1
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Yang Y, Zheng Q, Yang L, Wu L. Comparison of inflammatory markers, coagulation indicators and outcomes between influenza and COVID-19 infection amongst children: A systematic review and meta-analysis. Heliyon 2024; 10:e30391. [PMID: 38765052 PMCID: PMC11096948 DOI: 10.1016/j.heliyon.2024.e30391] [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: 09/23/2023] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024] Open
Abstract
Background Influenza and COVID-19 patients share similar features and outcomes amongst adults. However, the difference between these diseases is not explored in paediatric age group especially in terms of inflammatory markers, coagulation profile and outcomes. Hence, we did this review to compare the inflammatory, coagulation features and outcomes between influenza and COVID-19 infected children. Methods Literature search was done in PubMed Central, Scopus, EMBASE, CINAHL, Cochrane library, Google Scholar & ScienceDirect from November 2019 to May 2022. Risk of bias assessment was done through Newcastle Ottawa scale. Meta-analysis was done using random-effects model and the final pooled estimate was reported as pooled odds ratio (OR) or standardized mean difference (SMD) along with 95 % confidence interval (CI) depending on the type of outcome. Results About 16 studies were included with most studies having higher risk of bias. Influenza paediatric patients had significantly higher erythrocyte sedimentation rate (ESR) (pooled SMD = 0.60; 95%CI: 0.30-0.91; I2 = 0 %), lactate dehydrogenase (LDH) (pooled SMD = 2.01; 95%CI: 0.37-3.66; I2 = 98.4 %) and prothrombin time (PT) (pooled SMD = 2.12; 95%CI: 0.44-3.80; I2 = 98.3 %) when compared to paediatric COVID-19 patients. There was no significant difference in terms of features like CRP, procalcitonin, serum albumin, aPTT, mortality and need for mechanical ventilation. Conclusion Inflammatory markers like ESR, LDH and PT was significantly higher in influenza patients when compared to COVID-19 in children, while rest of the markers and adverse clinical outcomes were similar between both the groups. Identification of these biomarkers has helped in understanding the distinctness of COVID-19 and influenza virus and develop better management strategies.
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Affiliation(s)
- Yutang Yang
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250021, China
| | - Qi Zheng
- Department of Gynecology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250013, China
| | - Linlin Yang
- Department of Hematology and Rheumatology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250013, China
| | - Lei Wu
- Department of Pediatrics, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250013, China
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2
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Guadalupe-Fernández V, Martínez-Solanas E, Sabrià-Sunyé A, Ferrer-Mikoly C, Martínez-Mateo A, Ciruela-Navas P, Mendioroz J, Basile L. Investigating epidemiological distribution (temporality and intensity) of respiratory pathogens following COVID-19 de-escalation process in Catalonia, September 2016-June 2021: Analysis of regional surveillance data. PLoS One 2024; 19:e0285892. [PMID: 38335176 PMCID: PMC10857536 DOI: 10.1371/journal.pone.0285892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/03/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Following the low incidence rates of non-SARS-CoV-2 respiratory viruses registered during the strict lockdown enforced in the pandemic, a resurgence of several endemic viruses in Catalonia (Spain) was noted during the early summer of 2021. OBJECTIVES In this study, we investigated whether the circulation of non-SARS-CoV-2 respiratory viruses in Catalonia, assessed by Microbiological Reporting System of Catalonia (MRSC) and the Epidemiological Surveillance Network of Catalonia, was affected by the strict lockdown measures, as well as, the implication of the Coronavirus Disease 19 (COVID-19) de-escalation process in the late season outbreaks registered during the 2020-2021 season. STUDY DESIGN A retrospective comparison of epidemic patterns in the respiratory viruses' incidence, using regional public health surveillance data from MRSC, was performed between weeks 26/2016 to week 27/2021. Data were expressed as the weekly total number of test positivity for individual viruses. A segmented negative binomial regression model was conducted, with two parameters included (level and trend) for each segment of the time series (2020 pre-lockdown, 2020 post-lockdown and 2021). Results were reported as a unit changed in the strict lockdown. RESULTS A total of 51588 confirmed cases of the different respiratory viruses were included in the analysis, the majority were influenza cases (63.7%). An immediate reduction in the weekly number of cases was observed in 2020 after the COVID-19 outbreak for human adenovirus virus (HAdV) (β2 = -2.606; P <0.01), human parainfluenza virus (HPIV) (β2 = -3.023; P <0.01), influenza virus (IFV) (β2 = -1.259; P <0.01), but not for respiratory syncytial virus (RSV), where the number of cases remained unchanged. During 2020, a significant negative trend was found for RSV (β3 = -0.170, P <0.01), and a positive trend for HAdV (β3 = 0.075, P <0.01). During 2021, a significant reduction in the weekly number of cases was also observed for all respiratory viruses, and a borderline non-significant reduction for HPIV (β3 = -0.027; P = 0.086). Moreover, significant positive trends were found for each viral pathogen, except for influenza during 2020-2021 season, where cases remained close to zero. The respiratory viruses increased activity and their late season epidemic start particularly affected children under 6 years old. CONCLUSIONS Our data not only provides evidence that occurrence of different respiratory virus infections was affected by the strict lockdown taken against SARS-CoV-2 but it also shows a late resurgence of seasonal respiratory viruses' cases during the 2020-2021 season following the relaxation of COVID-19-targeted non-pharmaceutical interventions.
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Affiliation(s)
- Víctor Guadalupe-Fernández
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Erica Martínez-Solanas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Aurora Sabrià-Sunyé
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Carol Ferrer-Mikoly
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Ana Martínez-Mateo
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Pilar Ciruela-Navas
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Jacobo Mendioroz
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
- Research Support Unit of Central Catalonia, University Institute for Research in Primary Health Care Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Luca Basile
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
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3
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Pangot Q, Labaste F, Pey V, Médrano C, Tuijnman A, Ruiz S, Conil JM, Minville V, Vardon-Bounes F. Comparing COVID-19 and influenza: Epidemiology, clinical characteristics, outcomes and mortality in the ICU. J Clin Virol 2023; 169:105600. [PMID: 37948984 DOI: 10.1016/j.jcv.2023.105600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/26/2023] [Accepted: 10/01/2023] [Indexed: 11/12/2023]
Abstract
RATIONALE Several authors have compared COVID-19 infection with influenza in the ICU. OBJECTIVE This study aimed to compare the baseline clinical profiles, care procedures, and mortality outcomes of patients admitted to the intensive care unit, categorized by infection status (Influenza vs. COVID-19). METHODS Retrospective observational study. Data were extracted from the Toulouse University Hospital from March 2014 to March 2021. To compare survival curves, we plotted the survival at Day-90 using the Kaplan-Meier curve and conducted a log-rank test. Additionally, we performed propensity score matching to adjust for confounding factors between the COVID-19 and influenza groups. Furthermore, we use the CART model for multivariate analysis. RESULTS The study included 363 patients admitted to the ICU due to severe viral pneumonia: 152 patients (41.9 %) with influenza and 211 patients (58.1 %) with COVID-19. COVID-19 patients exhibited a higher prevalence of cardiovascular risk factors, whereas influenza patients had significantly higher severity scores (SOFA: 10 [6-12] vs. 6 [3-9], p<0.01 and SAPS II: 51 [35-67] vs. 37 [29-50], p<0.001). Overall mortality rates were comparable between the two groups (27.6 % (n = 42) in the influenza group vs. 21.8 % (n = 46) in the COVID-19 group, p=NS). Mechanical ventilation was more commonly employed in the influenza group (76.3 % (n = 116) vs. 59.7 % (n = 126), p<0.001); however, COVID-19 patients required longer durations of mechanical ventilation (18 [9-29] days vs. 13 [5-24] days, p<0.006) and longer hospital stays (23 [13-34] days vs. 18.5 [9-34.5] days, p = 0.009). The CART analysis revealed that the use of extra renal replacement therapy was the most influential prognostic factor in the influenza group, while the PaO2/FiO2-PEEP ratio played a significant role in the COVID-19 group. CONCLUSIONS Despite differences in clinical presentation and prognostic factors, the mortality rates at 90 days, after adjusting for confounding factors, were similar between COVID-19 and influenza patients.
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Affiliation(s)
- Quentin Pangot
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France
| | - François Labaste
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France
| | - Vincent Pey
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France
| | - Chloé Médrano
- Departments of Nephrology and Organ Transplantation, Toulouse University Hospital, Toulouse, France
| | - Adam Tuijnman
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France
| | - Stéphanie Ruiz
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France
| | - Jean-Marie Conil
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France
| | - Vincent Minville
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France
| | - Fanny Vardon-Bounes
- Anaesthesiology and Critical Care Department, Toulouse University Hospital, Toulouse, France.
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4
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Gize A, Kassa M, Ali S, Tadesse Y, Fantahun B, Habtu Y, Yesuf A. Epidemiological, clinical and laboratory profile of patients presenting with severe acute respiratory syndrome (SARS-CoV-2) in Ethiopia. PLoS One 2023; 18:e0295177. [PMID: 38039278 PMCID: PMC10691732 DOI: 10.1371/journal.pone.0295177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/16/2023] [Indexed: 12/03/2023] Open
Abstract
INTRODUCTION Data regarding patients presenting with severe acute respiratory syndrome (SARS-CoV-2) illness have not adequately been documented which provides distinct insights into low-resource settings like Ethiopia. Thus, the study aimed to compare epidemiological, clinical and laboratory profiles of patients presenting with acute respiratory syndrome illness in Addis Ababa Ethiopia. METHODS We used a comparative cross-sectional study design among patients with SARS-CoV-2 illness at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia from October 2020 to September 2021. Using a structured questionnaire a consecutive sampling technique was applied to collect socio-demographic data. Additionally, nasal swabs were collected to confirm SARS-CoV-2 infection using a Real-Time Polymerase Chain Reaction. Blood samples were also collected from the participants for laboratory profiles (hematological tests like; white blood cell count, hematocrit, and platelet count; and biochemical and enzymatic tests like; aspartate transaminase (AST), creatinine, etc) analysis. Data were entered and analyzed using SPSS version 23.0 and p-values ≤0.05 were considered as statistically significant. RESULTS Of the total 413 participants presenting with SARS-CoV-2 illness, 250 (60.5%) participants tested positive for COVID-19 disease. COVID-19 patients were less likely to use an alcohol-based method of hand washing (12.5% vs 87.5%; p = 0.048). The COVID-19 patients had a higher proportion of headache (67.3% vs 32.7%, p = 0.001), sore throat (72.5% vs 27.5%, p = 0.001), and loss of sense of taste (74.4% vs 25.6%, p = 0.002). Patients with COVID-19 have significantly higher neutrophil than their counterparts (68.2% vs 31.8%; p = 0.001). Similarly, creatinine (64.9% vs 35.1%, p = 0.001) from renal function and alkaline phosphatase (66.8% vs 33.2%, p = 0.046) in the liver function tests were significantly higher in the COVID-19 patients. CONCLUSION Our findings suggest the need to substantially consider headache, sore throat, and loss of taste as potential clinical diagnostic symptoms for early screening and testing. Elevation of neutrophil, creatinine, alkaline phosphatase profiles are also used for potential diagnostic biomarkers in screening and testing suspected patients.
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Affiliation(s)
- Addisu Gize
- Department of Microbiology, School of Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- CIH Center for International Health, LMU University Hospital, LMU Munich, Germany
| | - Melkayehu Kassa
- Department of Microbiology, School of Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Solomon Ali
- Department of Microbiology, School of Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yosef Tadesse
- Department of Anatomy, School of Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bereket Fantahun
- Department of Pediatrics, School of Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yitagesu Habtu
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aman Yesuf
- Department of Epidemiology, School of Public Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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5
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Abstract
COVID-19, the illness caused by SARS-CoV-2, became a worldwide pandemic in 2020. Initial clinical manifestations range from asymptomatic infection to mild upper respiratory illness but may progress to pulmonary involvement with hypoxemia and, in some cases, multiorgan involvement, shock, and death. Older adults, pregnant persons, those with common comorbidities, and those with immunosuppression are at greatest risk for progression. Vaccination is effective in preventing symptomatic infection and reducing risk for severe disease, hospitalization, and death. Antiviral treatment and immunomodulators have been shown to benefit certain patients. This article summarizes current recommendations on prevention, diagnosis, management, and treatment of COVID-19.
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Affiliation(s)
| | - Roy M Gulick
- Weill Cornell Medicine, New York, New York (K.M.M., R.M.G.)
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6
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Zhang Z, Tan J, Li Y, Zhou X, Niu J, Chen J, Sheng H, Wu X, Yuan Y. Bibliometric analysis of publication trends and topics of influenza-related encephalopathy from 2000 to 2022. Immun Inflamm Dis 2023; 11:e1013. [PMID: 37773718 PMCID: PMC10510462 DOI: 10.1002/iid3.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Influenza-related encephalopathy is a rapidly progressive encephalopathy that usually presents during the early phase of influenza infection and primarily manifests as central nervous system dysfunction. This study aimed to analyze the current research status and hotspots of influenza-related encephalopathy since 2000 through bibliometrics analysis. METHODS The Web of Science Core Collection (WOSCC) was used to extract global papers on influenza-related encephalopathy from 2000 to 2022. Meanwhile, the VOSviewer and CiteSpace software were used for data processing and result visualization. RESULTS A total of 561 published articles were included in the study. Japan was the country that published the most articles, with 205 articles, followed by the United States and China. Okayama University and Tokyo Medical University published the most articles, followed by Nagoya University, Tokyo University, and Juntendo University. Based on the analysis of keywords, four clusters with different research directions were identified: "Prevalence of H1N1 virus and the occurrence of neurological complications in different age groups," "mechanism of brain and central nervous system response after influenza virus infection," "various acute encephalopathy" and "diagnostic indicators of influenza-related encephalopathy." CONCLUSIONS The research progress, hotspots, and frontiers on influenza-related encephalopathy after 2000 were described through the visualization of bibliometrics. The findings will lay the groundwork for future studies and provide a reference for influenza-related encephalopathy. Research on influenza-related encephalopathy is basically at a stable stage, and the number of research results is related to outbreaks of the influenza virus.
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Affiliation(s)
- Zhengyu Zhang
- Medical Records Department, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Juntao Tan
- Operation Management OfficeAffiliated Banan Hospital of Chongqing Medical UniversityChongqingChina
| | - Ying Li
- Department of Medical Administration, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Xiumei Zhou
- Department of Infectious DiseasesPeople's Hospital of Pujiang CountyZhejiangChina
- PuJiang branch of the First Affiliated HospitalZhejiang University School of MedicineJinhuaChina
| | - Jianhua Niu
- Intensive Care Department, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Jun Chen
- Lung Transplant Department, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Hongfeng Sheng
- Department of OrthopedicsTongde Hospital of Zhejiang ProvinceHangzhouChina
| | - Xiaoxin Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Infectious DiseasesHangzhouZhejiangChina
| | - Yuan Yuan
- Medical Records DepartmentWomen and Children's Hospital of Chongqing Medical UniversityChongqingChina
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7
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Ojo MM, Peter OJ, Goufo EFD, Nisar KS. A mathematical model for the co-dynamics of COVID-19 and tuberculosis. MATHEMATICS AND COMPUTERS IN SIMULATION 2023; 207:499-520. [PMID: 36691571 PMCID: PMC9850643 DOI: 10.1016/j.matcom.2023.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/02/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
In this study, we formulated and analyzed a deterministic mathematical model for the co-infection of COVID-19 and tuberculosis, to study the co-dynamics and impact of each disease in a given population. Using each disease's corresponding reproduction number, the existence and stability of the disease-free equilibrium were established. When the respective threshold quantities R C , and R T are below unity, the COVID-19 and TB-free equilibrium are said to be locally asymptotically stable. The impact of vaccine (i.e., efficacy and vaccinated proportion) and the condition required for COVID-19 eradication was examined. Furthermore, the presence of the endemic equilibria of the sub-models is analyzed and the criteria for the phenomenon of backward bifurcation of the COVID-19 sub-model are presented. To better understand how each disease condition impacts the dynamics behavior of the other, we investigate the invasion criterion of each disease by computing the threshold quantity known as the invasion reproduction number. We perform a numerical simulation to investigate the impact of threshold quantities ( R C , R T ) with respect to their invasion reproduction number, co-infection transmission rate ( β c t ) , and each disease transmission rate ( β c , β t ) on disease dynamics. The outcomes established the necessity for the coexistence or elimination of both diseases from the communities. Overall, our findings imply that while COVID-19 incidence decreases with co-infection prevalence, the burden of tuberculosis on the human population increases.
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Affiliation(s)
- Mayowa M Ojo
- Department of Mathematical Sciences, University of South Africa, Florida, South Africa
- Thermo Fisher Scientific, Microbiology Division, Lenexa, KS, USA
| | - Olumuyiwa James Peter
- Department of Mathematical and Computer Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
- Department of Epidemiology and Biostatistics, School of Public Health, University of Medical Sciences, Ondo City, Ondo State, Nigeria
| | | | - Kottakkaran Sooppy Nisar
- Department of Mathematics, College of Arts and Sciences, Prince Sattam bin Abdulaziz University, Wadi Aldawaser, Saudi Arabia
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8
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Bonam SR, Hu H. Next-Generation Vaccines Against COVID-19 Variants: Beyond the Spike Protein. ZOONOSES (BURLINGTON, MASS.) 2023; 3:10.15212/zoonoses-2023-0003. [PMID: 38031548 PMCID: PMC10686570 DOI: 10.15212/zoonoses-2023-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Vaccines are among the most effective medical countermeasures against infectious diseases. The current Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spurred the scientific strategies to fight against the disease. Since 2020, a great number of vaccines based on different platforms have been in development in response to the pandemic, among which mRNA, adenoviral vector, and subunit vaccines have been clinically approved for use in humans. These first-generation COVID-19 vaccines largely target the viral spike (S) protein and aim for eliciting potent neutralizing antibodies. With the emergence of SARS-CoV-2 variants, especially the highly transmissible Omicron strains, the S-based vaccine strategies have been faced constant challenges due to strong immune escape by the variants. The coronavirus nucleocapsid (N) is one of the viral proteins that induces strong T-cell immunity and is more conserved across different SARS-CoV-2 variants. Inclusion of N in the development of COVID-19 vaccines has been reported. Here, we briefly reviewed and discussed COVID-19 disease, current S-based vaccine strategies, and focused on the immunobiology of N protein in SARS-CoV-2 host immunity, as well as the next-generation vaccine strategies involving N protein, to combat current and emerging SARS-CoV-2 variants.
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Affiliation(s)
- Srinivasa Reddy Bonam
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA 77555
| | - Haitao Hu
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA 77555
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA 77555
- Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, USA 77555
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9
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Clark K, Schenkel MS, Pittman TW, Samper IC, Anderson LBR, Khamcharoen W, Elmegerhi S, Perera R, Siangproh W, Kennan AJ, Geiss BJ, Dandy DS, Henry CS. Electrochemical Capillary Driven Immunoassay for Detection of SARS-CoV-2. ACS MEASUREMENT SCIENCE AU 2022; 2:584-594. [PMID: 36570470 PMCID: PMC9469961 DOI: 10.1021/acsmeasuresciau.2c00037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/09/2022] [Accepted: 08/16/2022] [Indexed: 05/28/2023]
Abstract
The COVID-19 pandemic focused attention on a pressing need for fast, accurate, and low-cost diagnostic tests. This work presents an electrochemical capillary driven immunoassay (eCaDI) developed to detect SARS-CoV-2 nucleocapsid (N) protein. The low-cost flow device is made of polyethylene terephthalate (PET) and adhesive films. Upon addition of a sample, reagents and washes are sequentially delivered to an integrated screen-printed carbon electrode for detection, thus automating a full sandwich immunoassay with a single end-user step. The modified electrodes are sensitive and selective for SARS-CoV-2 N protein and stable for over 7 weeks. The eCaDI was tested with influenza A and Sindbis virus and proved to be selective. The eCaDI was also successfully applied to detect nine different SARS-CoV-2 variants, including Omicron.
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Affiliation(s)
- Kaylee
M. Clark
- Department
of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Melissa S. Schenkel
- Department
of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Trey W. Pittman
- Department
of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Isabelle C. Samper
- Department
of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
- Department
of Chemical and Biological Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Loran B. R. Anderson
- Department
of Microbiology, Immunology, and Pathology, Colorado State University, Fort
Collins, Colorado 80523, United States
| | - Wisarut Khamcharoen
- Department
of Chemistry, Faculty of Science, Srinakharinwirot
University, Bangkok 10110, Thailand
| | - Suad Elmegerhi
- Department
of Microbiology, Immunology, and Pathology, Colorado State University, Fort
Collins, Colorado 80523, United States
| | - Rushika Perera
- Department
of Microbiology, Immunology, and Pathology, Colorado State University, Fort
Collins, Colorado 80523, United States
| | - Weena Siangproh
- Department
of Chemistry, Faculty of Science, Srinakharinwirot
University, Bangkok 10110, Thailand
| | - Alan J. Kennan
- Department
of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
| | - Brian J. Geiss
- Department
of Microbiology, Immunology, and Pathology, Colorado State University, Fort
Collins, Colorado 80523, United States
- School
of Biomedical Engineering, Colorado State
University, Fort Collins, Colorado 80523, United States
| | - David S. Dandy
- Department
of Chemical and Biological Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
- School
of Biomedical Engineering, Colorado State
University, Fort Collins, Colorado 80523, United States
| | - Charles S. Henry
- Department
of Chemistry, Colorado State University, Fort Collins, Colorado 80523, United States
- Department
of Chemical and Biological Engineering, Colorado State University, Fort Collins, Colorado 80523, United States
- School
of Biomedical Engineering, Colorado State
University, Fort Collins, Colorado 80523, United States
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10
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Romdhani M, Vedasalam S, Souissi A, Fessi MS, Varma A, Taheri M, Ghram A, Al Naama A, Mkaouer B, Ben Saad H, Dergaa I. Is there a diurnal variation of COVID-19 patients warranting presentation to the health centre? A chronobiological observational cross-sectional study. Ann Med 2022; 54:3060-3068. [PMID: 36308396 PMCID: PMC9635474 DOI: 10.1080/07853890.2022.2136399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The circadian clock regulates the function of the immune system, the replication of viruses, and the magnitude of infections. The aim of this study was to analyse whether hospital attendance in Coronavirus disease 2019 (COVID-19) patients presents a diurnal variation. METHODS Data from the electronic medical records of 1094 COVID-19 patients who presented to a Health Centre in Qatar during the month of July 2020 was retrospectively analysed. The following demographic (i.e. time of day (TOD), sex, age), clinical (i.e. cycle threshold (CT), temperature, oxy-haemoglobin saturation and resting heart-rate), biochemical (i.e. uraemia, glycaemia and albuminia) and haematological (i.e. leukocytes, erythrocytes ad platelets) parameters were collected. RESULTS Univariate analysis showed a significant effect of TOD on hospital admission (p < 0.001), with patients attending the health care centre more during the active behavioural phase (08h00-00h00) compared to the resting phase (00h00-08h00). COVID-19 infection blunted the circadian rhythms of core body temperature, neutrophils and leukocytes family and shifted the circadian rhythms of resting heart-rate and uraemia. Correlation analysis showed a near perfect negative correlation between the age of patients and the TOD (r=-0.97), with older patients attending the care centre earlier during the day. CONCLUSION COVID-19 infection affected the circadian rhythms of the host through disrupting the circadian rhythms of core temperature and innate immunity mediators. Old patients attend the health care centre earlier compared to younger ones. However, CT during polymerase chain reaction-test was unaffected by the TOD, which limits the conclusion that COVID-19 viral infection exhibits diurnal variation.
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Affiliation(s)
- Mohamed Romdhani
- Research Unit: Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia.,Motricité-Interactions-Performance, MIP, UR4334, Le Mans Université, Le Mans, France
| | | | - Amine Souissi
- Sports Medicine, Universite de Sousse, Faculte de Medecine de Sousse, Sousse, Tunisia
| | - Mohamed Saifeddin Fessi
- Research Unit: Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
| | - Amit Varma
- Primary Health Care Corporation, Doha, Qatar
| | - Morteza Taheri
- Department of Sport Sciences, Imam Khomeini International University, Qazvi, Iran
| | - Amine Ghram
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, US
| | | | | | - Helmi Ben Saad
- Laboratoire de Recherche (LR12SP09) "Insuffisance cardiaque" Sousse, Faculté de Médecine de Sousse, Hôpital Farhat HACHED, Université de Sousse, Sousse, Tunisie
| | - Ismail Dergaa
- Research Unit: Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia.,Primary Health Care Corporation, Doha, Qatar
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11
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Ojo MM, Benson TO, Peter OJ, Goufo EFD. Nonlinear optimal control strategies for a mathematical model of COVID-19 and influenza co-infection. PHYSICA A 2022; 607:128173. [PMID: 36106051 PMCID: PMC9461290 DOI: 10.1016/j.physa.2022.128173] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/29/2022] [Indexed: 05/29/2023]
Abstract
Infectious diseases have remained one of humanity's biggest problems for decades. Multiple disease infections, in particular, have been shown to increase the difficulty of diagnosing and treating infected people, resulting in worsening human health. For example, the presence of influenza in the population is exacerbating the ongoing COVID-19 pandemic. We formulate and analyze a deterministic mathematical model that incorporates the biological dynamics of COVID-19 and influenza to effectively investigate the co-dynamics of the two diseases in the public. The existence and stability of the disease-free equilibrium of COVID-19-only and influenza-only sub-models are established by using their respective threshold quantities. The result shows that the COVID-19 free equilibrium is locally asymptotically stable when R C < 1 , whereas the influenza-only model, is locally asymptotically stable when R F < 1 . Furthermore, the existence of the endemic equilibria of the sub-models is examined while the conditions for the phenomenon of backward bifurcation are presented. A generalized analytical result of the COVID-19-influenza co-infection model is presented. We run a numerical simulation on the model without optimal control to see how competitive outcomes between-hosts and within-hosts affect disease co-dynamics. The findings established that disease competitive dynamics in the population are determined by transmission probabilities and threshold quantities. To obtain the optimal control problem, we extend the formulated model by including three time-dependent control functions. The maximum principle of Pontryagin was used to prove the existence of the optimal control problem and to derive the necessary conditions for optimum disease control. A numerical simulation was performed to demonstrate the impact of different combinations of control strategies on the infected population. The findings show that, while single and twofold control interventions can be used to reduce disease, the threefold control intervention, which incorporates all three controls, will be the most effective in reducing COVID-19 and influenza in the population.
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Affiliation(s)
- Mayowa M Ojo
- Thermo Fisher Scientific, Microbiology Division, Lenexa, KS, USA
- Department of Mathematical Sciences, University of South Africa, Florida, South Africa
| | - Temitope O Benson
- Institute for Computational and Data Sciences, University at Buffalo, State University of New York, USA
| | - Olumuyiwa James Peter
- Department of Mathematical and Computer Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria
- Department of Epidemiology and Biostatistics, School of Public Health, University of Medical Sciences, Ondo City, Ondo State, Nigeria
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12
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Clinical progress in MSC-based therapies for the management of severe COVID-19. Cytokine Growth Factor Rev 2022; 68:25-36. [PMID: 35843774 PMCID: PMC9259053 DOI: 10.1016/j.cytogfr.2022.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/04/2022] [Indexed: 01/30/2023]
Abstract
Considering the high impact that severe Coronavirus disease 2019 (COVID-19) cases still pose on public health and their complex pharmacological management, the search for new therapeutic alternatives is essential. Mesenchymal stromal cells (MSCs) could be promising candidates as they present important immunomodulatory and anti-inflammatory properties that can combat the acute severe respiratory distress syndrome (ARDS) and the cytokine storm occurring in COVID-19, two processes that are mainly driven by an immunological misbalance. In this review, we provide a comprehensive overview of the intricate inflammatory process derived from the immune dysregulation that occurs in COVID-19, discussing the potential that the cytokines and growth factors that constitute the MSC-derived secretome present to treat the disease. Moreover, we revise the latest clinical progress made in the field, discussing the most important findings of the clinical trials conducted to date, which follow 2 different approaches: MSC-based cell therapy or the administration of the secretome by itself, as a cell-free therapy.
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13
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Clinical and Epidemiological Presentation of COVID-19 among Children in Conflict Setting. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111712. [PMID: 36360440 PMCID: PMC9688921 DOI: 10.3390/children9111712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
Background: This study aims to describe the observable symptoms of children with COVID-19 infection and analyze access to real-time polymerase chain reaction (RT-PCR) testing among children seeking care in Yemen. Method: In the period of March 2020−February 2022, data were obtained from 495 children suspected to have been infected with COVID-19 (from a larger register of 5634 patients) from the Diseases Surveillance and Infection Control Department at the Ministry of Public Health and Population in Aden, Yemen. Results: Overall, 21.4% of the children with confirmed COVID-19 infection were asymptomatic. Fever (71.4%) and cough (67.1%) were the most frequently reported symptoms among children, and children were less likely to have fever (p < 0.001), sore throat (p < 0.001) and cough (p < 0.001) compared to adults. A lower frequency of COVID-19-associated symptoms was reported among children with positive RT-PCR tests compared to children with negative tests. A lower rate of testing was conducted among children (25%) compared to adults (61%). Fewer tests were carried out among children <5 years (11%) compared to other age groups (p < 0.001), for children from other nationalities (4%) compared to Yemeni children (p < 0.001) and for girls (21%) compared to boys (30%) (p < 0.031). Conclusion: Understanding and addressing the cause of these disparities and improving guidelines for COVID-19 screening among children will improve access to care and control of the COVID-19 pandemic.
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14
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Yu B, Chen HH, Hu XF, Mai RZ, He HY. Comparison of laboratory parameters, clinical symptoms and clinical outcomes of COVID-19 and influenza in pediatric patients: A systematic review and meta-analysis. World J Clin Cases 2022; 10:10516-10528. [PMID: 36312478 PMCID: PMC9602229 DOI: 10.12998/wjcc.v10.i29.10516] [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: 05/16/2022] [Revised: 07/26/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND New and more severe clinical manifestations associated with the coronavirus disease 2019 (COVID-19) are emerging constantly in the pediatric age group. Patients in this age group are also primary carriers of the influenza virus and are at a higher risk of developing severe infection. However, studies comparing influenza and COVID-19 to show which condition causes a more severe form of disease amongst the pediatric age group are scarce.
AIM To compare the laboratory results, clinical symptoms and clinical outcomes in pediatric patients with COVID-19 and influenza.
METHODS A systematic and comprehensive search was carried out in databases and search engines, including EMBASE, Cochrane, MEDLINE, ScienceDirect and Google Scholar from 1964 until January 2022. A meta-analysis was carried out using a random-effects model and pooled odds ratio (OR) or standardized mean difference (SMD) and 95%CI.
RESULTS A total of 16 studies satisfied the inclusion criteria. Pediatric COVID-19 patients had a significantly reduced risk of cough (pooled OR = 0.16; 95%CI: 0.09 to 0.27), fever (pooled OR = 0.23; 95%CI: 0.12 to 0.43), and dyspnea (pooled OR = 0.54; 95%CI: 0.33 to 0.88) compared to influenza patients. Furthermore, total hemoglobin levels (pooled SMD = 1.22; 95%CI: 0.29 to 2.14) in COVID-19 patients were significantly higher as compared to pediatric influenza patients. There was no significant difference in symptoms such as sore throat, white blood cell count, platelets, neutrophil and lymphocytes levels, and outcomes like mortality, intensive care unit admission, mechanical ventilation or length of hospital stay.
CONCLUSION COVID-19 is associated with a significantly lower rate of clinical symptoms and abnormal laboratory indexes compared to influenza in the pediatric age group. However, further longitudinal studies of the outcomes between influenza and COVID-19 pediatric patients are needed.
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Affiliation(s)
- Bang Yu
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Hai-Hua Chen
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Xiao-Fei Hu
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Rui-Zhi Mai
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
| | - Hai-Yan He
- Emergency and Critical Care Center, Beijing Jingdu Children’s Hospital, Beijing 102200, China
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15
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The impact of COVID-19 on a Malaria dominated region: A
mathematical analysis and simulations. ALEXANDRIA ENGINEERING JOURNAL 2022; 65:23-39. [PMCID: PMC9683084 DOI: 10.1016/j.aej.2022.09.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/15/2022] [Accepted: 09/27/2022] [Indexed: 05/29/2023]
Abstract
One of society’s major concerns that
have continued for a long time is infectious diseases. It has been
demonstrated that certain disease infections, in particular multiple
disease infections, make it more challenging to identify and treat
infected individuals, thus deteriorating human health. As a result, a
COVID-19-malaria co-infection model is developed and analyzed to study
the effects of threshold quantities and co-infection transmission rate on
the two diseases’ synergistic relationship. This allowed us to better
understand the co-dynamics of the two diseases in the population. The
existence and stability of the disease-free equilibrium of each single
infection were first investigated by using their respective reproduction
number. The COVID-19 and malaria-free equilibrium are locally
asymptotically stable when the individual threshold quantities RC and RM are below unity. Additionally, the occurrence of the malaria
prevalent equilibrium is examined, and the requirements for the backward
bifurcation’s existence are provided. Sensitivity analysis reveals that
the two main parameters that influence the spread of COVID-19 infection
are the disease transmission rate (βc) and the fraction of the exposed individuals becoming
symptomatic (ψ), while malaria transmission is influenced by the abundance of
vector population, which is driven by recruitment rate (πv) with an increase in the effective biting rate (b), probability of malaria transmission per mosquito bite
(βm), and probability of malaria transmission from infected humans
to vectors (βv). The findings from the numerical simulation of the model show
that COVID-19 will predominate in the populace and drives malaria to
extinction when RM<1<RC, whereas malaria will dominate in the population and drives
COVID-19 into extinction when RC<1<RM. At the disease’s endemic equilibrium, the two diseases will
coexist with the one with the highest reproduction number predominating
but not eradicating the other. It was demonstrated in particular that
COVID-19 will invade a population where malaria is endemic if the
invasion reproduction number exceeds unity. The findings also demonstrate
that when the two diseases are at endemic equilibrium, the prevalence of
co-infection increases COVID-19’s burden on the population while
decreasing malaria incidence.
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16
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Influenza and COVID-19 Co-infection. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-131750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Ayala-Charca G, Salahandish R, Khalghollah M, Sadighbayan D, Haghayegh F, Sanati-Nezhad A, Ghafar-Zadeh E. A Low-Cost Handheld Impedimetric Biosensing System for Rapid Diagnostics of SARS-CoV-2 Infections. IEEE SENSORS JOURNAL 2022; 22:15673-15682. [PMID: 36346096 PMCID: PMC9454264 DOI: 10.1109/jsen.2022.3181580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/25/2022] [Indexed: 06/12/2023]
Abstract
Current laboratory diagnostic approaches for virus detection give reliable results, but they require a lengthy procedure, trained personnel, and expensive equipment and reagents; hence, they are not a suitable choice for home monitoring purposes. This paper addresses this challenge by developing a portable impedimetric biosensing system for the identification of COVID-19 patients. This sensing system has two main parts: a throwaway two-working electrode (2-WE) strip and a novel read-out circuit, specifically designed for simultaneous signal acquisition from both working electrodes. Highly reliable electrochemical signal tracking from multiplex immunosensors provides a potential for flexible and portable multi-biomarker detection. The electrodes' surfaces were functionalized with SARS-CoV-2 Nucleocapsid Antibody enabling the selective detection of Nucleocapsid protein (N-protein) along with self-validation in the clinical nasopharyngeal swab specimens. The proposed programmable highly sensitive impedance read-out system allows for a wide dynamic detection range, which makes the sensor capable of detecting N-protein concentrations between 0.116 and 10,000 pg/mL. This lightweight and economical read-out arrangement is an ideal prospect for being mass-produced, especially during urgent pandemic situations. Also, such an impedimetric sensing platform has the potential to be redesigned for targeting not only other infectious diseases but also other critical disorders.
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Affiliation(s)
- Giancarlo Ayala-Charca
- Biologically Inspired Sensors and ActuatorsDepartment of Electrical Engineering and Computer Science, Lassonde School of EngineeringYork UniversityTorontoONM3J1P3Canada
| | - Razieh Salahandish
- BioMEMS and Bioinspired Microfluidic LaboratoryDepartment of Mechanical and Manufacturing EngineeringUniversity of CalgaryCalgaryABT2N 1N4Canada
- Center for Bioengineering Research and EducationUniversity of CalgaryCalgaryABT2N 1N4Canada
| | - Mahmood Khalghollah
- BioMEMS and Bioinspired Microfluidic LaboratoryDepartment of Mechanical and Manufacturing EngineeringUniversity of CalgaryCalgaryABT2N 1N4Canada
- Department of Electrical and Software EngineeringUniversity of CalgaryCalgaryABT2N 1N4Canada
| | - Deniz Sadighbayan
- Biologically Inspired Sensors and ActuatorsDepartment of Electrical Engineering and Computer Science, Lassonde School of EngineeringYork UniversityTorontoONM3J1P3Canada
| | - Fatemeh Haghayegh
- BioMEMS and Bioinspired Microfluidic LaboratoryDepartment of Mechanical and Manufacturing EngineeringUniversity of CalgaryCalgaryABT2N 1N4Canada
| | - Amir Sanati-Nezhad
- BioMEMS and Bioinspired Microfluidic LaboratoryDepartment of Mechanical and Manufacturing EngineeringUniversity of CalgaryCalgaryABT2N 1N4Canada
- Center for Bioengineering Research and EducationUniversity of CalgaryCalgaryABT2N 1N4Canada
- Biomedical Engineering Graduate ProgramUniversity of CalgaryCalgaryABT2N 1N4Canada
| | - Ebrahim Ghafar-Zadeh
- Biologically Inspired Sensors and ActuatorsDepartment of Electrical Engineering and Computer Science, Lassonde School of EngineeringYork UniversityTorontoONM3J1P3Canada
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18
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Alemi F, Vang J, Wojtusiak J, Guralnik E, Peterson R, Roess A, Jain P. Differential diagnosis of COVID-19 and influenza. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000221. [PMID: 36962332 PMCID: PMC10021438 DOI: 10.1371/journal.pgph.0000221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 05/19/2022] [Indexed: 11/19/2022]
Abstract
This study uses two existing data sources to examine how patients' symptoms can be used to differentiate COVID-19 from other respiratory diseases. One dataset consisted of 839,288 laboratory-confirmed, symptomatic, COVID-19 positive cases reported to the Centers for Disease Control and Prevention (CDC) from March 1, 2019, to September 30, 2020. The second dataset provided the controls and included 1,814 laboratory-confirmed influenza positive, symptomatic cases, and 812 cases with symptomatic influenza-like-illnesses. The controls were reported to the Influenza Research Database of the National Institute of Allergy and Infectious Diseases (NIAID) between January 1, 2000, and December 30, 2018. Data were analyzed using case-control study design. The comparisons were done using 45 scenarios, with each scenario making different assumptions regarding prevalence of COVID-19 (2%, 4%, and 6%), influenza (0.01%, 3%, 6%, 9%, 12%) and influenza-like-illnesses (1%, 3.5% and 7%). For each scenario, a logistic regression model was used to predict COVID-19 from 2 demographic variables (age, gender) and 10 symptoms (cough, fever, chills, diarrhea, nausea and vomiting, shortness of breath, runny nose, sore throat, myalgia, and headache). The 5-fold cross-validated Area under the Receiver Operating Curves (AROC) was used to report the accuracy of these regression models. The value of various symptoms in differentiating COVID-19 from influenza depended on a variety of factors, including (1) prevalence of pathogens that cause COVID-19, influenza, and influenza-like-illness; (2) age of the patient, and (3) presence of other symptoms. The model that relied on 5-way combination of symptoms and demographic variables, age and gender, had a cross-validated AROC of 90%, suggesting that it could accurately differentiate influenza from COVID-19. This model, however, is too complex to be used in clinical practice without relying on computer-based decision aid. Study results encourage development of web-based, stand-alone, artificial Intelligence model that can interview patients and help clinicians make quarantine and triage decisions.
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Affiliation(s)
- Farrokh Alemi
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States of America
| | - Jee Vang
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States of America
| | - Janusz Wojtusiak
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States of America
| | - Elina Guralnik
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States of America
| | | | - Amira Roess
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, United States of America
| | - Praduman Jain
- Vibrent Health, Inc., Fairfax, VA, United States of America
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19
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Rodriguez-Nava G, Egoryan G, Dong T, Zhang Q, Hyser E, Poudel B, Yanez-Bello MA, Trelles-Garcia DP, Chung CW, Pyakuryal B, Imani-Ramos T, Trelles-Garcia VP, Bustamante-Soliz DS, Stake JJ. Comparison of clinical characteristics and outcomes of hospitalized patients with seasonal coronavirus infection and COVID-19: a retrospective cohort study. BMC Infect Dis 2022; 22:618. [PMID: 35840902 PMCID: PMC9284965 DOI: 10.1186/s12879-022-07555-4] [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: 06/10/2021] [Accepted: 06/20/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Unlike SARS-CoV and MERS-C0V, SARS-CoV-2 has the potential to become a recurrent seasonal infection; hence, it is essential to compare the clinical spectrum of COVID-19 to the existent endemic coronaviruses. We conducted a retrospective cohort study of hospitalized patients with seasonal coronavirus (sCoV) infection and COVID-19 to compare their clinical characteristics and outcomes. METHODS A total of 190 patients hospitalized with any documented respiratory tract infection and a positive respiratory viral panel for sCoV from January 1, 2011, to March 31, 2020, were included. Those patients were compared with 190 hospitalized adult patients with molecularly confirmed symptomatic COVID-19 admitted from March 1, 2020, to May 25, 2020. RESULTS Among 190 patients with sCoV infection, the Human Coronavirus-OC93 was the most common coronavirus with 47.4% of the cases. When comparing demographics and baseline characteristics, both groups were of similar age (sCoV: 74 years vs. COVID-19: 69 years) and presented similar proportions of two or more comorbidities (sCoV: 85.8% vs. COVID-19: 81.6%). More patients with COVID-19 presented with severe disease (78.4% vs. 67.9%), sepsis (36.3% vs. 20.5%), and developed ARDS (15.8% vs. 2.6%) compared to patients with sCoV infection. Patients with COVID-19 had an almost fourfold increased risk of in-hospital death than patients with sCoV infection (OR 3.86, CI 1.99-7.49; p < .001). CONCLUSION Hospitalized patients with COVID-19 had similar demographics and baseline characteristics to hospitalized patients with sCoV infection; however, patients with COVID-19 presented with higher disease severity, had a higher case-fatality rate, and increased risk of death than patients with sCoV. Clinical findings alone may not help confirm or exclude the diagnosis of COVID-19 during high acute respiratory illness seasons. The respiratory multiplex panel by PCR that includes SARS-CoV-2 in conjunction with local epidemiological data may be a valuable tool to assist clinicians with management decisions.
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Affiliation(s)
- Guillermo Rodriguez-Nava
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA.
| | - Goar Egoryan
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | - Tianyu Dong
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | - Qishuo Zhang
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | - Elise Hyser
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | - Bidhya Poudel
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | - Maria Adriana Yanez-Bello
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | | | - Chul Won Chung
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | - Bimatshu Pyakuryal
- Department of Internal Medicine, AMITA Health Saint Francis Hospital, 355 Ridge Ave, Evanston, IL, 60202, USA
| | - Taraz Imani-Ramos
- Department of Internal Medicine, AMITA Health Saint Joseph Hospital, Chicago, IL, USA
| | | | | | - Jonathan J Stake
- Department of Infection Prevention, AMITA Health Saint Francis Hospital, Evanston, IL, USA
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20
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Schuurman AR, Reijnders TDY, van Engelen TSR, Léopold V, de Brabander J, van Linge C, Schinkel M, Pereverzeva L, Haak BW, Brands X, Kanglie MMNP, van den Berk IAH, Douma RA, Faber DR, Nanayakkara PWB, Stoker J, Prins JM, Scicluna BP, Wiersinga WJ, van der Poll T. The host response in different aetiologies of community-acquired pneumonia. EBioMedicine 2022; 81:104082. [PMID: 35660785 PMCID: PMC9155985 DOI: 10.1016/j.ebiom.2022.104082] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Community-acquired pneumonia (CAP) can be caused by a variety of pathogens, of which Streptococcus pneumoniae, Influenza and currently SARS-CoV-2 are the most common. We sought to identify shared and pathogen-specific host response features by directly comparing different aetiologies of CAP. METHODS We measured 72 plasma biomarkers in a cohort of 265 patients hospitalized for CAP, all sampled within 48 hours of admission, and 28 age-and sex matched non-infectious controls. We stratified the biomarkers into several pathophysiological domains- antiviral response, vascular response and function, coagulation, systemic inflammation, and immune checkpoint markers. We directly compared CAP caused by SARS-CoV-2 (COVID-19, n=39), Streptococcus pneumoniae (CAP-strep, n=27), Influenza (CAP-flu, n=22) and other or unknown pathogens (CAP-other, n=177). We adjusted the comparisons for age, sex and disease severity scores. FINDINGS Biomarkers reflective of a stronger cell-mediated antiviral response clearly separated COVID-19 from other CAPs (most notably granzyme B). Biomarkers reflecting activation and function of the vasculature showed endothelial barrier integrity was least affected in COVID-19, while glycocalyx degradation and angiogenesis were enhanced relative to other CAPs. Notably, markers of coagulation activation, including D-dimer, were not different between the CAP groups. Ferritin was most increased in COVID-19, while other systemic inflammation biomarkers such as IL-6 and procalcitonin were highest in CAP-strep. Immune checkpoint markers showed distinctive patterns in viral and non-viral CAP, with highly elevated levels of Galectin-9 in COVID-19. INTERPRETATION Our investigation provides insight into shared and distinct pathophysiological mechanisms in different aetiologies of CAP, which may help guide new pathogen-specific therapeutic strategies. FUNDING This study was financially supported by the Dutch Research Council, the European Commission and the Netherlands Organization for Health Research and Development.
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Affiliation(s)
- Alex R Schuurman
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tom D Y Reijnders
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Tjitske S R van Engelen
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Valentine Léopold
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Anaesthesiology and Intensive Care, GH St Louis-Lariboisière, Inserm UMR-S 942 (MASCOT), Université de Paris, 75010 Paris, France
| | - Justin de Brabander
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Christine van Linge
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Michiel Schinkel
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Liza Pereverzeva
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Bastiaan W Haak
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Xanthe Brands
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Maadrika M N P Kanglie
- Department of Radiology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Inge A H van den Berk
- Department of Radiology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Renée A Douma
- Department of Internal Medicine, Flevo Hospital, Almere, the Netherlands
| | - Daniël R Faber
- Department of Internal Medicine, BovenIJ Hospital, Amsterdam, the Netherlands
| | - Prabath W B Nanayakkara
- Department of Internal Medicine, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - Jaap Stoker
- Department of Radiology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan M Prins
- Department of Internal Medicine, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - Brendon P Scicluna
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Centre for Molecular Medicine and Biobanking, University of Malta, Malta; Department of Applied Biomedical Science, Faculty of Health Sciences, Mater Dei hospital, University of Malta, Malta
| | - W Joost Wiersinga
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Internal Medicine, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - Tom van der Poll
- Centre for Experimental and Molecular Medicine (CEMM), Amsterdam University Medical Centres - Location AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Internal Medicine, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands.
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21
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Tasar S, Karadag-Oncel E, Yilmaz-Ciftdogan D, Kara-Aksay A, Ekemen-Keles Y, Elvan-Tuz A, Ustundag G, Sahin A, Kanık MA, Yılmaz N. Influenza is More Severe than Our Newest Enemy (COVID-19) in Hospitalized Children: Experience from a Tertiary Center. J Med Virol 2022; 94:4107-4114. [PMID: 35477866 PMCID: PMC9088615 DOI: 10.1002/jmv.27817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/04/2022] [Accepted: 04/26/2022] [Indexed: 12/15/2022]
Abstract
Understanding differences in terms of clinical phenotypes and outcomes of coronavirus disease 2019 (COVID‐19) compared with influenza is vital to optimizing the management of patients and planning healthcare. Herein, we aimed to investigate the clinical differences and outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and influenza. We performed a retrospective study of hospitalized children who were positive for SARS‐CoV‐2 between March 2020 and March 2021 and for influenza between January 2016 and February 2020 in respiratory samples. The primary outcome of this study was pediatric intensive care unit (PICU) admission, and the secondary outcome was the need for respiratory support. A total of 74 patients with influenza and 71 who were positive for SARS‐CoV‐2 were included. The distribution among the sexes was similar, but patients with COVID‐19 were older than patients with influenza (96 vs. 12, p < 0.001). In terms of underlying chronic diseases, the frequency was 26.7% in the COVID‐19 group and 54% in the influenza group (p = 0.001). The comparison of symptoms revealed that fatigue, headache, nausea, vomiting, and abdominal pain occurred more frequently with COVID‐19 (for all p < 0.05) and runny nose with influenza (p = 0.002). The frequency of admission to the PICU was relatively higher (18.9%) in the influenza group than with COVID‐19 (2.8%) with a significant ratio (p = 0.001), secondary bacterial infections were observed more frequently in the influenza group (20.2% vs. 4.2%, p = 0.003). Some 88.7% of patients with COVID‐19 did not need respiratory support, whereas 59.4% of patients with influenza did require respiratory support (p < 0.001). This study noted that influenza caused more frequent admissions to the PICU and a greater need for respiratory support in hospitalized pediatric patients than COVID‐19.
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Affiliation(s)
- Selin Tasar
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Eda Karadag-Oncel
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Dilek Yilmaz-Ciftdogan
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.,Department of Pediatric Infectious Diseases, Izmir Kâtip Celebi University, Izmir, Turkey
| | - Ahu Kara-Aksay
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Yildiz Ekemen-Keles
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aysegul Elvan-Tuz
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gulnihan Ustundag
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aslihan Sahin
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Muhammet Ali Kanık
- Department of Pediatrics, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Nisel Yılmaz
- Department of Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
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22
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Cheng X, Wan H, Yuan H, Zhou L, Xiao C, Mao S, Li Z, Hu F, Yang C, Zhu W, Zhou J, Zhang T. Symptom Clustering Patterns and Population Characteristics of COVID-19 Based on Text Clustering Method. Front Public Health 2022; 10:795734. [PMID: 35186839 PMCID: PMC8854172 DOI: 10.3389/fpubh.2022.795734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/03/2022] [Indexed: 01/08/2023] Open
Abstract
Background Descriptions of single clinical symptoms of coronavirus disease 2019 (COVID-19) have been widely reported. However, evidence of symptoms associations was still limited. We sought to explore the potential symptom clustering patterns and high-frequency symptom combinations of COVID-19 to enhance the understanding of people of this disease. Methods In this retrospective cohort study, a total of 1,067 COVID-19 cases were enrolled. Symptom clustering patterns were first explored by a text clustering method. Then, a multinomial logistic regression was applied to reveal the population characteristics of different symptom groups. In addition, time intervals between symptoms onset and the first visit were analyzed to consider the effect of time interval extension on the progression of symptoms. Results Based on text clustering, the symptoms were summarized into four groups. Group 1: no-obvious symptoms; Group 2: mainly fever and/or dry cough; Group 3: mainly upper respiratory tract infection symptoms; Group 4: mainly cardiopulmonary, systemic, and/or gastrointestinal symptoms. Apart from Group 1 with no obvious symptoms, the most frequent symptom combinations were fever only (64 cases, 47.8%), followed by dry cough only (42 cases, 31.3%) in Group 2; expectoration only (21 cases, 19.8%), followed by expectoration complicated with fever (10 cases, 9.4%) in Group 3; fatigue complicated with fever (12 cases, 4.2%), followed by headache complicated with fever was also high (11 cases, 3.8%) in Group 4. People aged 45–64 years were more likely to have symptoms of Group 4 than those aged 65 years or older (odds ratio [OR] = 2.66, 95% CI: 1.21–5.85) and at the same time had longer time intervals. Conclusions Symptoms of COVID-19 could be divided into four clustering groups with different symptom combinations. The Group 4 symptoms (i.e., mainly cardiopulmonary, systemic, and/or gastrointestinal symptoms) happened more frequently in COVID-19 than in influenza. This distinction could help deepen the understanding of this disease. The middle-aged people have a longer time interval for medical visit and was a group that deserve more attention, from the perspective of medical delays.
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Affiliation(s)
- Xiuwei Cheng
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Hongli Wan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Heng Yuan
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Lijun Zhou
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Chongkun Xiao
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Suling Mao
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Zhirui Li
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Fengmiao Hu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Chuan Yang
- Anyue County Center for Disease Control and Prevention, Ziyang, China
| | - Wenhui Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiushun Zhou
- Sichuan Center for Disease Control and Prevention, Chengdu, China
- *Correspondence: Jiushun Zhou
| | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Tao Zhang
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23
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Abstract
Seasonal influenza epidemics of variable severity pose challenges to public health. Annual vaccination is the primary way to prevent influenza, and a wide range of vaccines are available, including inactivated or live attenuated standard-dose, recombinant vaccines, as well as adjuvanted or high-dose vaccines for persons aged 65 years or older. Persons at increased risk for influenza complications include young children, persons with underlying medical conditions, and older adults. Prompt diagnosis of influenza can facilitate early initiation of antiviral treatment that provides the greatest clinical benefit. This article summarizes recommendations for providers on influenza vaccination, diagnostic testing, and antiviral treatment.
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Affiliation(s)
- Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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24
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Ng A, Fong B, Lo MF. Dynamic knowledge management in response to the pandemic outbreak: an interinstitutional risk-based approach to sustainability. KNOWLEDGE MANAGEMENT RESEARCH & PRACTICE 2021. [DOI: 10.1080/14778238.2021.1919574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Artie Ng
- School of Professional Education & Executive Development, The Hong Kong Polytechnic University, Hong Kong
| | - Ben Fong
- College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hong Kong
| | - Man Fung Lo
- Department of Mathematics and Information Technology, The Education University of Hong Kong, Hong Kong
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25
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Garner M, Reith W, Yilmaz U. [COVID-19: neurological manifestations-update : What we know so far]. Radiologe 2021; 61:902-908. [PMID: 34499188 PMCID: PMC8427155 DOI: 10.1007/s00117-021-00907-2] [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] [Accepted: 08/12/2021] [Indexed: 01/09/2023]
Abstract
Beyond pulmonary presentation, COVID-19 infection can manifest with a variety of both acute and chronic neurologic and neuropsychiatric (concomitant) symptoms and diseases. Nonspecific symptoms such as headache, fatigue, olfactory and gustatory disturbance have been reported more frequently, and severe disease such as encephalopathy, encephalitis, and cerebrovascular events have been reported relatively rarely. The heterogeneity of neurologic and neuropsychiatric presentations is large, as well as the range of recorded prevalences. Older patients, pre-existing neurologic and non neurologic comorbidities and severe COVID-19 disease were associated with increased risk of severe neurologic complications and higher in-hospital mortality. Probable neurotropic pathomechanisms of SARS-CoV‑2 have been discussed, but a multifactorial genesis of neurologic/neuropsychiatric symptoms and disease beyond these is likely.
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Affiliation(s)
- Malvina Garner
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66424 Homburg-Saar, Deutschland
| | - W. Reith
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66424 Homburg-Saar, Deutschland
| | - U. Yilmaz
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66424 Homburg-Saar, Deutschland
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