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Gidari A, Sabbatini S, Schiaroli E, Bastianelli S, Pierucci S, Busti C, Saraca LM, Capogrossi L, Pasticci MB, Francisci D. Synergistic Activity of Remdesivir-Nirmatrelvir Combination on a SARS-CoV-2 In Vitro Model and a Case Report. Viruses 2023; 15:1577. [PMID: 37515263 PMCID: PMC10385213 DOI: 10.3390/v15071577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND This study aims to investigate the activity of the remdesivir-nirmatrelvir combination against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and to report a case of Coronavirus Disease 2019 (COVID-19) cured with this combination. METHODS A Vero E6 cell-based infection assay was used to investigate the in vitro activity of the remdesivir-nirmatrelvir combination. The SARS-CoV-2 strains tested were 20A.EU1, BA.1 and BA.5. After incubation, a viability assay was performed. The supernatants were collected and used for viral titration. The Highest Single Agent (HSA) reference model was calculated. An HSA score >10 is considered synergic. RESULTS Remdesivir and nirmatrelvir showed synergistic activity at 48 and 72 h, with an HSA score of 52.8 and 28.6, respectively (p < 0.0001). These data were confirmed by performing supernatant titration and against the omicron variants: the combination reduced the viral titer better than the more active compound alone. An immunocompromised patient with prolonged and critical COVID-19 was successfully treated with remdesivir, nirmatrelvir/ritonavir, tixagevimab/cilgavimab and dexamethasone, with an excellent clinical-radiological response. However, she required further off-label prolonged therapy with nirmatrelvir/ritonavir until she tested negative. CONCLUSIONS Remdesivir-nirmatrelvir combination has synergic activity in vitro. This combination may have a role in immunosuppressed patients with severe COVID-19 and prolonged viral shedding.
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Affiliation(s)
- Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
- Clinic of Infectious Diseases, "Santa Maria" Hospital, Terni, 05100 Terni, Italy
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06123 Perugia, Italy
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Sabrina Bastianelli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Sara Pierucci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Chiara Busti
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Lavinia Maria Saraca
- Clinic of Infectious Diseases, "Santa Maria" Hospital, Terni, 05100 Terni, Italy
| | - Luca Capogrossi
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
| | - Maria Bruna Pasticci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
- Clinic of Infectious Diseases, "Santa Maria" Hospital, Terni, 05100 Terni, Italy
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, 06123 Perugia, Italy
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Armağan B, Konak HE, Özdemir B, Apaydın H, Atalar E, Akyüz Dağlı P, Güven SC, Erden A, Küçükşahin O, Omma A, Erten Ş. COVID-19 disease frequency, risk factors, and re-infection rates in patients with autoimmune rheumatic disease receiving rituximab. Int J Rheum Dis 2023; 26:930-937. [PMID: 36942871 DOI: 10.1111/1756-185x.14676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/01/2023] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Rituximab, which is used in autoimmune rheumatic diseases (ARD), can cause both an increased risk of development of COVID-19 disease and re-infection due to its potent and long-acting immunosuppression. So, we aimed to evaluate the frequency, risk factors and re-infection rates of COVID-19 in ARD patients receiving rituximab. METHODS A single-center retrospective study was performed with patients receiving rituximab for ARD in 12 months before the onset of COVID-19 in Turkey. The data regarding severe acute respiratory syndrome-coronavirus 2 reverse transcription polymerized chain reaction (RT-PCR) test, clinical, laboratory, and mortality data of all patients were collected from medical records. Logistic regression analysis was used for predictors of COVID-19 disease. COVID-19 re-infection was defined as RT-PCR positivity and recurrence of acute COVID-19 symptoms after at least 1 negative RT-PCR in patients with clinical improvement. RESULTS Ninety-eight ARD patients with rituximab were evaluated and 23 (23%) of them had COVID-19. The presence of hypogammaglobulinemia increased the risk of COVID-19 disease 8-fold. COVID-19 pneumonia occurred in 13 (57%) and these patients' age was higher than those without pneumonia (59.6 ± 11.8 vs 44.9 ± 14.2 years, P = 0.013). Mortality due to COVID-19 was 13% and COVID-19 re-infection was seen in 20% of survivors. CONCLUSION Regardless of the underlying rheumatic disease and organ involvements, hypogammaglobulinemia in ARD could be a risk factor for COVID-19 development, and advanced age could be for COVID-19 severity. Moreover, COVID-19 re-infection rates are high.
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Affiliation(s)
- Berkan Armağan
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | | | - Bahar Özdemir
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Hakan Apaydın
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | - Ebru Atalar
- Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
| | | | | | - Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Orhan Küçükşahin
- Division of Rheumatology, Department of Internal Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ahmet Omma
- Division of Rheumatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Şükran Erten
- Division of Rheumatology, Department of Internal Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Belloch García SL. A retrospective cross-sectional observational study of SARS-CoV-2 reinfection in La Ribera Health Department, Valencia, Spain. J Med Microbiol 2022; 71. [DOI: 10.1099/jmm.0.001599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. The possibility of reinfection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a widely proven fact and may have clinical implications.
Hypothesis /Gap Statement. It is not known whether there have been cases of reinfection by SARS-CoV-2 in La Ribera Health Department.
Aim. To determine whether there have been cases of reinfection by SARS-CoV-2 in La Ribera Health Department and to identify their characteristics.
Methodology. Retrospective cross-sectional observational study of cases of reinfection by SARS-CoV-2 in the population of La Ribera Department between March 2020 and February 2021. The positive baseline cohort includes all cases positive by RT-PCR for SARS-CoV-2, with reinfection cases being those that, after resolution of the first episode according to the World Health Organization (WHO) criteria, presented a new positive RT-PCR result.
Results. Out of a total of 15 687 cases with positive RT-PCR, 40 were considered to be reinfections, which meant a cumulative incidence of 0.255 % and an incidence density of 5.05 cases per 100 000 person-days. Most of the cases occurred during the highest incidence peaks of the pandemic in the department. Seventy-five per cent of the patients in these cases were older than 40 years, 42.5 % were healthcare professionals or nursing home residents and 12.5 % had an immunosuppressive comorbidity. There were no severe, critical or death cases. In the reinfection episodes, with respect to the first episode, there was a tendency to be milder, they required fewer days of hospitalization, their RT-PCR became negative earlier, they developed a greater humoral response and the sick leave period was shorter. The median period between the RT-PCR in the first episode and the RT-PCR in the second episode was 127.5 days (range: 48–301; IQR: 89.5–256.25)
Conclusions. SARS-CoV-2 reinfection cases are rare, tend to be mild and can occur within a median period of 127.5 days.
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Abrokwa SK, Müller SA, Méndez-Brito A, Hanefeld J, El Bcheraoui C. Recurrent SARS-CoV-2 infections and their potential risk to public health - a systematic review. PLoS One 2021; 16:e0261221. [PMID: 34882750 PMCID: PMC8659325 DOI: 10.1371/journal.pone.0261221] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/27/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To inform quarantine and contact-tracing policies concerning re-positive cases-cases testing positive among those recovered. MATERIALS AND METHODS We systematically reviewed and appraised relevant literature from PubMed and Embase for the extent of re-positive cases and their epidemiological characteristics. RESULTS In 90 case reports/series, a total of 276 re-positive cases were found. Among confirmed reinfections, 50% occurred within 90 days from recovery. Four reports related onward transmission. In thirty-five observational studies, rate of re-positives ranged from zero to 50% with no onward transmissions reported. In eight reviews, pooled recurrence rate ranged from 12% to 17.7%. Probability of re-positive increased with several factors. CONCLUSION Recurrence of a positive SARS-CoV-2 test is commonly reported within the first weeks following recovery from a first infection.
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Affiliation(s)
- Seth Kofi Abrokwa
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Sophie Alice Müller
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Alba Méndez-Brito
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Johanna Hanefeld
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Charbel El Bcheraoui
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
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Dhillon RA, Qamar MA, Gilani JA, Irfan O, Waqar U, Sajid MI, Mahmood SF. The mystery of COVID-19 reinfections: A global systematic review and meta-analysis. Ann Med Surg (Lond) 2021; 72:103130. [PMID: 34900250 PMCID: PMC8642249 DOI: 10.1016/j.amsu.2021.103130] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND As the COVID-19 pandemic rages on, reports on disparities in vaccine roll out alongside COVID-19 reinfection have been emerging. We conducted a systematic review to assess the determinants and disease spectrum of COVID-19 reinfection. MATERIALS AND METHODS A comprehensive search covering relevant databases was conducted for observational studies reporting Polymerase Chain Reaction (PCR) confirmed infection and reinfection cases. A quality assessment tool developed by the National Institute of Health (NIH) for the assessment of case series was utilized. Meta-analyses were performed using RevMan 5.3 for pooled proportions of findings in first infection and reinfection with a 95% confidence interval (CI). RESULTS Eighty-one studies reporting 577 cases were included from 22 countries. The mean age of patients was 46.2 ± 18.9 years and 179 (31.0%) cases of comorbidities were reported. The average time duration between first infection and reinfection was 63.6 ± 48.9 days. During first infection and reinfection, fever was the most common symptom (41.4% and 36.4%, respectively) whilst anti-viral therapy was the most common treatment regimen administered (44.5% and 43.0%, respectively). Comparable odds of symptomatic presentation and management were reported for the two infections. However, a higher Intensive Care Unit (ICU) admission rate was observed in reinfection compared to first infection (10 vs 3). Ten deaths were reported with respiratory failure being the most common cause of death (7/10 deaths). CONCLUSION Our findings support immunization practices given increased ICU admissions and mortality in reinfections. Our cohort serves as a guide for clinicians and authorities in devising an optimal strategy for controlling the pandemic. (249 words).
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Affiliation(s)
| | | | | | - Omar Irfan
- Amaris Consulting, Toronto, Ontario, Canada
| | - Usama Waqar
- Medical College, Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Syed Faisal Mahmood
- Section of Infectious Diseases, Aga Khan University, Karachi, Sindh, Pakistan
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Agossou O, Atchadé MN, Djibril AM. Modeling the effects of preventive measures and vaccination on the COVID-19 spread in Benin Republic with optimal control. Results Phys 2021; 31:104969. [PMID: 34804781 PMCID: PMC8592642 DOI: 10.1016/j.rinp.2021.104969] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 05/12/2023]
Abstract
Coronavirus disease (COVID-19) onset in December 2019 is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since, the spread of the virus and mortality due to COVID-19 have continued to increase daily leading to a pandemic. In absence of approved medicine and vaccines, many countries imposed policies such as social distancing, mask wearing, hand washing, airport screening, quarantine and others. But rapidly, they were confronted with the high economic and social cost resulting from those policies. Many vaccines have been proposed but their efficiency is still controversial. Now, governments and scholars search for how manage with preventives measures policies and vaccination campaigns to stop the COVID-19 spread. This work studied the effects of these different strategies as time-dependent interventions using mathematical modeling and optimal control approach to ascertain their contribution in the dynamic transmission of COVID-19. The model was proven to have an invariant region and was well-posed. The basic reproduction number was computed with and without respect of preventives measures. The optimal control analysis was carried out using the Pontryagin's maximum principle to figure out the optimal strategy necessary to curtail the disease. The findings revealed that the optimal implementation of preventive measures reduce highly the number of infected individuals but zero infection was not achieved in the population. That was obtained with the optimal implementation of vaccination campaigns which reduce the number of infected individuals. But the optimal and combined implementation of the two interventions performed better with less costs than the two singular implementations.
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Affiliation(s)
- Onésime Agossou
- National Higher School of Mathematics Genius and Modelization, National University of Sciences, Technologies, Engineering and Mathematics, Abomey, Republic of Benin
| | - Mintodê Nicodème Atchadé
- National Higher School of Mathematics Genius and Modelization, National University of Sciences, Technologies, Engineering and Mathematics, Abomey, Republic of Benin
- Université d'Abomey-Calavi/ International Chair in Mathematical Physics and Applications (ICMPA : UNESCO-Chair), 072 BP 50 Cotonou, Republic of Benin
- Saint-Petersburg State University of Economics, Department of Statistics and Econometrics, Russian Federation
| | - Aliou Moussa Djibril
- National Higher School of Mathematics Genius and Modelization, National University of Sciences, Technologies, Engineering and Mathematics, Abomey, Republic of Benin
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Gaudreault NN, Carossino M, Morozov I, Trujillo JD, Meekins DA, Madden DW, Cool K, Artiaga BL, McDowell C, Bold D, Balaraman V, Kwon T, Ma W, Henningson J, Wilson DW, Wilson WC, Balasuriya UBR, García-Sastre A, Richt JA. Experimental re-infected cats do not transmit SARS-CoV-2. Emerg Microbes Infect 2021; 10:638-650. [PMID: 33704016 PMCID: PMC8023599 DOI: 10.1080/22221751.2021.1902753] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
SARS-CoV-2 is the causative agent of COVID-19 and responsible for the current global pandemic. We and others have previously demonstrated that cats are susceptible to SARS-CoV-2 infection and can efficiently transmit the virus to naïve cats. Here, we address whether cats previously exposed to SARS-CoV-2 can be re-infected with SARS-CoV-2. In two independent studies, SARS-CoV-2-infected cats were re-challenged with SARS-CoV-2 at 21 days post primary challenge (DPC) and necropsies performed at 4, 7 and 14 days post-secondary challenge (DP2C). Sentinels were co-mingled with the re-challenged cats at 1 DP2C. Clinical signs were recorded, and nasal, oropharyngeal, and rectal swabs, blood, and serum were collected and tissues examined for histologic lesions. Viral RNA was transiently shed via the nasal, oropharyngeal and rectal cavities of the re-challenged cats. Viral RNA was detected in various tissues of re-challenged cats euthanized at 4 DP2C, mainly in the upper respiratory tract and lymphoid tissues, but less frequently and at lower levels in the lower respiratory tract when compared to primary SARS-CoV-2 challenged cats at 4 DPC. Viral RNA and antigen detected in the respiratory tract of the primary SARS-CoV-2 infected cats at early DPCs were absent in the re-challenged cats. Naïve sentinels co-housed with the re-challenged cats did not shed virus or seroconvert. Together, our results indicate that cats previously infected with SARS-CoV-2 can be experimentally re-infected with SARS-CoV-2; however, the levels of virus shed was insufficient for transmission to co-housed naïve sentinels. We conclude that SARS-CoV-2 infection in cats induces immune responses that provide partial, non-sterilizing immune protection against re-infection.
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Affiliation(s)
- Natasha N. Gaudreault
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Mariano Carossino
- Louisiana Animal Disease Diagnostic Laboratory and Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Igor Morozov
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Jessie D. Trujillo
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - David A. Meekins
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Daniel W. Madden
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Konner Cool
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Bianca Libanori Artiaga
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Chester McDowell
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Dashzeveg Bold
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Velmurugan Balaraman
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Taeyong Kwon
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Wenjun Ma
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
- Department of Veterinary Pathobiology and Department of Molecular Microbiology and Immunology, University of Missouri, Columbia, MO, USA
| | - Jamie Henningson
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Dennis W. Wilson
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - William C. Wilson
- Arthropod Borne Animal Disease Research Unit, Agricultural Research Service, United States Department of Agriculture, Manhattan, KS, USA
| | - Udeni B. R. Balasuriya
- Louisiana Animal Disease Diagnostic Laboratory and Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juergen A. Richt
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
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González-Iglesias I, Fernández-Prada M, Riestra-Suárez RM. Reinfection, reactivation or delayed complication of the initial SARS-CoV-2 infection. Med Clin (Barc) 2021; 157:e299-301. [PMID: 34175105 DOI: 10.1016/j.medcli.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/16/2022]
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Kobayashi K, Tachibana M, Tsutsumi Y. Neglected roles of IgG Fc-binding protein secreted from airway mucin-producing cells in protecting against SARS-CoV-2 infection. Innate Immun 2021; 27:423-436. [PMID: 34521229 PMCID: PMC8504265 DOI: 10.1177/17534259211043159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Both innate immunity and acquired immunity are involved in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The induction of Abs that neutralize the virus has been described, and certain Abs against endemic coronaviruses may cross-react with SARS-CoV-2. Detailed mechanisms to protect against the pandemic of SARS-CoV-2 remain unresolved. We previously reported that IgG Fc-binding protein (Fcγbp), a unique, large molecular weight, and mucin-like secretory Fc receptor protein, secreted from goblet cells of human small and large intestine, mediates the transportation of serum IgG onto the mucosal surface. In this review, we show that mucous bronchial gland cells and some goblet cells are immunoreactive for Fcγbp. Fcγbp traps the cross-reactive (both neutralizing and non-neutralizing) IgG bound to the virus and can consequently eliminate the virus from the mucosal surface to decrease viral loads. Fcγbp can also suppress immune overreaction by interfering with Fc-binding by macrophages and competing with complement fixation. Fcγbp secreted from mucin-producing cells of the airway functions as an important anti-infection mucosal defense. The Fcγbp-mediated mechanism can be a key factor in explaining why SARS-CoV-2 is less infective/lethal in children, and may also be involved in the unique Ab response, recurrent infection, and effects of serum therapy and vaccination.
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Affiliation(s)
| | - Mitsuhiro Tachibana
- Department of Diagnostic Pathology, Shimada General Medical Center, Shimada, Shizuoka, Japan
| | - Yutaka Tsutsumi
- Department of Diagnostic Pathology, Shimada General Medical Center, Shimada, Shizuoka, Japan.,Diagnostic Pathology Clinic, Pathos Tsutsumi, Inazawa, Aichi, Japan.,Yokkaichi Nursing and Health Care University, School of Medical Technology, Yokkaichi, Mie, Japan
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Mencacci A, Gili A, Gidari A, Schiaroli E, Russo C, Cenci E, Camilloni B, Graziani A, Melelli-Roia A, Francisci D, Stracci F. Role of Nucleocapsid Protein Antigen Detection for Safe End of Isolation of SARS-CoV-2 Infected Patients with Long Persistence of Viral RNA in Respiratory Samples. J Clin Med 2021; 10:jcm10184037. [PMID: 34575147 PMCID: PMC8469917 DOI: 10.3390/jcm10184037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022] Open
Abstract
Background. In SARS-CoV-2 infection, viral RNA may persist in respiratory samples for several weeks after the resolution of symptoms. Criteria to assess the end of infectivity are not unequivocally defined. In some countries, time from diagnosis is the unique criterion used, in addition to symptom cessation. This study evaluates the role of the Lumipulse® Antigen Assay (LAA) for the safe end of isolation of patients ≥21 days after the diagnosis of infection. Methods. A total of 671 nasopharyngeal swabs from patients diagnosed with infection at least 21 days before were assessed by RT-PCR and LAA, and the role of LAA in predicting the absence of infectivity was evaluated by virus cell culture. Results. Viable virus was present in 10/138 cultured samples. Eight out of ten infective patients suffered from a concomitant disease, predisposing them to long-term shedding of infective virus. In particular, infectious virus was isolated from 10/20 RT-PCR+/LAA+ cultured samples, whereas no viable virus was found in all 118 RT-PCR+/LAA– cultured swabs. LLA and RT-PCR agreed in 484/671 (72.1%) samples, with 100% and 26.7% concordance in RT-PCR negative and positive samples, respectively. Conclusions. Viable virus can be found ≥21 days after diagnosis in immunocompromised or severely ill patients. LAA better than RT-PCR predicts non-infectivity of patients and can be safely used to end isolation in cases with long persistence of viral RNA in the respiratory tract.
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Affiliation(s)
- Antonella Mencacci
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
- Correspondence: (A.M.); (A.G.); Tel.: +39-0755784277 (A.M.); +39-0755858033 (A.G.)
| | - Alessio Gili
- Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
- Correspondence: (A.M.); (A.G.); Tel.: +39-0755784277 (A.M.); +39-0755858033 (A.G.)
| | - Anna Gidari
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Elisabetta Schiaroli
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Carla Russo
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Elio Cenci
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Barbara Camilloni
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Alessandro Graziani
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Arduino Melelli-Roia
- Department of Medicine and Surgery, Microbiology and Clinical Microbiology, Santa Maria Della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (C.R.); (E.C.); (B.C.); (A.G.); (A.M.-R.)
| | - Daniela Francisci
- Department of Medicine and Surgery, Infectious Diseases Clinic, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (A.G.); (E.S.); (D.F.)
| | - Fabrizio Stracci
- Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy;
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11
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Fiorino S, Tateo F, Biase DD, Gallo CG, Orlandi PE, Corazza I, Budriesi R, Micucci M, Visani M, Loggi E, Hong W, Pica R, Lari F, Zippi M. SARS-CoV-2: lessons from both the history of medicine and from the biological behavior of other well-known viruses. Future Microbiol 2021; 16:1105-1133. [PMID: 34468163 PMCID: PMC8412036 DOI: 10.2217/fmb-2021-0064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
SARS-CoV-2 is the etiological agent of the current pandemic worldwide and its associated disease COVID-19. In this review, we have analyzed SARS-CoV-2 characteristics and those ones of other well-known RNA viruses viz. HIV, HCV and Influenza viruses, collecting their historical data, clinical manifestations and pathogenetic mechanisms. The aim of the work is obtaining useful insights and lessons for a better understanding of SARS-CoV-2. These pathogens present a distinct mode of transmission, as SARS-CoV-2 and Influenza viruses are airborne, whereas HIV and HCV are bloodborne. However, these viruses exhibit some potential similar clinical manifestations and pathogenetic mechanisms and their understanding may contribute to establishing preventive measures and new therapies against SARS-CoV-2.
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Affiliation(s)
- Sirio Fiorino
- Internal Medicine Unit, Budrio Hospital, Budrio (Bologna), Azienda USL, Bologna, 40054, Italy
- Author for correspondence: Tel.: +39 051 809 259;
| | - Fabio Tateo
- Institute of Geosciences & Earth Resources, CNR, c/o Department of Geosciences, Padova University, 35127, Italy
| | - Dario De Biase
- Department of Pharmacy & Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Claudio G Gallo
- Fisiolaserterapico Emiliano, Castel San Pietro Terme, Bologna, 40024, Italy
| | | | - Ivan Corazza
- Department of Experimental, Diagnostic & Specialty Medicine, University of Bologna, Bologna, 40126, Italy
| | - Roberta Budriesi
- Department of Pharmacy & Biotechnology, Alma Mater Studiorum-University of Bologna, Bologna, 40126, Italy
| | - Matteo Micucci
- Department of Pharmacy & Biotechnology, Alma Mater Studiorum-University of Bologna, Bologna, 40126, Italy
| | - Michela Visani
- Department of Pharmacy & Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Elisabetta Loggi
- Hepatology Unit, Department of Medical & Surgical Sciences, University of Bologna, Bologna, 40126, Italy
| | - Wandong Hong
- Department of Gastroenterology & Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang, 325035, PR China
| | - Roberta Pica
- Unit of Gastroenterology & Digestive Endoscopy, Sandro Pertini Hospital, Rome, 00157, Italy
| | - Federico Lari
- Internal Medicine Unit, Budrio Hospital, Budrio (Bologna), Azienda USL, Bologna, 40054, Italy
| | - Maddalena Zippi
- Unit of Gastroenterology & Digestive Endoscopy, Sandro Pertini Hospital, Rome, 00157, Italy
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Zaffina S, Lanteri P, Gilardi F, Garbarino S, Santoro A, Vinci MR, Carsetti R, Scorpecci A, Raponi M, Magnavita N, Camisa V. Recurrence, Reactivation, or Inflammatory Rebound of SARS-CoV-2 Infection With Acute Vestibular Symptoms: A Case Report and Revision of Literature. Front Hum Neurosci 2021; 15:666468. [PMID: 34456694 PMCID: PMC8385757 DOI: 10.3389/fnhum.2021.666468] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/15/2021] [Indexed: 01/08/2023] Open
Abstract
A case of recurrent coronavirus disease 2019 (COVID-19) with neurovestibular symptoms was reported. In March 2020, a physician working in an Italian pediatric hospital had flu-like symptoms with anosmia and dysgeusia, and following a reverse transcription PCR (RT/PCR) test with a nasopharyngeal swab tested positive for SARS-CoV-2. After home quarantine, 21 days from the beginning of the symptoms, the patient tested negative in two subsequent swabs and was declared healed and readmitted to work. Serological testing showed a low level of immunoglobulin G (IgG) antibody title and absence of immunoglobulin M (IgM). However, 2 weeks later, before resuming work, the patient complained of acute vestibular syndrome, and the RT/PCR test with mucosal swab turned positive. On the basis of the literature examined and reviewed for recurrence cases and vestibular symptoms during COVID-19, to our knowledge this case is the first case of recurrence with vestibular impairment as a neurological symptom, and we defined it as probably a viral reactivation. The PCR retest positivity cannot differentiate re-infectivity, relapse, and dead-viral RNA detection. Serological antibody testing and viral genome sequencing could be always performed in recurrence cases.
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Affiliation(s)
- Salvatore Zaffina
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Post-graduate School of Occupational Health, Section of Occupational Medicine and Labor Law, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paola Lanteri
- Department of Diagnostics and Applied Technology, Neurophysiopathology Centre, Fondazione IRCCS, Istituto Neurologico “Carlo Besta”, Milan, Italy
| | | | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy
| | - Annapaola Santoro
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Rosaria Vinci
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Post-graduate School of Occupational Health, Section of Occupational Medicine and Labor Law, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rita Carsetti
- Department of Laboratories, Unit of Diagnostic Immunology and Immunology Research Area, Unit of B-Cell Pathophysiology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandro Scorpecci
- Audiology and Otosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Nicola Magnavita
- Post-graduate School of Occupational Health, Section of Occupational Medicine and Labor Law, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vincenzo Camisa
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Post-graduate School of Occupational Health, Section of Occupational Medicine and Labor Law, Università Cattolica del Sacro Cuore, Rome, Italy
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13
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Gidari A, Sabbatini S, Bastianelli S, Pierucci S, Busti C, Monari C, Luciani Pasqua B, Dragoni F, Schiaroli E, Zazzi M, Francisci D. Cross-neutralization of SARS-CoV-2 B.1.1.7 and P.1 variants in vaccinated, convalescent and P.1 infected. J Infect 2021:S0163-4453(21)00362-5. [PMID: 34320390 DOI: 10.1016/j.jinf.2021.07.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/17/2021] [Accepted: 07/21/2021] [Indexed: 11/24/2022]
Abstract
Objectives The emergence of new variants of concern (VOCs) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) around the world significantly complicated the exit from Coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to evaluate the serum neutralizing activity of three cohorts. Methods BNT162b2-elicited serum (N = 103), candidates as hyper-immune plasma donors (N = 90) and patients infected with the SARS-CoV-2 P1 variant (N = 22) were enrolled. Three strains of SARS-CoV-2 have been tested: 20A.EU1, B.1.1.7 (alpha) and P.1 (gamma). Neutralizing antibodies (NT-Abs) titers against SARS-CoV-2 were evaluated. Results B.1.1.7 and P.1 are less efficiently neutralized by convalescent wild-type infected serums if compared to 20A.EU1 strain (mean titer 1.6 and 6.7-fold lower respectively). BNT162b2 vaccine-elicited human sera show an equivalent neutralization potency on the B.1.1.7 but it is significantly lower for the P.1 variant (mean titer 3.3-fold lower). Convalescent P.1 patients are less protected from other SARS-CoV-2 strains with an important reduction of neutralizing antibodies against 20A.EU1 and B.1.1.7, about 12.2 and 10.9-fold, respectively. Conclusions BNT162b2 vaccine confers immunity against all the tested VOCs, while previous SARS-CoV-2 infection may be less protective.
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14
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Awada H, Nassereldine H, Hajj Ali A. Severe acute respiratory syndrome coronavirus 2 reinfection in a coronavirus disease 2019 recovered young adult: a case report. J Med Case Rep 2021; 15:382. [PMID: 34271967 PMCID: PMC8284680 DOI: 10.1186/s13256-021-02965-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/16/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 has been a public health threat and a worldwide emergency for more than a year. Unfortunately, many questions concerning the pathophysiology, management, and long-term side effects remain unanswered, and novel aspects of the disease keep on emerging. Of concern to healthcare providers are the recent reported cases of reinfection. Serum coronavirus disease 2019 antibodies have been detected within a few days after onset of the disease. However, it remains unclear whether this immune response is universal, or whether it can lead to latent immunity. CASE PRESENTATION A previously healthy 27-year-old white man presented with fever, chills, back pain, and other constitutional symptoms, 2 days after being exposed to coronavirus disease 2019 positive patients. His severe acute respiratory syndrome coronavirus 2 polymerase chain reaction was positive, and his symptoms resolved over the next 2 weeks. One month after a confirmatory negative severe acute respiratory syndrome coronavirus 2 polymerase chain reaction, he was found to be ineligible for plasma donation as his anti-severe acute respiratory syndrome coronavirus 2 serology was negative. The patient redeveloped symptoms similar to his first infection 3 weeks after the negative serology test. He and his wife both tested positive via polymerase chain reaction. Their symptoms resolved over the next few days, and they had a negative polymerase chain reaction test 10 days after the positive polymerase chain reaction. CONCLUSION While studies showed that anti-severe acute respiratory syndrome coronavirus 2 immunoglobulins start to develop early after infection, our healthy young patient's immune system failed to mount latent immunity against the virus. This left him, especially amid widespread social and medical misconceptions, vulnerable to reinfection by severe acute respiratory syndrome coronavirus 2. Our case disputes the timelines for immune response that were set and supported by research studies. Our case also raises questions regarding prioritizing vaccinating other individuals over those with prior infection.
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Affiliation(s)
- Hussein Awada
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | | | - Adel Hajj Ali
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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15
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Pathania YS. Vulnerability of patients on immunosuppressive therapy to SARS-CoV-2 reinfection. BMJ Support Palliat Care 2021:bmjspcare-2021-003260. [PMID: 34257064 DOI: 10.1136/bmjspcare-2021-003260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Yashdeep Singh Pathania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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16
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Bach JF, Berche P, Chatenoud L, Costagliola D, Valleron AJ. COVID-19: individual and herd immunity. C R Biol 2021; 344:7-18. [PMID: 34213845 DOI: 10.5802/crbiol.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Immunity to the SARS-CoV-2 virus ensures protection against reinfection by this virus thanks to the combined action of neutralizing antibodies and T lymphocytes specific to viral proteins, in particular the Spike protein. It must be distinguished from the immune response that ensures healing of the infection following contamination that involves innate immunity, particularly type 1 interferons, and which is followed by adaptive cellular and humoral immunity. The importance of the effect of interferons is highlighted by the occurrence of severe forms of the disease in genetically deficient subjects or in patients with antibodies neutralizing type 1 interferon. Herd immunity is not an individual biological property. It is a mathematical property that qualifies the fact that when the proportion of subjects with individual immunity is high enough, there is little chance that an epidemic can occur. The level of that proportion-the herd immunity of the population can be computed under theoretical, often unrealistic, hypotheses, and is difficult to assess in natural conditions.
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Affiliation(s)
- Jean-François Bach
- Institut Necker-Enfants Malades, CNRS UMR8253, Inserm UMR1151, Paris, France.,Université de Paris, Paris, France
| | | | - Lucienne Chatenoud
- Institut Necker-Enfants Malades, CNRS UMR8253, Inserm UMR1151, Paris, France.,Université de Paris, Paris, France
| | - Dominique Costagliola
- Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Alain-Jacques Valleron
- Inserm U1195, Bâtiment Pincus - Hôpital du Kremlin-Bicêtre, 80 rue du Gal Leclerc 94276 Le Kremlin Bicêtre, France
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17
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Alzaabi AH, Ahmed LA, Rabooy AE, Zaabi AA, Alkaabi M, AlMahmoud F, Hamed MF, Bashaeb KO, Bakhsh AR, Adil S, Elmajed N, Abousalha AN, Uwaydah AK, Mazrouei KA. Longitudinal changes in IgG levels among COVID-19 recovered patients: A prospective cohort study. PLoS One 2021; 16:e0251159. [PMID: 34115768 PMCID: PMC8195379 DOI: 10.1371/journal.pone.0251159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/20/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To quantify SARS-CoV2 IgG antibody titers over time and assess the longevity of the immune response in a multi-ethnic population setting. SETTING This prospective study was conducted in a tertiary hospital in Abu Dhabi city, UAE, among COVID-19 confirmed patients. The virus-specific IgG were measured quantitatively in serum samples from the patients during three visits over a period of 6 months. Serum IgG levels ≥15 AU/ml was used to define a positive response. PARTICIPANTS 113 patients were analyzed at first visit, with a mean (SD) age of participants of 45.9 (11.8) years 87.5% of the patients were men. 63 and 27 participants had data available for visits 2 and 3, respectively. PRIMARY OUTCOME Change in SARS-CoV2 IgG antibody titers over the visits. RESULTS No mortality or re-infection were reported. 69% of the patients developed positive IgG response within the first month after the onset of symptoms. The levels of IgG showed a consistent increase during the first three months with a peak level during the third month. Increasing trend in the levels of IgG were observed in 82.5%, 55.6% and 70.4% of patients between visit 1 to visit 2, visit 2 to visit 3, and from visit 1 to visit 3, respectively. Furthermore, about 64.3% of the patients showed sustained increase in IgG response for more than 120 days. CONCLUSIONS Our study indicates a sustained and prolonged positive immune response in COVID-19 recovered patients. The consistent rise in antibody and positive levels of IgG titers within the first 5 months suggest that immunization is possible, and the chances of reinfection minimal.
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Affiliation(s)
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Abdulla E. Rabooy
- Radiology Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Ali Al Zaabi
- Pathology and laboratory Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Mohammed Alkaabi
- Microbiology Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Falah AlMahmoud
- Radiology Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Mai Farouk Hamed
- Laboratory Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Khalid Omar Bashaeb
- Radiology Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Abdul Rahim Bakhsh
- Internal Medicine Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Suha Adil
- Internal Medicine Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Nadeen Elmajed
- Internal Medicine Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Ahmed Nigm Abousalha
- Internal Medicine Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Ahmad Kanaan Uwaydah
- Infectious diseases Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Khulood Al Mazrouei
- Pulmonology Department, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
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18
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Bartolini D, Stabile AM, Bastianelli S, Giustarini D, Pierucci S, Busti C, Vacca C, Gidari A, Francisci D, Castronari R, Mencacci A, Di Cristina M, Focaia R, Sabbatini S, Rende M, Gioiello A, Cruciani G, Rossi R, Galli F. SARS-CoV2 infection impairs the metabolism and redox function of cellular glutathione. Redox Biol 2021; 45:102041. [PMID: 34146958 DOI: 10.1016/j.redox.2021.102041] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 01/01/2023] Open
Abstract
Viral infections sustain their replication cycle promoting a pro-oxidant environment in the host cell. In this context, specific alterations of the levels and homeostatic function of the tripeptide glutathione have been reported to play a causal role in the pro-oxidant and cytopathic effects (CPE) of the virus. In this study, these aspects were investigated for the first time in SARS-CoV2-infected Vero E6 cells, a reliable and well-characterized in vitro model of this infection. SARS-CoV2 markedly decreased the levels of cellular thiols, essentially lowering the reduced form of glutathione (GSH). Such an important defect occurred early in the CPE process (in the first 24 hpi). Thiol analysis in N-acetyl-Cys (NAC)-treated cells and membrane transporter expression data demonstrated that both a lowered uptake of the GSH biosynthesis precursor Cys and an increased efflux of cellular thiols, could play a role in this context. Increased levels of oxidized glutathione (GSSG) and protein glutathionylation were also observed along with upregulation of the ER stress marker PERK. The antiviral drugs Remdesivir (Rem) and Nelfinavir (Nel) influenced these changes at different levels, essentially confirming the importance or blocking viral replication to prevent GSH depletion in the host cell. Accordingly, Nel, the most potent antiviral in our in vitro study, produced a timely activation of Nrf2 transcription factor and a GSH enhancing response that synergized with NAC to restore GSH levels in the infected cells. Despite poor in vitro antiviral potency and GSH enhancing function, Rem treatment was found to prevent the SARS-CoV2-induced glutathionylation of cellular proteins. In conclusion, SARS-CoV2 infection impairs the metabolism of cellular glutathione. NAC and the antiviral Nel can prevent such defect in vitro.
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19
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Biagioli M, Marchianò S, Roselli R, Di Giorgio C, Bellini R, Bordoni M, Gidari A, Sabbatini S, Francisci D, Fiorillo B, Catalanotti B, Distrutti E, Carino A, Zampella A, Costantino G, Fiorucci S. Discovery of a AHR pelargonidin agonist that counter-regulates Ace2 expression and attenuates ACE2-SARS-CoV-2 interaction. Biochem Pharmacol 2021; 188:114564. [PMID: 33872570 PMCID: PMC8052506 DOI: 10.1016/j.bcp.2021.114564] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Abstract
The severe acute respiratory syndrome (SARS)-CoV-2 is the pathogenetic agent of Corona Virus Induced Disease (COVID)19. The virus enters the human cells after binding to the angiotensin converting enzyme (ACE)2 receptor in target tissues. ACE2 expression is induced in response to inflammation. The colon expression of ACE2 is upregulated in patients with inflammatory bowel disease (IBD), highlighting a potential risk of intestinal inflammation in promoting viral entry in the human body. Because mechanisms that regulate ACE2 expression in the intestine are poorly understood and there is a need of anti-SARS-CoV-2 therapies, we have settled to investigate whether natural flavonoids might regulate the expression of Ace2 in intestinal models of inflammation. The results of these studies demonstrated that pelargonidin activates the Aryl hydrocarbon Receptor (AHR) in vitro and reverses intestinal inflammation caused by chronic exposure to high fat diet or to the intestinal braking-barrier agent TNBS in a AhR-dependent manner. In these two models, development of colon inflammation associated with upregulation of Ace2 mRNA expression. Colon levels of Ace2 mRNA were directly correlated with Tnf-α mRNA levels. Molecular docking studies suggested that pelargonidin binds a fatty acid binding pocket on the receptor binding domain of SARS-CoV-2 Spike protein. In vitro studies demonstrated that pelargonidin significantly reduces the binding of SARS-CoV-2 Spike protein to ACE2 and reduces the SARS-CoV-2 replication in a concentration-dependent manner. In summary, we have provided evidence that a natural flavonoid might hold potential in reducing intestinal inflammation and ACE2 induction in the inflamed colon in a AhR-dependent manner.
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Affiliation(s)
- Michele Biagioli
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Silvia Marchianò
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Rosalinda Roselli
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | | | - Rachele Bellini
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Martina Bordoni
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Anna Gidari
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Daniela Francisci
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Bianca Fiorillo
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | - Bruno Catalanotti
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | - Eleonora Distrutti
- SC di Gastroenterologia ed Epatologia, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Adriana Carino
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Angela Zampella
- University of Naples Federico II, Department of Pharmacy, Naples, Italy
| | | | - Stefano Fiorucci
- Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy,Corresponding author
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20
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AbdelMassih AF, Menshawey R, Ismail JH, Husseiny RJ, Husseiny YM, Yacoub S, Kamel A, Hozaien R, Yacoub E, Menshawey E, Abdelmalek A, Abouelazaem A, Elhatw A, Aboelmaaty A, Shahib A, Mansour A, Kamal A, Mohamed B, Atif B, Ghabreal B, Abdelmalak C, Ibrahim D, Elsaify E, Magdy F, Hanna FG, Hafez H, Dahir H, Merhom K, Ahmed M, Bishara M, Tawfik M, Youssef M, El Sharnouby M, Hamouda M, Ammar M, Ali N, Daniel N, El-Husseiny N, Abdelraouf N, Abdelhameed NK, Ahmed R, Othman R, Mohamadein R, Allam R, Elgendy R, Shebl R, Elsherbiney S, Fouad S, Emel S, Owais S, Hetta S, El-Saman S, Abdelalim S, Galal S, Asar Y, Osman Y, Khalaf Y, Aziz Y, Khafagy Y, Gamal N, Castaldi B. PPAR agonists as effective adjuvants for COVID-19 vaccines, by modifying immunogenetics: a review of literature. J Genet Eng Biotechnol 2021; 19:82. [PMID: 34057580 PMCID: PMC8165506 DOI: 10.1186/s43141-021-00179-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/14/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several coronavirus vaccine have been fast-tracked to halt the pandemic, the usage of immune adjuvants that can boost immunological memory has come up to the surface. This is particularly of importance in view of the rates of failure of seroconversion and re-infection after COVID-19 infection, which could make the vaccine role and response debatable. Peroxisome proliferator-activated receptors (PPARs) have an established immune-modulatory role, but their effects as adjuvants to vaccination have not been explored to date. It is increasingly recognized that PPAR agonists can upregulate the levels of anti-apoptotic factors such as MCL-1. Such effect can improve the results of vaccination by enhancing the longevity of long-lived plasma cells (LLPCs). The interaction between PPAR agonists and the immune system does not halt here, as T cell memory is also stimulated through enhanced T regulatory cells, antagonizing PD-L1 and switching the metabolism of T cells to fatty acid oxidation, which has a remarkable effect on the persistence of T memory cells. What is even of a more significant value is the effect of PPAR gamma on ensuring a profound secretion of antibodies upon re-exposure to the offending antigen through upregulating lipoxin B4, therefore potentially assisting the vaccine response and deterring re-infection. SHORT CONCLUSION In view of the above, we suggest the use of PPAR as adjuvants to vaccines in general especially the emerging COVID-19 vaccine due to their role in enhancing immunologic memory through DNA-dependent mechanisms.
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Affiliation(s)
- Antoine Fakhry AbdelMassih
- Pediatric Cardiology Unit, Pediatrics' Department, Cairo University Children Hospital, Faculty of Medicine, Cairo University, Kasr Al Ainy Street, Cairo, 12411, Egypt.
- Pediatric Cardio-Oncology Department, Children Cancer Hospital of Egypt (57357), Cairo, Egypt.
| | - Rahma Menshawey
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Jumana H Ismail
- Pulmonology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Reem J Husseiny
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Yousef M Husseiny
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, New Giza University, 6th of October City, Egypt
| | - Shenoda Yacoub
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Aya Kamel
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rafeef Hozaien
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Elaria Yacoub
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Esraa Menshawey
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Abanoub Abdelmalek
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed Abouelazaem
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed Elhatw
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed Aboelmaaty
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Alaaelrahman Shahib
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Amany Mansour
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Aya Kamal
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Basant Mohamed
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Bemen Atif
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Beshoy Ghabreal
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Catherine Abdelmalak
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - David Ibrahim
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ebtesam Elsaify
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Farah Magdy
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Farid G Hanna
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Hadeer Hafez
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Hafsa Dahir
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Kerlos Merhom
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Maram Ahmed
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mariam Bishara
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mina Tawfik
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mina Youssef
- University at Buffalo School of Medicine and Biomedical, Buffalo, USA
| | - Mohamed El Sharnouby
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mourad Hamouda
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Musheera Ammar
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Nada Ali
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Nada Daniel
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nadine El-Husseiny
- Faculty of Dentistry, Cairo University, Giza, Egypt
- Pixagon graphic design Agency, Cairo, Egypt
| | - Noha Abdelraouf
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Nuran K Abdelhameed
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Radwa Ahmed
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Radwa Othman
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rahma Mohamadein
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rana Allam
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rana Elgendy
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rana Shebl
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Saged Elsherbiney
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sarah Fouad
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sara Emel
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sara Owais
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Sarah Hetta
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Samah El-Saman
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Shaimaa Abdelalim
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sherin Galal
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Yara Asar
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Yara Osman
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Yasmeen Khalaf
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Youstina Aziz
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, 6th October University, 6th of October City, Egypt
| | - Yousra Khafagy
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Nervana Gamal
- Research Accessibility Team, Student and Internship research program, Faculty of Medicine, Cairo University, Giza, Egypt
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21
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Piri SM, Edalatfar M, Shool S, Jalalian MN, Tavakolpour S. A systematic review on the recurrence of SARS-CoV-2 virus: frequency, risk factors, and possible explanations. Infect Dis (Lond) 2021; 53:315-324. [PMID: 33508989 PMCID: PMC7852280 DOI: 10.1080/23744235.2020.1871066] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Since late 2019, SARS-CoV-2 which leads to coronavirus disease 2019 (COVID-19), has caused thousands of deaths. There are some pieces of evidence that SARS-CoV-2 genome could be re-detectable in recovered patients. METHODS We performed a systematic review in the PubMed/Medline database to address the risk of SARS-CoV-2 recurrence. The last update was for 20 November 2020. Among the 1178 initially found articles, 66 met the inclusion criteria and were considered. FINDINGS In total, 1128 patients with at least one-time recurrence of SARS-CoV-2 were included. Recurrence rate has been reported between 2.3% and 21.4% in cohort studies, within a mean of 20 (ranged 1-98) days after discharge; younger patients are being affected more. Following the second course of disease, the disease severity decreased or remained unchanged in 97.3% while it increased in 2.6%. Anti-SARS-CoV-2 IgG and IgM were positive in 11-95% and 58.8-100%, respectively. Based on the literature, three possibilities include reactivation of previous disease, reinfection with the same virus, and false negative, which have been discussed in details. CONCLUSION There is a relatively notable risk of disease recurrence in previously recovered patients, even those who are immunised against the virus. More studies are required to clarify the underlying cause of this phenomenon.
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Affiliation(s)
- Seyed Mohammad Piri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Edalatfar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Shool
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Soheil Tavakolpour
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA,CONTACT Soheil Tavakolpour Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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22
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Ren X, Ren X, Lou J, Wang Y, Huang Q, Shi Y, Deng Y, Li X, Lu L, Yan S, Wang Y, Luo L, Zeng X, Yao X, Jin Y. A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR. EClinicalMedicine 2021; 34:100839. [PMID: 33898952 PMCID: PMC8052132 DOI: 10.1016/j.eclinm.2021.100839] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND With the increased number of patients discharged after having COVID-19, more and more studies have reported cases whose retesting was positive (RP) during the convalescent period, which brings a new public health challenge to the world. METHODS We searched PubMed, Web of Science, The Cochrane Library, CNKI, WanFang and VIP from December 1, 2019 to December 31, 2020. The included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. The RP rate of discharge patients was analyzed by a meta-analysis. We adhered to PRISMA reporting guideline. FINDINGS We have included 117 studies with 2669 RP participants after discharge. The methodological quality of 66 case reports were low to high, 42 case series and 3 cohort study were moderate to high, 3 case-control studies were moderate and 3 cross-sectional studies were low to moderate. The clinical manifestations of most RP patients were mild or asymptomatic, and CT imaging and laboratory examinations were usually normal. The existing risk factors suggest that more attention should be paid to sever patients, elderly patients, and patients with co-morbidities. The summary RP rate was 12·2% (95% CI 10·6-13·7) with high heterogeneity (I2 = 85%). INTERPRETATION To date, the causes and risk factors of RP result in discharged patients are not fully understood. High-quality etiological and clinical studies are needed to investigate these issues to further help us to make strategies to control and prevent its occurrence.
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Affiliation(s)
- Xiangying Ren
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- College of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Xiangge Ren
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Jiaao Lou
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- College of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Yongbo Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yuexian Shi
- School of Nursing, Peking University, Beijing, China
| | - Yuqing Deng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Thyroid Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyan Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Nephrology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liye Lu
- Yongnian District maternity and childcare hospital, Xinming Road No.28. Yongnian District, HanDan, Hebei, China
| | - Siyu Yan
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yunyun Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Lisha Luo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiantao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Corresponding authors.
| | - Xiaomei Yao
- Center for clinical practice guideline conduction and evaluation, Children's Hospital of Fudan University, Shanghai, China
- Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Corresponding author at: Center for clinical practice guideline conduction and evaluation, Children's Hospital of Fudan University, Shanghai, China.
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Corresponding authors.
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23
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Masiá M, Padilla S, Galiana A, Fernández-González M, Gutiérrez F. Incidence of delayed asymptomatic COVID-19 recurrences in a 6-month longitudinal study. J Infect 2021; 82:276-316. [PMID: 33794262 PMCID: PMC8007189 DOI: 10.1016/j.jinf.2021.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Mar Masiá
- Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel, Hernández, Camino de la Almazara 11, 03203 Elche, Alicante, Spain.
| | - Sergio Padilla
- Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel, Hernández, Camino de la Almazara 11, 03203 Elche, Alicante, Spain
| | - Antonio Galiana
- Microbiology Service, Hospital General de Elche, Camí de la Almazara S/N, 03203, Elche, Alicante, Spain
| | - Marta Fernández-González
- Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel, Hernández, Camino de la Almazara 11, 03203 Elche, Alicante, Spain
| | - Félix Gutiérrez
- Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel, Hernández, Camino de la Almazara 11, 03203 Elche, Alicante, Spain
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24
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Katal S, Myers L, Gholamrezanezhad A. SARS-CoV-2 reinfection: "New baseline" imaging concept in the era of COVID-19. Clin Imaging 2021; 78:142-5. [PMID: 33813316 DOI: 10.1016/j.clinimag.2021.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/02/2021] [Accepted: 03/18/2021] [Indexed: 01/06/2023]
Abstract
Recent reports have suggested COVID-19 relapse or reinfection may lead to readmission, which may cause a diagnostic challenge between recently infected patients and reinfections. Compounding this problem is the post-viral lung sequela that may be expected after COVID-19 pneumonia, similar to both SARS and MERS. Although chest imaging may play a role in the diagnosis of primary SARS-CoV-2 infection, reinfection or relapse of COVID-19 will have similar imaging findings. A “new-baseline” imaging can be obtained from COVID-19 patients at the time of hospital discharge or clinical recovery. This new reference can not only determine if readmissions are from relapse or reinfection of COVID-19, resolving COVID-19 or potentially a different viral infection (influenza), but also for long term sequela of COVID-19 lung infection. Strategic use of imaging before discharge may be helpful in the subset of the population at the highest risk of a secondary viral infection such as influenza. Determining the residual abnormalities in post-discharge imaging can guide us in the long-term management of patients for many years to come.
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25
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Bose G, Galetta K. Reactivation of SARS-CoV-2 after Rituximab in a Patient with Multiple Sclerosis. Mult Scler Relat Disord 2021; 52:102922. [PMID: 33895693 PMCID: PMC7992302 DOI: 10.1016/j.msard.2021.102922] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 12/14/2022]
Abstract
A 32-year-old woman with highly active MS was infected with SARS-CoV-2 while on treatment with rituximab. She recovered and was symptom-free for 21 days before receiving rituximab and IVIg for comorbid hypogammaglobulinemia. Three days after the infusion she redeveloped respiratory symptoms and required admission. Three SARS-CoV-2 nasopharyngeal swabs and antibody testing was negative; however, bronchial alveolar lavage detected SARS-CoV-2. Reactivation of SARS-CoV-2 after rituximab for MS has not been reported but is a known risk in other conditions. The timing of anti-CD20 treatment after SARS-CoV-2 infection requires further investigation and individual consideration to reduce the risk of reactivation.
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Affiliation(s)
- Gauruv Bose
- Brigham Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, 1(st) floor Neurosciences, Boston, MA.
| | - Kristin Galetta
- Brigham Multiple Sclerosis Center, Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, 60FE-1, 02115, Boston, MA.
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26
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Váncsa S, Dembrovszky F, Farkas N, Szakó L, Teutsch B, Bunduc S, Nagy R, Párniczky A, Erőss B, Péterfi Z, Hegyi P. Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases. Viruses 2021; 13:512. [PMID: 33808867 PMCID: PMC8003803 DOI: 10.3390/v13030512] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/29/2022] Open
Abstract
Repeated positivity and reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a significant concern. Our study aimed to evaluate the clinical significance of repeatedly positive testing after coronavirus disease 2019 (COVID-19) recovery. We performed a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. With available individual patient data reporting on repeatedly SARS-CoV-2 positive (RSP) patients, case reports, and case series were included in this analysis. We performed a descriptive analysis of baseline characteristics of repeatedly positive cases. We assessed the cases according to the length of their polymerase chain reaction (PCR) negative interval between the two episodes. Risk factors for the severity of second episodes were evaluated. Overall, we included 123 patients with repeated positivity from 56 publications, with a mean repeated positivity length of 47.8 ± 29.9 days. Younger patients were predominant in the delayed (>90 days) recurrent positive group. Furthermore, comparing patients with RSP intervals of below 60 and above 60 days, we found that a more severe disease course can be expected if the repeated positivity interval is shorter. Severe and critical disease courses might predict future repeatedly positive severe and critical COVID-19 episodes. In conclusion, our results show that the second episode of SARS-CoV-2 positivity is more severe if it happens within 60 days after the first positive PCR. On the other hand, the second episode's severity correlates with the first.
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Affiliation(s)
- Szilárd Váncsa
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
- Institute of Bioanalysis, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Lajos Szakó
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Brigitta Teutsch
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Stefania Bunduc
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- Fundeni Clinical Institute, Gastroenterology, Hepatology and Liver Transplant Department, 022328 Bucharest, Romania
- Doctoral School, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Rita Nagy
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- Heim Pál National Pediatric Institute, 1089 Budapest, Hungary
| | - Andrea Párniczky
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
- Heim Pál National Pediatric Institute, 1089 Budapest, Hungary
- Doctoral School of Theoretical Medicine, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
| | - Zoltán Péterfi
- Division of Infectious Diseases, First Department of Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary; (S.V.); (F.D.); (N.F.); (L.S.); (B.T.); (S.B.); (R.N.); (A.P.); (B.E.)
- János Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary
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27
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Gidari A, Sabbatini S, Bastianelli S, Pierucci S, Busti C, Bartolini D, Stabile AM, Monari C, Galli F, Rende M, Cruciani G, Francisci D. SARS-CoV-2 Survival on Surfaces and the Effect of UV-C Light. Viruses 2021; 13:v13030408. [PMID: 33807521 PMCID: PMC7998261 DOI: 10.3390/v13030408] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to establish the persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on inanimate surfaces such as plastic, stainless steel, and glass during UV-C irradiation which is a physical means commonly utilized in sanitization procedures. The viral inactivation rate, virus half-life, and percentage of titer reduction after UV-C irradiation were assessed. Infectivity was maintained on plastic and glass until 120 h and on stainless steel until 72 h. The virus half-life was 5.3, 4.4, and 4.2 h on plastic, stainless steel, and glass, respectively. In all cases, titer decay was >99% after drop drying. UV-C irradiation efficiently reduced virus titer (99.99%), with doses ranging from 10.25 to 23.71 mJ/cm2. Plastic and stainless steel needed higher doses to achieve target reduction. The total inactivation of SARS-CoV-2 on glass was obtained with the lower dose applied. SARS-CoV-2 survival can be long lasting on inanimate surfaces. It is worth recommending efficient disinfection protocols as a measure of prevention of viral spread. UV-C can provide rapid, efficient and sustainable sanitization procedures of different materials and surfaces. The dosages and mode of irradiation are important parameters to consider in their implementation as an important means to fight the SARS-CoV-2 pandemic.
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Affiliation(s)
- Anna Gidari
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
- Correspondence:
| | - Samuele Sabbatini
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06129 Perugia, Italy; (S.S.); (C.M.)
| | - Sabrina Bastianelli
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
| | - Sara Pierucci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
| | - Chiara Busti
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
| | - Desirée Bartolini
- Department of Pharmaceutical Sciences, Unit of Nutrition and Clinical Biochemistry, University of Perugia, 06122 Perugia, Italy; (D.B.); (F.G.)
| | - Anna Maria Stabile
- Department of Medicine and Surgery, Unit of Human, Clinical and Forensic Anatomy, University of Perugia, 06129 Perugia, Italy; (A.M.S.); (M.R.)
| | - Claudia Monari
- Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06129 Perugia, Italy; (S.S.); (C.M.)
| | - Francesco Galli
- Department of Pharmaceutical Sciences, Unit of Nutrition and Clinical Biochemistry, University of Perugia, 06122 Perugia, Italy; (D.B.); (F.G.)
| | - Mario Rende
- Department of Medicine and Surgery, Unit of Human, Clinical and Forensic Anatomy, University of Perugia, 06129 Perugia, Italy; (A.M.S.); (M.R.)
| | - Gabriele Cruciani
- Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123 Perugia, Italy;
| | - Daniela Francisci
- Department of Medicine and Surgery, Clinic of Infectious Diseases, “Santa Maria della Misericordia” Hospital, University of Perugia, 06129 Perugia, Italy; (S.B.); (S.P.); (C.B.); (D.F.)
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Nejadghaderi SA, Safiri S. The dilemma of herd immunity for COVID-19. J Med Virol 2021; 93:2578-2579. [PMID: 33386744 DOI: 10.1002/jmv.26768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/13/2020] [Accepted: 12/27/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Saeid Safiri
- Department of Community Medicine, Tuberculosis and Lung Disease Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Immunology Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Pedro N, Silva CN, Magalhães AC, Cavadas B, Rocha AM, Moreira AC, Gomes MS, Silva D, Sobrinho-Simões J, Ramos A, Cardoso MJ, Filipe R, Palma P, Ceia F, Silva S, Guimarães JT, Sarmento A, Fernandes V, Pereira L, Tavares M. Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration. Microorganisms 2021; 9:300. [PMID: 33540596 DOI: 10.3390/microorganisms9020300] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/12/2022] Open
Abstract
A few molecularly proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases of symptomatic reinfection are currently known worldwide, with a resolved first infection followed by a second infection after a 48 to 142-day intervening period. We report a multiple-component study of a clinically severe and prolonged viral shedding coronavirus disease 2019 (COVID-19) case in a 17-year-old Portuguese female. She had two hospitalizations, a total of 19 RT-PCR tests, mostly positive, and criteria for releasing from home isolation at the end of 97 days. The viral genome was sequenced in seven serial samples and in the diagnostic sample from her infected mother. A human genome-wide array (>900 K) was screened on the seven samples, and in vitro culture was conducted on isolates from three late samples. The patient had co-infection by two SARS-CoV-2 lineages, which were affiliated in distinct clades and diverging by six variants. The 20A lineage was absolute at the diagnosis (shared with the patient’s mother), but nine days later, the 20B lineage had 3% frequency, and two months later, the 20B lineage had 100% frequency. The 900 K profiles confirmed the identity of the patient in the serial samples, and they allowed us to infer that she had polygenic risk scores for hospitalization and severe respiratory disease within the normal distributions for a Portuguese population cohort. The early-on dynamic co-infection may have contributed to the severity of COVID-19 in this otherwise healthy young patient, and to her prolonged SARS-CoV-2 shedding profile.
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Ren X, Wang X, Ge Z, Cui S, Chen Z. Clinical features and corresponding immune function status of recurrent viral polymerase chain reaction positivity in patients with COVID-19 : A meta- analysis and systematic review. Int J Immunopathol Pharmacol 2021; 35:20587384211027679. [PMID: 34162269 PMCID: PMC8236784 DOI: 10.1177/20587384211027679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/27/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020. Since then, several studies have found COVID-19 patients with recurrent viral polymerase chain reaction (PCR) positivity. METHODS On May 6, 2021, an exhaustive literature search of the Web of Science, PubMed, Cochrane Library, Chinese National Knowledge Infrastructure databases, Embase, Wan Fang Data, VIP database, Sinomed database, BioRxiv, MedRxiv, and Research Square was conducted to find describing the laboratory indicators of recurrent and non-recurrent viral PCR positivity in patients with COVID-19. The data were statistically analyzed using STATA version 15.0. RESULTS In total, 22 studies-comprising 5154 laboratory-confirmed COVID-19 cases-were included in the analyses. Patients with less severe COVID-19 illness (i.e. those clinically classified as mild or common-type) seemed to exhibit recurrent PCR positivity more commonly than patients with more severe illness (i.e. those classified as severe or critical). There were also significant differences between the two groups in terms of the rates of headaches and dizziness, in addition to the levels of aspartate aminotransferase, C reactive protein, interleukin-6, and lactate dehydrogenase. Further, there were variations in the ratio of CD4+ T cells/CD8+ T cells on admission to the hospital. CONCLUSION In comparison to COVID-19 patients with non-recurrent viral PCR positivity, patients with recurrent virus PCR positivity seem to experience more severe immune function suppression upon hospital admission.
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Affiliation(s)
| | | | - Ziruo Ge
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Shuping Cui
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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31
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Barbarossa MV, Fuhrmann J. Germany's next shutdown-Possible scenarios and outcomes. Influenza Other Respir Viruses 2020; 15:326-330. [PMID: 33277962 PMCID: PMC8051701 DOI: 10.1111/irv.12827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 11/29/2022] Open
Abstract
With the rapid increase of reported COVID‐19 cases, German policymakers announced a 4‐week “shutdown light” starting on November 2, 2020. Applying mathematical models, possible scenarios for the evolution of the outbreak in Germany are simulated. The results indicate that independent of the effectiveness of the current restrictive measures they might not be sufficient to mitigate the outbreak. Repeated shutdown periods or permanently applied measures over the winter could be successful alternatives.
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Affiliation(s)
| | - Jan Fuhrmann
- Frankfurt Institute for Advanced Studies, Ruth-Moufang-Straße 1, Frankfurt, Germany.,Jülich Supercomputing Centre, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, Jülich, Germany
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