Morbidity, mortality and coronavirus antigen in previously coronavirus free kittens placed in two catteries with feline infectious peritonitis

Rapid Clinical Resolution and Differential Diagnosis of a Neurological Case of Feline Infectious Peritonitis (FIP) Using GS-441524

CASE SUMMARY

A 2-year-old male neutered domestic shorthair cat was presented with a progressive history of tetraparesis, ataxia, and inappetence over 4 days. A physical exam revealed mucopurulent nasal discharge and stertor. A neurologic exam revealed a multifocal neurolocalization. The cat was non-ambulatory tetraparetic and developed seizures while in hospital. Hematologic assessment revealed anemia, hypoalbuminemia and hyperglobulinemia. Magnetic resonance imaging (MRI) of the brain revealed multifocal meningeal contrast enhancement in the brainstem and cervical spine, as well as mandibular and retropharyngeal lymphadenopathy. Cerebrospinal fluid revealed marked neutrophilic pleocytosis; no infectious organisms were seen. Toxoplasma IgG/IgM and Cryptococcus antigen latex agglutination were negative. Mandibular and abdominal lymph nodes were aspirated, and cytology revealed mixed inflammation. The cat was suspected to have feline infectious peritonitis, and to aid in clinical diagnosis he was enrolled in research study-with targeted Nanopore-based sequencing specifically identifying and characterizing FCoV-1 RNA in spinal fluid and anal swab, but not in urine. The cat was treated with anticonvulsants (phenobarbital and levetiracetam), an antibiotic (ampicillin/clavulanic acid), and GS-441524. Neurologic signs did not improve on an antibiotic alone but improved significantly after two subcutaneous injections of GS-441524. The cat received an 84-day course of GS-441524 and, at the time of manuscript preparation (over 12 months after diagnosis), remains ambulatory and seizure-free without recurrence of neurologic signs and no detectable viral shedding in feces.

Stopping Feline Coronavirus Shedding Prevented Feline Infectious Peritonitis

After an incubation period of weeks to months, up to 14% of cats infected with feline coronavirus (FCoV) develop feline infectious peritonitis (FIP): a potentially lethal pyogranulomatous perivasculitis. The aim of this study was to find out if stopping FCoV faecal shedding with antivirals prevents FIP. Guardians of cats from which FCoV had been eliminated at least 6 months earlier were contacted to find out the outcome of their cats; 27 households were identified containing 147 cats. Thirteen cats were treated for FIP, 109 cats shed FCoV and 25 did not; a 4-7-day course of oral GS-441524 antiviral stopped faecal FCoV shedding. Follow-up was from 6 months to 3.5 years; 11 of 147 cats died, but none developed FIP. A previous field study of 820 FCoV-exposed cats was used as a retrospective control group; 37 of 820 cats developed FIP. The difference was statistically highly significant (p = 0.0062). Cats from eight households recovered from chronic FCoV enteropathy. Conclusions: the early treatment of FCoV-infected cats with oral antivirals prevented FIP. Nevertheless, should FCoV be re-introduced into a household, then FIP can result. Further work is required to establish the role of FCoV in the aetiology of feline inflammatory bowel disease.

Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in the Human Eye

PURPOSE

To determine the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in postmortem ocular specimens of patients with severe COVID-19 disease.

PATIENTS AND METHODS

Postmortem conjunctival (28 samples), aqueous humor (30 samples) and vitreous humor (30 samples) specimens were obtained bilaterally from the eyes of 15 deceased COVID-19 patients within one hour of death. The presence of viral RNA was evaluated in samples using Real-time reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTS

Positive RT-PCR SARS-COV-2 results were found in one conjunctival and 2 vitreous humor samples. All aqueous humor samples tested negative for the presence of SARS-COV-2 RNA. Of note, three positive samples were obtained from three different patients. The overall prevalence of positive RT-PCR ocular samples was 3.4% among all samples and 20% at the patient level.

CONCLUSION

SARS-CoV-2 RNA is detectable in postmortem conjunctival and vitreous humor samples of patients with severe COVID-19.

Reproductive Management in Catteries: Optimising health and wellbeing through veterinarian-breeder collaboration

PRACTICAL RELEVANCE

Many veterinarians - even those engaged in small animal reproduction - are uncomfortable with taking care of cat breeders or being in charge of catteries. Likely reasons for this are that feline reproduction is largely under-represented in undergraduate and graduate reproduction teaching, as well as in postgraduate education and science, whereas cat breeders themselves are often well informed and actively share knowledge with other cat breeders via the internet and social media.

CLINICAL CHALLENGES

A variety of problems can exist within a cattery, and collaboration between veterinarian and breeder to solve these is ultimately beneficial for the breeder, for the veterinarian, and for the health and wellbeing of the individual cats and of the cattery as a whole.

AIM

This review presents a comprehensive overview of aspects of cattery management that might negatively impact reproduction, including sanitation, hygiene and infectious disease control. It also discusses monitoring of reproductive performance, breeding recommendations, and the diagnostic and therapeutic approach to some common and specific problems.

EQUIPMENT AND TECHNICAL SKILLS

Reproductive management in the cattery requires no specialised equipment, as such. What it does need is an open mind, in terms of seeing how things are done, an open ear, for listening to the breeder, and the veterinarian's clinical skills in palpation, auscultation and, where required, further examination of the animals. Keeping abreast of the latest information on infectious diseases, disinfection and genetics ensures proper advice is provided.

EVIDENCE BASE

Current knowledge of reproductive management in catteries is summarised in order to apply an evidence-based approach, whenever possible. Notwithstanding, much of the information remains empirical.

Updates on Coronavirus-Related Ocular Manifestations: From the Past to COVID-19 Pandemic

Context: Coronaviruses are the largest RNA viruses associated with some ocular manifestations. There are various contradictory reports about the ocular manifestations of coronaviruses in humans. Different ocular tissues can affect coronavirus-associated infectious diseases. Evidence Acquisition: All manuscripts were collected from PubMed, Google Scholar, and other relevant databases. All searches were done by specific keywords, including "coronavirus," "ocular disease," and "eye." Results: There are various contradictory reports about the ocular effects of coronaviruses in humans. Different ocular tissues are involved in coronavirus-associated infectious diseases. The ductal connection between the upper respiratory tract and eye mucosa through the nasolacrimal duct can be an entrance to respiratory viruses, such as coronaviruses. The coronavirus can infect the retina, conjunctiva, cornea, and uvea of the eye. The primary SARS-CoV-2 receptor, ACE2, is mainly expressed in the posterior tissues of the eye, such as the retina and RPE. Feline CoV, SARS-CoV, MERS-CoV, and infectious bronchitis virus (IBV) are responsible for conjunctiva involvement in coronavirus-related ocular pathogenesis. Also, various studies are held on COVID-19 and the impact of the conjunctiva on diagnosis and medical complications. Given that the cornea has an acceptable expression of ACE2 and TMPRSS2 genes compared to lung tissue, some studies were done on the impact of the cornea in COVID-19. Feline infectious peritonitis virus (FIPV) is also related to uvea complications. The experiments of human and animal models on the effects of coronaviruses on the retina and cornea in the event of various epidemics of coronaviruses and new and unknown ocular complications can be of great help to future studies. Conclusions: Given the importance of investigating the pathogenesis and other routes of SARS-CoV-2 infection, especially in areas other than the respiratory tract, this report attempts to highlight the importance of eye infections caused by the virus, its role in maintaining the virus transmission chain, and its impact on public health.

Fundus evaluation in COVID-19 positives with non-severe disease

Purpose:

The aim of this work was to study and document retinal changes in coronavirus disease-2019 (COVID-19) positive patients with nonsevere disease using a nonmydriatic handheld fundus camera.

Methods:

A cross-sectional observational study was conducted on patients affected by COVID-19 who were admitted at our center. Our study included patients with no, mild, and moderate symptoms (nonsevere cases). Intensive care unit (ICU)-admitted patients were excluded considering the difficulty in procuring the fundus image by the handheld camera due to patients positioning. Patients with systemic conditions (diabetes, hypertension, and severe anemia) known to cause retinopathy were also excluded. Bedside anterior segment examination, fundus examination using indirect ophthalmoscopy and fundus imaging of each patient using a nonmydriatic handheld fundus camera was done by a trained ophthalmologist posted for COVID duty.

Results:

In a cohort of 138 patients, 94 (68.1%) were men and 44 (31.9%) were women. A total of 276 eyes were evaluated. The mean age of the patients was 38.51 ± 14.4 years. Anterior segment evaluation showed no abnormality in any of the eyes. On fundus screening using nonmydriatic handheld camera, a single streak of superficial retinal hemorrhage was noted at the posterior pole of the fundus in the left eye of one patient (0.72%), which was away from fovea. Laboratory tests revealed low hemoglobin (between 10 and 10.9 g/dL falling under mild Anemia) in 12 patients, elevated total leucocyte count in 6 patients, raised LDH in majority of patients (323 ± 101 Units/L) and elevated CRP (14.6 ± 30.99 mg/L). Rest of the lab parameters were within the normal range.

Conclusion:

In our study, COVID patients with mild-to-moderate symptoms did not show any inflammatory/infective or vaso-occlusive lesions in the retina attributable to COVID-19 infection, except one patient who had a single streak hemorrhage in the macula away from fovea, probably incidental.

The eye: "An organ that must not be forgotten in coronavirus disease 2019 (COVID-2019) pandemic"

The coronavirus family is a group of zoonotic viruses with some recognized reservoirs particularly some bats. A novel coronavirus emerged in the province of Wuhan (China) in December of 2019.The number of infected patient with serious respiratory infection quickly spread around the world to become a global pandemic. The clinical presentation and viral pathogenesis of the coronavirus disease named COVID-19 indicated that the virus is transmitted from person to person through infected droplets entering the respiratory mucosa. Close contact with infected individuals particularly in crowded environments has characterized the rapid spread of the infection. Clinical manifestations of the viral infection have mentioned the presence of some ocular findings such as conjunctival congestion, conjunctivitis and even corneal injury associated with the classical COVID-19 infection. Some animal models of different coronaviruses eye infections have described the viral pathogenesis through tear and conjunctival sampling. On the other hand, we are recommended protective measure to prevent contagion and limit the spread of the virus in health care professionals and contact lenses wearers.

Eyes on coronavirus

Recently, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has spread around the world and is receiving worldwide attention. Approximately 20% of infected patients are suffering from severe disease of multiple systems and in danger of death, while the ocular complications of SARS-CoV-2-infected patients have not been reported generally. Herein, we focus on two major receptors of SARS-CoV-2, ACE2 and CD147 (BSG), in human ocular cells, and interpret the potential roles of coronaviruses in human ocular tissues and diseases.

The efficacy and safety of Yuxingcao eye drops in the treatment of COVID-19 conjunctivitis: A protocol for a systematic review

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). There is no specific cure for this disease, and the clinical management mainly depends on supportive treatment. This disease may affect SARS-CoV-2 conjunctivitis. Yuxingcao eye drops is used in treating COVID-19 conjunctivitis in China.

METHODS

A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract, and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19 conjunctivitis. The heterogeneity of data will be investigated by Cochrane X and I tests. Then publication bias assessment will be conducted by funnel plot analysis and Egger test.

RESULTS

The results of our research will be published in a peer-reviewed journal.

CONCLUSION

Our study aims to systematically present the clinical evidence of Yuxingcao eye drops in treating COVID-19 conjunctivitis, which will be of significant meaning for further research and clinical practice.

PROSPERO REGISTRATION NUMBER

PROSPERO CRD42020209059.

Retinal involvement and ocular findings in COVID-19 pneumonia patients

Changes in immune and coagulation systems and possible viral spread through the blood–brain barrier have been described in SARS-CoV-2 infection. In this study, we evaluated the possible retinal involvement and ocular findings in severe COVID-19 pneumonia patients. A cross-sectional study was conducted on 46 patients affected by severe COVID-19 who were hospitalized in one intensive care unit (ICU) and in two infectious disease wards, including bedside eye screening, corneal sensitivity assessment and retinography. A total of 43 SARS-CoV-2-positive pneumonia patients affected with COVID-19 pneumonia were included, including 25 males and 18 females, with a median age of 70 years [IQR 59–78]. Except for one patient with unilateral posterior chorioretinitis of opportunistic origin, of whom aqueous tap was negative for SARS-CoV-2, no further retinal manifestation related to COVID-19 infection was found in our cohort. We found 3 patients (7%) with bilateral conjunctivitis in whom PCR analysis on conjunctival swabs provided negative results for SARS-CoV-2. No alterations in corneal sensitivity were found. We demonstrated the absence of retinal involvement in SARS-CoV-2 pneumonia patients. Ophthalmologic evaluation in COVID-19, particularly in patients hospitalized in an ICU setting, may be useful to reveal systemic co-infections by opportunistic pathogens.

COVID-19 Disease and Ophthalmology: An Update

The worldwide outbreak of the severe and acute respiratory coronavirus disease (COVID-19) caused by the coronavirus strain SARS-CoV-2 is currently the focal point of discussion due to the suffering this syndrome is causing to humanity. However, the ophthalmological implications of this syndrome has not yet been well described. Both eyes and tears as portals of entry and sources of contagion have been the subject of debate by many authors. The purpose of this review is to summarize the evidence currently available on COVID-19 and its ocular implications and manifestations, in both animals and humans, with the aim to facilitate prevention and educate the ophthalmological community on this subject. A review of the literature revealed that the results of some studies suggest that ocular symptoms commonly appear in patients with severe COVID-19 pneumonia and that it is possible to isolate the virus from the conjunctival sac of these patients. Conjunctivitis is not a common manifestation of the disease, but contact with infected eyes could be one route of transmission. Consequently, ophthalmologists need to have correct prevention strategies in place. Some guidelines regarding the prevention and management of ophthalmology clinics are reviewed. However, well-designed trials should be conducted to rule out other ocular manifestations that may result from COVID-19 infection and to understand the transmission of the virus through the eyes.

Pulmonary and Extra-Pulmonary Clinical Manifestations of COVID-19

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been recently identified as the culprit of the highly infectious, outbreak named coronavirus disease 2019 (COVID-19) in China. Now declared a public health emergency, this pandemic is present in more than 200 countries with over 14 million cases and 600,000 deaths as of July 18, 2020. Primarily transmitted through the respiratory tract, the most common clinical presentations of symptomatic individuals infected with SARS-CoV-2 include fever, dyspnea, cough, fatigue, and sore throat. In advanced cases, patients may rapidly develop respiratory failure with acute respiratory distress syndrome, and even progress to death. While it is known that COVID-19 manifests similarly to the 2003 Severe Acute Respiratory Syndrome (SARS) and the 2012 Middle East Respiratory Syndrome (MERS), primarily affecting the pulmonary system, the impact of the disease extends far beyond the respiratory system and affects other organs of the body. The literature regarding the extrapulmonary manifestations (cardiovascular, renal, hepatic, gastrointestinal, ocular, dermatologic, and neurological) of COVID-19 is scant. Herein, we provide a comprehensive review of the organ-specific clinical manifestations of COVID-19, to increase awareness about the various organs affected by SARS-CoV-2 and to provide a brief insight into the similarities and differences in the clinical manifestations of COVID-19 and the earlier SARS and MERS.

Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals

In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus - 2 (SARS-CoV-2) emerged from China. This virus causes the coronavirus disease 2019 (COVID-19). Since then, there have been anecdotal reports of ocular infection. The ocular implications of human CoV infections have not been widely studied. However, CoVs have been known to cause various ocular infections in animals. Clinical entities such as conjunctivitis, anterior uveitis, retinitis, and optic neuritis have been documented in feline and murine models. In this article, the current evidence suggesting possible human CoV infection of ocular tissue is reviewed. The review article will also highlight animal CoVs and their associated ocular infections. We hope that this article will serve as a start for further research into the ocular implications of human CoV infections.

On-farm biosecurity practices and causes of preweaning mortality in Canadian commercial mink kits

Background

Mink are an important animal commodity group in Canada and excessive kit mortality represents a significant loss to production. National biosecurity standards have been developed for Canadian mink farms, but it is unclear how well these standards have been implemented as there are no studies correlating management practices of mink producers with causes of death in mink kits. To that end, we surveyed Ontario mink producers on their biosecurity and management practices and conducted almost 5660 post mortem examinations on found-dead, preweaned kits to characterize mink farm biosecurity practices and causes of death in preweaned kits.

Results

We found that very few biosecurity and management practices were uniformly used by producers, despite good awareness of appropriate practices. Use of personal protective equipment was implemented by fewer than 50% of respondents, while control of mink shed access, disinfection of feed containers after use, and use of a rodent control program were the only practices implemented by greater than 70% of respondents. Only 18% of producers reported regular use of antimicrobials in feed or water, although 91% stated they used antimicrobials for treatment of bacterial diseases on a regular basis. On post mortem examination, no gross abnormalities were noted in 71% of the kits, 45% were thought to be stillborn or aborted, 27% had some form of abnormal fluid distribution in the body, and 2% had a congenital malformation. A subset of 69 gastrointestinal tract samples was submitted for bacterial culture, of which 45 samples yielded sufficient growth. Most interesting was the identification of Salmonella enterica serovar Heidelberg in 11% of samples.

Conclusions

The results of this study will provide a benchmark for Canadian mink producers and their veterinarians, defining the areas to which greater attention should be given to ensure more rigorous biosecurity practices are in place. Ultimately, these improvements in practices may contribute to increased mink production and animal well-being.

Electronic supplementary material

The online version of this article (doi:10.1186/s13028-017-0326-8) contains supplementary material, which is available to authorized users.

Ocular manifestations of feline viral diseases

Feline viral diseases are common and cats can be presented with a variety of clinical manifestations. Ocular disease associated with viral pathogens is not unusual, particularly with viruses causing upper respiratory tract disease in cats, such as feline herpesvirus type 1 and feline calicivirus. These agents mainly cause ocular surface disease. Other viruses, such as feline immunodeficiency virus and feline coronavirus, can cause uveitis, while feline leukemia virus can induce ocular lymphosarcoma. This review covers the most common viral pathogens of cats that cause ocular manifestations, the specific features of the ocular diseases caused by these viruses and therapeutic recommendations.

Canine and feline pregnancy loss due to viral and non-infectious causes: a review

Among the causes for pregnancy loss, viruses and non-infectious factors are among the most important. In both dogs and cats, research and clinical evidence provide proof that there is an increasing incidence of pregnancy loss associated with infectious diseases like herpesvirus, as well as the presence of toxicants or chemicals in the animal's diet and environment. Endocrine causes must be taken into consideration when dealing with pregnancy loss. This review will cover the most recent knowledge regarding viral and non-infectious of pregnancy losses in the dog and cat.

Prevalence of feline coronavirus types I and II in cats with histopathologically verified feline infectious peritonitis

Feline coronaviruses (FCoV) vary widely in virulence causing a spectrum of clinical manifestations reaching from subclinical course to fatal feline infectious peritonitis (FIP). Independent of virulence variations they are separated into two different types, type I, the original FCoV, and type II, which is closely related to canine coronavirus (CCV). The prevalence of FCoV types in Austrian cat populations without FIP has been surveyed recently indicating that type I infections predominate. The distribution of FCoV types in cats, which had succumbed to FIP, however, was fairly unknown. PCR assays have been developed amplifying parts of the spike protein gene. Type-specific primer pairs were designed, generating PCR products of different sizes. A total of 94 organ pools of cats with histopathologically verified FIP was tested. A clear differentiation was achieved in 74 cats, 86% of them were type I positive, 7% type II positive, and 7% were positive for both types. These findings demonstrate that in FIP cases FCoV type I predominates, too, nonetheless, in 14% of the cases FCoV type II was detected, suggesting its causative involvement in cases of FIP.

Development of clinical signs and occurrence of feline corona virus antigen in naturally infected barrier reared cats and their offspring

The onset and pattern of the clinical signs of feline corona virus (FCoV) infection in cats were studied in a setting behind an isolation barrier. Two FCoV-seropositive cats were the source of the infection, and 3 barrier reared cats - initially FCoV-seronegative - were the recipients. The first clinical sign in the recipients appeared 11 days after contact with the source of infection. After 2 years 1 male and 1 female of the recipients started to breed. Their offspring developed clinical signs of disease at an age of 4-5 weeks. A pattern of recurring upper respiratory tract signs and conjunctivitis at intervals of about 4 months was observed in both the recipients and their offspring, while CNS dependent signs and wasting remained or got worse, once developed. Once demonstrated, FCoV antigen persisted in membrana nictitans throughout the investigation, and was found in all cats but 4 (90%). The offspring died during 2 periods, around the first week of life (9/37), and at 3-5 months of age (5/25). For comparison 3 offspring were euthanized at an age of 1 day and 16 offspring at an age of 3-6 months. FCoV antigen was demonstrated in all organs investigated (100%) from offspring dying during the first period, and in 97% from those dying during the second period. For the offspring euthanized during the same 2 periods the corresponding findings were 95% and 85%. Offspring euthanized between 9 and 17 months (4 kittens) had antigen in 67% of all investigated organs. The incidence of FCoV antigen in almost every organ in the investigated newborn kittens suggests an intrauterine infection. The demonstration of FCoV antigen in all euthanised cats, suggests a persistent infection. Virus was cultivated from membrana nictitans, that was FCoV antigen positive in the M3 test.

Development of clinical signs and occurrence of feline corona virus antigen in naturally infected barrier reared cats and their offspring

The onset and pattern of the clinical signs of feline corona virus (FCoV) infection in cats were studied in a setting behind an isolation barrier. Two FCoV-seropositive cats were the source of the infection, and 3 barrier reared cats - initially FCoV-seronegative - were the recipients. The first clinical sign in the recipients appeared 11 days after contact with the source of infection. After 2 years 1 male and 1 female of the recipients started to breed. Their offspring developed clinical signs of disease at an age of 4-5 weeks. A pattern of recurring upper respiratory tract signs and conjunctivitis at intervals of about 4 months was observed in both the recipients and their offspring, while CNS dependent signs and wasting remained or got worse, once developed. Once demonstrated, FCoV antigen persisted in membrana nictitans throughout the investigation, and was found in all cats but 4 (90%). The offspring died during 2 periods, around the first week of life (9/37), and at 3-5 months of age (5/25). For comparison 3 offspring were euthanized at an age of 1 day and 16 offspring at an age of 3-6 months. FCoV antigen was demonstrated in all organs investigated (100%) from offspring dying during the first period, and in 97% from those dying during the second period. For the offspring euthanized during the same 2 periods the corresponding findings were 95% and 85%. Offspring euthanized between 9 and 17 months (4 kittens) had antigen in 67% of all investigated organs. The incidence of FCoV antigen in almost every organ in the investigated newborn kittens suggests an intrauterine infection. The demonstration of FCoV antigen in all euthanised cats, suggests a persistent infection. Virus was cultivated from membrana nictitans, that was FCoV antigen positive in the M3 test.