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Nygren D, Wasserstrom L, Torisson G, Holm K. Low usefulness of reporting tonsillar PCR Ct-values in pharyngeal infections with Fusobacterium necrophorum. Anaerobe 2024; 86:102831. [PMID: 38369049 DOI: 10.1016/j.anaerobe.2024.102831] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/15/2024] [Accepted: 02/01/2024] [Indexed: 02/20/2024]
Abstract
Tonsillar Fusobacterium necrophorum PCR Ct-values were higher in participants with asymptomatic tonsillar carriage than patients with pharyngeal infections. However, Ct-values were not associated with severity of disease or predictive of development of complications and hence lacked clinical usefulness. The reporting of F. necrophorum Ct-values in clinical samples is not recommended.
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Affiliation(s)
- David Nygren
- Division of Infection Medicine, Department for Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Infectious Diseases, Skåne University Hospital, Lund, Malmö, Sweden.
| | - Lisa Wasserstrom
- Clinical Microbiology Laboratory, Infection Control and Prevention, Laboratory Medicine, Lund, Sweden; Clinical Microbiology, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Gustav Torisson
- Department of Infectious Diseases, Skåne University Hospital, Lund, Malmö, Sweden; Clinical Infection Medicine, Lund University, Malmö, Sweden
| | - Karin Holm
- Division of Infection Medicine, Department for Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Infectious Diseases, Skåne University Hospital, Lund, Malmö, Sweden
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Liu J, Wen R, Wang N, Li G, Xu P, Li X, Zeng X, Liu C. A Retrospective Study on COVID-19 Infections Caused by Omicron Variant with Clinical, Epidemiological, and Viral Load Evaluations in Breakthrough Infections. Int J Med Sci 2024; 21:454-463. [PMID: 38250611 PMCID: PMC10797678 DOI: 10.7150/ijms.87167] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/09/2023] [Indexed: 01/23/2024] Open
Abstract
Purpose: To explore the clinical, epidemiological, and viral load characteristics of COVID-19 caused by the omicron variant. Methods: Based on the COVID-19 epidemic caused by SARS-CoV-2 Omicron BA.2 broke out in Shanghai, China. To analyze whether there is any association between clinical symptoms and viral load of COVID-19 with age, sex, and combined disease and whether the clinical symptoms and viral load are associated with vaccine-breakthrough infections. Results: The most common symptoms were cough, expectoration, and fatigue, which were more common in women than males (p < 0.001). The average viral clearance time in the > 75 years group was the longest (6.64 days). The viral load in the 60-75 years group was significantly higher than that in the other groups (p < 0.001). The 18-45 years old group had the most clinical symptoms at admission (45.39%). The days of nucleic acid-negative conversion, average viral load, highest viral load, and clinical symptoms in comorbid chronic disease patients are longer (p < 0.001). The average and highest viral loads in the unvaccinated group were longer than those in the vaccine breakthrough infection groups (p < 0.001). However, the clinical symptoms in the vaccine breakthrough infection group were significantly more severe than those in the unvaccinated group (p < 0.001). Conclusions: We found that female patients, the elderly, and those with underlying comorbidities had longer clinical positive symptoms and viral loads. Although vaccination may not reduce clinical symptoms, it can shorten the viral load and the time required for virus clearance.
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Affiliation(s)
- Jian Liu
- Department of Medical Imaging, Guizhou Provincial People Hospital, Guiyang City, Guizhou Province, 550000, China
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ru Wen
- Department of Medical Imaging, Guizhou Provincial People Hospital, Guiyang City, Guizhou Province, 550000, China
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Medical College, Guizhou University, Guizhou,550000, China
| | - Nanzhu Wang
- Department of Medical Imaging, Guizhou Provincial People Hospital, Guiyang City, Guizhou Province, 550000, China
| | - Guizhou Li
- College of Mathematics and Statistics, Chongqing University, Chongqing, 400044, China
| | - Peng Xu
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xiaoming Li
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xianchun Zeng
- Department of Medical Imaging, Guizhou Provincial People Hospital, Guiyang City, Guizhou Province, 550000, China
| | - Chen Liu
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
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Jemmieh K, Tawengi M, Alyaarabi T, Hassona A, Ghoul I, Al Abdulla S, Elzawawi KE, Karen O, Doi SA, Chivese T. No Association Between Ct Value and COVID-19 Severity and Mortality in Qatar. Int J Gen Med 2023; 16:5323-5331. [PMID: 38021068 PMCID: PMC10658937 DOI: 10.2147/ijgm.s404696] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background The association between the cycle threshold (Ct) which reflects the SARS-CoV-2 viral load and the severity of COVID-19 is still not clear. We investigated the association between Ct values, symptoms and the risk of ICU admission and mortality from COVID-19 in Qatar. Methods This case-control study used data of hospitalized individuals with confirmed COVID-19 during the period March to September 2020. Cases were defined as individuals with confirmed COVID-19 who were admitted to the intensive care unit (ICU) or died and controls as those who were not admitted to the ICU. The association between Ct value, symptoms, ICU admission and mortality was investigated using Ct value as a categorical variable (below and above 25) in multivariable regression models and adjusted for relevant confounders. Results A total of 622 participants with median age 53 (IQR: 53-63), of which 69% were males, were included. There were 236 ICU admissions and 111 deaths. When categorized, Ct value (<25 vs ≥25) had no association with the odds of ICU admission (OR 0.85, 95% CI 0.56 to 1.29) or odds of mortality (OR 1.21, 95% CI 0.71 to 2.08). Respiratory (OR 2.95, 95% CI 1.57 to 5.56) and gastrointestinal symptoms (OR 1.99, 95% CI 1.18 to 3.35) were associated with higher odds of ICU admission. Similarly, respiratory (OR 4.96, 95% CI 1.10 to 22.43) and gastrointestinal symptoms (OR 3.17, 95% CI 1.29 to 7.84) were associated with higher odds of mortality. Conclusion Although RT-PCR Ct has good diagnostic value, its prognostic value appears to be unreliable. Respiratory and gastrointestinal symptoms are associated with COVID-19 criticality and mortality in this setting.
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Affiliation(s)
- Khaleed Jemmieh
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Mohamed Tawengi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Tamader Alyaarabi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Aseel Hassona
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ikhlas Ghoul
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Sara Al Abdulla
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Khaled E Elzawawi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Omar Karen
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Suhail A Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
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Meyer M, Holfter A, Ruebsteck E, Gruell H, Dewald F, Koerner RW, Klein F, Lehmann C, Huenseler C, Weber LT. The Alpha Variant (B.1.1.7) of SARS-CoV-2 in Children: First Experience from 3544 Nucleic Acid Amplification Tests in a Cohort of Children in Germany. Viruses 2021; 13:v13081600. [PMID: 34452464 PMCID: PMC8402740 DOI: 10.3390/v13081600] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 07/16/2021] [Revised: 08/02/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
In May 2021, the Alpha variant (B.1.1.7) of SARS-CoV-2 was found in 91% of the SARS-CoV-2 cases in Germany. Not much is known about the symptoms, courses of disease, and infectiousness in pediatric patients with the Alpha variant. Objective: The aim of this retrospective analysis was to gain information on the infection with the Alpha variant in children and adolescents. Methods: Between 12 January 2021 and 3 June 2021, all nucleic acid amplification tests (NAATs) of children who received a swab for SARS-CoV-2 were included. Data were collected on standardized questionnaires. The analysis of data was anonymized and retrospective. Results: We investigated 3544 NAATs; 95 children were tested positive (2.7%) for SARS-CoV-2. For the sub-analysis, 65 children were analyzed. In 59 children, the Alpha variant was found (90.8%), and 54.2% (n = 32/59) were symptomatic. The most common symptoms were fever, cough, and rhinitis. The median Ct value was 24.0 (min 17.0; max 32.7). Conclusions: We can underline early findings that children are still less effected by SARS-CoV-2 infection with the spread of the Alpha variant. We found no evidence that children infected with the Alpha variant showed more severe symptoms or suffered from a more severe clinical course than those infected with the wild type.
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Affiliation(s)
- Meike Meyer
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (E.R.); (R.W.K.); (C.H.); (L.T.W.)
- Correspondence: ; Tel.: +49-221-478-42128
| | - Anna Holfter
- Departement of Pediatrics, Elisabeth-Krankenhaus Rheydt, 41239 Moenchengladbach, Germany;
| | - Esra Ruebsteck
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (E.R.); (R.W.K.); (C.H.); (L.T.W.)
| | - Henning Gruell
- Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (H.G.); (F.D.); (F.K.)
| | - Felix Dewald
- Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (H.G.); (F.D.); (F.K.)
| | - Robert Walter Koerner
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (E.R.); (R.W.K.); (C.H.); (L.T.W.)
| | - Florian Klein
- Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (H.G.); (F.D.); (F.K.)
| | - Clara Lehmann
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany;
- German Center for Infection Research (DZIF), 38124 Braunschweig, Germany
| | - Christoph Huenseler
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (E.R.); (R.W.K.); (C.H.); (L.T.W.)
| | - Lutz Thorsten Weber
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (E.R.); (R.W.K.); (C.H.); (L.T.W.)
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Lääveri T, Antikainen J, Mero S, Pakkanen SH, Kirveskari J, Roivainen M, Kantele A. Bacterial, viral and parasitic pathogens analysed by qPCR: Findings from a prospective study of travellers' diarrhoea. Travel Med Infect Dis 2021; 40:101957. [PMID: 33359433 DOI: 10.1016/j.tmaid.2020.101957] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The diagnostics of travellers' diarrhoea (TD) has been revolutionised by multiplex qPCR assays. While mostly of bacterial aetiology, viruses and parasites account for the disease among 10-20% of travellers. Despite this, prospective studies applying qPCR assays remain scarce that cover not only bacteria, such as the various diarrhoeagenic Escherichia coli (DEC), but also viral and parasitic pathogens. METHOD We analysed by qPCR pre- and post-travel stool samples of 146 Finnish travellers for bacterial, viral and parasitic pathogens: enteropathogenic (EPEC), enteroaggregative (EAEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC), and enteroinvasive (EIEC) E. coli; Shigella, Campylobacter, Salmonella, Yersinia and Vibrio cholerae; norovirus G1 and G2, rotavirus, enteroviruses, and sapovirus; and Giardia lamblia, Entamoeba histolytica, and Cryptosporidium. Symptoms and medication data during travel were collected by questionnaires. RESULTS We detected bacterial pathogens in 102/146 samples (69.9%; EAEC, EPEC, ETEC most common), viral ones in 13 (8.9%; norovirus most common), and parasitic ones in one (0.7%; Giardia). Noroviruses were associated with severe symptoms (23.5% versus non-severe 4.9%). In the TD group, 41.7% (5/12) of those with viral pathogens (vs. 13.3%; 11/83 without) took antibiotics. CONCLUSION Viral pathogens, particularly noroviruses, prevail in severe TD. The symptoms of viral disease are often severe and lead to unwarranted use of antibiotics.
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Correa-Martínez CL, Schwierzeck V, Mellmann A, Hennies M, Kampmeier S. Healthcare-Associated SARS-CoV-2 Transmission-Experiences from a German University Hospital. Microorganisms 2020; 8:E1378. [PMID: 32911751 PMCID: PMC7563154 DOI: 10.3390/microorganisms8091378] [Citation(s) in RCA: 13] [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: 07/22/2020] [Revised: 08/25/2020] [Accepted: 09/08/2020] [Indexed: 12/02/2022] Open
Abstract
During the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, healthcare systems worldwide have to prevent nosocomial SARS-CoV-2 transmission while maintaining duty of care. In our study, we characterize the transmission dynamic of SARS-CoV-2 in inpatients and healthcare workers (HCWs) at the University Hospital Münster (UHM) in northwest Germany. We identified 27 cases of healthcare-associated SARS-CoV-2 infections (4 inpatients and 23 HCWs) who had contact with patients and/or HCWs without the use of adequate PPE. The contacts of these index cases were followed up for SARS-CoV-2 infection after unprotected exposure and a quantitative measure of probability of becoming infected, the attack rate, was calculated. In addition, transmission was evaluated in the context of infection control measures established during the pandemic and we compared the epidemiological data of all index cases, including symptoms and Ct values of virology test results. The overall attack rate in the hospital setting was 1.3% (inpatients 0.9%, HCWs 1.6%). However, during an outbreak, the attack rate was 25.5% (inpatients 20.0%, HCWs 29.6%). For both scenarios, HCWs had a higher attack rate illustrating their role in healthcare-associated SARS-CoV-2 transmission. Taken together, our experiences demonstrate how infection control measures can minimize the transmission of SARS-CoV-2 in the healthcare setting.
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Affiliation(s)
- Carlos L. Correa-Martínez
- Institute of Hygiene, University Hospital Münster, 48149 Münster, Germany; (C.L.C.-M.); (V.S.); (A.M.)
| | - Vera Schwierzeck
- Institute of Hygiene, University Hospital Münster, 48149 Münster, Germany; (C.L.C.-M.); (V.S.); (A.M.)
| | - Alexander Mellmann
- Institute of Hygiene, University Hospital Münster, 48149 Münster, Germany; (C.L.C.-M.); (V.S.); (A.M.)
| | - Marc Hennies
- Institute of Virology, University Hospital Münster, 48149 Münster, Germany;
| | - Stefanie Kampmeier
- Institute of Hygiene, University Hospital Münster, 48149 Münster, Germany; (C.L.C.-M.); (V.S.); (A.M.)
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