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Cedro VQM, de Lima Gomes S, Simões ACCD, Sverzut TDVL, Bertti KCX, Tristão MT, Cavalcanti YW, Câmara JVF, Pereira AC. Cost-effectiveness analysis of COVID-19 tests in the unified health system. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:64. [PMID: 37705076 PMCID: PMC10498608 DOI: 10.1186/s12962-023-00469-1] [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: 01/30/2023] [Accepted: 08/17/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND To evaluate the cost-effectiveness ratio and economic impact of the Rapid Antigen Test (TR-Ag) to replace RT-PCR for the detection of the new Coronavirus in the Unified Health System (SUS). METHODS This is a cost-effectiveness analysis. Clinical protocols were used for the diagnosis of COVID-19 at the São José Municipal Hospital, located in the city of Itaberá-SP. The Incremental Cost-Effectiveness Ratio (ICER) was divided into two scenarios. In the first, the accuracy reported by the test manufacturers was included, and in the second, the cost resulting from a systematic review. Both were compared with the performance of the RT-PCR test. The increase in diagnoses was chosen as a health outcome and absenteeism was used as a criterion for assessing the economic impact. RESULTS The analysis resulted in incremental cost-effectiveness ratios of R$ 42,136.67 and R$ 68,329.73 for every thousand tests, according to the accuracy of the manufacturers' TR-Ag tests and what is reported in the literature in relation to RT-PCR, respectively. The average value found for the RT-PCR test (R$ 202.87) represents an increase of 165.32% in cost in relation to the value found for the TR-Ag. 4,305 tests were performed between April 2020 and December 2021 at the referral hospital. Also, maintaining the use of RT-PCR as the first choice for diagnosing COVID-19 and regulating absenteeism in the economically active population could have an impact of up to R$ 1,022,779.68 on municipal management. CONCLUSION It is concluded that the TR-Ag are configured as a cost-effective alternative for the SUS in the detection of the new Coronavirus. The strategy becomes economically favorable for the expansion of testing, combating the COVID-19 pandemic and reducing the impact on the local economy. However, studies are needed to validate the accuracy of the tests so that economic evaluations on the subject are more assertive.
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Affiliation(s)
- Vinicius Queiroz Miranda Cedro
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Stéfany de Lima Gomes
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Ana Clara Correa Duarte Simões
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Tatiana do Valle Lovato Sverzut
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Keila Cristina Xavier Bertti
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Marcelo Tadeu Tristão
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Yuri Wanderley Cavalcanti
- Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - João Victor Frazão Câmara
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Homburg/Saar, Germany
| | - Antonio Carlos Pereira
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
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Sookaromdee P, Wiwanitkit V. Positive Predictive Value of SARS-CoV-2 Spike Protein Antibody Test after COVID-19 Vaccination Policies. Int J Prev Med 2023; 14:75. [PMID: 37855004 PMCID: PMC10580214 DOI: 10.4103/ijpvm.ijpvm_290_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 04/28/2022] [Indexed: 10/20/2023] Open
Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India
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3
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Santer D, Schneider N, de Carvalho YSS, de Souza Bortolini RV, Silva FM, Franken DL, da Silva Fink J. The association between reduced calf and mid-arm circumferences and ICU mortality in critically ill COVID-19 patients. Clin Nutr ESPEN 2023; 54:45-51. [PMID: 36963893 PMCID: PMC9831974 DOI: 10.1016/j.clnesp.2023.01.006] [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: 08/25/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Patients with COVID-19 are at a high risk of malnutrition caused by inflammatory syndrome and persistent hypermetabolism, which may affect clinical outcomes. This study aimed to evaluate the changes in nutritional status indicators between two time points of nutritional assessments of COVID-19 patients during their stay in the intensive care unit (ICU). Moreover, the study also assessed the association of nutritional status with ICU mortality. METHODS This cohort study included retrospective data of adult patients admitted to a public hospital ICU in southern Brazil, between March and September 2020. These participants with confirmed COVID-19 diagnosis received nutritional assessment within the first 72 h after ICU admission. The anthropometric measurements collected included mid-arm circumference (MAC) and calf circumference (CC). The percentage (%) of MAC adequacy was calculated, and values < 50th percentile for sex and age were considered low. CC values of ≤33 cm for women and ≤34 cm for men were indicative of reduced muscle mass. Data on the date of discharge from the ICU and mortality outcome were collected. RESULTS A total of 249 patients were included (53.4% men, 62.2 ± 13.9 years of age, SOFA severity score 9.6 ± 3.5). Of these, 22.7 and 39.1% had reduced MAC and CC at ICU admission, respectively. In these participants, weight, MAC, CC, and % MAC decreased significantly from the first to second nutritional assessment (p < 0.05), but there was no significant difference between survivors and non-survivors. Patients with reduced CC (HR = 2.63; 95% CI 1.65-4.18) or reduced MAC (HR = 2.11; 95% CI 1.37-3.23) at the first nutritional assessment had approximately twice the risk of death in the ICU than those with normal CC and normal MAC, regardless of the severity assessed by the SOFA score and age. CONCLUSION Reduced MAC and CC values were identified in approximately 20 and 40% of COVID-19 patients admitted to the ICU, respectively. Additionally, these indicators of nutritional depletion were associated with an approximately 2-fold increase in the risk of ICU mortality. A significant reduction in anthropometric indicators during the first weeks of ICU stay confirmed the deterioration of nutritional status in these patients, although this was not associated with mortality.
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Affiliation(s)
- Danieli Santer
- Grupo Hospitalar Conceição, Multiprofessional Residency in Health, Porto Alegre, Rio Grande do Sul, Brazil
| | - Nicole Schneider
- Grupo Hospitalar Conceição, Multiprofessional Residency in Health, Porto Alegre, Rio Grande do Sul, Brazil
| | - Yasmim Sena Silva de Carvalho
- Grupo Hospitalar Conceição, Division of Nutrition and Dietetics of Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil
| | - Renata Vieira de Souza Bortolini
- Grupo Hospitalar Conceição, Division of Nutrition and Dietetics of Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil
| | - Flávia Moraes Silva
- Nutrition Department and Graduate Program of Nutrition Science at Universidade Federal de Ciências da Saúde de Porto Alegre, Rio Grande do Sul, Brazil
| | - Débora Luiza Franken
- Grupo Hospitalar Conceição, Division of Nutrition and Dietetics of Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jaqueline da Silva Fink
- Grupo Hospitalar Conceição, Division of Nutrition and Dietetics of Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil.
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Rahman AABA. Successful Role of Data Science In Managing Covid-19 Battle. 2023 INTERNATIONAL CONFERENCE ON ARTIFICIAL INTELLIGENCE AND SMART COMMUNICATION (AISC) 2023. [DOI: 10.1109/aisc56616.2023.10085065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Azrul Azlan Bin Abd Rahman
- National Defence University Malaysia,Research Fellow, Centre for Defence and International Studies (CDISS),Kuala Lumpur,57000
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5
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Macrae K, Martinez-Cajas J, Bessai K, Abdulhamed A, Gong Y. Quantitative Analysis of SARS-CoV-2 Antibody Levels in Cancer Patients Post Three Doses of Immunization and Prior to Breakthrough COVID-19 Infections. Curr Oncol 2022; 29:7059-7071. [PMID: 36290831 PMCID: PMC9599995 DOI: 10.3390/curroncol29100554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 01/13/2023] Open
Abstract
(1) Background: COVID-19 vaccine effectiveness should be carefully evaluated and explicitly defined. To our knowledge, this is the first report to quantitatively evaluate humoral responses post 3 doses of SARS-CoV-2 immunization and prior to breakthrough COVID-19 infection in Canadian cancer patients. (2) Methods: In a prospective cohort study, we enrolled 185 cancer participants post COVID-19 vaccination in Kingston, Ontario, Canada. IgG antibodies against the SARS-CoV-2 spike receptor-binding domain were quantified by immunoassay post three doses of immunization. With the COVID-19 rapid antigen test and polymerase chain reaction (PCR), 16 breakthrough infections were identified. Results: Following SARS-CoV-2 vaccination (including BNT162b2, AZD1222, and mRNA-1273), the mean serum anti-spike protein antibody level was 197.2 BAU/mL (binding antibody unit, SD ± 393.9), 1335.9 BAU/mL (±3337.8), and 3164.8 BAU/mL (±6500.9) post the first, second, and third dose of vaccination. Observed differences were significant (p ≤ 0.001). The average antibody level of 3164.8 BAU/mL post the third dose was 89.9 times that of the seroconversion level (35.2 BAU/mL). This indicates that most vaccines approved are effective in producing robust antibody responses. In 11 breakthrough cases confirmed by PCR, prior to infection, the average antibody concentration was 3675.6 BAU/mL with the highest concentration being 9107.4 BAU/mL. Compared with this average antibody concentration of 3675.6 BAU/mL (104.4 times that of the seroconversion concentration), 0% of single dosed, 9.6% of double vaccinated, and 29.5% of triple vaccinated cancer patients had higher SARS-CoV-2 antibody levels. When patients were split into hematological and solid cancer, the hematological cancer group demonstrated lower serological responses than the solid cancer group in the first and second doses (first dose, average concentration 11.1 vs. 201.4 BAU/mL, respectively, p < 0.05; second dose, average concentration 441.5 vs. 1725.9 BAU/mL, respectively, p < 0.05). There was no difference in the third dose level (1756.3 vs. 2548.0 BAU/mL, p = 0.21). (4) Conclusions: Most vaccines were effective in producing robust antibody responses when more than one dose was given, and the more doses the higher the serological response. Likely due to the highly contagious nature of SARS-CoV-2 variants, a significant number of participants had SARS-CoV-2 antibody responses lower than the average antibody concentration prior to the known breakthrough infections. Additional vaccination is likely required to ensure immunity against infection by SARS-CoV-2.
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Affiliation(s)
- Kathryn Macrae
- Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Jorge Martinez-Cajas
- Division of Infectious Diseases, Kingston Health Sciences Centre and Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Kristin Bessai
- Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Abulhameed Abdulhamed
- Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Yanping Gong
- Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen’s University, Kingston, ON K7L 3N6, Canada
- Correspondence:
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6
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Quantitative Analysis of SARS-CoV-2 Serological Responses Post Three Doses of Immunization and Prior to Breakthrough COVID-19 Infections. Vaccines (Basel) 2022; 10:vaccines10101590. [PMID: 36298455 PMCID: PMC9609966 DOI: 10.3390/vaccines10101590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Vaccine mediated SARS-CoV-2 antibody responses should be carefully evaluated. With regular follow-up in healthy individuals, we aimed to determine SARS-CoV-2 serological responses post three doses of immunization and prior to breakthrough infections in the Canadian population. Methods: In a prospective cohort study, we enrolled 140 healthy participants post COVID-19 vaccination in Kingston, Ontario, Canada. IgG antibodies against the SARS-CoV-2 spike receptor–binding domain were quantified by immunoassay post three doses of immunization. With COVID-19 rapid antigen test, polymerase chain reaction, and whole genome sequencing, 27 breakthrough infections were identified. Results: Following SARS-CoV-2 vaccine (including BNT162b2, AZD1222, and mRNA-1273), the median serum anti-spike protein antibody level was 143.6 BAU/mL (binding antibody unit, interquartile range 79.0–266.6) post the first dose of immunization, 1046.4 BAU/mL (423.9–1738.2) post the second dose, and 1604.7 BAU/mL (700.1–3764.0) post the third dose. Observed differences were significant (p ≤ 0.001). The median antibody level of 1604.7 BAU/mL post third dose is 45.6 times that of the seroconversion level (35.2 BAU/mL). This indicates that most vaccines approved are effective in producing robust antibody responses. In seven breakthrough cases characterized by whole genome sequencing, prior to infection, antibody concentrations of breakthrough cases were at 3249.4 (Delta), 2748.4 (Delta), 4893.9 (Omicron), 209.1 (Omicron), and 231.5 (Omicron), 725.7 (Omicron), and 2346.6 (Omicron) BAU/mL. Compared with the average antibody concentration of 2057.7 BAU/mL (58 times that of the seroconversion concentration) from above seven cases, 37.2% of triple vaccinated, 19.0% of double vaccinated, and 1.5% single dosed individuals have higher SARS-CoV-2 antibody levels. Conclusions: Most vaccines are effective in producing robust antibody responses when more than one dose is given, and the more doses the higher the serological response. Likely due to the highly contagious nature of SARS-CoV-2 variants, a significant number of participants have SARS-CoV-2 antibody responses lower than the average antibody concentration prior to the known breakthrough infections. Additional vaccination is likely required to ensure immunity against infection by SARS-CoV-2.
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7
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Bagno FF, Sérgio SAR, Figueiredo MM, Godoi LC, Andrade LAF, Salazar NC, Soares CP, Aguiar A, Almeida FJ, da Silva ED, Ferreira AGP, Durigon EL, Gazzinelli RT, Teixeira SMR, Fernandes APSM, da Fonseca FG. DEVELOPMENT AND VALIDATION OF AN ENZYME-LINKED IMMUNOASSAY KIT FOR DIAGNOSIS AND SURVEILLANCE OF COVID-19. JOURNAL OF CLINICAL VIROLOGY PLUS 2022:100103. [PMID: 35993012 PMCID: PMC9384617 DOI: 10.1016/j.jcvp.2022.100103] [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: 06/22/2021] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 11/28/2022] Open
Abstract
There is a massive demand to identify alternative methods to detect new cases of COVID-19 as well as to investigate the epidemiology of the disease. In many countries, importation of commercial kits poses a significant impact on their testing capacity and increases the costs for the public health system. We have developed an ELISA to detect IgG antibodies against SARS-CoV-2 using a recombinant viral nucleocapsid (rN) protein expressed in E. coli. Using a total of 894 clinical samples we showed that the rN-ELISA was able to detect IgG antibodies against SARS-CoV-2 with high sensitivity (97.5%) and specificity (96.3%) when compared to a commercial antibody test. After three external validation studies, we showed that the test accuracy was higher than 90%. The rN-ELISA IgG kit constitutes a convenient and specific method for the large-scale determination of SARS-CoV-2 antibodies in human sera with high reliability.
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Affiliation(s)
- Flávia F Bagno
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Sarah A R Sérgio
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
| | - Maria Marta Figueiredo
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
- Universidade Estadual de Minas Gerais, Divinópolis, MG, Brazil
| | - Lara C Godoi
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
| | - Luis A F Andrade
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
| | - Natália C Salazar
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
| | - Camila P Soares
- Universidade de São Paulo (USP), Instituto de Ciências Biomédicas, São Paulo, SP, Brazil
| | - Andressa Aguiar
- Geriatric and Convalescent Hospital Dom Pedro II, São Paulo, SP, Brazil
| | - Flávia Jaqueline Almeida
- Department of Pediatrics, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Edimilson D da Silva
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Antônio G P Ferreira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Edison Luiz Durigon
- Universidade de São Paulo (USP), Instituto de Ciências Biomédicas, São Paulo, SP, Brazil
| | - Ricardo T Gazzinelli
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Belo Horizonte, MG, Brazil
| | - Santuza M R Teixeira
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
- Universidade Federal de Minas Gerais, Depto de Bioquímica e Imunologia, Belo Horizonte, MG, Brazil
| | - Ana Paula S M Fernandes
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Belo Horizonte, MG, Brazil
| | - Flavio G da Fonseca
- Centro de Tecnologia de Vacinas (CT Vacinas), BH-Tec, UFMG. Belo Horizonte, MG, Brazil
- Universidade Federal de Minas Gerais, Depto de Microbiologia, ICB/UFMG, Belo Horizonte, MG, Brazil
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8
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Bagno FF, Sérgio SA, Figueiredo MM, Godoi LC, Andrade LA, Salazar NC, Soares CP, Aguiar A, Almeida FJ, da Silva ED, Ferreira AG, Durigon EL, Gazzinelli RT, Teixeira SM, Fernandes APS, da Fonseca FG. Development and validation of an enzyme-linked immunoassay kit for diagnosis and surveillance of COVID-19. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 2:100101. [PMID: 35959109 PMCID: PMC9356643 DOI: 10.1016/j.jcvp.2022.100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 11/01/2022] Open
Abstract
There is a massive demand to identify alternative methods to detect new cases of COVID-19 as well as to investigate the epidemiology of the disease. In many countries, importation of commercial kits poses a significant impact on their testing capacity and increases the costs for the public health system. We have developed an ELISA to detect IgG antibodies against SARS-CoV-2 using a recombinant viral nucleocapsid (rN) protein expressed in E. coli. Using a total of 894 clinical samples we showed that the rN-ELISA was able to detect IgG antibodies against SARS-CoV-2 with high sensitivity (97.5%) and specificity (96.3%) when compared to a commercial antibody test. After three external validation studies, we showed that the test accuracy was higher than 90%. The rN-ELISA IgG kit constitutes a convenient and specific method for the large-scale determination of SARS-CoV-2 antibodies in human sera with high reliability.
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9
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Duarte GDC, Simoni V, Ribeiro GN, Haddad R, Moschen M, Toledo RSM, Ottoboni MAP, Mendrone-Junior A, Langhi DM. Development and implementation of a COVID-19 convalescent plasma program in a middle-income economy. Hematol Transfus Cell Ther 2022; 44:206-212. [PMID: 35071990 PMCID: PMC8767797 DOI: 10.1016/j.htct.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 01/04/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Convalescent Plasma therapy is one of the therapeutic strategies that has been used for patients with the Covid-19 disease. Implementing a program with national extension to supply hospitals with this blood component is a great challenge mainly in a middle-income economy. Objectives Our objective was to develop and implement a Covid-19 Convalescent Plasma Program which met established quality standards and was adapted to a reality of limited resources. Methods A multicentric convalescent plasma collection program was developed and implemented, based on four main sequential procedures: selective donor recruitment, pre-donation antibody screening (Anti-SARS-CoV-2- Chemiluminescence IgG Abbott), convalescent plasma collection by apheresis or whole-blood processing and distribution to the hospitals according to local demand. Results From the 572 candidates submitted to the pre-donation antibody screening, only 270 (47%) were considered eligible for plasma donation according to the established criteria. Higher levels of total antibody were associated with the donor age being above 45 years old (p = 0.002), hospital admission (p = 0.018), and a shorter interval between the diagnosis of the SARS-CoV-2 infection and plasma donation (p < 0.001). There was no association between the ABO and Rh blood groups and their antibody levels. Of the 468 donations made, 61% were from the collection of whole-blood and 39%, from apheresis. The Covid-19 Convalescent Plasma units obtained were distributed to 21 different cities throughout the country by air or ground transportation. Conclusion The implementation of a Covid-19 Convalescent Plasma program in a continental country with relatively scarce resources is feasible with alternative strategies to promote lower cost procedures, while complying with local regulations and meeting quality standards.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Dante Mario Langhi
- HHemo, São Paulo, SP, Brazil; Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, SP, Brazil
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10
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Nicoletti ADS, Visacri MB, da Ronda CRDSC, Vasconcelos PEDNS, Quintanilha JCF, de Souza RN, Ventura DDS, Eguti A, Silva LFDS, Perroud Junior MW, Catharino RR, Reis LO, Dos Santos LA, Durán N, Fávaro WJ, Lancellotti M, da Costa JL, Moriel P, Pincinato EDC. Differentially expressed plasmatic microRNAs in Brazilian patients with Coronavirus disease 2019 (COVID-19): preliminary results. Mol Biol Rep 2022; 49:6931-6943. [PMID: 35301654 PMCID: PMC8929466 DOI: 10.1007/s11033-022-07338-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/03/2022] [Indexed: 01/08/2023]
Abstract
Background Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is known that host microRNAs (miRNAs) can be modulated to favor viral infection or to protect the host. Herein, we report preliminary results of a study aiming at identifying differentially expressed plasmatic miRNAs in Brazilian patients with COVID-19. Methods and results miRNAs were extracted from the plasma of eight patients with COVID-19 (four patients with mild COVID-19 and four patients with severe/critical COVID-19) and four healthy controls. Patients and controls were matched for sex and age. miRNA expression levels were detected using high-throughput sequencing. Differential miRNA expression and enrichment analyses were further evaluated. A total of 18 miRNAs were differentially expressed between patients with COVID-19 and controls. miR-4433b-5p, miR-6780b-3p, miR-6883-3p, miR-320b, miR-7111-3p, miR-4755-3p, miR-320c, and miR-6511a-3p were the most important miRNAs significantly involved in the PI3K/AKT, Wnt/β-catenin, and STAT3 signaling pathways. Moreover, 42 miRNAs were differentially expressed between severe/critical and mild patients with COVID-19. miR-451a, miR-101-3p, miR-185-5p, miR-30d-5p, miR-25-3p, miR-342-3p, miR-30e-5p, miR-150-5p, miR-15b-5p, and miR-29c-3p were the most important miRNAs significantly involved in the Wnt/β-catenin, NF-κβ, and STAT3 signaling pathways. Conclusions If validated by quantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in a larger number of participants, the miRNAs identified in this study might be used as possible biomarkers for the diagnosis and severity of COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s11033-022-07338-9.
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Affiliation(s)
| | | | - Carla Regina da Silva Correa da Ronda
- Faculty of Pharmaceutical Sciences, University of Campinas, Cândido Portinari Street, 200, Cidade Universitária Zeferino Vaz-Barão Geraldo, Campinas, SP, 13083-871, Brazil
| | | | | | | | | | - Adriana Eguti
- Hospital Estadual Sumaré Dr. Leandro Francheschini, Sumaré, SP, Brazil
| | | | - Mauricio Wesley Perroud Junior
- School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Hospital Estadual Sumaré Dr. Leandro Francheschini, Sumaré, SP, Brazil
| | - Rodrigo Ramos Catharino
- Faculty of Pharmaceutical Sciences, University of Campinas, Cândido Portinari Street, 200, Cidade Universitária Zeferino Vaz-Barão Geraldo, Campinas, SP, 13083-871, Brazil.,Innovare Biomarkers Laboratory, University of Campinas, Campinas, SP, Brazil
| | | | | | - Nelson Durán
- Laboratory of Urogenital Carcinogenesis and Immunotherapy, University of Campinas, Campinas, SP, Brazil
| | - Wagner José Fávaro
- Laboratory of Urogenital Carcinogenesis and Immunotherapy, University of Campinas, Campinas, SP, Brazil
| | - Marcelo Lancellotti
- Faculty of Pharmaceutical Sciences, University of Campinas, Cândido Portinari Street, 200, Cidade Universitária Zeferino Vaz-Barão Geraldo, Campinas, SP, 13083-871, Brazil
| | - José Luiz da Costa
- Faculty of Pharmaceutical Sciences, University of Campinas, Cândido Portinari Street, 200, Cidade Universitária Zeferino Vaz-Barão Geraldo, Campinas, SP, 13083-871, Brazil
| | - Patricia Moriel
- Faculty of Pharmaceutical Sciences, University of Campinas, Cândido Portinari Street, 200, Cidade Universitária Zeferino Vaz-Barão Geraldo, Campinas, SP, 13083-871, Brazil.
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Menter DG, Afshar-Kharghan V, Shen JP, Martch SL, Maitra A, Kopetz S, Honn KV, Sood AK. Of vascular defense, hemostasis, cancer, and platelet biology: an evolutionary perspective. Cancer Metastasis Rev 2022; 41:147-172. [PMID: 35022962 PMCID: PMC8754476 DOI: 10.1007/s10555-022-10019-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/04/2022] [Indexed: 01/08/2023]
Abstract
We have established considerable expertise in studying the role of platelets in cancer biology. From this expertise, we were keen to recognize the numerous venous-, arterial-, microvascular-, and macrovascular thrombotic events and immunologic disorders are caused by severe, acute-respiratory-syndrome coronavirus 2 (SARS-CoV-2) infections. With this offering, we explore the evolutionary connections that place platelets at the center of hemostasis, immunity, and adaptive phylogeny. Coevolutionary changes have also occurred in vertebrate viruses and their vertebrate hosts that reflect their respective evolutionary interactions. As mammals adapted from aquatic to terrestrial life and the heavy blood loss associated with placentalization-based live birth, platelets evolved phylogenetically from thrombocytes toward higher megakaryocyte-blebbing-based production rates and the lack of nuclei. With no nuclei and robust RNA synthesis, this adaptation may have influenced viral replication to become less efficient after virus particles are engulfed. Human platelets express numerous receptors that bind viral particles, which developed from archetypal origins to initiate aggregation and exocytic-release of thrombo-, immuno-, angiogenic-, growth-, and repair-stimulatory granule contents. Whether by direct, evolutionary, selective pressure, or not, these responses may help to contain virus spread, attract immune cells for eradication, and stimulate angiogenesis, growth, and wound repair after viral damage. Because mammalian and marsupial platelets became smaller and more plate-like their biophysical properties improved in function, which facilitated distribution near vessel walls in fluid-shear fields. This adaptation increased the probability that platelets could then interact with and engulf shedding virus particles. Platelets also generate circulating microvesicles that increase membrane surface-area encounters and mark viral targets. In order to match virus-production rates, billions of platelets are generated and turned over per day to continually provide active defenses and adaptation to suppress the spectrum of evolving threats like SARS-CoV-2.
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Affiliation(s)
- David G Menter
- Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Vahid Afshar-Kharghan
- Division of Internal Medicine, Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - John Paul Shen
- Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephanie L Martch
- Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anirban Maitra
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Scott Kopetz
- Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kenneth V Honn
- Department of Pathology, Bioactive Lipids Research Program, Wayne State University, 5101 Cass Ave. 430 Chemistry, Detroit, MI, 48202, USA
- Department of Pathology, Wayne State University School of Medicine, 431 Chemistry Bldg, Detroit, MI, 48202, USA
- Cancer Biology Division, Wayne State University School of Medicine, 431 Chemistry Bldg, Detroit, MI, 48202, USA
| | - Anil K Sood
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Center for RNA Interference and Non-Coding RNA, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
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12
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Huang C, Wang M, Rafaqat W, Shabbir S, Lian L, Zhang J, Lo S, Song W. Data-driven test strategy for COVID-19 using machine learning: A study in Lahore, Pakistan. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 80:101091. [PMID: 34121777 PMCID: PMC8184360 DOI: 10.1016/j.seps.2021.101091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/03/2021] [Accepted: 05/25/2021] [Indexed: 06/02/2023]
Abstract
AIMS We aimed at giving a preliminary analysis of the weakness of a current test strategy, and proposing a data-driven strategy that was self-adaptive to the dynamic change of pandemic. The effect of driven-data selection over time and space was also within the deep concern. METHODS A mathematical definition of the test strategy were given. With the real COVID-19 test data from March to July collected in Lahore, a significance analysis of the possible features was conducted. A machine learning method based on logistic regression and priority ranking were proposed for the data-driven test strategy. With performance assessed by the area under the receiver operating characteristic curve (AUC), time series analysis and spatial cross-test were conducted. RESULTS The transition of risk factors accounted for the failure of the current test strategy. The proposed data-driven strategy could enhance the positive detection rate from 2.54% to 28.18%, and the recall rate from 8.05% to 89.35% under strictly limited test capacity. Much more optimal utilization of test resources could be realized where 89.35% of total positive cases could be detected with merely 48.17% of the original test amount. The strategy showed self-adaptability with the development of pandemic, while the strategy driven by local data was proved to be optimal. CONCLUSIONS We recommended a generalization of such a data-driven test strategy for a better response to the global developing pandemic. Besides, the construction of the COVID-19 data system should be more refined on space for local applications.
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Affiliation(s)
- Chuanli Huang
- State Key Laboratory of Fire Science, University of Science and Technology of China, Hefei, 230027, PR China
- Department of Architectural and Civil Engineering, City University of Hong Kong, Hong Kong, China
| | - Min Wang
- Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
| | - Warda Rafaqat
- State Key Laboratory of Fire Science, University of Science and Technology of China, Hefei, 230027, PR China
| | - Salman Shabbir
- Program Officer, Punjab Information Technology Board, Arfa Kareem Tower, Ferozpur Road, Lahore, Pakistan
| | - Liping Lian
- School of Urban Planning and Design, Shenzhen Graduate School, Peking University, No. 2199, Lishui Road, Nanshan District, Shenzhen, 518055, China
| | - Jun Zhang
- State Key Laboratory of Fire Science, University of Science and Technology of China, Hefei, 230027, PR China
| | - Siuming Lo
- Department of Architectural and Civil Engineering, City University of Hong Kong, Hong Kong, China
| | - Weiguo Song
- State Key Laboratory of Fire Science, University of Science and Technology of China, Hefei, 230027, PR China
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13
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Pu R, Liu S, Ren X, Shi D, Ba Y, Huo Y, Zhang W, Ma L, Liu Y, Yang Y, Cheng N. The screening value of RT-LAMP and RT-PCR in the diagnosis of COVID-19: systematic review and meta-analysis. J Virol Methods 2022; 300:114392. [PMID: 34856308 PMCID: PMC8629515 DOI: 10.1016/j.jviromet.2021.114392] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/28/2021] [Accepted: 11/28/2021] [Indexed: 02/08/2023]
Abstract
The purpose of this systematic review is to evaluate the test accuracy of reverse-transcription loop-mediated isothermal amplification (RT-LAMP) and reverse transcription-PCR (RT-PCR) for the diagnosis of coronavirus disease 2019 (COVID-19). We comprehensively searched PUBMED, Web of Science, the Cochrane Library, the Chinese National Knowledge Infrastructure, and the Chinese Biomedical Literature Service System until September 1, 2021. We included clinical studies assessing the sensitivity and specificity of RT-PCR and RT-LAMP using respiratory samples. Thirty-three studies were included with 9360 suspected cases of SARS-CoV-2 infection. The RT-PCR or other comprehensive diagnostic method was defined as the reference method. The results showed that the overall pooled sensitivity of RT-PCR and RT-LAMP was 0.96 (95 % CI, 0.93-0.98) and 0.92 (95 % CI, 0.85-0.96), respectively. RT-PCR and RT-LAMP had a 0.06 (95 % CI, 0.04-0.08) and 0.12 (95 % CI, 0.06-0.16) false-negative rates (FNR), respectively. Moreover, subgroup analysis showed mixed sampling and multiple target gene diagnosis methods had better diagnostic value than single-site sampling and a single target gene. The sensitivity and FNR were also significantly affected by the reference method. Comparing RT-LAMP with established suboptimal RT-PCR may exaggerate the performance of RT-LAMP. RT-PCR and RT-LAMP showed high values in the diagnosis of COVID-19, but there was still a FNR of about 6%-12%.
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Affiliation(s)
- Ruiyang Pu
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, PR China
| | - Sha Liu
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, PR China
| | - Xiaoyu Ren
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, PR China
| | - Dian Shi
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yupei Ba
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yanbei Huo
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Wenling Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Lingling Ma
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yanyan Liu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yan Yang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, PR China
| | - Ning Cheng
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, PR China.
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14
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Fathi Karkan S, Maleki Baladi R, Shahgolzari M, Gholizadeh M, Shayegh F, Arashkia A. The evolving direct and indirect platforms for the detection of SARS-CoV-2. J Virol Methods 2022; 300:114381. [PMID: 34843826 PMCID: PMC8626143 DOI: 10.1016/j.jviromet.2021.114381] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/26/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023]
Abstract
Diagnosis of SARS-CoV-2 by standard screening measures can reduce the chance of COVID-19 spread before the symptoms become severe. Detecting viral RNA and antigens, anti-viral antibodies, and CT-scan are the most routine diagnostic methods. Accordingly, several diagnostic platforms including thermal and isothermal amplifications, CRISPR/Cas‑based approaches, digital PCR, ELISA, NGS, and point-of-care testing methods with variable sensitivities, have been developed that may facilitate managing and preventing the further spread of the infection. Here, we summarized the currently available direct and indirect testing platforms in research and clinical settings, including recent progress in the methods to detect viral RNA, antigens, and specific antibodies. This summary may help in selecting the effective method for a special application sucha as routine laboratory diagnosis, point-of-care tests or tracing the the virus spread and mutations.
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Affiliation(s)
- Sonia Fathi Karkan
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Medical Nanotechnology, Tabriz Medical University, Tabriz, Iran
| | - Reza Maleki Baladi
- Young Researchers and Elite Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Mehdi Shahgolzari
- Department of Medical Nanotechnology, Tabriz Medical University, Tabriz, Iran
| | - Monireh Gholizadeh
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Immunology, Pasteur Institute of Iran, Tehran, Iran
| | - Fahimeh Shayegh
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Arashkia
- Deaprtment of Molecular Virology, Pasteur Institute of Iran, Tehran, Iran.
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15
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Protection against COVID-19: beyond antibodies. THE LANCET INFECTIOUS DISEASES 2022; 22:4-5. [PMID: 34509186 PMCID: PMC8428468 DOI: 10.1016/s1473-3099(21)00561-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022]
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16
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David CND, Varela FH, Sartor ITS, Polese-Bonatto M, Fernandes IR, Zavaglia GO, Kern LB, Ferreira CF, Bastos GAN, Pitrez PM, Almeida WAFD, Porto VBG, Zavascki AP, Stein RT, Scotta MC. Diagnostic accuracy of a SARS-CoV-2 rapid test and optimal time for seropositivity according to the onset of symptoms. CAD SAUDE PUBLICA 2022; 38:e00069921. [DOI: 10.1590/0102-311x00069921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022] Open
Abstract
Point-of-care serological tests for SARS-CoV-2 have been used for COVID-19 diagnosis. However, their accuracy over time regarding the onset of symptoms is not fully understood. We aimed to assess the accuracy of a point-of-care lateral flow immunoassay (LFI). Subjects, aged over 18 years, presenting clinical symptoms suggestive of acute SARS-CoV-2 infection were tested once by both nasopharyngeal and oropharyngeal RT-PCR and LFI. The accuracy of LFI was assessed in periodic intervals of three days in relation to the onset of symptoms. The optimal cut-off point was defined as the number of days required to achieve the best sensitivity and specificity. This cut-off point was also used to compare LFI accuracy according to participants’ status: outpatient or hospitalized. In total, 959 patients were included, 379 (39.52%) tested positive for SARS-CoV-2 with RT-PCR, and 272 (28.36%) tested positive with LFI. LFI best performance was achieved after 10 days of the onset of symptoms, with sensitivity and specificity of 84.9% (95%CI: 79.8-89.1) and 94.4% (95%CI: 91.0-96.8), respectively. Although the specificity was similar (94.6% vs. 88.9%, p = 0.051), the sensitivity was higher in hospitalized patients than in outpatients (91.7% vs. 82.1%, p = 0.032) after 10 days of the onset of symptoms. Best sensitivity of point-of-care LFI was found 10 days after the onset of symptoms which may limit its use in acute care. Specificity remained high regardless of the number of days since the onset of symptoms.
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Affiliation(s)
| | - Fernanda Hammes Varela
- Hospital Moinhos de Vento, Brasil; Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Marcelo Comerlato Scotta
- Hospital Moinhos de Vento, Brasil; Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
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17
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Lin YT, Tseng YC, Hsu CP. Using Container Houses to Reduce the Risks to Health-Care Workers While Performing the Throat Swab Test and Blood Sampling for SARS-CoV-2. J Acute Med 2021; 11:146-149. [PMID: 35155091 PMCID: PMC8743189 DOI: 10.6705/j.jacme.202112_11(4).0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/25/2020] [Accepted: 01/14/2021] [Indexed: 06/14/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is still pandemic all over the world. Patients requesting screening in emergency departments (ED) have continually increased. Establishing additional screening stations outside of the ED to increase the number of patients tested and protect the safety of health care workers poses an urgent challenge. We employed a container house near the entrance of an ED to create an outdoor screening station, which separates suspected patients of COVID-19 from regular emergency patients to prevent cross infections. In our experience, a container house station can not only provide additional screen area but also reduce the consumption of personal protective equipment. Container houses are sturdier than tents and can be fully assembled rapidly. Appropriate protective equipment can be installed with them to fulfi ll demands for COVID-19 screening.
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Affiliation(s)
- Yang-Tse Lin
- Hsinchu Cathay General Hospital Department of Emergency Medicine Hsinchu Taiwan
| | - Yu-Chi Tseng
- Hsinchu MacKay Memorial Hospital Department of Emergency Medicine Hsinchu Taiwan
| | - Chan-Peng Hsu
- Hsinchu Cathay General Hospital Department of Emergency Medicine Hsinchu Taiwan
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18
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Global Pandemic as a Result of Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak: A Biomedical Perspective. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.4.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In December 2019, a novel coronavirus had emerged in Wuhan city, China that led to an outbreak resulting in a global pandemic, taking thousands of lives. The infectious virus was later classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Individuals infected by this novel virus initially exhibit nonspecific symptoms such as dry cough, fever, dizziness and many more bodily complications. From the “public health emergency of international concern” declaration by the World Health Organisation (WHO), several countries have taken steps in controlling the transmission and many researchers share their knowledge on the SARS-COV-2 characteristics and viral life cycle, that may aid in pharmaceutical and biopharmaceutical companies to develop SARS-CoV-2 vaccine and antiviral drugs that interfere with the viral life cycle. In this literature review the origin, classification, aetiology, life cycle, clinical manifestations, laboratory diagnosis and treatment are all reviewed.
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19
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Visacri MB, Nicoletti AS, Pincinato EC, Loren P, Saavedra N, Saavedra K, Salazar LA, Moriel P. Role of miRNAs as biomarkers of COVID-19: a scoping review of the status and future directions for research in this field. Biomark Med 2021; 15:1785-1795. [PMID: 34784802 PMCID: PMC8601154 DOI: 10.2217/bmm-2021-0348] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Aim: miRNAs are potential biomarkers of several diseases. This review aimed to identify the miRNAs that could serve as biomarkers of COVID-19. Materials & methods: A literature search of nine databases was carried out for studies published before 13 June 2021 that described dysregulated miRNAs in cells or animals infected by SARS-CoV-2 or in patients with COVID-19. Two independent reviewers selected the studies and extracted data; disagreements were resolved by a third reviewer. Results: Twenty studies were included in this scoping review; results suggested that miR-21-5p, miR-146a, miR-126-3p, miR-144 and miR-155 are the most important dysregulated miRNAs that could serve as biomarkers for diagnosing and indicating the severity of COVID-19. miRNAs appear to play key roles in viral replication, proliferation of infected cells, immune response, inflammation and cardiovascular dysfunction. Conclusion: This review provides insights into the role of miRNAs as biomarkers in COVID-19 and the current status and future directions for research in this field.
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Affiliation(s)
- Marília B Visacri
- Department of Pharmacology, School of Medical Sciences, University of Campinas, Campinas, 13083-887, Brazil
| | - Aline S Nicoletti
- Department of Pharmacology, School of Medical Sciences, University of Campinas, Campinas, 13083-887, Brazil
| | - Eder C Pincinato
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas, Campinas, 13083-887, Brazil
| | - Pía Loren
- Center of Molecular Biology & Pharmacogenetics, Scientific & Technological Bioresource Nucleus, Universidad de La Frontera, Temuco, 4811230, Chile
| | - Nicolás Saavedra
- Center of Molecular Biology & Pharmacogenetics, Scientific & Technological Bioresource Nucleus, Universidad de La Frontera, Temuco, 4811230, Chile
| | - Kathleen Saavedra
- Center of Molecular Biology & Pharmacogenetics, Scientific & Technological Bioresource Nucleus, Universidad de La Frontera, Temuco, 4811230, Chile
| | - Luis A Salazar
- Center of Molecular Biology & Pharmacogenetics, Scientific & Technological Bioresource Nucleus, Universidad de La Frontera, Temuco, 4811230, Chile
| | - Patricia Moriel
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, 13083-871, Brazil
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20
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Yu MM. Can a radioimmunoassay kit be developed for accurate detection of the S protein of severe acute respiratory syndrome coronavirus 2? World J Clin Infect Dis 2021; 11:60-62. [DOI: 10.5495/wjcid.v11.i3.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/18/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019 spread worldwide within only a few months. The screening and timely isolation of infected individuals have been regarded as an effective means of epidemic prevention and control. Therefore, effective screening of infected individuals plays a vital role in epidemic prevention and control. At present, reverse transcription-polymerase chain reaction (RT–PCR) is the main method for the in vitro detection of SARS-CoV-2. However, RT–PCR requires certified laboratories, expensive equipment, and trained technicians. Therefore, it is necessary to develop simpler and more convenient methods. Some studies have shown that the PepKAA peptide has a high affinity for the S protein of SARS-CoV-2. The tyrosine in PepKAA is labeled with 125I and used to design a radioimmunoassay kit for the detection of the S protein of SARS-CoV-2, which is of great significance for the early diagnosis of COVID-19.
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Affiliation(s)
- Ming-Ming Yu
- Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266100, Shandong Province, China
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21
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Saadeh R, Alfaqih MA, Al‐Shdaifat A, Alyahya M, Alrabadi N, Khader Y, Beni Yonis O, Allouh MZ. Perceptions of primary healthcare physicians in Jordan of their role in the COVID-19 pandemic: A cross-sectional study. Int J Clin Pract 2021; 75:e14797. [PMID: 34482611 PMCID: PMC8646772 DOI: 10.1111/ijcp.14797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/07/2021] [Accepted: 09/02/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Following the remarkable spread of coronavirus disease 2019 (COVID-19), worldwide, it quickly became apparent that many public health systems worldwide were not prepared to manage such a pandemic. We aimed to assess the perceptions of primary care physicians (PCPs) in Jordan towards their role during COVID-19. METHODS A cross-sectional study using a self-administered questionnaire was performed. The study participants included PCPs from the Ministry of Health, academic institutions, and the private sector in Jordan. RESULTS A total of 221 PCPs participated in the study. Most participants reported not having received any training on infection control (59.7%) or COVID-19 (81%). More than half PCPs (53.4%) felt positive about the way patients received and/or complied with their instructions. More than half PCPs (55.7%) educated their patients on protective measures against COVID-19 infection and considered this as part of their role and responsibility. Over 80% of the participants would apply social distancing, hand sanitation, facial masks, and patient education, but only half (51.1%) reported planning to order COVID-19 test kits. CONCLUSIONS PCPs had a positive attitude towards controlling COVID-19 infection and showed a willingness to educate patients on how to protect themselves. However, PCPs should be provided special training on COVID-19.
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Affiliation(s)
- Rami Saadeh
- Department of Public Health and Community MedicineFaculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Mahmoud A. Alfaqih
- Department of Physiology and BiochemistryFaculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Amjad Al‐Shdaifat
- Department of Internal and Family MedicineFaculty of MedicineHashemite UniversityZarqaJordan
| | - Mohammad Alyahya
- Department of Health Management and PolicyFaculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Nasr Alrabadi
- Department of PharmacologyFaculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Yousef Khader
- Department of Public Health and Community MedicineFaculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Othman Beni Yonis
- Department of Public Health and Community MedicineFaculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Mohammed Z. Allouh
- Department of AnatomyCollege of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUAE
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22
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Watkinson N, Givargis T, Joe V, Nicolau A, Veidenbaum A. Detecting COVID-19 Related Pneumonia On CT Scans Using Hyperdimensional Computing. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:3970-3973. [PMID: 34892100 DOI: 10.1109/embc46164.2021.9630898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pneumonia is a common complication associated with COVID-19 infections. Unlike common versions of pneumonia that spread quickly through large lung regions, COVID-19 related pneumonia starts in small localized pockets before spreading over the course of several days. This makes the infection more resilient and with a high probability of developing acute respiratory distress syndrome. Because of the peculiar spread pattern, the use of pulmonary computerized tomography (CT) scans was key in identifying COVID-19 infections. Identifying uncommon pulmonary diseases could be a strong line of defense in early detection of new respiratory infection-causing viruses. In this paper we describe a classification algorithm based on hyperdimensional computing for the detection of COVID-19 pneumonia in CT scans. We test our algorithm using three different datasets. The highest reported accuracy is 95.2% with an F1 score of 0.90, and all three models had a precision of 1 (0 false positives).
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23
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Del Brutto OH, Costa AF, Recalde BY, Mera RM. Factors Associated With a Persistent Seronegative Status 1 Year After a SARS-CoV-2 Massive Infection Outbreak in Community Dwellers Living in Rural Ecuador: A Prospective Population-based Study. J Prim Care Community Health 2021; 12:21501327211054989. [PMID: 34715744 PMCID: PMC8558583 DOI: 10.1177/21501327211054989] [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] [Indexed: 12/05/2022] Open
Abstract
Background The SARS-CoV-2 pandemic is affecting millions of people living in rural areas of Low- and Middle-Income Countries and is causing an already anticipated devastating effect on the health and economics of these populations. More information is needed to modify behaviors that may counterbalance the consequences of mass spread of the virus in these underserved communities. This study aimed to identify factors associated with a persistent SARS-CoV-2 seronegative status 1 year after a massive infection outbreak in middle-aged and older adults living in rural Ecuador. Methods Individuals enrolled in the Atahualpa Project Cohort as of March 2020 received 5 rounds of tests for determination of SARS-CoV-2 antibodies in blood. Individuals who remained seronegative up to April 2021 were considered “persistently seronegative.” An adjusted Poisson regression model was fitted to estimate the incidence risk ratio of factors directly or inversely associated with a persistent seronegative status. Results A total of 673 individuals received baseline tests. Thirty-one declined consent or died and 429 seroconverted, leaving 213 seronegative subjects. Average SARS-CoV-2 incidence rate was 9.87 events (95% C.I.: 8.91-10.83) per 100 person-months of observation. The use of flushing toilet systems (instead of open latrines) increased 1.5 times the possibility of remaining seronegative. Likewise, every additional bedroom in the house increased by 15% the possibility of remaining seronegative. In contrast, every additional person in the house and having high cholesterol levels significantly reduced the possibility of remaining seronegative. Conclusions The use of flushing toilet systems and the number of bedrooms in the house directly influenced the possibility of remaining seronegative among individuals living in this rural setting. Study results also demonstrated a sustained transmission of the virus even after a significant proportion of the population has been infected. Our findings reinforce the mass spread of SARS-CoV-2 in rural communities.
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Affiliation(s)
| | - Aldo F Costa
- Hospital Universitario Reina Sofía, Córdoba, Andalucía, Spain
| | - Bettsy Y Recalde
- Universidad Espíritu Santo - Ecuador, Samborondón, Guayaquil, Ecuador
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Albuquerque JOMD, Kamioka GA, Madalosso G, Costa SA, Ferreira PB, Pino FA, Sato APS, Carvalho ACAD, Amorim ABP, Aires CC, Kataoka APAG, Savani ESMM, Bessa TAF, Aguiar BSD, Failla MA, Santos EAD, Brito EMT, Santos MCHD, Silva SMSE, Caldeira LAV, Zamarco LC, Fonseca SMS, Lima MMDC, Marques IA, Silva FÉVD, Glasser PR, Burihan PCPR, Cavazzana CL, Mello DSD, Pellini ACG, Nishio FY, Kian FM, Braga EDS, Bertelli NMP, Fracini W, Gonçalves MDÁ, Zular PS, Piva RDS, Masi E. Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020-2021. Rev Saude Publica 2021; 55:62. [PMID: 34706038 PMCID: PMC8522737 DOI: 10.11606/s1518-8787.2021055003970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.
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Affiliation(s)
| | - Gabriela Akemi Kamioka
- Secretaria Municipal de Saúde. Coordenadoria de Vigilância em Saúde.São Paulo, SP, Brasil.,Universidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Geraldine Madalosso
- Secretaria Municipal de Saúde. Coordenadoria de Vigilância em Saúde.São Paulo, SP, Brasil
| | - Selma Anequini Costa
- Secretaria Municipal de Saúde. Coordenadoria de Vigilância em Saúde.São Paulo, SP, Brasil
| | - Paula Bisordi Ferreira
- Secretaria Municipal de Saúde. Coordenadoria de Vigilância em Saúde.São Paulo, SP, Brasil
| | - Francisco Alberto Pino
- Secretaria de Agricultura e Abastecimento. Instituto de Economia Agrícola. São Paulo, SP, Brasil
| | | | | | | | - Caroline Cotrim Aires
- Secretaria Municipal de Saúde. Coordenadoria de Vigilância em Saúde.São Paulo, SP, Brasil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paula Regina Glasser
- Secretaria Municipal de Saúde. Coordenadoria de Vigilância em Saúde.São Paulo, SP, Brasil
| | | | | | | | | | | | | | - Elza de Santana Braga
- Secretaria Municipal de Saúde. Coordenadoria Regional de Saúde. São Paulo, SP, Brasil
| | | | - Wagner Fracini
- Secretaria Municipal de Saúde. Coordenadoria Regional de Saúde. São Paulo, SP, Brasil
| | | | - Paulete Secco Zular
- Secretaria Municipal de Saúde. Coordenadoria Regional de Saúde. São Paulo, SP, Brasil
| | | | - Eduardo Masi
- Secretaria Municipal de Saúde. Coordenadoria de Vigilância em Saúde.São Paulo, SP, Brasil
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25
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Feitosa NM, da Costa Rodrigues B, Petry AC, Nocchi KJCV, de Moraes Brindeiro R, Zilberberg C, Monteiro-de-Barros C, Mury FB, de Souza-Menezes J, Nepomuceno-Silva JL, da Silva ML, de Medeiros MJ, de Souza Gestinari R, da Silva de Alvarenga A, Pozzobon APB, Silva CAO, das Graças Dos Santos D, Silvestre DH, de Sousa GF, de Almeida JF, da Silva JN, Brandão LM, de Oliveira Drummond L, Neto LRG, de Mello Carpes R, Dos Santos RC, Portal TM, Tanuri A, Nunes-da-Fonseca R. Molecular testing and analysis of disease spreading during the emergence of COVID-19 in Macaé, the Brazilian National Capital of Oil. Sci Rep 2021; 11:20121. [PMID: 34635707 PMCID: PMC8505656 DOI: 10.1038/s41598-021-99475-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/21/2021] [Indexed: 01/12/2023] Open
Abstract
The Brazilian strategy to overcome the spread of COVID-19 has been particularly criticized due to the lack of a national coordinating effort and an appropriate testing program. Here, a successful approach to control the spread of COVID-19 transmission is described by the engagement of public (university and governance) and private sectors (hospitals and oil companies) in Macaé, state of Rio de Janeiro, Brazil, a city known as the National Oil Capital. In 2020 between the 17th and 38th epidemiological week, over two percent of the 206,728 citizens were subjected to symptom analysis and RT-qPCR testing by the Federal University of Rio de Janeiro, with positive individuals being notified up to 48 h after swab collection. Geocodification and spatial cluster analysis were used to limit COVID-19 spreading in Macaé. Within the first semester after the outbreak of COVID-19 in Brazil, Macaé recorded 1.8% of fatalities associated with COVID-19 up to the 38th epidemiological week, which was at least five times lower than the state capital (10.6%). Overall, considering the successful experience of this joint effort of private and public engagement in Macaé, our data suggest that the development of a similar strategy countrywise could have contributed to a better control of the COVID-19 spread in Brazil. Quarantine decree by the local administration, comprehensive molecular testing coupled to scientific analysis of COVID-19 spreading, prevented the catastrophic consequences of the pandemic as seen in other populous cities within the state of Rio de Janeiro and elsewhere in Brazil.
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Affiliation(s)
- Natália Martins Feitosa
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Bruno da Costa Rodrigues
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Ana Cristina Petry
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Keity Jaqueline Chagas Vilela Nocchi
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Rodrigo de Moraes Brindeiro
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, 21941-902, Brazil
| | - Carla Zilberberg
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Cintia Monteiro-de-Barros
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Flavia Borges Mury
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Jackson de Souza-Menezes
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - José Luciano Nepomuceno-Silva
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Manuela Leal da Silva
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Marcio José de Medeiros
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Raquel de Souza Gestinari
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Alessandra da Silva de Alvarenga
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Allan Pierre Bonetti Pozzobon
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Carina Azevedo Oliveira Silva
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Daniele das Graças Dos Santos
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Diego Henrique Silvestre
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Graziele Fonseca de Sousa
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Janimayri Forastieri de Almeida
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Jhenifer Nascimento da Silva
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Layza Mendes Brandão
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Leandro de Oliveira Drummond
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Lupis Ribeiro Gomes Neto
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Raphael de Mello Carpes
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Renata Coutinho Dos Santos
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Taynan Motta Portal
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil
| | - Amilcar Tanuri
- Laboratório de Virologia Molecular, Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, 21941-902, Brazil.
| | - Rodrigo Nunes-da-Fonseca
- Instituto de Biodiversidade e Sustentabilidade-NUPEM, Universidade Federal do Rio de Janeiro (UFRJ), Av. São José do Barreto 764, Macaé, 27965-550, Brazil.
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Yousefghahari B, Navari S, Sadeghi M, Soleimaniamiri S, Soleimaniamiri M, Heidari B, Babaei M, Ghodrati K, Guran A, Gholinia H. Risk of COVID-19 infection in patients with rheumatic disease taking disease-modifying anti-rheumatic drugs. Clin Rheumatol 2021; 40:4309-4315. [PMID: 34052904 PMCID: PMC8164488 DOI: 10.1007/s10067-021-05779-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/15/2021] [Accepted: 05/19/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Patients with rheumatic disease taking long-term disease-modifying anti-rheumatic drugs (DMARDs) are expected to have a higher risk of infection due to the alterations in cellular immunity associated with these medications. However, the potential risks associated with these drugs remain unclear. This study aimed to estimate the risk of COVID-19 infection in patients with rheumatic disease taking disease-modifying anti-rheumatic drugs. METHODS Patients with autoimmune rheumatic disease taking DMARDs with or without long-term (> 6 months) HCQ treatment prior to the COVID-19 outbreak were selected consecutively. The diagnosis of COVID-19 was made based on the history of symptoms suggestive of the disease and/or serum IgG positivity. During statistical analysis, the risk of COVID-19 infection was calculated in rheumatic patients taking DMARDs versus controls, as well as in patients taking HCQ versus those who are not. The ORs and 95% CIs were also calculated. The participants in the control group were selected from individuals without RD. RESULTS A total of 800 patients with RD and 449 controls were analyzed. COVID-19 infection was detected in 16.8% of rheumatic patients versus 17.6% of controls (OR 0.95; 95% CI 0.7-1.28). The proportions of COVID-19 infection in HCQ users versus non-users were 15.3% and 18.1%, respectively (OR 0.87; 95% CI 0.61-1.26). These results remained unchanged after adjusting for all covariates using logistic regression analysis. CONCLUSION These findings indicate that rheumatic patients taking DMARDs are not at a higher risk of COVID-19 infection, and that HCQ therapy has no influence on the risk of COVID-19 infection. Key points • The risk of COVID-19 infection is not higher in patients with RD on DMARD therapy. • The prevalence of COVID-19 infection in HCQ users has not significant difference relative to non-users. • Significant percent of RD patients taking DMARDs had asymptomatic infection. • There was a positive association between leflunamide therapy and the risk of COVID-19 infection.
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Affiliation(s)
- Behnaz Yousefghahari
- Clinical Research Development Unit of Rohani Hospital, Babol University of Medical Sciences, Ganjafrooz Ave, Babol, Iran.
| | - Sanaz Navari
- Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Sadeghi
- Clinical Research Development Unit of Rohani Hospital, Babol University of Medical Sciences, Ganjafrooz Ave, Babol, Iran
| | | | | | - Behzad Heidari
- Clinical Research Development Unit of Rohani Hospital, Babol University of Medical Sciences, Ganjafrooz Ave, Babol, Iran
| | - Mansour Babaei
- Clinical Research Development Unit of Rohani Hospital, Babol University of Medical Sciences, Ganjafrooz Ave, Babol, Iran
| | | | | | - Hemmat Gholinia
- Clinical Research Development Unit of Rohani Hospital, Babol University of Medical Sciences, Ganjafrooz Ave, Babol, Iran
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Chauhan N, Soni S, Jain U. Optimizing testing regimes for the detection of COVID-19 in children and older adults. Expert Rev Mol Diagn 2021; 21:999-1016. [PMID: 34324823 PMCID: PMC8425447 DOI: 10.1080/14737159.2021.1962708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/28/2021] [Indexed: 02/08/2023]
Abstract
Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is a major pandemic and continuously emerging due to unclear prognosis and unavailability of reliable detection tools. Older adults are more susceptible to COVID-19 than children showing mature Angiotensin-Converting Enzyme 2 (ACE2), low concentration of immune targets, and comorbid conditions. Several detection platforms have been commercialized to date and more are in pipeline, however, the rate of false-positive results and rapid mutation of SARS-CoV-2 is increasing. Additionally, physiological, and geographical variations of affected individuals are also calling for diagnostic methods optimization.Areas Covered: Extensive information related to the optimization and usefulness of SARS-CoV-2 diagnostic methods based on sensitivity and specificity as definitive and feasible investigative tools is discussed. Moreover, an option of combining laboratory diagnostic methods to improve diagnostic strategies is also proposed and discussed in the comparative section of optimization studies.Expert Opinion: The review article explains the importance of optimization strategies for SARS-CoV-2 detection in children and older adults. There are advancements in COVID-19 detection including CRISPR-based, electrochemical, and optical-based sensing systems. However, the lack of sufficient studies on a comparative evaluation of standardized SARS-CoV-2 diagnostic methods among children and older adults, limit the authentication of commercialized kits.
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Affiliation(s)
- Nidhi Chauhan
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| | - Shringika Soni
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| | - Utkarsh Jain
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
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28
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Mohit E, Rostami Z, Vahidi H. A comparative review of immunoassays for COVID-19 detection. Expert Rev Clin Immunol 2021; 17:573-599. [PMID: 33787412 DOI: 10.1080/1744666x.2021.1908886] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: The gold standard for diagnosis of coronavirus disease 2019 (COVID-19) is detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR), which is expensive, time-consuming and may result in false-negative results. Serological tests can be employed for RT-PCR negative patients, contact tracing, determining the probability of protection against re-infection, and seroepidemiological studies.Areas covered: The main methodologies of serology-based tests for the detection of SARS-CoV-2 including enzyme-linked immunosorbent assays (ELISAs), chemiluminescent immunoassays (CLIAs) and lateral flow immunoassays (LFIAs) were reviewed and their diagnostic performances were compared. Herein, a literature review on the databases of PubMed, Scopus and Google Scholar between January 1, 2020 and June 30, 2020 based on the main serological methods for COVID-19 detection with the focus on comparative experiments was performed. The review was updated on December 31, 2020.Expert opinion: Serology testing could be considered as a part of diagnostic panel two-week post symptom onset. Higher sensitivity for serology-based tests could be achieved by determining combined IgG/IgM titers. Furthermore, higher sensitive serological test detecting neutralization antibody could be developed by targeting spike (S) antigen. It was also demonstrated that the sensitivity of ELISA/CLIA-based methods are higher than LFIA devices.
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Affiliation(s)
- Elham Mohit
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Rostami
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Vahidi
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Moura AD, da Costa HHM, Correa VA, de S Lima AK, Lindoso JAL, De Gaspari E, Hong MA, Cunha-Junior JP, Prudencio CR. Assessment of avidity related to IgG subclasses in SARS-CoV-2 Brazilian infected patients. Sci Rep 2021; 11:17642. [PMID: 34480056 PMCID: PMC8417219 DOI: 10.1038/s41598-021-95045-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/05/2021] [Indexed: 01/07/2023] Open
Abstract
SARS-CoV-2 is considered a global emergency, resulting in an exacerbated crisis in the health public in the world. Although there are advances in vaccine development, it is still limited for many countries. On the other hand, an immunological response that mediates protective immunity or indicates that predict disease outcome in SARS-CoV-2 infection remains undefined. This work aimed to assess the antibody levels, avidity, and subclasses of IgG to RBD protein, in symptomatic patients with severe and mild forms of COVID-19 in Brazil using an adapted in-house RBD-IgG ELISA. The RBD IgG-ELISA showed 100% of specificity and 94.3% of sensibility on detecting antibodies in the sera of hospitalized patients. Patients who presented severe COVID-19 had higher anti-RBD IgG levels compared to patients with mild disease. Additionally, most patients analyzed displayed low antibody avidity, with 64.4% of the samples of patients who recovered from the disease and 84.6% of those who died in this avidity range. Our data also reveals an increase of IgG1 and IgG3 levels since the 8th day after symptoms onset, while IgG4 levels maintained less detectable during the study period. Surprisingly, patients who died during 8–14 and 15–21 days also showed higher anti-RBD IgG4 levels in comparison with the recovered (P < 0.05), suggesting that some life-threatening patients can elicit IgG4 to RBD antibody response in the first weeks of symptoms onset. Our findings constitute the effort to clarify IgG antibodies' kinetics, avidity, and subclasses against SARS-CoV-2 RBD in symptomatic patients with COVID-19 in Brazil, highlighting the importance of IgG antibody avidity in association with IgG4 detection as tool laboratory in the follow-up of hospitalized patients with more significant potential for life-threatening.
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Affiliation(s)
- Andrew D Moura
- Center of Immunology, Institute Adolfo Lutz, São Paulo, Brazil
| | | | - Victor A Correa
- Center of Immunology, Institute Adolfo Lutz, São Paulo, Brazil
| | | | - José A L Lindoso
- Institute of Infectology Emilio Ribas, São Paulo, Brazil.,Department of Infectious Disease, School of Medicine, São Paulo University, São Paulo, Brazil.,Laboratory of Protozoology, Institute of Tropical Medicine, São Paulo, Brazil
| | | | - Marisa A Hong
- Center of Immunology, Institute Adolfo Lutz, São Paulo, Brazil
| | - Jair P Cunha-Junior
- Laboratory of Immunochemistry and Immunotechnology, Department of Immunology, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Mendicino DA, Moretti ER. Tests for the Detection of Antibodies to SARS-CoV-2: Importance of the Critical Professional Interpretation. Int J Prev Med 2021; 12:61. [PMID: 34447503 PMCID: PMC8356986 DOI: 10.4103/ijpvm.ijpvm_349_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/23/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Diego A Mendicino
- Centro de Investigaciones Sobre Endemias Nacionales, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Edgardo R Moretti
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Instituto de Biología y Medicina Experimental de Cuyo, CCT CONICET, Argentina
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31
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Tess BH, Granato CFH, Alves MCGP, Pintão MCT, Nunes MC, Rizzatti EG, Reinach FDC. Assessment of initial SARS-CoV-2 seroprevalence in the most affected districts in the municipality of São Paulo, Brazil. Braz J Infect Dis 2021; 25:101604. [PMID: 34416142 PMCID: PMC8352673 DOI: 10.1016/j.bjid.2021.101604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/20/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022] Open
Abstract
Background São Paulo city has been one of the regions most affected by the COVID-19 pandemic in Brazil. Frequent asymptomatic and oligosymptomatic infections and poor access to diagnostic tests make serosurveys crucial to monitor the magnitude of the epidemic and to inform public health policies, such as vaccination plans. Objectives To estimate, early in the epidemic, the seroprevalence of antibodies to SARS-CoV-2 in adults living in the six most affected districts in São Paulo city, and to assess potential associated risk factors. Methods This was a cross-sectional population-based survey of 1,152 households randomly selected from 72 census tracts. During the period May 4–12, 2020, 463 participants completed a questionnaire on sociodemographic characteristics and history of symptoms in the past two weeks, and provided a blood sample. Prevalence of SARS-CoV-2 antibodies was the outcome of interest and was estimated based on results of two immunoassays, Maglumi SARS-CoV-2 chemiluminescence assay Immunoglobulin (Ig) M (IgM) and IgG, and Roche electrochemiluminescence assay total Ig. Serum samples reactive to either assay were considered positive. Results Weighted overall seroprevalence was 6% (95%CI 3.9–8.3%). No association was observed between seropositivity and sex, age group or education level. Participants who reported black and brown skin color showed a 2.7 fold higher prevalence than people with white skin (p = 0.007). Among the 30 seropositive individuals, 14 (46.6%) reported no COVID-19 compatible symptoms in the past two weeks. Conclusion This study represents the first assessment of SARS-CoV-2 seroprevalence in the city of São Paulo and 6% is the baseline estimate of a series of population-based seroprevalence surveys. Serological screening using sound serological assays is the key tool to monitoring temporal and geographic changes in the spread of the virus through an important epicenter of the COVID-19 pandemic in Brazil. Ultimately, it may inform prevention and control efforts.
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Affiliation(s)
- Beatriz Helena Tess
- Universidade de São Paulo, Faculdade de Medicina FMUSP, Departamento de Medicina Preventiva, São Paulo, SP, Brazil.
| | | | | | | | | | - Edgar Gil Rizzatti
- Grupo Fleury, Divisão de Pesquisa e Desenvolvimento, São Paulo, SP, Brazil
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Yi-Song Liew T, Zhi Qiang Seah B, Chua CG, Boon Chuan Tan B. Management of SARS-CoV-2 in the Military and Lessons for Future Pandemics. Mil Med 2021; 187:e1530-e1537. [PMID: 34415340 DOI: 10.1093/milmed/usab337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/18/2021] [Accepted: 08/03/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in devastating consequences, with high death tolls and significant impact on global health, geopolitics, and socioeconomic aspects of society among others. Militaries around the world have been affected in many ways, in terms of force attrition and disruption to operations. MATERIALS AND METHODS The Republic of Singapore Air Force (RSAF) had formulated multiple strategies and executed several contingency plans to respond swiftly and effectively to the pandemic. Measures taken by the RSAF included leveraging pandemic drawer plans, continuous medical intelligence gathering on SARS-CoV-2 characteristics, conducting rapid disease testing and contact tracing, formulating a risk assessment matrix for personnel based overseas, enforcing safe management measures and mask-wearing, and ensuring that critical medical functions were sustained. RESULTS This article summarizes important lessons learnt that may be applied to future pandemics, including the importance of threat assessment, pandemic preparedness, adopting a tiered defense strategy, widespread testing, expeditious contact tracing and isolation, effective communication, and re-defining the new norms for post-pandemic recovery. CONCLUSION The military remains essential to every country's defense and security. However, its unique construct and nature of operations may render it susceptible to uncontained viral transmission. To minimize manpower attrition and maximize force health in the face of a devastating pandemic, well-thought and tailored management measures must be implemented.
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Affiliation(s)
- Terence Yi-Song Liew
- Headquarters Republic of Singapore Air Force Medical Service, 492 Airport Road, 539945, Singapore
| | - Benjamin Zhi Qiang Seah
- Headquarters Republic of Singapore Air Force Medical Service, 492 Airport Road, 539945, Singapore
| | - Choon Guan Chua
- Headquarters Republic of Singapore Air Force Medical Service, 492 Airport Road, 539945, Singapore
| | - Benjamin Boon Chuan Tan
- Headquarters Republic of Singapore Air Force Medical Service, 492 Airport Road, 539945, Singapore
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Gonçalves CCA, Barroso SPC, Herlinger AL, Galliez RDM, de Almeida TB, Boullosa LT, Nascimento ERDS, de Almeida JM, da Costa RMDSC, da Paixão TM, Couceiro JNDSS, Frauches TS, de Souza Jr WR, Costa AR, Faffe DS, Leitão IDC, da Silva BO, de Lira GS, de Almeida ILC, Ferreira ODC, Castiñeiras TMPP, Mariani D, Tanuri A. COVID-19 diagnosis by RT-qPCR in alternative specimens. Mem Inst Oswaldo Cruz 2021; 116:e210085. [PMID: 34406222 PMCID: PMC8370469 DOI: 10.1590/0074-02760210085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/11/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The high demand for adequate material for the gold standard reverse transcription real-time polymerase chain reaction (RT-qPCR)-based diagnosis imposed by the Coronavirus disease 2019 (COVID-19) pandemic, combined with the inherent contamination risks for healthcare workers during nasopharyngeal swab (NP) sample collection and the discomfort it causes patients, brought the need to identify alternative specimens suitable for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVES The aim of this work was to compare saliva and gingival fluid swabs to NP swabs as specimens for RT-qPCR-based SARS-CoV-2 diagnosis. METHODS We compared gingival fluid swabs (n = 158) and saliva (n = 207) to the rayon-tipped NP swabs obtained from mild-symptomatic and asymptomatic subjects as specimens for RT-qPCR for SARS-CoV-2 detection. FINDINGS When compared to NP swabs, gingival fluid swabs had a concordance rate of 15.4% among positive samples, zero among inconclusive, and 100% among negative ones. For saliva samples, the concordance rate was 67.6% among positive samples, 42.9% among inconclusive, and 96.8% among negative ones. However, the concordance rate between saliva and NP swabs was higher (96.9%) within samples with lower cycle threshold (Ct) values (Ct > 10 ≤ 25). MAIN CONCLUSIONS Our data suggests that whereas gingival fluid swabs are not substitutes for NP swabs, saliva might be considered whenever NP swabs are not available or recommended.
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Affiliation(s)
- Cássia Cristina Alves Gonçalves
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Shana Priscila Coutinho Barroso
- Hospital Naval Marcílio Dias, Instituto de Pesquisas Biomédicas, Laboratório de Biologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Alice Laschuk Herlinger
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Rafael de Mello Galliez
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, Rio de Janeiro, RJ, Brasil
| | - Tailah Bernardo de Almeida
- Instituto de Estudos do Mar Almirante Paulo Moreira, Departamento de Biotecnologia Marinha, Arraial do Cabo, RJ, Brasil
| | - Lidia Theodoro Boullosa
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Erica Ramos dos Santos Nascimento
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Jessica M de Almeida
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Raissa Mirella dos Santos Cunha da Costa
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
- Hospital Naval Marcílio Dias, Instituto de Pesquisas Biomédicas, Laboratório de Biologia Molecular, Rio de Janeiro, RJ, Brasil
| | | | | | | | | | | | - Débora Souza Faffe
- Universidade Federal do Rio de Janeiro, Instituto de Biofísica, Rio de Janeiro, RJ, Brasil
| | | | - Bianca Ortiz da Silva
- Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Decania, Rio de Janeiro, RJ, Brasil
| | - Guilherme Sant’Anna de Lira
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, Rio de Janeiro, RJ, Brasil
| | - Isabela Labarba Carvalho de Almeida
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, Rio de Janeiro, RJ, Brasil
| | - Orlando da Costa Ferreira
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
| | | | | | - Diana Mariani
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Amilcar Tanuri
- Universidade Federal do Rio de Janeiro, Instituto de Biologia, Departamento de Genética, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil
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Agustina R, Syam AF, Wirawan F, Widyahening IS, Rahyussalim AJ, Yusra Y, Rianda D, Burhan E, Salama N, Daulay R, Halim ARV, Shankar AH. Integration of symptomatic, demographical and diet-related comorbidities data with SARS-CoV-2 antibody rapid diagnostic tests during epidemiological surveillance: a cross-sectional study in Jakarta, Indonesia. BMJ Open 2021; 11:e047763. [PMID: 34376448 PMCID: PMC8359859 DOI: 10.1136/bmjopen-2020-047763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/25/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Affordable options for COVID-19 epidemiological surveillance are needed. Virus detection by reverse transcription-PCR (RT-PCR) is sensitive but costly, and antigen-based rapid diagnostic tests (RDTs) are cheap but with reduced sensitivity; both detect current infection but not exposure. RDT-IgM/IgG antibodies to SARS-CoV-2 detect exposure but have poor sensitivity for current infection. We investigated if the integration of symptomatic, demographical and diet-related comorbidities data with antibody RDTs improves their potential to assess infection rates in addition to exposure, thereby broadening their utility for surveillance. DESIGN We conducted a cross-sectional study using data from community surveillance for SARS-CoV-2. Health workers collected nasopharyngeal swabs for RT-PCR and RDT antigen assessments and venous blood for RDT-IgM/IgG from symptomatic and asymptomatic persons. Data on age, gender, contact history, symptoms (ie, fever, cough, runny nose, sore throat, headache, dyspnoea and diarrhoea), diet-related comorbidities (ie, diabetes and hypertension) and chest radiology were collected. SETTING High-risk communities in Jakarta, Indonesia, in May 2020. PARTICIPANTS 343 community members' data were included. OUTCOME MEASURES RDT-IgM/IgG sensitivity, specificity and predictive values and area under receiver operating characteristic curve for RT-PCR positivity using RDT results alone and in combination with other predictors, including symptom components derived from principal component analysis. RESULTS There were 24 PCR-confirmed infections. RDT-IgM/IgG-positive tests were associated with infection (OR 10.8, 95% CI 4.43 to 26.4, p<0.001) with an area under the curve (AUC) of 0.708% and 50% sensitivity, 91.5% specificity, 30.8% positive predictive value (PPV) and 96.1% negative predictive value (NPV). RDT results combined with age, gender, contact history, symptoms and comorbidities increased the AUC to 0.787 and yielded 62.5% sensitivity, 87.0% specificity, 26.6% PPV and 96.9% NPV. CONCLUSIONS SARS-CoV-2 RDT-IgM/IgG results integrated with other predictors may be an affordable tool for epidemiological surveillance for population-based COVID-19 exposure and current infection, especially in groups with outbreaks or high transmission.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center - Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ari Fahrial Syam
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Fadila Wirawan
- Human Nutrition Research Center - Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Indah S Widyahening
- Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Clinical Epidemiology and Evidence-Based Medicine Unit, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ahmad Jabir Rahyussalim
- Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Yusra Yusra
- Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Davrina Rianda
- Human Nutrition Research Center - Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Erlina Burhan
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ngabila Salama
- Health Office, Government of DKI Jakarta Province, Jakarta, Indonesia
| | - Rebekka Daulay
- Health Office, Government of DKI Jakarta Province, Jakarta, Indonesia
| | | | - Anuraj H Shankar
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Eijkman-Oxford Clinical Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
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Brümmer LE, Katzenschlager S, Gaeddert M, Erdmann C, Schmitz S, Bota M, Grilli M, Larmann J, Weigand MA, Pollock NR, Macé A, Carmona S, Ongarello S, Sacks JA, Denkinger CM. Accuracy of novel antigen rapid diagnostics for SARS-CoV-2: A living systematic review and meta-analysis. PLoS Med 2021; 18:e1003735. [PMID: 34383750 PMCID: PMC8389849 DOI: 10.1371/journal.pmed.1003735] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/26/2021] [Accepted: 07/14/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND SARS-CoV-2 antigen rapid diagnostic tests (Ag-RDTs) are increasingly being integrated in testing strategies around the world. Studies of the Ag-RDTs have shown variable performance. In this systematic review and meta-analysis, we assessed the clinical accuracy (sensitivity and specificity) of commercially available Ag-RDTs. METHODS AND FINDINGS We registered the review on PROSPERO (registration number: CRD42020225140). We systematically searched multiple databases (PubMed, Web of Science Core Collection, medRvix, bioRvix, and FIND) for publications evaluating the accuracy of Ag-RDTs for SARS-CoV-2 up until 30 April 2021. Descriptive analyses of all studies were performed, and when more than 4 studies were available, a random-effects meta-analysis was used to estimate pooled sensitivity and specificity in comparison to reverse transcription polymerase chain reaction (RT-PCR) testing. We assessed heterogeneity by subgroup analyses, and rated study quality and risk of bias using the QUADAS-2 assessment tool. From a total of 14,254 articles, we included 133 analytical and clinical studies resulting in 214 clinical accuracy datasets with 112,323 samples. Across all meta-analyzed samples, the pooled Ag-RDT sensitivity and specificity were 71.2% (95% CI 68.2% to 74.0%) and 98.9% (95% CI 98.6% to 99.1%), respectively. Sensitivity increased to 76.3% (95% CI 73.1% to 79.2%) if analysis was restricted to studies that followed the Ag-RDT manufacturers' instructions. LumiraDx showed the highest sensitivity, with 88.2% (95% CI 59.0% to 97.5%). Of instrument-free Ag-RDTs, Standard Q nasal performed best, with 80.2% sensitivity (95% CI 70.3% to 87.4%). Across all Ag-RDTs, sensitivity was markedly better on samples with lower RT-PCR cycle threshold (Ct) values, i.e., <20 (96.5%, 95% CI 92.6% to 98.4%) and <25 (95.8%, 95% CI 92.3% to 97.8%), in comparison to those with Ct ≥ 25 (50.7%, 95% CI 35.6% to 65.8%) and ≥30 (20.9%, 95% CI 12.5% to 32.8%). Testing in the first week from symptom onset resulted in substantially higher sensitivity (83.8%, 95% CI 76.3% to 89.2%) compared to testing after 1 week (61.5%, 95% CI 52.2% to 70.0%). The best Ag-RDT sensitivity was found with anterior nasal sampling (75.5%, 95% CI 70.4% to 79.9%), in comparison to other sample types (e.g., nasopharyngeal, 71.6%, 95% CI 68.1% to 74.9%), although CIs were overlapping. Concerns of bias were raised across all datasets, and financial support from the manufacturer was reported in 24.1% of datasets. Our analysis was limited by the included studies' heterogeneity in design and reporting. CONCLUSIONS In this study we found that Ag-RDTs detect the vast majority of SARS-CoV-2-infected persons within the first week of symptom onset and those with high viral load. Thus, they can have high utility for diagnostic purposes in the early phase of disease, making them a valuable tool to fight the spread of SARS-CoV-2. Standardization in conduct and reporting of clinical accuracy studies would improve comparability and use of data.
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Affiliation(s)
- Lukas E. Brümmer
- Division of Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Mary Gaeddert
- Division of Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Stephani Schmitz
- Division of Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Marc Bota
- Agaplesion Bethesda Hospital, Hamburg, Germany
| | - Maurizio Grilli
- Library, University Medical Center Mannheim, Mannheim, Germany
| | - Jan Larmann
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus A. Weigand
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Nira R. Pollock
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | | | | | | | | | - Claudia M. Denkinger
- Division of Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Partner Site Heidelberg University Hospital, German Center for Infection Research (DZIF), Heidelberg, Germany
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Dall'Agnol J, Schwartz E, Lise F. Recommendations for specimen collection for detection and diagnosis of COVID-19. ABCS HEALTH SCIENCES 2021. [DOI: 10.7322/abcshs.2020195.1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Introduction: The spread of SARS-CoV-2 has caused a global public health crisis (pandemic). One of the most important measures to control the transmission chain of the new coronavirus is to identify those infected through laboratory testing. Objective: Synthesize the recommendations for the specimen collection for detection and diagnosis of COVID-19. Methods: This is an integrative review, considering the publications of the following databases: PubMed and Google Academic from January 2020. Results: 468 publications were identified, 20 of which were considered eligible. The publications recommend that technical training for specimen collection and careful observation of infection prevention protocols are fundamental. This manuscript highlights the steps for specimen collection as materials for collection, storage, transportation, individual protection, and laboratory analysis of samples. Currently, the Reverse Transcription - Polymerase Chain Reaction test is the recommended and gold standard method of identifying COVID-19 cases. Serological tests play an important role in research and surveillance. Conclusion: In summary, the documents ensure that the RT-PCR is the gold standard for SARS-CoV-2 detection and recommend standardization of collection and conditioning methods to avoid errors related to the collection and false negative results.
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Faldini C, Mazzotti A, Arceri A, Broccoli E, Barbagli E, Di Martino A. Covid-19 orthopedic trauma patients characteristics and management during the first pandemic period: report from a single institution in Italy. Musculoskelet Surg 2021; 106:407-426. [PMID: 34075546 PMCID: PMC8169387 DOI: 10.1007/s12306-021-00715-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/24/2021] [Indexed: 01/01/2023]
Abstract
Purpose COVID-19 disease is a declared pandemic, affecting all aspects of healthcare, including orthopedics. The aim of this study is to describe the COVID-19 orthopedic trauma patients characteristics and management in a dedicated Orthopedic and Traumatology Hospital in Italy during the first pandemic period. Material and methods A cohort of 25 consecutive patients with suspected or confirmed COVID-19 infection were retrospectively analyzed. Health system rearrangement, patients’ clinical presentation, diagnostic tools role, laboratory finding, treatment and outcomes were evaluated. Results Health system rearrangement was fast. There was no clear prevalence of comorbidity or surgery type between confirmed and suspected COVID-19 cases. Nine positive swabs tests and 14 cases with only suspected CT scan findings were recorded. Several laboratory changes have been reported since the onset of symptoms: anemia, leukocytosis, lymphopenia, coagulation abnormalities, alkaline phosphatase, liver enzymes and C-reactive protein alterations. Nineteen patients were treated by oxygen supplement, three patients were administered antivirals, eight antibiotic therapy, and nine hydroxychloroquine. The number of discharges reported in this study was greater than 52% and the number of deaths reached 20%. Conclusion To our experience, the development of patient management algorithms allows the differentiation of the clinical pathways of negative and suspected/positive patients, reducing exposure, and virus spreading. The execution of swabs on all patients allows an early diagnosis and a more adequate management. Considering the different therapy patterns used, there were no significant differences, but anti-thromboembolic prophylaxis administered to all the orthopedic patients may have contributed to complications and mortality rates reduction.
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Affiliation(s)
- C Faldini
- 1St Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123, Bologna, Italy
| | - A Mazzotti
- 1St Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
| | - A Arceri
- 1St Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - E Broccoli
- 1St Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.,Istituto Ortopedico Rizzoli Covid-Ward, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - E Barbagli
- Istituto Ortopedico Rizzoli Covid-Ward, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - A Di Martino
- 1St Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123, Bologna, Italy
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Criado PR, Criado RFJ, Gianotti R, Abdalla BAZ, Pincelli TPH, Michalany AO, Michalany NS. Urticarial vasculitis revealing immunolabelled nucleocapsid protein of SARS-CoV-2 in two Brazilian asymptomatic patients: the tip of the COVID-19 hidden iceberg? J Eur Acad Dermatol Venereol 2021; 35:e563-e566. [PMID: 34033181 PMCID: PMC8242908 DOI: 10.1111/jdv.17391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- P R Criado
- UCARE (Urticaria Center of Reference and Excellence), Centro Universitário Saúde ABC (Faculdade de Medicina do ABC), Santo André, Brazil.,Alergoskin Alergia e Dermatologia, Santo André, Brazil
| | - R F J Criado
- UCARE (Urticaria Center of Reference and Excellence), Centro Universitário Saúde ABC (Faculdade de Medicina do ABC), Santo André, Brazil.,Alergoskin Alergia e Dermatologia, Santo André, Brazil
| | - R Gianotti
- Clinica Dermatologica, Università degli Studi di Milano, Milano, Italy
| | - B A Z Abdalla
- UCARE (Urticaria Center of Reference and Excellence), Centro Universitário Saúde ABC (Faculdade de Medicina do ABC), Santo André, Brazil
| | - T P H Pincelli
- Department of Dermatology, Mayo Clinic, Jacksonville, FL, USA
| | - A O Michalany
- Laboratório Paulista de Dermatologia, São Paulo, Brazil
| | - N S Michalany
- Laboratório Paulista de Dermatologia, São Paulo, Brazil
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de Almeida SM, Spalanzani RN, Nogueira MB, Sanada B, Cavalli BM, Rotta I, Takahashi GR, Pereira LA, Moreira FB, Dino CL, Graf ME, de Almeida BM, Domino NR, Genelhoud G, Bochnia-Bueno L, Raboni SM. Rapid Serological Tests for SARS-CoV-2: Diagnostic Performance of 4 Commercial Assays. Med Princ Pract 2021; 30:385-394. [PMID: 33887722 PMCID: PMC8339017 DOI: 10.1159/000516776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the diagnostic performance of lateral flow immunochromatographic assays (LFAs) of 4 different manufacturers to identify SARS-CoV-2 antibodies (IgM, IgG, or total), comparing them with the nucleic acid amplification test (NAAT) or the clinical defined test (definite or probable SARS-CoV-2 infection, respectively). METHODS One hundred nineteen serum samples were randomly selected by convenience and distributed in the following groups: (1) group with SARS-CoV-2 infection (n = 82; RT-qPCR positive [definite, n = 70] and probable [n = 12]); (2) other diseases (n = 27; other viruses identified [n = 8] and SARS of other etiologies [n = 19]); and (3) healthy control group (n = 10). LFAs of 4 manufacturers were compared: MedTest Coronavirus (COVID-19) IgG/IgM (MedLevensohn, Brazil); COVID-19 IgG/IgM ECO Test (Ecodiagnóstica, Brazil); Camtech COVID-19 IgM/IgG Rapid Test Kit (Camtech Diagnostics Pte Ltd, Singapore); and 1-Step COVID-19 Test for total antibodies (Guangzhou Wondfo Biotech Co., China). RESULTS The 4 tests studied showed high diagnostic performance characteristics for the diagnoses of definite or probable SARS-CoV-2 infection. The best measures were for the Wondfo test: sensitivity (86.59%; 95% CI: 77.26-93.11%), specificity (100%; 90.51-100%), DOR (257; 60-1,008), LR+ (33.43; 4.82-231.85), LR- (0.13; 0.08-0.23), accuracy (90.76%; 84.06-95.29%), and Matthews correlation coefficient (MCC) 0.82. Although considering only the probable SARS-CoV-2 infection (PCR-) cases, all the kits studied showed limited values. CONCLUSION Our data demonstrate the excellent performance of LFA for the diagnoses of definite or probable SARS-CoV-2 infection. There was substantial heterogeneity in sensitivities of IgM and IgG antibodies among the different kits. LFA tests cannot replace molecular diagnostics but should be used as an additional screening tool.
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Affiliation(s)
| | | | - Meri B. Nogueira
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | - Beatriz Sanada
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Indianara Rotta
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | | | | | - Maria E. Graf
- Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Natalia R. Domino
- Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil
| | - Gustavo Genelhoud
- Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Sonia M. Raboni
- Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil
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Delayed hemodialysis in COVID-19: Case series with literature review. Clin Nephrol Case Stud 2021; 9:26-32. [PMID: 33732571 PMCID: PMC7962471 DOI: 10.5414/cncs110240] [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: 05/13/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Increased incidence of kidney injury has been seen in patients with COVID-19. However, less is known about COVID-19 susceptibility and outcomes in end-stage renal disease (ESRD) patients on hemodialysis (HD). Reduced angiotensin-converting enzyme 2 (ACE-2) from SARS-CoV-2 binding and increased angiotensin II (Ang-II) activity have been suggested as mechanisms for COVID-19 renal pathophysiology. MATERIALS AND METHODS In this case series, we analyzed the data of 3 patients with ESRD who had a delay in receiving their regular HD. Reduced oxygen requirement, resolved hyperkalemia, and normalized fluid status were used for the basis of discharge. RESULTS Presenting symptoms included fever, dyspnea, and dry cough. Laboratory markers were characteristic for COVID-19, such as lymphopenia, elevated D-dimer, C-reactive protein (CRP), and interleukin 6 (IL-6). All 3 of our reported patients required urgent HD upon admission. However, we report no fatalities in our case series, and our patients did not have a severe course of illness requiring endotracheal intubation. We reviewed COVID-19 pathophysiology and how patients with ESRD on HD may be particularly at risk for infection. CONCLUSION New renal failure or ESRD sequelae, such as hyperkalemia, uremic encephalopathy, and fluid overload, can be exacerbated by a delay in receiving HD due to COVID-19 infection. Both direct COVID-19 infection and the challenges this pandemic creates to health care logistics present unique threats to ESRD patients on HD.
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Santoso MS, Masyeni S, Haryanto S, Yohan B, Hibberd ML, Sasmono RT. Assessment of dengue and COVID-19 antibody rapid diagnostic tests cross-reactivity in Indonesia. Virol J 2021; 18:54. [PMID: 33706767 PMCID: PMC7948652 DOI: 10.1186/s12985-021-01522-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/02/2021] [Indexed: 01/31/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic remains ongoing around the world, including in areas where dengue is endemic. Dengue and COVID-19, to some extent, have similar clinical and laboratory features, which can lead to misdiagnosis, delayed treatment and patient’s isolation. The use of rapid diagnostic tests (RDT) is easy and convenient for fast diagnosis, however there may be issues with cross-reactivity with antibodies for other pathogens. Methods We assessed the possibility of cross-reactivity between SARS-CoV-2 and dengue antibodies by: (1) testing five brands of COVID-19 IgG / IgM RDTs on 60 RT-PCR-confirmed dengue samples; (2) testing 95 RT-PCR-confirmed COVID-19 samples on dengue RDT; and (3) testing samples positive for COVID-19 IgG and/or IgM on dengue RDT. Results We observed a high specificity across all five brands of COVID-19 RDTs, ranging from 98.3 to 100%. Out of the confirmed COVID-19 samples, one patient tested positive for dengue IgM only, another tested positive for dengue IgG only. One patient tested positive for dengue IgG, IgM, and NS1, suggesting a co-infection. In COVID-19 IgG and/or IgM samples, 6.3% of COVID-19 IgG-positive samples also tested positive for dengue IgG, while 21.1% of COVID-19 IgM-positive samples also tested positive for dengue IgG. Conclusion Despite the high specificity of the COVID-19 RDT, we observed cross-reactions and false-positive results between dengue and COVID-19. Dengue and COVID-19 co-infection was also found. Health practitioners in dengue endemic areas should be careful when using antibody RDT for the diagnosis of dengue during the COVID-19 pandemic to avoid misdiagnosis.
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Affiliation(s)
- Marsha S Santoso
- Dengue Research Unit, Eijkman Institute for Molecular Biology, Ministry of Research and Technology/National Agency for Research and Innovation of the Republic Indonesia, Jl. Diponegoro 69, Jakarta, 10430, Indonesia
| | - Sri Masyeni
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa, Denpasar, Bali, 80235, Indonesia
| | | | - Benediktus Yohan
- Dengue Research Unit, Eijkman Institute for Molecular Biology, Ministry of Research and Technology/National Agency for Research and Innovation of the Republic Indonesia, Jl. Diponegoro 69, Jakarta, 10430, Indonesia
| | - Martin L Hibberd
- Department of Pathogen Molecular Biology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - R Tedjo Sasmono
- Dengue Research Unit, Eijkman Institute for Molecular Biology, Ministry of Research and Technology/National Agency for Research and Innovation of the Republic Indonesia, Jl. Diponegoro 69, Jakarta, 10430, Indonesia.
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Wickramarachchi L, Peters J, Thakrar A, Wong JML, Mazis G, Beckles V, Lacey S, Chin K. A dual-site trauma system during COVID-19 pandemic - Our experience in a high-risk area with 60-day mortality report. J Orthop 2021; 24:42-46. [PMID: 33613008 PMCID: PMC7879933 DOI: 10.1016/j.jor.2021.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/07/2021] [Indexed: 01/08/2023] Open
Abstract
AIM We set up a COVID-free trauma site due to the high rates of COVID-19 infections within our hospital. We aimed to determine the incidence of post-operative COVID-19 infection within the first two weeks post-treatment at the COVID-free site and the postoperative mortality rate. We analysed data for non-hip fracture and fragility hip fracture patients separately. METHOD Data was collected for 138 patients presented during the study period, having 147 operations in total. 103 were non-hip fracture patients and 35 were hip fracture patients. RESULTS All patients were followed up and none of the non-hip fracture cohort developed symptoms of COVID-19 infection. Postoperative 60-day mortality rate for this cohort was 0.97%. Of the 35 hip fracture patients, none were tested positive for COVID-19. However, two patients were treated as suspected COVID cases due to their symptoms. CONCLUSION Establishing a separate site with screening for COVID-19 infection can allow safe emergency surgery.
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Affiliation(s)
| | | | - Amit Thakrar
- Barking Havering and Redbridge University Hospitals NHS Trust, UK
| | - James ML. Wong
- Barking Havering and Redbridge University Hospitals NHS Trust, UK
| | - George Mazis
- Barking Havering and Redbridge University Hospitals NHS Trust, UK
| | - Verona Beckles
- Barking Havering and Redbridge University Hospitals NHS Trust, UK
| | - Sandra Lacey
- Barking Havering and Redbridge University Hospitals NHS Trust, UK
| | - Kuen Chin
- Barking Havering and Redbridge University Hospitals NHS Trust, UK
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Kobashi Y, Shimazu Y, Nishikawa Y, Kawamura T, Kodama T, Obara D, Tsubokura M. The difference between IgM and IgG antibody prevalence in different serological assays for COVID-19; lessons from the examination of healthcare workers. Int Immunopharmacol 2021; 92:107360. [PMID: 33508702 PMCID: PMC7836839 DOI: 10.1016/j.intimp.2020.107360] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/15/2020] [Accepted: 12/28/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The objective of this study was to investigate the differences between the results of two serology assays for detection of COVID-19 among medical staff, who are at higher risks of infection. METHODS The immunochromatography (ICG) rapid test kit and the chemiluminescence immunoassay (CLIA) quantitative antibody test were performed. The differences in IgM and IgG antibody prevalence in different serological assays were descriptively analyzed. RESULTS A total of 637 participants were included in this research. Two staff were IgM positive in the CLIA quantitative antibody test (cutoff value: 10 AU/ml) of 51 staff who were IgM positive in the rapid test kit. Six staff were IgG positive in the CLIA quantitative antibody test of 56 staff who were IgG positive in the rapid test kit. The proportion of antibody positive staff differed greatly between the rapid test kit and the CLIA quantitative antibody test. CONCLUSIONS There was a vast difference in the proportions of IgG and IgM antibody positive staff in the rapid test kit and the CLIA quantitative antibody test results. The results from the only rapid test kit might have to be interpreted with caution. Further studies to evaluate antibody testing accuracy are required to promote the understanding of each assay's characteristics and determine their purposes in each community.
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Affiliation(s)
- Yurie Kobashi
- Department of General Internal Medicine, Hirata Central Hospital, Hirata, Ishikawa district, Fukushima 963-8202, Japan,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima City, Fukushima 960-1295, Japan,Corresponding author at: Department of General Internal Medicine, Hirata central hospital, Hirata, Ishikawa district, Fukushima 963-8202, Japan
| | - Yuzo Shimazu
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima City, Fukushima 960-1295, Japan,Southern Tohoku Research Institute for Neuroscience, 7-115, Yatsuyamada, Koriyama, Fukushima 963-8563, Japan
| | - Yoshitaka Nishikawa
- Department of General Internal Medicine, Hirata Central Hospital, Hirata, Ishikawa district, Fukushima 963-8202, Japan
| | - Takeshi Kawamura
- Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo 153-8904, Japan,Proteomics Laboratory, Isotope Science Center, The University of Tokyo, Tokyo 113-0032, Japan
| | - Tatsuhiko Kodama
- Laboratory for Systems Biology and Medicine, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo 153-8904, Japan
| | - Daiji Obara
- Department of General Internal Medicine, Hirata Central Hospital, Hirata, Ishikawa district, Fukushima 963-8202, Japan
| | - Masaharu Tsubokura
- Department of General Internal Medicine, Hirata Central Hospital, Hirata, Ishikawa district, Fukushima 963-8202, Japan,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima City, Fukushima 960-1295, Japan
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Serological antibody testing in the COVID-19 pandemic: their molecular basis and applications. Biochem Soc Trans 2021; 48:2851-2863. [PMID: 33170924 DOI: 10.1042/bst20200744] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022]
Abstract
The ongoing COVID-19 pandemic has placed an overwhelming burden on the healthcare system, and caused major disruption to the world economy. COVID-19 is caused by SARS-CoV-2, a novel coronavirus that leads to a variety of symptoms in humans, including cough, fever and respiratory failure. SARS-CoV-2 infection can trigger extensive immune responses, including the production of antibodies. The detection of antibody response by serological testing provides a supplementary diagnostic tool to molecular tests. We hereby present a succinct yet comprehensive review on the antibody response to SARS-CoV-2 infection, as well as molecular mechanisms behind the strengths and limitations of serological antibody tests. The presence of antibodies can be detected in patient sera within days post symptom onset. Serological tests demonstrate superior sensitivity to molecular tests in some periods of time during disease development. Compared with the molecular tests, serological tests can be used for point-of-care testing, providing faster results at a lower cost. Commercially available serological tests show variable sensitivity and specificity, and the molecular basis of these variabilities are analysed. We discuss assays of different complexities that are used to specifically quantitate neutralising antibodies against SARS-CoV-2, which has important implications for vaccine development and herd immunity. Furthermore, we discuss examples of successful applications of serological tests to contact tracing and community-level sero-surveying, which provide invaluable information for pandemic management and assessment.
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Ristić M, Nikolić N, Čabarkapa V, Turkulov V, Petrović V. Validation of the STANDARD Q COVID-19 antigen test in Vojvodina, Serbia. PLoS One 2021; 16:e0247606. [PMID: 33617597 PMCID: PMC7899368 DOI: 10.1371/journal.pone.0247606] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/09/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Since COVID-19 pandemic is a global crisis, tests with high sensitivity and specificity are crucial for the identification and management of COVID-19 patients. There is an urgent need for low-cost rapid antigen COVID-19 test with a good diagnostic performance. Although various antigen rapid detection tests are widely available, strong evidence of their usefulness in clinical practice are still limited. Therefore, our aim was to evaluate clinical performance of STANDARD Q COVID-19 Ag Test (SD Biosensor, Gyeonggi-do, South Korea). METHODS The performance of the STANDARD Q COVID-19 Ag Test for the detection of SARS-CoV-2 antigen was evaluated in comparison to RT-qPCR results in 120 symptomatic patients (median age 49, IQR 36-70) who presented to health care facility in Novi Sad, Vojvodina, Serbia. RESULTS Twenty five out of 120 samples have been tested positive using STANDARD Q COVID-19 Ag Test, and all of them were also positive on RT-qPCR. Overall, the STANDARD Q COVID-19 Ag Test showed sensitivity of 58.1% (95% CI 42.1-73.0) but it was higher in the early days of disease, when the highest viral loads were detected. During the first five days after the symptom onset, the sensitivity ranged from 66.7% to 100% and the pooled accuracy and Kappa values were high (0.92 and 0.852). CONCLUSIONS A strong agreement between performance of STANDARD Q COVID-19 Ag Test and RT-qPCR was observed during the first five days of illness, suggesting that this rapid antigenic test can be very useful for COVID-19 diagnosis in the early phase of disease.
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Affiliation(s)
- Mioljub Ristić
- Department of Epidemiology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Nataša Nikolić
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
- Department of Microbiology with Parasitology and Immunology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - Velibor Čabarkapa
- Faculty of Medicine, Department of Pathophysiology and Laboratory Medicine, University of Novi Sad, University of Novi Sad, Novi Sad, Serbia
- Centre of Laboratory Medicine, Clinical Centre of Vojvodina, Novi Sad, Serbia
| | - Vesna Turkulov
- Department of Infectious Diseases, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Infectious Diseases, Clinical Centre of Vojvodina, Novi Sad, Serbia
| | - Vladimir Petrović
- Department of Epidemiology, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
- Institute of Public Health of Vojvodina, Novi Sad, Serbia
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Del Brutto OH, Wu S, Mera RM, Costa AF, Recalde BY, Issa NP. Cognitive decline among individuals with history of mild symptomatic SARS-CoV-2 infection: A longitudinal prospective study nested to a population cohort. Eur J Neurol 2021; 28:3245-3253. [PMID: 33576150 PMCID: PMC8014083 DOI: 10.1111/ene.14775] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Neurological complications of SARS-CoV-2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS-CoV-2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among individuals with a history of mild symptomatic SARS-CoV-2 infection was assessed. METHODS Stroke- and seizure-free Atahualpa residents aged ≥40 years, who had pre-pandemic cognitive assessments as well as normal brain magnetic resonance imaging and electroencephalogram recordings, underwent repeated evaluations 6 months after a SARS-CoV-2 outbreak infection in Atahualpa. Patients requiring oxygen therapy, hospitalization, and those who had initial neurological manifestations were excluded. Cognitive decline was defined as a reduction in the Montreal Cognitive Assessment (MoCA) score between the post-pandemic and pre-pandemic assessments that was ≥4 points greater than the reduction observed between two pre-pandemic MoCAs. The relationship between SARS-CoV-2 infection and cognitive decline was assessed by fitting logistic mixed models for longitudinal data as well as exposure-effect models. RESULTS Of 93 included individuals (mean age 62.6 ± 11 years), 52 (56%) had a history of mild symptomatic SARS-CoV-2 infection. Post-pandemic MoCA decay was worse in seropositive individuals. Cognitive decline was recognized in 11/52 (21%) seropositive and 1/41 (2%) seronegative individuals. In multivariate analyses, the odds for developing cognitive decline were 18.1 times higher among SARS-CoV-2 seropositive individuals (95% confidence interval 1.75-188; p = 0.015). Exposure-effect models confirmed this association (β = 0.24; 95% confidence interval 0.07-0.41; p = 0.006). CONCLUSIONS This study provides evidence of cognitive decline among individuals with mild symptomatic SARS-CoV-2 infection. The pathogenesis of this complication remains unknown.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo-Ecuador, Samborondón, Ecuador
| | - Shasha Wu
- Department of Neurology, University of Chicago, Chicago, IL, USA
| | - Robertino M Mera
- Department of Epidemiology, Gilead Sciences, Inc, Foster City, CA, USA
| | - Aldo F Costa
- Department of Neurology, Hospital Universitario Reina Sofía, Cordoba, Spain
| | | | - Naoum P Issa
- Department of Neurology, University of Chicago, Chicago, IL, USA
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Caramelli B, Escalante-Rojas MC, Chauhan HKC, Siciliano RF, Bittencourt MS, Micelli AC. The "false-positive" conundrum: IgA reference level overestimates the seroprevalence of antibodies to SARS-CoV-2. J Glob Health 2021; 11:05001. [PMID: 33604032 PMCID: PMC7882210 DOI: 10.7189/jogh.11.05001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background On 12 June 2020, Brazil reached the second position worldwide in the number of COVID-19 cases. Authorities increased the number of tests performed, including the identification of antibodies to SARS-CoV-2 (IgG, IgA, and IgM). There was an overflooding of the market with several tests, and the presence of possible false-positive results became a challenge. The purpose of this study was to describe the seroprevalence and immunoglobulin blood levels in a group of asymptomatic individuals using the reference levels provided by the manufacturer. Methods Levels of IgG and IgA antibodies to SARS-CoV-2 were determined in blood serum by the same ELISA (enzyme-linked immunoassay) test. Patients must be free of symptoms. Results From 20 to 22 May 2020, 938 individuals were tested. There were 441 (47%) men, age 53 years (interquartile range (IQR) = 39-63.2). The sample included 335 (35.7%) subjects aged ≥60 years old. Subjects with a positive test were 54 (5.8%) for IgG and 96 (10.2%) for IgA and 42 (4.5%) for both IgG and IgA. The prevalence of IgG and IgA positive test was not different in men and women and not different in individuals under 60 and over 60 years of age. Conversely, analysing only individuals with positive tests, the levels of IgG in positive subjects were significantly higher than those with an IgA positive test, 3.00 (IQR = 1.68-5.65), and 1.95 (IQR = 1.40-3.38), respectively; P = 0.017. Additionally, individuals with isolated IgA positive tests had significantly lower levels of IgA than those with both IgA and IgG positive tests: 1.95 (IQR = 1.60-2.40) and 3.15 (IQR = 2.20-3.90), respectively, P = 0.005. These latter data suggest that IgA shows a deviation of the distribution to the left in comparison to IgG distribution data. Indeed, many subjects reported as IgA positive had immunoglobulin levels slightly elevated. Conclusions In conclusion, we strongly suggest caution in the interpretation of IgA test results. This recommendation is more important for those with positive IgA just above the reference level.
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Affiliation(s)
| | | | | | | | - Marcio S Bittencourt
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil; Center for Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, Sao Paulo, Brazil
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Böger B, Fachi MM, Vilhena RO, Cobre AF, Tonin FS, Pontarolo R. Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19. Am J Infect Control 2021; 49:21-29. [PMID: 32659413 PMCID: PMC7350782 DOI: 10.1016/j.ajic.2020.07.011] [Citation(s) in RCA: 275] [Impact Index Per Article: 91.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To collate the evidence on the accuracy parameters of all available diagnostic methods for detecting SARS-CoV-2. METHODS A systematic review with meta-analysis was performed. Searches were conducted in Pubmed and Scopus (April 2020). Studies reporting data on sensitivity or specificity of diagnostic tests for COVID-19 using any human biological sample were included. RESULTS Sixteen studies were evaluated. Meta-analysis showed that computed tomography has high sensitivity (91.9% [89.8%-93.7%]), but low specificity (25.1% [21.0%-29.5%]). The combination of IgM and IgG antibodies demonstrated promising results for both parameters (84.5% [82.2%-86.6%]; 91.6% [86.0%-95.4%], respectively). For RT-PCR tests, rectal stools/swab, urine, and plasma were less sensitive while sputum (97.2% [90.3%-99.7%]) presented higher sensitivity for detecting the virus. CONCLUSIONS RT-PCR remains the gold standard for the diagnosis of COVID-19 in sputum samples. However, the combination of different diagnostic tests is highly recommended to achieve adequate sensitivity and specificity.
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Maple PAC, Sikora K. How Useful is COVID-19 Antibody Testing - A Current Assessment for Oncologists. Clin Oncol (R Coll Radiol) 2021; 33:e73-e81. [PMID: 33350940 PMCID: PMC7553121 DOI: 10.1016/j.clon.2020.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 12/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic due to infection by a new human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has seriously disrupted the provision of oncology services and their uptake. Antibody testing, both at an individual level and of populations, has been widely viewed to be a key activity for guiding the options for treatment of high-risk individuals, as well as the implementation of safe control of infection measures. Ideally, the detection of a specific antibody should signify that all individuals tested have been infected by SARS-CoV-2 and that in the case of specific IgG that they are immune to further infection. This would enable SARS-CoV-2-infected individuals to be appropriately managed and healthcare workers shown to be immune to return to work where they would no longer pose a risk to their patients or be at risk themselves. Unfortunately, this is not the case for COVID-19, where it has been shown that immunity may not be protective, and seroconversion delayed or absent. The variability in antibody test performance, particularly that of lateral flow assays, has caused confusion for the public and healthcare professions alike. Many antibody test devices have been made available without independent evaluations and these may lack both adequate sensitivity and specificity. This review seeks to educate healthcare workers, particularly those working in oncology, of the current benefits and limitations of SARS-CoV-2 antibody testing.
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Affiliation(s)
- P A C Maple
- Clinical Neurology Research Group, Division of Clinical Neuroscience, University of Nottingham School of Medicine, Queen's Medical Centre, Nottingham, UK
| | - K Sikora
- Medical Division, Rutherford Cancer Centres, London, UK.
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Ortenzi F, Albanese E, Fadda M. A Transdisciplinary Analysis of COVID-19 in Italy: The Most Affected Country in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9488. [PMID: 33352883 PMCID: PMC7767319 DOI: 10.3390/ijerph17249488] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/25/2022]
Abstract
As of 27 March 2020, 199 countries and territories and one international conveyance are affected by the COVID-19 pandemic. As of the same date, Italy represents the third country worldwide in total number of cases and the first one in total number of deaths. The purpose of this study is to analyse the Italian case and identify key problem questions and lessons learned from the Italian experience. The study initially provides a general overview of the country's characteristics and health care system, followed by a detailed description of the Italian epidemiological picture regarding COVID-19. Afterwards, all non-pharmaceutical measures adopted by the Government against COVID-19 are presented in chronological order. The study explores some estimations of the economic impact of the epidemic, as well as its implications for society, lifestyle, and social media reactions. Finally, the study refers to two types of mathematical models to predict the evolution of the spread of COVID-19 disease. Having considered all of the above-mentioned aspects, some significant issues can be raised, including the following: (1) the available epidemiological data presents some gaps and potential biases; (2) mathematical models always come with high levels of uncertainty; (3) the high number of deaths should be interpreted in light of the national demographic context; and (4) the long-term management of the epidemic remains an open question. In conclusion, the Italian experience definitely highlights the importance of preparedness and early action, effective interventions and risk communication.
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Affiliation(s)
- Flaminia Ortenzi
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland; (E.A.); (M.F.)
| | - Marta Fadda
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland; (E.A.); (M.F.)
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