Hunting severe acute respiratory syndrome coronavirus 2 (2019 novel coronavirus): From laboratory testing back to basic research

Smart healthcare: A prospective future medical approach for COVID-19

COVID-19 has greatly affected human life for over 3 years. In this review, we focus on smart healthcare solutions that address major requirements for coping with the COVID-19 pandemic, including (1) the continuous monitoring of severe acute respiratory syndrome coronavirus 2, (2) patient stratification with distinct short-term outcomes (eg, mild or severe diseases) and long-term outcomes (eg, long COVID), and (3) adherence to medication and treatments for patients with COVID-19. Smart healthcare often utilizes medical artificial intelligence (AI) and cloud computing and integrates cutting-edge biological and optoelectronic techniques. These are valuable technologies for addressing the unmet needs in the management of COVID. By leveraging deep learning/machine learning capabilities and big data, medical AI can perform precise prognosis predictions and provide reliable suggestions for physicians' decision-making. Through the assistance of the Internet of Medical Things, which encompasses wearable devices, smartphone apps, internet-based drug delivery systems, and telemedicine technologies, the status of mild cases can be continuously monitored and medications provided at home without the need for hospital care. In cases that develop into severe cases, emergency feedback can be provided through the hospital for rapid treatment. Smart healthcare can possibly prevent the development of severe COVID-19 cases and therefore lower the burden on intensive care units.

Rapid detection of porcine circovirus type 2 by a red latex microsphere immunochromatographic strip

Abstract

To establish a rapid and specific antigen detection method for porcine circovirus type 2 (PCV2), monoclonal antibodies (mAbs) were produced against the PCV2 epidemic strains and a red latex microsphere immunochromatographic strip was established. A total of eight anti-PCV2b and four anti-PCV2d mAbs were produced, and seven mAbs were confirmed to react with PCV2a, PCV2b, and PCV2d strains using an immunoperoxidase monolayer assay. The results of micro-neutralization tests showed that the mAbs 2C8, 9H4, 10G7, 7B9, and 7C7 had good neutralizing activity, whereas the neutralizing activity of the mAbs 4B3, 4C9, 6H9, and 7E2 was lower than 50%. Three mAbs, 4B3, 7C7, and 9H4, and PCV2 pAb were selected for the establishment of a red latex microsphere immunochromatographic strip, and the combination of mAb 7C7 labeled with red latex microspheres and mAb 9H4 exhibited the greatest detection ability. The immunochromatographic strip had minimum detection limits of 10^2.5 TCID₅₀/0.1 ml, 10^0.7 TCID₅₀/0.1 ml, and 10^1.5 TCID₅₀/0.1 ml for PCV2a/CL, PCV2b/MDJ, and PCV2d/LNHC, respectively. Furthermore, no cross-reactivity was found for African swine fever virus, classical swine fever virus, porcine respiratory and reproductive syndrome virus, porcine parvovirus, porcine pseudorabies virus, porcine circovirus type 1, transmissible gastroenteritis virus, porcine epidemic diarrhea virus, porcine rotavirus, or porcine deltacoronavirus using the immunochromatographic strip. Using PCR as a reference standard, the detection sensitivity, specificity, and overall coincidence rate of the immunochromatographic strip were 81.13%, 100%, and 90.00%. Additionally, the detection ability of the immunochromatographic strip was correlated with that of virus titration. The immunochromatographic strip was used to detect 183 clinical disease samples, and the average positive detection rate was 22.95%. In summary, this method has good sensitivity and specificity and is simple, convenient, and quick to operate. It has high application value for on-site diagnosis of PCV2 and virus quantification.

Key points

• A red latex microsphere immunochromatographic strip for PCV2 detection was developed.

• The method was not only simple to operate, but also takes less time.

• The method had good sensitivity and specificity.

The clinical manifestations and interval changes of reverse-transcriptase quantitative polymerase chain reactions among different specimens of coronavirus disease 2019 patients

BACKGROUND

Since December 2019, a number of cases and deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have been reported worldwide. In spite of clinical manifestations similar to the SARS-CoV epidemic in 2003, affected organs and severity are yet to be defined. Moreover, viral load alterations and viral shielding among different specimens remained scarce. Therefore, clarifying clinical presentations and correlations among viral loads, disease severity, and viral shielding of SARS-CoV-2 infection is crucial in the disease prevention.

METHODS

The clinical courses of SARS-CoV-2 cases were presented through Gantt charts. Laboratory examinations and reverse-transcriptase quantitative polymerase chain reactions (RT-qPCR) among different specimens were tested periodically. Cycle thresholds (CT) were recorded and presented as viral loads.

RESULTS

From March 2020 to April 2020, 4 SARS-CoV-2 cases were presented, of which, cases 1 and 2 manifested the symptoms severer than cases 3 and 4, along with higher serum lactate dehydrogenase levels and graded for lymphocytopenia. Case 4 initially exhibited anosmia but recovered within a short period. Curves of the CT of all the cases, except case 2, concaved upward after prescribing hydroxychloroquine (HCQ) and azithromycin. Except for case 4, the CT in most stool specimens remained undetectable; however, none of the cases presented gastrointestinal symptoms. Surprisingly, the CT values of the saliva specimens were inconsistent with those of the nasopharyngeal swabs and sputum.

CONCLUSION

SARS-CoV-2 manifests various symptoms. Sudden onset of central nervous system symptoms should be considered. The timing of HCQ and azithromycin administration might be a key factor in the viral load reduction. Positive prediction values of RT-qPCR of different specimens should be tested carefully to prevent false-negative results.

An Overview of Nucleic Acid Testing for the Novel Coronavirus SARS-CoV-2

In this note we analyze the problems in the nucleic acid testing (NAT) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and we also give some suggestions for improving the accuracy of NAT diagnosis. NAT testing is considered to be the diagnostic “gold standard”; at present there are few reviews on NAT for SARS-CoV-2. Moreover, many false-negative results always appear in the procedure of detecting, which has affected early diagnosis of the disease and brought a great challenge to mitigation and containment of the pandemic. In conclusion, comprehensive analyses of serological and imaging findings should be performed to guide the formulation of an accurate clinical diagnosis, treatment plan, and monitoring therapeutic efficacy, in an effort to achieve early diagnosis, containment, and treatment of the disease, thereby effectively reducing progression of the pandemic. This article presents a literature overview of SARS-CoV-2 nucleic acid testing, aiming to provide support for clinicians.

The Perspective on Bio-Nano Interface Technology for Covid-19

The field of bio-nano interfaces paves the way for a better understanding, development, and implementation of the advanced biotechnological process. Interfacing biomolecules with the nanomaterials will result in the development of new tools and techniques that, in turn, will enable to explore the fundamental process at the nano level and fabricate cost-effective portable devices. Fascinating biomolecules like DNA, RNA and proteins in the regime of nanoscale are intelligent materials that are capable of storing the information and controlling the basic structure and function of the complex biological systems. Following this concept, the current pandemic situation would be a natural selection process, where the selective pressure is on the ssRNA of Covid-19 to choose the suitable progeny for survival. Consequently, the interaction of human DNA invoking response with Covid-19 happens at the nanoscale and it could be a better candidate to provoke combat against the virus. The extent of this interaction would give us the insights at the nanotechnological level to tackle the prevention, diagnosis and treatment for Covid-19. Herein, the possible features and obstacles in Covid-19 and a probable solution from the advent of nanotechnology are discussed to address the current necessity. Moreover, the perspective sustainable green graph mask that can be prepared using green plant extract/graphene (Bio-Nano composite mask) is suggested for the possible protection of virus-like Covid-19. The composite material will not only effectively trap the virus but also inactivate the virus due to the presence of antiviral compounds in the plant extracts.

Clinical presentation and outcome across age categories among patients with COVID-19 admitted to a Spanish Emergency Department

Aim

According to age, there are differences in the clinical profile, presentation, management, and short-term outcomes of patients with COVID-19 admitted to the Emergency Department.

Findings

A statistically significant association was found between demographic data, comorbidities, clinical, radiographic, analytical, and therapeutic variables and short-term results according to age-dependent categories. Age was a prognostic factor for hospital admission and in-hospital and 30-day mortality, and was associated with not being admitted to intensive care.

Message

Clinical presentation, management, and short-term outcomes differ according to age among patients with COVID-19 admitted to the Emergency Department.

Electronic supplementary material

The online version of this article (10.1007/s41999-020-00359-2) contains supplementary material, which is available to authorized users.

Purpose

To determine the differences by age-dependent categories in the clinical profile, presentation, management, and short-term outcomes of patients with laboratory-confirmed COVID-19 admitted to a Spanish Emergency Department (ED).

Methods

Secondary analysis of COVID-19_URG-HCSC registry. We included all consecutive patients with laboratory-confirmed COVID-19 admitted to the ED of the University Hospital Clinico San Carlos (Madrid, Spain). The population was divided into six age groups. Demographic, baseline and acute clinical data, and in-hospital and 30-day outcomes were collected.

Results

1379 confirmed COVID-19 cases (mean age 62 (SD 18) years old; 53.5% male) were included (18.1% < 45 years; 17.8% 45–54 years; 17.9% 55–64 years; 17.2% 65–74 years; 17.0% 75–84 years; and 11.9% ≥ 85 years). A statistically significant association was found between demographic, comorbidity, clinical, radiographic, analytical, and therapeutic variables and short-term results according to age-dependent categories. There were less COVID-specific symptoms and more atypical symptoms among older people. Age was a prognostic factor for hospital admission (aOR = 1.04; 95% CI 1.02–1.05) and in-hospital (aOR = 1.08; 95% CI 1.05–1.10) and 30-day mortality (aOR = 1.07; 95% CI 1.04–1.09), and was associated with not being admitted to intensive care (aOR = 0.95; 95% CI 0.93–0.98).

Conclusions

Older age is associated with less COVID-specific symptoms and more atypical symptoms, and poor short-term outcomes. Age has independent prognostic value and may help in shared decision-making in patients with confirmed COVID-19 infection.

Electronic supplementary material

The online version of this article (10.1007/s41999-020-00359-2) contains supplementary material, which is available to authorized users.