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Bond KA, Dendle C, Guy S, Slavin MA, Smibert O, Ibrahim N, Kinsella PM, Morrissey CO, Moso MA, Sasadeusz JJ. Outcomes of Antiviral Retreatment for Immunocompromised Hosts With Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Polymerase Chain Reaction Positivity: A Multicenter Australian Retrospective Case Series. Open Forum Infect Dis 2024; 11:ofae449. [PMID: 39189033 PMCID: PMC11346352 DOI: 10.1093/ofid/ofae449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024] Open
Abstract
Outcomes are presented for a multisite retrospective case series, describing a contemporary cohort of 22 immunocompromised patients with persistent coronavirus disease 2019 (COVID-19) polymerase chain reaction positivity who were retreated with antiviral therapy. For those with data available 14 and 30 days after commencement of antiviral therapy, 41% (9 of 22) and 68% (15 of 22), respectively, cleared COVID-19.
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Affiliation(s)
- K A Bond
- Department of Microbiology, Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Reference Laboratory, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - C Dendle
- Department of Infectious Diseases, Monash Health, Melbourne, Victoria, Australia
- Department of Infectious Diseases, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
| | - S Guy
- Department of Infectious Diseases, Eastern Health, Melbourne, Victoria, Australia
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - M A Slavin
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - O Smibert
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia
| | - N Ibrahim
- Department of Infectious Diseases, Monash Health, Melbourne, Victoria, Australia
| | - P M Kinsella
- Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - C O Morrissey
- Department of Infectious Diseases, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
| | - M A Moso
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - J J Sasadeusz
- Department of Infectious Diseases, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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Zhu Y, Yurgelonis I, Noell S, Yang Q, Guan S, Li Z, Hao L, Rothan H, Rai DK, McMonagle P, Baniecki ML, Greasley SE, Plotnikova O, Lee J, Nicki JA, Ferre R, Byrnes LJ, Liu W, Craig TK, Steppan CM, Liberator P, Soares HD, Allerton CMN, Anderson AS, Cardin RD. In vitro selection and analysis of SARS-CoV-2 nirmatrelvir resistance mutations contributing to clinical virus resistance surveillance. SCIENCE ADVANCES 2024; 10:eadl4013. [PMID: 39047088 PMCID: PMC11268423 DOI: 10.1126/sciadv.adl4013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/11/2024] [Indexed: 07/27/2024]
Abstract
To facilitate the detection and management of potential clinical antiviral resistance, in vitro selection of drug-resistant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) against the virus Mpro inhibitor nirmatrelvir (Paxlovid active component) was conducted. Six Mpro mutation patterns containing T304I alone or in combination with T21I, L50F, T135I, S144A, or A173V emerged, with A173V+T304I and T21I+S144A+T304I mutations showing >20-fold resistance each. Biochemical analyses indicated inhibition constant shifts aligned to antiviral results, with S144A and A173V each markedly reducing nirmatrelvir inhibition and Mpro activity. SARS-CoV-2 surveillance revealed that in vitro resistance-associated mutations from our studies and those reported in the literature were rarely detected in the Global Initiative on Sharing All Influenza Data database. In the Paxlovid Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients trial, E166V was the only emergent resistance mutation, observed in three Paxlovid-treated patients, none of whom experienced COVID-19-related hospitalization or death.
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Affiliation(s)
- Yuao Zhu
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Irina Yurgelonis
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Stephen Noell
- Pfizer Worldwide Research, Development & Medical, Groton, CT 06340, USA
| | - Qingyi Yang
- Pfizer Worldwide Research, Development & Medical, Cambridge MA 02139, USA
| | - Shunjie Guan
- Pfizer Worldwide Research, Development & Medical, Cambridge MA 02139, USA
| | - Zhenghui Li
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Li Hao
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Hussin Rothan
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Devendra K. Rai
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Patricia McMonagle
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Mary Lynn Baniecki
- Pfizer Worldwide Research, Development & Medical, Cambridge MA 02139, USA
| | | | - Olga Plotnikova
- Pfizer Worldwide Research, Development & Medical, Groton, CT 06340, USA
| | - Jonathan Lee
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Jennifer A. Nicki
- Pfizer Worldwide Research, Development & Medical, Groton, CT 06340, USA
| | - RoseAnn Ferre
- Pfizer Worldwide Research, Development & Medical, La Jolla, CA 92121, USA
| | - Laura J. Byrnes
- Pfizer Worldwide Research, Development & Medical, Groton, CT 06340, USA
| | - Wei Liu
- Pfizer Worldwide Research, Development & Medical, La Jolla, CA 92121, USA
| | - Timothy K. Craig
- Pfizer Worldwide Research, Development & Medical, Groton, CT 06340, USA
| | - Claire M. Steppan
- Pfizer Worldwide Research, Development & Medical, Groton, CT 06340, USA
| | - Paul Liberator
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
| | - Holly D. Soares
- Pfizer Worldwide Research, Development & Medical, Groton, CT 06340, USA
| | | | | | - Rhonda D. Cardin
- Pfizer Worldwide Research, Development & Medical, Pearl River, NY 10965, USA
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Asplin P, Mancy R, Finnie T, Cumming F, Keeling MJ, Hill EM. Symptom propagation in respiratory pathogens of public health concern: a review of the evidence. J R Soc Interface 2024; 21:20240009. [PMID: 39045688 PMCID: PMC11267474 DOI: 10.1098/rsif.2024.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
Symptom propagation occurs when the symptom set an individual experiences is correlated with the symptom set of the individual who infected them. Symptom propagation may dramatically affect epidemiological outcomes, potentially causing clusters of severe disease. Conversely, it could result in chains of mild infection, generating widespread immunity with minimal cost to public health. Despite accumulating evidence that symptom propagation occurs for many respiratory pathogens, the underlying mechanisms are not well understood. Here, we conducted a scoping literature review for 14 respiratory pathogens to ascertain the extent of evidence for symptom propagation by two mechanisms: dose-severity relationships and route-severity relationships. We identify considerable heterogeneity between pathogens in the relative importance of the two mechanisms, highlighting the importance of pathogen-specific investigations. For almost all pathogens, including influenza and SARS-CoV-2, we found support for at least one of the two mechanisms. For some pathogens, including influenza, we found convincing evidence that both mechanisms contribute to symptom propagation. Furthermore, infectious disease models traditionally do not include symptom propagation. We summarize the present state of modelling advancements to address the methodological gap. We then investigate a simplified disease outbreak scenario, finding that under strong symptom propagation, isolating mildly infected individuals can have negative epidemiological implications.
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Affiliation(s)
- Phoebe Asplin
- EPSRC & MRC Centre for Doctoral Training in Mathematics for Real-World Systems, University of Warwick, Coventry, UK
- Mathematics Institute, University of Warwick, Coventry, UK
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, UK
| | - Rebecca Mancy
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Thomas Finnie
- Data, Analytics and Surveillance, UK Health Security Agency, London, UK
| | - Fergus Cumming
- Foreign, Commonwealth and Development Office, London, UK
| | - Matt J. Keeling
- Mathematics Institute, University of Warwick, Coventry, UK
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, UK
- School of Life Sciences, University of Glasgow, Glasgow, UK
| | - Edward M. Hill
- Mathematics Institute, University of Warwick, Coventry, UK
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, UK
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Shire FM, Sharbatti S, AlNajjar F, Sulaiman Abumuaileq L, Abuelkher R, Sabri H, Beevi A, Alqahtani A, Beshtawy R. The Impact of Viral Load on the Severity and Outcome Among Patients With COVID-19: A Cross-Sectional Study. Cureus 2024; 16:e64137. [PMID: 39119409 PMCID: PMC11307488 DOI: 10.7759/cureus.64137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Objectives This study aimed to assess the relationship between illness severity and mortality among COVID-19 patients along with the cycle threshold (Ct) value measured by viral load. Methods A cross-sectional study was conducted based on records of the emergency room at Rashid Hospital located in Dubai, United Arab Emirates. This research was carried out on all of the appropriate records of patients who were hospitalized at Rashid Hospital in Dubai between May 2020 and January 2021. Clinical and laboratory data were used as severity indicators, and in-hospital death was designated as the outcome. Results A total of 1,633 cases were included in the analysis. The percentage of deceased patients was higher in patients with a low Ct value (11.6%) than in patients with a high Ct value (6.9%) (p-value = 0.003). Logistic analysis revealed a statistically significant correlation (OR=2.046; p-value=0.002) between mortality and viral load, as measured by the Ct value. Patients with low Ct values and aberrant laboratory findings had a higher frequency of respiratory problems and required oxygen therapy, according to clinical and laboratory markers. Conclusions A correlation was found between viral load and mortality. Advanced age, history of chronic disease, and abnormal clinical and laboratory findings were all independently linked to a greater mortality rate in COVID-19 patients, indicating that they might be utilized as predictive and prognostic factors along with the viral load.
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Affiliation(s)
- Fatma M Shire
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Shatha Sharbatti
- Community Medicine Department, Gulf Medical University, Ajman, ARE
| | - Firas AlNajjar
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | | | - Rand Abuelkher
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Hebah Sabri
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Aasiya Beevi
- Medical Education Department, Dubai Medical College for Girls, Dubai, ARE
| | - Alia Alqahtani
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
| | - Rami Beshtawy
- Emergency Department, Rashid Hospital, Dubai Academic Health Corporation, Dubai, ARE
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Ibrahim F, Natasha A, Yasmon A, Rizal CT, Fithriyah, Karuniawati A, Saharman YR, Sudarmono P. Evaluation of SARS-CoV-2 quantification from oropharyngeal swabs, nasopharyngeal swabs, and naso-oropharyngeal swabs: A cross-sectional study. Heliyon 2024; 10:e28647. [PMID: 38586376 PMCID: PMC10998208 DOI: 10.1016/j.heliyon.2024.e28647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
The current naso-oropharyngeal swab for SARS-CoV-2 detection faces several problems, such as waste issues and its use for quantitative studies. This study aimed to evaluate the total RNA and viral loads from different upper respiratory tract swabs types and whether SARS-CoV-2 quantification can use the current internal control for normalization. This cross-sectional study collected positive specimens with single oropharyngeal or nasopharyngeal swabs and naso-oropharyngeal swabs. The samples were extracted, tested with qualitative RT‒PCR, and then tested with quantitative RT‒PCR. The RNA eluate was measured for the total RNA concentration. The total RNA concentration, viral load, and RNaseP Ct values were collected and analysed statistically. The positive results came from 41 oropharyngeal swabs, 34 nasopharyngeal swabs, and 36 naso-oropharyngeal swabs. The total RNA increased significantly from oropharyngeal swabs to nasopharyngeal swabs to naso-oropharyngeal swabs. Significant differences in RNaseP Ct values between groups and their correlations with total RNA were found. In addition, the increase in the total RNA and the RNaseP Ct values were unrelated to the viral load. The physical features in the naso-oropharyngeal area and the swabbing procedures could affect the total RNA but not the viral load. However, since the virus particles could present inside and outside human cells, the increase in collected human cells may not always be followed by the viral load increase. Normalization using the RNaseP Ct value became unnecessary due to the factors mentioned above. Therefore, a careful approach is needed in viral load studies of swab specimens.
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Affiliation(s)
- Fera Ibrahim
- Department of Microbiology Faculty of Medicine Universitas Indonesia / Dr. Cipto Mangunkusumo Hospital, Pegangsaan Timur 16 Street, East Jakarta, 10430, Indonesia
| | - Augustine Natasha
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Andi Yasmon
- Department of Microbiology Faculty of Medicine Universitas Indonesia / Dr. Cipto Mangunkusumo Hospital, Pegangsaan Timur 16 Street, East Jakarta, 10430, Indonesia
| | - Chairunnisa Tawadhu Rizal
- Jakarta Health Laboratory Center, Ministry of Health, Percetakan Negara No.23B street, Central Jakarta, Indonesia
| | - Fithriyah
- Department of Microbiology Faculty of Medicine Universitas Indonesia / Dr. Cipto Mangunkusumo Hospital, Pegangsaan Timur 16 Street, East Jakarta, 10430, Indonesia
| | - Anis Karuniawati
- Department of Microbiology Faculty of Medicine Universitas Indonesia / Dr. Cipto Mangunkusumo Hospital, Pegangsaan Timur 16 Street, East Jakarta, 10430, Indonesia
| | - Yulia Rosa Saharman
- Department of Microbiology Faculty of Medicine Universitas Indonesia / Dr. Cipto Mangunkusumo Hospital, Pegangsaan Timur 16 Street, East Jakarta, 10430, Indonesia
| | - Pratiwi Sudarmono
- Department of Microbiology Faculty of Medicine Universitas Indonesia / Dr. Cipto Mangunkusumo Hospital, Pegangsaan Timur 16 Street, East Jakarta, 10430, Indonesia
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Guilbaud R, Franco Yusti AM, Leducq V, Zafilaza K, Bridier-Nahmias A, Todesco E, Soulie C, Fauchois A, Le Hingrat Q, Kramer L, Goulenok T, Salpin M, Daugas E, Dorent R, Ottaviani S, Zalcman G, Ghosn J, Choquet S, Cacoub P, Amoura Z, Barroux B, Pourcher V, Spano JP, Louet M, Marcelin AG, Calvez V, Charpentier C, Descamps D, Marot S, Ferré VM, Coppée R. Higher Levels of SARS-CoV-2 Genetic Variation in Immunocompromised Patients: A Retrospective Case-Control Study. J Infect Dis 2024; 229:1041-1049. [PMID: 37956413 DOI: 10.1093/infdis/jiad499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection lasts longer in immunocompromised hosts than in immunocompetent patients. Prolonged infection is associated with a higher probability of selection for novel SARS-CoV-2 mutations, particularly in the spike protein, a critical target for vaccines and therapeutics. METHODS From December 2020 to September 2022, respiratory samples from 444 immunocompromised patients and 234 health care workers positive for SARS-CoV-2, diagnosed at 2 hospitals in Paris, France, were analyzed using whole-genome sequencing using Nanopore technology. Custom scripts were developed to assess the SARS-CoV-2 genetic diversity between the 2 groups and within the host. RESULTS Most infections were SARS-CoV-2 Delta or Omicron lineages. Viral genetic diversity was significantly higher in infections of immunocompromised patients than those of controls. Minor mutations were identified in viruses sequenced from immunocompromised individuals, which became signature mutations for newer SARS-CoV-2 variants as the epidemic progressed. Two patients were coinfected with Delta and Omicron variants. The follow-up of immunocompromised patients revealed that the SARS-CoV-2 genome evolution differed in the upper and lower respiratory tracts. CONCLUSIONS This study found that SARS-CoV-2 infection in immunocompromised patients is associated with higher genetic diversity, which could lead to the emergence of new SARS-CoV-2 variants with possible immune evasion or different virulence characteristics.
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Affiliation(s)
- Romane Guilbaud
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
| | - Anna-Maria Franco Yusti
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
| | - Valentin Leducq
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Karen Zafilaza
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Antoine Bridier-Nahmias
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
| | - Eve Todesco
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Cathia Soulie
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Antoine Fauchois
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Quentin Le Hingrat
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
| | - Laura Kramer
- Service de Pharmacie, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Tiphaine Goulenok
- Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Mathilde Salpin
- Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Eric Daugas
- Service de Néphrologie, Université Paris Cité, Inserm U1149, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Richard Dorent
- Service de Cardiologie, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Sébastien Ottaviani
- Service de Rhumatologie, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Gérard Zalcman
- Service d'Oncologie Thoracique, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Jade Ghosn
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
- Service de Maladies Infectieuses, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Sylvain Choquet
- Service d'Hématologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Patrice Cacoub
- Service de Médecine Interne et Immunologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Zahir Amoura
- Service de Médecine Interne 2, Centre National de Référence des Histiocytoses, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Benoit Barroux
- Service d'Urologie et de Transplantation Rénale, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Valérie Pourcher
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière, Paris, France
| | - Jean-Philippe Spano
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- Service d'Oncologie Médicale, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Martine Louet
- Service de Santé au Travail, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Anne-Geneviève Marcelin
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Vincent Calvez
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Charlotte Charpentier
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
| | - Diane Descamps
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
| | - Stéphane Marot
- Service de Virologie, Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Valentine Marie Ferré
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
| | - Romain Coppée
- Infection, Antimicrobials, Modelling, Evolution, Université Paris Cité and Sorbonne Paris Nord, Inserm, Paris, France
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7
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Jirakittayakorn N, Tamboon E, Mitrirattanakul S. Effect of 1% H 2O 2 on Three Salivary Stress Biomarkers, Cortisol, Alpha-Amylase, and sIgA. Int Dent J 2024; 74:343-351. [PMID: 37985342 PMCID: PMC10988260 DOI: 10.1016/j.identj.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Due to the COVID-19 pandemic, several associations worldwide have been recommending the use of 1% hydrogen peroxide solution as a preprocedural mouth rinse before dental treatments to reduce viral load in saliva. This protocol is also employed in stress studies, especially in the context of dental treatment that uses salivary biomarkers as an indicator. However, the effect of 1% hydrogen peroxide as mouth rinse on salivary biomarkers remains unclear. OBJECTIVE This study aims to investigate the effects of 1% hydrogen peroxide solution as a preprocedural mouth rinse on 3 salivary stress biomarkers-salivary cortisol, salivary secretory IgA, and salivary α-amylase-both on chemical influence and mechanical irrigation. MATERIALS AND METHODS Ninety healthy participants with confirmed negative Reverse Transcription Polymerase Chain Reaction results for COVID-19 at most 2 days prior to the experiment were included in this study. All participants were randomly allocated into 3 groups: experimental (1% hydrogen peroxide solution), positive control (distilled water), and negative control (no mouth rinse). Saliva samples were collected before and after mouth rinsing with the respective solutions. Salivary biomarkers were analysed using specific enzyme-linked immunosorbent assay kits. RESULTS Salivary cortisol and salivary α-amylase did not significantly differ before and after rinsing, whilst salivary sIgA levels decreased in all 3 groups. Nonetheless, there were no significant differences in the changes of these biomarkers across the 3 groups. CONCLUSIONS This study shows that using 1% hydrogen peroxide solution as a preprocedural mouth rinse for universal precaution does not alter the levels of these 3 salivary biomarkers.
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Affiliation(s)
- Nantawachara Jirakittayakorn
- Faculty of Dentistry, Mahidol University, Bangkok, Thailand; School of Dentistry, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand
| | - Eakapong Tamboon
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok Thailand.
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Valmoria KMF, So PNH, Montemayor ES. The Time to Negative Conversion among Adult COVID-19 Patients on Chronic Hemodialysis Admitted at the Philippine General Hospital - A Retrospective Cohort Study. ACTA MEDICA PHILIPPINA 2024; 58:22-27. [PMID: 39005616 PMCID: PMC11240000 DOI: 10.47895/amp.vi0.6460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Objectives In the Philippines, patients on chronic hemodialysis with COVID-19 remain admitted in hospitals despite clinical recovery because most free-standing dialysis units require proof of negative conversion via Reverse Transcriptase - Polymerase Chain Reaction (RT-PCR). This study aims to determine the time to negative conversion of COVID-19 RT-PCR testing among adult patients on chronic hemodialysis with COVID-19 admitted at the Philippine General Hospital (PGH) and bring insight in using the symptom or time-based procedure as recommended by local guideline, and ultimately, to ensure delivery of adequate hemodialysis despite being infected with COVID-19, shorten isolation period, and conserve resources especially in resource-limited settings. Methods This is a retrospective cohort study on all adult patients on chronic hemodialysis who were admitted in PGH after the diagnosis of COVID-19 by RT-PCR between March 2020 and February 2021. Descriptive statistics was used in summarizing the data. Results A total of 90 patients on chronic hemodialysis who tested positive for COVID-19 via RT-PCR admitted at PGH were included in the study. Most of these patients had moderate COVID-19 at 53.3%. The median number of days from onset of symptoms to clinical recovery was 14.5 days. The median time to first negative conversion was 18 days. Most of these patients had negative conversion at the second week. The correlation coefficient between time to clinical recovery and negative conversion was 0.214. Conclusion Among adult patients on chronic hemodialysis who were admitted in PGH after the diagnosis of COVID-19, the time to negative conversion was longer compared to the time to clinical recovery with a very weak correlation between the two.
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Affiliation(s)
- Kristine May F Valmoria
- Division of Nephrology, Department of Medicine, Philippine General Hospital, University of the Philippines
| | - Paolo Nikolai H So
- Division of Nephrology, Department of Medicine, Philippine General Hospital, University of the Philippines
| | - Elizabeth S Montemayor
- Division of Nephrology, Department of Medicine, Philippine General Hospital, University of the Philippines
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9
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Kumar S, Granados J, Aceves M, Peralta J, Leandro AC, Thomas J, Williams-Blangero S, Curran JE, Blangero J. Pre-Infection Innate Immunity Attenuates SARS-CoV-2 Infection and Viral Load in iPSC-Derived Alveolar Epithelial Type 2 Cells. Cells 2024; 13:369. [PMID: 38474333 PMCID: PMC10931100 DOI: 10.3390/cells13050369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
A large portion of the heterogeneity in coronavirus disease 2019 (COVID-19) susceptibility and severity of illness (SOI) remains poorly understood. Recent evidence suggests that SARS-CoV-2 infection-associated damage to alveolar epithelial type 2 cells (AT2s) in the distal lung may directly contribute to disease severity and poor prognosis in COVID-19 patients. Our in vitro modeling of SARS-CoV-2 infection in induced pluripotent stem cell (iPSC)-derived AT2s from 10 different individuals showed interindividual variability in infection susceptibility and the postinfection cellular viral load. To understand the underlying mechanism of the AT2's capacity to regulate SARS-CoV-2 infection and cellular viral load, a genome-wide differential gene expression analysis between the mock and SARS-CoV-2 infection-challenged AT2s was performed. The 1393 genes, which were significantly (one-way ANOVA FDR-corrected p ≤ 0.05; FC abs ≥ 2.0) differentially expressed (DE), suggest significant upregulation of viral infection-related cellular innate immune response pathways (p-value ≤ 0.05; activation z-score ≥ 3.5), and significant downregulation of the cholesterol- and xenobiotic-related metabolic pathways (p-value ≤ 0.05; activation z-score ≤ -3.5). Whilst the effect of post-SARS-CoV-2 infection response on the infection susceptibility and postinfection viral load in AT2s is not clear, interestingly, pre-infection (mock-challenged) expression of 238 DE genes showed a high correlation with the postinfection SARS-CoV-2 viral load (FDR-corrected p-value ≤ 0.05 and r2-absolute ≥ 0.57). The 85 genes whose expression was negatively correlated with the viral load showed significant enrichment in viral recognition and cytokine-mediated innate immune GO biological processes (p-value range: 4.65 × 10-10 to 2.24 × 10-6). The 153 genes whose expression was positively correlated with the viral load showed significant enrichment in cholesterol homeostasis, extracellular matrix, and MAPK/ERK pathway-related GO biological processes (p-value range: 5.06 × 10-5 to 6.53 × 10-4). Overall, our results strongly suggest that AT2s' pre-infection innate immunity and metabolic state affect their susceptibility to SARS-CoV-2 infection and viral load.
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Affiliation(s)
- Satish Kumar
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, McAllen, TX 78504, USA; (J.G.); (M.A.); (J.T.)
| | - Jose Granados
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, McAllen, TX 78504, USA; (J.G.); (M.A.); (J.T.)
| | - Miriam Aceves
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, McAllen, TX 78504, USA; (J.G.); (M.A.); (J.T.)
| | - Juan Peralta
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX 78520, USA; (J.P.); (A.C.L.); (S.W.-B.); (J.E.C.); (J.B.)
| | - Ana C. Leandro
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX 78520, USA; (J.P.); (A.C.L.); (S.W.-B.); (J.E.C.); (J.B.)
| | - John Thomas
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, McAllen, TX 78504, USA; (J.G.); (M.A.); (J.T.)
| | - Sarah Williams-Blangero
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX 78520, USA; (J.P.); (A.C.L.); (S.W.-B.); (J.E.C.); (J.B.)
| | - Joanne E. Curran
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX 78520, USA; (J.P.); (A.C.L.); (S.W.-B.); (J.E.C.); (J.B.)
| | - John Blangero
- Division of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX 78520, USA; (J.P.); (A.C.L.); (S.W.-B.); (J.E.C.); (J.B.)
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10
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Ali S, Cella E, Johnston C, Rojas AC, Brown AN, Deichen M, Azarian T. Environmental surface monitoring as a noninvasive method for SARS-CoV-2 surveillance in community settings: Lessons from a university campus study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169456. [PMID: 38123097 DOI: 10.1016/j.scitotenv.2023.169456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/22/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
Environmental testing of high-touch objects is a potential noninvasive approach for monitoring population-level trends of SARS-CoV-2 and other respiratory viruses within a defined setting. We aimed to determine the association between SARS-CoV-2 contamination on high-touch environmental surfaces, community level case incidence, and university student health data. Environmental swabs were collected from January 2022 to November 2022 from high-touch objects and surfaces from five locations on a large university campus in Florida, USA. RT-qPCR was used to detect and quantify viral RNA, and a subset of positive samples was analyzed by viral genome sequencing to identify circulating lineages. During the study period, we detected SARS-CoV-2 viral RNA on 90.7 % of 162 tested samples. Levels of environmental viral RNA correlated with trends in community-level activity and case reports from the student health center. A significant positive correlation was observed between the estimated viral gene copy number in environmental samples and the weekly confirmed cases at the university. Viral sequencing data from environmental samples identified lineages concurrently circulating in the local community and state based on genomic surveillance data. Further, we detected emerging variants in environmental samples prior to their identification by clinical genomic surveillance. Our results demonstrate the utility of viral monitoring on high-touch environmental surfaces for SARS-CoV-2 surveillance at a community level. In communities with delayed or limited testing facilities, immediate environmental surface testing may considerably inform epidemic dynamics.
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Affiliation(s)
- Sobur Ali
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Catherine Johnston
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA
| | - Ana C Rojas
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA
| | - Ashley N Brown
- Institute for Therapeutic Innovation, Department of Medicine, College of Medicine, University of Florida, Orlando, FL 32827, USA
| | - Michael Deichen
- Student Health Services, University of Central Florida, Orlando, FL, USA
| | - Taj Azarian
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA.
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11
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Le Bert N, Samandari T. Silent battles: immune responses in asymptomatic SARS-CoV-2 infection. Cell Mol Immunol 2024; 21:159-170. [PMID: 38221577 PMCID: PMC10805869 DOI: 10.1038/s41423-024-01127-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/16/2024] Open
Abstract
SARS-CoV-2 infections manifest with a broad spectrum of presentations, ranging from asymptomatic infections to severe pneumonia and fatal outcomes. This review centers on asymptomatic infections, a widely reported phenomenon that has substantially contributed to the rapid spread of the pandemic. In such asymptomatic infections, we focus on the role of innate, humoral, and cellular immunity. Notably, asymptomatic infections are characterized by an early and robust innate immune response, particularly a swift type 1 IFN reaction, alongside a rapid and broad induction of SARS-CoV-2-specific T cells. Often, antibody levels tend to be lower or undetectable after asymptomatic infections, suggesting that the rapid control of viral replication by innate and cellular responses might impede the full triggering of humoral immunity. Even if antibody levels are present in the early convalescent phase, they wane rapidly below serological detection limits, particularly following asymptomatic infection. Consequently, prevalence studies reliant solely on serological assays likely underestimate the extent of community exposure to the virus.
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Affiliation(s)
- Nina Le Bert
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.
| | - Taraz Samandari
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
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12
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Zhang W, Wu H, Guo Q, Xu X, Pu Y, Chen C, Cao M, Sun D, Lu W, Yi H, Zhou S, Fang B. Association of clinical characteristics and vaccines with risk of persistently viral clearance in patients infected with SARS-CoV-2 Omicron variant in Shanghai, China. Heliyon 2024; 10:e23256. [PMID: 38192786 PMCID: PMC10772582 DOI: 10.1016/j.heliyon.2023.e23256] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024] Open
Abstract
Importance The global COVID-19 pandemic does not appear to end in the near future. Currently, limited data are available on the risk factors for delayed viral clearance in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection. Objective This study aimed to investigate the association of clinical characteristics and vaccination with prolonged viral clearance. Methods This retrospective cohort included 16,985 patients who had contracted the SARS-CoV-2 Omicron variant between April 5 and May 30, 2022, in Shanghai, China, and had mild or no symptoms. The patients were admitted to the quarantine venue at the Shanghai New International Expo Center. Results Of the 16,985 participants, the occurrence of viral clearance was ≤8 and > 8 days in 11,009 (64.8 %) and 5976 (35.2 %) participants, respectively. Risk factors related to patients who remained persistently polymerase chain reaction (PCR)-positive were sex (Male, odds ratio [OR] 1.221, p < 0.001), older age (35-49, OR 1.389, p < 0.001; 50-64, OR 1.659, p < 0.001; ≥65, OR 2.139, p < 0.001), presence of symptoms (OR 1.093, p = 0.030), number of vaccinations (two doses, OR 0.753, p < 0.001; three doses, OR 0.797, p < 0.001; four doses, OR 0.543, p < 0.001), and cycle threshold (Ct) value for ORF1ab gene at diagnosis (25-35, OR 0.235, p < 0.001; >35, OR 0.079, p < 0.001). The lower rates of increase in Ct values were observed in the later viral shedding group than in the early viral shedding group for ORF1ab (β = -0.791, p < 0.001) and N genes (β = -0.825, p < 0.001). Conclusion Prolonged SARS-CoV-2 RNA detection and higher viral concentrations were associated with factors such as male sex, older age, symptomatic status, and fewer doses of vaccination in patients admitted to Shanghai Makeshift Hospital between April 5 and May 30, 2022.
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Affiliation(s)
- Wen Zhang
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Hongze Wu
- Jiujiang Traditional Chinese Medicine Hospital, Jiujiang, 332005, Jiangxi, PR China
| | - Quan Guo
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Xiangru Xu
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Yuting Pu
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Caiyu Chen
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Min Cao
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Ding Sun
- Department of Rheumatology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Wei Lu
- Department of Nursing, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
| | - Hui Yi
- Jiujiang Traditional Chinese Medicine Hospital, Jiujiang, 332005, Jiangxi, PR China
| | - Shuang Zhou
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Zhangjiang Hi Tech Park, Pudong New Area, Shanghai 201203, PR China
| | - Bangjiang Fang
- Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
- Institute of Emergency and Critical Care Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, PR China
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13
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Negi S, Diksha, Kalita D, Ranakoti N, Negi A, Kandwal D, Gupta SK, Mathuria YP. Trend of viral load during the first, second, and third wave of COVID-19 in the Indian Himalayan region: an observational study of the Uttarakhand state. Front Microbiol 2024; 14:1279632. [PMID: 38298537 PMCID: PMC10829093 DOI: 10.3389/fmicb.2023.1279632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024] Open
Abstract
India had faced three waves throughout the Coronavirus disease 2019 (COVID-19) pandemic, which had already impacted economic lives and affected the healthcare setting and infrastructure. The widespread impacts have inspired researchers to look for clinical indicators of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prognosis. Cyclic threshold values have been used to correlate the viral load in COVID-19 patients and for viral transmission. In light of this correlation, a retrospective study was conducted to assess the trend of viral load in clinical and demographic profiles across the three waves. Data of a total of 11,125 COVID-19-positive patients were obtained, which had a Ct value of <35. We stratified Ct values as follows: under 25 (high viral load), 25-30 (moderate viral load), and over 30 (low viral load). We found a significantly high proportion of patients with high viral load during the second wave. A significantly high viral load across the symptomatic and vaccinated populations was found in all three waves, whereas a significantly high viral load across age groups was found only in the first wave. With the widespread availability of real-time PCR and the limited use of genomic surveillance, the Ct value and viral load could be a suitable tool for population-level monitoring and forecasting.
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Affiliation(s)
- Shailender Negi
- Viral Research and Diagnostic Laboratory (VRDL), All India Institute of Medical Sciences, Rishikesh, India
| | - Diksha
- Viral Research and Diagnostic Laboratory (VRDL), All India Institute of Medical Sciences, Rishikesh, India
| | - Deepjyoti Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Guwahati, India
| | - Neeraj Ranakoti
- Viral Research and Diagnostic Laboratory (VRDL), All India Institute of Medical Sciences, Rishikesh, India
| | - Ashish Negi
- Viral Research and Diagnostic Laboratory (VRDL), All India Institute of Medical Sciences, Rishikesh, India
| | - Diksha Kandwal
- Viral Research and Diagnostic Laboratory (VRDL), All India Institute of Medical Sciences, Rishikesh, India
| | - Shailesh Kumar Gupta
- Viral Research and Diagnostic Laboratory (VRDL), All India Institute of Medical Sciences, Rishikesh, India
| | - Yogendra Pratap Mathuria
- Viral Research and Diagnostic Laboratory (VRDL), All India Institute of Medical Sciences, Rishikesh, India
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India
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14
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Khyati, Manchanda V, Pumma P, Chawla R, Garg S, Saxena S. Diagnostic performance of saliva RT-PCR test as a diagnostic tool and its utility in the detection of SARS-CoV-2 shedding with different patient characteristics: Prospective observational study. Indian J Med Microbiol 2024; 47:100490. [PMID: 37890412 DOI: 10.1016/j.ijmmb.2023.100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Salivary shedding of SARS-CoV-2 is a known entity and its role has been established in transmission of the disease. The present study was performed to evaluate the duration of viral shedding in saliva in COVID-19 patients and its variation among symptomatic and asymptomatic patients with or without co-morbidities. METHODS The present prospective observational study was conducted at the COVID-19 care hospital associated with primary to tertiary care in New Delhi, India. A total of 124 COVID-19 confirmed cases enrolled in two phases (January-March 2021; April-June 2021) who consented for 48hrly saliva and nasopharyngeal swab (NPS) specimens till discharge from the hospital for SARS-CoV-2 detection were included. The specimens obtained were tested for SARS-CoV-2 by Real-Time PCR. RESULTS The sensitivity and the specificity of RT-PCR on saliva were 81.7 % and 85.0 %, respectively. The sensitivity of saliva-based PCR was comparable in symptomatic and asymptomatic patients (81.6 % vs 82.1 %). The sensitivity of saliva-based PCR markedly increased in the second phase of enrollment as compared to the first phase (92.6 % vs 78.5 %) indicating higher level of salivary shedding by the delta variant of SARS-CoV-2. The sensitivity of PCR on saliva was the highest up to day seven of illness. The median duration of RNA shedding in saliva was comparable among the symptomatic and asymptomatic patients. The severity of the disease was not associated with the duration of SARS-CoV-2 shedding in saliva. CONCLUSIONS SARS-CoV-2 shedding in saliva continued till seven days in large number of patients including asymptomatic patients. Saliva is non-inferior to NPS specimen in the diagnosis of SARS-CoV-2. Saliva specimen is recommended as a good alternate to NPS for SARS-CoV-2 testing.
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Affiliation(s)
- Khyati
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
| | - V Manchanda
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India.
| | - P Pumma
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
| | - R Chawla
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
| | - S Garg
- Department of Medicine, Maulana Azad Medical College, 110002, New Delhi, India
| | - S Saxena
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
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15
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Sunagawa J, Park H, Kim KS, Komorizono R, Choi S, Ramirez Torres L, Woo J, Jeong YD, Hart WS, Thompson RN, Aihara K, Iwami S, Yamaguchi R. Isolation may select for earlier and higher peak viral load but shorter duration in SARS-CoV-2 evolution. Nat Commun 2023; 14:7395. [PMID: 37989736 PMCID: PMC10663562 DOI: 10.1038/s41467-023-43043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023] Open
Abstract
During the COVID-19 pandemic, human behavior change as a result of nonpharmaceutical interventions such as isolation may have induced directional selection for viral evolution. By combining previously published empirical clinical data analysis and multi-level mathematical modeling, we find that the SARS-CoV-2 variants selected for as the virus evolved from the pre-Alpha to the Delta variant had earlier and higher peak in viral load dynamics but a shorter duration of infection. Selection for increased transmissibility shapes the viral load dynamics, and the isolation measure is likely to be a driver of these evolutionary transitions. In addition, we show that a decreased incubation period and an increased proportion of asymptomatic infection are also positively selected for as SARS-CoV-2 mutated to adapt to human behavior (i.e., Omicron variants). The quantitative information and predictions we present here can guide future responses in the potential arms race between pandemic interventions and viral evolution.
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Affiliation(s)
- Junya Sunagawa
- Department of Advanced Transdisciplinary Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hyeongki Park
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Kwang Su Kim
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Department of Scientific Computing, Pukyong National University, Busan, South Korea
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - Ryo Komorizono
- Laboratory of RNA Viruses, Department of Virus Research, Institute for Life and Medical Sciences (LiMe), Kyoto University, Kyoto, Japan
| | - Sooyoun Choi
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - Lucia Ramirez Torres
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Joohyeon Woo
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Yong Dam Jeong
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan
- Department of Mathematics, Pusan National University, Busan, South Korea
| | - William S Hart
- Mathematical Institute, University of Oxford, Oxford, UK
| | - Robin N Thompson
- Mathematical Institute, University of Oxford, Oxford, UK
- Mathematics Institute, University of Warwick, Coventry, UK
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Coventry, UK
| | - Kazuyuki Aihara
- International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Shingo Iwami
- interdisciplinary Biology Laboratory (iBLab), Division of Natural Science, Graduate School of Science, Nagoya University, Nagoya, Japan.
- Institute of Mathematics for Industry, Kyushu University, Fukuoka, Japan.
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.
- Interdisciplinary Theoretical and Mathematical Sciences Program (iTHEMS), RIKEN, Saitama, Japan.
- NEXT-Ganken Program, Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan.
- Science Groove Inc, Fukuoka, Japan.
| | - Ryo Yamaguchi
- Department of Advanced Transdisciplinary Sciences, Hokkaido University, Sapporo, Hokkaido, Japan.
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC, Canada.
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16
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Voidarou C, Rozos G, Stavropoulou E, Giorgi E, Stefanis C, Vakadaris G, Vaou N, Tsigalou C, Kourkoutas Y, Bezirtzoglou E. COVID-19 on the spectrum: a scoping review of hygienic standards. Front Public Health 2023; 11:1202216. [PMID: 38026326 PMCID: PMC10646607 DOI: 10.3389/fpubh.2023.1202216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
The emergence of COVID-19 in Wuhan, China, rapidly escalated into a worldwide public health crisis. Despite numerous clinical treatment endeavors, initial defenses against the virus primarily relied on hygiene practices like mask-wearing, meticulous hand hygiene (using soap or antiseptic solutions), and maintaining social distancing. Even with the subsequent advent of vaccines and the commencement of mass vaccination campaigns, these hygiene measures persistently remain in effect, aiming to curb virus transmission until the achievement of herd immunity. In this scoping review, we delve into the effectiveness of these measures and the diverse transmission pathways, focusing on the intricate interplay within the food network. Furthermore, we explore the virus's pathophysiology, considering its survival on droplets of varying sizes, each endowed with distinct aerodynamic attributes that influence disease dispersion dynamics. While respiratory transmission remains the predominant route, the potential for oral-fecal transmission should not be disregarded, given the protracted presence of viral RNA in patients' feces after the infection period. Addressing concerns about food as a potential viral vector, uncertainties shroud the virus's survivability and potential to contaminate consumers indirectly. Hence, a meticulous and comprehensive hygienic strategy remains paramount in our collective efforts to combat this pandemic.
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Affiliation(s)
| | - Georgios Rozos
- Veterinary Directorate, South Aegean Region, Ermoupolis, Greece
| | - Elisavet Stavropoulou
- Department of Medicine, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Elpida Giorgi
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christos Stefanis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Vakadaris
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Natalia Vaou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christina Tsigalou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Yiannis Kourkoutas
- Laboratory of Applied Microbiology and Biotechnology, Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Eugenia Bezirtzoglou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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17
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Shoraka S, Mohebbi SR, Hosseini SM, Zali MR. Comparison of plasma mitochondrial DNA copy number in asymptomatic and symptomatic COVID-19 patients. Front Microbiol 2023; 14:1256042. [PMID: 37869674 PMCID: PMC10587688 DOI: 10.3389/fmicb.2023.1256042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Since the beginning of the COVID-19 pandemic, a wide clinical spectrum, from asymptomatic infection to mild or severe disease and death, have been reported in COVID-19 patients. Studies have suggested several possible factors, which may affect the clinical outcome of COVID-19. A pro-inflammatory state and impaired antiviral response have been suggested as major contributing factors in severe COVID-19. Considering that mitochondria have an important role in regulating the immune responses to pathogens, pro-inflammatory signaling, and cell death, it has received much attention in SARS-CoV-2 infection. Recent studies have demonstrated that high levels of cell-free mitochondrial DNA (cf-mtDNA) are associated with an increased risk of COVID-19 intensive care unit (ICU) admission and mortality. However, there have been few studies on cf-mtDNA in SARS-CoV-2 infection, mainly focusing on critically ill COVID-19 cases. In the present study, we investigated cf-mtDNA copy number in COVID-19 patients and compared between asymptomatic and symptomatic cases, and assessed the clinical values. We also determined the cf-nuclear DNA (cf-nDNA) copy number and mitochondrial transcription factor A (TFAM) mRNA level in the studied groups. Materials and methods Plasma and buffy coat samples were collected from 37 COVID-19 patients and 33 controls. Briefly, after total DNA extraction, plasma cf-mtDNA, and cf-nDNA copy numbers were measured by absolute qPCR using a standard curve method. Furthermore, after total RNA extraction from buffy coat and cDNA synthesis, TFAM mRNA levels were evaluated by qPCR. Results The results showed that cf-mtDNA levels in asymptomatic COVID-19 patients were statistically significantly higher than in symptomatic cases (p value = 0.01). However, cf-nDNA levels were higher in symptomatic patients than in asymptomatic cases (p value = 0.00). There was no significant difference between TFAM levels in the buffy coat of these two groups (p value > 0.05). Also, cf-mtDNA levels showed good diagnostic potential in COVID-19 subgroups. Conclusion cf-mtDNA is probably important in the outcome of SARS-CoV-2 infection due to its role in inflammation and immune response. It can also be a promising candidate biomarker for the diagnosis of COVID-19 subgroups. Further investigation will help understanding the COVID-19 pathophysiology and effective diagnostic and therapeutic strategies.
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Affiliation(s)
- Shahrzad Shoraka
- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Seyed Reza Mohebbi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Hosseini
- Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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18
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Burhan E, Liu K, Marwali EM, Huth S, Wulung NGHML, Juzar DA, Taufik MA, Wijaya SO, Wati DK, Kusumastuti NP, Yuliarto S, Pratomo BY, Pradian E, Somasetia DH, Rusmawatiningtyas D, Fatoni AZ, Mandei JM, Lantang EY, Perdhana F, Semedi BP, Rayhan M, Tarigan TRS, White N, Bassi GL, Suen JY, Fraser JF. Characteristics and outcomes of patients with severe COVID-19 in Indonesia: Lessons from the first wave. PLoS One 2023; 18:e0290964. [PMID: 37747884 PMCID: PMC10519602 DOI: 10.1371/journal.pone.0290964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 08/18/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Indonesia's national response to COVID-19 evolved rapidly throughout 2020. Understanding pandemic response and outcomes is crucial for better mitigation strategies ahead. This study describes the characteristics and outcomes of patients admitted to ICU during the early stages of the pandemic. METHODS This is a multi-centre prospective observational study including patients from twelve collaborating hospitals in Indonesia. All patients were clinically suspected or laboratory-confirmed COVID-19 cases admitted to ICU between January 2020 and March 2021. The primary outcome was monthly ICU mortality. Descriptive statistics of patient characteristics and treatment were generated as secondary outcomes. RESULTS From 559 subjects, the overall mortality was 68% and decreased over the study period, while the mortality of patients that received mechanical ventilation was 92%, consistently high over the study period. Fatal cases showed 2- and 4-day delays from symptoms onset to hospital admissions and ICU admissions, respectively. Evidence-backed approaches which could influence patient outcome, such as extracorporeal membrane oxygenation, prone positioning, renal replacement therapy, and neuromuscular blockade were scarcely administered. CONCLUSIONS The mortality rate of COVID-19 patients in Indonesia was extremely high during the first major outbreak of disease, particularly in those mechanically ventilated. Delayed admission and unavailability of evidence-based approaches due to high burden on health facility during COVID-19 crisis could be addressed by efficient public health measures and enhancing health infrastructure to improve the future pandemic response.
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Affiliation(s)
- Erlina Burhan
- Faculty of Medicine, Department of Pulmonology and Respiratory Medicine, Universitas Indonesia and Persahabatan Hospital, Jakarta, Indonesia
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Eva M. Marwali
- Pediatric Cardiac Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Samuel Huth
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - Dafsah A. Juzar
- Departement of Cardiology and Vascular Medicine, Intensive Cardiovascular Care Unit, National Cardiovascular Center Harapan Kita and Universitas Indonesia, Jakarta, Indonesia
| | - Muhammad A. Taufik
- Anesthesiology and Critical Care Department, Fatmawati General Hospital, Jakarta, Indonesia
| | - Surya O. Wijaya
- Intensive Care Unit, Sulianti Saroso Hospital, Jakarta, Indonesia
| | - Dyah K. Wati
- Pediatric Intensive Care Unit, Sanglah Hospital, Denpasar, Bali, Indonesia
| | - Neurinda P. Kusumastuti
- Pediatric Intensive Care Unit, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | - Saptadi Yuliarto
- Pediatric Intensive Care Unit, Saiful Anwar Hospital, Malang, East Java, Indonesia
| | | | - Erwin Pradian
- Intensive Care Unit, Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Dadang H. Somasetia
- Pediatric Intensive Care Unit, Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | | | - Arie Z. Fatoni
- Intensive Care Unit, Saiful Anwar Hospital, Malang, East Java, Indonesia
| | - Jose M. Mandei
- Pediatric Intensive Care Unit, RSUP Prof Dr R. D. Kandou Manado, Indonesia
| | - Eka Y. Lantang
- Intensive Care Unit, RSUP Prof Dr R. D. Kandou Manado, Indonesia
| | - Fajar Perdhana
- Intensive Care Unit, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | | | - Muhammad Rayhan
- Pediatric Cardiac Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Tiffany R. S. Tarigan
- Pediatric Cardiac Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | | | - Gianluigi L. Bassi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Jacky Y. Suen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - John F. Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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19
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Tshabane C, Kuonza L, Mdose H, Musekiwa A, Motaze NV. Estimation of shedding time in laboratory-confirmed COVID-19 cases in South Africa: a population-based record linkage study, March-December 2020. Pan Afr Med J 2023; 46:24. [PMID: 38107342 PMCID: PMC10724037 DOI: 10.11604/pamj.2023.46.24.41047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/23/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction in South Africa, COVID-19 cases are notifiable and hospitalized cases are reported on a dedicated platform. It is crucial to estimate the duration of SARS-CoV-2 shedding to inform public health interventions. We aimed to estimate viral shedding time among laboratory-confirmed COVID-19 cases in South Africa. Methods we analyzed COVID-19 PCR results from 5 March to 31 December 2020. We included cases with at least 2 consecutive positive PCR tests and a subsequent negative test. We performed multiple linear regression to determine the association between shedding time and predictor variables (age, sex, admission status and province). We included 2752 cases that met the inclusion criteria. Results about 39.9% (1099/2752) of participants were inpatients and 60.1% (1653/2752) were outpatients. The median shedding time was 17 days (range: 1-128). There was no difference in shedding time between males and females and between hospitalized patients and outpatients. Individuals aged 0-4 years had the lowest shedding time (median: 14 days, range: 1-72). After adjusting for age, sex and province, shedding time was shorter for hospitalized patients compared to outpatients (co-efficient: -0.14, CI: -0.24 - -0.03, P-value: 0.014). Six provinces (KwaZulu-Natal, Gauteng, Limpopo, North West, Mpumalanga, and Western Cape) had a significant association with shedding time. Conclusion the duration of viral shedding within our population varies from 1-128 days. Although prolonged shedding might not necessarily indicate infectiousness, individual patient monitoring and management are needed for patients with prolonged shedding. Further studies are required to explore the association between comorbidities and SARS-CoV-2 shedding time.
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Affiliation(s)
- Carroll Tshabane
- South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Lazarus Kuonza
- South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Hetani Mdose
- South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Alfred Musekiwa
- South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nkengafac Villyen Motaze
- South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
- Medicine Usage in South Africa, School of Pharmacy, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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20
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Huang R, Peng X, Yu S, Tian Y, Gao C. Attitudes and intentions toward seeking professional psychological help among Chinese healthcare workers during the COVID-19 pandemic. Front Psychiatry 2023; 14:1223895. [PMID: 37779617 PMCID: PMC10539927 DOI: 10.3389/fpsyt.2023.1223895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Background It has been suggested that healthcare workers (HCWs) are experiencing massive stressors that threaten their mental health during the COVID-19 pandemic, but little is known about their attitudes and intentions toward seeking professional psychological help. This study aimed to investigate the attitudes and intentions of Chinese HCWs toward seeking professional psychological help during the COVID-19 pandemic and the associated factors. Methods A total of 1,224 Chinese HCWs working in hospitals were recruited online from 12 hospitals in Hunan province in China for a survey conducted in November 2022. The Chinese version of the attitudes toward seeking professional psychological help scale-short form (ATSPPH-SF) and the general help-seeking questionnaire (GHSQ) were separately used to assess the attitudes and intentions of the respondents toward seeking professional psychological help. Demographic and socio-psychological data were collected using a self-developed questionnaire, the perceived social support scale, the self-stigma of seeking help scale, and the patient health questionnaire-9 scale. Results The 1,208 HCWs in the final analysis showed relatively negative attitudes and low intentions toward seeking professional psychological help during the COVID-19 pandemic. Results of the multiple linear regression analysis showed that female sex (p = 0.031), experience of psychological learning (p < 0.001), and social support (p < 0.001) had a positive predictive effect on the attitudes of these HCWs toward seeking professional psychological help, whereas self-stigma of seeking help (p < 0.001) and depressive symptoms (p < 0.001) exerted negative effects. Moreover, experience of psychological learning (p = 0.004) and social support (p < 0.001) had a positive predictive effect on the intentions of these HCWs toward seeking professional psychological help, whereas divorced marital status (p = 0.011) and self-stigma of seeking help (p < 0.001) exerted negative effects. Conclusion The overall attitudes and intentions of HCWs toward seeking professional psychological help were not optimistic. Effective interventions targeted at influencing factors should be formulated to promote the professional psychological help-seeking attitudes and intentions of HCWs who are at risk of developing mental health problems.
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Affiliation(s)
- Ruirui Huang
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Xiaoyan Peng
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Shuai Yu
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Yumei Tian
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Chuanying Gao
- Department of Nursing, The First Affiliated Hospital of Hunan University of Medicine, Huaihua, China
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21
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Tan J, Shen Y, Ge Y, Martinez L, Huang H. Age-related model for estimating the symptomatic and asymptomatic transmissibility of COVID-19 patients. Biometrics 2023; 79:2525-2536. [PMID: 36517992 PMCID: PMC9877699 DOI: 10.1111/biom.13814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 11/16/2022] [Accepted: 11/25/2022] [Indexed: 12/16/2022]
Abstract
Estimation of age-dependent transmissibility of COVID-19 patients is critical for effective policymaking. Although the transmissibility of symptomatic cases has been extensively studied, asymptomatic infection is understudied due to limited data. Using a dataset with reliably distinguished symptomatic and asymptomatic statuses of COVID-19 cases, we propose an ordinary differential equation model that considers age-dependent transmissibility in transmission dynamics. Under a Bayesian framework, multi-source information is synthesized in our model for identifying transmissibility. A shrinkage prior among age groups is also adopted to improve the estimation behavior of transmissibility from age-structured data. The added values of accounting for age-dependent transmissibility are further evaluated through simulation studies. In real-data analysis, we compare our approach with two basic models using the deviance information criterion (DIC) and its extension. We find that the proposed model is more flexible for our epidemic data. Our results also suggest that the transmissibility of asymptomatic infections is significantly lower (on average, 76.45% with a credible interval (27.38%, 88.65%)) than that of symptomatic cases. In both symptomatic and asymptomatic patients, the transmissibility mainly increases with age. Patients older than 30 years are more likely to develop symptoms with higher transmissibility. We also find that the transmission burden of asymptomatic cases is lower than that of symptomatic patients.
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Affiliation(s)
- Jianbin Tan
- School of MathematicsSun Yat‐sen UniversityGuangzhouChina
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public HealthUniversity of GeorgiaAthensGeorgiaUSA
| | - Yang Ge
- School of Health ProfessionsUniversity of Southern MississippiHattiesburgMississippiUSA
| | | | - Hui Huang
- School of MathematicsSun Yat‐sen UniversityGuangzhouChina
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22
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Xie G, Wang L, Zhang J. How are countries responding differently to COVID-19: a systematic review of guidelines on isolation measures. Front Public Health 2023; 11:1190519. [PMID: 37719732 PMCID: PMC10502310 DOI: 10.3389/fpubh.2023.1190519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/08/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Isolation strategies have been implemented in numerous countries worldwide during the ongoing community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, various countries and organizations have implemented their isolation measures at varying intensities, even during the same period. Therefore, we systematically reviewed the key information contained in currently available guidelines regarding the isolation of the general population, aiming to better identify the heterogeneity of the current isolation strategies. Methods We conducted searches in four evidence-based medicine (EBM) databases and five guideline websites to identify guidelines, guidance, protocols, and policy documents published by authoritative advisory bodies or healthcare organizations, which provided information on the implementation of isolation for general populations with COVID-19. One author extracted data using a standardized data extraction checklist, and a second author double-checked all extractions for completeness and correctness. Discrepancies were resolved through discussion. The information extracted from the included articles was summarized both narratively and using tables. Results We included 15 articles that provided information on isolation measures recommended by nine different countries and organizations. The included articles consistently recommended isolating individuals with a positive COVID-19 test, regardless of the presence of symptoms. However, there were variations in the duration of isolation, and substantial differences also existed in the criteria for ending the isolation of COVID-19 patients. Conclusion Different countries and organizations have substantial differences in their isolation policies. This reminds us that scientifically sound guidelines on isolation that balance the risk of prematurely ending isolation with the burden of prolonged isolation are a crucial topic of discussion when faced with a pandemic.
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Affiliation(s)
- Guangmei Xie
- Reproductive Medicine Center, Gansu Maternal and Child Health Care Hospital, Lanzhou, Gansu, China
- Reproductive Medicine Center, Gansu Provincial Central Hospital, Lanzhou, Gansu, China
| | - Li Wang
- Reproductive Medicine Center, Gansu Maternal and Child Health Care Hospital, Lanzhou, Gansu, China
- Reproductive Medicine Center, Gansu Provincial Central Hospital, Lanzhou, Gansu, China
| | - Jun Zhang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
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23
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Breulmann M, Kallies R, Bernhard K, Gasch A, Müller RA, Harms H, Chatzinotas A, van Afferden M. A long-term passive sampling approach for wastewater-based monitoring of SARS-CoV-2 in Leipzig, Germany. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 887:164143. [PMID: 37182773 PMCID: PMC10181866 DOI: 10.1016/j.scitotenv.2023.164143] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
Wastewater-based monitoring of SARS-CoV-2 has become a promising and useful tool in tracking the potential spread or dynamics of the virus. Its recording can be used to predict how the potential number of infections in a population will develop. Recent studies have shown that the use of passive samplers is also suitable for the detection of SARS-CoV-2 genome copies (GC) in wastewater. They can be used at any site, provide timely data and may collect SARS-CoV-2 GC missed by traditional sampling methods. Therefore, the aim of this study was to evaluate the suitability of passive samplers for the detection of SARS-CoV-2 GC in wastewater in the long-term at two different scales. Polyethylene-based plastic passive samplers were deployed at the city-scale level of Leipzig at 13 different locations, with samples being taken from March 2021 to August 2022. At the smaller city district level, three types of passive samplers (cotton-cloth, unravelled polypropylene plastic rope and polyethylene-based plastic strips) were used and sampled on a weekly basis from March to August 2022. The results are discussed in relation to wastewater samples taken at the individual passive sampling point. Our results show that passive samplers can indicate at a city-scale level an accurate level of positive infections in the population (positive-rate: 86 %). On a small-scale level, the use of passive samplers was also feasible and effective to detect SARS-CoV-2 GC easily and cost-effectively, mirroring a similar trend to that at a city-scale level. Thus, this study demonstrated that passive samplers provide reproducible SARS-CoV-2 GC signals from wastewater and a time-integrated measurement of the sampled matrix with greater sensitivity compared to wastewater. We thus recommend the use of passive samplers as an alternative method for wastewater-based epidemiology. Passive samplers can in particular be considered for a better estimation of infections compared to incidence levels.
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Affiliation(s)
- Marc Breulmann
- Centre for Environmental Biotechnology, Helmholtz Centre for Environmental Research-UFZ, Permoserstraße 15, 04318 Leipzig, Germany.
| | - René Kallies
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research-UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Katy Bernhard
- Centre for Environmental Biotechnology, Helmholtz Centre for Environmental Research-UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Andrea Gasch
- Wastewater Monitoring Department, Kommunale Wasserwerke Leipzig GmbH, Johannisgasse 7-9, 04103 Leipzig, Germany
| | - Roland Arno Müller
- Centre for Environmental Biotechnology, Helmholtz Centre for Environmental Research-UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Hauke Harms
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research-UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Antonis Chatzinotas
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research-UFZ, Permoserstraße 15, 04318 Leipzig, Germany; Institute of Biology, Leipzig University, 04103 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, 04103 Leipzig, Germany
| | - Manfred van Afferden
- Centre for Environmental Biotechnology, Helmholtz Centre for Environmental Research-UFZ, Permoserstraße 15, 04318 Leipzig, Germany
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24
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Han J, Baek HJ, Noh E, Yoon K, Kim JA, Ryu S, Lee KO, Park NY, Jung E, Kim S, Lee H, Hwang YS, Jung J, Lee HJ, Cho SI, Oh S, Kim M, Oh CM, Yu B, Hong YS, Kim K, Jung S, Han MA, Lee MS, Lee JJ, Hwangbo Y, Yim HW, Kim YM, Lee J, Lee WY, Park JH, Oh S, Jo HS, Kim H, Kang G, Nam HS, Lee JH, Oh GJ, Shin MH, Ryu S, Hwang TY, Park SW, Kim SK, Seol R, Park KS, Kim SY, Kwon JW, Kim SS, Kim B, Lee JW, Jang EY, Kim AR, Nam J, Lee SY, Kim DH. Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample. Epidemiol Health 2023; 45:e2023075. [PMID: 37591786 PMCID: PMC10728614 DOI: 10.4178/epih.e2023075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/13/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVES We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
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Affiliation(s)
- Jina Han
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Hye Jin Baek
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Eunbi Noh
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Kyuhyun Yoon
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Jung Ae Kim
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | | | - No Yai Park
- Graduate School of Public Health, Inje University, Seoul, Korea
| | - Eunok Jung
- Department of Mathematics, Konkuk University, Seoul, Korea
| | - Sangil Kim
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Jaehun Jung
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Hun Jae Lee
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sung-il Cho
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | | | | | - Chang-Mo Oh
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Byengchul Yu
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
| | - Young-Seoub Hong
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Keonyeop Kim
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sunjae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ah Han
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Moo-Sik Lee
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jung-Jeung Lee
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Young Hwangbo
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae-Hyun Park
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Sungsoo Oh
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hyeongsu Kim
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Gilwon Kang
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Soyeon Ryu
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Tae-Yoon Hwang
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
| | - Soon-Woo Park
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
| | - Sang Kyu Kim
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Roma Seol
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Su Young Kim
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jun-wook Kwon
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sung Soon Kim
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Byoungguk Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - June-Woo Lee
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Eun Young Jang
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Ah-Ra Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - Jeonghyun Nam
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
| | - The Korea Community Health Survey Group
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, Korea
- Department of Nursing, Kyungmin University, Uijeongbu, Korea
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
- Gallup Korea, Seoul, Korea
- Graduate School of Public Health, Inje University, Seoul, Korea
- Department of Mathematics, Konkuk University, Seoul, Korea
- Department of Internal Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
- Seegene Medical Foundation, Seoul, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Korea
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
- MAPO-gu Public Health Center, Seoul, Korea
- GUNPO-si Public Health Center, Gunpo, Korea
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Preventive Medicine, Kosin University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, Korea
- Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
- Department of Occupational & Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Health Policy and Management, Kangwon National University School of Medicine, Chuncheon, Korea
- Department of Preventive Medicine, Konkuk University School of Medicine, Seoul, Korea
- Department of Health Information and Management, Chungbuk National University College of Medicine, Cheongju, Korea
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
- Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan, Korea
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Gyeongsan, Korea
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
- National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Center for Vaccine Research, National Institute of Infectious Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju, Korea
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Dong-Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
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25
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Faruque MRJ, Bikker FJ, Laine ML. Comparing SARS-CoV-2 Viral Load in Human Saliva to Oropharyngeal Swabs, Nasopharyngeal Swabs, and Sputum: A Systematic Review and Meta-Analysis. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:5807370. [PMID: 37600753 PMCID: PMC10435302 DOI: 10.1155/2023/5807370] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/04/2022] [Accepted: 07/27/2023] [Indexed: 08/22/2023]
Abstract
A systematic review and meta-analysis were conducted to investigate the SARS-CoV-2 viral load in human saliva and compared it with the loads in oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, the salivary viral loads of symptomatic and asymptomatic COVID-19 patients were compared. Searches were conducted using four electronic databases: PubMed, Embase, Scopus, and Web of Science, for studies published on SARS-CoV-2 loads expressed by CT values or copies/mL RNA. Three reviewers evaluated the included studies to confirm eligibility and assessed the risk of bias. A total of 37 studies were included. Mean CT values in saliva ranged from 21.5 to 39.6 and mean copies/mL RNA ranged from 1.91 × 101 to 6.98 × 1011. Meta-analysis revealed no significant differences in SARS-CoV-2 load in saliva compared to oropharyngeal swabs, nasopharyngeal swabs, and sputum. In addition, no significant differences were observed in the salivary viral load of symptomatic and asymptomatic COVID-19 patients. We conclude that saliva specimen can be used as an alternative for SARS-CoV-2 detection in oropharyngeal swabs, nasopharyngeal swabs, and sputum.
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Affiliation(s)
- Mouri R. J. Faruque
- Department of Periodontology, Academic Center for Dentistry Amsterdam, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam, Netherlands
- Department of Oral Biochemistry, Academic Center for Dentistry Amsterdam, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam, Netherlands
| | - Floris J. Bikker
- Department of Oral Biochemistry, Academic Center for Dentistry Amsterdam, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam, Netherlands
| | - Marja L. Laine
- Department of Periodontology, Academic Center for Dentistry Amsterdam, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam, Netherlands
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26
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Flood MT, Sharp J, Bruggink J, Cormier M, Gomes B, Oldani I, Zimmy L, Rose JB. Understanding the efficacy of wastewater surveillance for SARS-CoV-2 in two diverse communities. PLoS One 2023; 18:e0289343. [PMID: 37535602 PMCID: PMC10399835 DOI: 10.1371/journal.pone.0289343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
During the COVID-19 pandemic, wastewater-based surveillance has been shown to be a useful tool for monitoring the spread of disease in communities and the emergence of new viral variants of concern. As the pandemic enters its fourth year and clinical testing has declined, wastewater offers a consistent non-intrusive way to monitor community health in the long term. This study sought to understand how accurately wastewater monitoring represented the actual burden of disease between communities. Two communities varying in size and demographics in Michigan were monitored for SARS-CoV-2 in wastewater between March of 2020 and February of 2022. Additionally, each community was monitored for SARS-CoV-2 variants of concern from December 2020 to February 2022. Wastewater results were compared with zipcode and county level COVID-19 case data to determine which scope of clinical surveillance was most correlated with wastewater loading. Pearson r correlations were highest in the smaller of the two communities (population of 25,000) for N1 GC/person/day with zipcode level case data, and date of the onset of symptoms (r = 0.81). A clear difference was seen with more cases and virus signals in the wastewater of the larger community (population 110,000) when examined based on vaccine status, which reached only 50%. While wastewater levels of SARS-CoV-2 had a lower correlation to cases in the larger community, the information was still seen as valuable in supporting public health actions and further data including vaccination status should be examined in the future.
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Affiliation(s)
- Matthew T Flood
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, Michigan, United States of America
| | - Josh Sharp
- Department of Biology, Northern Michigan University, Marquette, Michigan, United States of America
| | - Jennifer Bruggink
- Department of Biology, Northern Michigan University, Marquette, Michigan, United States of America
| | - Molly Cormier
- Department of Biology, Northern Michigan University, Marquette, Michigan, United States of America
| | - Bailey Gomes
- Department of Biology, Northern Michigan University, Marquette, Michigan, United States of America
| | - Isabella Oldani
- Department of Biology, Northern Michigan University, Marquette, Michigan, United States of America
| | - Lauren Zimmy
- Department of Biology, Northern Michigan University, Marquette, Michigan, United States of America
| | - Joan B Rose
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, Michigan, United States of America
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27
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de Graaf M, Langeveld J, Post J, Carrizosa C, Franz E, Izquierdo-Lara RW, Elsinga G, Heijnen L, Been F, van Beek J, Schilperoort R, Vriend R, Fanoy E, de Schepper EIT, Koopmans MPG, Medema G. Capturing the SARS-CoV-2 infection pyramid within the municipality of Rotterdam using longitudinal sewage surveillance. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 883:163599. [PMID: 37100150 PMCID: PMC10125208 DOI: 10.1016/j.scitotenv.2023.163599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/07/2023] [Accepted: 04/15/2023] [Indexed: 05/03/2023]
Abstract
Despite high vaccination rates in the Netherlands, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to circulate. Longitudinal sewage surveillance was implemented along with the notification of cases as two parts of the surveillance pyramid to validate the use of sewage for surveillance, as an early warning tool, and to measure the effect of interventions. Sewage samples were collected from nine neighborhoods between September 2020 and November 2021. Comparative analysis and modeling were performed to understand the correlation between wastewater and case trends. Using high resolution sampling, normalization of wastewater SARS-CoV-2 concentrations, and 'normalization' of reported positive tests for testing delay and intensity, the incidence of reported positive tests could be modeled based on sewage data, and trends in both surveillance systems coincided. The high collinearity implied that high levels of viral shedding around the onset of disease largely determined SARS-CoV-2 levels in wastewater, and that the observed relationship was independent of variants of concern and vaccination levels. Sewage surveillance alongside a large-scale testing effort where 58 % of a municipality was tested, indicated a five-fold difference in the number of SARS-CoV-2-positive individuals and reported cases through standard testing. Where trends in reported positive cases were biased due to testing delay and testing behavior, wastewater surveillance can objectively display SARS-CoV-2 dynamics for both small and large locations and is sensitive enough to measure small variations in the number of infected individuals within or between neighborhoods. With the transition to a post-acute phase of the pandemic, sewage surveillance can help to keep track of re-emergence, but continued validation studies are needed to assess the predictive value of sewage surveillance with new variants. Our findings and model aid in interpreting SARS-CoV-2 surveillance data for public health decision-making and show its potential as one of the pillars of future surveillance of (re)emerging viruses.
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Affiliation(s)
- Miranda de Graaf
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands; Pandemic and Disaster Preparedness Centre Rotterdam and Delft, the Netherlands.
| | - Jeroen Langeveld
- Partners4urbanwater, Nijmegen, the Netherlands; Delft University of Technology, Stevinweg 1, 2628 CN Delft, the Netherlands
| | - Johan Post
- Partners4urbanwater, Nijmegen, the Netherlands
| | - Christian Carrizosa
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Eelco Franz
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ray W Izquierdo-Lara
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Goffe Elsinga
- KWR Water Research Institute, Groningenhaven 7, 3433 PE Nieuwegein, the Netherlands
| | - Leo Heijnen
- KWR Water Research Institute, Groningenhaven 7, 3433 PE Nieuwegein, the Netherlands
| | - Frederic Been
- KWR Water Research Institute, Groningenhaven 7, 3433 PE Nieuwegein, the Netherlands
| | - Janko van Beek
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Rianne Vriend
- Regional Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Ewout Fanoy
- Regional Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Evelien I T de Schepper
- Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands; Pandemic and Disaster Preparedness Centre Rotterdam and Delft, the Netherlands
| | - Gertjan Medema
- Pandemic and Disaster Preparedness Centre Rotterdam and Delft, the Netherlands; KWR Water Research Institute, Groningenhaven 7, 3433 PE Nieuwegein, the Netherlands; Delft University of Technology, Stevinweg 1, 2628 CN Delft, the Netherlands
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28
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Kim PY, Kim AY, Newman JJ, Cella E, Bishop TC, Huwe PJ, Uchakina ON, McKallip RJ, Mack VL, Hill MP, Ogungbe IV, Adeyinka O, Jones S, Ware G, Carroll J, Sawyer JF, Densmore KH, Foster M, Valmond L, Thomas J, Azarian T, Queen K, Kamil JP. A collaborative approach to improving representation in viral genomic surveillance. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001935. [PMID: 37467165 PMCID: PMC10355392 DOI: 10.1371/journal.pgph.0001935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/05/2023] [Indexed: 07/21/2023]
Abstract
The lack of routine viral genomic surveillance delayed the initial detection of SARS-CoV-2, allowing the virus to spread unfettered at the outset of the U.S. epidemic. Over subsequent months, poor surveillance enabled variants to emerge unnoticed. Against this backdrop, long-standing social and racial inequities have contributed to a greater burden of cases and deaths among minority groups. To begin to address these problems, we developed a new variant surveillance model geared toward building 'next generation' genome sequencing capacity at universities in or near rural areas and engaging the participation of their local communities. The resulting genomic surveillance network has generated more than 1,000 SARS-CoV-2 genomes to date, including the first confirmed case in northeast Louisiana of Omicron, and the first and sixth confirmed cases in Georgia of the emergent BA.2.75 and BQ.1.1 variants, respectively. In agreement with other studies, significantly higher viral gene copy numbers were observed in Delta variant samples compared to those from Omicron BA.1 variant infections, and lower copy numbers were seen in asymptomatic infections relative to symptomatic ones. Collectively, the results and outcomes from our collaborative work demonstrate that establishing genomic surveillance capacity at smaller academic institutions in rural areas and fostering relationships between academic teams and local health clinics represent a robust pathway to improve pandemic readiness.
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Affiliation(s)
- Paul Y. Kim
- Department of Biological Sciences, Grambling State University, Grambling, LA, United States of America
| | - Audrey Y. Kim
- Department of Biological Sciences, Grambling State University, Grambling, LA, United States of America
| | - Jamie J. Newman
- School of Biological Sciences, Louisiana Tech University, Ruston, LA, United States of America
| | - Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, United States of America
| | - Thomas C. Bishop
- Physics and Chemistry Programs, Louisiana Tech University, Ruston, LA, United States of America
| | - Peter J. Huwe
- Mercer University School of Medicine, Macon, GA, United States of America
| | - Olga N. Uchakina
- Mercer University School of Medicine, Macon, GA, United States of America
| | - Robert J. McKallip
- Mercer University School of Medicine, Macon, GA, United States of America
| | - Vance L. Mack
- Mercer Medicine, Macon, GA, United States of America
| | | | - Ifedayo Victor Ogungbe
- Department of Chemistry, Jackson State University, Jackson, MS, United States of America
| | - Olawale Adeyinka
- Department of Chemistry, Jackson State University, Jackson, MS, United States of America
| | - Samuel Jones
- Health Services Center, Jackson State University, Jackson, MS, United States of America
| | - Gregory Ware
- Center of Excellence for Emerging Viral Threats, Louisiana State University Health Shreveport, Shreveport, LA, United States of America
| | - Jennifer Carroll
- Center of Excellence for Emerging Viral Threats, Louisiana State University Health Shreveport, Shreveport, LA, United States of America
| | - Jarrod F. Sawyer
- Center of Excellence for Emerging Viral Threats, Louisiana State University Health Shreveport, Shreveport, LA, United States of America
| | - Kenneth H. Densmore
- Center of Excellence for Emerging Viral Threats, Louisiana State University Health Shreveport, Shreveport, LA, United States of America
| | - Michael Foster
- School of Biological Sciences, Louisiana Tech University, Ruston, LA, United States of America
| | - Lescia Valmond
- Department of Biological Sciences, Grambling State University, Grambling, LA, United States of America
| | - John Thomas
- Department of Biological Sciences, Grambling State University, Grambling, LA, United States of America
| | - Taj Azarian
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, United States of America
| | - Krista Queen
- Center of Excellence for Emerging Viral Threats, Louisiana State University Health Shreveport, Shreveport, LA, United States of America
| | - Jeremy P. Kamil
- Center of Excellence for Emerging Viral Threats, Louisiana State University Health Shreveport, Shreveport, LA, United States of America
- Department of Microbiology and Immunology, Louisiana State University Health Shreveport, Shreveport, LA, United States of America
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29
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Do KH, Yang J, Do OS, Yoo SJ. Epidemiological analysis of coronavirus disease (COVID-19) patients on ships arriving at Busan port in Korea, 2020. PLoS One 2023; 18:e0288064. [PMID: 37450548 PMCID: PMC10348537 DOI: 10.1371/journal.pone.0288064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/17/2023] [Indexed: 07/18/2023] Open
Abstract
Quarantine played an important role in preventing the spread of infectious diseases between countries in the early stages of the COVID-19 outbreak. In particular, in ports, infection during transit can cause a large number of patients on board ships and can flow into the community. In this study investigated cause of the cause of transmission in ships and suggested the way of preventing secondary transmission by analyzing clinical and epidemiological characteristics of COVID-19 patients identified at Busan Port (South Korea) in 2020. During the study period, out of 19,396 ships that arrived at Busan Port, 50 ships had COVID-19 confirmed cases. Among the 50 ships, type of deep-sea fishing vessels (24 ships, 48.0%), ships weighing less than 5,000 tons (31 ships, 62.0%), and ships from Russia (41 ships, 82.0%) had the highest positivity rates. Total 283 of the 25,450 arrivals tested positive for COVID-19 (a positivity rate of 1.1%), and 270 (95.4%) were asymptomatic. Moreover, the number of COVID-19 patients increased with the duration of the waiting period between arrival and sample collection (12.7% to 37.4%), and the positivity rate was significantly higher for those working as stewards (64.3%). These results indicate secondary transmission was active on board ships and that infection among stewards importantly contributed to group outbreaks. In addition, onboard residence time after arrival significantly elevated to COVID-19 positivity rates, indicating that rapid isolation, as determined using various screening techniques, might be effective at preventing onboard transmission and subsequent community outbreaks.
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Affiliation(s)
- Kee Hun Do
- Gimhae Airport National Quarantine Station, Gyeongnam Regional Disease Response Center, Korea Disease Control and Prevention Agency, Busan, Korea
| | - Jinseon Yang
- Busan National Quarantine Station, Gyeongnam Regional Disease Response Center, Korea Disease Control and Prevention Agency, Busan, Korea
| | - Ok Sook Do
- Busan National Quarantine Station, Gyeongnam Regional Disease Response Center, Korea Disease Control and Prevention Agency, Busan, Korea
| | - Seok-Ju Yoo
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea
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30
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Heudobler M, Baurecht H, Schmied H, Heudobler D, Jochem C, Sedlmeier AM, Weber A, Bauernfeind S, Leitzmann M, Salzberger B, Lampl BMJ. Association of epidemiological and clinical features with PCR cycle threshold values of SARS-CoV-2 infection: a cross-sectional study. Pathog Glob Health 2023; 117:476-484. [PMID: 36519354 PMCID: PMC10262808 DOI: 10.1080/20477724.2022.2158003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The cycle threshold (Ct) in quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR) is inversely correlated to the amount of viral nucleic acid or viral load and can be regarded as an indicator of infectivity. We examined the association of socio-demographic and clinical characteristics of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) polymerase chain reaction (PCR) positive cases with PCR cycle threshold (Ct) values at the time of diagnosis. SARS-CoV-2 cases reported between 12 October 2020 and 24 January 2021 in Regensburg were analyzed employing bivariate and multivariable methods. We included 3,029 SARS-CoV-2 cases (31% asymptomatic at diagnosis) and analyzed the association of case characteristics with Ct values in 2,606 cases. Among symptomatic patients, cough (38.0%), rhinitis (32.4%), headache (32.0), and fever/chills (29.9%) were the most frequent complaints. Ct values ≤20 were more frequent in symptomatic cases (20.9% vs. 11.3%), whereas Ct values >30 were more common in asymptomatic cases (32.6% vs. 18.0%). Ct values >20 and ≤30 were most common in symptomatic and asymptomatic cases (48.0% vs 40.7%). We observed lower median Ct values of E and N gene in symptomatic cases. In a random forest model, the total number of symptoms, respiratory symptoms, and age were most strongly associated with low Ct values. In conclusion, certain symptoms and age were associated with lower Ct values. Ct values can be used as a pragmatic approach in estimating infectivity at the first notification of a case and, thus, in guiding containment measures.
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Affiliation(s)
- Marlies Heudobler
- Regensburg Department of Public Health, Altmühlstraße 3, Regensburg, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Helen Schmied
- Regensburg Department of Public Health, Altmühlstraße 3, Regensburg, Germany
| | - Daniel Heudobler
- Department of Internal Medicine 3, University Hospital Regensburg, Regensburg, Germany
| | - Carmen Jochem
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Anja M Sedlmeier
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Andrea Weber
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Stilla Bauernfeind
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Bernd Salzberger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Benedikt M J Lampl
- Regensburg Department of Public Health, Altmühlstraße 3, Regensburg, Germany
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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31
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Ebraham L, Xu C, Wang A, Hernandez C, Siclari N, Rajah D, Walter L, Marras SAE, Tyagi S, Fine DH, Daep CA, Chang TL. Oral Epithelial Cells Expressing Low or Undetectable Levels of Human Angiotensin-Converting Enzyme 2 Are Susceptible to SARS-CoV-2 Virus Infection In Vitro. Pathogens 2023; 12:843. [PMID: 37375533 DOI: 10.3390/pathogens12060843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The oral cavity is thought to be one of the portals for SARS-CoV-2 entry, although there is limited evidence of active oral infection by SARS-CoV-2 viruses. We assessed the capacity of SARS-CoV-2 to infect and replicate in oral epithelial cells. Oral gingival epithelial cells (hTERT TIGKs), salivary gland epithelial cells (A-253), and oral buccal epithelial cells (TR146), which occupy different regions of the oral cavity, were challenged with replication-competent SARS-CoV-2 viruses and with pseudo-typed viruses expressing SARS-CoV-2 spike proteins. All oral epithelial cells expressing undetectable or low levels of human angiotensin-converting enzyme 2 (hACE2) but high levels of the alternative receptor CD147 were susceptible to SARS-CoV-2 infection. Distinct viral dynamics were seen in hTERT TIGKs compared to A-253 and TR146 cells. For example, levels of viral transcripts were sustained in hTERT TIGKs but were significantly decreased in A-253 and TR146 cells on day 3 after infection. Analysis of oral epithelial cells infected by replication-competent SARS-CoV-2 viruses expressing GFP showed that the GFP signal and SARS-CoV-2 mRNAs were not evenly distributed. Furthermore, we found cumulative SARS-CoV-2 RNAs from released viruses in the media from oral epithelial cells on day 1 and day 2 after infection, indicating productive viral infection. Taken together, our results demonstrated that oral epithelial cells were susceptible to SARS-CoV-2 viruses despite low or undetectable levels of hACE2, suggesting that alternative receptors contribute to SARS-CoV-2 infection and may be considered for the development of future vaccines and therapeutics.
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Affiliation(s)
- Laith Ebraham
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Chuan Xu
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Annie Wang
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Cyril Hernandez
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Nicholas Siclari
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Divino Rajah
- Global Technology Center, Colgate-Palmolive Company, Piscataway, NJ 08855, USA
| | - Lewins Walter
- Global Technology Center, Colgate-Palmolive Company, Piscataway, NJ 08855, USA
| | - Salvatore A E Marras
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
- Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Sanjay Tyagi
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Daniel H Fine
- Department of Oral Biology, School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
| | - Carlo Amorin Daep
- Global Technology Center, Colgate-Palmolive Company, Piscataway, NJ 08855, USA
| | - Theresa L Chang
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
- Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USA
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Opsteen S, Files JK, Fram T, Erdmann N. The role of immune activation and antigen persistence in acute and long COVID. J Investig Med 2023; 71:545-562. [PMID: 36879504 PMCID: PMC9996119 DOI: 10.1177/10815589231158041] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/09/2023] [Accepted: 01/24/2023] [Indexed: 03/08/2023]
Abstract
In late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) triggered the global coronavirus disease 2019 (COVID-19) pandemic. Although most infections cause a self-limited syndrome comparable to other upper respiratory viral pathogens, a portion of individuals develop severe illness leading to substantial morbidity and mortality. Furthermore, an estimated 10%-20% of SARS-CoV-2 infections are followed by post-acute sequelae of COVID-19 (PASC), or long COVID. Long COVID is associated with a wide variety of clinical manifestations including cardiopulmonary complications, persistent fatigue, and neurocognitive dysfunction. Severe acute COVID-19 is associated with hyperactivation and increased inflammation, which may be an underlying cause of long COVID in a subset of individuals. However, the immunologic mechanisms driving long COVID development are still under investigation. Early in the pandemic, our group and others observed immune dysregulation persisted into convalescence after acute COVID-19. We subsequently observed persistent immune dysregulation in a cohort of individuals experiencing long COVID. We demonstrated increased SARS-CoV-2-specific CD4+ and CD8+ T-cell responses and antibody affinity in patients experiencing long COVID symptoms. These data suggest a portion of long COVID symptoms may be due to chronic immune activation and the presence of persistent SARS-CoV-2 antigen. This review summarizes the COVID-19 literature to date detailing acute COVID-19 and convalescence and how these observations relate to the development of long COVID. In addition, we discuss recent findings in support of persistent antigen and the evidence that this phenomenon contributes to local and systemic inflammation and the heterogeneous nature of clinical manifestations seen in long COVID.
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Affiliation(s)
- Skye Opsteen
- Division of Infectious Diseases, Department
of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jacob K Files
- Division of Infectious Diseases, Department
of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tim Fram
- Division of Infectious Diseases, Department
of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nathan Erdmann
- Division of Infectious Diseases, Department
of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Snipaitiene K, Zablockiene B, Sabaliauskaite R, Zukauskaite K, Matulyte E, Smalinskaite T, Paulauskas M, Zablockis R, Lopeta M, Gagilas J, Puriene A, Jancoriene L, Jarmalaite S. SARS-CoV-2 RT-qPCR Ct values in saliva and nasopharyngeal swab samples for disease severity prediction. J Oral Microbiol 2023; 15:2213106. [PMID: 37213664 PMCID: PMC10193917 DOI: 10.1080/20002297.2023.2213106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023] Open
Abstract
Background Comparison of clinical value of RT-qPCR-based SARS-CoV-2 tests performed on saliva samples (SSs) and nasopharyngeal swab samples (NPSs) for prediction of the COVID-19 disease severity. Methods Three paired SSs and NPSs collected every 3 days from 100 hospitalised COVID-19 patients during 2020 Jul-2021 Jan were tested by RT-qPCR for the original SARS-CoV-2 virus and compared to 150 healthy controls. Cases were divided into mild+moderate (Cohort I, N = 47) and severe disease (Cohort II, N = 53) cohorts and compared. Results SARS-CoV-2 was detected in 65% (91/140) vs. 53% (82/156) of NPSs and 49% (68/139) vs. 48% (75/157) of SSs collected from Cohort I and II, respectively, resulting in the total respective detection rates of 58% (173/296) vs. 48% (143/296) (P = 0.017). Ct values of SSs were lower than those of NPSs (mean Ct = 28.01 vs. 30.07, P = 0.002). Although Ct values of the first SSs were significantly lower in Cohort I than in Cohort II (P = 0.04), it became negative earlier (mean 11.7 vs. 14.8 days, P = 0.005). Multivariate Cox proportional hazards regression analysis showed that Ct value ≤30 from SSs was the independent predictor for severe COVID-19 (HR = 10.06, 95% CI: 1.84-55.14, P = 0.008). Conclusion Salivary RT-qPCR testing is suitable for SARS-CoV-2 infection control, while simple measurement of Ct values can assist in prediction of COVID-19 severity.
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Affiliation(s)
- Kristina Snipaitiene
- Institute of Biomedical Sciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
- Laboratory of Genetic Diagnostic, National Cancer Institute of Lithuania, Vilnius, Lithuania
| | - Birute Zablockiene
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rasa Sabaliauskaite
- Laboratory of Genetic Diagnostic, National Cancer Institute of Lithuania, Vilnius, Lithuania
| | - Kristina Zukauskaite
- Institute of Biomedical Sciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
- Laboratory of Genetic Diagnostic, National Cancer Institute of Lithuania, Vilnius, Lithuania
| | - Elzbieta Matulyte
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Mindaugas Paulauskas
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rolandas Zablockis
- Clinic of Chest Diseases, Immunology and Allergology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | | | - Alina Puriene
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ligita Jancoriene
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Sonata Jarmalaite
- Institute of Biomedical Sciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
- Laboratory of Genetic Diagnostic, National Cancer Institute of Lithuania, Vilnius, Lithuania
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Jubair M, Rahman S, Begum MN, Talha M, Musarrat R, Rahman AKMS, Uddin MS, Wen A, Ning Y, Nahar K, Rahman MZ, Rahman M. SARS-CoV-2 antigen detection by saliva; an alternative to nasopharyngeal specimen: A cross-sectional study. Health Sci Rep 2023; 6:e1275. [PMID: 37216057 PMCID: PMC10196438 DOI: 10.1002/hsr2.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
Background and Aims Saliva samples are less invasive and more convenient for patients than naso- and/or oropharynx swabs (NOS). However, there is no US Food and Drug Administration-approved severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen test kit, which can be useful in a prolonged pandemic to reduce transmission by allowing suspected individuals to self-sampling. We evaluated the performances of High sensitive AQ+ Rapid SARS-CoV-2 Antigen Test (AQ+ kit) using nasopharyngeal swabs (NPs) and saliva specimens from the same patients in laboratory conditions. Methods The real-time reverse transcription-polymerase chain reaction (rRT-PCR) test result was used for screening the inrolled individuals and compared as the gold standard. NP and saliva samples were collected from 100 rRT-PCR positives and 100 negative individuals and tested with an AQ+ kit. Results The AQ+ kit showed good performances in both NP and saliva samples with an overall accuracy of 98.5% and 94.0%, and sensitivity of 97.0% and 88.0%, respectively. In both cases, specificity was 100%. AQ+ kit performance with saliva was in the range of the World Health Organization recommended value. Conclusion xOur findings indicate that the saliva specimen can be used as an alternative and less invasive to NPs for quick and reliable SARS-CoV-2 antigen detection.
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Affiliation(s)
- Mohammad Jubair
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | - Sezanur Rahman
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | - Mst. Noorjahan Begum
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | - Muhammad Talha
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | - Raisha Musarrat
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | | | | | | | | | - Kamrun Nahar
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | - Mohammed Ziaur Rahman
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
| | - Mustafizur Rahman
- Virology Laboratory, Infectious Diseases Divisionicddr,b: International Centre for Diarrhoeal Disease Research, BangladeshDhakaBangladesh
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Abeldt P, Bains A, Barks M, Fellines G, Garbutt A, Lissy J, Milnes M, Myers K, Bick J, Rosenberg M. Decreasing the Risk for Transmission of SARS-CoV-2 During In-Person Visitation Within a State Prison System. JOURNAL OF CORRECTIONAL HEALTH CARE 2023. [PMID: 37093021 DOI: 10.1089/jchc.22.04.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
In congregate living settings when active coronavirus disease 2019 (COVID-19) transmission is present, limiting the scope of dental care to urgent and emergent treatment minimizes exposure risk for patients and staff. Engineering controls to mitigate aerosol production during dental procedures, including enhanced high-volume evacuation, high-efficiency particulate absorbing air filtration, and the use of a dental dam provide additional protection for dental providers and staff. Properly fitted N-95 respirators are of particular importance to limit COVID-19 transmission when SARS-CoV-2 containing aerosols may be present. When patients are known to be COVID-19 positive, the use of powered air-purifying respirators is appropriate. Further protection against the spread of disease among patients and staff may be provided by point-of-care testing for patients prior to dental procedures during outbreaks.
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Affiliation(s)
- Philip Abeldt
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
| | - Amardeep Bains
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
| | - Michael Barks
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
| | - George Fellines
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
| | - Arthur Garbutt
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
| | - Jeff Lissy
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
| | - Matthew Milnes
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Kevin Myers
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
| | - Joseph Bick
- California Correctional Health Care Services, Elk Grove, California, USA
| | - Morton Rosenberg
- California Correctional Health Care Services, Adult Correctional Dental Care, Elk Grove, California, USA
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Lyu X, Luo Z, Shao L, Awbi H, Lo Piano S. Safe CO 2 threshold limits for indoor long-range airborne transmission control of COVID-19. BUILDING AND ENVIRONMENT 2023; 234:109967. [PMID: 36597420 PMCID: PMC9801696 DOI: 10.1016/j.buildenv.2022.109967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/16/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
CO2-based infection risk monitoring is highly recommended during the current COVID-19 pandemic. However, the CO2 monitoring thresholds proposed in the literature are mainly for spaces with fixed occupants. Determining CO2 threshold is challenging in spaces with changing occupancy due to the co-existence of quanta and CO2 remaining from previous occupants. Here, we propose a new calculation framework for deriving safe excess CO2 thresholds (above outdoor level), C t, for various spaces with fixed/changing occupancy and analyze the uncertainty involved. We categorized common indoor spaces into three scenarios based on their occupancy conditions, e.g., fixed or varying infection ratios (infectors/occupants). We proved that the rebreathed fraction-based model can be applied directly for deriving C t in the case of a fixed infection ratio (Scenario 1 and Scenario 2). In the case of varying infection ratios (Scenario 3), C t derivation must follow the general calculation framework due to the existence of initial quanta/excess CO2. Otherwise, C t can be significantly biased (e.g., 260 ppm) when the infection ratio varies greatly. C t can vary significantly based on specific space factors such as occupant number, physical activity, and community prevalence, e.g., 7 ppm for gym and 890 ppm for lecture hall, indicating C t must be determined on a case-by-case basis. An uncertainty of up to 6 orders of magnitude for C t was found for all cases due to uncertainty in emissions of quanta and CO2, thus emphasizing the role of accurate emissions data in determining C t.
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Affiliation(s)
- Xiaowei Lyu
- School of the Built Environment, University of Reading, UK
| | - Zhiwen Luo
- Welsh School of Architecture, Cardiff University, UK
| | - Li Shao
- School of the Built Environment, University of Reading, UK
| | - Hazim Awbi
- School of the Built Environment, University of Reading, UK
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37
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Drain PK, Dalmat RR, Hao L, Bemer MJ, Budiawan E, Morton JF, Ireton RC, Hsiang TY, Marfatia Z, Prabhu R, Woosley C, Gichamo A, Rechkina E, Hamilton D, Montaño M, Cantera JL, Ball AS, Golez I, Smith E, Greninger AL, McElrath MJ, Thompson M, Grant BD, Meisner A, Gottlieb GS, Gale M. Duration of viral infectiousness and correlation with symptoms and diagnostic testing in non-hospitalized adults during acute SARS-CoV-2 infection: A longitudinal cohort study. J Clin Virol 2023; 161:105420. [PMID: 36913789 PMCID: PMC9981266 DOI: 10.1016/j.jcv.2023.105420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Guidelines for SARS-CoV-2 have relied on limited data on duration of viral infectiousness and correlation with COVID-19 symptoms and diagnostic testing. METHODS We enrolled ambulatory adults with acute SARS-CoV-2 infection and performed serial measurements of COVID-19 symptoms, nasal swab viral RNA, nucleocapsid (N) and spike (S) antigens, and replication-competent SARS-CoV-2 by viral growth in culture. We determined average time from symptom onset to a first negative test result and estimated risk of infectiousness, as defined by positive viral growth in culture. RESULTS Among 95 adults, median [interquartile range] time from symptom onset to first negative test result was 9 [5] days, 13 [6] days, 11 [4] days, and >19 days for S antigen, N antigen, culture growth, and viral RNA by RT-PCR, respectively. Beyond two weeks, virus growth and N antigen titers were rarely positive, while viral RNA remained detectable among half (26/51) of participants tested 21-30 days after symptom onset. Between 6-10 days from symptom onset, N antigen was strongly associated with culture positivity (relative risk=7.61, 95% CI: 3.01-19.22), whereas neither viral RNA nor symptoms were associated with culture positivity. During the 14 days following symptom onset, the presence of N antigen remained strongly associated (adjusted relative risk=7.66, 95% CI: 3.96-14.82) with culture positivity, regardless of COVID-19 symptoms. CONCLUSIONS Most adults have replication-competent SARS-CoV-2 for 10-14 after symptom onset. N antigen testing is a strong predictor of viral infectiousness and may be a more suitable biomarker, rather than absence of symptoms or viral RNA, to discontinue isolation within two weeks from symptom onset.
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Affiliation(s)
- Paul K Drain
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States; Division of Allergy and Infectious Diseases, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, United States.
| | - Ronit R Dalmat
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
| | - Linhui Hao
- Department of Immunology, Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA, United States; Center for Emerging & Re-emerging Infectious Diseases, University of Washington, Seattle, WA, United States
| | - Meagan J Bemer
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Elvira Budiawan
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Jennifer F Morton
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Renee C Ireton
- Department of Immunology, Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA, United States; Center for Emerging & Re-emerging Infectious Diseases, University of Washington, Seattle, WA, United States
| | - Tien-Ying Hsiang
- Department of Immunology, Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA, United States; Center for Emerging & Re-emerging Infectious Diseases, University of Washington, Seattle, WA, United States
| | - Zarna Marfatia
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Roshni Prabhu
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Claire Woosley
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Adanech Gichamo
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Elena Rechkina
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Daphne Hamilton
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | - Michalina Montaño
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States
| | | | | | - Inah Golez
- Department of Immunology, Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA, United States; Center for Emerging & Re-emerging Infectious Diseases, University of Washington, Seattle, WA, United States
| | - Elise Smith
- Department of Immunology, Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA, United States; Center for Emerging & Re-emerging Infectious Diseases, University of Washington, Seattle, WA, United States
| | - Alexander L Greninger
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States
| | - M Juliana McElrath
- Division of Allergy and Infectious Diseases, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, United States; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Matthew Thompson
- Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, United States
| | | | - Allison Meisner
- International Clinical Research Center, Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Geoffrey S Gottlieb
- Division of Allergy and Infectious Diseases, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, United States; Center for Emerging & Re-emerging Infectious Diseases, University of Washington, Seattle, WA, United States; Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, WA, United States; Environmental Health & Safety Department, University of Washington, Seattle, WA, United States
| | - Michael Gale
- Department of Immunology, Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA, United States; Center for Emerging & Re-emerging Infectious Diseases, University of Washington, Seattle, WA, United States
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Li L, Chen Z, Huang Y, Guo Z, Dong H, Xie Y, Zhou N, Zhou Z. Investigation of gauze and medical bottle co-pyrolysis on the product formation, reactivity, and reaction pathway of char, liquid oil, and gas. BIOMASS CONVERSION AND BIOREFINERY 2023:1-14. [PMID: 37363205 PMCID: PMC10024516 DOI: 10.1007/s13399-023-04006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 06/28/2023]
Abstract
Effective in-site treatment of medical waste has become a weak link in hospitals. Pyrolysis technology is a treatment method for medical waste that can enable rapid disposal in hospital settings and relieve environmental pressure, while also producing high-value products and reducing disposal costs. In this work, the effects of feedstock ratio and temperature on product yield and components of gauze (GA) and medical bottles (MB) co-pyrolysis have been investigated. The higher yield of solid products was obtained by co-pyrolysis of GA and MB at 400 ℃. With the addition of MB and an increase in temperature for the co-pyrolysis of GA and MB in a similar ratio, the pyrolysis oil and gas yields gradually increased. According to GC-MS analysis, co-feeding 75% MB to GA improved the alcohol content from 33.21% to a maximum yield of 59.8% at a pyrolysis temperature of 700 ℃. The content of aliphatic hydrocarbon reached 38.68% when the pyrolysis temperature and MB addition ratio were 700 °C and 75%, respectively. The GC data shows that the main gas components of co-pyrolysis of GA/MB were CH4 and H2, while the pyrolysis of pure GA or MB resulted in CO or CO2. Additionally, the solid carbon products obtained have an excellent pore structure. This strategy can benefit medical waste control and resource utilization for the low-cost disposal of medical waste and the acquisition of high-value resource products. Graphical Abstract
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Affiliation(s)
- Li Li
- Reproductive and Genetic Hospital Citic Xiangya, Changsha, 410128 People’s Republic of China
| | - Zhaoguang Chen
- School of Chemistry and Materials Science, Hunan Agricultural University, Changsha, 410128 People’s Republic of China
| | - Yingzhen Huang
- School of Chemistry and Materials Science, Hunan Agricultural University, Changsha, 410128 People’s Republic of China
| | - Zhenhao Guo
- School of Chemistry and Materials Science, Hunan Agricultural University, Changsha, 410128 People’s Republic of China
| | - Hang Dong
- School of Chemistry and Materials Science, Hunan Agricultural University, Changsha, 410128 People’s Republic of China
| | - Yu Xie
- School of Chemistry and Materials Science, Hunan Agricultural University, Changsha, 410128 People’s Republic of China
| | - Nan Zhou
- School of Chemistry and Materials Science, Hunan Agricultural University, Changsha, 410128 People’s Republic of China
- Hunan Engineering Research Center for Biochar, Changsha, 410128 People’s Republic of China
| | - Zhi Zhou
- School of Chemistry and Materials Science, Hunan Agricultural University, Changsha, 410128 People’s Republic of China
- Hunan Engineering Research Center for Biochar, Changsha, 410128 People’s Republic of China
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Qiu S, Chen Z, Zhu A, Zeng Q, Liu H, Liu X, Ye F, Jin Y, Wu J, Yang C, Wang Q, Chen F, Chen L, Tian S, Du X, Hu Q, Cheng J, Chen C, Li F, Sun J, Wang Y, Zhao J, Zhao J, Song H. Successful clearance of persistent SARS-CoV-2 asymptomatic infection following a single dose of Ad5-nCoV vaccine. Signal Transduct Target Ther 2023; 8:123. [PMID: 36922500 PMCID: PMC10015148 DOI: 10.1038/s41392-023-01345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 03/17/2023] Open
Abstract
Persistent asymptomatic (PA) SARS-CoV-2 infections have been identified. The immune responses in these patients are unclear, and the development of effective treatments for these patients is needed. Here, we report a cohort of 23 PA cases carrying viral RNA for up to 191 days. PA cases displayed low levels of inflammatory and interferon response, weak antibody response, diminished circulating follicular helper T cells (cTfh), and inadequate specific CD4+ and CD8+ T-cell responses during infection, which is distinct from symptomatic infections and resembling impaired immune activation. Administration of a single dose of Ad5-nCoV vaccine to 10 of these PA cases elicited rapid and robust antibody responses as well as coordinated B-cell and cTfh responses, resulting in successful viral clearance. Vaccine-induced antibodies were able to neutralize various variants of concern and persisted for over 6 months, indicating long-term protection. Therefore, our study provides an insight into the immune status of PA infections and highlights vaccination as a potential treatment for prolonged SARS-CoV-2 infections.
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Affiliation(s)
- Shaofu Qiu
- The Chinese PLA Center for Disease Control and Prevention, 100071, Beijing, China
| | - Zhao Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Airu Zhu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Qiuhui Zeng
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Hongbo Liu
- The Chinese PLA Center for Disease Control and Prevention, 100071, Beijing, China
| | - Xiaoqing Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Yingkang Jin
- Pediatric Pulmonary Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623, Guangzhou, Guangdong, China
| | - Jie Wu
- Guangdong Provincial Center for Disease Control and Prevention, 510399, Guangzhou, Guangdong, China
| | - Chaojie Yang
- The Chinese PLA Center for Disease Control and Prevention, 100071, Beijing, China
| | - Qi Wang
- The Chinese PLA Center for Disease Control and Prevention, 100071, Beijing, China
| | - Fangli Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Lan Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Sai Tian
- The Chinese PLA Center for Disease Control and Prevention, 100071, Beijing, China
| | - Xinying Du
- The Chinese PLA Center for Disease Control and Prevention, 100071, Beijing, China
| | - Qingtao Hu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Jinling Cheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Canjie Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Fang Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Jing Sun
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Yanqun Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China
| | - Jingxian Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China. .,Guangzhou Laboratory, Bio-island, 510320, Guangzhou, Guangdong, China.
| | - Jincun Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 510182, Guangzhou, Guangdong, China. .,Guangzhou Laboratory, Bio-island, 510320, Guangzhou, Guangdong, China. .,Institute of Infectious Disease, Guangzhou Eighth People's Hospital of Guangzhou Medical University, 510060, Guangzhou, Guangdong, China. .,Shanghai Institute for Advanced Immunochemical Studies, School of Life Science and Technology, ShanghaiTech University, 201210, Shanghai, China. .,National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, 518112, Shenzhen, Guangdong, China.
| | - Hongbin Song
- The Chinese PLA Center for Disease Control and Prevention, 100071, Beijing, China.
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Bhowmik R, Pardasani M, Mahajan S, Magar R, Joshi SV, Nair GA, Bhattacharjee AS, Abraham NM. Persistent olfactory learning deficits during and post-COVID-19 infection. CURRENT RESEARCH IN NEUROBIOLOGY 2023; 4:100081. [PMID: 36919010 PMCID: PMC9985517 DOI: 10.1016/j.crneur.2023.100081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/31/2022] [Accepted: 02/12/2023] [Indexed: 03/07/2023] Open
Abstract
Quantifying olfactory impairments can facilitate early detection of Coronavirus disease 2019 (COVID-19). Despite being a debated topic, many reports provide evidence for the neurotropism of SARS-CoV-2. However, a sensitive, specific, and accurate non-invasive method for quantifying persistent neurological impairments is missing to date. To quantify olfactory detectabilities and neurocognitive impairments in symptomatic COVID-19 patients during and post-infection periods, we used a custom-built olfactory-action meter (OAM) providing accurate behavioral readouts. Ten monomolecular odors were used for quantifying olfactory detectabilities and two pairs of odors were employed for olfactory matching tests. We followed cohorts of healthy subjects, symptomatic patients, and recovered subjects for probing olfactory learning deficits, before the Coronavirus Omicron variant was reported in India. Our method identifies severe and persistent olfactory dysfunctions in symptomatic patients during COVID-19 infection. Symptomatic patients and recovered subjects showed significant olfactory learning deficits during and post-infection periods, 4-18 months, in comparison to healthy subjects. On comparing olfactory fitness, we found differential odor detectabilities and olfactory function scores in symptomatic patients and asymptomatic carriers. Our results indicate probable long-term neurocognitive deficits in COVID-19 patients imploring the necessity of long-term tracking during post-infection period. Differential olfactory fitness observed in symptomatic patients and asymptomatic carriers demand probing mechanisms of potentially distinct infection routes.
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Affiliation(s)
- Rajdeep Bhowmik
- Laboratory of Neural Circuits and Behaviour (LNCB), Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 411008, India
| | - Meenakshi Pardasani
- Laboratory of Neural Circuits and Behaviour (LNCB), Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 411008, India
| | - Sarang Mahajan
- Laboratory of Neural Circuits and Behaviour (LNCB), Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 411008, India
| | - Rahul Magar
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals (BJGMC & SGH), Pune, Maharashtra, 411001, India
| | - Samir V. Joshi
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals (BJGMC & SGH), Pune, Maharashtra, 411001, India
| | - Ganesh Ashish Nair
- Laboratory of Neural Circuits and Behaviour (LNCB), Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 411008, India
| | - Anindya S. Bhattacharjee
- Laboratory of Neural Circuits and Behaviour (LNCB), Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 411008, India
| | - Nixon M. Abraham
- Laboratory of Neural Circuits and Behaviour (LNCB), Department of Biology, Indian Institute of Science Education and Research (IISER), Pune, Maharashtra, 411008, India
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41
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Charlotte N. High Rate of SARS-CoV-2 Transmission Due to Choir Practice in France at the Beginning of the COVID-19 Pandemic. J Voice 2023. [PMID: 33386191 DOI: 10.1101/2020.07.19.20145326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To document the case of a high transmission rate of SARS-CoV-2 generating a cluster linked to an indoor choir rehearsal hold at the beginning of the COVID-19 pandemic in France. METHOD Case study. Data were obtained via a questionnaire. RESULTS Twenty-seven participants, including 25 singers, 1 conductor and 1 accompanist attended a choir practice on March 12, 2020. The practice was indoor and took place in a non ventilated space of 45 m2. No choir member reported having been symptomatic for COVID-19 between March 2 and March 12.The mean age of the participants was 66.9 (range 35-86) years. The secondary attack rate was 70%: 19/27 participants were diagnosed with COVID-19 from 1 to 12 days after the rehearsal with a median of 5.1 days. Thirty-six percent of the cases needed a hospitalization (7/19), and 21% (4/19) were admitted to an ICU. The index cases were asymptomatic and possibly multiple. CONCLUSION In the absence of valid barrier measures to prevent COVID-19 transmission, indoor choir practice should be suspended during the SARSCoV-2 surging phases. Transmission of the virus among gatherings from asymptomatic cases is a crucial issue and a main challenge to COVID-19 control.
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Charlotte N. High Rate of SARS-CoV-2 Transmission Due to Choir Practice in France at the Beginning of the COVID-19 Pandemic. J Voice 2023; 37:292.e9-292.e14. [PMID: 33386191 PMCID: PMC7833901 DOI: 10.1016/j.jvoice.2020.11.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To document the case of a high transmission rate of SARS-CoV-2 generating a cluster linked to an indoor choir rehearsal hold at the beginning of the COVID-19 pandemic in France. METHOD Case study. Data were obtained via a questionnaire. RESULTS Twenty-seven participants, including 25 singers, 1 conductor and 1 accompanist attended a choir practice on March 12, 2020. The practice was indoor and took place in a non ventilated space of 45 m2. No choir member reported having been symptomatic for COVID-19 between March 2 and March 12.The mean age of the participants was 66.9 (range 35-86) years. The secondary attack rate was 70%: 19/27 participants were diagnosed with COVID-19 from 1 to 12 days after the rehearsal with a median of 5.1 days. Thirty-six percent of the cases needed a hospitalization (7/19), and 21% (4/19) were admitted to an ICU. The index cases were asymptomatic and possibly multiple. CONCLUSION In the absence of valid barrier measures to prevent COVID-19 transmission, indoor choir practice should be suspended during the SARSCoV-2 surging phases. Transmission of the virus among gatherings from asymptomatic cases is a crucial issue and a main challenge to COVID-19 control.
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43
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Abstract
SARS-CoV-2 viral load and detection of infectious virus in the respiratory tract are the two key parameters for estimating infectiousness. As shedding of infectious virus is required for onward transmission, understanding shedding characteristics is relevant for public health interventions. Viral shedding is influenced by biological characteristics of the virus, host factors and pre-existing immunity (previous infection or vaccination) of the infected individual. Although the process of human-to-human transmission is multifactorial, viral load substantially contributed to human-to-human transmission, with higher viral load posing a greater risk for onward transmission. Emerging SARS-CoV-2 variants of concern have further complicated the picture of virus shedding. As underlying immunity in the population through previous infection, vaccination or a combination of both has rapidly increased on a global scale after almost 3 years of the pandemic, viral shedding patterns have become more distinct from those of ancestral SARS-CoV-2. Understanding the factors and mechanisms that influence infectious virus shedding and the period during which individuals infected with SARS-CoV-2 are contagious is crucial to guide public health measures and limit transmission. Furthermore, diagnostic tools to demonstrate the presence of infectious virus from routine diagnostic specimens are needed.
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Affiliation(s)
- Olha Puhach
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Benjamin Meyer
- Centre for Vaccinology, Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Isabella Eckerle
- Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland.
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
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44
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Harris JD, Park SW, Dushoff J, Weitz JS. How time-scale differences in asymptomatic and symptomatic transmission shape SARS-CoV-2 outbreak dynamics. Epidemics 2023; 42:100664. [PMID: 36706626 PMCID: PMC9830934 DOI: 10.1016/j.epidem.2022.100664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/07/2022] [Accepted: 12/24/2022] [Indexed: 01/12/2023] Open
Abstract
Asymptomatic and symptomatic SARS-CoV-2 infections can have different characteristic time scales of transmission. These time-scale differences can shape outbreak dynamics as well as bias population-level estimates of epidemic strength, speed, and controllability. For example, prior work focusing on the initial exponential growth phase of an outbreak found that larger time scales for asymptomatic vs. symptomatic transmission can lead to under-estimates of the basic reproduction number as inferred from epidemic case data. Building upon this work, we use a series of nonlinear epidemic models to explore how differences in asymptomatic and symptomatic transmission time scales can lead to changes in the realized proportion of asymptomatic transmission throughout an epidemic. First, we find that when asymptomatic transmission time scales are longer than symptomatic transmission time scales, then the effective proportion of asymptomatic transmission increases as total incidence decreases. Moreover, these time-scale-driven impacts on epidemic dynamics are enhanced when infection status is correlated between infector and infectee pairs (e.g., due to dose-dependent impacts on symptoms). Next we apply these findings to understand the impact of time-scale differences on populations with age-dependent assortative mixing and in which the probability of having a symptomatic infection increases with age. We show that if asymptomatic generation intervals are longer than corresponding symptomatic generation intervals, then correlations between age and symptoms lead to a decrease in the age of infection during periods of epidemic decline (whether due to susceptible depletion or intervention). Altogether, these results demonstrate the need to explore the role of time-scale differences in transmission dynamics alongside behavioral changes to explain outbreak features both at early stages (e.g., in estimating the basic reproduction number) and throughout an epidemic (e.g., in connecting shifts in the age of infection to periods of changing incidence).
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Affiliation(s)
- Jeremy D Harris
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Sang Woo Park
- Department of Ecology and Evolutionary Biology, Princeton, NJ, USA.
| | - Jonathan Dushoff
- Department of Biology, McMaster University, Hamilton, Ontario, Canada; Department of Mathematics and Statistics, McMaster University, Hamilton, Ontario, Canada; M. G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada.
| | - Joshua S Weitz
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA; School of Physics, Georgia Institute of Technology, Atlanta, GA, USA; Institut de Biologie, École Normale Supérieure, Paris, France.
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45
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Kang W, Yang P, Dang B, Zhang W, Gang Y, Wang W, Ma C, Zhao Y, Zhang Y, Hao C, Quan H, Li J, Cao J, Kang W, Shang L. Dynamics of disease characteristics and viral RNA decay in patients with asymptomatic and mild infections during the Omicron wave in Shanghai, China: A retrospective cohort study. Int J Infect Dis 2023; 130:60-70. [PMID: 36849069 DOI: 10.1016/j.ijid.2023.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
OBJECTIVES Asymptomatic infections and mild diseases were more common during the Omicron outbreak in Shanghai, China in 2022. This study aimed to assess the characteristics and viral RNA decay between patients with asymptomatic and mild infections. METHODS A total of 55,111 patients infected with SARS-CoV-2 who were quarantined in the National Exhibition & Convention Center (Shanghai) Fangcang shelter hospital within 3 days after diagnosis from April 9 to May 23, 2022 were enrolled. The kinetics of cycle threshold (Ct) values of reverse transcription-polymerase chain reaction were assessed. The influencing factors for disease progression and the risk factors for the viral RNA shedding time (VST) were investigated. RESULTS On admission, 79.6% (43,852/55,111) of the cases were diagnosed with asymptomatic infections, and 20.4% were mild diseases. However, 78.0% of initially asymptomatic subjects developed mild diseases at the follow-up. The final proportion of asymptomatic infections was 17.5%. The median time of symptom onset, the duration of symptoms, and the VST were 2 days, 5 days, and 7 days, respectively. Female, age 19-40 years, underlying comorbidities with hypertension and diabetes, and vaccination were associated with higher risks of progressing to mildly symptomatic infections. In addition, mildly symptomatic infections were found to be associated with prolonged VST compared with asymptomatic infections. However, the kinetics of viral RNA decay and dynamics of Ct values were similar among asymptomatic subjects, patients with asymptomatic-to-mild infection, and patients with mild infection. CONCLUSION A large proportion of initially diagnosed asymptomatic Omicron infections is in the presymptomatic stage. The Omicron infection has a much shorter incubation period and VST than previous variants. The infectivity of asymptomatic infections and mildly symptomatic infections with Omicron is similar.
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Affiliation(s)
- Wen Kang
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Peng Yang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, China
| | - Bianli Dang
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wenjing Zhang
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Yi Gang
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Wei Wang
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Chunyan Ma
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Yanyan Zhao
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Ying Zhang
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Chunqiu Hao
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Huiqin Quan
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Jing Li
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Jiaojiao Cao
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China
| | - Wenzhen Kang
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an, China; The Third Branch of Fangcang Shelter Hospital of the National Exhibition and Convention Center, Shanghai, China.
| | - Lei Shang
- Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University, Xi'an, China.
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46
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Li Y, Harrison LJ, Chew KW, Currier JS, Wohl DA, Daar ES, Evering TH, Wu R, Giganti M, Ritz J, Javan AC, Coombs R, Moser C, Hughes MD, Eron JJ, Smith DM, Li JZ. Nasal and Plasma Severe Acute Respiratory Syndrome Coronavirus 2 RNA Levels Are Associated With Timing of Symptom Resolution in the ACTIV-2 Trial of Nonhospitalized Adults With Coronavirus Disease 2019. Clin Infect Dis 2023; 76:734-737. [PMID: 36210483 PMCID: PMC9619579 DOI: 10.1093/cid/ciac818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/14/2022] Open
Abstract
Acute Coronavirus Disease 2019 symptoms limit daily activities, but little is known about its association with severe acute respiratory syndrome coronavirus 2 viral burden. In this exploratory analysis of placebo recipients in the ACTIV-2/A5401 platform trial, we showed that high anterior nasal RNA levels and detectable plasma RNA were associated with delayed symptom improvement. Clinical Trials Registration. https://clinicaltrials.gov/ct2/show/NCT04518410.
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Affiliation(s)
- Yijia Li
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Linda J Harrison
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Kara W Chew
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA USA
| | - Judy S Currier
- David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA USA
| | - David A Wohl
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC USA
| | - Eric S Daar
- Lundquist Institute at Harbor-UCLA Medical Center, Los Angeles, CA USA
| | | | - Ryan Wu
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Mark Giganti
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Justin Ritz
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | | | - Robert Coombs
- Department of Laboratory Medicine & Pathology, University of Washington, Seattle, WA USA
| | - Carlee Moser
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Michael D Hughes
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Joseph J Eron
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC USA
| | - Davey M Smith
- Department of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Jonathan Z Li
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
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47
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Zach M, Greslehner GP. Understanding immunity: an alternative framework beyond defense and strength. BIOLOGY & PHILOSOPHY 2023; 38:7. [PMID: 36819127 PMCID: PMC9929241 DOI: 10.1007/s10539-023-09893-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 01/10/2023] [Indexed: 05/25/2023]
Abstract
In this paper we address the issue of how to think about immunity. Many immunological writings suggest a straightforward option: the view that the immune system is primarily a system of defense, which naturally invites the talk of strong immunity and strong immune response. Despite their undisputable positive role in immunology, such metaphors can also pose a risk of establishing a narrow perspective, omitting from consideration phenomena that do not neatly fit those powerful metaphors. Building on this analysis, we argue two things. First, we argue that the immune system is involved not only in defense. Second, by disentangling various possible meanings of 'strength' and 'weakness' in immunology, we also argue that such a construal of immunity generally contributes to the distortion of the overall picture of what the immune system is, what it does, and why it sometimes fails. Instead, we propose to understand the nature of the immune system in terms of contextuality, regulation, and trade-offs. We suggest that our approach provides lessons for a general understanding of the organizing principles of the immune system in health and disease. For all this to work, we discuss a wide range of immunological phenomena.
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Affiliation(s)
- Martin Zach
- Department of Analytic Philosophy, Institute of Philosophy, Czech Academy of Sciences, Jilská 352/1, 110 00 Prague, Czech Republic
| | - Gregor P. Greslehner
- Department of Philosophy, University of Vienna, Universitätsstraße 7, 1010 Vienna, Austria
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Yanson K, Laviers W, Suhaidi F, Greeley Z, Merryman C, Proctor R, Hall D, Neely L. Clinical performance evaluation of BD SARS-CoV-2 reagents for BD MAX TM System in asymptomatic individuals. Diagn Microbiol Infect Dis 2023; 105:115861. [PMID: 36495738 PMCID: PMC9671610 DOI: 10.1016/j.diagmicrobio.2022.115861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/14/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022]
Abstract
Transmission by asymptomatic individuals is a persistent hurdle in the effort to control the spread of SARS-CoV-2. Therefore, it is essential to continue developing assays and evaluate their performance for detection of SARS-CoV-2 in individuals without COVID-19 symptoms. In this study, 223 nasopharyngeal swab specimens collected from COVID-19 asymptomatic individuals were tested using the BD SARS-CoV-2 (RT-PCR-based) reagents for the BD MAX™ System and compared with results obtained with the Biomerieux BioFire® Respiratory RT-PCR Panel. Positive and negative percent agreements of 100% (95% CI, 84.5%-100%) and 99.0% (95% CI, 96.5%-99.7%), respectively, were observed for the BD SARS-CoV-2 assay. These results demonstrate the effectiveness of the BD SARS-CoV-2 assay for detecting SARS-CoV-2 in asymptomatic individuals and suggest that this assay can facilitate optimized case surveillance and infection control efforts. Investigations using larger sample sizes of asymptomatic individuals would be beneficial to support the findings in this study.
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Affiliation(s)
- Karen Yanson
- Corresponding author. Tel: 410-316-4793; fax: 410-316-4041
| | | | | | | | | | | | | | - Lori Neely
- Corresponding author. Tel: 410-316-3616; fax: 410-316-3690
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49
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Mouliou DS. The Deceptive COVID-19: Lessons from Common Molecular Diagnostics and a Novel Plan for the Prevention of the Next Pandemic. Diseases 2023; 11:diseases11010020. [PMID: 36810534 PMCID: PMC9944891 DOI: 10.3390/diseases11010020] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
The COVID-19 pandemic took place during the years 2020-2022 and the virus, named SARS-CoV-2, seems likely to have resulted in an endemic disease. Nevertheless, widespread COVID-19 has given rise to several major molecular diagnostics' facts and concerns that have emerged during the overall management of this disease and the subsequent pandemic. These concerns and lessons are undeniably critical for the prevention and control of future infectious agents. Furthermore, most populaces were introduced to several new public health maintenance strategies, and again, some critical events arose. The purpose of this perspective is to thoroughly analyze all these issues and the concerns, such as the molecular diagnostics' terminologies, their role, as well as the quantity and quality issues with a molecular diagnostics' test result. Furthermore, it is speculated that society will be more vulnerable in the future and prone to emerging infectious diseases; thus, a novel preventive medicine's plan for the prevention and control of future (re)emerging infectious diseases is presented, so as to aid the early prevention of future epidemics and pandemics.
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50
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Bugallo-Sanz X, Balboa-Barreiro V, Pérez-Martínez O, García-Rodríguez R, Gómez-Besteiro I, Pereira-Rodríguez MJ. [COVID-19 epidemiology in health and social health workers in the health area of A Coruña and Cee]. Semergen 2023; 49:101938. [PMID: 36889056 PMCID: PMC9870758 DOI: 10.1016/j.semerg.2023.101938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/17/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Since the beginning of the pandemic, it has become necessary to know the epidemiological evolution of SARS-CoV-2. Therefore, this study aims to describe the characteristics of the casuistry of COVID-19 in health and social-health workers in the health area of A Coruña and Cee during the first epidemic wave, as well as to determine the association between the clinical profile and/or its duration and the condition of RT-PCR repositivization. MATERIALS AND METHODS During the study period, 210 cases belonging to healthcare and social-healthcare workers from the healthcare area of A Coruña and Cee were diagnosed. A descriptive analysis of sociodemographic factors was carried out, as well as the search for association between the clinical picture and the duration of detection of a positive RT-PCR. RESULTS The most affected categories were nursing (33.3%) and nursing assistants (16.2%). The mean time taken for cases to become RT-PCR negative was 18.3±9.1 days, with a median of 17. It was observed that 26 cases (13.8%) had a positive result in a subsequent RT-PCR, without meeting criteria for reinfection. The existence of skin manifestations and arthralgias was associated with repositivization after adjusting for age and sex (OR=4.6 and OR=6.5, respectively). CONCLUSIONS In healthcare professionals diagnosed with COVID-19 during the first wave, symptoms such as dyspnea, skin manifestations and arthralgias led to RT-PCR repositivization after a previous negative result and without meeting criteria for reinfection.
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Affiliation(s)
- X Bugallo-Sanz
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España.
| | - V Balboa-Barreiro
- Unidad de Apoyo a la Investigación, Complexo Hospitalario Universitario A Coruña (CHUAC) - Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, España
| | - O Pérez-Martínez
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España; Servizo de Epidemioloxía. Dirección Xeral de Saúde Pública, Consellería de Sanidade-Xunta de Galicia, A Coruña, España
| | - R García-Rodríguez
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España
| | - I Gómez-Besteiro
- Unidad de Apoyo a la Investigación, Complexo Hospitalario Universitario A Coruña (CHUAC) - Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, España
| | - M J Pereira-Rodríguez
- Servicio de Medicina Preventiva y Salud Laboral, Complexo Hospitalario Universitario A Coruña (CHUAC), Área Sanitaria de A Coruña y Cee, A Coruña, España
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