Christina Liscynesky, Courtney Hebert, and Shandra R. Day. "367. Clinical Characteristics and Outcomes in Patients with Pneumonia secondary to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S253. http://dx.doi.org/10.1093/ofid/ofaa439.562.
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Abstract Background Since discovery in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes the disease of COVID-19 has become a global pandemic. Little is known about which risk factors lead to more severe disease or increased mortality in patients diagnosed with SARS-CoV-2. We aimed in this study to compare clinical characteristics associated with disease severity and increased mortality in hospitalized patients with COVID-19. Methods This was a single-center, retrospective study at The Ohio State University Wexner Medical Center to compare clinical characteristics associated with increased mortality in hospitalized patients with confirmed SARS-CoV-2. Adults patients positive for SARS-CoV-2 between March 1, 2020 and April 20, 2020 were included in the study. Prisoners and pregnant women were excluded. Baseline demographics, clinical characteristics, and outcomes were collected, and then compared to determine association with mortality. Statistical analysis used univariate and multivariate logistic regression analysis to evaluate the relationship between patient characteristics and mortality. Results The cohort included 92 patients. Median age was 58 years (ranging from 25–93) and 47/92 were men (51%). 12 patients were admitted directly to the intensive care unit (ICU), with 22 additional patients transferred to the ICU. 23 patients required mechanical ventilation. Clinical characteristics significantly associated with mortality in univariate analysis included underlying coronary artery disease (CAD) (OR=7.8, p = 0.002), chronic obstructive pulmonary disease (OR=5.21, p=0.02), living in an extended care facility (ECF) (OR=4.2, p=0.025), and immunocompromised status (OR=4.2, p=0.025). Multivariate analysis showed a statistically significant association in patients with underlying CAD (OR=13.1, p=0.001) and those admitted from an ECF (OR=12.1, p=0.005), when adjusted for other variables in the model. Characteristics Associated with Mortality in Patients with COVID-19 in Univariate Analysis Conclusion Our study found that CAD and admission from an ECF were associated with SARS-CoV-2 mortality, when adjusted for age and other comorbidities. Further studies are necessary to identify potential preventative strategies to mitigate mortality in this vulnerable population. Disclosures All Authors: No reported disclosures
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Moeller, Alexander, Leo Thanikkel, Liesbeth Duijts, Erol A. Gaillard, Luis Garcia-Marcos, Ahmad Kantar, Nathalie Tabin, Steven Turner, Angela Zacharasiewicz, and Mariëlle W. H. Pijnenburg. "COVID-19 in children with underlying chronic respiratory diseases: survey results from 174 centres." ERJ Open Research 6, no. 4 (October 2020): 00409–2020. http://dx.doi.org/10.1183/23120541.00409-2020.
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BackgroundEarly reports suggest that most children infected with severe acute respiratory syndrome coronavirus 2 (“SARS-CoV-2”) have mild symptoms. What is not known is whether children with chronic respiratory illnesses have exacerbations associated with SARS-CoV-2 virus.MethodsAn expert panel created a survey, which was circulated twice (in April and May 2020) to members of the Paediatric Assembly of the European Respiratory Society (ERS) and via the social media of the ERS. The survey stratified patients by the following conditions: asthma, cystic fibrosis (CF), bronchopulmonary dysplasia (BPD) and other respiratory conditions.ResultsIn total 174 centres responded to at least one survey. 80 centres reported no cases, whereas 94 entered data from 945 children with coronavirus disease 2019 (COVID-19). SARS-CoV-2 was isolated from 49 children with asthma of whom 29 required no treatment, 19 needed supplemental oxygen and four children required mechanical ventilation. Of the 14 children with CF and COVID-19, 10 required no treatment and four had only minor symptoms. Among the nine children with BPD and COVID-19, two required no treatment, five required inpatient care and oxygen and two were admitted to a paediatric intensive care unit (PICU) requiring invasive ventilation. Data were available from 33 children with other conditions and SARS-CoV-2 of whom 20 required supplemental oxygen and 11 needed noninvasive or invasive ventilation.ConclusionsWithin the participating centres, in children with asthma and CF, infection with SARS-CoV-2 was well tolerated, but a substantial minority of children with BPD and other conditions required ventilatory support indicating that these latter groups are at risk from SARS-CoV-2 infection.
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Tang, Nelson Leung-Sang, Paul Kay-Sheung Chan, Chun-Kwok Wong, Ka-Fai To, Alan Ka-Lun Wu, Ying-Man Sung, David Shu-Cheong Hui, Joseph Jao-Yiu Sung, and Christopher Wai-Kei Lam. "Early Enhanced Expression of Interferon-Inducible Protein-10 (CXCL-10) and Other Chemokines Predicts Adverse Outcome in Severe Acute Respiratory Syndrome." Clinical Chemistry 51, no. 12 (December 1, 2005): 2333–40. http://dx.doi.org/10.1373/clinchem.2005.054460.
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Abstract Background: Exaggerated activation of cytokines/chemokines has been proposed as a factor in adverse outcome of severe acute respiratory syndrome (SARS). Previous studies on chemokines have included only small numbers of patients, and the utility of plasma chemokines as prognostic indicators is unclear. Methods: We studied 255 archival plasma samples collected during the first or second week after disease onset. The chemokines interferon-inducible protein-10 (IP-10), monokine induced by interferon-γ (MIG), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), and regulated upon activation normal T cell expressed and secreted (RANTES) were measured by cytometric bead array with a 4-color FACSCalibur flow cytometer. Reverse transcription and real-time quantitative PCR and immunohistochemical staining were performed to analyze the production of IP-10 in lung tissue at autopsy. Conditional logistic regression was used to identify independent predictors for adverse disease outcome. Results: Increases in IP-10, MIG, and IL-8 during the first week after onset of fever were associated with adverse outcome (intensive care unit admission or death) in the univariate analysis. During the second week, only MIG concentration was associated with prognosis. After adjusting for other risk factors, plasma IP-10 concentration at the first week remained as an independent prognostic factor, with an odds ratio for adverse outcome of 1.52 (95% confidence interval, 1.05–2.55) per fold increase in plasma IP-10 concentration above the median. During the second week, chemokines provided little independent prognostic information. IP-10 was increased in lung tissue from patients who died of SARS. Conclusions: Increased plasma IP-10 during the first week of SARS symptoms is an independent predictor of outcome. Chemokine activation may be an early event in SARS, and an exaggerated host response may produce complications.
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Prasaath Sastha K R, Balasubramanian Arul, and Ramalingam Kothai. "Understanding COVID-19 – The Pandemic of 2020." International Journal of Research in Pharmaceutical Sciences 11, SPL1 (May 14, 2020): 94–102. http://dx.doi.org/10.26452/ijrps.v11ispl1.2228.
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It all started in December 2019, a seafood market in Wuhan, China, with a series of pneumonia alike cases admitted with severe acute respiratory depression. Since they were unable to detect the precise cause, they named it "Pneumonia of unknown etiology". Later it was identified as SARS COV 2 (Severe Acute Respiratory Syndrome – coronavirus 2). At first, the disease spread locally affecting the people of Wuhan, and then started spreading throughout China, creating a worldwide panic. The World Health Organization (WHO) declared COVID-19 in China as a Public Health Emergency of International Concern. The Center for Disease Control and Prevention (CDC) from China and local healthcare units organized an intensive outbreak investigation program. The causative organism of this infection is a new virus that belongs to the “coronavirus (CoV)” family. After which the disease was called nCoV-19 (Novel coronavirus – 19). On February 11, 2020, the WHO Director General, Dr. Tedros Adhanom Ghebreyesus, renamed the disease as "COVID-19," which is the acronym of "coronavirus disease 2019". Viral epidemics like SARS-CoV in 2002, H1N1 influenza in 2009, and the most recent one the MERS-CoV Middle East Respiratory Distress Syndrome Coronavirus (first identified in Saudi Arabia) in 2012 threatened the health of mankind in the past two decades. All of these were successfully prevented by systematically approaching the problem to solve it. Healthcare professionals around the world are well trained to manage any type of health crisis. On March 11, 2020, the WHO declared COVID-19 as a "PANDEMIC" pointing to over 118,000 cases and 80,000 dead in 110 countries or more. In a media briefing, the WHO Director General said: "This is not just a public health crisis, it is a crisis that will touch every sector, so every sector and every individual must be involved in the fight."
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Donath, Helena, Stefan Zielen, Boris Wittekindt, Thomas Klingebiel, Jürgen Graf, Martin Eckrich, Christian Walter, and Katharina Blümchen. "Effects of the SARS-CoV2-Lockdown on Pediatric Care in the Rhine-Main Area." Klinische Pädiatrie 233, no. 01 (November 12, 2020): 31–36. http://dx.doi.org/10.1055/a-1263-1467.
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Abstract Background The effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and lockdown on pediatric diseases and care are not well characterized in Germany. Patients and Methods To investigate the effects of the lockdown on pediatric medical care in the Rhine-Main area, a survey asking 115 pediatricians and an analysis of the inpatient admissions at the Department for Children and Adolescents Goethe-University, Frankfurt in April 2020 compared to April 2019 was performed. Results 65/115 (56.5%) pediatricians answered the survey. Pediatricians estimated the reduction of patient consultations in April 2020 vs. 2019 by 40% (median), however, according to their practice administration software, patient visits decreased by 30%. The median number of cases with the diagnosis J21 (acute bronchitis) were significantly less in April 2020 vs. April 2019 (50 vs. 10 cases per pediatrician; p<0.001). Simultaneously, hospital admissions decreased by 43.7% from 402 total cases in April 2019 to 226 cases in April 2020. Hospital admissions due to acute respiratory tract infections or asthma exacerbations as well as neonatal and oncological disorders were significantly reduced compared to the previous year (83.7; 38.1 and 22.1% respectively less to 2019). Conclusion The lockdown in April 2020 resulted in significantly fewer visits to pediatricians in general practice and hospital admissions, especially for acute respiratory tract infections. The health and economic consequences are discussed.
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Buchan, Blake W., Derek Gerstbrein, Amorina Cruz, Jess Hoff, Emily Sievert, Nathan A. Ledeboer, and Matthew L. Faron. "Evaluation of a High-Definition PCR Assay for the Detection of SARS-CoV-2 in Extracted and Nonextracted Respiratory Specimens Collected in Various Transport Media." American Journal of Clinical Pathology 156, no. 1 (May 3, 2021): 24–33. http://dx.doi.org/10.1093/ajcp/aqab060.
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Abstract Objectives We conducted an analytic and clinical comparison of a novel high-definition polymerase chain reaction PCR (HDPCR) assay to traditional real-time PCR (RT-PCR) for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in upper respiratory specimens. Methods Analytic performance of RT-PCR, HDPCR, and extraction-free HDPCR was established through replicate testing of a serially diluted clinical specimen containing SARS-CoV-2. A clinical comparison of all 3 assays was conducted using 351 prospectively collected upper respiratory swab specimens obtained from symptomatic and asymptomatic individuals collected in various transport media. Results RT-PCR and HDPCR assays using extracted nucleic acid demonstrated similar analytic limits of detection (LoD) and clinical performance, with 100% positive and negative agreement. Extraction-free HDPCR demonstrated a 1.5 to 2.0 log10 increase in LoD based on cycle threshold values. However, clinical performance of extraction-free HDPCR remained high, demonstrating 97.8% positive and 99.6% negative agreement with RT-PCR. An overall increase in “invalid” and “presumptive” results was observed when using the extraction-free method, but this was highly variable based on transport medium used. Conclusions HDPCR performs similar to RT-PCR for the detection of SARS-CoV-2. The use of an extraction-free HDPCR protocol maintained high clinical performance despite reduced analytic LoD, with the benefit of reduced hands-on time and cost of reagents associated with nucleic acid extraction.
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Farah, Sameera, Ashwin Atkulwar, Manas Ranjan Praharaj, Raja Khan, Ravikumar Gandham, and Mumtaz Baig. "Phylogenomics and phylodynamics of SARS-CoV-2 genomes retrieved from India." Future Virology 15, no. 11 (November 2020): 747–53. http://dx.doi.org/10.2217/fvl-2020-0243.
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Background: This is the first phylodynamic study attempted on SARS-CoV-2 genomes from India to infer the current state of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) evolution using phylogenetic network and growth trends. Materials & Methods: Out of 286 retrieved whole genomes from India, 138 haplotypes were used to build a phylogenetic network. The birth–death serial model (BDSIR) package of BEAST2 was used to calculate the reproduction number of SARS-CoV-2. Population dynamics were investigated using the stamp date method as implemented in BEAST2 and BEAST 1.10.4. Results: A median-joining network revealed two ancestral clusters. A high basic reproduction number of SARS-CoV-2 was found. An exponential rise in the effective population size of Indian isolates was detected. Conclusion: The phylogenetic network reveals dual ancestry and possibility of community transmission of SARS-CoV-2 in India.
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Zhan, Ting, Meng Liu, Yalin Tang, Zheng Han, Xueting Cheng, Junsheng Deng, Xiaoli Chen, Xia Tian, and Xiaodong Huang. "Retrospective analysis of clinical characteristics of 405 patients with COVID-19." Journal of International Medical Research 48, no. 8 (August 2020): 030006052094903. http://dx.doi.org/10.1177/0300060520949039.
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Objective This study was performed to investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We analyzed the electronic medical records of 405 hospitalized patients with laboratory-confirmed COVID-19 in the Third Hospital of Wuhan. Results The patients’ median age was 56 years, 54.1% were female, 11.4% had a history of smoking, and 10.6% had a history of drinking. All cases of COVID-19 were community-acquired. Fever (76.8%) and cough (53.3%) were the most common clinical manifestations, and circulatory system diseases were the most common comorbidities. Gastrointestinal symptoms were present in 61.2% of the patients, and 2.9% of the patients were asymptomatic. Computed tomography showed ground-glass opacities in most patients (72.6%) and consolidation in 30.9%. Lymphopenia (72.3%) and hypoproteinemia (71.6%) were observed in most patients. About 20% of patients had abnormal liver function. Patients with severe disease had significantly more prominent laboratory abnormalities, including an abnormal lymphocyte count and abnormal C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, D-dimer, and albumin levels. Conclusion SARS-CoV-2 causes a variety of severe respiratory illnesses similar to those caused by SARS-CoV-1. Older age, chronic comorbidities, and laboratory abnormalities are associated with disease severity.
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Guest, Jodie L., Carlos del Rio, and Travis Sanchez. "The Three Steps Needed to End the COVID-19 Pandemic: Bold Public Health Leadership, Rapid Innovations, and Courageous Political Will." JMIR Public Health and Surveillance 6, no. 2 (April 6, 2020): e19043. http://dx.doi.org/10.2196/19043.
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The world is experiencing the expansive spread of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in a global pandemic that is placing strain on health care, economic, and social systems. Commitment to implementing proven public health strategies will require bold public health leadership and courageous acts by politicians. Developing new innovative communication, mitigation, and health care approaches, particularly in the era of social media, is also clearly warranted. We believe that the best public health evidence must inform activities in three priority areas to stop this pandemic: (1) coordinated and consistent stay-at-home orders across multiple jurisdictions, including potential nationwide mandates; (2) rapid scale-up of SARS-CoV-2 testing; and (3) improved health care capacity to respond. This editorial outlines those areas, the rationale behind them, and the call for innovation and engagement of bold public health leadership to empower courageous political action to reduce the number of deaths during this pandemic.
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Saponaro, Federica. "Vitamin D Status as a Potential Modifiable Risk Factor for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A282. http://dx.doi.org/10.1210/jendso/bvab048.573.
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Abstract In March 2020, the infection COVID-19 spread as a pandemic emergence. Among multiple biological and environmental factors, hypovitaminosis D is a credible candidate. The aim of this study is to shed light on the pathogenic role of vitamin D deficiency in the susceptibility to SARS-CoV-2 and in the aggressive immune and inflammatory response by the host. We retrospectively analyzed the biochemical panel of immune system markers and the tandem mass spectrometry coupled to liquid chromatography (LC-MS-MS) measured vitamin D, in the serum samples of patients with SARS-CoV-2 studied in all aspects of clinical relevant parameters. RESULTS between 18th March and 20th April 2020 we enrolled 29 consecutive patients with COVID-19. They were 17 (58.6%) males and 12 (41.4) females, and the median age was 79 (69–88) years. Mean 25OHD was 17.3±2.1 ng/ml, with a median of 15.7 1 ng/ml (i.r. 6.7–25). Twenty-five patients (86.2%) had 25OHD levels <30 ng/ml, 18 patients (62.0%) had 25OHD levels <20 ng/ml and 10 patients (34.5%) had severe vitamin D deficiency (<10 ng/ml). In the group of patients with severe disease (ARDS, cardiovascular complications, CID) 69.2% (n=9/13) of patients presented hypovitaminosis D (<20 ng/ml). All patients who dead for COVID-19 during hospitalization (n=6) had 25OHD≤30 ng/ml and 5/6 had 25OHD≤20 ng/ml. IL-6 and CRP were measured in all patients and were considered surrogate markers of cytokines storm. The majority of patients had levels of IL-6 (n=22, 75.8%) and CRP (n=25, 86.2%) above the upper limit of the reference range of our laboratory (IL6 6.59 and CRP 1 mg/dl) and the median was IL 6=16.1 (i.r. 7.3–36.3) and CRP=6.67 (2.64–11.52). Patients with 25OHD <20 ng/ml had higher levels of IL-6 (p=0.004; 19.9 vs 10.4) and CRP (p=0.009, 9.85 vs 1.40) and did not differ for the other clinical and biochemical variables. If we considered as 25OHD cut-off the mean value in our population (17.3 ng/ml), patients with lower levels of 25OHD had higher age (p=0.033) and higher levels of IL6 (p=0.016), CRP (p=0.04), troponin (p=0.04) and D-dimer (p=0.017), compared to the others. An inverse correlation was found between 25OHD levels and IL-6, CRP, and troponin. In a univariate regression analysis hypovitaminosis D (<20 ng/ml) was a predictive factor for IL6 (expressed as LnIL6) levels (β=0.57, P=0.003) and for PCR levels (β=0.42, P=0.034). We also performed a multivariate regression analysis with hypovitaminosis D (<20 ng/ml), sex, BMI, age (<70 years) and ARDS as independent variables. Notably, hypovitaminosis D (β=0.49, P<0.02), BMI (β=0.4, P=0.04) and ARDS (β=0.44, P=0.02) were confirmed to be significant variables for IL6 (expressed as LnIL6) level prediction. In the same multivariate model hypovitaminosis D (β=0.49, P=0.034) was confirmed as independent predictor of CRP levels. In conclusion, hypovitaminosis D is related to the negative prognostic inflammatory status in patients with SARS-Cov2.
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D’Avolio, Antonio, Valeria Avataneo, Alessandra Manca, Jessica Cusato, Amedeo De Nicolò, Renzo Lucchini, Franco Keller, and Marco Cantù. "25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2." Nutrients 12, no. 5 (May 9, 2020): 1359. http://dx.doi.org/10.3390/nu12051359.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), with a clinical outcome ranging from mild to severe, including death. To date, it is unclear why some patients develop severe symptoms. Many authors have suggested the involvement of vitamin D in reducing the risk of infections; thus, we retrospectively investigated the 25-hydroxyvitamin D (25(OH)D) concentrations in plasma obtained from a cohort of patients from Switzerland. In this cohort, significantly lower 25(OH)D levels (p = 0.004) were found in PCR-positive for SARS-CoV-2 (median value 11.1 ng/mL) patients compared with negative patients (24.6 ng/mL); this was also confirmed by stratifying patients according to age >70 years. On the basis of this preliminary observation, vitamin D supplementation might be a useful measure to reduce the risk of infection. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations and to confirm our preliminary observation.
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Gerussi, Valentina, Maddalena Peghin, Alvisa Palese, Valentina Bressan, Erica Visintini, Giulia Bontempo, Elena Graziano, Maria De Martino, Miriam Isola, and Carlo Tascini. "Vaccine Hesitancy among Italian Patients Recovered from COVID-19 Infection towards Influenza and Sars-Cov-2 Vaccination." Vaccines 9, no. 2 (February 18, 2021): 172. http://dx.doi.org/10.3390/vaccines9020172.
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We aimed to assess the attitude towards influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations among coronavirus disease 2019 (COVID-19) recovered patients. We performed a cross-sectional study consisting of a standardized telephone interview carried out between September and November 2020 targeting a cohort of adult in- and out-patients that had recovered from COVID-19 after the first wave (March–May 2020) at Udine Hospital (Italy). Overall, 599 people participated (320 female, median age 53 years) and most had experienced an acute COVID-19 with mild illness (409, 68.3%). The majority were hesitant or undecided towards influenza (327, 54.6%) and SARS-CoV-2 (353, 59.2%) vaccines. Older age, public work exposure, and previous 2019 flu shots were the main factors associated with a positive attitude toward both vaccinations (p < 0.05). Being hospitalized during the acute COVID-19 phase was associated with the willingness to get a flu shot (94/272, 34.5%) but not SARS-CoV-2 vaccine (70/244, 28.7%). Vaccine hesitancy is diffuse and multifactorial also among COVID-19 recovered.
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Yu, Jingyou, Lisa H. Tostanoski, Lauren Peter, Noe B. Mercado, Katherine McMahan, Shant H. Mahrokhian, Joseph P. Nkolola, et al. "DNA vaccine protection against SARS-CoV-2 in rhesus macaques." Science 369, no. 6505 (May 20, 2020): 806–11. http://dx.doi.org/10.1126/science.abc6284.
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The global coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made the development of a vaccine a top biomedical priority. In this study, we developed a series of DNA vaccine candidates expressing different forms of the SARS-CoV-2 spike (S) protein and evaluated them in 35 rhesus macaques. Vaccinated animals developed humoral and cellular immune responses, including neutralizing antibody titers at levels comparable to those found in convalescent humans and macaques infected with SARS-CoV-2. After vaccination, all animals were challenged with SARS-CoV-2, and the vaccine encoding the full-length S protein resulted in >3.1 and >3.7 log10 reductions in median viral loads in bronchoalveolar lavage and nasal mucosa, respectively, as compared with viral loads in sham controls. Vaccine-elicited neutralizing antibody titers correlated with protective efficacy, suggesting an immune correlate of protection. These data demonstrate vaccine protection against SARS-CoV-2 in nonhuman primates.
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Shi, Ding, Wenrui Wu, Qing Wang, Kaijin Xu, Jiaojiao Xie, Jingjing Wu, Longxian Lv, et al. "Clinical Characteristics and Factors Associated With Long-Term Viral Excretion in Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Single-Center 28-Day Study." Journal of Infectious Diseases 222, no. 6 (July 2, 2020): 910–18. http://dx.doi.org/10.1093/infdis/jiaa388.
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Abstract Background Despite the ongoing spread of coronavirus disease 2019 (COVID-19), knowledge about factors affecting prolonged viral excretion is limited. Methods In this study, we retrospectively collected data from 99 hospitalized patients with coronavirus disease 2019 (COVID-19) between 19 January and 17 February 2020 in Zhejiang Province, China. We classified them into 2 groups based on whether the virus test results eventually became negative. Cox proportional hazards regression was used to evaluate factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding. Results Among 99 patients, 61 patients had SARS-CoV-2 clearance (virus-negative group), but 38 patients had sustained positive results (virus-positive group). The median duration of SARS-CoV-2 excretion was 15 (interquartile range, 12–19) days among the virus-negative patients. The shedding time was significantly increased if the fecal SARS-CoV-2 RNA test result was positive. Male sex (hazard ratio [HR], 0.58 [95% confidence interval {CI}, .35–.98]), immunoglobulin use (HR, 0.42 [95% CI, .24–.76]), APACHE II score (HR, 0.89 [95% CI, .84–.96]), and lymphocyte count (HR, 1.81 [95% CI, 1.05–3.1]) were independent factors associated with a prolonged duration of SARS-CoV-2 shedding. Antiviral therapy and corticosteroid treatment were not independent factors. Conclusions SARS-CoV-2 RNA clearance time was associated with sex, disease severity, and lymphocyte function. The current antiviral protocol and low-to-moderate dosage of corticosteroid had little effect on the duration of viral excretion.
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Woo, Patrick C. Y., Susanna K. P. Lau, Beatrice H. L. Wong, Kwok-hung Chan, Chung-ming Chu, Hoi-wah Tsoi, Yi Huang, J. S. Malik Peiris, and Kwok-yung Yuen. "Longitudinal Profile of Immunoglobulin G (IgG), IgM, and IgA Antibodies against the Severe Acute Respiratory Syndrome (SARS) Coronavirus Nucleocapsid Protein in Patients with Pneumonia Due to the SARS Coronavirus." Clinical Diagnostic Laboratory Immunology 11, no. 4 (July 2004): 665–68. http://dx.doi.org/10.1128/cdli.11.4.665-668.2004.
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ABSTRACT By using a recombinant severe acute respiratory syndrome coronavirus (SARS-CoV) nucleocapsid protein-based enzyme-linked immunosorbent assay (ELISA) and serum specimens serially collected (from day 0 to day 240 after symptom onset) from patients with pneumonia due to SARS-CoV, we analyzed the longitudinal profiles of immunoglobulin G (IgG), IgM, and IgA antibodies against the SARS-CoV nucleocapsid protein in patients with pneumonia due to SARS-CoV. For IgG, the median optical density at 450 nm (OD450) turned positive at day 17 and a biphasic response was observed. At day 240, all patients were still positive for anti-nucleocapsid protein IgG antibody. For IgM, the median OD450 turned positive at day 20.5, peaked at about day 80, and fell to below the baseline level at about day 180. At day 240, 36% of the patients were still positive for anti-nucleocapsid protein IgM antibody. For IgA, the median OD450 turned positive at day 17, peaked at about day 50, and fell to below the baseline level at about day 180. At day 240, 36% of the patients were still positive for anti-nucleocapsid protein IgA antibody. The time of seroconversion detected by the recombinant SARS-CoV nucleocapsid protein-based ELISA and that detected by indirect immunofluorescence assay were similar. The median times of seroconversion for IgG, IgM, and IgA detected by the indirect immunofluorescence assay were 17 days (17 days by ELISA), 16.5 days (20.5 days by ELISA), and 17.5 days (17 days by ELISA), respectively, after disease onset. One, four, and one of the six patients who died did not produce any IgG, IgM, and IgA antibodies against the nucleocapsid protein of SARS-CoV, respectively, although these antibodies were detected in all six patients by the indirect immunofluorescence assay. Further studies should be performed to see whether SARS-CoV nucleocapsid protein antibody positivity has any prognostic significance.
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Patel, Pratik A., Stacey A. Lapp, Laila Hussaini, Austin Lu, Evan J. Anderson, Christina A. Rostad, Claire L. Stokes, and Melinda G. Pauly. "#52: Clinical Features and Management of Pediatric Patients Presenting with New Onset Acute Leukemia and Concomitant COVID-19." Journal of the Pediatric Infectious Diseases Society 10, Supplement_2 (June 1, 2021): S4. http://dx.doi.org/10.1093/jpids/piab031.006.
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Abstract Background Infections represent a significant cause of morbidity and mortality in pediatric patients undergoing treatment for hematologic malignancies. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led to a worldwide pandemic of coronavirus disease 2019 (COVID-19) and pediatric patients with cancer appear to be at higher risk of severe disease than reported in the general pediatric population. Data are limited on the optimal management of children infected with SARS-CoV-2 and a new diagnosis of leukemia. The objective of this study was to describe our experience of six children who presented with a new diagnosis of acute leukemia and concurrent COVID-19. Methods The study was IRB approved and children were enrolled following informed consent and assent as appropriate for age. The clinical presentations, serologic responses, treatments, and outcomes of patients who presented with acute leukemia and concurrent SARS-CoV-2 infection were abstracted. Residual blood was tested by ELISA for quantitative IgG to the SARS-CoV-2 spike protein receptor binding domain (RBD). Results From March 1, 2020 to Dec 31, 2020, 6 patients were identified with a new diagnosis of acute leukemia and SARS-CoV-2 infection including 3 with acute myeloid leukemia (AML) and 3 with acute lymphoblastic leukemia (ALL). The median age of our cohort was 9 years old (range 1 to 19 years old), 5 of 6 were male, and 4 of 6 patients were Hispanic. All 6 patients presented with symptoms that could be attributed to COVID-19 or acute leukemia, with fever being the most common. All 3 of the AML patients presented with hyperleukocytosis (white blood cell count > 50 x 109/L) and required oxygen therapy and intensive care. At the time of presentation, all patients with specimens available (n=5) had IgG antibodies to SARS-CoV-2 RBD. All patients received COVID-19 directed therapy, with remdesivir (n=5) and convalescent plasma (n=5) being the most common. Chemotherapy was modified or delayed in 5 of the 6 patients. The patient who received standard AML chemotherapy without awaiting COVID-19 directed treatment had delayed serologic response, delayed viral clearance from the nasopharynx, protracted respiratory failure, and ultimately died. For patients with a 12-week follow-up (n=5), 2 patients with AML had died, and the ALL patients were in remission and continuing their leukemia treatment. Conclusion COVID-19 may present concurrently in children with new onset leukemia resulting in severe morbidity and mortality. Our experience adds to growing evidence that children with AML and SARS-CoV-2 infection are at risk for severe COVID-19. Screening for SARS-CoV-2 infection with subsequent delay in chemotherapy and administration of COVID-19 directed therapies should be considered for pediatric patients with newly diagnosed acute leukemia and COVID-19.
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Virata, Michael D., Merceditas Villanueva, Sheela Shenoi, Joseph B. Ladines-Lim, and Lydia Aoun-Barakat. "543. SARS-CoV-2 Viral Dynamics For Symptomatic People Living with HIV Requiring Hospitalization For COVID-19." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S338. http://dx.doi.org/10.1093/ofid/ofaa439.737.
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Abstract Background Over 8 million people have been infected with severe acute respiratory syndrome 2 (SARS-CoV-2). People living with HIV (PWH) affected by SARS-CoV-2 represent a small proportion of patients admitted to the hospital for COVID-19 disease. Viral dynamics in this subpopulation are still unknown. Methods We conducted a retrospective cohort study from a large, urban academic center in New Haven, CT of patients consecutively admitted with laboratory confirmed SARS-CoV-2 infection through May 31, 2020. Main outcome measure was the ribonucleic acid (RNA) viral load (VL) detected in respiratory samples by cycle threshold (Ct) values and trend over time as a measure of nucleic acid concentration and replication. Epidemiological, clinical, laboratory results, ART treatment, COVID treatment and outcomes were abstracted from patient records. We evaluated the relationship between virologic data and disease severity. Results Among 19 PWH hospitalized with covid19, 84% were >50 years of age, 53% were women, 63% were black, 95% were on antiretrovirals, 95% with undetectable HIV VL (< 50 copies/ml), and median CD4 count of 827.9 cells/mm3. Symptom duration was 2–14 days. Median length of stay was 12 days. There was no in-hospital mortality. A total of 62 respiratory samples were collected at various time points and evaluated for SARS-CoV-2 RNA viral load. Eight patients had 1 specimen. Patient with more severe disease had higher baseline SARS-CoV-2 viral loads. Mean Ct values for N1 and N2 on admission were 21.6 and 23.7, respectively. Conclusion PWH with COVID19 represents only a small percentage of hospitalized patients and viral dynamics are not well defined. SARS-CoV-2 VL was higher among PWH with advanced disease at the presentation of illness. Overall, PWH with COVID-19 had favorable outcomes. Disclosures All Authors: No reported disclosures
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Cho, J., J. Lee, CH Sia, CS Koo, BYQ Tan, W. Hong, E. Choi, et al. "Extrapulmonary manifestations and complications of severe acute respiratory syndrome coronavirus 2 infection: a systematic review." Singapore Medical Journal, September 21, 2021. http://dx.doi.org/10.11622/smedj.2021100.
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Introduction: We aimed to describe the extrapulmonary manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, including their frequency, onset with respect to respiratory symptoms, pathogenesis and association with disease severity. Methods: We searched the MEDLINE and Embase databases for SARS-CoV-2-related studies. Meta-analysis, observational studies, case series and case reports published in English or Chinese between 1 January and 1 May 2020 were included. Reports with only paediatric or obstetric cases were excluded. Results: 169 articles were included. Early manifestations (preceding respiratory symptoms until Day 6 of onset) included olfactory and gustatory disturbance (self-reported in up to 68% and 85% of cases, respectively), gastrointestinal symptoms (up to 65.9%) and rash (up to 20.4%). From Day 7 onwards, hypercytokinaemia, paralleled multi-organ complications including acute cardiac injury (pooled incidence of 17.7% in 1,412 patients, mostly with severe disease and 17.4% mortality), kidney and liver injury (up to 17% and 33%, respectively) and thrombocytopenia (up to 30%). Hypercoagulability resulted in venous thromboembolic events in up to 31% of all patients. Uncommon disease presentation and complications comprised Guillain-Barré syndrome, rhabdomyolysis, otitis media, meningoencephalitis and spontaneous pneumomediastinum. Conclusion: Although the systemic manifestations of SARS-CoV-2 infection are variegated, they are deeply interwoven by shared mechanisms. Two phases of extrapulmonary disease were identified: (a) an early phase with possible gastrointestinal, ocular and cutaneous involvement and (b) a late phase characterised by multiorgan dysfunction and clinical deterioration. A clear, multidisciplinary consensus to define and approach thromboinflammation and cytokine release syndrome in SARS-CoV-2 is needed.
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Massachi, Jonathan, Kevin Christopher Donohue, and John Daniel Kelly. "Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing." American Journal of Tropical Medicine and Hygiene, August 9, 2021. http://dx.doi.org/10.4269/ajtmh.21-0365.
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Evaluating the reinfection may offer some insight into areas for further investigation regarding durability of immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sixty cases of reinfection with viral sequencing were identified in PubMed, Embase, Web of Science, and medRxiv before May 1, 2021.Episodes of infection were separated by a median of 116 days. Severity of illness was greater among individuals reinfected within 90 days of initial infection, no asymptomatic initial cases developed severe reinfection, nearly half of cases had suspected escape variants, and nearly all individual tested following reinfection were found to have detectable levels of anti-SARS-CoV-2 antibodies. This analysis is limited by the heterogeneous methods used among reports. Reinfection continues to be relatively rare. As the case rate presumably increases over time, this review will inform measurements to determine the natural history and causal determinants of reinfection in more rigorous observational cohort studies and other standardized surveillance approaches.